Thursday, February 24, 2011

Injured

Since December 4 2009, I have ran at least two miles everyday...

That is until today.

Being durable with my running is something I have taken pride in for much of my running career.  I have always been able to recover from hard workouts, races or long runs fairly smooth; holding up to 100+ mile weeks for several months straight is not uncommon for me and it is what I love to do.  In fact, the only time I can remember taking a day off from running for being injured was during the summer of 2009 when I tried to hurdle a down tree in the forest and I didn't quite make it.  I busted my bursa sac under my knee - after one day off I was back at it.  The only other times I would take off was after a season when coach recommended a week or two off to recover.  

My Achilles Tendon has been hurting since last Monday, Feb. 14.  Yesterday, after 20 miles for the day, I was grimacing so bad that I ended up walking the last mile back to my house.  It was no longer fun to run and the pain was the worse pain I've ever experienced while running.

I went into the trainers room and talked with Boggs this morning.  He let me know my achilles was inflamed/swollen bigger than he has ever seen an achilles.  After about 30 minutes of talking while he was ice massaging, he said abruptly, "Mike, I know this might be hard for you, but if you keep pushing it like you have been you could risk rupturing that thing and you'll have to get surgery and be out at least 9 months recovering.  Why not take some days off from running and it could heal completely?"

It was basically the same advice he gave me last week when I first showed him my inflamed achilles.  When he told me Achilles Tendinitis was all it was, I shrugged it off because I just thought tendinitis was something that came and went real quick.  I just told myself, "just run through this like the last nagging pain, it will go away...."

Well, it never really went away.  Here is a picture I snapped a little while ago:
It is the left achilles (even though the right one looks more alien-like).  Swelling makes the tendon look like it's not even there. 
Taking today off was not easy but after the end of yesterdays run, I knew I could not handle that type of pain much longer.  Plus, Boggs' hallowing words about getting surgery and taking over nine months to recover real hit deep with me.  There is no way I want that and maybe, just maybe taking a few days or more will lead to one healthy left achilles.

How many days I will take off? I have no clue.  Maybe I will wake up tomorrow and feel 100% and go for 20 miles.  That is what happened yesterday.  I felt good enough to run and I ran 20 miles.  Then the chains fell off.  Maybe it will be a whole week or maybe two.  I hope it doesn't take that long...

So, after spending the majority of this new year averaging about 20 miles a day or about 2.5 hours, I ran 0.  It certainly gave me a lot more time to just do nothing - thinking was what I did the most.

I started to think why I got injured.  Over-use is something a lot of people keep telling me.  But I still will not buy into that excuse completely.  I spend 22 straight weeks and 32 total weeks at 100 or more miles in 2010 and never once had a problem physically.  On the other hand, I never went above 130, which I have now did 5 times in 2011 alone.  Maybe I hit the tipping point with mileage.  Maybe 151 was too much.

I also went back to a few days prior to my achilles first hurting.  On the 11th, I ran the indoor 5k at Cedarville in which I went sub-15.  The next morning, I picked right up on my "ultra" training and did a hard 30 mile trail run.  The next few days is when I first noticed the achilles.  Before that, nothing... Then the past week I tried to fix it up with a lot of icing, but never really took it easy.  I even felt good Saturday morning and went for another 30 mile run, and it felt fine!

The stress caused by running around a 200 meter track 25 miles at a high speed plus 30 miles of strength running is a lot to ask a body to do.  I am not so sure I can blame over-use as much as I can blame the things or types of running I did in the middle of the many miles.  All in all, the cause of my injury is probably a huge combination of everything I have did in the past month ranging from running, sleeping, eating, etc...

From here, I don't know what I will do.  I planned on doing the Nueces 50 Mile race on March 5th.  That seems to be out of the picture now.  I will not completely rule it out as I would still race it if somehow I took a week off and I was completely healed.  The past year of fitness I have built will not be lost.  This came at a bad time.  I was really looking forward to Nueces.

Mentally, I am having (or I should say, will have) a hard time.  Running has been such a big part of my life and taking it away abruptly might not go so well.  Eating will not be the same.  Sleeping will not be the same.  But like I said, maybe somehow I will be good in a couple days and this post will be completely irrelevant.

With the way I feel currently and with the amount of swelling, this could be worse than I hope.

I would like to hear any advice from anyone reading this.  Has anyone dealt with an achilles injury?  Why do you think this happened?  What should I do?  Any natural/holistic/simple (or not simple) remedies for recovery?  Anything, let me know...

WMO

9 comments:

  1. Michael,

    I hate to hear this. I've been there myself with achilles tendinitis and peritendinosis back in '08.

    Rest, Ice, Ibuprofen 600 mg. 4x's/day for 1 week (if you're like me, you don't like to take meds, but you need to try to stop some of this inflammation), and keep the area mobile. Try to minimize your weight bearing exercises for a while though.

    I felt like the top part of the shoe heel was contributing to my problem, so I ended up cutting them off. Especially when there was still some residual swelling. You may not figure out the "cause", although I think your speculation is probably correct. Our bodies cerainly have an overload breaking point.

