Tibial stress reaction 9 weeks out from Kona
I just got back from the doctor. I'm 9 weeks out from Kona. I've had mild shin pain on the front inside of my left shin for about a month. It never actually hurts to run or walk, but it's tender to the touch for about an inch in an area three inches above my ankle and I notice it while running. Does that make sense? It doesn't affect my gait, and I don't wince in pain, but I can definitely tell it's there. Until this week, it hasn't slowed down my running, but I wanted to get it checked out. The MRI showed a tibial stress reaction, but not a full-blown stress fracture.
This is my one chance to do Kona. I got a lottery spot, and don't see myself qualifying anytime in this lifetime or paying $60K for a charity spot. My main concern is to get to the starting line able to hobble to the finish, if necessary. If I end up with a full-blown stress fracture on Oct. 9, it's worth it to me. I'll bring a removable cast with me for the trip home (only half joking). I've got all winter to recover.
The doc said to cut way back on the running, but not to stop entirely, and to stop the high-intensity stuff. No restrictions on swimming or biking. I'm OK with that. It's hard for him to give more specific guidance, though, do to lack of familiarity with IM training. Any thoughts on how to modify the EN plans? I plan on sticking to gravel/dirt as much as possible to lessen the shock, and he said brisk walking is fine (which is good because I've got a puppy who needs to get out). Elliptical is OK. Any thoughts on frequency vs. duration? In other words, 30 min. easy runs 4x week vs. one hour 2x week? I'm planning on making up the lost running time with extra biking and a fourth swim each week. Or should I be doing the elliptical or aqua jogging? I ran for almost 2 hours last Thursday, and have been running 90 minutes or more each week for the long run for about 6 weeks.
Any guidance or just anecdotes would be most appreciated. I'm in a funk about this. I know people show up undertrained due to injury and do much better than those who try to stick with a plan and blow themselves up in the process. I accept that intellectually, but it's still hard to internalize it.
My overall fitness right now is pretty good. I'm swimming faster than I ever have (time for an all-out 100 yards has gone down from 1:20 to 1:16), and did a 4.4 mile swim race in June, so the endurance is there as well. I ran a 3:13 marathon in December, and despite not doing an OS (I wasn't planning on an IM this year until the Kona lottery came through), my run is as good as ever (apart from the tibia!). Biking is at least where it was for Lake Placid last year.
Comments
Here's what I recommend from an Orthopedic Surgeon/Ironman:
Psychologically plan on either walk/jog or walk the entire Kona Marathon....the whole goal here is being able to walk. IF leg pain gets bad enough you cant walk we have problem. ANYthing you do until Kona must be modified based on pain and swelling so you can AT LEAST walk the marathon.
IF your training and you have pain and swelling. Shut down the walking and jogging.
Here's what I recommend:
1. I agree with as much swimming and biking as you can. I agree, go to 4 workout a week.
2. Run/walk only 3 days a week (you have plenty of base and ability)
3. Running/jogging is allowed only if pain does NOT increase during or after.
4. You could do more water jogging to subsititute for outside.
5. You as cushioned as shoe as you can buy
6. NO CEMENT or asphalt. Just soft surfaces, soft track, good trails, good grass, etc.
7. Plan: 2 x/week do 30minutes of walk/jog and then 1x/wk a walk 1hr to 2.5 hr ONLY if pain doesnt increase. Plan a route close to home so you can abort any time. I would maybe start out just walking, if that goes OK, then add some jogging.
8. NO speed work. ALL slow. Remember you must be able to cover 26.2 mile NO matter how slow.
IF more questions, PM me anytime. YOU will do this, but we must be smart and very conservative about this.
I had a stress fx 9 weeks out from IMCDA and pool ran for 6 weeks and did the IM, ran almost the whole way. Not at all injured after either!
Carrie
I agree with Carrie:
Water jogging is great substitute if you have access to equipment to do it.
There is NO PERFECT solution here. Alot of Empiric/trial and error stuff here.
"Less is more" is a fine adage that will work here.
The other thing that scares me is that my life may be turned upside down over the weekend. I'm a lawyer for Verizon, and the labor contract with our unions expires Saturday night. I've been "trained" to install/repair phone lines, which involves schlepping an 80 pound ladder and climbing poles. We're supposed to work 12-hour days with no days off for the first 10 days of a strike, then go to a 72 hour week after that with six days on and one day off. I don't think anything acute would happen, but I don't think I'd get much healing done when on my feet all day in heavy boots. My doc said he'd write a letter to try to get me out of it, but it seems odd to be raising an injury that prevents me from working at the same time I'm training for an IM! Even if I get out, I'd be stuck in a call center 12 hours a day. Either way, my training would be shot to hell just based on time constraints.
Coming from this industry, I'd use this stress 'fracture' as an excuse to get out of contingency work. But I hate the whole concept with every ounce of my being. But that's just me.
If you can't run with your own body weight, how on earth could they expect you to schlep all that crap around and be on your feet all day. They can't, if you ask me!
Call center is better than install/repair work, IMHO.
I was pain free from a full blown stress fracture at 6 weeks and 2 days (at age 43, which I think is supposedly pretty good as these things take longer I think as you get older) so I have to believe the ultra sound and calcium/D helped. I also did pool running. I felt pretty out of shape in my first 5 minute test "run" when pain free, but have snapped back after about 2 weeks of slowly upping the time. and 2x stay OFF the pavement.
GOOD LUCK!!!
Keith,
In Kona 2003, I was throwing up on the bike before the airport 100 miles into the bike. My body was in meltdown-(pre EN) and I almost fell off my bike from the dry heaving. I got to T2 and collapsed in a chair. 20 minutes in T2 and I started to walk. I walked the entire marathon and finished in 14 hours. So walking the marathon is possible with lots of time to spare. I am not proud of my time, but I was in a really dark place in T2, and I somehow willed myself to get off that chair. I am proud that I finished and gave the best that I had on that day.
I would get really fit swimming and biking. I would look at pool running. I would get AQX shoes for your pool running. They are meant for the pool and have wings on the sides for added resistance. There is 2 types of pool running Deep water where your feet do not touch or barely touch the bottom of the pool. Shallow is like running through the surf with lots of resistance and the water comes up to your waistline. If you can get some open water swims and work on your sighting skills. Better yet if you can get some ocean swims with the waves, currents, and assorted sea life!!! YOU ARE GOING TO DO WELL. If you execute on race day (not like me), you will do fine.
I've run every other day, starting last Saturday with 20 minutes on a cinder trail. 30 min on Monday on the rubber track. 45 min. on the treadmill (+15 on the elliptical) on Wednesday. 32 min. this morning on the track until I felt a little twinge, so I stopped, but felt fine immediately thereafter.
Whatever plan I'm doing is not really EN anymore, but I'm OK with that. Last week I only got in 8 hours of training. (45 min. swim or bike before work, two days off, and a 4 hour bike ride on Sunday.) This week, I should get in 13-13.5 hours.