Injured But Happy

Injured but happy. Those words are total opposites in running. How on earth can being injured and being happy co-exist?

About a month ago training was going really well. I had a place in the Reading Half Marathon and I was really excited to get back into road races. All my runs had been going well. I had kept my long runs at a conservative pace without going mad. Shorter, faster runs were feeling more like my old self again and I was feeling quite chilled out about it all. And then one morning I got up and there was a sharp pain in my shin when I walked down stairs. That pain was also there a bit when I walked. After a couple of days rest and some stretching and foam rolling I went out for an 8 mile run. Not even half way in I turned back. There was a pressure in my leg that was building and wouldn’t ease off. I didn’t feel distraught but wasn’t feeling overly confident.

I left my decision right until the last minute as to whether to sack it off. The day before Reading I tried a jog. Every step on my left leg brought on a searing pain on the inside of my shin. The decision had been made. No half marathon for me.

I didn’t cry, I didn’t get overly frustrated. I didn’t come to my blog straight away to moan or blub about it as I might have done previously (Note: nothing wrong with that, just highlighting a change in me here). Instead I carried on about my business, took some ibruprofen and shrugged my shoulders. The only thing that bothered me about it was that I would be unable to take my beginners running group as effectively and I hated letting them down. But shit happens.

The difference in me compared to a few years ago when I was injured is this: running is no longer my emotional crutch. I am happy in other areas of my life and I think it is because I have decided to unapologetically be me. I stopped holding back on the person I wanted to be. I enrolled on my MSc. I have set up my own physio clinic. I went after a volunteer job to be physio for a national squad and I got it. I stopped hiding myself in running. Instead running is something that I do alongside everything else in life. I stopped looking inward, stopped thinking about luck and bad omens, stopped overthinking running and stopped paying attention to social media. Yes it sucks to be injured but I accepted it and moved on. I did what I could do about it and then got on with my life while waiting for my injury to heal.

Four weeks post injury and I managed a pain free run today. I don’t even think I’ve been particularly patient but it hasn’t felt like that long since I had to rest. After I ran I was of course happy but I think I would have felt like that anyway. It’s weird to feel that I am happy. I went for a long time feeling so anxious and stressed that I never thought I would feel like this. I have the excitement of the new clinic and the work with Cricket Wales and it’s a really good feeling. Hopefully the leg has settled and I will be able to run again on the weekend but I’m being mindful about it instead of overthinking it. Plus there are other things right now helping to fill the place in my head that I had expected running to fill for so long.

New Shoes

As Paulo Nutini, that great Scottish bard sang ‘I put some new shoes on and suddenly everything is right’. He wasn’t wrong.

Despite being a physio of fair experience, a physio who often reminds clients about the importance of changing your trainers at the appropriate intervals, I appeared to have dropped the bollock on that myself. And the only thing I can put it down to is not writing down all my training runs and totally underestimating how much running I had actually been doing.

Last year I replaced my Saucony with an identical Saucony. I was focussing on the London Triathlon so in my mind my training had mainly been cycling and swimming, my two weak points. Running when it happened didn’t seem to be as important in the training diary that I kept. It was all about water and wheels. After the triathlon my regimented diary keeping seemed to tail off and again in my head so had my running.

About a week ago I started to have severe pain in my left foot, right under the big toe. I could hardly put my foot to the floor. I mentioned it to my other half, and when I suggested I needed new trainers he laughed and said ‘Nah, you’ve only just got those’. I felt like that too (although I’m sure he’s trying to stop me shopping) but the foot pain was telling me something wasn’t right. I looked at the tread and they didn’t seem overly worn. I did the squish test and they still seemed fairly robust. I then put my hand inside the left shoe and found a huge dent that was the size of my big toe, not just a little put of wear but almost worn through the trainer. How the ‘eff had I missed that?

I then went back through my training diary again up until I had stopped recording runs. I scrolled through Strava and discovered a fair few runs that I had completely forgotten about. But I had managed to convince myself I wasn’t doing that much running, because many of the runs had been so short that I had taken them for granted perhaps? So note to self…..

ALL RUNS COUNT. ALL RUNS ARE WEAR ON YOUR TRAINERS KAT, WHETHER THEY ARE THREE MILES OF THIRTEEN MILES.

