Nagging concern

Those were the days!  On my way to a Personal Best 14:26
5,000m in the 1977 Victorian Interclub A Grade Final

I ran a little harder this morning on my 10km to see whether my legs had loosened up at all.  The pace was faster, and though moving more freely than yesterday, I don't feel ready to run hard over a short distance as will be required in Saturday's club relay.  There's 48 hours to go, and with just light training planned, that may be enough to loosen up.

Getting a massage was suggested by a friend, but it doesn't seem sensible to try something new at this juncture.  I think I'm too "old school" anyway, and have a bias towards letting my body sort itself out.  I did resolve while running, however, to find out if there was anybody willing to take my place in the relay and am pursuing that option.

I also decided that if I am going to run, then I will warm up for at least 10km beforehand, including the planned run-throughs, and also that I won't try to run faster than a comfortable pace, particularly in the first kilometre.  After all, the event is just a bit of fun and there's not a lot riding on the result.

Managing the Achilles

Today's flat even road run passing through Avoca Beach
took the pressure off my painful Achilles tendon injury.

For a year now, whenever I have been able to run consistently for a few weeks, my right Achilles tendon has become painful.  Achilles injuries have been the bane of my running life.  I guess there were deficiencies in my genetic design and an addiction to distance running didn't help.

The only long-term relief I have experienced came from major surgeries in which the tendon was cleaned up, the bursa removed, a heel spur removed and a corner of my heel bone cut off.  This was done to my left heel in my thirties and my right heel in my fifties and on both occasions it took a long time to recover.  Two earlier, less radical, surgeries on the left heel only gave relief for a couple of years each time.

Today's run included this flat section
approaching McMasters Beach.

Of course, surgery is the last resort, especially if it's going to stop you running for more than a year.  To avoid surgery, I have tried just about every possible treatment  - ice packs, massage, cortisone injections, post-run cold running water, anti-inflammatories, stretching, orthotics, heel raises, shoe heel cut-outs, running on flat surfaces, avoiding hills, doughnut bandages, alternating shoes - apart from retirement from long distance running.  My conclusion is that none of these non-surgical treatments provides a permanent solution.

At best, they are delaying actions, and that's what I feel I have been doing with my current right Achilles problem.  For a while the Hoka shoes seemed to place less strain on the Achilles (but more strain on my bad right knee).  Now, even they don't seem to provide relief.  My heel became very sore on Monday's long trail run wearing the Hokas.  For today's 15km run, I changed back to my Nike shoes and stayed on the road.  The heel was sore but didn't get worse, although I was running slowly.

I really don't want to have more surgery, so I guess I'll keep trying most things that provide temporary relief, short of cortisone or anti-inflammatories.  They just mask the problem while you do more damage.

Murray Marathon

I just walked 5km today, again with no problems, and even jogged the last 100 metres to see how it felt.  I'm seriously thinking of jogging a few kilometres tomorrow, ever ready to stop if anything feels amiss.

In years gone by, when I couldn't run because of injury, I often tackled other endurance sports.  Browsing through some old magazines, I found this article I wrote for the Victorian Marathon Club Newsletter published in June 1985, about my first attempt at the Red Cross Murray Marathon (now run by the YMCA).

MISERABLE MURRAY MARATHONING

The start of a recent Murray Marathon.

Following my third left Achilles tendon operation in April 1984, I found myself under doctor’s orders to do little or no running for six months, the first two of which were to be spent on crutches.  After these two months, I abandoned the crutches for a bicycle, and after one more month, combined the cycling with a little jogging.  The combination didn't work and I found myself with a stress fracture in my left foot and orders to stay off my foot for six weeks.  So it was off to the Richmond pool for a mile of slow freestyle each morning - terribly boring.

After the required rest period passed I began jogging, but aware of the Byrnes’ penchant for sometimes slightly overdoing things, began to look for some other form of exercise to combine it with.  Then, brainwave (!), I would start canoeing and enter the Red Cross Murray River Canoe Marathon, a long held ambition of mine.  Inquiries revealed that entries for the five-day, 404km event from Yarrawonga to Swan Hill closed at the end of November, giving me a month to decide whether I could do it and a further month after that to sharpen up.

