Carole Harbison micro forum
HI Coach Patrick!
I joined back in beginning Feb and have been ramping up my run distance on the get faster intermediate plan before going onto the IM Full plan for IMLP. I have a chronic peroneal tendonitis issue that I had been managing at lower run volumes (15-20 miles/week) and hasn't been a problem for the last year, but it's flaring up now that I'm above 20 miles per week. It's been very sore the last two days where I feel like I can't run on it. Maybe I still ramped up too quickly to try to get into the plan. 
Last week I was at 23 miles, and on the plan this week is...
Today: 70 min with 3x1 miZ4 intervals...was going to push back to tomorrow and if I feel ok try a few miles at low intensity, no intervals
Thurs: 80 min negative split run. Seems optimistic.
Fri: 50 min Z1 w strides (billed as an optional run, which I have been doing in previous weeks)
Sat: 45 min Z2 as a pre-bike brick
I'm just not sure how to handle getting the run volume up to snuff without my peroneal acting up, as the plans keep increasing mileage from here on out in preparation for IMLP so I will never really be able to "catch up" without tipping the scale into injury. I do notice more of a problem when I do speed work, I was able to train for a marathon up to 30 miles/week but almost all of that running was at Z2-TRP.
Any thoughts, suggestions welcome--both on how to progress this week and in general with the run volume. I want to stay out of run jail!!
Comments
Thanks for checking in...I think we have hit a basic limit for you...if 20 miles is the "cap" for actual running, then let's just work around it. By that I mean what are other activities you can do that are similar to running but that are also not as costly as actual running. Activities that fall into the space include the elliptical and water running.
So my suggestion is that we tap your mileage on the road at 20 miles. We can work with this because your longest run on the road would never be more than that distance. The tricky part will be supplementing additional miles off the road that will allow you to continue building run fitness safely.
Taking a look at your upcoming week, my suggestion is that you stick to running on Tuesday, Thursday, and Saturday. Some of those runs should not exceed 20 miles. All the other scheduled runs in your program should be done either as water running time in the pool, or time on the elliptical.
In the short term we want to make sure that you stay healthy. So please don't push any of your runs as you recover and absolutely keep them on alternating days so you have as much rest as possible. Of all the runs you've listed for this week, you can absolutely get rid of the Saturday brick runners needed or simply push it to Sunday. Let me know what you think!
~ Patrick
My question is- I guess I need to take a few days totally off from running to ice, graston, foam roll, and PT. Would bumping up the biking and swimming to 4x/week be good to compensate or not really worth it at this stage (e.g. so far out from IMLP)?
Also when I come back to running hopefully next week, I suppose I'd start at like 12 miles per week, and ramp up 10% each week from there. That'd get me back up to 20ish miles per week by the end of April at least. I may have to do all that running at just low intensity too, since high intensity efforts seem to irritate things. Does that seem like a reasonable approach in your experience? Or is it better to do less miles and add in some high intensity? In the meantime, I'm reformulating my expectations that maybe I won't get to the running fitness I was hoping for this season, but do at least want to get thru and finish my first IM as strong and uninjured as possible. Thank you!!
YES to the lower intensity…we aren’t in a rush right now and HEALTHY Carole is much faster than injured “FITTER” carole from higher intensity intervals.
Some more questions for you:
1. Can you do the elliptical and if so, do you experience pain from that?
2. When’s the last time you got new shoes?
3. Are you seeing anyone (ART?) for soft tissue work?
~ Coach P
Thanks! Glad to have the link to run jail info, I hadn't come across that poking around the site but it's super helpful. Also for the reassurance not to freak out over a week off this early in the season, like many folks, I'm a worrier seeing workouts go by undone.
Answers to your other questions--
1. Can you do the elliptical and if so, do you experience pain from that? I'm going to try the elliptical tonight or tomorrow night and see how that goes, in the past it's been alright except for when I've been at my most injured (not there now, fortunately). Aqua jogging is it's own peculiar kind of torture for me (though I don't know anyone who says "Yay! Aqua jogging! Let's go!") so I'm hopefully I can follow Level 1 run jail to do elliptical this week in combo with biking/swimming and maybe try a short run at the end of the week if it seems reasonable to do so.
2. When’s the last time you got new shoes? I got this pair of shoes back in October (your question prompted me to actually look, I thought it was end of November when I got them!!), so while I was probably only logging 10-15miles a week for much of that I am likely around 250+ miles on these. Maybe will just swap them out since it can't hurt to do so.
