Monday, September 18, 2017

Ultra Loony update

Well, the training so to speak is in the bag and it's taper time for TCM weekend, I got through 17 miles yesterday and I have a chance. Here are my weekly totals for the last 7 weeks:

6
0
0
0
2
32
30

I have made progress especially considering just 2 weeks ago I could only walk and that was a slow walk (to put it in perspective, 9 miles of the 32 miles from last week were a walk on labor day, a few days later I was able to do a run-walk and so it began). I still have no speed or turnover and if I do try to stretch it out, the pain is increased. The good news is I am able to do the run-walk and I know it can work and I am hoping that the 2 week taper will get me to the starting line just a little bit healthier and increase my odds further. Regardless, I intend to give it a go. What do I have to lose? I have had a DNF, I can live with another one if I have to but I don't want a DNS.

Back to my long run for this marathon journey, I felt good for about 12 or 13 miles but then I slowed down as the pain increased and I ended up having to walk the last 2 miles and could not have run through it. That said, I am close to being able to get to a marathon pace and if I can have a little marathon majic it will happen. It has before.

When I am faced with these go/no go decisions, I think why do I do this? The answer is fairly simple, because I can and it's what I signed up for. Yes, this adductor tear is not fun but I have healed enough to get through the 10k and 5k and possibly the marathon. Would I rather abort the Loony and just do the marathon, no. I want it all and if I can heal a bit more and manage the pain, I can do it. Last year I had the knee issue which made for a very, very long day but I got through it, was it fun, yes at times and at other times, it was not, as matter of fact, I do remember pausing and taking a deep breath and was close to dropping but then I leaned in and I embraced it and savored it all the way to the finish.

Image result for images about running in pain
It's about putting your mind to it and then shutting out the negatives. I will be slow and it will be an extremely long day again but I want to try, no I have to try, it is who I am. In so many ways, knowing I feel every step means I am alive, to run without pain would be and is a great experience, I so look forward to having those kind of runs again. For this Ultra Loony though,  I do know that managing the pain will be the journey and I will embrace it and do what I can, which what I have on the day. I will ask myself to start and command, plead my way to the finish (I do love the internal debate I will have) and if it's meant to be, I will do it. If it is not then I will welcome the journey and go as long as I can.





Saturday, September 2, 2017

Ultra Loony update - training is overrated

I tried to run today as I was hoping to get things back on track, it was my first attempt since I tore the adductor muscle a month ago, well it didn't go well, had pain on each step which I kind of expected as it is still sore. I did figure out that I might be able to do a fast walk though so some progress and possibly what I will need to do to get to the start line. I didn't push to walk as I still felt some discomfort, so instead I went into the pool and found out I can now swim with no pain and pool run, so the cross training can expand.

So it's time to focus on cross training and then hope that I can run by next week or next weekend, I am thinking that my experience and running base can get me through the weekend events it if I can get to the start line of each race pain free or relatively so.

The question I will need to ponder though is will I pull the plug if I can't run soon, great question, not sure how I will answer.

Monday, August 21, 2017

Ultra Loony in jeopardy?

Ugh, it seems like every August I end up with an injury not usually caused by running, well the cycle repeats.

Back on the 5th of August, I chose to relive my youth and paid a price. The price a strain of my right hip. How did it happen, well I was doing something that I have done for about 50 years and apparently it wasn't a good idea. We were at a friends cabin in Northern Minnesota and decided to go water skiing, I have slalom skied most of my life but couldn't get up, besides my age and apparently lack of strength, the boat seemed to pause then accelerate and the rope just seemed to jerk out of my hands so I decided to go for 2 skis, something I haven't done as much but the last time at their cabin it's what I did. So I donned the second ski,was headed up, the boat jerked again but with 2 skis no problem, right? Very wrong! I felt a tearing in my right hip, let go of the rope and knew I had done something bad.