Competitors in a recent Murray Marathon.

By following up personal contacts I borrowed an old white-water kayak (stable, slow, difficult to steer) and entered my first race, a 20 miler, a few days later.  I never discovered where I came but I didn't fall out!  Soon after, Phil Hamer, an ex- Box Hill marathoner, lent me a touring kayak (TK1, unstable, faster, easier to steer) and I plunged into daily training.

Two weeks later I strained some ligaments in my upper back quite badly and had to give away completely all paddling and running for two weeks - I even had difficulty walking.  My illusions of being competitive with the best rapidly faded and it looked unlikely that I would be able to participate at all.  However, frequent physiotherapy got me back on the water and road in time for four more weeks training.  I should admit to falling out of the kayak into the lovely Yarra more than once in that time.

Competitors in a recent Murray Marathon.

Barb and two of her girlfriends agreed to be my land crew (together with one of their two-year old daughters) and we arrived in Yarrawonga ready and rarin' to go at Lunchtime on Boxing Day.  The remainder of the day was spent registering, checking equipment and some practice paddling.  After watching a few of the novices fall out in front of the assembled crowds, I refrained from the latter.  Equipment was in large part dictated by the hot sunny weather and comprised sunglasses, Arab-like headdress, pyjama pants, long-sleeved top and chamois gloves.  Into the kayak went two 2-litre drink containers from which long plastic tubes were connected by safety pins high on my chest so that drinks could be taken without stopping paddling, a mandatory life jacket (not worn) and a container of jelly beans.  My seat had two layers of foam rubber as well as a sheepskin cover.

Day 1 dawned bright and sunny and I arrived at the start with minutes to spare after watching some of the earlier, slower classes get under way.  There were 500 paddlers in 300 canoes, 69 of which were in my class - the Men's Open TK1.  Water turbulence caused by the frenetic early paddling was my biggest problem as the starting gun boomed and I only just avoided tipping out whilst dodging a capsized competitor.
The key to marathon paddling is 'wash-riding', i.e. sitting right on the tail (only inches away) of another competitor and effectively surfing on his wake.  This technique reduces the paddling effort required by about 10% but takes careful concentration and occasional sprints as the leader (who, not surprisingly, sometimes objects to giving people free rides) surges to get away.  I resolved to spend as much time as possible wash-riding and every time a TK1 passed me I would detach myself from one kayak and attach myself to the new one.  By paddling hard and wash-riding I found myself well-placed after 60km when some of the short-comings of my paddling technique began to manifest themselves in my right wrist, which swelled up, turned red and blue and became extremely painful - tenosynovitis.  I struggled on for the last 32km, finishing 14th for the day.

Day 2 was even longer, 96km, and soon after the start I damaged the deltoid muscle in my right shoulder and was reduced to virtually one-armed paddling.  Each day's paddling was divided into four or five checkpoints about 2 hours apart (with a medical post half-way between each).  Just prior to the first of these, five TK2’s (two men) swept past me creating waves which my weakened condition couldn’t cope with and I fell out much to my embarrassment in front of the assembled hundreds.  The day continued to deteriorate.  I felt I had reached the low point of my life - limping from medical post to medical post, administering ice packs, receiving massages, scoffing copious Aspros, falling out and generally wishing I was dead.  Only the embarrassment of sending my caring land crew back to Melbourne after 1½ days prevented my withdrawal.  After 10 hours I finished - 54th this time - dreading the next three days.

Day 3 is a bit blurred in my memory though I do remember falling out once for no particular reason in front of a group of fishermen.  The intensive medical treatment continued, and as I grew gradually used to my disabilities, my average speed improved.  Withdrawing, though pleasant to contemplate, was not an option since ex- Club member Mike Hall and his family and Ray & Marilyn Wilson were expected in Echuca, the stage finish, to see the spectacle.  I was 37th for the day.

