Working It

Base building is here. Base for what?

The Boston Marathon.

Yep, I'm in. I signed up back in September because I wasn't sure I was ever going to qualify again and I still had enough time to get my ankle better.  

I have never gone into marathon training without a base. My training plans were either a step down or pretty what I would run normally (at least in the early weeks). To be honest, I am probably going to go into Boston undertrained. But now is the time to take it slow. The last thing I want to do is injure myself again.

On the plus side, I stopped doing all of the stretches, exercises, and other things that I thought were helping my ankle. Nothing happened when I stopped. So that is a good sign. I need be very careful and see what happens over the next few weeks.

Sunday - Rest. Traveling got in the way of exercise. That usually doesn't happen.

Monday - Core work and clamshell planks in the AM. 3.1 miles on the treadmill in the PM. That included 1.25 

miles running (9 minute pace/6.7 mph) and the rest walking fast (just under 14 minute pace/4.3 mph).

Tuesday - Upper body strength training, planks, clamshell planks, and balance  exercises.

Wednesday - 3.1 miles on the treadmill with 1.25 miles running. Same speeds as Monday.

Thursday - Rest.

Friday - 30 minutes on the stationary bike.

Saturday - 3.4 miles on the treadmill with 1.5 miles running. Same speeds as Monday and Wednesday. Also did pushups and squats.

Total miles: 4

Turning the Corner?

The good news. I made it through a week with the walking boot, then a half-and-half week.

The upside to being stuck in a walking boot was wearing yoga pants and sneakers (well, one sneaker) to work. I could have worn skirts or regular pants. But I felt pretty self-conscious. By the end, I didn't care, but in the beginning I did. Then I had problems with shoes. The boot has a decent heel to it. Flat shoes were out. I needed a shoe with a little height so that I wasn't walking lopsided. I went to a shopping mall and a grocery store where I got some funny looks. Whatever, people. Most people didn't say anything. Actually, several people didn't even notice for days. Only one person asked me what happened (we decided bar fight sounded better than tendonitis), and only one person offered to open a door. I always found a seat on the Metro.

The bad news. The boot started hurting my foot, and I still wasn't better by the end of 2 weeks. So. very. frustrating. There is a good deal of trial and error with this particular injury, but come on. Really, tendon? Why were you still unhappy? Unhappy tendon made me unhappy. Literally. My mental health took a downward turn over the last several weeks. I was cranky, frustrated, and just not my usual self.

But then there was better news. I started getting through days without pain unassisted by the walking boot or anti-inflammatory meds. You know when you get a cut and it starts to itch when it heals? That's kinda how my ankle felt. Now I gotta start doing my PT exercises again. I kept working on my hips and foam rolling, but I stopped doing anything involving my ankle a few weeks ago. I'm done with actually going to PT. Everything I was doing, I can pretty much do on my own.

So now I wait and see. Again. Very cautiously.

Not Working It

I haven't posted a weekly recap for the last few weeks because it would be pretty boring. There has been a whole lot of not working out over the last few weeks.  I did some walking, yoga, strength training, core work, PT exercises, biking on the stationary bike, and yoga. A lot of rest. No cardio at all for the last week because I am extremely limited in what I can do. I am not one to skip out on working out, but I really can't.

It probably wasn't a good idea to go for a walk on the Mall about a week ago. I had some time to kill after work before I needed to be somewhere else. Runners everywhere. Perfect weather. 

Maybe ... maybe ... maybe I'll be back out there soon.

Here We Go Again

My sports doc recommended a cortisone shot or a walking boot. And prescription anti-inflammatory meds.

I was very leery of a cortisone shot immediately. There are a number of risks. Tendon rupture is one. Cortisone shots stop the pain, but they don't really treat it. Also, did you hear about the recent series of meningitis cases from bad steroids? No thank you.

So I opted for the boot. One week on, then every other day for another week. Be very jealous. I am not looking forward to people treating me like the walking wounded, but I am looking forward to running a social psychology experiment on altruistic behavior on the Metro. I'm actually not kidding about that last part.