After the injury I refused ice and ibuprofen as I wanted to deny it. The denial didn't go so well as although I could walk certain movements (bending, standing, sitting, turning, you get the point) caused significant pain. I had some bruising appear but then a week after I had a lot more bruising, see picture below, the interesting part to me is the point of initial pain was about 12 to 16 inches further up towards my hip.


I had to go to Atlanta for work this past week and since I had convinced myself that it was getting better, I tried to run, Suffice to say that was stupid, way too painful. So after my failed run I debated going to the Dr, just to make sure I knew what I had done and could do to get back to running ASAP. Well, last Friday I went and got it diagnosed, his prognosis was an adductor strain, grade 2 and I might not be running by Twin Cities Marathon, meaning it could derail me for another 6 weeks, double ugh!!.

So I am facing my current reality, no running, this week, if it seems better I might try this weekend, if not try over labor day. Mentally this is a tough one, the only thing I can do is walk carefully and potentially bike. I tried elliptical, no go, swimming, no go, I did do the exercise bike and that kind of worked, no significant pain but I noticed I was doing some compensation so not sure what I will do.

Right now, I am hoping to use the training plan below as my ramp to get to the start line of the Ultra Loony. It might not be a great idea but as a charter member, I have to right? I should add that I have done three marathons this year, the last being Grandma's so I had some base but will probably continue to lose it while not running.

- 3 3 - 3 5 7 21
Sun, Sep 3, 17
5 2 3 2 2 6 13 33
Sun, Sep 10, 17
- 2 3 2 2 5 18 32 September Sun, Sep 17, 17
- 2 3 2 2 5 13 27
Sun, Sep 24, 17
- 2 3 2 - 9.3 26.2 43
Sun, Oct 1, 17
Stay tuned, as I have been meaning to post more often and who knows maybe I will as it's good for my mind to capture my thoughts as I work through this.


Wednesday, June 14, 2017

Trails and my knee

I have been focused this year on just running healthy, losing some weight and enjoying my runs. It has gone well, the knee has held up with manageable pain but I have not ventured onto the trails.

In my desire to get back to the trails, I had a recent email exchange with a Dr Ben Shatto (check out his blog - The Physical Therapy Advisor) who has been on the Marathon Training Academy (thanks Trevor and Angie) podcast where he has provided insight on running injuries.
So I decided to ask for advice and I was pleasantly surprised that he got back to me almost immediately and when I asked a follow-up question, he again got back to me. I also think his advice is worth pursuing as I have tried the traditional methods without any success. Check out his site and take a listen to the Marathon Training Academy podcast, I especially enjoyed their recent show where Trevor provided his recap of the Flying Pig Marathon which was my first marathon of the year and things went well. My next race was MedCity and things went ok from as it related to the knee but it was a bit warm and my back acted up so I just slowed it down and got to finish line in one piece.
Marathon Training Academy
Next up for me is Grandma's and then my intent is give Dr. Ben's advice a try to see if I can work myself back on the trails

Here are the emails:

Hi Dr. Shatto,

I have a question for you and it may be too specific to me to be worth answering on your page so I will understand if you don't answer, as well as if there is no answer.

I am a 59 year old marathon and ultra runner (50+ marathons, ~10 ultras up to 50 miles) and have had medial meniscus surgery on both knees, the injuries happened while playing indoor soccer and basketball in the 90's. After my surgeries I was able to resume running on all surfaces with no limitations or issues. Unfortunately I injured my left knee again in 2014 and had a second meniscus surgery. After the surgery, I was told I had no functional medial meniscus left but was told that I have no arthritis of note and I again was able to resume running a few weeks after the surgery. Prior to the surgery, I had adopted the Galloway run-walk method (90 seconds of running, 30 seconds of walking) to help manage the pain and as an attempt to continue with the races I had signed up for. 

