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Calf Issues - 9 weeks out from IMCDA

I'm not sure if this topic belongs in the Medical Help Forum or the Training Forum - b/c I've got a coupe of questions that fall into both buckets. I vented a bit on the home page & got some good feedback so that prompted me to start a thread. I'll start here and see what happens.

Context: Halfway through the run at IM Cali 70.3 (March 29) I started getting some pretty bad pain in my left calf....to the point that at mile 7ish I had to resort to a walk, stretch, run/hobble, walk stretch run/hobble, repeat for 6+ miles.  Killed my race - finished with a 2:02 half marathon which was discouraging.  Anyway - this was a new pain for me.  I'd experienced some hamstring issues on that same leg in the past and it actually reappeared in a minor fashion about a week out of the race.  Within a few days of getting back to Texas I got a deep tissue massage and set up some time to see my ART guy.  Fast forward to today and in that period I've seen my ART guy a handful of times and I've attempted a run on 4/12 & 4/13. My ART guy and I discovered that the left side is weak...real weak...& that the whole chain is tight.  So I've started back up my glute exercises to try and strengthen that up more. 

On the 12th I got two miles in and bonked (had come off a 4 hour bike ride where I ignored nutrition for the final 45 minutes - shame on me).  On the 13th I managed to run 5k - but when I was done there was some pain in my calf.  Between the 13th and today I've done no outside running.  Biking and swimming cause me no problems so I've been logging hours there and I've tried aqua jogging in the deep end of the pool one time with no pain, but not sure .  I went out this morning after my swim to test the calf - I'd had no pain in the prior couple days and it was feeling good.  I got 4.5 miles into the run and the calf tightened/locked up again. And now it hurts again - stink.

With that here are some of my questions:

  1. Should I try to get an MRI or some x-rays on my calf to determine if there is a stress fracture or if this is purely muscular?
  2. IMCDA is 9 weeks or so away.  This will be my first full IM - so I don't know what I don't know here...and I'm trying to not freak out even though I've already trying to figure out how I'm going to make the leap from 70.3 to 140.6.  I'm thinking worst case scenario here - but let's assume that whatever the issue is it requires that I take the next 4-6 weeks off running outside.  If that's the case and I focus on the bike, the swim and aqua jogging.  Is that going to kill me for IMCDA?  Or....all things being equal, will I be able to maintain my fitness enough to where I'd still be able to go? 
  3. Is aqua jogging supposed to totally replace outside running on a 1:1 basis?  So if the schedule calls for a 90 minute run should I be trying to get 90 minutes of aqua jogging in?

Appreciate your help here...

- David

Comments

  • If finishing IM CDA is a life and death requirement *this* year (doubtful), and you can walk, then, sure, you can finish it. Otherwise why not consider using WTC's transfer option and go to Tahoe or some other later season IM to give your self time to get better situated.

    As to restarting run, assuming medically cleared, at this point you'll need to give yourself a minimum 4 weeks to ramp back up, starting with something kess than 4 miles per wko, and increasing mileage/time by 10-15% per week. And eschewing intervals, hills, long runs during that ramp up.

    Get the rest and strengthening you need, then re start run training sensibly. IM will still be there when you are ready. You are still too young to take my attitude, which is, I'll run till I fall apart, cause who knows how long I'll last anyway image
  • David, Not sure if you had a chance to look at what was posted last year on this subject: I've included what I suggested below.  Regardless, Google "Calf Muscle Heart Attack" ... the author gives a good description and steps to follow to recover. But recovery is slow and with IMCDA breathing down your neck, you may want follow Al's advice and check your transfer options. I did a sprint tri when I was about 1/2 way recovered and there was just no way to run without pain. Lucky for me it was only a 5K ... 



    My March 2013 Post: A few years ago I experienced a similar problem. The pain just came on and I could barley walk much less run. Very painful and for no apparent reason. I found an article that was title something like "Calf Muscle Heart Attack" and I knew that was me. The two most likely causes were a) micro tears in the calf muscle and/or b) Compartment syndrome, which is when the muscle builds up and restricts the blood flow. 

    I never actually found out which it was - it didn't matter to me at the time. The treatment was going to be the same. 