3. Are you seeing anyone (ART?) for soft tissue work? I got acupunture with electrostimulation today but am otherwise just doing self massage/graston based on what I learned from many many sessions back in 2013 when the injury was fresh. Also self-prescribed PT this week from my arsenal of exercises to strengthen hips/medial glutes since that really helped me the first time as well.
I'm optimistic, thanks again for talking it through with me and I'll keep you posted if I need any other help modifying.
Ps "Yay aqua jogging!" has me laughing so hard...
In the meantime, I ordered another aquajogging belt off Amazon, despite how much it hurt my soul to do so.
As for your race it's really up to you...you can go as close as you want...it just depends on what you want your race should be. I personally would consider the impact of training for placid (bike / swim) vs your recovery timeline. If you think your current (modified) training is still hampering your recovery, we might have to back it down.
Let me know what you are thinking and if you want to talk...
Update from here. I took two full weeks off of running, a course of daily meloxicam, daily ankle strengthening PT, and have been swimming, aquajogging and on the bike ~10-11hrs per week to keep building general fitness. Things were feeling good, so I tried 2x5 minutes of running on Weds and then last night had a VO2 interval workout on the bike. About an hour after I got off the bike...foot pain. So at this point with only 15 weeks to go I'm afraid there's my answer about the season.
Now just have to decide, do I race Quassy as an aquabike and then do IMLP a) planning to DNF, b) considering trying to walk the marathon or c) only in my head as I sit in my rental cabin with my feet up and a bucket of beer. I suppose I'll keep fighting this thing and see what happens, but realistically knowing how the course of recovery took a year last time I've got to say, I'm not optimistic.
Any thoughts? Am I being too premature if writing off my season? It just tough to lose one, two, three weeks, then try to return, then lose two more weeks again back to square one over and over again...time slips by very quickly with no progress that way. I guess these are getting into macro questions
Thanks! Hope your recovery is going ok!!
Having spent more than 10 years with bad feet, seeing a good ankle bone orthopedist made a world of difference.
The MRI showed the stress fractures, ultrasound for the neuroma. Easy fix for neuroma is either steroid injection or alcohol. I always got the alcohol shot... worked better.
Never heard of an alcohol shot for a neuroma, my partner is wondering if he has one (MRI not definitive) but cortisone did nothing...maybe worth a try there.
Thank you!!
MRI will miss neuroma.
also, Asics might be the wrong shoe for this problem... they are so soft you can't feel the ground and you won't be using your toes at all, or your midfoot.
try some Altras... and make sure your great toe is pointing forward and that your not angled out.I had a stress fracture in the left fibula in 2008 and the only thing that helped me get better was breaking the other foot which forced me to get off of my feet for a full 6 weeks. Make sure you don't have a fracture...
best of luck! I'm an ER doctor but I have dealt with this issue many years. To keep out of run jail my ART person works on my ankles and IT once a week to keep stuff from sticking together. I use Aleve, cheaper than Meloxicam and works better. 500mg twice a day for 5 days only. Ice massage after running with stretching....
strengthening of smaller muscles of the ankles and the roller blading for abductors are essential or you will get stuck in run jail.. have to change your gait.
Glad to hear you have found a way to stay out of run jail, gives me hope.
medial gluts also reflect same issue. (of weakness in abductors) lateral motion will help both issues... your peroneals will take over for weakness in lateral abductors. medial glutes and piriformis will get tight for same issue. As triathletes we move forward and back too much... a tennis player or basketball player will move sideways and the do not get the same issue... speed skaters, in line skating... have stronger ankles. (wear wrist guards!)
best wishes... and have fun roller blading! great way to stay running fit while staying off the feet (so to speak...)
Carole, I think Patty has given you some great stuff to do. There is no _one time_ to really throw in the towel on the season. My coaching (and personal) experience has shown that there is always someone training less and facing more adversity than you (or I)...so it's really when your personal bandwidth for adjusting things runs out. Some of my best races have come off of the hardest constraints...
Hi Coach Patrick! Question around tapering before racing quassy as a tuneup for LP. It is a B race, but don't want to go in on totally fried legs--also cause its reputation as a brutal course suggests a little taper would make the day more pleasant all around! This is what I was thinking for the schedule the week before (below), but definitely interested in your input and what you have seen work well for folks in the past. It is only a slight dip in volume including race time but gets me a couple easy days before the race. I can't responsibly add any more run volume here, but am I cutting back too much on the bike? This was supposed to be a bike-focus week.
