Getting to know your injury

Looking north from Crackneck during yesterday's run

All regular runners, or at least those past the age of 40, have those injuries which are "old friends".  They may be there all of the time, or only occasionally, but the symptoms have become very familiar and you have learnt what can be tolerated and what is becoming serious.

In my case, I have a right knee, right heel and lower back problems that have been with me for many years.  The knee and heel hurt most days when walking or running (or even when typing this), while the lower back problem comes and goes.

Looking south from Cromarty Hill during yesterday's run

I now have a right calf problem (strange how it's all in the same leg......not!), that I'm learning how to manage.  In the last week, I have stepped up my mileage after resting the calf strain for a couple of weeks.  Since my blog post two days ago, I ran 22km yesterday (a bit of a struggle over the last 5km in very humid conditions) and a 12km today (relatively quick), conscious of calf stiffness, but without it affecting my gait in any discernible way.  Yet, while treating myself to the new Star Wars movie earlier today, there was spasmodic sharp pain in the lower calf while sitting, so there's something going on.

I'll keep running the higher mileage so long as the calf pain doesn't get worse, but I have a feeling that it's going to be around for a while.  Not long enough to become an "old friend", I hope.

Long runs needed

The You Yangs, where I plan to do a long run next Monday

It is now more than four weeks since I ran further than 20km in a single run, not a good situation for someone planning a 64km trail race in less than four weeks.  Not only does it make me suspect my physical fitness for an ultra-distance trail race, but also impacts on my psychology.  Throughout my running career, high mileage has brought confidence and results, and that experience is hard for me to ignore.

I'm still carrying a minor right calf strain that was aggravated on Sunday's run, and although I managed to get around this morning's faster 9km (after a 4km warm-up) without inflicting further damage, I could feel tightness and minor pain the whole way.  I will not start in the Bogong to Hotham (B2H) if there is any residual pain or stiffness in the calf, but also won't start unless I successfully get through at least two long (30+ kilometres) runs beforehand.  The first will be a training run next Monday, possibly in the Victorian You Yangs (near where I will visiting next week), and the second may be the annual Beyond the Black Stump FatAss Run near Berowra on New Year's Day.

In a perfect world I will manage both runs without problems and the calf will be pain-free by 10 January.  On the other hand, I have mentally accepted that I may not be able to run and looked up the last date for getting my money back on the race (27 December) and my motel booking (1 January).  As I mull over my options and fitness, it is becoming clearer in my mind that running well in the Six Foot Track Marathon on 12 March is more important to me, and is not something I want to jeopardise by running B2H when unprepared.

Maybe a misjudgment

Negotiating the mangroves bordering Riley's Bay

I took a chance yesterday and ran the longest and hardest run since straining my right calf in a race two weeks ago.  Normally I would assume at least three weeks recovery was necessary for a soft tissue injury, but with an ultra-distance trail race looming in early January, I felt the need to get training seriously again.

Though I started out slowly, and never felt like I was cruising, I got through the seriously hilly 14km run unscathed and at a reasonable average pace.  My mind was focused on my calf the whole way, but I couldn't detect a recurrence of the injury.

Traversing Maitland Bay

Now, I knew that running longer this morning might be tempting fate, and my initial plans were for an easy and flat 20km.  But when club-mates, Kirsten and Melissa, said that they were planning a no-pressure two hour run on trails in beautiful Bouddi National Park, I found it hard to resist and rationalised that that was the distance I was planning anyway.  Kirsten and Melissa are good company and friendly rivals of mine and I further rationalised that if I could get through two hours of running with them, I could consider my calf fixed and resume normal training.

The first few kilometres were no problem, though I was quite tired from yesterday, but then I rolled the suspect ankle as we traversed some mangroves and shortly afterwards hyper-extended the same calf when I misjudged a step.  From that point on I was conscious of some pain in the lower calf the whole way, though it moved around a bit.  I finished the run as intended, but the calf has since been somewhat painful.  I enjoyed the run, but should have stuck to my original plan.  Tomorrow I will just walk five kilometres, as I usually do on Mondays after a heavy running weekend, and am hoping that by Tuesday the calf feels normal again.  If not, I will be kicking myself.

