Monday, May 25, 2015

The Day After the Med City Marathon

It’s been more than 24 hours since the Med City Marathon, and I’m still trying to figure out where I stand.  Clearly I wasn’t sufficiently recovered to run a marathon on a hilly course, but I didn’t know if I had suffered a serious setback in my recovery.

Immediately after the race, just walking back to the hotel was uncomfortable.  As soon as I got there, I applied an ice pack.  That helped considerably.  By the time I got home, I was in no immediate discomfort.  That said, I didn’t walk around much.  I wore a compression wrap, and I iced my leg periodically.  Later in the day, I did my stretches, but other than that, I mostly stayed off my feet.

One of my stretches involves standing and alternately moving each leg to the side.  Two weeks ago, I could only move my right foot about six inches to the side before noticing discomfort.  That range expanded a little bit each day.  Eventually, I could swing each leg about three feet to the side with no discomfort.  It was a nice measuring stick of my recovery.  Last night, I could still swing my leg three feet to the side with no discomfort.  That was a pleasant surprise.  By that measure, I still feel as good as I did before the race.

I didn’t know how I would feel today.  Would there be delay onset muscle soreness?  During the night I rolled over in my sleep and noticed some momentary discomfort.  Walking around the house I sometimes feel OK, but sometimes notice mild discomfort, depending on how I move.  As far back as Wednesday, I was walking around with no discomfort.  By that measure, I’ve regressed about a week.

This morning I did my core workout.  The first time I did this workout after the injury, I had to do my twists sitting down, but I felt OK doing sit-ups and leg raises.  This morning, out of habit, I did the twists in a standing position.  No problem.  On sit-ups and leg raised, however, I felt some discomfort.  Huh?

In the afternoon, I did weight training.  The last time I did weight training, I was slow and deliberate with all my movements, but still felt a small amount of discomfort doing things like stepping over the weight bench.  Today, I had no problems.  Then I did my hip and groin strengthening exercises.  Again, I had no problems.

Ideally, I’d try to get another PT appointment this week.  Today is a holiday, and I leave for South Africa tomorrow.  Even if I could get a last-minute appointment in the morning, I just wouldn’t have time.  For this week, I’m on my own.

Prior to yesterday’s race, I was running every other day and feeling fine.  I only ran a little bit farther before noticing discomfort yesterday, so it seems unlikely that the distance was the issue.  Most likely, the real problem was running so many hills.  All of my post-injury training runs were on a relatively flat loop through our neighborhood.  The Med City Marathon begins with seven miles of long gradual hills.  I suspect the long sections of downhill running were a bit too much at this point in my recovery.  If so, the Comrades Marathon is going to be a big problem.  That course has dozens of hills, including some big ones.

During a PT appointment last Tuesday, the therapist asked me if I could bring my compression wrap with me during the race.  I was skeptical.  I sometimes run with a fanny pack, but my wrap is fairly bulky.  I didn’t know if it would fit in the fanny pack.  I also didn’t think I could wear the wrap for the whole race.  It’s made of neoprene, and it covers most of my thigh.  If this year’s race is anywhere near as hot as last year was, I would sweat profusely wearing a wrap like that.  At the time, I was reasonably confident that I wouldn’t need it.  Now I think having it with me is a good idea.  I know what it’s like to finish a marathon in pain after pulling a hamstring five miles into the race.  I would’ve given anything to be able to wrap my leg during that race.

I checked to see if I could fit the compression wrap into my fanny pack.  It barely fits, but I’m able to zip it shut.  As long as I don’t have to put anything else bulky in there, I can make it work.

The Comrades Marathon is mostly uphill in the first 35K.  After that it’s rolling.  I think my leg will be OK running uphill.  I worry about all the downhill running.  Fortunately, most of the downhill running will come in the second half of the race.  I can’t wear the compression wrap for the entire race.  Aside from being too hot, it constricts all of the other muscles in my thigh.  I’m toying with the idea of stopping at the top of each big hill to put the wrap on and then taking it off when I reach the bottom.  That way, my groin will be protected running downhill, but the larger muscles that I need for climbing won’t be restrained.

