Posts tagged ‘Stress fracture’

January 20, 2015

Reunited and it Feels so Good

Graph1

This was my first entry in my running log since November. Apparently it stretches the bar graph to fill the space available.

 

I had my first date with the treadmill this morning since before Thanksgiving, and it was glorious.  I had 6×800’s at 3:43 pace scheduled, and I really had no idea whether I’d be able to handle it, both from a cardio standpoint as well as the questionable structural integrity of my foot.  I ended up cutting it to 5 repeats instead of 6, as I decided not to exceed 4 miles including the warm up and down, but it felt great.  I can feel the injury twinge a bit while I’m running, but my foot didn’t feel at all sore afterward, so I’m assuming I’m still in the safe zone and not setting back my recovery.  I’m still a bit wary, though, as my foot strike seems a bit altered now (another reason for cutting the workout a bit short).  I’ve always pronated more on my left side, and I suspect that may have been the cause of the injury in the first place.  Now I seem to be pushing off my big toe more than the lesser ones, and I’m curious if the avoidance of pain may actually serve to correct my stride.  Any slight alteration in gait changes biomechanics and alters the stress put on joints, muscles, and soft tissue, though, and I’ve learned the hard way to be ginger as my body adapts.  More than once I’ve caused a more major injury by compensating for a minor one, and I definitely don’t need to compound this one.

But back to the intervals.  It was amazing!  The cardio felt fine the whole way through, and I definitely could have banged out the last repeat without any trouble.  It was satisfyingly tiring in the way only a good speed workout is, and I felt properly worn out and hungry for the first time in weeks.  I found myself wondering what the runners’ equivalent of smoking a cigarette after is… 

It's looking slightly better.

It’s looking slightly better.

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January 19, 2015

Making Progress

Stress Fracture Update

The big news this week is that I ran… twice!  The first one was supposed to be just a mile, but turned into two, and the second was supposed to be 3.5 and ended up being 2.5 due to freezing rain, but still, I ran!  My foot felt a bit sore for about the first mile or so of each, and again towards the end of both runs, but overall there seemed to be no increased soreness or swelling afterward.  I did notice that my arch felt a bit tight a few hours after, and I think I will probably need to be a bit more diligent about stretching and using the foam roller as I ease back into running.  I’ve been keeping up with the strength, biking, and swimming this week as well, and weirdly, I think I can actually feel my body starting to adapt to the new training.  Everything stays the same for days or weeks, and then suddenly the hand weights that felt heavy last week seem to be lighter, or something will just click mid-swim.  Last week I looked in the mirror and thought that it seemed odd that my arms didn’t really look any different after a month of swimming and weight training, and then two days later I looked like I had taken up a blacksmithing hobby.  (I actually did a little in college and have some lovely candlesticks to show for it…)

Anyway, I’m trying hard to come up with a training plan for the next several weeks that will challenge me without risking reinjury.  My successful runs this weekend gave me enough confidence to sign up for a 4-mile race a month from now, and I’ve decided to try using a slightly modified FIRST plan to train.  I’ll actually be doing the cross-training this time, which should fold nicely into my tri plans, and if all goes well, a fast 4-miler will set me up for faster distance work this spring.  I still need to lay out my full race calendar for the year, but I want to hold off a few more weeks to see what kind of running volume I’m able to handle before I start committing to the spring races that I really want to do.  In related news, I got the email on Thursday for my guaranteed entry to the NYC Marathon, and $227 later I am officially in!  Long Run Buddy is as well, and I’m very excited to have a training partner for the full distance of my long runs this fall.

When do I get to call myself a Triathlete?