Day 4 began with some optimism and I actually chased a few canoes to wash-ride.  The optimism was misplaced.  I strained the ligaments in my back again after four hours and limped across the line 24th for the day.  It was only the conviction of the doctors that none of my injuries would lead to permanent disabilities if I soldiered on that kept me going.

Competing in my second Murray Marathon
(possibly 1986).

I set out on Day 5, the final day, intent only on survival, slowly paddling down the river until, 20km from the finish, the old competitive spirit surfaced again.  In the distance in front of me, I spied another TK1 and set out in pursuit.  Unknown to me, he in turn was pursuing another TK1.  Two hours later, the three of us were together - exhausted- and straining for the finish 3km away.  The last 200m was a mad sprint (I nearly fell out twice) with me taking the silver medal in our little trio.  After 37 hours of paddling I came 32nd in my class and was a physical wreck, unable to even lift a toothbrush with my right arm.  Two and a half weeks passed before I would jog again.  The finish of the race was followed by a presentation and huge New Year's Eve in the Swan Hill Showgrounds.

The Red Cross organisation was superb.  In addition to the medical posts a large medical centre operated at each campsite until 10pm at night and from 5 .30am each morning where queues could be found for massages, physios, doctors and repairs to hands, bums, wrists and miscellaneous.  On the fourth night the team of about 12 masseurs massaged over 400 paddlers.  Including land crews and officials, the camp totalled near 3000 people, yet the special teams of volunteer marshals wearing colour-coded jackets ensured that everything worked smoothly and no-one got lost driving between check points.

To ensure no paddlers missed the start each day (the slowest left first at 7 .00am) the organisers kindly drove a loudspeaker van around the campsite at 5:00am playing 'Morning Has Broken' and 'Always Look on the Bright Side of Life to the accompaniment of unprintable shouts and comments from roused paddlers and land crews.

No canoeist could complete the course without the aid of a land crew and I owe a great debt to mine.  The girls nursed me through each day, literally lifting me out of the canoe at check points, filling drink bottles, administering 2-3 Aspros each time and a couple of handfuls of jelly beans, massaging shoulders, offering words of encouragement to unreceptive ears and spending long hours driving and waiting in the hot sun.  Even after they had lifted my disabled body from the canoe for the last time each day they still had to put up the tents and prepare the meals whilst I lay down or sought medical treatment.  I can't say it was a pleasant experience but it was one not to be missed and I will be back - better prepared and more competitive - in a few years time.  Even the land crew said they'd come back though Barb thought it might be easier to be a paddler next time.

Perseverance is not always good

Deep Vein Thrombosis is the formation
 of a blood clot (thrombus) in a deep
 vein, predominantly in the legs.

There are whole worlds out there that I know little or nothing about.  I'm a bit of a current affairs nut, and an avid reader on a wide range of subjects, but there's nothing like a new injury or illness as motivation to expand your knowledge of a subject.

During my running life I have had serious injuries to my Achilles tendons, knees and lower back, as well as the usual torn and strained muscles, tendons and ligaments.  In each case, I've learned a lot about those injuries, including through missteps I have made in dealing with them.

I like to think that my own experiences allow me to offer soundly-based views on the running-linked injuries of friends when asked.  In the case of soft tissue injuries, I generally advise patience and the avoidance of activities that worsen the symptoms.  If something seems more serious or inexplicable, I usually suggest starting with a doctor.  They have a range of diagnostic tools at their disposal and a broader range of knowledge about the possible causes than ancillary or alternative health care professionals.  I'm not a fan of starting with the latter because I believe their field of knowledge and the tools they have available make it less likely they will consider all of the possible sources of a problem.  This can lead to misdiagnosis and a delay in recovery.

Pulmonary Embolism  is a blockage of the main artery
of the lung or one of its branches by a substance
 that has travelled from elsewhere in the body
through the bloodstream (embolism).

