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IMAZ looming and diagnosed with Plantar Plate Tear and 2nd MTP Dislocation Syndrome and doctor advis

I have been dealing with issues with the 2nd metatarsal in my left foot.  It's been an issue since February or so.  I have just been dealing with it.  There's constant pain but nothing to bad and it bothers me while running.

I had hoped the 5-6 weeks of not doing a damn thing resting between the Syracuse 70.3 and the start of my IMAZ training this week would cure it but it did not.  Apparently I should have gone to the doctor sooner.

Yesterday I saw an orthopedic surgeon who specializes in sports injuries related to the feet.  X-rays and other tests were thankfully negative for fractures and other major structural damage.  The diagnosis was a Plantar Plate Tear and 2nd MTP Dislocation Syndrome.  His treatment plan was 30-45 days of anti-inflammatories, splinting my bad toe to the toe next to it 24/7 for the foreseeable future, ice, stretches and no running for 4-6 weeks.  I have a follow-up appointment in four weeks.

I'm not in great running shape right now since I had not been running for 6 weeks.  Tacking on another 4-6 weeks of running is a problem as that would give me only 8-10 weeks to get into IM running shape after not running for nearly three months.  Continuing to run isn't really going to make the injury worse per se... it just isn't going to get better.

The options as I see them regarding the no running thing:

  1. 100% follow the doctor's orders.  I can just swim and bike like a maniac and hope for the best when I get back to running.  Maybe mix in some elliptical training although the thought of spending anything over 30 minutes on the elliptical machine sounds about as appealing as getting waterboarded.
  2. Stop running for a couple of weeks and see how I feel.
  3. Continue to run and deal with the healing process after IMAZ.  I have sucked it up for the past six months so what's another three months and change???

Or am I putting way too much emphasis on the fact I will "only" have 10 weeks of run training for IMAZ... as in it's not ideal but not that big of a deal. 

Comments

  • Posted By Bob McCallum on 09 Aug 2012 03:17 PM

    ...Yesterday I saw an orthopedic surgeon who specializes in sports injuries related to the feet. ...His treatment plan was 30-45 days of anti-inflammatories, splinting my bad toe to the toe next to it 24/7 for the foreseeable future, ice, stretches and no running for 4-6 weeks.  I have a follow-up appointment in four weeks....The options as I see them regarding the no running thing:

    1. 100% follow the doctor's orders.  I can just swim and bike like a maniac and hope for the best when I get back to running.  Maybe mix in some elliptical training although the thought of spending anything over 30 minutes on the elliptical machine sounds about as appealing as getting waterboarded.
    2. Stop running for a couple of weeks and see how I feel.
    3. Continue to run and deal with the healing process after IMAZ.  I have sucked it up for the past six months so what's another three months and change???

    Or am I putting way too much emphasis on the fact I will "only" have 10 weeks of run training for IMAZ... as in it's not ideal but not that big of a deal. 



    Bob - you went to the trouble (and ?expense) of finding and seeing a physician with the training and experience specific to your area of concern. You need a very good reason to avoid following his advice. You've already lost a major part of your run fitness; another 4 weeks off is not going to make that any worse.

    Can you finish an IM on 10 weeks of run training? Absolutely. WIll you race at the speed you'd have if you'd been training for 10 months? Absolutely not. It wil/ also hurt - your quads more than your foot, probably. But you will be able to run the whole way (assuming you get medical clearance) and you will be able to finish. If you had four more weeks of training, I don't think your performance on race day would be any better.

    Tendon tears take 8-12 months to heal completely, IIRC. Unless you give it that long, recovery and racing will inherently present problems in terms of training restrictions and pain. I've had similar PF issues twice, and it was 6-8 months before the pain went away, no matter what I did. I just lived with the diminshed ability to train at hard efforts and slower speeds in races. But I never bothered to see a doctor. Who knows what I might have been told.

