An Abrupt End to the Racing Season :-(

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It is with a snarling, frustrated, heavy relieved, accepting, grateful heart that I must call an abrupt end to my 2018 trail racing season. I’ll miss both the Pikes Peak Ascent and my main event, the Grand Traverse. It’s all due to a gimpy left calf and a bad decision on my part.

Good decisions

The calf strain came a few weeks ago while climbing during a race. I did the right thing. I quit the race and avoided further injury. I took two weeks off from running. I saw Dr. Nick Studholme who taped my foot and calf and helped me understand the injury. We decided on a collection of exercises to help the area heal and get stronger. I did calf and lower-leg strength work to my level of tolerance.

Last Monday I did an easy road run for the first time and I felt good. Great! Then I had a decision to make: Do I continue a slow, gradual return to running protocol? Or do I jump quickly back into hard training?

A bad decision

I chose option two, a seven-mile trail run with intervals. Everything felt fine until about mile three. I took a big step off a rock, landed on my left foot, and felt some pain low in the calf, the same area that was hurt in the race. I didn’t crumple in agony but there was noticeable discomfort. I kept running. I hoped the pain might fade out or simply be a minor annoyance. It hurt more as I ran and hurt less when I walked. That is a clear-cut indication of an acute injury that must be unloaded and allowed to rest. I made the wrong decision.

The Pikes Peak Ascent is two weeks away. Uphill running will put my calf under massive stress. I was running uphill when I hurt it the first time. Two weeks is probably enough time to start running again, but by god isn’t nearly enough time to prepare for an 8000 ft. ascent.

Madness

The 40+ mile Grand Traverse is four weeks away. Four weeks… That’s not much time… Is it enough time…? If you’re an endurance athlete then you may recognize the following line of “reasoning.” The conversation I had with myself went something like this:

“I’ve heard of athletic miracles, of players coming back from near-disastrous injuries and illness with incredible performances. Can that be me?”

“Can I replace running with mega-miles on the bike, rehab the calf, and get to the start line of the Grand Traverse?”

“Are there miracle drugs? Can steroids help? If so, should I attempt to use them?”

(I’ve never considered steroids but I did learn a few things about them. The good news is that several significant factors including ugly/weird other effects put me off this route.)

Panic

I screeched into a blistering panic for about 48 hours. I came up with all sorts of irrational, desperate thoughts. It was agonizing and depressing. The emotional part of my brain had a flailed and reeled as the rational part held up the facts about my injury and the reality of running a 40-mile race in four weeks.

Waaah! The poor privileged white man may not get to run recreationally through the woods! 

In the context of the wider world, of suffering, of true hardship, this was not an actual problem… but sometimes things bother me.

Sanity and calm

I spoke with my coach, Andrew Simmons of Lifelong Endurance. He helped me. He did what a good coach should do: Tell the truth. We both agreed that Pikes was out. As for the GT, he said there was a far outside possibility that I could jog/hike the race, stagger across the finish line in misery,  damage my calf severely, and destroy my ability to run for 60-90 days. These were the facts. My decision was crystal clear. No more racing. Heal up. Get ready for next year.

We agreed to reconnect again in several weeks. He recommended I be able to run 20-25 miles per week with 10-12 mile long runs before I commit to serious training.

To be very clear, I place no blame on Andrew or the running plan for my injury. I was making solid progress and I have been entirely satisfied with Andrew’s coaching. I fully intend to enlist his help again on future races.

The upside

Adverse events are guaranteed to happen. Any athletic endeavor comes with risk. Trail running is risky. Ultra-distance running even more so. There are innumerable variables that must align for a successful race and a successful season. It’s entirely likely that something or several somethings can go wrong. How does one react? To me, that’s a crucial issue. Does one wallow in self-pity and self-criticism or is there a better way? I choose to observe several positive details:

First and most importantly, my mind is right. I love the training: running in the mountains, preparing to race. My motivation is sky high—I love the process! — and I am deeply grateful for my time on the trail in the mountains. I have every intention of running the races I missed this year. I carry no negative emotions around trail running.

