Lessons in Injury

“Pain insists upon being attended to. God whispers to us in our pleasures, speaks in our consciences, but shouts in our pains. It is his megaphone to rouse a deaf world.” C.S. Lewis

Forget about cougars, the monster tree almost got me this morning!

This whole ultramarathon training process has been going really well up until now.  Amazingly well actually.  I've had no pain, no injuries, and I've been following good advice for recovery.  That is, until last Tues, 5 days ago.  I said I wanted to gain experience as a physio in the personal pain department.  Well here it is.

I have an old hamstring/sciatic nerve injury from about 2 years ago that occasionally gives me some grief, usually in the first 2-4 weeks of increasing mileage during a periodization period.  Then it disappears with a few physio sessions and when my body adapts to the mileage, but I am left with a chronically stiffer R posterior chain (back, buttock, hamstring).

Last Tues I was running my first time after a significant increase in "time on feet" and mileage.  It was to be an 8K tempo run.  I do these runs in town right after work and was about 3 minutes into my run (not warmed up yet) when I turned to cross the street and caught my left toe on a man hole cover.  Yes, after running hours in gnarly trails, a man hole cover got me.  That sent me flying into a dramatic lunge with my right leg as I tried to avoid plastering my "oh-so-valuable physio hands" and of course, my iPhone, into the pavement.  I felt a searing pain in my R hamstring and buttock.  Nothing popped, but oh did it hurt.  I had had a bad day at work and really needed that run for emotional medicine.  I thought that I had just torn my hamstring and almost burst into tears.  But after walking a few steps, then jogging with very short stride and high cadence, the pain subsided a little and I ran on.  I finished the 8K with a good tempo pace. Maybe not so wise, but it forced to me work on cadence as I couldn't stretch out my R leg at all.

That night...no meds (reminder that current research does not support NSAIDS as a good treatment for running injuries), no stretching as I felt that the muscle had been yanked enough and needed to be left alone.  Went to bed and woke with burning pain from butt to ankle. Darn.

The next day I was worried. Really worried.  I thought it was all over.  I checked for bruising on the back of my leg, but thankfully there was none! I did acupuncture on myself (yes, I'm certified), gently stretched.  After explaining my issues to my coach and saying that I was going to take the day off, she suggested light cycling that day.  I should have thought of that, as it's totally what we learned in our recent running course.  Relative rest.  I had 6K easy on the schedule, so I biked 10K or 30 minutes, which I thought equaled a 6K easy run.  I kept it light, spinning with no pain allowed, and it felt great! I got off that bike totally buoyant with renewed energy.

The next morning I felt ok, a little tight but ok.  I had a long hill climb on the schedule and woke at 5:00 am to do 1km hill repeats on a long hill in town by headlamp.  The benefit of darkness allowed me the luxury of going slow and not freaking out about how long the hill was.  My mantra was "short stride, high cadence, no pain."  And it worked!

I am proud to say I followed the "Quantification of Stress" formula from The Running Clinic:
1) Apply stress not greater than 2-3/10 pain
2) Pain must return to baseline 30-60 min post-exercise.
3) No morning stiffness greater than the previous morning.

And I am happy to say that after a shorter 16K run today with some nice hills on my down week, my hamstring is only a little cranky and I'm going to be ok.  I am convinced that it's not only my hamstring but also my sciatic nerve, so will do some physio magic on that this week.  I feel like I narrowly escaped a show-stopper and that it's not over yet.  I'm going to take it easy this week as well to make sure I'm ready for 40K next Sunday.  Here's to a human body that heals!

Here's a quote from yours truly:  

"The human body will heal if you give it the conditions in which to do so." 

And there-in lies the science and the art of recovery.

Weekly Tally:
Distance: 68.4K
Elevation climb: 2194m
Time spent: 7:17
Pain level: at worst: 7/10  at best: 1/10

Cougar!

Today a LONG run was on the schedule, and it was my son's 5th birthday party this afternoon.  So Sarah and I start at the crack of dawn at 7:00.  As we trotted along the river and started our climb UP, I was thinking about what I might blog about today, as I seem to be running out of great commentary.  Then, around 8:00 as we were climbing up to our first summit of the day along Branch 21, we saw...our first COUGAR ever!  I saw it first and thought it was a deer.  Then I thought, "Oh, that's some kind of wild dog!", and as I look over Sarah is pumping her first in the air and shouting "YA! It's a cougar!"  Hmm.  Not my first reaction.  It was definitely a small cougar though, with a white belly and a really long tail that looked something like this pic.  Luckily it was scared of us and ran into the forest about 200m ahead of us. Needless to say, Sarah checked her GPS and we had reached our goal for that climb and turned around to scamper out of there.  I'm glad I was with her and the kitty cat was keeping his distance!