When I totted it all up I had about 300 miles on paper (good old pen and paper). That’s not including runs that have completely left my memory altogether. I must completely switch off for some of those runs and I really believe that. The Sauconys went in the bin and I found myself some neutral Asics at an outlet store (Macarthur Glen Asics store in Bridgend, what a discovery!). First couple of runs and all the weird aches and pains in my feet and calves have eased off. Funny that *head butts desk at own stupidity*

So the moral of the story? Keep your training diary up to date. It all counts. Slow, fast, long or short, those runs all contribute to improving you and wearing out your shoes. If I make a resolution to keep my diary and a note of the date I start running in new shoes I might avoid total shoe disaster next time. And in new shoes the Reading Half Marathon might actually be alright.

 

 

When Running Is The Problem.

I love running. I honestly really do. In my job I do my utmost to keep people running. I hate having to tell people they shouldn’t run but sometimes I have to for their own good and to enable any exercise therapy or treatment we do to be effective. Not everyone takes my advice and hey, sometimes people do get better with or without my advice. I can only go on what I find during an assessment and advise accordingly.

What I have found increasingly over the last few years is that with an increase in the running population has come an increased tendency for people to downright refuse to stop. They will continue to run even when there are a set of circumstances in front of them which are screaming at them to stop running, not permanently, just for a while.

I have had two cases in clinic recently where the best advice was certainly to stop running. But neither runner really accepted this. the compulsion to run was so strong that these runners were prepared to continue until any running at all was impossible. The most extreme of the two was a patient with a stress fracture so chronic that you could actually palpate the bony callus on his shin and hear the bone clicking when they hopped up and down. When I gave my diagnosis (which was confirmed by x-ray) the patient told me they had known in their gut for a few months that it was likely to be a fracture but hadn’t wanted to stop running, for fear of losing out on races and everything he gained from running. And yet the first question this person asked was ‘do I really have to stop running?’

I do sympathise because being injured is awful but I do feel that I’m increasingly in a ‘shoot the messenger’ situation when I have given advice to rest from running (that’s rest, not give up). I have had a patient swear at me because I advised them to rest for two weeks from running and to cross train instead. Actual aggressive language used because I gave a professional opinion. I may be good but I can’t speed up the natural healing times of muscle, tendon or bone. They all need their time to be appropriately treated and severity of an injury will always have a much bigger impact. Continuing to over load healing tissues will always mean things take much longer to heal, I don’t make this shit up.

Recently I have become aware of a personal trainer who is encouraging their beginners running group to run pretty much daily. Firstly, you’re going to put people off running because before long it will start to seem like a chore but secondly that is far too much for beginners who are just getting used to putting 4 TIMES THEIR BODY WEIGHT through their lower limbs. It’s making beginners over train and a study has found that training error and over training are the most common cause of over use injuries in recreational runners. In fact the most common type of injury among recreational runners is overuse injury, not sprains and strains. They are injuries that are unavoidable and yet more and more injuries like this are walking through my clinic door. (If you fancy a read that’s Taunton et al who published a study in the British Journal of Sports Medicine in 2002, just to show again I’M NOT MAKING THIS SHIT UP!).

Why this obsession with running hard and fast all the time? Why are people being made to feel like they have to? Running every day doesn’t suit the majority of runners and to do that I think you have to be a runner of great experience who has built up to it sensibly over a longer period of time. That’s why I felt quite glad that I saw an orthopaedic surgeon comment that people planning on training for a marathon should have been running 2-3 times a week in the 6 months before training commenced. The body needs to be trained to train, conditioned to be able to handle the task that is given to it.

So if you’re a runner who feels like they need to keep up with everyone on social media and feel guilty about not joining in with run streaks, please don’t. Think about what your own running goals are. Be smart with your training. Give your body a rest from the pounding it gets 3- 4 times a week with some cross training, pilates or yoga. And if you get a niggle or are concerned about any pain that isn’t your usual post run pain go and ask your GP or an appropriate clinician for advice. Some things can’t be diagnosed via Twitter.

 

The Wisdom of Farmers.