Lack of patience

A wintry looking evening at Terrigal when I went for a short
evening walk

I haven't been able to feel any pain from my calf strain for the last five days, either walking or running (though my chronic right heel problem bothers me most of the time), but have stuck to my plan of increasing my running distance by one kilometre each day.

My base fitness should be good, given the last six months of fairly steady training, but even on these very short jogs I have been feeling unfit.  My heart rate has been barely going above 120bpm and my quads feel stiff and leaden.  It's probably all mental, but that matters too.

Potato chips were few and far between for the larine residents

I feel like I need to snap out of it, with Bogong to Hotham just a month away, but worry that the weakness in my calf is still there even though I can't feel it.  Today my impatience got the better of me, and though I stuck to the planned 5km run (plus a few kilometres of walking), I stepped up the pace with the goal of getting my heart rate a little higher and my legs moving faster.  I survived unscathed running the last 3km under 5:00/km pace and the last under 4:30/km, without really straining.  Pushing it up the last hill, I did wonder what I would tell myself if the calf tore at that point and whether I should quit while I was ahead, but I ran through to the end safely.

I can't say that the calf problem is behind me, and it probably isn't, but I needed a circuit-breaker to get my confidence up a little.  If there's no follow-up pain on tomorrow's easier 6km, I might try running the whole of the Trotters' 14km "Woody's Wun" on Saturday, but non-competitively.

Two types of runner?

Heading north along the Lake Front Trail towards downtown
Chicago

I sometimes think there are two kinds of runners - those who are happy to train on out-and-back courses and those who will always look for a loop.

When I pulled out of the Central Coast Half Marathon ten days ago with a calf strain, I ended up walking back along the course for an hour with another runner who had also pulled out.  She was from Chicago and I commented that I thought Chicago one of the most boring places to run.  She didn't agree and countered that it had the wonderful trail along Lake Michigan.  This is true and I'm very familiar with the trail from extended business trips to Chicago in years past and more recently visits to Sharon who is working there for a year.  The trail is scenic and extremely well patronised by runners, walkers and cyclists.

Looking south along the Lake Front Trail
[Photo:  Alanscottwalker]

As an occasional run, the Lake Front Trail is fantastic, but to run there every day would drive me nuts.  It obviously didn't bother my new friend, perhaps supporting my casual observation that there is a cohort of runners defined by their willingness to run out-and-back, often on the same route.  I know and have known runners who never give it a second thought.  So long as they are running in a safe and conducive environment, it's fine.

Personally, I avoid running out-and-back like the plague, and know other runners of like mind.  Psychologically, running out-and-back seems harder to me.  If I run a loop course, I feel like I am going somewhere.  Perhaps it is mentally more stimulating, but I doubt that it helps me train harder (though it may make training run more palatable on those days when it's hard to get out).  On the other hand, it could be argued that the runner going out-and-back is toughening themselves mentally whilst doing the same training.  There's no right or wrong.  It's just a distinction that interests me.

With respect to my current training, I have so far stuck to my plan of increasing my running distance by one kilometre per day this week.  Today I managed 4km of walking followed by 3km of running without feeling any pain in my strained right calf, though I already feel like I have lost fitness from two weeks ago.  Hopefully, sticking with the short-term plan will bring back the feeling of fitness without risking the recurrence of the calf injury.

Coming to terms

My walk this morning took me along the
Kurrawyba Lane

Hope of running the Bogong to Hotham 64km (B2H) in five weeks time hasn't totally gone, but I'm starting to come to terms with the likelihood that I may not be in the shape to beat the challenging 34km cut-off time during the race.  If the time doesn't look to be in my grasp then I won't run.

There's an almost constant analysis going on in my head about what are my priorities and the best way to achieve them.  Although I really want to run B2H, my most important race in the next nine months is the Six Foot Track 45km on 12 March.  The two certainly aren't mutually exclusive, but I don't want running in B2H to risk my chances in Six Foot.  This means not running B2H unless I'm in good shape.

