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Training Plan for this week

Rich (I sent this to Patrick but did not hear back):

I start the IM intermediate on Monday, June 2nd. It has me running Tuesday - Saturday each day.  Right now I'm still suffering with an issue I believe to be related to the sesamoid bones under the ball of my big toe (left foot) - I've tried numerous things (hokas, new inserts, inserts and a metatarsal pad, etc etc etc). I've had this issue off and on since last September, but in January/February of this year it came and has not gone away (gotten worse). Every change brings a new issue in my legs or feet (my right Achilles is now acting up after about 30 minutes).

I have an appointment with a podiatrist Friday, June 6,  that EVERYONE (including one of the judges I appear before) appears to use (I've been calling every day in the hope that someone will have cancelled).  I'm hoping beyond hope that he will figure it out, fit me for orthotics, and I'll go on my merry way running sub 8 minute miles in my next HIM (I know I have the capability but for the foot/feet issue). 

In the meantime, what do I do about the runs...it SERIOUSLY hurts during and after, but I'm afraid to stop running for fear that I'll get behind.  I don't think the bone(s) are fractured b/c I can walk, but it's like a throbbing open knife wound when I run...and afterwards, like today in regular tennis shoes, the ball of the big toe (left foot) is burning. My HIM is June 15th, I have an Olympic July 12, and my first full IM is August 24.  The full IM is my A race, I did IM 70.3 Florida already so the HIM on June 15th (a B race) I can do without IF I HAVE TO, but I'd prefer to race.

Thanks, Kay

Comments


  • Posted By Kay Baker on 02 Jun 2014 10:00 AM

    Rich (I sent this to Patrick but did not hear back):

    I start the IM intermediate on Monday, June 2nd. It has me running Tuesday - Saturday each day.  Right now I'm still suffering with an issue I believe to be related to the sesamoid bones under the ball of my big toe (left foot) - I've tried numerous things (hokas, new inserts, inserts and a metatarsal pad, etc etc etc). I've had this issue off and on since last September, but in January/February of this year it came and has not gone away (gotten worse). Every change brings a new issue in my legs or feet (my right Achilles is now acting up after about 30 minutes).

    I have an appointment with a podiatrist Friday, June 6,  that EVERYONE (including one of the judges I appear before) appears to use (I've been calling every day in the hope that someone will have cancelled).  I'm hoping beyond hope that he will figure it out, fit me for orthotics, and I'll go on my merry way running sub 8 minute miles in my next HIM (I know I have the capability but for the foot/feet issue). 

    In the meantime, what do I do about the runs...it SERIOUSLY hurts during and after, but I'm afraid to stop running for fear that I'll get behind.  I don't think the bone(s) are fractured b/c I can walk, but it's like a throbbing open knife wound when I run...and afterwards, like today in regular tennis shoes, the ball of the big toe (left foot) is burning. My HIM is June 15th, I have an Olympic July 12, and my first full IM is August 24.  The full IM is my A race, I did IM 70.3 Florida already so the HIM on June 15th (a B race) I can do without IF I HAVE TO, but I'd prefer to race.

    Thanks, Kay

    Hey Kay,

    Sorry about your injury. I have a loonnggg history of problems with my left ankle and feet (very, very flat) in general. Notes:

    • Don't run this week, at all
    • Let's see what the doc says. If he prescribes orthotics of some other insert, understand that they're may be further delays, as a function (1) getting physically in your position. Ie, they may be custom = some ordering, production, and deliver time. And (2) you'll need to start running with them gradually to give your body time to adapt...but we'll know more after your appointment on Friday, you're not going to fix anything before then so it's better to just stand down. 
    • I'd say your HIM in couple weeks is out. It's just not worth the risk of your bigger IM goal in August. 

    So the short answer/plan is:

    • Stand down
    • See what the doc says
    • Go from there
    • It's is what it is. The pain you describe is NOT good and if you continue to run I can 100% guarantee that you'll jack something else up, as you favor that foot and place more stress on something else. 

    You're still good for your Aug IM. You will likely just need to adjust your goals and expectations about the race to fit the reality of you having to fix this foot vs training they way you'd like to. It is what it is. That said, as long as you can ride a bike you'll be fine for Ironman. The run might be slow and it will likely not be pretty (again, is what it is) but zero issues having a pretty good race on the back of a very solid bike. 

  • Rich:

    Thank you for your thoughtful response. After not running at all since last Thursday's 55 minute run, I did a 20 minute run off my bike last night (had to switch the Wednesday brick to Monday b/c of other commitments) and had same issues, so yes, no more running this week suits me just fine.

    I've contacted the June 15 race person and I can defer to next year or to another race they have (Rev3) for $25 extra, so I'm fine with missing that trip - saves travel $$$$ for something else (like a new race outfit!).

    Thanks again, and I will keep you posted.