I hadn’t been able to do much over the weekend. Youngest had been ill so most of the time had been spent cleaning up vomit. I didn’t feel able to get out and leave him while he was unwell. So yesterday afternoon came my chance to get out. Although when I had the chance to go the rain was hammering down.

Now I am usually a total fair weather rider. A bit of damp and I would rather run, swim or stay at home. But I decided the time had come for me to head out in the rain. After all I would be sopping wet when I jumped on the bike during the London Triathlon. So really I would just be replicating the conditions of the event. It was also fairly mild so I knew I wouldn’t get cold either. My plan was to ride for roughly 90 minutes and follow that up with a run.

I headed out and was soaked through immediately. I considered going home as it really was hammering down but ‘NO!’ I thought to myself. It is the tough sessions that make you better. I was mindful of the road surfaces and as I made my way through country lanes I was careful on the down hills.

As I relaxed slightly on another downhill I came face to face with a tractor with a front loader. I jumped, braked and my wheels skidded. As I headed for the tractor I decided that I didn’t feel like taking on a huge metal object with spikes in front of it. In a split second I opted for the second worst option: the hedgerow.

I had expected just to hit the hedge and fall sideways. But instead I flipped over and somersaulted. Everything went black as I felt my neck and my back whip round. And then I was on the floor with my bike beside me. I sat up and looked down. Everything seemed okay but for a moment I thought I saw white on my shin. ‘Bone?!!’ was the next though that flashed through my mind. The farmer who had been on the tractor was standing over me trying to get me up and I mumbled something about a broken leg. Ridiculous looking back now but I really went into shock.

I felt the blood draining away from my head. The farmer insisted I would feel better if I stood up but I kept pulling myself back down to the floor. Every time he pulled me back up I pushed myself back down again, not wanting to pass out standing up. I knew he meant well but I knew where I would feel safer.

After a while I managed to get up and the farmer, who was called Phil, helped me onto the tractor where I sat beside his Welsh Collie Meggy. Phil placed my bike on his front loader and after a phone call to my husband he insisted on driving me all the way home.

As we weaved through the back lanes of the local villages Phil and I chatted. I bemoaned how daft I was and how stupid I had been for going out in the first place.

‘Shit happens Kath’, was his reply, ‘there’s nothing you could do about it. Bikes get fixed, people not so easily’.

And he was right. I have a tendency to over analyse and judge myself for my decisions when things go wrong. But Phil as right. I couldn’t have predicted what was going to happen and it wasn’t anyone’s fault. It was literally just ‘one of those things’. Yes I was sore and had a bruised ego but I was relatively unscathed. I needed to focus on that and be thankful rather than going over ‘what ifs’.

As we made our way through Pontyclun High Street it must have looked a sight. My bike hanging off the front loader of a tractor. He insisted on taking me all the way to my front door even though I told him to drop me by the high street and I would walk. I couldn’t thank him enough. He had been in the middle of doing his work when I had met him round the corner and I had probably added hours to his day. But again he said ‘Shit happens’.

My body is fine although it is bruised and a bit sore today. My ego is fine because really I had done nothing untoward, I had just been cycling in a modest manner. My bike seems fine and that’s good too. Sometimes shit does happen and you just have to pick yourself up and carry on. Or get a farmer to give you a lift home. I might give myself a rest day today though. Think I deserve it.

Training and Contentment

Yesterday evening I went for a slow half hour run. I had no watch on and the idea behind going for this run was to perk me up. There was no training agenda or pressure behind it. As I ran alongside the river I pondered over my week of exercise:

Exactly one week earlier I had made a 70 mile round trip to the Mumbles on my bike with some friends.

Tuesday I had gone swimming for an hour. It was surprisingly tough but I think that was because I was still recovering from Sunday’s mammoth effort.

Wednesday I ran for roughly 50 minutes and just under six miles. This was the longest and furthest I have run for many months. I had expected my legs to feel like lead after Sunday’s ride but they carried me with no real problems.

Friday I went out for a 36 mile bike ride with my local club, the Pontyclun Flyers. This was the fastest ride I had ever been on and even though I was usually found bringing up the rear I managed to maintain contact and didn’t find myself adrift.

Saturday I did a fast 3 and a bit miles. I hadn’t intended for it to be quick but I felt so good that I just let myself fall into a natural rhythm.