In the last two weeks, through doctors, the Web, and articles given to me by others, I've become a lot wiser about the subjects of Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE) and Atrial Fibrillation (AFib), and their associated symptoms, treatments and prognoses.  Of course, there's much more I don't know about these subjects, but one thing I have learned is that runners need to be much quicker in seeking the opinion of a doctor if they start to feel inexplicably short of breath, dizzy or light-headed, or experience chest pains, hyperventilation or persistent leg pain.  There can be life-threatening medical conditions underlying these symptoms and endurance runners are at higher risk of developing them, especially if they have a long background of endurance training.

Atrial Fibrillation is the most common cardiac arrhythmia
(heart rhythm disorder).  The normal regular electrical impulses
generated by the sinoatrial node are overwhelmed by
disorganized electrical impulses usually originating in the
roots of the pulmonary veins, leading to irregular conduction
of ventricles impulses which generate the heartbeat.

Many runners, and particularly males, think seeking medical advice about these symptoms is a waste of time and/or a sign of weakness.  All endurance athletes get used to dealing with fatigue and injury "niggles" and there's a strong temptation to dismiss them as a "cost of doing business".  Two friends, both distance runners, have recently been diagnosed with PE, but only after persevering with their symptoms for much longer than me and ending up in hospital emergency wards.

I will now be quick to advise any runners suffering from the symptoms described above to urgently seek the advice of a doctor.  Early intervention is important and delay could be fatal.  It's just not worth the risk of persevering.

After mentoring this morning's track session at the Terrigal Haven, I walked for about 6km, feeling fresh and healthy the whole way, and wishing I could be running my usual post-track session 11km.

Massage, or not

Flexibility was never one of my strong points.  Here I'm
comparing capabilities with friend, Bill, after a long run.

An accomplished marathoner, and fellow Trotter, Melanie, has suggested on several occasions that massage might help my arch problem.  She has been suffering from a similar injury and found that deep massage of the arch has made a difference.

I have had mixed experiences with massages over the course of my running career.  The earliest experience I can remember was a positive one.  I had developed a painful knee while living and running in London in the mid-70s and a visit to Ted Chapple (sp?), a well-known sports masseur, was recommended.  He manipulated the knee, and had me adopt various positions to test the pain levels.  He then asked whether I had been doing any slow running. In fact, I had been encouraging my then wife, Barb, to tackle some longer distances in her running and we had been jogging up to 25km together on some evenings.  Ted worked on my quadriceps for a while and suggested I increase the pace of my running.  I did, and the pain disappeared almost immediately and didn't come back.

My next experience of massage was less positive.  I had been trying to manage chronic Achilles tendon pain in my left heel and was getting desperate.  Friends suggested I make an appointment with a well-known sports masseur, which I did.  It turned out to be one of the most memorable experiences of my life.  The masseur located the most painful spot on my heel and proceeded to vigorously massage it with his thumbs and fingers, telling me that he had discovered a knot which needed to be broken down.  I almost had tears in my eyes by the time he finished and I later learned that there was a calcification on my heel which was rubbing on the tendon, inflaming it and the bursa.  The masseur had been pressing on the calcification, and there's little doubt in my mind that he made the injury worse rather than better.  I later heard that the same masseur had been working hard on the site of another runner's injury, causing him excruciating pain.  The runner begged him several times to stop, which he didn't, and the runner finally sat up and punched the masseur!

Since that time, I have tended to avoid therapeutic massage unless recommended by a doctor.  My view is that any injury that appears to be chronic or structural needs to be assessed by a doctor, probably with the use of appropriate scans, before enlisting the aid of other health professionals.  This is the course I have followed with injuries over many years.  I have benefited from the services of masseurs on a number of occasions, but rarely make them my first port of call for injuries.

On the other hand, I don't have any problem with massages designed to relax muscles and tendons as part of a training program or post-race recovery.  It's more the use of massage to promote the repair of specific injuries that I avoid without first getting a doctor's recommendation.  This is just my personal opinion, and I have many athlete friends who happily rely on masseurs or physiotherapists for the treatment of injuries and tightness and are pleased with the results.

I walked about 3km this morning, wearing my new insoles, and did feel less discomfort and a little more positive that I could continue walking for exercise while waiting for the injury to heal.