Friday, August 22, 2014

Injury Recovery with a Deadline

Running marathons every weekend is manageable until you have an injury.  Then you freak out.  I’ve been going through that this week.  On Sunday, I ran a downhill race.  During the race, my calves were getting tight, and I worried that it might be putting extra stress on my Achilles tendons.  I made it through the race OK, but an hour after the race, I started feeling tightness in my left Achilles tendon.  By the end of the day, I realized I was in the early stages of Achilles tendonitis.  I had another race in six days.  It was time to freak out.

It’s been 10 years since I last had an injury that sidelined me for more than a week.  When I did, it was Achilles tendonitis.  My next race is in Wisconsin, so I don’t have to fly.  My only non-refundable expense was my entry fee.  I could have skipped this race, but I never seriously entertained that idea.  Instead of asking myself if I could be ready to race, I asked myself how I could be ready.  Here’s how my week has progressed.

Sunday night
I’ve found that Achilles tendonitis responds well to stretching.  I stretched periodically.  Each time, it helped temporarily, but the tightness returned after an hour or two.  By dinner time, I was concerned that walking on it too much could make it worse.  I had two home-made heel lifts in my shoe bag, so I put them both in my left shoe.  The lifts raised my left heel by about two millimeters.  That reduced the tension on the tendon.  I was able to walk comfortably going to dinner.

Before going to bed, I did more stretching, and it felt better.  During the night, however, I needed to make a trip to the bathroom.  Without shoes (and the lifts), there was more tension.  It felt really tight, so I took small steps.

After stretching, my Achilles tendon felt much better than it did during the night.  I flew home that day, so I was going to be on my feet a lot.  You don’t realize how much walking you do in an airport until you’re injured.  I continued to wear two heel lifts in my shoe.  I felt fine until it was time to board.  Going down the jet way, I had to walk slowly.  When I got home it was worse.  I not only took small steps, but I always put my left foot forward first.  If my right foot ever went in front of my left foot, I could feel the tension.

So far, I was doing my best to keep it from getting worse, but I needed to reduce the inflammation and speed the healing.  Then I remembered that I was in a similar situation a year ago.  On that occasion, I had eight days to recover from Achilles tendonitis.  Last year, I made a speedy recovery through repeated applications of ice and heat.

I have a whirlpool tub in my basement bathroom.  I filled it with hot water.  I also filled a five gallon pail with a combination of cold water and ice cubes.  I placed the bucket right next to the tub, so I could move my leg from one to the other.  I started by submerging my left foot and ankle in the ice water for five minutes.  Then I moved it to the hot whirlpool bath for five minutes.  I kept alternating for half an hour.

When I woke up, I was noticing my calves more than my Achilles tendon.  I was finally experiencing Delayed Onset Muscle Soreness (DOMS).  It was encouraging that my left calf didn’t feel any worse than my right calf.  I wanted to do ice/heat treatments twice a day, but I was out of ice.

After lunch, I went grocery shopping and picked up enough bags of ice cubes to last me through the week.  Because I felt a little bit better, I only wore one heel lift in my shoe.  That was premature.  With only one lift, I felt a little bit of tension as I walked.  I took short steps while I was at the store.

Ordinarily, I would have gone running on Tuesday.  Instead, I planned on doing a short workout on the stationary bike – nothing too strenuous – just enough to work the soreness out of my legs.  I also had DOMS in my quads.  By late afternoon, I started to wonder if even cycling would put too much strain on my Achilles tendon.  I took a complete rest day.  After dinner, I did an ice/heat treatment.

I felt a little bit better, but I knew it was still too soon to run.  I started the day with the short bike workout that I had skipped on Tuesday.  Then I did my first of two ice/heat treatments.

Any time you have an injury, you should ask yourself what went wrong.  I was now doing that.  Running downhill puts more stress on your Achilles tendons than running on level ground.  I accepted that risk, but I could have done more to minimize it.  I was worried about beating up my quads, so I told myself to relax.  I didn’t want to resist the hill.  “Putting on the brakes” while running downhill is not only inefficient, but it’s hard on your quads.  Something I forgot about was the risk of over-striding.  I tried to run naturally, but running downhill can cause you to lengthen your stride.  A book I’m currently reading reminded me of the value of reducing your stride length on hills.  Had I made a conscious effort to take shorter but more frequent strides, I probably could have reduced the stress on my Achilles tendons.  This has been a painful reminder.

In the afternoon, I did weight training.  Although I seemed to be improving, I went back to wearing two lifts in my left shoe.  In the evening, I spent enough time on my feet to realize that even with two lifts, I still felt tension.  Up to this point, I had not taken any ibuprofen.  I used to take it any time I was recovering from an injury, but in recent years, I’ve been much more conservative about NSAIDs.  It’s like I forgot they even existed.  By now, I was getting a little desperate, so I started regularly taking ibuprofen to reduce the inflammation.  Finally, I ended the day with another ice/heat treatment.

For most of the week, I was hoping I could go for a run by Thursday.  Mostly, I just wanted to evaluate my ankle, so I wouldn’t go into my race without any idea how I felt while running.

I felt better when I woke up than I had the night before.  I felt better still after stretching.  Even still, it was obvious by now that running was still too risky.  I only had two more days to heal, and I didn’t want to risk a setback.  I did my morning ice/heat treatment, and I took some more ibuprofen.

I was a bit frustrated with myself.   When I had one week to recover from the same injury last year, I was doing things that I forgot to do this year.  Last year, I bought an Achilles tendon support that doesn’t raise my heel, but has a strap that goes around my ankle to compress the tendon.  I bought it so I could continue running while I was recovering.  Until now, I had forgotten about it.  Since heel lifts alone didn’t seem to be enough, I decided to use the Achilles tendon support whenever I needed to be on my feet.

Either I was feeling much better or the support worked better than the lifts.  Either way it was good news.  I was cautiously optimistic that I could still race.  I had been having doubts.

I didn’t do any workouts that day.  It was my third rest day in four days, and I also planned to rest on Friday.  I made peace with that.  I finished the day with another ice/heat treatment and some stretching.

I woke up feeling optimistic.  I did 10 minutes of core exercises.  Other than that, it’s another rest day.  After breakfast, I did my last ice/heat treatment.

Today I drive to Wisconsin for the Wausau Marathon.  The race is tomorrow.  I’m hopeful that I’ll be ready to race, but I won’t know for sure until tomorrow morning.  I feel good now, but I haven’t run since Sunday.  I really don’t know how I’ll feel when I start running.  It won’t be the first time that I’ve traveled to a race without knowing if I’d be able to finish.

I may wear the Achilles tendon support.  I may go with a heal lift instead.  If I’m feeling good enough, I may race without any type of support.  That will be a race morning decision.  It’s possible that I’ll run one mile and stop.  I don’t really know what to expect.  I’ve recovered quickly from injuries before, but I can’t take that for granted.

Wish me luck … I’ll let you know how it goes.

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