And then yesterday’s run. A run to get rid of a hangover to be truthful.

I haven’t managed to train like this for nearly two years and I can’t quite believe I managed it. What has struck me about the past week is that none of it has felt like a chore. Each session I have done has been because I wanted to, not because I felt compelled to or under pressure. The weekend has also seen me run on consecutive days. I haven’t achieved that for a long, long time.

I definitely credit the bike for keeping my fitness up and swimming is giving me the opportunity to work on different muscle groups. Running continues to be my default ‘favourite’ activity and I think it always will be but thanks to the other activities I have been doing, I find myself far more content with running and in a way that I haven’t been for ages. It feels like it has been a long time coming but it feels worth all the pain and angst of not running to finally feel like I’m back ‘there’ again.

I’m not going to rush into anything race wise for running. I’m enjoying the lack of pressure and right now I think it would be more sensible for me to ‘train to train’ again. I don’t even feel myself inclined yet to go to a Parkrun, because I know I can just walk outside my front door and run 5km around my locality.

I think that the other reason I feel more content with running right now is because I’m enjoying it and the other modes of training I am doing. I am enjoying getting out on the bike for long stints with friends and I am getting a satisfaction from getting my head down in the pool for length upon length of front crawl. I am also enjoying the lack of pressure from a PB point of view. Triathlon is new ground for me so I have no idea what to expect. I’m just hoping to have a great experience at a great event. I’m not bothered about how fast I go and that is a great thing to feel. I get to enjoy all of it: swimming, cycling and running.

Next month sees me attempt Velothon Wales on a course that includes the infamous Tumble climb, which I’m nervous about but also excited to take on. I hope to get in a couple more long, hilly rides before then. I thought this would be the end of cycling sportives for me but the Pontyclun Flyers are joining in with the Women’s Rapha 100 on the 26th July and I’m quite tempted to sign up. I also have my eye on a local novice pool triathlon in July as a way to ease me in to the world of multi sports and transitions.

I can honestly say that right now I feel excited about my upcoming challenges and that I look forward to my time on the bike, in the pool or pounding the pavements. I’m not looking to break records or PB’s and I don’t even feel I’m doing all these things for the medal I might get at the end. I’m doing it all for me and I am content with that. And right now that feels like a really nice place to be.

Slow Down

I have completely lost the ability to pace myself. A couple of years of injury has totally wiped my inner speedometer. Maybe I hadn’t realised that one of the benefits of a GPS watch is that your body can start to naturally assume a certain pace. This was something that definitely happened during my first marathon in Edinburgh. And definitely did NOT happen during last year’s London Marathon. I stopped using my GPS when I was injured because it seemed a bit pointless. However I am wondering if I played down the benefits of using it.

My problem is that I just want to run too fast. I think it’s my many years as a middle distance track runner where a great deal of my training involved fast reps and intervals. Even racing meant a sprint from the gun before settling into the pack. Long distance running was a massive learning curve for me when I first started because I wanted to do everything too quickly and too soon.

As I continue to get back to running after being injured for so long, I feel that I am back to square one where my pace is concerned. I am in such a rush to get back to where I was that I think I’m in danger of injuring myself again. I need to get over the frustrations I have with my running ability and suck it up. I am rebuilding virtually from scratch. So I might have to dig out the GPS watch and make a conscious effort to slow down, re-wire my inner speedo and build my baseline again.

Slow and Crap

Slow and Crap is how I feel about my running right now. I don’t feel anywhere like the runner I was in 2012. I don’t recognise myself as the 42 minute 10km/20 minute 5km runner that I was. Right now I can’t imagine being anywhere near as good at running as I was when I ran Edinburgh in 2012. Injury has caused me to see that runner as being someone in the past.

As I run along the pavements I occasionally catch a glance of myself in the reflection of the window of a parked car or a shop. The runner I see is hunched over, her form all over the place as she tries desperately to catch up to where she once was.

I know this is the hardest part, getting the running fitness back and feeling at ease with running again. I just think I’d forgotten how hard it was and it’s so difficult not to turn round and say ‘ahh fuck it, I give up’.

I won’t though. I just won’t.

