Menu

Injury and Rehab

Water Works!

, ,

Growing up I liked playing Monopoly. Most everyone wanted to buy Boardwalk, Park Place and the expensive properties hoping to put houses and a hotel on them. And collect big $ when someone landed on them. But I also liked Water Works, one of the utilities. The payback was decent – averaging about $28 and up to $48 rent (based on a roll of the dice) on a $150 investment. Chances were in the course of a couple of trips around the board someone would land there. Nothing fancy, but a dependable return. And that is what deep water running offers to runners. I was reminded of this twice in the past two weeks. 

The first time I had gone for a fairly hard run in the cold rain.  Came back to the gym, warmed up and thoroughly stretched, planning on a hard track workout the next day.  But that night I didn’t sleep well and woke up with some back pain.  It seemed wise to delay the track workout a day.  So I headed to the gym and since the pool schedule didn’t allow for a water run, I jumped on the StairMaster.  If anything, that made things worse and as the day progressed the back hurt more.  Sleeping that night was uncomfortable and in the morning just walking was painful.  Clearly running was off the table.  So I headed to the pool!  

I slowly walked from my car to the Y and did 45 minutes in the 88 degree program pool – it’s like a bath but on that day welcomed.  I felt the back in the water but it wasn’t getting worse.  After sitting on a heat pad most of the day while working, by evening things were maybe 30-40% better.   The next day, I headed to UVM and did an hour in the pool (78 degrees so I wear a shorty wetsuit – no legs) followed by stretching and light weights (on parts other than the back.)  More heat pad and by evening I felt 80%+ recovered.  Rested well that night and in the morning went for a very easy 5-mile run, mostly on dirt.  No problems!   The following day I ran 8 miles, including two-miles of tempo near the end. Felt nearly 100% – saved by the water!

But then three days later after a solid 7-mile run, I came back to the gym for some stretching. I regularly perform one-legged balances on an inverted Bosu ball while doing dumbbell presses with a 10-pound weight in the opposite hand. But for some reason I picked up a 15-pound weight, lost my balance and took an awkward step off the ball jamming my ankle. I quickly felt something pinch in the area of the ankle dorsiflexors, the muscles that allow you to lift your foot upward when running. Sure enough, after a couple hours it began to throb and it was clear running wasn’t going to be an immediate option.

This was Tuesday and my dilemma was I had an important team race on Saturday. Nobody wants to totally rest during the days leading up to a race. So I was in the pool. Two solid pool workouts the next two days along with stretching and foot orbits had me at 90%, enough do an easy four miles the day before the race. By race day there was hardly a trace and I felt nothing (in the ankle!) during or after the race. Once again, water worked!

Suffice it to say, I will make an ongoing argument for deep water running.  I’ve been doing this for over 25 years.  Usually twice a week between running days and more when injured, using an aqua-jogging belt so the effort can go into running and not into staying on top of the water.  Maybe some find it boring, though with new technology you can get wireless headphones and listen to podcasts or music through your phone sitting on the pool deck.  Time passes by looking around and counting your cadence (the only real measure besides heart rate to monitor.)  It’s not “running” but is the closest thing to it I have found.  And many top echelon runners have also found this method useful in bridging their training gaps.

I have tried, regrettably with little success, to interest fellow runners in deep water running as both a regular part of their routine and a bridge to maintain fitness when running is not an option.  Most runners attempt to “run through” their injuries, big and small, or take time off, which I submit for masters runners is problematic.  We’re already losing muscle and CV function and total rest only exacerbates that. I’ll keep preaching water running to my friends and clients.  And will be waiting for someone to write a guest blog post about how they have found it to be the magic elixir of sorts.  For sure, there’s nothing like a good run.  But if you can’t (or shouldn’t!) do that, deep water running is a great alternative.  Water works!   

To Race or Not Race: That Is The Question!

, , ,

Is it a stretch to suggest this Shakespearian corollary applies to competitive runners? Most of us have at least some of our identity connected to this sport we love. Not seeing our friends at races and toeing the line attacks our sense of self.   George Sheehan probed this years ago in his first book Running and Being.