     

  • Well... to put your situation into perspective I injured my foot in January, took 3 months OFF totally, water running or elliptical only (btw, you can make the elliptical less painful with intervals, keeps thing short and sweet and the intensity high!) started back running in March VERY SLOWLY, and got back mostly into things with 8 weeks to go to my A Race, IMC in 2.5 weeks. The water running/elliptical did help keep SOME fitness, but I was a lot better off resting it and letting it heal. I don't have the best situation heading into IMC, but I am healthy (as Coach P so emphatically insisted I prioritze that key element, I say it a lot now!) I found trying to run with n injury I started to compensate and other things were getting injured... not fun.

    Personally, I do not think continuing to run is smart, nor will it help you in the long run. Change your focus to the bike, take 5 minutes iff your IM swim, and deal with getting the run back next year. IMHO. Good luck.
  • Pool run !

    If done right,  the fitness received is almost as good as land running.

  • At the risk of repeating myself, I had an injury that meant not running and I had a race in 5 weeks, so I water ran. I spoke with Coach P and worked on a plan. I managed to do my race and run (use that word loosely) the half marathon.
  • Okay... best option is to follow the doc's advice. 

    Obviously my training plan needs some tweaking to compensate for losing the run.  I do the typical 3S, 3B, 3R routine for 9 workouts per week.  I also limit myself to 12-13 hours per week training.  I was thinking of going to 5 bikes and 4 swims until I'm cleared to run.

    Probably something along the lines of...

    M: Swim for 60 minutes

    Tu: Bike for 60 minutes

    W: Bike for 60 minutes, Swim for 60 minutes

    Th: Bike for 60 minutes, Swim for 60 minutes

    F: Bike for 120 minutes

    Sat: Swim for 60 minutes

    Sun: Bike for 240 minutes

    Given those parameters - how should I structure the bike workouts?  FTP sessions for the 60' rides, ABP type ride for the 120' and typical long ride for the 240'???

  • Looking ahead to when I can run again...

    I should have 10 weeks of run training prior to IMAZ but that's after about 10 weeks of no running. How should I build my runs so that a) I don't screw myself up by going too long too soon and b) so that I have some modicum of run fitness? My plan was a sub-4 run but I just have no expectations now. It's not like it's a crippling injury and I should be able to jump back into it but my run legs are definitely going to be a little rusty after a 10 week layoff.

    So let's say I really only have about eight weeks of good run training before hitting a two week taper. Opinions are welcome on how I should structure my 3-4 run workouts per week for those eight weeks to maximize run fitness (not necessarily worried about speed) given the cards I have been dealt.
  •  Why aren't you pool running??!!

  • Running in place in the pool for any length of time sounds a 1000x worse than a treadmill... and I hate the treadmill.
  • Eat your broccoli and run in the pool. It’s all good for you.
  • @Bob, I'd go to 4 bikes / 4 swims. If you are tying to keep your hours down you don't need to do a ton of riding. So:
    Mon Swim
    Tues FTP bike
    Wed Swim
    Thurs FTP Bike, Swim
    Fri - ABP Ride
    Sat- Swim
    Sunday - Endurance Ride

    In addition to that I would be working on core / functional strength b/c you have time. Also want to watch body comp. What others have said re pool running, it's mindless stuff but given the alternative (Starting from scratch in 4 weeks) that's even more unpalatable to me (as a coach).
  • I'm going to hit the elliptical next week. I just can't do the pool running. It's mind numbing.

    I have been doing more stretching and core stuff. Thanks for the advice.
  • Bob, you should of discussed this with me when I saw you at Tremblant. I have a great program that is all intervals and in no way mind numbing.
  •  I wasn't at IMMT. 

  • I should be able to start running this week. I'm going to go for an easy run tomorrow to see how it feels. I have a follow-up with the doctor on Wednesday. Regardless... I'm going to be running and I can take more time off to heal starting November 19th.

    I did break down and did some aqua running the past couple of weeks. It wasn't as terrible as I remembered so I'm thinking about incorporating some aqua jogging into my training regimen. Thinking of breaking up my long run into 2:00 normal running and :30 aqua jogging to lessen some of the wear and tear on my foot.
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