The one thing though after the 2014 surgery I have not been able to run trails as the knee stability isn't good and after a few downhills or uneven surfaces the knee hurts to where running is problematic. I tried braces and they didn't help enough to be able to run trails. As a final note, last year I had an issue around mile 20 of a long run, eventually had a MRI, they noted another medial tear and a cyst on the joint towards the lateral side. He thought the cyst might have been related to the tear but didn't think that there was enough left to cause the pain so figured it was the cyst. We discussed that I might have some loose material or something else but decided to take some time off along with PT which focused on core stability and that seemed to help resolve the issue plus avoiding the trails.

I would love to get back to running trails and I know I need to always work on my core and proprioception but is there anything else I can do that might help my knee to get me back on trails? 

I very much enjoyed your podcast on MTA and appreciate the info on Facebook and your website.

Thank you,

Mike

Hi Mike,

Thanks for the email and kind words.  Sounds like your knees have been through a lot.  It is hard to say if you can get back to trail running but it is always worth the try if that is what your goal is.  So I know you have don't a lot of core stability work which is good and I would encourage you to keep up with it, along with the proprioceptive training.  I would also hope that you have been doing a lot hip strengthening work.  Particularly for the hip external rotators and glut medius.  In addition I would put a "strong" emphasis on weight training of the legs in general.  The stronger the legs are the more they can help absorb shock and support the joint.  

Thinking a little outside of the box I would also make sure you have adequate hip and especially foot/ankle mobility.  As you know the uneven surface of the trail can be an issue so if your foot/ankle and hip can accommodate for the unevenness even a little bit more then the knee would need to do less.  So foot/ankle mobility is huge.  Also, there is newer evidence that in the cases of medial knee pain having a flatter shoe without much medial support (basically without a lot of arch support or built up too much) is helpful.  It goes against what may appear logical or traditional thinking as often times one would build up the shoe with a medial post to help support the medial knee but that added support is like a beacon and the body tends to move towards the perceived extra stability.  What we want is you to move away from it.  The only way to know is to try.  Also a less support shoe allows the foot/ankle complex to do more.  Though this does expose you increased risk of ankle sprains.  

Lastly you may consider a knee off loading brace.  This would be a custom fit brace.  They can be pricey and would need a bracing expert to measure and fit for you.  But they can work well.

Hope that helps.  Good luck!

Ben

Ben,

It actually does help out a lot, if I could ask a follow-up question to make sure I interpreted your response correctly. I have run generally in mild support shoes but have migrated to low drop shoes like Brooks Pure Cadence, Altra Provision and Intuition and more recently Hoka Infinite and Claytons. 

So my question is do you mean minimal drop and no support like the Kinvara or Merrell Vapor Gloves or is what I am running in ok? I have found the Hoka's to be generally too narrow or too cushioning but the Infinites I like as they are wider and somewhat firm, of course they are discontinued :-) so I will need to find an alternative. I do like my Altra's and have found that they work well.

If so, if I notice some knee tweaking as move away from stability do I keep the mileage low and let the knee and more importantly the foot adapt?

Thank you once again,

Mike

Hi Mike,
Yes I would suggest moving to more of a minimal drop shoe and particularly something without a lot of medial posting.  Meaning a shoe that offers some support for a more flat foot.  The theory has always been to support the arch and foot to help keep the knee from wanting to roll inwards. (the Infinites or something similar may work fine).  But some research now shows that it actually encourages the knee to roll in more as it feels there is external stability there.  This of course is not what you would want.  You want your body to naturally try to stay clear of the medial side.  So try to find a shoe that is wider and if possibly not overly rigid to allow the foot an increased ability to adapt to the trail surface.  
Though as you eluded....the progression onto the trails needs to be very slow as the foot and entire leg need to adapt to the surface.  This may be the hardest part of all as you are used to long distances but for a while you need to keep them short.  The rest of our body will be capable but the leg may not be.  And of course during this process keep working hard on all the other strength and stability drills.
Best of luck.

Ben  

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