EDIT 6/1/15: I just want to say that I wrote this literally as soon as I came in from the run above. It wasn’t a plea for sympathy, I know it’s going to be hard. I just needed to get this off my chest. I was typing the emotions I felt , in that moment.

My Tips For Getting Over Injury

Seeing as I’ve had a little bit of experience of a chronic injury over the last year (possibly more) I thought a post about how I dealt with the issues I faced and how I managed being injured without going totally crazy might be of use. When I’m talking about tips for injury I don’t mean those little pulls and scrapes that resolve within a couple of weeks. I’m talking about injuries that are with you for the long haul. Below are things that I believe helped me. Read them, take them with a pinch of salt, slag them off but you never know they might help someone.

Acceptance

For ages I think I was in denial that I did have Achilles tendinopathy. This meant that I continued to run or do things that were only helping to worsen the problem. I think the moment that I accepted that I had an injury and that I needed to do something about it was the moment I started to improve my chances of resolving it.

Rest

Rest is a dirty word to runners. When my Achilles started to niggle I carried on training, mainly because I was training for London but also because I was being a bit stubborn. Lets face it deferring wouldn’t have been the end of the world! In this Running Times article John Ball talks about there being ‘a bit of OCD with runners’. I wondered about that comment but then decided, as we’re all on a spectrum of sorts with our behaviours, maybe it’s very true. The need and the drive to run, despite being a Physio who should know better, was so overwhelming that I had to keep training.

In the end I definitely made things a lot worse and my tendinopathy became very deeply entrenched. I needed to rest, to let things settle and allow myself to put strategies in place to get over the injury. It is frustrating but to get back to running sometimes it is best to do no running at all.

Seek Help: Physiotherapy, Rehabilitation and Treatment

All treatment and therapy interactions are leaps of faith. You have to believe in the person you are speaking to. You also have to trust that they have the knowledge to help you. A lot of runners will see one clinician and because they don’t hear what they want to hear i.e. you’ll be fine keep running, they declare the therapist as clinician rubbish and seek treatment elsewhere. If that is the case then I think you may have to revisit tip one again.

What you will find if you do go shopping around is that Physiotherapists pretty much give out similar advice. Healing times do not change depending on the clinic that you visit. Neither do the physiological effects of exercise alter depending on who you see. This may sound harsh but sometimes you have to get on board with what the health professional is telling you.

In the early stages of injury I didn’t even listen to myself and trust my own knowledge as a Physiotherapist. That running OCD kicked in and I didn’t do any of my rehabilitation. But then after giving myself a stern talking to, accepting my problem, chatting with colleagues and reading the evidence about tendinopathy I embarked on a programme to target my tendinopathy. And guess what? After three months it’s worked.

Three months sounds like forever in running terms but I told myself it was better than knocking running on the head altogether. I’m not out of the woods yet but I am getting there. So my main point for tip three is to do your exercises and do not expect an over night miracle. Stick with it. Exercises take time and patience.

Embrace Cross Training

As runners we like to think, or I certainly did, that running is the best thing in the world and nothing else can compare. So when you are forced to do something else it can feel like a poor replacement for our first love. I had to get over that deluded ideal when I realised I faced months of no running at all. I was desperate to keep my fitness up and so I purchased my first road bike. And I discovered how awesome cycling is. Now that I can run again I can credit cycling with maintaining my base level fitness because it hasn’t been a total shock to the system during the first few runs. So embrace cross training, whether it is cycling, swimming, aqua jogging or walking. It will be your running saving grace.

Do Other Things

Use the time you would have been running to do or try other things. It doesn’t have to be fitness related. You could try something crafty if you are so inclined (I did try knitting) or you could be as extreme as me and sign up to a post graduate course. Admittedly a tad more expensive but the mind is as important as the body!

Talk About It

Find people who you know won’t think you’re crazy for missing running. Blog about it, tweet about it, just don’t bottle it up. When you’re used to doing something almost daily, something that feeds your body and your soul (runners know what I mean) and then you can’t do it at all it can feel a bit like a loss. I know that it seems extreme to talk about it in those terms but it can feel like you need to grieve a bit or have a little bit of a cry. I know I did but I just think that shows how much running means to me.