    Kay
  • Great! The key to remember is that more injured you are, the more your injury drives the train with regards to your training and your performance expectations on race day. At some point you gotta stop coulda shoulda woulda, maybe stand down hard to fix it, and then carry on with ammended goals and expectations. It is what it is, sez the guy with a loonngg history of gravity-induced injuries and training/racing compromises :-)
  • Rich:

    Let's assume the podiatrist at my appointment tomorrow (Friday June 6) says no running for 2 weeks, here is your steroid injection and here are your orthotics (which they tell me I'd get by June 11th), but when you do start running, go short and slow. 

    So that basically puts me at the end of June to start back running for real.  Can I still get in shape for a full IM race on August 24th....realistically?  And if so, what should my expectations be?  I was hoping to beat 12 hours at IMKY.

    My pace at HIM Florida (April 13) was 8:27min/mile. Total race time was 5 hours 21 minutes.  I've kept up my biking and swimming.  I REALLY want/need to do this full. It may be my only one I ever do, although my significant other believes that once I do one I'll want to do more (he really does know me well b/c that's what I think might happen also).  I was a good runner but I'm older now and with this set back......?

    Comments? Thoughts? if a talking to is what I need to get my head out of my ass, my number is 770-330-2629.  Thanks for your time, Kay

  • Update:

    Podiatrist says he's going with sesamoiditis not a fracture at this point. Prescribed orthotics and stem (for other issues that he thinks are related). I can't get the orthotics til next Wednesday. He's a runner and he knows my itch to get back out there. He recommended once i have the orthos to do 3 x week with runs no more than 40 minutes (shorter when I first start out with the orthos). I'm going back in a month. I can increase the time if I'm not having problems. If I am still having problems, he'll want an MRI to rule out a fracture - he showed me some dark spots that he said could be an old fracture that I've aggravated, or just arthritis. It's focused in the medial sesamoid (rather than the lateral) on the left foot. He didn't see anything in the right foot.

    I'm not going to worry too much about pool running unless and until it becomes a fracture situation - in which case he said it's 3 months no running. I'll miss IMKY if that's the case.

    Have a great weekend. Kay

  • Posted By Kay Baker on 06 Jun 2014 03:14 PM


    Update:



    Podiatrist says he's going with sesamoiditis not a fracture at this point. Prescribed orthotics and stem (for other issues that he thinks are related). I can't get the orthotics til next Wednesday. He's a runner and he knows my itch to get back out there. He recommended once i have the orthos to do 3 x week with runs no more than 40 minutes (shorter when I first start out with the orthos). I'm going back in a month. I can increase the time if I'm not having problems. If I am still having problems, he'll want an MRI to rule out a fracture - he showed me some dark spots that he said could be an old fracture that I've aggravated, or just arthritis. It's focused in the medial sesamoid (rather than the lateral) on the left foot. He didn't see anything in the right foot.



    I'm not going to worry too much about pool running unless and until it becomes a fracture situation - in which case he said it's 3 months no running. I'll miss IMKY if that's the case.



    Have a great weekend. Kay

    Ok, sounds about standard. If it were me, I'd do my first runs as around the block so that if I have to bail, I'm just a short walk from my house. And be prepared to run like 15', max, or do run / walk, etc. Based on how different these orthotics are from what you're used to, they may require some significant adaptation time so be smart. 

  • Rich:

    Update: 2 runs with orthotics at 35 minutes - incorporating running 1 mile then walking to simulate aid station (guessing it's about 30-45 seconds?). Pacing is about 9:30 per mile. I'm 'ok' with that, although I'm hoping that will improve with time. Ball of big toe on left foot (problem area) is not painful per se, but feels "hot"....the good news is the right achilles is not bothering me like it was before while running. I am doing a-stem twice a week. I think it probably is helping some. The good news is that the ortho fitter (also a PT person married to a PhD PT person) took video of me running and showed it to her husband who is doing a study on people who run 'heavy/loud' - I knew this already but I am apparently one of those people. They both suggest the heavy running can be causative of foot/knee/etc injuries due to the heavy weight landing on each foot as I run.

    Podiatrist has me on a 6 day steroid to get rid of the inflammation that is in that area of the foot. Then prescribed Mobic (generic name) for as needed for pain/inflammation after the runs. I'm icing the affected area after each run.

    He wants to do an evaluation of my running - he's learned of studies that re-train runners how to run 'softer' - the ortho fitter had already suggested that I mentally imagine landing softer and I have done that on my runs - it might only be in my head but I think eventually everything you think about translates to your physical body - what you think about becomes what you do (or something like that). Evaluation is tomorrow. I may or may not make any changes at this point since I don't want to create any additional injury to my legs/feet but if it makes sense and is not to drastic I will see if I can incorporate it into my running.

    In other news, have you heard about these 'patches' that are a new thing - FG Xpress power strips - made with Korean red ginseng and some kind of plankton ??? - supposed to help by using the natural elements to heal inflammation among other benefits. My massage therapist just gave me some to try out. Just curious b/c I'm always a little skeptical.
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