    Listen to your body, you'll know when you can go again. Forget about "getting in your miles" or about any certain races; just see how quickly you recover. Don't worry about what everyone tells you when they say, "dude, I dealt for this for X amount of time!". . . blah, blah, blah - you don't need that, you are an experiment of one and this may end up not being a big deal for you.

    Lay off the running until you're sure it's close to 100%. Get on the bike and/or pool to maintain fitness and you might just be back better than ever!

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  2. Sorry to hear that your running streak had to come to an end. I look back on my own streak and there are times that I probably should have taken time off as well, but didn't and it certainly prolonged the recovery process while also limiting any reasonable training.

    Hit the elliptical in a few days, a bit of biking, deep water running and core work. Good time to focus on those things.

    So many reasons why it could have happened and a good time to reflect on your training log. Just a quick peak and my thoughts would be that you might need to incorporate a couple of lower volume days and easier days into the mix (ie Mon and Fri's). This doesn't need to even affect your overall mileage much as you may even be able to do some longer runs on the other days. Anyhow...just a quick thought.

    As for recovery, there are 3 things that I have found that have been the best things for speeding up the healing process when I have had achilles issues.

    1. Accupuncture: I was a huge skeptic until I tried it. I had an acute achilles injury that happened during a track workout that lingered for three weeks. I hobbled to keep my streak alive, but was thinking that I might have to take some time off. I tried accupuncture and thought I'd noticed some improvment when I was done. The next day I felt it noticeably better and within a week I was back doing track workouts.

    2. Low Intensity Laser Therapy. I also had really good success with this on flareups and was able to turn it around quickly. Not all systems are the same. I used to work at a clinic that used the BioFlex system which is far superior to anything else I had seen at the time. If you can find one in your area, it would be worth checking out. In combination with accupuncture would be ideal. www.bioflexlaser.com

    3. Zanagen. Topical cream that is very different from anything else on the market. I have had great success with this very recently too. www.Zanagen.com

    I have no connections to either BioFlex or Zanagen, but just putting it out there as things that have helped to allow me to run everyday.

    Good luck with the recovery. Hope things improve soon.

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  3. As Casseday mentioned...'Vitamin I' may be helpful with the inflammation if you're ok with taking it. Just be careful as it could mask things when you are ready to start back up.

    Ice is of course good too (bucket of ice with water), but if you decide to try the laser approach, it's not recommended to ice for the rest of the day after a treatment.

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  4. With my Achilles tendonitis and later some peroneal tendonitis, I've found that they ended up healing with use (easy runs) rather than complete rest. That being said, I didn't do any fast stuff until I felt they were back to 100%. The advice given to me was use it and if it comes back to a baseline level of pain/discomfort each time then keep lightly using it, but if it starts to degenerate then you need to back off. Also, I run in pretty minimal shoes, usually with no/very little heel lift, which causes stress on the Achilles, so I used a shoe with slightly higher heel lift (NB MT101) temporarily for a few weeks to help alleviate some stress on the tendon as well. Not sure what you are running in, but another factor to consider.

    Like someone above mentioned, you are a unique runner with a unique issue and it doesn't really matter what I went through or someone else did for that matter. I never had swelling to quite the degree that you show in your picture and would venture to guess my injury was not as serve yours. However, I thought it might be helpful to add my two cents...hope you can get back at it soon enough.

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  5. "Hit the elliptical in a few days, a bit of biking, deep water running and core work. Good time to focus on those things. "

    Derrick nailed it.. get going with some other non-impact sports that won't stress the achilles for a couple weeks. Have some fun with other stuff than running. Bike with a supportive boot that won't strain. You will lose less fitness than you think and in the mog run will come back stronger. RICE it and elevate every chance you get, be conservative.

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  6. .. I meant to say "..long run", not mog run.

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  7. Agree with Dave and Derrick - pour your energy into a couple of non impacting things and have fun with that any you will be fine. Your base is HUGE. Even if you did not run for six weeks (which I am guessing would not happen) you have more fitness built in 2011 to call on ...

    I can't speak to outside therapies.

    Oh, and learn from this (right? - live and learn). I'd say over use is not just VOLUME but how that volume is delivered (as you note).

    The Achilles will recover and become stronger from this (coming from a guy who actually severed his via a lawn mower).

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  9. Casseday, cutting the top part of the heels off is good advice. I did this to a few pairs of my shoes and it seems to free up the movement down there.

    Derrick, thanks for the advice. I looked into the alternative therapies you listed, but most of those things are out of my price range. I cannot justify dropping $80 for an acupuncture session and $50 for a 4 oz bottle of cream. Maybe some day when I get a job... For now, I will stick to the RICE method Dave mentioned.

    GZ, I am hoping it comes back better than ever. The lawn mower incident doesn't sound like fun...

    Anonymous, if you are who I think you are, you are as much as an ultra-runner as I am. Thanks for the quote, I'll stay positive.

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