Terrigal Beach was getting ready for a big day of
beach activities

The question then is, can I be in good shape in five weeks time.  It doesn't seem likely if I take off the usual three weeks for a soft tissue injury, as seems to be the problem with my right calf.  I need to get running again sooner rather than later.  Since the run on Thursday morning that brought renewed calf pain after 6km, I have walked 5km each day with no pain.  I can do single leg heel raises without pain.  This makes me think the injury can't be that serious.

So, I have a new flexible plan.  Starting tomorrow with an easy 2km jog, I'm going to increase the distance by a kilometre a day for the rest of the week and see what happens.  If the gradually increasing distance doesn't re-strain the calf, then my supposition is that there will be no setback to the repair process and I'll get to next week with a stronger calf and some running kilometres under my belt.  Another low kilometre week will then get me to the three-week soft tissue recovery time and I'll step up the training.

If at any time during this process the calf strain reoccurs, I'll back off, and write off B2H.

Looking for positives

View from Barangaroo during today's walk in Sydney

With just 500 metres to go on my first attempt to run since Sunday, my lower right calf suddenly started hurting again.  It was only a short run (6.2km) and had gone well up until that point with no pain at all.  I was just starting to congratulate myself on my injury management and plan the next few weeks training.  Then, in just a few steps, I went from optimism to frustration.

Sydney skyline from Barangaroo during today's walk

My first thoughts were that if I could just have completed the run pain free, then the injury would have another day of repairing, and tomorrow I would have had an even better chance of surviving the same short run.  More frustration.

However, later I could see a few positives from the experience.  Firstly, the injury is real and I had begun to fear it was just a niggle that could have been safely ignored in last Sunday's race.  Secondly, the "reinjury" this morning has only set me back a few days, not weeks.  And thirdly, when it happened this morning, I was near the end of the run and stopped pretty quickly so it's probably not as badly damaged as on Sunday.

Circular Quay during today's walk

The whole episode preyed on my mind all day as I walked around Sydney on a pre-committed day in town, and I think a week of walking followed by a week of short easy runs should be enough to get running seriously again without losing too much fitness.  I could feel the calf a little while walking in Sydney, but it wasn't too bad.  More like a cramp than a tear.

Perspective

Looking towards Wamberal on my evening walk

Sustaining a running injury is a "first world problem" unless you are a professional athlete.  I'm not minimising the impact an injury can have on someone who is dedicated to, or maybe obsessed with, running, but it all needs to be kept in perspective.

Terrigal this evening

That's what I have been trying to do since straining my right calf during last Sunday's race.  I had built up the importance of the race in my mind and really was upset at not realising my expectations.  It's a missed opportunity that may not be repeated, but it's not life-threatening, or even lifestyle threatening, and definitely not unique.  It's not hard to make a list of running friends who have had bigger dreams smashed in just the last year.  Nevertheless, it's hard to stop thinking depressingly about the race outcome, and I guess the hurt will last a while longer.

On the positive side, I'm now referring to my injury as a calf strain rather than a calf tear.  After being painful when walking on Sunday and yesterday, the pain is barely perceptible today, and I went for a gentle walk this evening.  I'm trying to avoid undue optimism, or resume running too soon, but if I manage walking without pain tomorrow and Thursday I'll try a short jog on Friday.  I would really like to do the Trotters Run on Saturday morning, because it's one I mapped and carries my name (Dave's Damn Run), but common sense tells me it would be a mistake to run with others so soon.

Tantalising failure

Feeling good at 5km
[Photo courtesy of Jenny Barker]

As I went through the 8km mark, gradually closing on a bunch of runners in front of me in today's Central Coast Half Marathon, I told myself that I just had to keep going like this for another 50+ minutes and I would have a good run.  I had avoided looking at my watch so didn't know what my pace was, but club-mate Melissa was one of those I was catching and I was pretty sure she was going to run in the low 90s (final time 92:26).