Second, I try to be resilient in these circumstances. I’m not Mr. Spock, I have emotions and I definitely experience the intense anguish familiar to any athlete who’s hobbled by an injury. Once the teeth gnashing and the freakout is over though I try to move forward in a positive way. Ruminating and stewing over past events is wasted energy, it won’t heal my calf faster, and unless you have a time machine I can borrow so I can go back and fix my mistake, I’ll never be able to change the past. Move forward.

Third, I recognize the significance of my weak link. My left lower-leg/ankle/foot/calf is a continual problem. I do just enough rehab/strength work to push the problem away, then I ignore the weak link and the problems return. I believe the recent hard running I’ve done has exposed the weak link again. Calf work is boring for me. I don’t like it so it’s easy to avoid it. The problem is that it’s critical for my running success. (I’ve discussed this in the past.) It stares me in the face. I have a choice: I can continue to follow the same process and thus I should expect the same problem to return. Or I can devote significant energy to build up my lower leg, armor it, make it strong and resilient, and expect to perform better. I have a chance to make a better choice going forward and address my calf strength the way I should.

Finally, I had a great experience working with my coach. We moved my running in the right direction. Specifically, we worked on tempo runs. I got faster over longer distances. The hard runs felt good and I made progress. My final long run of 20 miles felt superb. I fully believe that I’ll return to a high level of performance with Andrew’s guidance.

There is always an upside to a regrettable situation. Always. Now I get to spend a lot of time on the mountain bike!

Exercise, Stress, Work, Injury, Life… & Crossfit

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A couple of recent articles have me thinking…

Unfortunately for many of us, exercise and injury (or just pain) live very close to each other. I’ve heard a lot of people say things like “I can’t run anymore because of my knees,” or, “The bench press hurts my shoulders.”

Something that’s supposed to be healthy hurts us? That doesn’t sound right.

Exercise and the big picture

When “Healthy” Habits Aren’t comes from Whole 9. It’s written by Kate Galliett of Fit for Real Life. She gives discusses a big-picture view of our exercise habits within the context of our often stressful, unbalanced lives.

She says:

“Exercise is not meant to break you. Exercise habits are not meant to suck other important aspects of your health dry. Exercising is not meant to be a numbing agent to things your body is telling you.”

Seems obvious, right? Who would argue that we exercise in order to feel bad and get hurt? Yet the reality is that multitudes of gym goers, runners, and all sorts of recreational athletes inhabit a world in which their chosen activity puts them in pain every day. This picture is out of whack. Pain is a way of telling us that something needs to change. (Remember though, pain doesn’t always equal injury, but pain is not to be ignored.)

I like this:

“Chronic stress is not helpful for fat loss, muscle gain, or performance improvement. It’s also not helpful for any of the health factors that keep you alive & kicking well into your later years. And many habits society deems ‘healthy’ are much less so when looked at in context to modern, busy, stressed lives.”

And to the previous point, this is extremely important to remember:

“Stress is stress. It’s the same to your body whether you define where it comes from as ‘good’ or ‘bad.'”

Living organisms need a certain level of stress to flourish. With the right amount of stress applied in a progressive way plus rest, plus food, that organism gets stronger. Too much stress of any type plus inadequate rest and/or inadequate food and that organism breaks down. We don’t want that but that’s where a lot of us are.

Why exercise?

A lot of us identify in part by our physical activity. “I’m a runner,” I’m a cyclist,” “I’m a powerlifter,” or “I’m a Crossfitter.” Self-image matters a lot, whether or not you want to admit it. This paradigm can get a little out of control.

Sometimes it seems we get to where we’re working out just to work out. And sometimes we push harder thinking we’ll get stronger yet in reality we’ve dug ourselves a hole and we’re digging harder to get out.

“Take a break? Back off? Are you insane? That’s for losers! I HAVE TO WORK OUT! THAT’S WHAT I DO!”

Well… Okay… But are you realizing a benefit?