So there we have it. A very non-scientific list of tips in how to get over and survive a running injury. I am aware that as Physiotherapist I could have been a bit more in depth about aspects of my injury but this is a running blog not a Physio blog. Hopefully you’re not injured as I have been but if you are unlucky to have a chronic injury maybe there’s something here that can help you a little bit. Here’s to lots of amazing running in 2015. Happy New Year!

 

 

 

Getting Over It

After months of months of no running and feeling like my injury woes were never ending, I seem to have had a rather lovely surprise for Christmas. Over the last two weeks my Achilles on one side and my calf on the other seem to be very gradually settling and allowing me to get out on some tentative runs. I think I refused to believe it the first few times. Up until maybe two or three weeks ago I was still ready to concede defeat and forget about running. But after the last couple of runs I am really starting to believe I might be winning this battle against my own body.

After the London Marathon there was very little I could do without my Achilles flaring up and being really painful. And then when I would think that I could manage a small ten minute run my other calf would tighten up and cause me to limp. At one point even getting on the turbo trainer was enough to flare both sides up. When things were like that I was almost distraught. I know distraught is a total hyperbole to describe it but for someone who has been battling anxiety for the past year that is how I was when I felt like running was done for good.

Somewhere along the line I made a decision to stop running and rest. Somehow I developed the patience to not force myself out running and make myself worse. And back in September I made myself set two key goals and somehow I decided to stick with them:

No running until after Christmas or even into the New Year.

Get rehabilitating properly (I’d fart arsed around it but I hadn’t rehabbed properly and given it a chance to work).

I spoke to Physiotherapy colleagues and did my own research via journal articles and books. And then I embarked on the strictest regime of rehabilitation that I could handle.

It hasn’t been easy. There were more flare ups. There were days I didn’t believe anything was going to work and feeling like it was all futile. There were times I wondered if running was even worth all this effort. And then I would remember that I love running and that I have been a runner since I was 11 years old and 34 is far to young to throw in the towel. I took inspiration from all sorts of places: Jo Pavey, the Twitter running community, my Physiotherapy colleagues and patients who I had successfully helped in returning them to their hobbies. And I don’t know when the transition from feeling too injured to run to feeling able to have a little jog occurred but I’m now on my fourth or fifth run of thirty minutes. This would have been inconceivable back in September but looking back at my goals my timing has almost been spot on.

I’m still hedging my bets about things. I am leaving a day between runs and I continue to cross train to enable me to get in some strength work and some longer cardio sessions. I am incredibly fearful that I will relapse and won’t be able to run again. The fear of failure is still rather strong. I won’t book in any races or join a club yet because I want to be running consistently and they might be long term goals for 2015. But with some hope, and a little bit of light beckoning me towards the end of the tunnel, I feel like I could be getting somewhere. And hopefully in the New Year I’ll be able to do more of this:

The Past Year

In the past year I have not run very much at all. I ran the London Marathon and then that was it. My Achilles tendon continued to be a nightmare and I decided to knock regular running on the head until I got on top of my injury. In terms of running this year has not gone the way I had hoped but other things have happened to help me fill the void slightly.

I discovered that I quite liked cycling and bought myself a road bike.

I started a new course which I love and have already gained so much from. It has also helped me re-ignite the passion for my profession which I really thought had waned.

I have come to terms with my lack of running and embraced other means of getting my running buzz.

I have become much more versatile in training at home when time is short and the kids are around.

I have gone back to circuit training and remembered how much I love that anaerobic burn from intense exercise.

I made a decision not to enter any races at all and that helped me take back some control over my injuries and niggles.

I attended a Mindfulness course and seem to have got over my insomnia *touches all the wooden objects*.

This year has been uneventful in terms of running and races but there has been plenty happening in other areas of my life. Hopefully as I continue to quietly work on my rehab I will be back to running and racing but I’m not going to force it. I’ve filled my life with lots of other fulfilling things so I’ve become less dependent of running for making me feel good.

I still miss being able to run daily in the way I did but I’m less panicked about it and I really hope that this will happen in 2015 but I’m in no hurry. I’ve got plenty to keep me engaged and excited about 2015. Including the small issue of a Velothon. Probably should book some training time in somewhere……