However, to shift from the existential to the practical side of the question, we competitive runners find ourselves in this predicament, probably several times a year. We train to do well in peak races that have meaning for various reasons.   For me I look forward to doing well in the USATF-New England Grand Prix series and the BAA Distance Medley (5K, 10K, Half). I know the best runners will be at the Grand Prix races and I want my age-class competition to know I need to be reckoned with! At root, these rivalries are supportive and rewarding. Camaraderie develops because we have each made sacrifices over an extended time. And races are a celebration of that. The BAA races are all large (~10,000 runners) events drawing an international field and there’s a definite “buzz” being part of then.

If you’ve followed my blog, 2017 has been a year marred by a bad fall in February resulting in rib surgery and not being able to run for three months and then only incrementally returning to training. I essentially lost seven months of high-level racing, which I missed dearly.   I was looking for some redemption in the fall and beginning to feel the chops returning in September. I had increased the quality of my workouts, throwing in speed and some hills, had shed several pounds, and lined up at the Lone Gull 10K Grand Prix race on September 24 ready to race. It was a warm day so I scaled back expectations a bit, but otherwise met my goal. I saw the BAA Half Marathon two weeks later as an additional statement of my return. But as I warmed down from Lone Gull, my left hamstring felt tight then started to hurt.   As I made the long drive to Vermont later that day, it was throbbing. Clearly I had done something.

On the surface, it didn’t seem this should be happening. I had progressively upped my mileage, including 14-15 mile long runs every other week along with regular strength work. But the quality had been lacking.   So during the prior month I started doing eight to ten 100-150 meter striders several times a week. And was doing 800-meter repeats on the track at least weekly. I had also moved from my Boston apartment the prior month and was moving things to Burlington, Vermont where I had recently bought a condo. On top of that I was in the final stages of retiring from the Boston non-profit I had been with for 10 years. Certainly the running was helping to moderate and manage these changes, but the overall stress level was high. Something was bound to give. And it turned out to be my hamstring.

I proactively approached the recovery by water running the next four days along with light stretching and weights. The hamstring mostly calmed down, so I went for a run but felt it quickly tighten up and begin to hurt. So I walked a bit and headed back to the pool. Fortunately, my massage therapist had a slot that afternoon. He did his thing and suggested I had strained but not torn the hamstring as he was not finding “hot spots” indicating a tear. That was good news, but based on my symptoms I surmised I had a 1½ grade strain. The literature says it takes 1-3 weeks for Grade 1 strains to heal and 4-8 for a Grade 2, so that left me thinking I needed three to four weeks of active recovery (including light running) to fully resolve the issue. I kinesio taped the hamstring and in several days was able to run six miles at a gentle pace, though with some tightness and post-run soreness.

But the BAA Half was looming – two weeks after Lone Gull. At stake was a third straight age-class title, which would qualify me for a waiver from the $200 fee for next year’s medley and a guaranteed entry. In spite of walking/jogging the BAA 5K in April and a pretty slow BAA 10K in June, a respectable Half would give me a chance for the title. I was feeling game to give it a try. But then three days before the race, I came down with a nasty cold that developed into a hacking cough, making it hard to sleep. I went for a five mile run on Friday and barely moved! To meet my goal I needed to run 2 ½ minutes per mile faster on Sunday.

Sometimes you have to step back from the moment to gain perspective.   I assessed I had a 25% chance of running the BAA Half at my goal pace and not setting the hamstring back; a 50% chance I would finish the race at a slower pace (which would hardly be satisfying) and leave the hamstring more sore, setting back full recovery at least a couple weeks; and a 25% chance I would further injure the hamstring and set my self up for an extended recovery.   While I have taken many risks in my life, I generally live by the law of averages. I didn’t like the 25% chance of doing no harm. So I didn’t run. My choice was borne out by the six-mile run I did during the time of the race at a pace well over a minute slower than I would have attempted at the race. The taped hamstring felt stiff throughout the run, and was a tad sore afterwards. Pushing it for more than twice the distance would almost certainly have resulted in one of the 75% negative outcomes.

I thought I might question my choice. But I’m actually relieved I could make this decision and look forward to resolving this issue over the next two to three weeks and get back to serious training and racing.

I know other runners have stories like this. Sometimes we take a chance and win; sometimes we lose. But the important thing is the long view — to stay in the game. That was my motivation today.