Not if your workout hurts you. And if you’re piling stress on top of stress on top of stress, and you’re working harder despite the fact that you’re not sleeping enough, your job is killing you and your family is driving you crazy—all during allergy season—then don’t be surprised if you feel like a wreck. It might be time to try something different.

To me, the takeaway message of the article is that the actions and habits we practice in the pursuit of health and fitness don’t exist in isolation. These practices exist alongside a wide range of other influences in our lives. There are times when we need to take a step back, look at the big picture and at times modulate our beloved running, swimming, weight training or what-have-you. Read the full article for the whole discussion.

The Wellness Continuum

To expand a bit, this article reminded me of something I learned about in grad school, something called the Wellness Continuum.

The Wellness Continuum

The Wellness Continuum

I’ve talked with a lot of people who view health exclusively through the diet and exercise lens. In this view, diet and exercise are separate and distinct from all other aspects of health. To me, this view is like looking through a microscope.

With the Wellness Continuum, we can examine our lives with a telescope. We can see an amazing range of interrelated factors that contribute to or take away from our overall health. Most of us, myself included, probably do very well in some of these categories while other categories deserve extra attention.

To reiterate, none of these factors exist in isolation. These conditions all blend together to determine our well being. If we ignore one aspect of health then the whole operation is diminished.

Crossfit & Injuries

High-intensity workout injuries spawn cottage industry comes from the Washington Post. The article discusses not only injuries that may be generated from Crossfit workouts but also the businesses that have sprung up to treat said injuries.

One observation of the article is this:

“Many people who do the high-intensity workouts aren’t adequately conditioned for such rigorous workouts, or have back and spine conditions that could worsen, said Dr. Marc Umlas, chief of orthopedic surgery at Mount Sinai Medical Center in Miami, who said his office has seen an increase in injuries from workouts at CrossFit and similar programs.

“’They plunge headfirst into a high intensity workout and they get injured,’ Umlas said.”

The article describes various business that offer treatment strategies for such injuries. A trainer, Lauren Roxburgh said something related to the theme of the previous article on healthy habits:

“’In our lifestyle it’s been very much about the doing. … It’s all about pushing through, doing, doing, doing, and it hasn’t been enough about the yin, which is the being, being in the moment, being present in our bodies,’ she said.”

That sounds like yoga-speak for respecting the need for rest and recovery. More more more harder harder harder exercise isn’t always better better better. There’s a time for hard work and a time for backing away from hard work.

“It depends…”

“What do you think of Crossfit?”

I’m often asked that. As with most questions, the most accurate answer is “It depends….” on a lot of things.

(To be clear, I’m not a Crossfit coach. I’ve never worked out in a Crossfit gym.  I’ve met lots of Crossfitters and I’m aware of a lot of what I’ll call the Crossfit culture and its components.)

I love that Crossfit has re-popularized free-weights, the Olympic lifts and body weight training. I love that in many Crossfit facilities there is a supportive community that bonds through tough workouts. I’ve met good Crossfit coaches who recognize the need for proper technique and proper progression in doing these workouts.

I’ve also seen some horrendous exercise technique displayed by Crossfitters. I’m aware of a mentality in many (maybe not most) Crossfitters that the harder and faster the workout the better. Some in the Crossfit culture view this mentality with pride. I think it’s a questionable approach.

My answer is it depends on the condition of the individual participant. Is this a raw beginner or an experienced lifter? How well does the person move? Who’s coaching him or her? Does the culture at a particular Crossfit facility emphasize good technique and proper rest and recovery strategies? Or is it all “Go! Go! Go! Ignore the pain!”

Adaptation to imposed demands

Human beings can adapt to all sorts of stresses and conditions. As it relates to exercise; if we work in a progressive manner; gradually applying stress to our bones, muscles and connective tissue; consuming appropriate calories and nutrients; and resting appropriately then our structures will adapt to those imposed demands. (Read up on Davis’s law and Wolff’s law for more on how this process works.)

If, on the other hand, we go hell-bent-for-leather into a new workout routine (particularly if we don’t spend time on learning good exercise technique) then we may outrace our body’s ability to adapt.

