The Night Before… My First 1/2 Marathon.

So I said I’d be back in October, but it’s a little later in October than I had hoped.  Life has been kind of trapped in an up and down cycle for awhile.  Here’s the quickest of updates before we start to talk about the good stuff…

The Bad

In the past couple of months two rather emotionally taxing situations arose.  First, there was the unexpected break up from my long time favorite person. All the appropriate words to describe what that feels like just won’t come out, I guess horrible and wasteful and sad generally sum it up.  Shortly after that, my grandmother ended up in the hospital with a broken hip and now has to be in long-term care, a very sudden change in her health situation. She is currently suffering from dementia, which is sad and difficult in many, many ways for her as well as our family.

I don’t really think going any more in depth than that is necessary.  Suffice it to say, enough bad things.  I mean… It feels just like rainbows and sunshine around these parts. As a side note, I highly recommend grabbing Tig Notaro’s “Live.”  It’s $5 via Louis CK’s site. It’s 30 minutes of laughter and perspective.

The Good

:: My new job has continued to go well. It is such a relief to not constantly think or want to say “I hate my job.”  There is so much power in that.

:: I started playing the violin.  I love it.  I have wanted to play for a long time and finally am.  Lessons have been going well, though I must admit that some of the simpler mechanics are hard when trying to put them all together.  I at least don’t sound awful too often.  I just wish I had more time to devote to it.

Violin!

:: School officially started.  I don’t mind the online format at all.  The flexibility is great and I do feel like I’m putting work into it. I am still in somewhat introductory classes because I’ve never done any academic work in business. I will be excited to start getting into more of my focus: human resources.

:: Miscellaneous good things: I have gotten to spend time with family and a lot of time with friends. I’ve seen some people I haven’t in a long time. I got to see some good bands play, caught Bert Kreisher, watched roller derby, etc.  The cats are doing well…

Cat raft

Life on the Cat Raft.

I am probably forgetting a million things. The main attractions in life have been work, school, violin, a little bit of derby, and running.

Oh, yeah… Running!

So my toe was acting up anyway and then I did a dumb thing like drop part of a projection screen on it.  I ended up with pretty bad toe issues, lost most of my toe nail, and had an infection that wouldn’t go away because I waited too long to go to the doctor.  After almost a month of doctor visits, he finally cleared me for the race tomorrow.  I have barely run much of anything over that past month and before that even because I was trying not to make the toe worse.  If it isn’t one thing, it’s another.  At least the peroneal tendonitis went away.

Here we are now, the eve before the Columbus Marathon.  This is a big deal for me.  Last year at this time, I had just had my gallbladder out.  The weekend after the surgery, we were headed to breakfast and ran into the road closures from the marathon. I remember looking out the car window longingly at the running they were doing.  This year, here I am.  It was only a year ago that I started running, when a 5k seemed forever.  Now I’m about to do a lot more than that.

I know I am not well-prepared.  I never got where I wanted to on my long runs in training.  I know I can comfortably do over 7 miles.  I think I can get through the next 3 okay.  At that point, those last 3.1 miles are going to really be something to work for, I think.  I am going in with the mindset that I will be slow and I might have to walk a lot.  This is my first half, so while I have a time goal in mind, it’s a PR regardless of time. No matter what happens, I think I’ve come a long way in a year.

It is already past my bedtime and I haven’t yet gotten everything ready for tomorrow, so I’ll leave it here and pick up post-race.

Here we go…

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Tendinitis, what?

I have been complaining about my ankle so much that the injury has its own name:  Anklemania.  This particular problem traces all the way back to January or February.  It’s come and gone a little bit.  I am still surprised I made it through the quarter marathon on it.  After that race, my phyiscal therapist encouraged me to take time off and see a doctor.

I waited a while to do either of those things.

Actually, I haven’t been running very much at all.  Major life changes and timing and the heat and my aversion to pain have all played a part in that.  I haven’t run in a week! But on Thursday, I did finally go to a sports medicine doctor.