Even though I’m holding off on committing to any major (running) races for a few more weeks, I did sign up for two sprint-tri’s in May and June, and suddenly that whole endeavor is getting much more real.  My swim classes started last Tuesday, and I’m so, SO glad I enrolled.  The class is geared to novice (but not absolute beginner) swimmers and is focused on the basics of technique and efficiency.  I’ve always seen myself as a weak swimmer and was nervous that I should have signed up for the beginner class, but I seem to be at least at the average skill level in the group.  A few of my classmates have done the NYC Tri before, so I feel a bit more confident that I’ll be able to get through the swim in the allotted time, not to mention survive a dip in the Hudson.  There are also several veteran runners/first-time triathletes in the class who are signed up for the NYC race, and it will be great to get to know a few other newbies as well.  Last week’s session focused mainly on breathing technique, and in addition to working side lying kicking and one arm drills, our coach referred us to this video, created by sea mammal Michael Phelps’ coach, Bob Bowman.  His explanation is very clear and after a very focused half hour in the pool this weekend I actually did start to feel the bow wave on my head.

This week I hope to start structured training for the 4-miler and settle into a workable training schedule that incorporates multiple swim, bike, run, and strength workouts each week.  I will be doing two-a-days several times a week, but I’m hoping that scheduling more short and varied sessions will keep me healthy while still building fitness and strength.  I’m trying to alternate days so that I minimize doing the same activity back-to-back, but I still have to work out the kinks.  I’m incorporating a lot more strength training that I did last season, and I hope that will help me prepare for a heavier training load and avoid injury.

Here’s the plan this week:

Monday

Weight training – JM No More Trouble Zones

 

Tuesday 

AM

Running – Intervals

6×800 @ 3:38*

RI 90 sec

PM

Swim class

 

Wednesday

AM

Swim – 30 min

PM

Strength – JM Ripped in 30 Week 2

 

Thursday

AM

Running – Tempo

2 mi @ 8:04*

1 mi easy

2 mi @ 8:04*

PM

Optional 30 min bike

 

Friday

AM

Strength – 1 hr with Trainer

 

Saturday

AM

3 mi easy

PM

30 min swim

 

Sunday

AM

Brick:

Cycle

10 min easy

10 min tempo

10 min easy

5 min hard

5 min easy

Long Run – 7 mi @ 8:34* (If all goes well this week)

 

*I should note that these paces are pegged to my last marathon and I have no idea if I’ll be able to handle the speed after 6 weeks off.

January 9, 2015

Recalibrating

This was a big year in running for me—I set new PR’s at every distance I raced, finally ran a marathon, and then ran another one.  The thing that I am most proud of, though, was learning how to really work hard at my training.  I’ve never been one to skip workouts, but this year I tried to bring focus and purpose to every run.  The hard days were really hard, and easy runs became opportunities to work on form and efficiency, rather than just zone-out sessions.  More than anything else, though, I learned that the voice in my head telling me I was too tired and I couldn’t do it was usually just that—my head being tired.  I’m still working on it, but I got much, much better at ignoring that voice, pulling up my big girl tights, and pushing through.

I’m now dealing with the other side of that coin, however, which was misreading the signs that I was overdoing it on the bike.  Although I felt some discomfort, the pain never felt remotely like what I recognized as an injury—I just thought I was putting in some tough workouts.  As runners, we rely on our ability to listen to our bodies and differentiate between the discomfort of a hard workout and the pain that indicates an impending injury.  My mistake was assuming that my ability to discern that line extended to a new sport in which I had little experience.  The fact that cycling (and swimming, too) is not weight-bearing means that the threshold for and severity of discomfort are entirely different, and I failed to calibrate for that.

For the past two weeks I’ve been slowly returning to something that resembles an actual training schedule, albeit without the running.  In contrast to my usual approach, I’m going mostly by feel and making it up a week at a time.  I’m realizing that switching from running to tackling the other triathlon disciplines is a bit like driving in the snow.  I know exactly how the car handles under normal conditions, and while that’s useful information, I still need to go easy on the gas pedal and leave lots of extra braking distance.  My general zeal for new athletic endeavors combined with marathon-level endurance have proved to be a dangerous combination, so I’m trying to recalibrate a bit.  To that end, I’m mixing up my workouts so that I’m not doing the same activity on consecutive days, and still incorporating lots of strength training.  For biking since the injury, my approach so far has been to stop before I feel like I’ve really had enough.   I seem to be finding my groove with the swim workouts—I actually got (temporarily) thrown out of the slow lane by the lifeguard and upgraded to the medium lane last weekend.  My classes start next week, so I’m expecting that will lend a bit more structure to my pool workouts as well.  This is how week 1 of Operation: Recovery has looked:

Tuesday

30 Minute Swim:

Warmup
4 x 25m
Drill:
4 x 25m Catchup
4 x 25m Kick
4 x 25m Fist
Cooldown
Easy 25m resting as needed for remainder of 30 minutes

 

Wednesday

AM: Strength training – Jillian Michaels’ No More Trouble Zones

PM: 30 min moderate biking

 

Thursday

35 Minute Swim:

Warmup

4 x 25m

Ladder 
25m, 2 X 50m, 2 X 75m, 2 X 50m, 25m
Cooldown
Easy 25m resting as needed for remainder of 35 minutes

 

Friday

AM: 45 min moderate biking

PM: 15 min strength training – Nike’s Strength for Runners

 

Saturday

45 min swim:

Warmup 
4 x 25m
Drill 
2 x 25m Right Arm
2 x 25m Left Arm
2 x 25m Kick
2 x 25m Scull
Endurance
2 x 50m
Cooldown 
Easy 25m resting as needed for remainder of 45 minutes.

 

Sunday

AM: Strength training – Jillian Michaels’ No More Trouble Spots

PM:1 hour moderate biking

December 31, 2014

Getting Stronger

I’m not really one for year-in-review appraisals or New Year’s resolutions.  In general, I associate New Year’s with two weeks of noobs crowding the gym.  (Newbies please note: if you are walking on a treadmill, the automatic cool-down period at the end is not for you.  Do not walk in slow motion for five minutes while others are waiting, only to hop off and resume a brisk pace to the locker room. Seriously.)

In light of my recent injury, though, I can’t help being a bit more reflective than usual this year.  I had easily the best training year of my life.  I learned how to set challenging goals and not to let myself off the hook for them.  I learned to train hard and successfully.  Injury aside, I think also I learned how hard I can push myself, and it’s harder than I thought.  As a friend said recently, “You have to cross the line now and then to figure out where it actually is.”  The stress fracture, too, has been instructive.  I’ve been reminded that I’m not Superwoman and no matter how good of shape I’m in, I still need to be gentle with myself.  I enjoyed running this year more fully than I ever have, and I’m now even more acutely aware how precious every step is.  I have realized these past few weeks how much running has become part of my identity, and how it’s become a measuring stick for how may day, or week, or life is going.

My foot continues to improve, albeit slower than I would like.  Interestingly, it seems to plateau for several days at a time, and then overnight will suddenly feel markedly better.  The injury first became apparent just after Thanksgiving, but I’m pretty sure that walking four miles on it at the Jingle Bell Jog and the pain that ensued after probably set things back a bit.  That would put me at somewhere around week three of the healing process, which means the bone callus should be forming now.   There is a distinct bump at the site of the injury now and the area is definitely less tender now, so that’s all to go the good.

Swimming really has been the silver lining to all of this, as I may have actually set myself up to drown in the Hudson next summer had I not been absolutely forced to focus on the swim.  I’m far worse at it than I expected, and I never would have dedicated this much time to it if running or biking were at all possible.  I don’t enjoy swimming yet, but I’ve been working hard, and after watching several YouTube videos to study up on technique I’ve definitely been able to make some headway.  Last week I realized that I was “swimming flat,” meaning that my hips were staying parallel to the bottom of the pool while my upper body rotated.  I finally got the reach-and-roll rhythm going and suddenly instead of flapping around, I felt like I was actually gliding through the water.  Make no mistake, I’m still terrible, but I can now reliably overtake some of the oldest women in the slow lane.  At any rate, my swim classes start in two weeks, and I am perhaps unreasonably optimistic that they will help tremendously.