Posterior tibial tendonitis seems to be one of those tricky things to treat. There is a lot of trial and error to figure out what works. Rest alone (meaning, no exercise) is not enough to get the tendon to calm down. Even walking can continue to irritate the tendon. For most people, walking is not optional. Enter the walking boot which immobilizes the angry tendon.

Cross your fingers that this works. I am patiently not running, but I am quickly running out of patience with not running. I don't know what I am going to do for exercise since cardio and yoga are off-limits. Body weight exercise that don't involve my feet/legs? Core work?

Hey, angry tendon, please cut this out. Pretty please?

Injury Emotion Cycle

You go through many emotions when you are injured.

For example:

I am sad that the weather is finally cooler and I can't go outside and run.

I am discouraged that I am still in pain. Four weeks of PT left me at pretty much the same place I started. I go back to see the sports doctor tomorrow because I ran out of PT appointments.

I am disappointed that I am missing my favorite half marathon for the first time in its existence. Goodbye, Amica Newport Half Marathon legacy.

I am frustrated that I can't go running in Rock Creek Park or on the Mall.

I am scared that I will get injured again.


It was bittersweet seeing people run their last 20 milers before Marine Corps last weekend.

I don't like looking at my calendar with no races lined up.

I am trying really really really hard to stay positive. It is getting harder and harder to be optimistic.

PT Part II - The Beautiful Letdown

Bonus points if you get the song allusion in the song title. The band is coming to my area this week!!

I'm going to post this because the last time I complained about the pesky ankle and angry tendon, things felt better. Go figure.

I went through 4 weeks of PT. Ran out of appointments. The angry tendon, or something else, is still angry. Isn't this where I started?

The angry tendon felt better, and then it didn't. It felt better again, and then it didn't again. Yet, I couldn't replicate what is causing the pain in PT. Movement doesn't hurt. Doing nothing (sitting around, lying in bed) hurts. It's more like an itchy, irritated, aggravated feeling than actual pain, but it is near constant. Or at least daily.

I think what happened is that I had a physical therapist (not the one I usually see) dig into the angry tendon and not surprisingly aggravate it. The angry tendon was tender to the touch for nearly 2 weeks. Today was the first day in a while where I couldn't feel the angry tendon when I woke up. That's good, I guess. Maybe I just need some time to rest. And not see that physical therapist anymore.

Now I wait and see for a week or two and go back to the sports doctor. I don't know if there is something seriously wrong or I just need more PT. It would be fantastic to know what's really going on.

Down the Injury Spiral

It's been a while since I first realized I was injured. Early July.

There was some bad behavior for a few weeks. I was cranky. And still eating like I was training for a marathon. And not exercising as much. And not sleeping as well. Wash, rinse, repeat.

It became painfully obvious that I could not run Marine Corps. Even if I got better quickly, I wasn't going to have enough time to train properly.

Not gonna lie. It was really hard to back out of a race. I have never backed out of a race. Knowing it was the right decision didn't make it any easier.

In some ways, I was relieved. I didn't have a training schedule I have to stick to. I like sleeping in on Saturday morning and having all of Saturday to do things. I didn't have to go running in the hot humid summer. I had a decent amount of traveling recently, and I hadn't adjusted my schedule to accommodate being on the road.

But in some ways, I was worried. Running is one of my mental health strategies. I know I am crankier without running. Yes, I am still exercising, but it is different than running. Other activities don't produce the same endorphins. I was not sleeping as well. I couldn't keep eating like I was training for a marathon when I was not, in fact, training for a marathon. I added some extra fluff (still within my normal weight range, and I probably had a few pounds to add back from my spring training cycle). However, it took me from early July to now to get my my eating in check and to stop the scale from slowly creeping up.

Part of the mental health thing is exactly that. Mental. Your attitude has a lot to do with how you feel. No, you cannot always be in complete control of your attitude. But you can be aware of it and try to change it. In some ways, it is very much like a skill that you practice in long-distance running. Tell the negative thoughts to shut up and focus on the positive (say, for example, mile 18 of the Chicago Marathon) where I realized I wasn't going to reach my A day goal and decided to focus on going after a PR and getting more bang for my buck by being out on the course longer). OK, so I'm not getting my running endorphins. Moping about it won't make things better. Yes, it is OK to miss running. Especially now that we are getting hints of fall. I know it is in my long-term best interest to not run at the moment. Now, I am OK with that. Really.

I cannot control being able to run or not. I can control how I feel about that.

PT Update

I am 2 weeks into at least 4 weeks of physical therapy.

My eval appointment and first week went well. No one tells you that PT hurts. Oh boy, does it hurt. But then you feel better. The near constant pain went away. Immediately. I could run across a street with no pain. No, not actual running. Just enough to make the light. That hadn't happened in a while. I got a list of stretching exercises to do on my own. I bought a hot-cold pack so that I could get some heat on my ankle. I put Superfeet inserts in my running shoes.

Second week. Eh. Not as good. I started getting pains in the beginning again. But only when I was doing nothing. Not exactly sure why, but I think I spent too much time walking around barefoot and jumping up and down a chair to put stuff away in a closet. Dumb move, self. Don't do that again. I did get run briefly on an anti-gravity treadmill. Very weird. I have lost a lot of endurance. It was good to run, though, even if it was partly assisted by a pressurized bubble.

New week, less pain. If I were writing this yesterday, it was a different story. Today is better. Ahh. I was diligent about wearing my running shoes all the time (at work, at home) and more mindful about what I do with my feet while I am sitting. My ankle is still hurting. But it's a different kind of hurt. It's achy but feels stronger, if that makes sense. I guess that's good?

Apparently, I have some mechanical problems. A problem with the structure of my right tibia (it's supposed to turn more than it does). An imbalance in my hips. The main issue is that my right foot does not stay straight when I run. I land with my toes pointing outward and then flick my toes outward when I pick up my foot. This puts a strain on that tendon on the inside of my ankle. My left foot stays straight. Huh. That makes sense. I can see this in the wear patterns on my shoes. But only on the shoes that I started wearing in April. After I moved to Washington, DC. Mad hillz yo are not good for my ankle.

My physical therapist told me I am not built to be a runner. Haha. Really? That is a stupid statement. I'm pretty sure the rest of my body is built to be a runner. Unless I was just lucky that I have made it this far ...

What I think happened is that switching to running in Rhode Island (where I was mostly running flats) to running in DC (where I was not mostly running flats) exacerbated whatever was going on. You know how you aren't supposed to change anything too abruptly in running? That includes switching from running 20-30 miles a week on flats to running 20-30 miles a week on mostly hills. Not a smart idea. You need to transition gradually. My other theory is that my ankle was gradually getting worse and I compensated by doing other other things. Runners are stubborn, so it takes a while for us to realize we are injured, something is wrong, and we need to stop running. Enter the month of June.

Where I go from here, I am still not sure. I still not cleared to run and don't know when that will happen. Maybe soon? I might get to run on a treadmill this week. Correct whatever imbalance is causing the problems, figure out how to get my right foot straighter, stretch more, and don't run on hills.

That's more difficult than it sounds.

Off the Rhode

As of last week, I have a diagnosis of posterior tibial tendonitis and some Achilles tendonitis as well.

Could be better. Could be worse, I suppose.

Where is the posterior tibial tendon? It stretches from your calf, wraps around your ankle near that bone that sticks out (which is the area where I am having the most pain), and attaches to the sole of your foot. That explains some of the plantar fasiitis-like pain on my sole. Add in the Achilles tendon and that explains the sporadic pain on the sides of my ankle and back of my heel. It all fits together.

This started to get worse when I moved to DC. One of the things that can aggravate this injury is running on hilly surfaces. Hmmm.

Yesterday, someone I just met picked me out as a runner and correctly identified my right side as the injured one. Before I said anything. I didn't realize it was that obvious.

Today, I went to my first physical therapy session. Um, ouch. But good ouch. I felt better than I have in a long time. I have at least a few weeks of PT, some exercises to do on my own, some high doses of ibuprofen for the rest of the week, Superfeet insoles, and one of those packs that you can heat up in the microwave. Yeah, I'm getting old.

I have no idea yet about a prognosis, but it seems promising. Plus I have an excuse to buy new shoes and wear my running shoes to work.