Then, on a minor corner on the winding bike path, I felt a little twinge in my lower right calf.  Twinges come and go all of the time at my age, so I concentrated on maintaining my form and hoped it would go away as most others do.  Five hundred metres later it was still there, and although I had easily maintained my pace, I was starting to worry that it might be more than a twinge.  It was now moderately painful on every step.  I ran another couple of hundred metres trying to favour the calf a little and loosen it up.  That didn't work, and I knew I had to make a decision.  I could keep running and it might yet go away - maybe just a minor cramp.  But it could also get worse and if I pushed on it might become a serious injury, taking a month or two to heal.

With great frustration, I decided the risks of continuing were too great, and the rewards too small, and stopped at about the 9km mark.  Then, I had a long walk back, sharing my misery with a girl who had also dropped out, until we were lucky enough to get a lift to the finish with club-mate Jenny who had been out taking photographs.

I'm disappointed and depressed.  Disappointed that I didn't capitalise on my fitness and see what I could run for a half marathon at present.  I can speculate, but that's not reality.  Depressed because I now fear the injury will significantly hamper my preparation for the Bogong to Hotham 64km in early January.

Eight hours later, the calf is sore walking around, though not acutely painful.  I hope my DNF has indeed saved me from a worse injury.  Nevertheless, history tells me that regardless of what therapy I employ it's going to be something like three weeks before it is whole again.  I know I've had a good run for six months and was overdue for a running injury, but that doesn't make it any easier.

Does it matter

The sun rises behind Terrigal Haven this morning
[Photo courtesy of Jenny Barker]

After supervising the usual Trotters track session as the sun rose at Terrigal Haven this morning, I headed out unenthusiastically for my own 10km run on a day forecast to be very hot.  Even though it was not that bad at 7:00am, the run was not enjoyable.  It was hard, on top of yesterday's lethargic short run, to believe I had any chance of running a good Half Marathon in three days time.  Even my chronic right heel was bothersome despite a light training week.

Experience tells me that I've done the training and that I won't run that badly on Sunday.  However, part of the reason it's all weighing on my mind a little is that exactly how well I run will impact my plans for the next nine months.  If I finish in a time that gives me any confidence that I could run a near 3-hour marathon in April, then I'll delay the start of my planned three-month hike around Ireland until after that marathon.  It's unlikely I'll ever have the chance, small as it is, to run that kind of time again.

If my time on Sunday gives me little hope of a sub-3 marathon in April then I'll give the marathon a miss and start my hike earlier - an attractive outcome because I am looking forward to the hike and early spring will be a better time to start.

I haven't booked any flights yet and also need to start on the detailed planning, so I need to make a decision one way or the other.  I'll be trying as hard as I can on Sunday and hoping that I'll get a clear indication.  Since both outcomes do have attractions, what am I worried about.

Strava

The Wycombe Road Hill

I felt very guilty running just 7km with the boys this morning after a 3km warm-up.  The traditional run includes an effort up one significant hill, which is logged on Strava, along with efforts up a few smaller ones.  I didn't feel that fresh warming up, but my legs didn't feel as tired as recently.  It was more a lack of flexibility and looseness that hampered my running, but I did feel stronger and neared my best time for the last few months for the climb up the Wycombe Road hill, though I have never run up it as hard as I can.

I'm only a recent convert to Strava, and really haven't got into it as much as I could.  I think there are a number of other well-known local hills I could identify as segments.  It is a bit addictive checking your own times as well as those of other Strava users on the segments, and does encourage you to try a bit harder than otherwise.

The run this morning finished with a couple of kilometres on the flat Terrigal Drive and I loped along at under 4:20/km reasonably comfortably, which was encouraging.  Hopefully, with another four days of easy training I will have loosened up some more.

Natural Bridges National Monument

Owachoma Bridge

When travelling the US and Canada for a year in a campervan in 1985/86, I had the opportunity to run in some places of awe-inspiring beauty.  Even though some of the runs were quite short, I still remember them well and an 8.5 mile run in Natural Bridges National Monument in Utah is a good example.