That doctor asked questions and felt all around my left foot and ankle and decided that I probably had peroneal tendonitis. You can read things about it here and here. Basically, there are two tendons that run behind the ankle bone and one of them attaches down along the side of your foot.  Because the main part of the tendons’ job is to stabilize the foot so running on uneven surfaces (like I did back in January when the trouble started) can cause problems.  Not resting it enough right off (especially from injury through March, when I ran the most) probably aggravated it.

I have been prescribed physical therapy for six weeks to strengthen it.  If it doesn’t start to feel better pretty quickly, I go back in three weeks and we look at maybe a stress fracture and start taking x-rays, etc.  If it takes a turn for the worst, I go back ASAP. But, if I go six weeks of PT and all goes well, I should be good. I am allowed to run unless it hurts or I end up limping afterwards.  If that happens, I have to use the elliptical, bike, etc.

Incidentally, I had a final PT check up for my back on Wednesday which went really well.  My therapist joked that he would see me in two weeks for my ankle.  Boy, was he right!  I wonder if he’ll take my PT graduation shirt away…

You’re Doing It Wrong!

If you’ve been following along, you may have read a little bit about my ankle problems.  I thought that was actually all over, but I was apparently kidding myself.  After 4.05 miles yesterday, I have found myself with the same ankle pain back again.  Now, I think I know why.

Yesterday, as I was running, I was paying special attention to the way my feet were falling.  The right one was doing a fantastic job.  It was light.  It hit in the mid-foot area.  It came up.  It felt like a well-oiled machine doing what it was supposed to do.  But the left foot?  It was not coming down as light or bouncing back up very well.  The more I noticed it, the more awkward I felt.  Fast forward about 24 hours and I am having trouble walking normally.

Incidentally, I had physical therapy this morning and since I knew I wasn’t walking right, I mentioned how my ankle had started to bother me again.  After some discussion, he gave me an article I have read a few times before: The Once and Future Way to Run.  In the article is a video for the 100-Up.  I think I may have actually mentioned this before.  Well, I have done the 100-Up a few times, but never stuck with it.  My PT said I should start and keep going.  With my new discovery on how my foot is working, I can see the difference between what it’s doing and what the feet in the video are doing.  If I can get it right, maybe everything else will improve as well!

I wanted to go out for a little bit today, but I am staying in and 100-Up-ing instead.  I can’t hobble my way through the Cap City quarter next week after all.

10 Minutes of Nothing New

I was saving an update on my back until today, when I was supposed to have a wonderfully enlightening visit with my physiatrist.  Unfortunately, the words “enlightening” and “wonderful” could not be applied here today.

I have seen this doctor once before when I first had my MRI for the herniated disc.  She prescribed me some medicine and physical therapy.  She told me that if things did not progress well conservatively, I would have to start thinking about a steroid injection.  I have not seen this woman since and have worked solely with my physical therapist for the past many, many months.  I should note that I really love my PT and feel he is very helpful and encouraging.

The doctor, however… Not so much.  I spent ten minutes with her today.  Ten minutes in which she told me the following:

  • I could have re-herniated the disc a couple weeks ago. I could also just be one of those people who is prone to doing such things.
  • I should finish physical therapy. Despite my questions, she did not give me a time frame for this, only said that my PT would know when I should be done.
  • I don’t need another MRI because she would only need that if she were going to give me an injection or have a surgeon look at it. Neither of those things are necessary unless my leg pain gets worse.
  • If the pain in my leg gets worse or if I have another episode, I should call her.
  • Do not bend, twist, or lift things for six weeks.

My internal monologue:

  • I was already told that by your colleague at urgent care when it happened. Read charts much?
  • I have been in PT for a really long time now. A really long time.  And this still happened.
  • Thanks for not making me spend a whole load of money on a diagnostic tool for treatment that is not in consideration. This is not sarcasm.
  • If the pain gets worse or I have another episode, I am going to find another doctor.
  • Duh. Seriously and completely: duh.

I really appreciate the focus on conservative treatment.  I don’t want the shot or surgery.  I really just want to feel like I can do something to get better and protect myself against this happening again.  It’s frustrating to hear that I just need to keep doing what I’ve been doing and even then, it could just be for nothing and I could re-herniate again. Maybe another doctor wouldn’t tell me anything different.  The position I am in is just not the best one.

There is good news though!  Yesterday, my physical therapist told me I could start going on walks.  I did for about 30 minutes and added a little very slow, light jogging.  I had no problems with my back or legs during or after! I am really excited about that.  He also gave me the clear to at least walk the quarter marathon for Cap City.  I figure that in a month’s time, if things keep going well, I can probably run some of it.  Good news! Good news!

Post-Physical Therapy Back Update

I had my first physical therapy appointment this morning since my herniated disc “re-flare.”  When I walked in, I was apparently bent and shifted into a strange pose that when my PT mimicked it, I was horrified.  He immediately took me through preliminary movements to see my range of motion. I could lean forward pretty well, but I could not lean back at all without pain.

We went over to the wall and he had me stand a little away from it, lean on my left arm a little, and just “glide” myself against the wall.  I did this several times and it started to help almost immediately.  We varied it with leaning forward a little bit and working my way up to standing straight as I glided a few times in each position. It didn’t feel awesome, but every time I stepped away from the wall for him to check my alignment again, it was improved.  I could even start to lean backwards more.  We did a few other things, most of them didn’t feel very good, but I still felt like my ability to move around was improving and has improved a lot since Friday.

Back Care Notes

The session today was pretty short and ended with ice and instructions: I am to keep doing the glides in order to get myself into a more neutral position in my back.  If it doesn’t hurt, I can use the recumbent bike at the gym.  I can start with with 10-15 minutes, walk a little bit, and continue on if my back feels okay. I must use ice and the muscle relaxers would do me well at night since I can’t take them when I’m at work.

I cannot: run, jump, lift (including upper body lifts), twist, sit in a chair without back support, etc.

My PT said that it’s possible that once I am done with the steroids I am currently on, things could get worse again.  The steroids are taking care of the current inflammation, but it could just come back. He also thinks the doctor is probably going to want to go with a more “aggressive” treatment at this point.  He mentioned the shot, which he knows I am pretty against.  I don’t know what other options there are after that aside from surgery, which I am also not interested in either.  My doctor’s appointment is in the middle of being rescheduled, so we’ll see when that happens.

I have to say, I am pretty upset about this whole business.  I was doing so, so well. I was keeping to a good schedule of 3x a week strength training, 3x a week running.  My back was feeling good.  My ankle stopped hurting.  I was about to run over 6 miles for the first time ever!  Now, I can’t do any of that. I am going to try the bike tomorrow and see how it goes, keep up with my instructions, and all of that.

I am hoping being able to bike will help my sanity. That’s the real problem.  I am so grumpy from pain and steroids and not being able to do the things I would normally.  Usually, if I was this grumpy, I could go for a run or go to the gym and work it out, so to speak.  With that not being an option, I just feel like I’m a pile of irritability and unhappiness. Strange how I never thought I’d run like I do now and now that I can’t run, things just aren’t as awesome.  In the little bit of time I’ve been running, it has become such a part of my life and my mental well-being, even.

While I don’t know if I will be able to run by the time the Cap City quarter comes around, the pacing requirement is pretty low, so I think I can at least walk it.  That’s my goal now: let’s just get to the point where 6.55 miles is something I can do in one way or another.

Disc Herniation, Take 2!

I know I have mentioned my herniated disc before, but for those not following along, here’s the story:

March 28, 2011 – I was deadlifting over 100lbs.  I came up wrong on the lift, felt a pop in my back, dropped the bar, and thought I was going to pass right out.  I could barely move, but luckily one of the trainers was nearby and helped me sit down. I couldn’t breathe very well and I was deathly pale, which made them think that my blood sugar dropped the minute the injury hit. One of the owners sat with me and iced my back for I am not sure how long.  Eventually, with the help of everyone and a very big stick they loaned me, I was able to drive myself home.  I had to re-ice my back just to get up the stairs to my apartment.  I have no idea how I did that because by the time I landed in bed, I could barely move.

Most of that week was an awful experience and the pain wasn’t something I’d ever felt before.  I am lucky that my friends are helpful and a couple of them came by those first few days to help with the cat, get meds, get food, etc. Not so lucky that it hurt so much to move that I almost passed out any time I had to get out of bed.

I was able to get along better as the week went on (I remember rejoicing when I could sleep on my side again), but it took a long time for the doctor to send me for my MRI.  I didn’t get that until part way through April of last year and then the appointment with the physiatrist didn’t take place until May.  By that point, I had made quite a bit of progress on my own, but still used a cane to walk at times to help me feel more stable on my feet with the leg pain and residual back pain I was experiencing.

L5-S1 herniated disc

From my MRI: To my untrained eye, this certainly looks like a disc popping out...

During the appointment with the physiatrist, she explained that I had a disc herniation at the L5-S1 (which is in your lower back).  The disc was pressing on a nerve, which was causing the sciatica in my leg, so she prescribed me a medication to help with that.  I was told about my options, which included an epidural steroid injection and physical therapy.  I chose to go with PT for the time being and only do the injection if it didn’t work.

Physical therapy started in June. I’ve been at it ever since with varying amounts of attendance. The main focus has been to develop my core muscles so that they could support my low back. I started back into the gym at some point and that’s when I started running due to lack of other possible activity (read: no heavy lifting).  I’ve been pretty regular in my activity level for the past couple of months. I finally felt like I was out of the woods and almost wondered why I was still in PT every other week.

Fast forward to two days ago. I had gone on a short run, come back and started to stretch.  I was about to go into one of the yoga poses that I do during stretching and that’s when it hit. I tried to stretch it out with things from PT. I applied ice pretty quickly and that seemed to help, but I could no longer stand up straight and the pain was intensifying.  I tried to call and talk to my physical therapist, but he was out of the office until Tuesday (incidentally when my next appointment with him is) and so they referred me to the orthopedic urgent care that they have.

I went in as soon as I realized that I wasn’t going to make it better on my own and that the pain was not subsiding. They asked some questions, did some quick tests, and told me that I had re-flared the disc. “Oh, yeah. This can just happen at any time now.  There might not seem to be any reason for it,” they said.  Great news, right? They did a thing on my legs that indicated that my nerve was being pushed on again.  I was given a prescription for steroids to help get the inflammation to go down, but I was told I could wait to use them since I could maybe wake up in the morning and feel better. They also gave me a muscle relaxer and told me not to return to work until Monday and to not do any heavy lifting.  I have to have a follow up with my physiatrist in a couple weeks and keep my PT appointment.

I am back to being friends with my cane.  My leg pain has only gotten worse in the last day, but I started the steroids yesterday morning. The back pain is nowhere near what it was the first time around and I’m thankful for that. My mobility really isn’t that bad and I can do most things, just uncomfortably. Yesterday was a big friend gathering and I had to leave not very far in because my leg pain was only getting worse and I couldn’t get comfortable. Ice and rest seem to be the biggest help and I’m hoping that the steroids will start working fast. I’m going to spend pretty much all day today resting so tomorrow at work won’t be a bad experience. I am anxiously awaiting my PT appointment to see what else I can be doing and I’m sure that I will get more info about the whys and hows of relapse.

Here’s to hoping this is the only relapse there is.

It’s Not a Tumor… Just a Strain.

My physical therapist took a look at my ankle yesterday.  I see him every two weeks and since I had complained about it for the past session and the one yesterday, he started poking around.  His diagnosis: it’s probably just strained.  Not sprained, but strained.  I told him I thought it was probably overuse and he agreed it could be.

ankle elevation and calf sleeves

New CEP calf sleeves and ankle elevation up the wall.

I am to keep icing it, elevating it, etc.  If it isn’t better in another two weeks, I am being sent to the doctor. I took yesterday off from running despite my plan for a long run.  I had intended to do six miles either Monday or yesterday, but my ankle + rain on Monday left things a little short and then yesterday was yesterday.  Originally, I had planned to do weights today and maybe try the elliptical or bike for cardio with less impact.  I decided this morning (after a somewhat painful evening of standing at work last night) that I was taking a full day off from extra activity.