To compound issues, if we undertake some sort of intense Crossfit-type workout, and our personal Wellness Continuum is out of balance then it’s highly likely that aches and pains will soon follow.

Discipline

With exercise, most people equate discipline with getting up early, working out hard every day and “pushing your limits.” I would offer that “discipline” really means doing what you need to do, not just what you want to do.

For we who love exercise, working out isn’t the problem! We love being in the gym, on the road, on the trail or in the pool. Sweating and lifting heavy things isn’t the hard part. It’s taking a break that’s near impossible! Taking easy days, letting injuries heal, doing our rehab exercises, tapering for a race, taking off-days or god-forbid, taking an off-season?! …That’s discipline.

So… There’s that.

MRIs & Docs May Not Have All the Answers

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We’d like to think that our modern medical technology and treatment methods can diagnose and heal any problem. PET scans, CAT scans, MRIs and X-Rays allow us to peer inside the body and examine tissues and organs. Our MDs and surgeons are the beneficiaries of hundreds of years of evolving medical education. But guess what! Not every ache and pain has an obvious cause and many docs are as mystified by our ailments as we are.

New Study Finds 70 Percent of Able-Bodied Hockey Players Have Abnormal Hip and Pelvis MRIs comes from Science Daily.  The piece explains the findings of a study conducted by the American Orthopedic Society for Sports Medicine.  The study used the MRIs of the pelvis and hips of 39 collegiate and professional hockey players.  Seventy percent of the images showed abnormalities yet only two players reported pain.  In other words, most of the players had what we might identify as “injuries” yet only two of them were “hurt.”  So this goes to the issue of just how valuable are these sorts of diagnostic tools.

Matthew Silvis, MD, Assistant Professor, Department of Family Medicine and Orthopedics at Hershey Medical Center at Penn State University College of Medicine stated,

“Unexpectedly, the majority of players had some abnormality in their MRI, but it didn’t limit their playing ability. The study raises many questions, but its value to surgeons is to recognize that imaging doesn’t replace good clinical judgment, which includes a detailed history and complete physical exam. This study might make you hesitate to read too much into an MRI.”

A lot of us probably assume the MRI is very precise and can show us exactly why our back, knee or shoulder is in pain.  Yet we may need to think about whether or not we’re looking at chickens or eggs here.  Do these abnormalities cause pain, or are they simply coincidental to pain?

Obviously the only reason anyone gets an MRI outside of a study like this is because we’re in pain and we need to know why.  (I have yet to meet anyone who had an MRI simply out of curiosity about what they look like on the inside.)  So automatically we have a self-selected group to study.  If this study is any indication then in fact it’s entirely likely that people who feel healthy may indeed appear to be injured according to their MRI.  Thus what is seen on an MRI and attributed to our pain–bone spurs, a torn labrum, or a herniated disks for instance–may or may not be the cause of our pain.  Perhaps the source of our pain is something else entirely.  The point is the MRI is not always as precise as we’d like to believe.

I’ve had personal experience with this sort of situation.  Several years ago I was performing a barbell snatch and I felt a pop followed by very sharp pain in my left shoulder.  A cortisone shot helped only temporarily.  I underwent an MRI and according to the image there was no serious injury.  It wasn’t until a surgeon had a look inside my shoulder and saw that my supraspinatus tendon was about 90% detached.  After he reattached the tendon he later explained how MRIs can be helpful but they’re not always very precise.

On a simiar theme, a recent New York Times story examines to what degree doctors sought medical attention for their aches and pains.  You might be surprised to learn that docs who were interviewed rarely visted other docs when they’re hurting.  (The Times story also references the MRI story mentioned above.)  Doctor-athlete, Paul D. Thompson, a marathon runner and a cardiologist at Hartford Hospital in Hartford said the following:

“I think most folks should not go, because most general doctors don’t know a lot about running injuries,” he said, adding, “Most docs, often even the good sports docs, then will just tell you to stop running anyway, so the first thing is to stop running yourself.”

