Boston and a new minor (?) injury
I've been opting in the JOS thread and i didn't want to hijack that thread, so I thought I would start a new one.
Quick version of a long story: In October, I got a bit of achilles tendonosis in both of my heels. With PT and careful comeback, I trained for Boston over the winter and have been running as fast as I've ever done. Maybe faster. This past Saturday (April 5) I made the mistake of doing my last reasonably long run in the wrong running shoes. (They were not intended to be my running shoes...but I ended up without my regular ones and these were new "running shoe sneakers.) The upshot is that the run went well, but I've aggravated the achilles on my right leg...but about 1/3 the way up from my ankle to knee....i.e., much higher spot than before. I ran on it Tuesday April 8, thinking it felt pretty OK...but the pain increased throughout the run and lingered (albeit reduced) overnight and into this morning.
The bottom line here is that I made a stupid mistake. The shoes I ran in are perfectly fine running shoes (for someone else) and essentially brand new, but they are really my new walkabout shoes and they are not my Newtons. I should have stopped what I was doing...gone back home.. and done a shorter long run if I had to. But I let pride get the best of me and I thought I was invincible. Wrong.
Needless to say I am extremely bummed.
I am not giving up on Boston just yet however. We have all heard of people who got horribly sick or something of that sort in the 2-3 weeks before a race and ended up doing well.
I spent an hour in the pool today, doing some water running. I am all about RICE and self massage and my old achilles exercises again. I'm going to do the same tomorrow. I'm taking zero risk about ANY re-irritation. Over the weekend, I am planning on cycling. I talked to Patrick yesterday, and he suggested an easy run by Saturday, but that was before I woke up with it still sore today. I'm going to err on the side of conservatism, at least when it comes to impact.
I may or may not run another day between now and April 21.
This is not how I planned it. But I still want to make the best of it. Any thoughts are welcome.
Comments
Getting to the starting line healthy is MUCH more important than any fitness from last minute wko's. But going cold turkey this close it the dance is hard.
On several occasions in the past I have had calf issues flair up just before race day and I was able to run fine by wrapping it with self-stick disposable ace bandages. Thing is, my issues seemed more like knots or niggles in my Soleus as compared to the Achilles so this may not apply at all.
Did you have big plans for PR or some other lofty goal? If the issue does not resolve somewhat can you still run Boston?
In both cases, the most important exercise that seemed to help a lot was eccentric calf work. You can do them on the floor, but it's best on a staircase.
-stand with the balls of both feet on the stair edge (heels hanging over) and with a hand loosely on the railing for balance, etc.
-use both feet to quickly stand up to tip-toes.
-lift the non working foot (or at least take your weight off it)
-slowly, slowly, slowly lower yourself down to at least the "flat" position with the working calf/foot. If you can tolerate it, you can dip the heel below the balls of your feet on the stair.
-repeat. You can do sets of 10-15 to start and you can do ~3 sets per day. You can work up to doing 3 x 15 in one "set" a couple times a day over the course of a few weeks.
There's actual evidence from autopsies/biopsies, etc that this does do a lot of good for the tissues in your achilles, according to the docs/PTs I have seen...not just anecdote.
Depending on what causes the tendonosis, various balancing exercises on one foot and/or one-leg gentle squats are often recommended. But the key short/medium term one (I think) is the eccentric calf extension I described above.
That said, yes, my training has gone very, very well up to this point and I am quite sure that if healthy enough I can set a marathon PR (weather permitting of course). So, yeah, it's important to me to get back the way I want to be.
Last year I went to an AIrrosti practitioner - its sort of a mix of PT and massage. And they had me doing stuff that I would have done anyway, but it made me feel better that I was actively doing something about it. I did eccentric strength and some careful calf stretches, lots of time with the foam roller.
I also vote on being conservative, get it healed. Do a test run to see where its at, so you can decide what you want to do on race day. Since it hasn't been a lingering issue that you ran on for days or weeks I think ti will heal soon. Good luck.
Sorry to hear about your injury! I hope it heals up well and you have a great race!
My two cents (well maybe 4 cents):
Where you describe the pain sounds less like tendinitis/tendinosis and more like a muscle strain. Eccentric loading would be contraindicated for a muscle strain. Even stretching is bad in the acute phase. Rest/ice and then heat is good, and eventually some deep massage when you can tolerate it. Physical therapy would probably be helpful- they have lots of shiny machines that can help with the inflammation. No NSAIDS!
I think if pool running doesn't hurt AT ALL, you should continue to do that. Fitness starts to drop after about 3 days of complete inactivity. Just don't push it.
Pool running yesterday was entirely painless.
How are your achilles tendons?
http://members.endurancenation.us/Forums/tabid/57/aft/15430/Default.aspx
Running the marathon wasn't great for the achilles, but it's really very manageable. I had a small setback on the original (degenerative) part, but no reinjury of the one I described in this post. I'll be fine.