Despite the pouring rain of the last 2 days, this morning dawned with dry skies (not dry ground) and a little sun.  We changed socks 2 hours into the run which was like a little slice of heaven.  I've never done that before and I will sure carry an extra pair now.  I also experimented with different food today.  I tried potatoes with olive oil and salt, steamed and then broiled.  Wow.  They hit the spot perfectly, although they took a little while to reach my blood stream. I also tried Oskri bars for the first time...lots of coconut that made my tummy squirrely after 4 hours, but good nonetheless.

Just after cougar siting.

Since I had a time limit due to my son's birthday party and this was the first time we added elevation to the long run, we only did 33K again rather than the 36 planned, but time of feet was a full hour longer than my previous longest run.  So recovery was super important if I was going to be functional as a mom this afternoon.  My epsom salts and compression socks came through again!

Some of the rain run off from the last few days!

Total Distance: 33.14
 Time: 4:21
 Fuel: 2 Oskri bars, 4 Mejool Dates, 1 cup potatoes (895 calories)
Notes on Fuel: worked pretty well, the coconut pineapple Oskri bar is best saved for post-run as it's heavier and hard to get down, the potatoes were a definite repeat item
Post run recovery: I actually gained 1.5 lbs this run but no symptoms of hyponatremia, and felt ok due to better fueling mid run, so the recovery routine worked well but my legs are pretty tired.
Plans for next week: Keep checking those runs off!
Gratitude: Cougars that keep their distance, and dry skies this morning!

Arc'teryx - MOVE

 This guy speaks my language! 

Comox Valley Road Runners Half Marathon

Recovery is part of your training.  Racing is part of your training.

This morning was the annual CVRR Half Marathon.  I LOVE this race. Almost as much as I love the Snow to Surf.  This was the 6th year I've done it.  I had 33K on the schedule, so did 4K before (I ran from my house) and 8K after.  My coach Sarah recommended that I do the race even though I couldn't really "race" it given the extra mileage I needed to save energy for.  I followed her advice, but still slightly doubting the benefit of a road race with no elevation as training for a mountain ultra.

Well, here is what I learned.

1) Sarah knows what she's talking about.

2) Adrenalin does crazy things to the body AND to the mind.

3) My legs are not trained for 33K on the road.

4) Running a race in the middle of a training run prepares you to run on tired legs for the last bit.

Why was this race good prep for my ultra?  I really really really tried to run on feel for this race.  I didn't want to go out too fast, I didn't want to feel the pressure of all the other racers passing me.  I tried to run my own race, even if it meant not getting a PR.  The hardest part is that I COULD have blown my PR away - I felt great.  But I held back, telling myself that I had 33K to complete that day, not just 21.1.  I didn't have a watch and going totally on feel, I failed to eat enough and drink enough (lost 4 lbs).  I blame that solely on adrenalin.  I had only 2 dates the whole race.  I knew better, but I felt like a million bucks as I (yes I did) raced the last 3K to the finish line.  I had a girl panting down my back and just couldn't let her beat me!

But no sooner did I cross that finish line complete with the 100M sprint to the finish, and the adrenalin rush STOPPED. I chatted with friends for 90 sec and then started a painful trot towards the airpark to complete another 8K.  I didn't make it far before I needed to stop for 2 more dates and a fruit bar.  Pace dropped by 45 sec/km.  Hips seized up.  Once the sugar hit my system it was better, but I shuffled painfully up the hill to my house and collapsed on the living room floor totally spent.

My new ibuprofen...the Strawburst Anti-Inflammatory Smoothie by Scott Jurek (Eat & Run)

And to top it all off, I was out of epsom salts for my post-run bath!!!  Oh well, I survived and learned a valuable lesson:  No matter how well you practice, in a race situation your brain and your hormones can betray you.  In my big race I WILL watch the clock and eat/drink on time, regardless of how I feel.

Total Distance: 33K (road)
Time: 3:14
Fuel: 1 Fruit Bars, 4 Mejool Dates: 312 calories
Notes on Fuel: totally not enough calories or water (calories burned: 2259)
Post run recovery: water, water, water, and SALT!
Plans for next week: ramping up the mileage and more hills!

From Running Trails to Running School!

 This weekend, Sarah Seads (Kinesiologist, Personal Trainer, Run Coach and my dear friend) and I ventured across the water to Vancouver to take a course.  New Trends in the Prevention of Running Injuries, offered by The Running Clinic, was one of the best courses I have been to in a long while.  We came away with our heads FULL of new information based on ultra-current research.  We were encouraged that many of the things we are teaching our patients and clients are bang on correct.  However, we were also forced to change many beliefs that have been core to our rehab programs.