    I treated this by using "The Stick" to massage the calf, not running until I was pain-free, and when I started back running, I had to stop immediately if/when there was pain. It took a while for this muscle condition to fully mend. 

  • Hi David! I've been struggling with the same issues leading up to Texas. Here are a few steps I've taken and happy to update that I no longer have issues!

    1 - I had the area dry needled and/or grastoned on a weekly basis, along with ART.
    2 - Used my foam roller on both calf muscles as soon as I woke up (due to a bit of tendonitis it was causing in my foot)
    3 - Bought a new pair of running shoes. I've always run in the Newton Gravity's, and have the new design that looks to be a tad less aggressive with the five lugs.
    4 - Bought new inserts
    6 - Stretching at least 3 times a day (or whenever I walk up the stairs) for 30-60 seconds.

    I was struggling with it for almost 3 months. I'm about 95% now and ready to take on whatever May 17th has in store for me.

    Good luck! EB


  • oops not sure what happened to 5...
  • @Al - fortunately finishing CDA is not a life or death issue...however, we've built one of our family vacations around this race. I've bought seven plane tickets (2 adult, 5 kids & 1 lab baby) and we've rented a house for the week (Wed through Wed). So...not life or death but definitely a "this is something I really, really, really want to do."

    @Jim - started doing some reading on the "calf heart attack" thing. Definitely a lot of similarities between what's been described & what I'm experiencing. Will continue to do some research on that topic.

    In meantime, I guess I'll continue with the ART appts 3x per week, hit it with The Stick & foam roller and focus on biking, swimming and pool jogging. Which by the way - anyone have any thoughts on my question about duration of pool running vs. training plan running duration?
  • David, sounds very similar to my calf issue earlier this year. I went for physical therapy where she did Astym twice a week and I had to totally stop running for a month. I also was told that I needed to do pelvic and glute strengthening, in addition to the calf exercises (which I began very carefully!) When I began running again, I started out with just a few miles, including a walking break every mile. I increased a little each week (and as Al said, no intervals, hills, etc.). I am now back to where I left off (12 miles) and am able to do some fast intervals with no problem. I think the walking breaks really help. Sounds like you might be okay for IMCDA if you don't have any expectations for a "normal" marathon. Best of luck with your recovery!
  • David,

    Deep Water Running is a good option for you ....if you have to 'run' while you shouldn't be running.

    It is not exactly a 1':1' thing, tho. Now, if your workout had you running for an hour, the DWR may last an hour but you gotta break it up. Sets or intervals. Hard sprints. High knees. High cadence. Some ez laps with form focus mixed in between.

    If you try to replace your long run with a DWR long run, you will go .... nuts. And, if you actually do 2.5 hrs of steady state pool running, I'm not sure how much benefit you'll get from that. ROI stuff.

    The purpose is to keep some muscle memory without the impact, right? If you do it with intensity, but without breaking down on form, you will work some muscles you didn't know you had.

    If you can do this 3x week, preferably 4, I'll bet you can maintain more run fitness than you think. But, there will still be a transition phase of about 2 weeks for you to get your land legs back. It's a gravity thing. Land runs feel a little sluggish at first. Ironically, I found that my cadence went up, was 'easier' to have a hi cadence, due to all that high resistance in the water.

    Yes, your running is gonna take a hit from this. DWR is rehab, recovery, an effort to minimize that hit. I do believe it can get you thru CdA, if you play it smart, and realistically.

    FWIW, my calf/achilles probs actually stem from Posterior Tibial Tendonitis. One of the consequences of poor running build/form. PT does help. Similar to what Carol referred to in the above post.



  • In addition to any medical, rest, strength and stretching plan -- do yourself a favor, go and get a Trigger Point hard foam roller. Spend 10-15 minutes per night rolling the calf while you are watching TV, etc.

    I had persistent calf cramps, tightness for 2 years. Even forced a DNS at IM Arizona in '11. Started rolling it just after, and the calf problems went away in 3-4 weeks. They've been away since.

    The key move: side-to-side roll your calf on top of the roller (in addition to the more obvious long vertical strokes). That breaks up the knots and tightness.

    Good luck!
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