The race is in six days.  This is mostly a rest week.  I’ll still do my hip and groin strengthening exercises every other day, but I’ll only run once, if at all.  Ideally, I’d like to go for a short run on Thursday or Friday, so I can evaluate how my leg feels, both with and without the wrap.

I’ll continue doing the other things I’ve been doing to treat inflammation.  At home, I ice a few times a day using gel ice packs.  Staying in a hotel, I can use the ice machines to make an ice pack the old fashioned way.  Our morning paper gets delivered in plastic bag.  This morning, as I took the newspaper out of the bag, it occurred to me that this is a nice size bag for an ice pack.  Now it’s in my suitcase.

I can also continue to use the compression wrap and low doses of ibuprofen, although I’m leery about taking any on race day.

I still have six days to heal.  I’m sure I’ll feel better in six days, but I won’t be 100 percent.  I was willing to skip the Ogden Marathon.  I was willing to stop during the Med City Marathon.  Comrades is my “A” race.  I’m not willing to skip this one.  I may have to adjust my goals, but I’m going to finish this one if I can.

Sunday, May 24, 2015

Race Report: 2015 Med City Marathon

This morning I set out to run the Med City Marathon in Rochester, MN.  I only ran half of it.  I entered this race long before my recent groin injury.  Since Rochester is only a 75 mile drive for me, I didn’t have to make any non-refundable travel reservations.  I could afford to wait and see how I was feeling before making a final decision about whether to race.  I booked a hotel for Saturday night, but I could cancel, if necessary, as late as Saturday.

Last weekend, I was registered for the Ogden Marathon, but it was too early in my recovery.  Trying to do that race seemed much too risky, so I cancelled my travel plans.  As this race approached, I was feeling much better.  I had two physical therapy appointments during the week, and my therapists could see noticeable improvement with each visit.  I also noticed a difference.  I had a wider range of motion on my stretches, I was walking normally, and I wasn’t noticing any discomfort walking, running or doing any of my stretches.

Even before the injury, I had promised myself that I wouldn’t run hard in this race.  At most, I would run just fast enough to break four hours.  This didn’t need to be a goal race.  Mostly, I wanted to finish another of the many Minnesota marathons.  This race is 20 years old, but I’ve never done it.

In the past, I’ve sometimes told myself I would use a race as a training run, only to run it all out.  This time, I had no such temptation.  Not having done a long training run since my last race on May 3rd, I wanted to get something long under my belt.  Mostly, I needed that as a confidence boost.  Being injured made me realize how ambitious my summer race schedule is.  I didn’t want to mess it up by running too hard.

During the week, I discussed my plans with two different physical therapists.  They didn’t see any problem with starting the race, as long as I was willing to stop if I experienced any pain.  That’s been my number one rule for running.  If I have pain, I’m supposed to stop.

Rochester is known as Med City because it’s home to the Mayo Clinic.  The Mayo Clinic is a non-profit medical center that has over 50,000 employees, including 3,800 physicians and scientists.  For at least 20 years, it’s been ranked among the best hospitals in the world.  Not surprisingly, the Mayo Clinic is a large part of Rochester’s identity.

I drove to Rochester on Saturday and stayed at the downtown Doubletree.  Doubletree is just a block from Mayo Civic Center, which was the site of most pre-race and post-race activities.  After checking in at Doubletree, I walked over to the civic center to pick up my race packet.  Then I had pre-race pizza with a few other Marathon Maniacs at Victoria’s, a nearby Italian restaurant.

I didn’t sleep well last night.  I woke up after about an hour and couldn’t get back to sleep.  I eventually caught a few short cat naps, but I never slept for very long.  When I got up this morning, I was really dragging.  Usually I shake that off as soon as I start getting ready for a race.  Today I didn’t.  It might be because I didn’t feel the same sense of urgency.  I wasn’t really looking at this as a race.

I was also sore and stiff.  My neck and shoulders were stiff because I was tossing and turning all night.  Both of my legs were a little bit sore in my thighs.  I think that was from all the stationary bike workouts I’ve been doing.  I’m not used to them yet.

The race started at 7:00, but I had to board a bus to the start between 5:20 and 6:20.  The buses were loading just around the block from the hotel, so I didn’t have to allow too much time to get there.  I got up at 4:50 and was on a bus an hour later.

The overnight low was 60 degrees, which was warmer than I expected.  There was about a 50% chance of rain.  As usual, that added some guesswork to my decision of what to wear.  Since I wasn’t going to run fast, I decided to err on the side of dressing warm.

In the past, my pre-race routine always included getting up early and taking a hot bath to loosen up my legs, so I could do a bunch of static stretches.  I still did some stretching, but after getting to the starting area I also did a dynamic warm-up routine that one of my therapists gave me.

The course is point-to-point.  It starts in the small town of Byron.  The first several miles are rolling hills along country roads.  The middle miles go through neighborhoods in Rochester, including a few parks and paved bike paths alongside rivers.  The finish is in downtown Rochester, next to the Mayo Civic Center.

We were dropped off at Byron High School.  When I got there, I saw tables for race morning packet pickup.  When I signed up for this race, I didn’t notice that they had that option.  I could have driven down to Rochester this morning.  It would have meant getting up much earlier, but in retrospect, I probably would have gotten more sleep.  Oh, well.

I didn’t know what pace I would run, but I lined up near the 4:00 pace group.  I was going to run whatever pace felt comfortable.  It would be nice to break 4:00, but only if I could run that pace without working too hard.

This isn’t a large marathon, but there’s also a half marathon and a relay.  We all started together, so there were enough runners to make the first mile a bit congested.  After we had enough room to run freely, I discovered that it felt awkward to run with the 4:00 group.  The pace was too slow.  I haven’t been wearing a watch on my recent training runs, but apparently, I’m running them faster than the pace we were starting.  I left the 4:00 group behind and ran a pace that felt more comfortable.  After a few miles, I found myself near the 3:45 group.

The early miles were non-stop hills.  None of them were steep, but a few were long.  In general, I maintained an effort that felt comfortable and didn’t worry if I sped up or slowed down.  There was one exceptionally long hill that started around the five mile mark.  Running downhill started to feel a bit uncomfortable.  I was noticing some tension in some of the muscles of my right leg.  It occurred to me that I might be overstriding, and that might put a strain on my recovering groin muscles.  I made a conscious effort to shorten my stride.

After about seven miles, the character of the course changed.  We left the highway and turned onto a paved bike path.  I wondered if that meant we were done with the hilly part of the course.  On cue, one of the spectators said, “No more hills.  That part is over with.” We were also done running past farms.  Now we were on a greenbelt in the outskirts of Rochester.

Around eight miles, I saw a small vehicle going around us on the grass.  It was about the size of a golf cart or ATV.  I didn’t pay much attention to it, but assumed it was somehow related to the race.

With temperatures around 60 and high humidity, it felt a bit warm.  Then it started to rain.  It was a light rain.  It was just enough to cool us off, but not enough to be uncomfortable.

At nine miles, I started to have a vague sensation of soreness in my right thigh.  I assumed the hills in the early miles were beating up my quads a little.  Then it occurred to me that I had already run farther than any of my recent training runs.  I couldn’t really localize the soreness, but it wasn’t that far from my injured groin.  It might be my quadriceps, it might be my hip flexor, or it might be my groin.  That concerned me.  If I had felt the same sort of soreness in my left leg, I probably wouldn’t have worried about it.  After all, I had some soreness in my upper legs before the race even started.

We were leaving the greenbelt behind to run down city streets.  At 10 miles, I noticed we were crossing Broadway.  I wonder how far we were from the downtown area.

Over the next mile, I realized that the soreness in my right leg might be subtle, but it was also persistent.  I tried to notice where I was feeling it.  It was hard to tell.  Then I decided to reach down with my hand and touch the area that felt sore.  I fully expected to reassure myself that it was my quad or my hip flexor.  As I touched the center of the soreness, I realized it was on the inside of my thigh.  This was groin discomfort.  I needed to stop running.

I was just passing the 11 mile mark.  I didn’t really have a good exit strategy.  I needed to figure out how and where I could get a ride to the finish area.  I asked the next volunteer.  She had a van, but she was a course marshal and couldn’t leave her post until her shift was over.  She said there were some carts going along the course to pick up runners who needed to drop.  I asked her if they were operating this early in the race.  She said she had already seen one go by.  Then I realized that was probably what I saw going by me earlier in the race.  For the time being, I kept moving, but I slowed down.

A few friends went by, and we talked about my situation.  They all agreed I should drop, but didn’t know where I could get a ride back.  One suggested, if nothing else, I could stop at halfway.

We went by an aid station at 12 miles.  We were going through a large park, so the only people around were the aid station volunteers.  There were several vehicles parked nearby, but everyone I saw was working the aid station.

Finally, a few blocks later, the marathon and half marathon courses separated.  I followed the half marathon course, knowing it would bring me to the finish in less than a mile.  I continued to slow down, hoping it would minimize whatever damage I was doing by running.  I would have walked, but I also wanted to get back to the hotel quickly, so I could begin treating the injury.  I was now glad I stayed in a hotel.

The marathon and half marathon both use the same finish line.  I didn’t want to confuse the timekeepers by appearing to finish the marathon in 1:57, so I ducked under the ropes and walked around the finish line.  I wasn’t a half marathon finisher, since I was registered for the marathon.  This turned into a 13.1 mile training run.

I didn’t stay in the finish area any longer than I had to.  I just needed to retrieve my gear bag.  Walking back to the hotel was uncomfortable.  Fortunately, it was only a few blocks.  When I got to my room, I emptied my plastic gear bag and headed for the ice machine.  I used the bag to make an ice pack.  I had a compression wrap with me, so I used that to hold the ice pack against my leg.  I iced for 20 minutes.  That seemed to help.

After getting cleaned up, I put the compression wrap on my leg for the drive home.  When I got home, I used a gel ice pack to ice my leg again.

I’m only a little bit disappointed that I couldn’t finish the race.  Mostly, I’m concerned about my leg.  I don’t know how much of a setback I suffered.  The Comrades Marathon is one week from today.  Before today, I was confident I would be 100% recovered.  I thought I was 90-95% recovered already.  Now I’m not sure where I stand.  It will probably be another day before I can access how much this set me back.

I didn’t really think I was taking a big risk by doing this race.  I’ve been running every other day.  Had I not done the race, today would still have been a running day.  My last three runs were 5.25 miles, 7 miles and 8.1 miles.  Today, I probably would have run about 10 miles.

I thought I could run as long as I felt good and stop immediately if I didn’t.  There were two problems with that.  First, distinguishing between normal soreness and injury soreness proved to be more difficult than I anticipated.  Second, stopping immediately requires a good exit strategy.  I didn’t have one.  I should have stopped after nine miles, but I ended up running 13.1.

I wasn’t ready to run 26.2 miles on a course that’s moderately hilly in the first seven.  The Comrades Marathon is 54.5 miles, and it’s very hilly.  I’m worried.

Tuesday, May 19, 2015

Week Two of Rehab: Strengthening

Today I saw a different physical therapist.  For the past week, I’ve been working on healing and improving my flexibility.  I’m about 50% recovered, but I need to start working on strength.  After several exercises to test my strength and flexibility, my therapist gave me a few exercises to do at home.

In addition to rebuilding strength in the inured muscles, I’m also going to be strengthening my hips.  That should not only help with recover from this injury, but also help me with my chronic hamstring issues.

She also showed me several dynamic stretching exercises that I can do as a warm-up before running.  I tried some of them today.  After the exercises I did earlier, some of the weaker muscles in my right leg were getting tired, and I had trouble with my balance.  After that the therapist demonstrated the remaining warm-up exercises.

I went home with a list of warm-up exercises, and a few diagrams to remind me how to do my strengthening exercises.  My therapist also gave me a Theraband to use for a couple of the exercises.

Everyone I’ve seen about this injury knows my goal is to run the Comrades Marathon a week from Sunday.  We’re all on the same page as far as my recover schedule.  Yesterday, I ran 5.25 miles with no discomfort.  For the next week, I’ll be running every other day.  On the days I run, I’ll do the dynamic warm-up exercises.  On the days I don’t run, I’ll do my new strengthening exercises.

I’ll run seven miles tomorrow.  If that feels OK, I’ll probably run the same distance on Friday.  I’m registered for the Med City Marathon on Sunday.  If all goes well, I plan to run it, but I’ll go at an easy pace.  If I have any discomfort, I’ll stop immediately.  I have the green light to do the whole race, but only if I don’t experience any discomfort.

Monday, May 18, 2015

Injury Update: My First Week of Rehab Has Been Promising.

It’s been a week since I saw the doctor about my groin injury.   After one week of rehab, I’m feeling optimistic.  I’m not there yet, but I’ve come a long way.

Last Monday was my third consecutive day of complete rest.  On Tuesday, I started physical therapy, and I was encouraged to begin cross-training on the stationary bike.  I was also given a few stretches to do three times a day.  Later that day, I did 15 minutes on the bike.  It was surprisingly tiring, reminding me that that I’ve been neglecting the bike for too long.

On Wednesday, I increased to 20 minutes on the bike.  I also did a short core workout.  My core workout is a circuit of three exercises that I do three times.  I didn’t have any trouble with my sit-ups or my leg raises, but on my first set of side-to-side twists, I noticed that it stretches my groin a little too much.  On my second set, I did that exercise sitting down.  That helped, but I could still feel the stretch.  On my third set, I made a point of keeping my knees together.  That felt OK.  I probably wasn’t working as many muscle groups, but I wanted to be careful not to overdo it.

In general, I was feeling a little bit better each day.  I was also noticing a difference in my stretches.  After a couple days, I felt perfectly normal doing one of my stretches.  By the end of the week, I had doubled my range of motion on another stretch.

On Thursday, I ran for the first time in six day.  I started with three miles on the treadmill.  I wore a compression wrap on my upper thigh and ran at a slow pace.  I didn’t feel any discomfort in my groin, but I did feel some discomfort in some of the other muscles in my thigh.  The wrap was kind of snug, and I think some of the muscles were too constricted.

On Friday, I ran outside and increased the distance to 3.5 miles.  I wore the wrap again, but it wasn’t as snug.  Again, I felt no discomfort in my groin.  I still felt a little bit of discomfort in other muscles, but not as much.

I was originally scheduled to run the Ogden Marathon on Saturday, but I cancelled my travel plans rather than risk a setback.  Friday’s run made me wonder if I could have done that race.  It’s just as well that I didn’t try.  On Saturday, I started seeing posts from friends that did that race.  They all ran fast times, but they had to endure heavy rain and cold temperatures.  At least three friends commented that they couldn’t feel their arms.  I regret that I lost an opportunity to go for my second sub four hour marathon in Utah.  I don’t regret missing an opportunity to suffer from hypothermia.

Instead, I ran another 3.5 miles, but this time I didn’t wear the wrap.  I didn’t have any discomfort, although I was going at a pretty conservative pace.  Saturday’s run gave me a total of 10 miles for the week.  I’ve run at least 10 miles every week for more than 10 years, so I was happy to be able to keep that streak going.

I took a break from running on Sunday, but did a few different cross-training workouts.  In the morning, I did another core workout and 25 minutes on the stationary bike.  In the afternoon, I did weight training.  It was my first weight training workout since the injury, and I was long overdue.  I had been afraid to do weight training.  My big concern wasn’t the exercises themselves, but all the other movements I go through getting weights and bars into position.

As it turns out, I was right to be concerned, but moving weights around wasn’t the problem.  Where I really felt tension in my groin was moving myself into position.  Each time I had to swing a leg over my weight bench, I could feel the stretch.  I got through the workout, but it made me nervous.

After being home for the weekend, I was back at work again, which meant much more walking around.  I noticed a real difference.  A week ago, I could only walk by wearing a compression wrap and taking teeny tiny steps.  I’m still wearing the wrap, but now I can walk normally with no discomfort.  I’m walking more confidently and more comfortably.

I’m pleased with my progress so far.  I like my chances of being recovered in time for the Comrades Marathon.  I’m also scheduled to do the Med City Marathon on Sunday, but it’s still unclear whether I’ll be recovered in time.  I’ll wait until Friday or Saturday before making a decision.