Sunday, December 13, 2009

The art of healing

Even with the stress fracture a few years ago, I count myself lucky for not suffering any serious injuries my whole athletic life. Suddenly I feel like I’m tight-roping the border between the good life and something much more uncool.

It all started last April when I just finished a 10-mile tempo. My training for a 3:40 Cleveland Marathon was beautifully on schedule and on pace. But as I turned down my street at the end of a cool down, I felt an ache near my left ankle. It was my achilles tendon.

Knowing that my achilles was nothing to mess with, I took off I couple days. Then the shin splints struck. (You know the story: I felt paralyzed for the first 30-40 minutes of any run and could almost never stretch into my normal pace.) My limited motion probably protected my achilles from being overused, but once the splints cleared up, and I continued training this summer, the achilles ache came and went.

Well, it’s back with a vengeance now. So, I’ve taken off 2.5 weeks (since the Turkey Trot) and I’m not sure it’s done the trick. I cheated with an easy 3-miler on Saturday and I’ve felt achy today.

What a tricky thing this achilles is, however. It’s tight and painful when I wake up in the morning, and can get a little tweaky throughout the day, but the pain doesn’t hinder my stride when I’m running. In fact, after a warm-up I don’t notice the tendon at all.

Some side effects: I’ve been getting some pain in my shins when I run and some afterward too. My sciatic nerve knocks lightly sometimes to remind me that it’s still there. And only every once in a while, I feel what seems like a resultant tightness somewhere else in my leg, like my hamstring or around my knee.

Like everything else in running, though, healing takes time. Especially the achilles. That part of your heel gets lower blood flow than other reaches of your extremities, so healing often takes a long time. And let’s just say rupturing the thing is the scariest thing you can read about doing.

(Pause to shudder and cry.)

So, I sit here on the eve of training for the Pittsburgh Marathon on May 2, wondering if I should give it another week… wondering whether another week should be a month… wondering whether a week or a month would do any good… wondering whether I should just run through it… wondering if I should just break on running all together until my achilles feels perfect.

After Saturday’s test run, I feel inclined to go both ways. Because my achilles aches today, I feel like I shouldn’t run at all. Because the three miles really stunk, I feel like I should get running fast—there’s no way this body’s running 26.2 any time soon!

When I visited Dr. T last spring regarding my shin splints, he checked out my achilles, but it wasn’t as achy at that time as it is now. I’m not sure, aside from shaming me into rest right now, what could be done for it. Is that, however, a reason to not get it checked out? Is the achiness I feel just something I must live with to train for endurance? Oh, these eternal questions.

1. Follow my training schedule, follow my feelings. I start with four miles on Monday morning with no assigned paces for the week. It’s worth a try. I just need to stay vigilant and honest.

2. Warm up like I mean it. Short and simple: I rarely do a proper warm-up and push myself to hit paces right out of the gate and wonder why I don’t hit my paces as often as I like and why I hurt. I think we all know the answers to my questions.

3. Rest when and where I can. My training schedule, for the most part, allows a day of non-impact cross-training between days of running. I’ll have to optimize rest and stretching for my achilles (and the rest of my body) on these days.

4. Return to yoga. Strange this about me is that I’m all about yoga (like seven days a week, 2-3 sessions a day) during some times of year. But oftentimes when I’m training for a race, I skip it altogether. I realize how much it helps me relax and heal. Now I just need to shed the lazy and hop to it… on the mat.

5. Get hot and then get icy. It’s time to get serious about warming up, using heat, seeking massage and icing my injuries. There’s more to healing and treatment than stretching and sitting. I will heart RICE.

I hadn’t intended to be dealing with an injury at the outset of a 19-week plan, but what marathon training doesn’t get interesting? May will be here before I know it. I hope my achilles will be on board for a marathon by then.


The Salty One said...

Boo! Bad achilles!

But, on a positive note, I think all us serious athlete chicks have some nagging injury or other at most times of our training. There's definitely a line that when crossed leads to injury, but often we can keep on keeping on without that happening. But it takes maintenence. Do calf raises. Stretch. Massage. Ice. Ibuprofen to the extent you can tolerate it.

I've had plantar's fasciitis to some degree since 2006. I've had it band issues on and off for longer. Figure out what is particularly irksome to your achilles and avoid that in favor of stuff that isn't so bad. I've had achilles problems after running on snow or slippery surfaces--may want to avoid those. There might be a pair of shoes that bug it--ones that are lower in the heel, perhaps?

I really think you're golden though if it doesn't hurt while running. Take care if it afterwards with a good stretch, self-massage, an ice pack and some motrin, but forget about it on the run. If it flares up while running to the point that it affects your stride or to the point that it scares you then stop and walk home. These things do take time, and these soft tissue injuries don't go away with rest, unless you want to rest for about 6 months.

The "guides" that talk about what to do when you're "injured" aren't written for serious focused athletes and kind of lump everyone into the worst case scenario so they're sort of a one-size fits all easy answer type thing. However, serious training and aches and pains are complex and there is no easy answer. My answer os to soldier forward and trust your gut, erring on the side of running on it :)

GP said...

Wow: that helps so much. Thanks!

I'm always uncertain whether I'm toeing a dangerous line (because I'm prone to push too far) and all the achilles stuff scares the bejesus out of me.

Tell the average person you have a gimpy achilles and they give you the "lay off that... it'll take 12 years to never for that to heal." Bah. Bug and Hum.

Landon said...

If you're committed to stretching, yoga, warming up, etc. in order to stay injury-free I'd say you're in great shape. I also know you and your tendency to push things beyond the pale. I'm just glad you're thinking about being safe and I hope you continue to. I don't want to run May 2nd alone.

Shannon - said...

I just came across your blog and wanted to say hello!

I look forward to reading more --- and hope you feel better SOON!