Sarah has summarized the most important points on her blog here, so I won't bother repeating it all.  You can go there to check it out!

It's crazy how much shoes have changed over the years.

My Personal Top 5 Take Away Points:

1) I will be getting back into my minimal shoes again and for good.
2) I will throw away my kids "big bulky shoes" and get them connected to the ground again.
3) Minimal shoes aren't going away.  "Barefoot running" is a great tool for most people, but must be transitioned into and executed correctly.  Minimal running is NOT for everyone.
4) Stretching....big changes that I must accept.  That's for another post.
5) Even though I do it rarely, I won't be taking NSAIDS at all anymore.  Nothing good comes of it.

We were reminded that 80% of all running injuries come from training errors. My impression is that the approach to running and injuries has changed more in the past 3 years than during my whole career as a physio (14 years).  Research is being published every day that is blowing our current belief systems to bits.  As health care providers we do the best we can with the knowledge that we have, but at the end of the day we have to accept that 5 years from now we may be doing things totally differently!

Guess who's leg is mine?

 

Stairs!

This week I desperately tried to get some climbing training in...without going into the mountains.  That meant a lot of stair repeats at Goose Spit.  I am a little maniacal about my GPS and my stats...and according to my records I managed to get approx 6000' of elevation in this week in total.  That is how much I can expect during my race, spread out over the whole week.  I'm going to have to ramp it up and pray that the snow melts soon.

I must say I'm tired and ready for a down week.  Sarah and I are headed to Vancouver this weekend for a course on running injuries.  Perfect timing as my body needs a rest this weekend.

Here are a few pics from this week!

Goose Spit Stairs - the view makes it all worth it!

Part of the ELM 10K group that I joined on Thurs night after a short chat about running injuries - this is also my summer Thurs night trail running gang...makes me long for summer.

Deb - always pushing the limits and dragging my butt up the hills!

Week 10: Lessons in Recovery

This morning the time changed...and the weather changed!  It was a grunt to get up early, but oh the reward.  Spring like temperatures and clear skies greeted Sarah and I as we ran from our houses to Seal Bay Park (yet again), twice around the park and home.  Hopefully this will be the last time the snow keeps us out of the mountains.

As my runs are getting longer, I am really trying to figure out what works well for me for recovery.  I am by now means an expert, and have been trying different things to shorten my down time.  The last 2 weeks I think I've done quite well.  Here are a few things I've learned about what works and doesn't work for MY body at THIS point in time.

1. Eat within 30 min of finishing my workout.  This is really hard, as eating is the LAST thing I want to do, but if I can at least get something into me quickly it pays off.  Usually a shake or energy bar.
2. Warm bath for 20 min with loads of epsom salts. I know ice is recommended, but this winter my core temp needed a hot bath!
3. Stretching within 1 hour.
4. Foam rolling, usually in the evening when I have the time to invest into it.  I have really loved using the foam roller the last few weeks.  I get really tight gluts and hamstrings, and the foam roller isn't always comfortable to use, but totally works.  Ascent Physiotherapy (my office) stocks them.
   
5. Compression socks.  I recently got my first pair of these and I LOVE THEM!  I have bad veins in my legs (I've actually had vein surgery) and today these babies made my legs feel like they had springs on them all day long rather than sluggish dead weights.
6. Hydration plus plus.  I drink LOTS of water all day after a long run.  Today I tried coconut water for the first time cause I've heard so much about it.  If you crave sweet things after a run, then it may be for you, but I found it sickeningly sweet.  I would rather get my electrolytes from a banana (per Sarah's suggestion) which is cheaper with less packaging than from a can of overpriced water.  I also usually crave salt, so sweet isn't high on my priority list.
7. Easily digestable lunch.  I have been really liking having fish or chicken and rice or potatoes (seasoned with plenty of salt) plus veggies for lunch following a long run.  I am not a vegetarian, but am not opposed to those options also, however beans and legumes take longer to make and I usually do them for suppers.
8. Finally - it seems that now that I'm running 5 instead of 4 days per week with higher mileage, I'm recovering better.  Seems weird but it's true.  My legs are just getting used to it.

Total Distance: 30K
Time: 3:23
Fuel: 2 Fruit Bars, 4 Mejool Dates: 480 calories
Notes on Fuel: more calories this week = better energy
Post run recovery: Compression socks rock.
Plans for next week: Joining the ELM 10K clinic to give the injury talk, followed by more hills!
Gratitude: Spring is in the air!!!!