So all-and-all, as much as we’d love to believe that the modern mainstream medical profession has all the answers–or at least the tools to find all the answers, it simply ain’t so in a lot of cases.  The fact of the matter is most MDs don’t fully understand human movement and how all the parts of the body–bones, muscles, organs, and most importantly the nervous system–act together in a 3-D world governed by gravity.  Just look at how many specialists there are around us.  There are podiatrists for the feet, spine specialists, knee specialists, shoulder specialists, low-back doctors, etc.  There are surgeons that specialize in opening us up and tinkering about.  There are docs to analyze blood, the eyes, reproductive organs, the heart, our minds….  But guess what, we’re all one big system! If we or the people who are assessing us believe that we’re just a bunch of separate parts then we’re way off the mark.  And if your doc just wants to feed you pain medicine–definitely go get another opinion.  (As one acquaintance put it, “Your pain wasn’t caused by an ibuprofen deficiency.”)

(BTW, please don’t take this as my hating on the entire medical profession.  If I’m in a car crash and I’ve got a piece of steel stuck in me, please go get me a surgeon and not a massage therapist or chiro.)

Recognize that the arms and neck are highly affected by the feet.  Weak eye muscles can cause bad posture and thus neck pain.  Medication for our high cholesterol may cause low-back pain.  Shoulder pain may be rooted in poor wrist and hand mechanics.  Even if the tissue of a years-old injury has healed, the ability to move and control the limb may not have been restored–and that may be causing pain in any number of areas.  The bad mood you’re in may be driving that aggravating hip pain.

The body and the nervous system is tremendously complex and all its parts are highly interactive at all times.   Always keep this in mind if you’re in pain and looking for relief.

Achilles Tendon Injury Resource

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I just found this site The Running World According to Dean and it’s got some very interesting information, particularly some good information on Achilles tendonitis and/or tendonosis.  I’m going through this issue right now and it’s tremendously frustrating and mysterious.

achilles tendon

Click image for source.

It’s not a cut-and-dried sort of thing.  It seems everyone’s Achilles issue is particular to them.  It may arise from simple overuse like running too much, too fast, up too many hills and/or running too fast up too many hills.  It could also arise from various biomechanical issues that aren’t always easy to identify.  The wrong shoes seem to also play a role.  Even certain types of medication can contribute to the matter.

Beyond the many causes, there are almost as many treatment recommendations: ice, heat, stretch, don’t stretch, run a little, don’t run at all, orthotics, shoes…  Anyhow, if you’re going through any of this then this site might be of help to you.

Running in Groups

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The Sept. 16 New York Times Personal Best column discusses the benefits of group running.  Several top runners and coaches are quoted as saying performance improves among athletes who train in groups.  Advocates of group training say that athletes train harder with a group compared to training alone.  Tim Nokes explains in Nokes’ Lore of Running that group training is a key component Kenyan runners—the best distance runners in the world.  Kevin Hanson, coach of the Hanson-Brooks Distance Project notes that runners in dominant distance running nations train in groups.

There’s actually scant scientific evidence that group training provides any benefit over training alone. (There are simply too many variables for which to account to do a valid scientific study.)  The experience of athletes and coaches however, and the results at the finish line gives strong suggestion that group training pays off.

Be careful though.  Group training tends to be more intense.  Too much intensity may lead to injuries such as shin splints, knee pain, or Achilles tendon irritation.  Intense training must be balanced with appropriate rest and recovery.

The article has some interesting information but I’m also a little confused about certain parts.  Both Dathan Ritzenhein and Kara Goucher referred to injuries they had sustained prior to running with a group.  The article seems to imply that they resolved their injuries simply by training in a group.  How did that happen?  The article also mentions the need for recovery and the possibility of training too hard due to the competitive dynamics of group training.  So what’s at work here?  Group training can help.  It might also hinder, but the issue of the runners’ injuries is never explained.  I’d like to see exactly how Ritzenhein and Goucher overcame their injuries.  Did running in a group have anything to do with the process?

Anyhow, here’s a list of Denver area running groups: