Saturday, 18 June 2011

Not so much wallowing as drowning

Thanks for all the responses to my last post - really appreciated the thought behind them and flattered that my ramblings were of interest.

I haven't posted since, partly as I've been really busy and partly because I've had little to post about. I've also hardly commented on other people's blogs since either - apologies for that too.

I did start a post entitled 'Injuries Don't Negotiate' but it didn't get past draft stage and I've cannibalised it for this entry, which is part update and part (hopefully) cathartic heart pouring.

I got Tim Noakes's excellent book 'Lore of Running' a couple of years ago. Its a mighty tome of close to 1000 pages and can be pretty scientific and heavy going too but as a reference source to dip in and out of it really is excellent. I wish I'd referred to it a few weeks ago.

Based on Noakes's comprehensive guidance on achilles injury and the other research I have done on line I'm certain that I have a mild case of plantar fasciitis that resulted from sudden weight gain along with with achilles tendonisis on the left. The former has settled down almost completely (at least when not running) but the latter is a fairly big problem; with recuperation still very much a work in progress.

Taking Noakes's description on board it looks like the causes were:

  1. Age - Its a degenerative condition not uncommon in middle aged male runners. There's a cheery thought.
  2. Wearing stiff soled shoes with very low heels - My post marathon running was done almost exclusively in new Saucony minimalist shoes. The heel height is extremely low and there's not much flexibility in the soles. Might be coincidence but the injury came on after switching to these shoes. Might have been wise to have transitioned to them as the pre marathon running was done in far more built up Nike Lunar Eclipse and (for tempo and speed work) Newton Sir Isaacs.
  3. Sudden single long run - Noakes states this as a common trigger and I can only remember the pain being notable after the 16.5 mile run I did a few weeks ago. That run was notably longer than anything I'd done since Paris so, again, sems quite a coincidence if it wasn't the trigger.
In summary: looks like the underlying problem is age related degeneration (cue more cheery thoughts), with possible aggravation from switching too quickly to radically different footwear and an immediate trigger/breakdown point from suddenly trying to do a long hilly run off the back of very little training.

According to Noakes recovery is measured in months and years rather than weeks, though in most cases a good recovery can be made eventually.

In terms of treatment he advocated immediate complete rest (i.e. avoid standing and walking as well as running) for 1 - 3 weeks minimum at the first sign of symptoms. Oops. That's where the negotiating came in as I tried to cut back and run through discomfort and it didn't play ball. He also suggested regular icing, which I did belatedly do and found it surprisingly effective.

He classes all injuries through 4 levels of severity and for this injury I'd summarise his ideas as:

  1. Soreness each morning - complete rest for a week, change footwear, stretch calves.
  2. Discomfort during running but doesn't interfere with run - treatment as above but drop intensity and distances upon starting again.
  3. Pain during running that interferes with performance - 3 weeks complete rest, treatments as above, re-start with light jogging only until symptoms become Level 1.
  4. Pain prevents running - try approaches above and if no joy consult a surgeon.
I'd say I definitely got to Level 3. Arguably I got to 4 as on several attempts I had to abandon runs at the first stride but (I hope) that may have been a hint of caution on my part and I was actually only at L3.

In the last 3 weeks I've ran twice: 0.7 miles and 2 miles the week before last. Both were 'testers' pre-Noakes and both went OK but brought on some soreness afterwards. On Thursday I had to run about 150m as I was late picking Charlotte up and that also left some tenderness if the achillies was pinched in the next 24 hours.

It seems like everything got 80% better in the first week but since then the rate of improvement has slowed to a crawl. I'm a bit sore on a morning and during the day may feel occasional stiffness/creakiness in the achillies but generally feel its OK, but I'm not convinced its good for running (from Thursday's experience). I'm probably a bit scared of trying too. At the moment I'm thinking of leaving it another 6 days until next Saturday then trying again - back in the old trainers.

I did try going to the gym a couple of weeks ago but found that the cross trainer and rower both aggravated things immediately. I haven't been back since. I feel a bit ashamed to go due to my change in size and whilst the exercise bike is OK injury wise its still less than inspiring. Besides, as you'll see below' I haven't really had the time.

My weight and size remain unchanged at best and at worst a further couple of pounds on. I've managed a couple of days of good diet but that's about it. I haven't had a day off work in 3 weeks and my weekdays in the last 10 days have been 13-14 hours a day. I'm absolutely shattered and living off generally appalling convenience foods plus sweets/biscuits and chocolate.

Last year when I was at 11st 7lbs I got rid of all my bigger clothes. Now, at somewhere between 13st and 13st 7lb, I honestly have virtually nothing I can wear:

  • One pair previously baggy jeans are just about OK
  • One pair jogging pants with forgiving waist
  • 2 t-shirts that just about fit
  • One pair of hugely baggy gym shorts now just fit but my arse looks like the back end of a bus in them
  • One running/gym shirt still fits
  • One suit (just) fits though I had to buy 2 bigger shirts to wear with it
Sue and the kids have gone strawberry picking but I've stayed at home as the only clean clothes I have that fit are some jogging pants and an old stripey polo shirt. I don't want to wear that and leave the house - I look like a participant from the Jeremy Kyle show.

Sometimes I feel very pragmatic about things and accept that until my achillies is fixed there's little I can do. Other times I actually feel really down about it. Not so much wallowing in self pity as drowning in it.

The clothes thing falls into the latter despite my JK jibe, and even the fact of feeling down about that depresses me further - it doesn't seem a very manly thing to feel let alone admit too. On top of that there's an underlying fear that the injury just wont get better or will take many months before it becomes tolerable from a running perspective. Lastly there's the fact of the injury being largely down to age related degeneration. I can't begin to say how depressing a reality that is.

Happy days.


Maria said...

Firstly, I think you are entitled to some self pity. Secondly, nice to see you back. Thirdly, no-one minds you not posting or commenting if you are busy. Fourthly (how long can I keep this up for?)at least you have a good idea of what the problem is, and how to fix it. You might not like it, but you know. Fifth- I am sure once you get some motivation going you could find other things at the gym to do- my one had those arm cycling machines which were good for cardio if you could not use your legs. Or would you try an exercise class? They tend to me more female dominated, but we have men at body pump and I know some go to spinning- might that be an option? I just find classes more fun than plodding away for an hour. Just a thought. Your Jeremy Kyle comments made me laugh too! :)Chin up.

Alison said...

I'd like to reiterate Maria's 1-3!

From thereon in I'm going to take the pragmatic approach, with a dose of sympathy for good measure.

I can understand the weight gain dragging you down, and that you don't want to buy new, larger clothes because it's an admission of that gain. But given your comment about strawberry picking, and the likelihood that it's just contributing to a lack of self-confidence and feeling of self-pity, I would strongly recommend that you buy just a couple of items to tide you over until you get the weight off again. You need to be able to get on with (and enjoy) the rest of your life, regardless of what's going on with your running. And if you're ashamed to leave the house, and tramping around in jogging bottoms in it, then I don't see that happening.

As for the injury, I don't see it as being predominantly age related. Using counterfactuals, it sounds like you probably wouldn't have had a problem without the switch in shoes and sudden long run. So while you are ageing (sorry mate, but it happens to all of us!), that's not sufficient to keep you from running. Other external (and contingent) factors are in play; factors that you have control over, and can do something about in the mid- to long-term.

When it comes to the recovery itself, I know that PF is notoriously difficult to recover from. But with a positive attitude, and some strict discipline, both of which I know you are capable of, you will hopefully be back in a matter of months. While that seems an age away right now, in the general scheme of things it is not all that bad. And it is definitely better than never running again.

In the meantime, I think your priority has to be getting your mood (and motivation) up. Not watching depressing films might be a start! The next thing, go you swim? If you want to keep some fitness and help yourself lose the weight, then it's that an cycling. And while you might feel embarrassed compared to your previous state of fitness, no one else is likely noticing. And even if they are, what are your choices? You either sit at home and wallow, and don't effect any change, or you bootstrap yourself.

Injury is tough. Combine that with weightgain and I can completely understand that you feel really demoralised and overwhelmed. I'm taking the fact that you've started blogging again though as a sign that you're ready for a gentle shove towards positive management of this situation. If this is too much though then I can suggest The West Wing as excellent, liberal feel good entertainment :-)

Really is good to have you back.

RoseC said...

I'm really sorry that i missed your posting of this and only popped over after seeing the comments on Alison's blog.

I too would like to re-iterate Maria's 1-3 points AND Alison's age related comments.

When I read your post my immediate thought was that it was likely to be 90% shoes and 10% sudden increase in distance that caused the injury.

Have you seen a physio? It would really help to get a professional diagnosis and some help on what you can/can't try to do at the moment.

Now - weight/clothes etc etc etc.
Alison is definitely right on that. You NEED to be able to go out and do things with the family. Primark or suchlike should do the trick perfectly. You don't have to spend much, just get some jean or shorts and a couple of t-shirts...looking good makes you feel better which helps you make better food choices etc....there's a very definite link and I'm sure you know that.

I also think that if you are properly depressed rather than momentarily down then you should really go and speak to your doctor about it. It's never worth trying to battle on if you need some help. However, it might just be a lack of exercise endorphins and just a matter of finding something that can give you that buzz. The physio could probably help with that.


~Jessica~ said...

Oh God Rob, I'm so sorry you're feeling like this. You've typed out more or less word for word a lot of my thoughts and I know how distressing the whole process of injury and weight gain is only too well. Even your self-depricating jibes seem curiously 'Jess-esque' in their cruelty! Even if you did look like a participant in Jeremy Kyle, I'd just like to point out that you've got so much going for you besides whatever clothes you're wearing or the size of your arse in a certain pair of shorts, where as the lot from JK are lucky if they have a walnut between their ears. I know it's hypocritical of me to say but clothes do not maketh the man: you're obviously a sensitive guy (and NO, that does not mean 'unmanly') that has a keen sense of his own physicality. I don't think this is limited to women in the slightest: so many of the *very* macho/masculine guys at my gym complain about loss of muscle tone for example (the bodybuilding ones that are amused by the fact I know as much or more about protein powders as they do...) and even some of the sub 3:20 marathon runners complain about 'pudge' around the middle and get down when they're injured...

~Jessica~ said...

...I'm having to split this epic comment due to word limits. Damn you Blogger. Anyway, I HATE going to the gym due to the obvious difference in my size, something that quite a few people are very vocal about pointing out. But not going just perpetuates the cycle of negativity we both seem to gravitate towards when injured: it's not all or nothing: would swimming or upper body stuff not help? You'd still be burning calories and keeping a level of residual fitness at the very least. Being depressed about our size and then exercising less just leads to more gain, more depression about our size, and therefore the loop continues.

But 14 hour workdays!?! I'm surprised you're still sane. I don't think any person would find time to exercise much or cook healthier foods with a schedule like that. It's insane. Cut yourself some slack in that regard, because I'd like to see anyone cope with that without turning to a) food b) booze c) drugs or d) all of the above.

I know it's probably weird coming from a 25 year old lass, but I don't care: I have to send a huge online *hug* anyway. You WILL get through this and come out stronger on the other side, so there.