We were there in mid-January, the depths of winter at an altitude of 6500ft, and had the entire campground and National Park to ourselves.  It was cold and crisp, and I can remember standing outside our van after dark looking up at a brilliantly starlit night sky in absolute silence and stillness watching for satellites and the more frequent flashing lights of airliners passing noiselessly far overhead.

Kachina Bridge

There was a scenic loop drive through the park that we travelled earlier with overlooks to the three spectacular natural rock bridges for which the park was named.  The road was well-surfaced, undulating and roughly followed the edges of a plateau with occasional views into the bordering canyons.  The vegetation was mostly pinyon-juniper forest with plenty of snow on the ground.  I can just remember cruising around the same loop the next morning soaking up the scenery and solitude, and feeling privileged to have it all to myself.

For yesterday's training, I just walked 5km, and for today ran an easy 6.5km with my daughter who is visiting the area.  I did feel a little looser and fresher today, so maybe my taper is working.

Wake up call?

I skipped the run back along Wamberal Beach to Terrigal
and ran on the road instead

Yesterday's easy 6km jog was anything but easy.  It was humid, which didn't help, but I felt lethargic from the outset and my legs just didn't want to run.

Today's Saturday Trotters' run was Enzo's Edventure, a particularly challenging 15km to which my fatigued legs were not looking forward.  I told myself that once the adrenalin and competitive juices started pumping I would find that I wasn't as tired as I thought.  I ran 3km to warm up but still didn't feel very inspired and then when we set out on our "Edventure" I struggled up the early steep hills, further back in the field than I have become accustomed to recently. Reminding myself that I'm supposed to be tapering, and hoping that I would find it easier as I warmed up, I tried not to worry and just settle into a comfortable pace.

As the run wore on, I did start catching people, including some of the early front-runners, but never felt comfortable.  My legs feel strong, but tired, and I'm not moving freely.  I also felt some twinges in my hamstrings on some of the steeper descents, possibly sciatic, and there's an unwelcome stiffness in my lower back.  I wimped out on the last section along the beach from Wamberal and ran the road alternative, telling myself that cambered soft sand was unwise when my bad right knee was also hurting, but I was probably just looking for an excuse not to make the run any harder than it already was.  My time of 1:15:00 for just under 15km wasn't as bad as feared, but wasn't achieved easily.

I was going to run 20-25km easy on the road tomorrow, but now think the smarter strategy would be to do a much shorter run, or maybe just a walk.  I will feel guilty about missing a longer run, but it's hard to see how missing it will be detrimental to my fitness for next weekend's Half Marathon.  I definitely need to freshen up.

How important is running

Keith (in green hoops) just ahead of me in a 3000m race in
Hamilton, NZ, in January 1979.

I have a long-time friend, Keith, who was a talented runner in his prime and with whom I have run many miles over the past forty years.  He has struggled with a knee problem over the last decade that has severely limited his ability to run, and despite doing some swimming and cycling for fitness, is desperate to get back to running.  Like me, running has played such a large part in his life and self-perception, that its absence really is depressing.

Keith has tried arthroscopy and various other treatments, and can walk without significant problems, but misses his running so much that he has booked in for a partial knee replacement next week.  If you Google "running with a partial knee replacement", you can find instances of runners doing so successfully.  You can also find a study that suggests no difference in knee replacement failure rates after seven years between two groups, one of whom exercised more vigorously than advised by their surgeons.  However, I couldn't find any website where doctors recommended running, especially long-distance running, after a partial or total knee replacement.

Partial and total knee replacement diagram
[Source:  Wikipedia]

I'm concerned for the welfare of my friend.  Although I understand completely what is driving him to have this surgery, I fear that his post-op resumption of running will risk failure of the joint replacement and maybe even leave him worse off than at present.  However, I also know that I don't know what I would do in the same situation.  Given that I hope to keep running for many years to come and already have one knee with problems, I suspect I will find out at some point.  In the meantime, I have my fingers crossed for a successful surgical outcome for Keith, and do hope he can realise his ambition to resume running.