I know this is probably a good idea.  Mentally, it’s hard to swallow.  I want to do things and it makes me feel so much better to do them.  I feel kind of defeated even though I logically know I’m just resting so that I can do more later. Funny how your brain can work against you like that.

On a side note: the other day, I snagged some of those lovely CEP calf sleeves you see in the picture above.  My ankle felt pretty rough for a lot of my run on Monday, but man did my legs feel great!  I have to say I think I’m a true believer in compression now.

Anklemania, or How Do You Always Get Hurt?

If you’ve looked at my Twitter in the last couple weeks, you will have heard me bitching about my ankle.  It’s no surprise to anyone who knows me that there is somehow something wrong.  I usually end up in the ER for an annual visit of some sort: 2011 was for the my gallbladder, 2010 was for pleurisy, and years prior were mostly for asthma.  I didn’t end up in the ER for my herniated disc, though the owner of my gym offered to call an ambulance.  That time, I probably should have gone if for no other reason than to get better pain medication or to get diagnosed faster.

At any rate, I have actually been dealing with left foot problems since I was in Boston in January.  While taking a run with my sister around Cambridge where there are some very uneven sidewalks that are often made of brick, I think I did something to my toe or foot.  I’m not sure which came first because eventually, it was both.  My theory was that I hurt one and then walked so strangely to compensate, that I aggravated the other.  I guess it really doesn’t matter where it started. As for my ankle, it has been giving me trouble since around the 5k almost two weeks ago.  When we went to the expo for packet pick-up, I was half-searching for two things: a hat and something to help my just-starting-to-ache ankle.  I never did find a hat, but I did find something helpful.

First, I stumbled upon a booth selling compression socks, but that wasn’t really what I wanted.  I then found CEP products.  I wanted this ankle support, but my (somewhat swollen) ankle measured in a size they didn’t have, so I went back to the compression sock booth.  I settled on some Sigvaris athletic recovery socks.  The sales woman explained a few things about the socks, that they could be worn during activity or for just recovery, the type of compression, etc.  I signed for them and we were off.  Of course, after the expo, we went and walked around Disney parks, so the only time I had with the socks before the race was a small amount of time the night before.  I didn’t want to wear them for the race because I didn’t know how it would be to run in them.  I did wear them after, and that seemed to calm my feet/ankle/calves down a little.  After the race, though, we went park hopping again and that was also probably not helpful.

After two weeks,  I am  still dealing with ankle pain.  I’m sure it’s partially because I haven’t taken real time off from activity.  The stiffness and pain usually subside with use, flare a little bit during activity, but then go away until I am suddenly stationary for awhile and then it doesn’t feel so good again.  My trainer suggested icing after all activity, which I’ve been doing.  I’ve been wearing the compression socks and elevating for recovery as well.  I took today off of running because going out in the wind and rain with my ankle feeling stiff and painful just seemed like too many negatives.  I am hoping that by the time I go out for a run tomorrow, I will be a little better off.

So, if you have ideas about how to ensure better ankle strength and support or just how to get this healed up a little faster, I’d love to hear any suggestions.  I fear RICE (rest, ice, compression, elevation) is my only option and that doesn’t sound like a quick fix.

That last statement actually answers the question in this post’s title: I always get hurt because I want things too fast.  I hurt my back because I did too much lifting too quickly.  I was too tired and didn’t check my form while using heavy weight, taking for granted what my body could do.  My ankle has bothered me because I haven’t taken the appropriate amount of time to heal.  Hell, it’s probably just from overuse in the first place. Not resting to the point of pain and then not resting when there is pain just means more pain.

The moral of this story: take it slow. Whatever physical activity you are jumping into, don’t follow my lead and jump a little slower.  I try to listen to my body and then I promptly tell it to shut up.  Don’t do that.  Avoid anklemania for yourself.