Part of my current frustration with swimming is that I am not good enough to get a really hard, satisfying workout in.  I’ve also been strength training, though, and I am finding an appreciation for pushing through a really hard set that I’ve never had before.  I tend to rush through lifting, so I do best with a trainer or video to guide me on form and pace.  It’s been difficult to find really challenging workout videos that don’t require a lot of high impact cardio intervals, but so far I’m most impressed with Jillian Michaels’ No More Trouble Zones.  I can do most of the workout without modifications and the sets move fast enough to provide a good cardio component as well.  I really do feel like I will come through this injury stronger physically, and maybe mentally as well.

Cheers,

ModC

December 22, 2014

Taking the Stress Out of Stress Fractures

Beyond the Pounding Model

If I can take any comfort in this injury, it’s that there are concrete steps I can take to support the healing process.  Unlike a lot of the tweaky soft tissue injuries I’ve had in the past, this is a clear diagnosis with a clear progression of recovery.  I take some satisfaction in knowing what processes should be occurring when, and how I can possibly help them along.

As soon as I began to suspect that I had a stress fracture, I started researching the condition, its causes, and the healing process.  It’s actually quite interesting, and not as simple as the repeated pounding model that most of us imagine it to be.  Stress fractures are certainly correlated with repetitive stress, however, studies have shown that the mechanism is far more complex.  Repetitive loading causes a slight distortion in the bone, which in turn leads to decreased blood flow and oxygen to the area, particularly during long workouts.  Muscle fatigue can magnify these effects as the soft tissues become less able to resist the stresses applied.

The lack of oxygen seems to then trigger the bone’s rebuilding cycle to begin.  The normal cycle of tissue breakdown and rebuilding ultimately results in stronger bones, however the early stages of the process actually significantly weaken the structure.  As microscopic damage occurs, osteoclast cells are sent to the area to absorb the compromised bone.  In fact, osteoclasts actually cut tunnels within the existing bone structure along the lines of stress.  (How cool is that?)  Once the damaged tissue is cleared away, osteoblast cells come in and begin to deposit new bone within the matrix.  It takes 10-20 days for the newly placed bone to mature, however, and it is during this time that the injured area is most vulnerable.  If the cycle progresses normally, in about three weeks the bone is stronger and effectively reinforced along the direction of stress.  If too much stress is placed on the bone during the remodeling process, however, the repair process will be interrupted, and/or damage will outpace the body’s ability to repair it.   The microscopic fissures begin to merge, and a crack forms in the bone.

At this point, the injury becomes painful and activity must be reduced.  As the bone begins to heal, a soft bone callus forms around the injured area.  While the initial fracture is often not visible on x-rays, the bone callus will appear as a ghosted area.  After about a month, the callus will begin to harden and the injury is markedly less painful.  The bone is still not at full strength, however, and returning to full activity at this point can result in a recurrence of the fracture.  The callus can also put pressure on adjacent bones and tissues causing a change in gait and/or pain and numbness in the area.  After 8 weeks, if all goes well, the bone should be returning to full strength and normal activities can be slowly resumed.

Nutrition for Healing

For the stress fracture to heal, further stress on the bone must be limited.  And while the time frame needed for the new bone to mature cannot effectively be accelerated, the rebuilding process can be supported by supplying the required minerals and nutrients, along with plenty of rest.  It’s worth noting here that NSAIDs block one of the inflammatory markers that stimulate osteoblasts, and taking them will slow the healing process.  Curcumin and ginger reduce inflammation without disrupting the development of new bone, however.  Studies have also shown that supplementing with additional vitamins and minerals can aid healing and reduce complications:

Vitamin C & E  – anti-oxidant properties help counteract the release of free radicals that occurs during a fracture

Vitamin D – aids in the absorption of calcium

Magnesium – also needed for calcium absorption, and often deficient in runners as it can be lost through sweat

Calcium – bone is nearly 70% calcium phosphate, so adequate supplies are critical to fracture healing

In addition to the supplements above, I’ve also been adding a tablespoon of gelatin to my coffee every morning.  There’s a batch of bone broth going in the crock pot, and I’m keeping my protein intake a bit higher than I normally would when I’m not running as well.  (Despite runners’ tendency to not want to gain weight while they are sidelined, this is NOT the time to restrict calories.)  Getting adequate rest and sleep is, of course, critically important, and that is made slightly easier by the fact that I’m not running at 6 AM every morning.

