"We run when we're scared, we run when we're ecstatic, we run away from our problems and run around for a good time." Christopher McDougall (Born to Run)

Sunday, June 26, 2011

Making Progress

It has been three weeks since I've posted an update. The one major thing (well major in my eyes) that I dealt with in the past few weeks was coming to terms with the fact that I wouldn't be able to run the SF Marathon. Because of my injury, I got way off track on my training regimen. I will, however, be ready to run a 1/2 marathon by July 31st. So I downgraded from the full to the half, and that sure is better than not being able to run at all. This will be my third 1/2 marathon, and maybe my fastest? The route will have several hills, so it may be challenging to beat my time from the Oakland 1/2 (which was flat), but I'm going to give it a shot.

The last three weeks I have intensely focused on my stride and the number of steps per second I take while running. I still run with the metronome, but now use it for about half of my runs. Each week for the past five weeks I've been adding one mile per week. Dr. Jess had me start with just 3 miles, which was tough considering I was running 14 before I got injured. The exciting thing is that by increasing my steps per minute to an average of 180-182 I have gotten a little faster. Last week my long run was 6 miles, and I kept an average pace of 9:08.

This past work-week I only managed to run once, but I had a strong 3 mile run with an 8:28 pace. I had a few stop-light breaks during the run, which helped, but overall I didn't actually push myself that hard. This week I think I will try for an 8:20 or 8:18 for my short run.

On Thursday I went to a yoga class for the first time in a long, long time. I go through spurts where I attend a lot of yoga classes. Then I will go for months without attending any. I struggled during Thursday's class, which isn't normal for me, and a sure-tell sign of how weak my upper body strength is. Today, Sunday, my arms and shoulders were still sore. It's time that I incorporate more cross-training into my weekly routine.

Looking ahead to the 1/2 marathon, I figured out this past week that I needed to start increasing my long run mileage by more than 1 mile per week, otherwise I wouldn't be ready. Today I ran 8 miles (increase of 2 from last week). I ran down to Lake Merritt and back and was, again, surprised by my time. For my long runs I usually clock between a 9:30 and 10:00 pace, depending on the length of the run and whether it is a new distance. Today, I successfully ran 8 miles with no pain during or after the run. Not only that, I ran an average 9:07 pace for the 8 miles. I think that might have been my fastest 8 mile. I would have gotten a sub-9 minute mile if the run had been flat, but the incline on the way back dragged my time above 9 minutes.

All in all, while getting injured was not fun, I am starting to think that I am becoming a stronger runner. By focusing on my form and working on key muscle weaknesses, I am slowly getting faster and hopefully, more efficient. I am still going to Dr. Jess Greaux about once a week. She has been exploring other parts of my right leg to see what other muscles are having issues. We discovered that I have a really tender and tight spot on my upper thigh, slightly to the back of my IT band. I also have a lot of tenderness in the lower part of my calf. The good news is that the area surrounding the upper portion of my peroneus muscles is markedly better. The scar tissue in the muscle and the nerve entrapment are almost entirely gone!! Now I just need to get the remainder of my leg muscles healthy!

I've now got my eyes on the inaugural Half Moon Bay Marathon in late September. I haven't registered yet. I am going to wait a few more weeks to assess how my body is feeling and whether or not I continue to make progress. I also need to plan out a new training program that will prepare me in enough time. There are so many marathons to choose from in the fall, that I am confident I'll be able to find one that works.

Monday, June 6, 2011

Diagnosis, a Video, and a Metronome

First Visit: Initial Diagnosis
During my first appointment with Dr. Jess Greaux at Innersport I learned that my suspicions about the pain originating from the peroneal tendons and peroneal muscles was correct. Unfortunately, I was hoping that I had a simple tendonitis, but her initial diagnosis is that I have tendinosis. Tendinosis is defined as damage to a tendon at a cellular level. It is thought to be caused by microtears in the connective tissue in and around the tendon, leading to an increase in tendon repair cells. Explained another way, tendinosis is an accumulation over time of small-scale injuries that don't heal properly; it is a chronic injury of failed healing. She pointed out that I had a build-up of scar tissue all along the side of my right calf where it was currently experiencing tenderness and pain.

Dr. Greaux (or Dr. Jess) used Active Release Technique (ART) and the Graston Technique on the side of my right calf where the muscles and tendons were tender to the touch. She also applied Spyder Tech tape to the side of my calf. My first visit was on a Thursday, and by Sunday the pain and tenderness on the side of my calf was dramatically decreased. That Sunday I even went for a 4 mile and I had NO PAIN! This was amazing considering just prior to my visit I was experiencing pain after running a mile or less.

Second Visit: Video Analysis
While things were looking up, I still awaited finding the cause of the tendinosis. Dr. Jess had me do a running analysis during my second visit. In order to analyze my stride, Dr. Jess' assistant took a video of me running in front of the office at the beginning of my appointment. She took a video from the side and from the front/back. As I ran for the video I purposely didn't think at all about my stride so that I would demonstrate whatever bad form I have when I am not paying attention. Dr. Jess analyzed the video and we discussed what was out of alignment. I was embarrassed to find out that I was heel-striking worse than I thought I was, I wasn't taking enough steps per minute, and my feet were staying on the ground too long. One of my hips was also dropping down more than the other one. All in all, my alignment and my form need improvement.

A Metronome
After seeing the weaknesses in my running form, Dr. Jess directed me to purchase a portable digital metronome to run with. She said if counting every foot-strike I should be at 176-180 on the metronome. If I am counting one foot strike, it should be 88-90 on the metronome. She also directed me to do running exercises which I basically call "knee thrusts" where you thrust your knees forward as hard as you can, lifting your leg in a more exaggerated fashion forward. Finally, during both of my visits she gave me several different exercises to do at home, some stretching exercises and some glute strengthening exercises. Dr. Jess also told me during my second visit that until further direction from her, I am not allowed to run more than 3 miles every other day. She didn't say I had to give up on running the San Francisco Marathon, but also didn't say that I could. So the jury is still out on that issue.

Like a good student, I purchased a metronome immediately after my second appointment so that I could start running with it. I purchased the Seiko DM70B Pocket Digital Metronomee, and had it delivered within two days to my office. I ran with it on Thursday and found it was challenging at first to make sure I was taking enough steps per minute. On Saturday while at the gym I ran on the treadmill and instead of using the metronome I just counted 30 foot strikes for 10 second increments every few minutes to make sure I was taking an average of 180 steps per minute.

This week I have two appointments, Dr. Jess recommends that her patients come twice a week during the initial weeks. I will report back soon with any updates.