By way of running update--I am so happy to be back up to 18.5 miles per week with the long day today being the split run at 10 miles total (6 and 4). So far things have been holding together--I found a great PT who has been doing ART weekly, foam roll/stretch/do PT exercises every day, and bought a good pair of neutral shoes (Nike Zoom Pegasus) that are working well for me. I also haven't needed any more NSAIDS, which makes me happy. General training wise, I've also been upping the bike volume slightly to account for the loss of run time, adding in an extra (short) trainer ride or slightly extending the weekday rides, which has been working well.
Hope everything is going well with your injury management as well!!
Thursday: 60' ride with some pick ups.
Friday: 30' run with some pick ups as well.
Saturday: Swim only, no spin.
Sunday: Race.
There's no upside to Saturday exercise -- it's too much of a PITA in my mind. Just make sure all gears and brakes work, etc!
And thanks for taking pics--do you have the link to the site where all of them are housed? My phone got wet today and I'm not sure she'll recover--it turned on just long enough for me to see that there were pictures up!
I hope you find some good ones!!!!
~ Coach P
Ps can't wait for the RR!
@Carole Harbison -
Welcome back!!!!!
Here's your updated Season Plan, as promised. This is where you'll return to post all your "coach" questions as responses; I'll see them and reply. This first post is my best outline of how to proceed with your races, but you can ask any / all questions you want. So post away, know that I reply here usually M/W/F each week.
Power User Tip: Click the Star icon by the Title of this thread to subscribe, and you'll get email updates when I do reply.
Your Notes
Raced as a plan athlete last year for 2x 70.3s. In the fall been running about 4-5x and 20-25 miles/week with speed work and have seen good gains on time going from a 9:45 easy pace to a 9:20. I've also been doing tabata/strength classes 2x/week. Not much swimming and not much on the bike since the fall.
Your Races
Ironman Canada (2018-07-29) #IMCanada_18
Season Update
These are your recommended training plans, including the date you should start each one (sometimes you won’t complete a full plan but transition to another one). You can change your plans on the Training Plan page by clicking the Move / Change button. Learn more about each plan on the Training Plan Central Page.
Coach Notes
Carole, great to have you back on the Team. Given where IMC falls on the schedule, I'd like to make sure you are dialed into the OutSeason® for January. Yes, it started this week, but no worries! The testing isn't until Week FIVE. And you can use the new workout descriptions to make sure you are following the right level of work for you -- for example, choose "L1" on the bike as it's been a while.
Please let me know if you think that can / can't happen and let's get a call on the books so we are on the same page - https://calendly.com/pmccrann/15min
Let's get to work!
~ Coach P
Ps here's how to set up your Strava account if it helps at all so you and I can connect... http://members.endurancenation.us/Resources/Wiki/tabid/91/Default.aspx?topic=Strava+Central
One thing though, I do have another race that didn't seem to get logged in the system-- I'm also doing the 70.3 in Mont Tremblant on June 24, which may affect where I go after swim camp.
Otherwise this sounds great!!
When you do get back, we could use a swim camp as a transition point to get back into exercise before jumping into the full plan a little early. But let’s see how you feel when you get back.
So--I just did the long silent scream that is transferring WKOs for the season into training peaks
Monday is a rest day and then you might want to load of the last week of the 70.3 plan to make that happen. Then it’s back to the full plan to get you into Canada!
So far this week I started back into week 13 of JOS, but am wondering whether to modify from the original plan of starting swim camp after week 14 of JOS before diving into the IMFull plan. TBH I'm a little bit un-psyched about swim camp for a couple reasons-- one is the volume goes way down to ~6h/week and I feel like I just had a big training break. Two is that I have a concern about radial nerve injury due to an extra rib, so I would like to ease into the swimming volume rather than go from essentially nothing (a little bit of cord work only) to 3 swims and ~7k yards in a week. I did 1800 yards today and may try to get in a second short swim this week to start that easing process.
I'm ready to roll, want to have a killer season this year, and am ready to work! Let me know if you have thoughts on how to proceed.
That issue with your rib sounds spectacular and uncomfortable, you’ll have to tell me about it in our next call. In the meantime, let’s ramp up that swimming slowly. We can use these to “transition” weeks to make sure you get back on the right path in the water. At the end of the day good some frequency is just great for total body health and comfort on race day… It’s not usually a critical success factor. That run durability that you’ve been fostering is significantly more important!
2 questions- wondering about tapering (and not going insane). In 2016 I lost about 18 TSS points and my form was at +32. Is that in the range of what I should go for or too much? I felt really rested, but hard to know if I lost more fitness than needed--I think I would only know if I hadn't rested enough and that's not an experiment I want to do!
Also, just for curiosity, this year week 18 of the plan only had 2 long rides on it instead of the three in previous years. Any specific reason for removing the third ride? Too much?
Thanks, can't wait to race!!