It’s hard sitting still with my foot up, it’s hard to resist the urge to put the regular pedals back on my bike and work up a good sweat, and it’s really hard to not run.  I’m getting in some good strength training and am starting to see results in the pool as well.  There is certainly a silver lining to be appreciated, but no matter what, getting injured sucks.  I’m trying to remind myself that after a year of hard training I really do need some rest.  My foot may be the most acute issue, but I will certainly benefit from a little down time and switching up the routine.  I’m probably not losing as much fitness as I imagine, and even if I am, I’ll get it back.  I did it once already, and it’s easier to regain fitness than to build it up from scratch.  If all else fails, I’m thinking of developing a bone broth-based cocktail.

~ModC

December 18, 2014

The Brussels Sprouts of Training

Although I’m still awaiting the results of my MRI, a trip to the podiatrist on Tuesday confirmed my suspicion of a metatarsal stress fracture.  I’m now boot-bound for the immediate future, and am likely looking at 6-8 weeks before I can start running again.  The good news is that I can continue to swim and I may be cleared for cycling and pool running in a few weeks.

I’m upset, of course, and disappointed that I probably won’t be able to run the Hot Chocolate 10-Miler and the Fred Lebow Half Marathon that I am registered for in January.  It’s been ages since I’ve raced the shorter distances, and I was really looking forward to getting back to training in earnest.  I had also planned to run the Shamrock Marathon in March, but depending on when I’m cleared to resume full training that may not be feasible either.  It’s certainly not the end of the world, but as any athlete knows, injuries are incredibly frustrating and it’s easy to get a bit depressed on top of the physical trauma.  I know my own tendencies in that department, so I’m working hard to reframe the situation into something positive.

I’ve realized that one of the most difficult aspects of dealing with injury for me (and I suspect for many runners who are a bit Type-A) is the loss of the structure and routine that training provides.  When I’m working through an injury and can’t do my “real” workouts,  I usually tend to do somewhat aimless sessions just so I can feel like I got my exercise in.  This time around, I’m trying to approach time the time away from running as an opportunity to address some weaknesses that I never seem to have time for otherwise.  I’m setting specific goals and building a training plan to get there.  I want to improve my upper body and core strength with weight training twice a week, complete a 30-day chin-up challenge, and build up to swimming 500m with this training plan.  The hard part, of course, is garnering the same level enthusiasm I have for my running.  Getting better at things you’re bad at is unglamorous, eat-your-veggies kind of training–the sort that is hard and ugly and generally not much fun.  Rather than running around the park with at least a modicum of grace, I’m flapping around in the pool just trying not to inhale water.  The learning curve is steep at this end, but so are the incremental gains.  In 6-8 weeks I may just have a new set of skills.

~ModC

 

 

December 15, 2014

Still Limping

After a lot of rest and Advil last week, my foot was actually feeling a bit better by Friday.  I have an appointment tomorrow with a podiatrist who specializes in runners and triathletes, but by the weekend I was hopeful that it might be a moot point.  On Saturday I could hop without wincing, and I even wore footwear other than my running shoes to dinner.  On Sunday I had a bunch of errands to do, as well as a pile of laundry and cooking for the week.  I swam in the morning and then spent a good portion of the day on my feet.  By evening I was visibly limping again and my chiro friend asked me if I had considered the possibility of a stress fracture.  I had, of course, but mostly to convince myself that if I had one, my foot would probably hurt more than it does.  After two weeks with no improvement, though, it does seem like the most likely scenario.  I’m also pretty sure that the fact that I can actually feel my third and fourth metatarsals inside my foot is not a good sign.  I imagine that I’ll get a definitive answer tomorrow, but just in case, I stopped taking the Advil (it can impede healing of fractures) and ate an extra bowl of bone broth soup last night.  Either way, it looks like I might be spending more time training in the pool than I originally thought.