The Gift of Injury

, , ,

Going through some papers, I came across this piece I wrote 21 years ago, about midway through my running career. I am not sure what I did with this and if anyone else ever read it, but it reminded me how critical a juncture this was. The injury was patellar tendinitis, reportedly the 5th most common running injury. I did not run for over three months. But upon returning, I did so progressively with a commitment to avoid this going forward. Thus began my consistent use and tracking of running equivalents, mostly water running and Stairmaster and by incorporating REQs an adherence to daily workouts. It also marked the start of taping my knees with Leukotape right below the kneecap to take pressure off the patella tendon. The physical therapist used this during rehab and I just kept doing it. I buy Leukotape in bulk and don’t leave home without it. I tried the Cho-Pat, but find tape works much better. Also at this time, I began a regimen of weight exercises for my legs and knees four to five times a week. Specifically for the knees I use the quad machine, but rather than isotonic (up and down) reps I choose a weight that I can hold straight out with each leg for a count of 10, lower it slowly, then do the other leg. I call these isometric “holds” and do 10 to 15 per leg. Over time, this has built the quads above my knee, helping to keep the patella tracked.

There can be a silver lining in the cloud of injury, and I certainly found that with this bout of patellar tendonitis. Along with ITB syndrome and patellofemoral pain (runner’s knee), sore knees comprise three of the top five running injuries. So it behooves us to strengthen this vital part of our kinetic chain!

The Gift of Injury
(From November 22, 1995 – Thanksgiving Day)

I have been running for 18 years, typically 1,800 to 2,000 miles a year, five to six days a week. Fortunate to avoid a major injury, I have rarely been off my feet for more than a week. It’s been a large part of my life. In fact, I have wondered (without much interest in finding out!) what life without running would be like.

So, I was not elated to hear my doctor prescribe a likely two-month layoff to recover from persistent knee pain. And even that might not do it. It was not good news. But I had been dealing with this for over a year and it was affecting training, race times, and my enthusiasm for running. Running was still a tonic—something to look forward to and organize the day around, a way to stay fit, a social link, and stress releaser. The timing of this was bad. I was heading into a busy work cycle and was several pounds above normal weight. So with some trepidation, I agreed to the prescription of rest from running and rehab.

That evening, I thought about how to constructively approach this. There was a lot I could do: swim, pool running, bike, lift weights, some StairMaster – anything limiting direct pounding on the knee. But none of these seemed to be the elixir to replace a brisk seven to 10 mile run.

First, I decided it was a good opportunity to really learn to swim. I had been working on my stroke off and on during the past year, but it was still a mess. And lingering memories of nearly drowning as a kid kept me from relaxing and exerting myself in the water. It was time to get beyond that!  Second, I vowed to work out every day. Because of work that meant early morning workouts. Third, I knew it would be tough to keep from gaining weight. But instead of aiming to hold steady, I challenged myself to lose the extra weight, so when I was ready to run again, I would tread lightly.

So how has it gone these past two months? Swimming, surprisingly and pleasantly, is coming around with the help of a swim video, lifeguard tips, a pull buoy, and consistent training – at least four times a week. To vary the workout, I even started doing flip turns (my first were a real joke!) I discovered that as with running, going faster has benefits. With swimming, it leads to a sensation of gliding through the water and with proper rotation and reach, better stroke efficiency and reduced drag. My times are approaching 30 minutes for a mile (I figure about a 7:00 minute/mile running pace equivalent), which for “real” swimmers is not great shakes. But it’s all relative. A year ago, 40 minutes for a mile was a dream. Most notable though I’ve begun to look forward to the pool workouts, which with water running last about an hour. I’m not sure why this is, but swimming typically leaves me more refreshed than running. I’ve stuck to the schedule and have missed only one day since going on this program. On non-swimming days, I find a combination of StairMaster, stationary bike, weights, and stretching works well.

The extra weight went away, at least in part due to the early-to-early schedule. Late night cravings for pretzels, etc., have been largely displaced by early bedtimes. Also, I cannot eat thinking I will work it off doing a long run the next day. The fact is these activities do not burn calories the way running does. So I am more aware of what I eat throughout the day.

I do miss running! Especially the racing, although this is gratefully the off-season. I have no doubt that when I return, the fire will burn again. However, I think this pause has shown me I’ve been “chained” (I had to run!) to running, and I feel those shackles have been loosed. As with gaining a new friend while old ones are away, running will now compete with swimming for my time. It’s a dilemma I never expected but welcome.

So what I thought was going to be a hardship has turned out to be a gift. It answered the question of what life would be without running. As for all you injured runners, maybe I’ll see you at the pool!

Running Times – Gone!

, ,

Running Times started in 1977, the year I took up distance running. There really weren’t good running books back then so the magazine became my go-to source. I devoured every issue, usually reading it cover to cover the day received. Without fail, there was something, usually many somethings that could be incorporated immediately into one’s training and racing. I kept piles of RT around, only discarding them when making long distance moves. 

There were regular features. I loved the Shoe Guy, J.D. Denton, who owed a Fleet Feet store in Davis CA. His offbeat articles on life in a running store were funny, refreshing, and educational. The Owner’s Manual, written by various authors but often Pete Pfitzinger and Owen Anderson, provided a plethora of training advice. I lost count the number of times I had developed an injury or training impasse that the current issue addressed, as if the writers had been talking to my training partners! Nutrition, coaching, shoe reviews, performance tips, race results, and the latest discoveries in sports medicine and psychology were regular topics. Generally an accomplished masters runner was profiled along with their training regimen, providing many good ideas to try. Every year they ranked the top masters (about 10 deep) by age group. Alternately, it showcased high school and collegiate runners. Without Running Times, I probably would not have been aware of others in my cohort around the country or the juggernaut college programs.

What made Running Times unique was both the quality and depth of its articles. RT was not glossy, like Runner’s World, but was full of substance. Many articles were four to six pages long, with illustrations to break up text. Every issue had a nice balance. Even the ads were good – I bought a number of books and gear from the Marketplace section. For many years the last page was reserved for “By The Numbers”, a list of obscure running factoids. 

About 15 years ago I stopped discarding. The pile grew. There was no way to mine the gold in those pages. So last year I started going through the pile, from oldest forward, cut out articles and pasted them in notebooks by topic. Typically about half of each issue was worth saving. This process took several months, because I invariably read the articles while cataloging. Gems galore! I left room in the binders for many more years of Running Times.

Then in the December 2015 issue, a bombshell. Rodale Press, the publisher of Runner’s World, which had acquired Running Times in 2007, would discontinue it in January. I had passively wondered if/when the ax would fall when the magazine was sold. Rodale said they would maintain the tradition and focus on more serious running. And for many years they did. Maybe the 115,000 circulation, compared to Runner’s World 800,000, wasn’t enough to justify RT. The public statement was that Rodale wanted to stay “focused and aligned for continued growth as a company.” Another way of saying Running Times wasn’t paying off. They said they would incorporate aspects of RT into Runner’s World. But after four issues, it’s clear Running Times is gone, solid gone. Remnants of RT in Runner’s World are hard to find.

We live in a world of change. And in business consolidation rules. The small guy gets squeezed out. Maybe it’s a faint hope that some enterprising, idealistic folks will buy the rights to Running Times and recreate the magic that leapt off the pages for 38 years. Meanwhile, I have three filled notebooks to leaf through. Not all is lost!

Eccentric Heel Dips – The Magic Elixir!

,

We runners have some predictable issues and injuries. Starting from the bottom the most prevalent are plantar fasciitis (PF), Achilles tendinitis, calf strains, sore knees, tight hamstrings, hip and groin strains, and lower back pain. If you’ve been running very long, you’ve probably had bouts with all of these. I certainly have!

What to do? Could there be a one-size-fits-all solution to these multiple maladies up and down the kinetic chain? Well, no. But I have found one rather simple exercise that both directly and indirectly addresses these issues – eccentric heel dips. I think some of my clients consider me eccentric and obsessive when I impress upon them the importance of doing them – day in and day out. Perhaps they are right. Meanwhile I take my own medicine and perform them multiple times each day.

Here’s the basic description: Stand on the edge of a stair or any kind of a riser that allows you to dip your heels to a comfortable stretch. Supported only by the front of your foot, allow your body weight to stretch the heel downward, allowing one foot to take the majority of the weight. When you hit bottom, and just after a second or two, push back up onto your toes with both feet and then repeat the downward stretch with the other foot. Remember this is a dynamic, not static stretch – keep moving! Do some while bending the knee and some with straight legs. Repeat for one to two minutes if you have the time – 15 seconds if you’re going up an escalator. Any amount of time is beneficial. Find excuses to do these throughout the day, and certainly before and after you run. Focus on where you feel the stretch. Do not be surprised if you feel it all the way up your back. There are neuromuscular connections all through the kinetic chain.

Now that I’ve described these, let’s explore what’s going on. First, with eccentric exercises, there is negative resistance applied to the muscle, which lengthens it. Muscles resist force rather than produce it. An illustration is the basic bicep curl. When we lift the weight towards us we are concentrically shortening the muscle. When we let the weight down it is eccentrically lengthening. While we might think of concentric exercises as more strengthening and eccentric as stretching, eccentric action also strengthens muscles. In fact, about 30-40% more weight can be handled eccentrically. Not surprising, eccentric exercise helps build concentric capacity. For example, if we lower the weight slowly when doing bench presses, over time that helps increase the amount of weight we can press back up. As it relates to running, heel dips not only ward off debilitating injuries but also enhance spring in our step and improve balance.

Give heel dips a try! But do not expect an overnight miracle. You have to be willing to do them regularly to see the benefits. Heel dips are most helpful with calf, heel, and foot issues. But if your hamstrings are tight (and what runner’s are not!), you should feel a slight stretch there too. If there is pain, don’t overdo it. While this stretch will improve circulation and help healing, it can also increase irritation and inflammation. As with all things, too much of something good can be detrimental. Once you get the hang of this, start holding a 10-pound weight while doing your dips.

So maybe it’s not magic. But it sure is effective! I’ve been doing these consistently for over six months and have not had the recurring hamstring and calf issues I had been plagued by. Maybe they will work for you too!

The Art of Recovery

, ,

Like many, for years I ran with the mindset that faster was better. If you want to race fast, you’ve got to train fast – an extension of the no pain, no gain philosophy. For me, that worked pretty well. Have never been a high mileage runner – more than 40 MPW on five days a week seemed to invite injury. But most of it was pretty fast paced – usually between just 45 and 60 seconds/mile slower than 10K race pace.

I‘ve been racing for 38 years and thankfully spent very little time on the DL – until three years ago. For the first 35 years, I was out of action an average of about 2-3 weeks a year. I attributed this, in part, to taking the approach of not running through injuries. If something cropped up, I hit the pool and Stairmaster until things felt solid. And then it was immediately back to the fast-paced stuff. The two exceptions were a 3-month outage due to a torn piriformis (which I hadn’t even known existed!) and a two-month layoff due to patella tendonitis, for which 15 years later I still preventively tape.

So along I went on my merry way. Averaged 1,930 miles from 2008 to 2011. And was half convinced I could ward off Father Time. Then things started to happen! Calf pulls and hip strains became ongoing occurrences keeping me off the roads for weeks at a time. Though I dutifully pool ran and StairMastered and kept up with strength training, my average mileage between 2012 and 2014 dipped to 1,287/year – a 33% drop. And my race times reflected that. I realized that to achieve my best times, even age-graded, required more than 25 mpw of running. How could I get back to 40 mpw without nagging injuries? Though a creature of habit, I was willing to try something new.

In his book, Build Your Running Body, Pete Magill, a California-based coach and national caliber masters runner, talks about the importance of recovery from races, hard workouts (which by his description was most of mine!) and other stresses. Coach and author Greg McMillan suggests running these at a 7-hour (yes hour!) marathon pace, a shade faster than walking.  Yikes – who of us is going to road test that? Kenyans are known to run 9 min/mi recovery runs, though this may be their second run of the day. So there’s a spectrum of possibilities but the midrange for recreational runners seems to fall in the 2-3 minutes/mile slower-than-10K race pace, something I considered snail’s pace!

I decided several months ago to test out this recovery stuff. I planned out a training schedule that gradually built me back to 40 mpw. I have now been there for three weeks. I am running five to six days a week but two of the days are strictly recovery runs, generally shorter — 5 to 6 miles, at 2:15 – 2:30 per mile slower than my target 10K pace. This has not been easy to do. I’ve had to hold back while focusing to retain my normal cadence and bounce. But I now find myself looking forward to these runs, largely because they leave me feeling looser the day after or the day before a tough effort. I’ve even allowed this “snailing” to creep into my long runs, where I have moved from targeting ~75 seconds over 10K pace to 90+. Rather than feeling washed, I’m more invigorated after these runs. The side benefit is that when I do hard efforts, there is no excuse to keep from digging deep. I’m not saving anything for tomorrow’s run.

Not enough time has passed to see the effect on race times. But so far I’m optimistic the higher mileage and more focused hard workouts will show results. We are all an Experiment of One. I’ll have a lab report after the fall races!