Finding a Fix (Hopefully)

After three months of at-home muscle rolling/sticking/abusing and rehab exercises, my hamstring injury is still just kind of, there. Not getting worse but not getting better, and I’m finally just fed up of not feeling 100%.

shitty legs

symbolic “these are my legs, they want to feel better so they can want to run again instead of feeling like the bird poop they’re stepping in” pic

The massage and Active Release Therapy that Dr AJ did back in January made me feel like a new person with a brand new leg – all the crap built up in my muscles was being worked out and put in its place and it felt like rainbows and glitter and happy marathons (<— oxy moron?) Unfortunately as I continued to run and workout, that build up slowly started coming back. It finally became apparent I wasn’t going to clear up this tendonosis shit on my own, so I started the search for a local office to beg healing from (I saw Dr AJ in Arizona on a work trip, ICYMI.)

Friday I pulled out all our insurance paperwork – there is a disturbing amount of verbage regarding whether certain cosmetic surgeries are covered or not, by the way – and tried to translate what might be the most cost-effective form of treatment for me. Other than a sinus-related rhinoplasty or medically-necessary tummy tuck, which are real things I guess. I’m still not 100% confident that months down the road bills for a billion dollars won’t show up, but it seemed a chiropractor was the way to go. If anyone reading works for Cigna in CA and can tell me if “Covered, $15 copay” actually means “you’re about to fuck your financial world up, honey” I’d appreciate it.

Anyway, my first appointment was this morning. I blindly picked a name off the network list based on who was closest and who had anything “sport”-related in the name. It’s early going, but the signed athlete posters (surfers, motocross, soccer, mountain bikers) and casual “former triathlete” mention made me feel in good hands. Well that and my currently bruised, numb, and taped, but pain-less left leg.

I’m going back for more treatment in a few days, and in the meantime he said to just “be smart” about workouts and running. No, there’s no need to shut down. Yes, the treadmill is your friend. Yes, running faster and shorter is better than slower and longer. You said marathons? You look like a 5k or 1500 runner. Thanks dude, I know I have boobs and a body fat % in the double digits, I’d be mad but that metal knife tool you’re digging into my ass hurts more than your words so keep on, man.

trackstar

now do I look like a track runner to you, doc?

Why is someone saying “you don’t look like a marathoner” the only thing that triggers my desire to run one? Instead of saying I hate long distance and actually prefer shorter and faster, I got way defensive and played my 2-minutes-from-BQ [lame] card like my only goal in the world was to get back to a 26.2 start line.

Tell me I can’t so I will.

[haha jk not running a marathon]

[[… right now]]

Ok I’m going now before I say something I’ll regret.

Sarah OUaL

Coming Back and Running Cadence (also, a trick to staying sane on the treadmill)

I’m slowly growing my mileage and slowly growing my hair out. Which would you like to hear about?

Running? Ok fine. Operation awkward pixie grow-out will have to wait for a rainy day.

photo 3 (1)a

ironic bandana and heavily-filtered on purpose

It’s been five weeks since my visit to Dr AJ and my diagnosis with high hamstring tendinosis, which in laymen’s terms is: chronic pain in the butt crease caused by effed up tendons that connect the hamstring to the hip bone. A little more eloquently explained by a smart doctor runner from the “for running clarity” article AJ sent me:

The hamstring is made up of 3 muscles which all attach to your ischial tuberosity – the bone in your bottom. The hamstring tendon is vulnerable to compression against the ischial tuberosity when the hip is flexed and also has to deal with high loads during running. This combination of compressive and tensile load can make it vulnerable to developing tendinopathy. So, baring this in mind, what 3 activities are likely to cause high load on the tendon; Running uphill, running carrying a heavy load and doing prolonged speed work.

- source, Running-Physio

post-script self memo: hurry up and get the eff back to healthy so everyone can stop reading “high hamstring tendinosis” every time they come here and want to take you out back and saw your stupid leg off to put you (and them) out of your laymen misery.

So somewhere back in like, August I did something like that. And kept running through it like a moron because it never felt like a “big enough deal” to really address it. I’m lucky it didn’t turn into a more serious issue, but if I wanted to finally straighten out those tendons and get back to running pain-free I had to do a few things:

  • Treatment. ART and deep-tissue massage recommended to break up all the junk build up, but for a girl on a budget I was assured extensive foam rolling (this plus lateral side-to-side rolling) and softball-sitting would suffice.
  • PT exercises to strengthen and prevent re-injury. I keep saying I’m going to do a post on these, and I probablymaybesomeday will. Hips, glutes, obliques primarily.
  • Run. Smartly.

The last part was going to be the tricky one. I mean, I’m sure you’ve dealt with some degree of injury at some point, and that “I’d kill a stranger’s baby just for a few good miles” urge to run when we shouldn’t is a real bitch to fight. And then on top of that, getting brainwashed by endorphins and “woopsies ran twice as far/twice as fast as I should have” is a greedy threat every time you do make it into your sneakers. Knowing how far to push, and having the clarity and discipline to rein it in when needed, is probably the toughest of all.

My guidelines for comeback are simple on paper, but knowing the evil runner brain hiding ready to sabotage them, I approached them with overt caution and a side of “quit being a baby, seriously?” Scaredy cat, safety first when there’s nothing to rush back for. The guidelines were as follows:

Run one mile. If no residual pain or stiffness the next day, run a little further. Then a little further.

Never let the 10-point pain scale tip past a 2-3. Step back when needed. Repeat.

No hills, sprints, or friends until 100% pain and niggle-free.

I’ve slowly built my way up over the last month+, and last night I ran 5 whole miles. It felt like my early runner days, bragging to my college roommates about running two miles “straight! no stopping!” when I came in the door and beamed at Bri, still sweating, earbuds still blaring. Sure have missed those little victories.

strava 5m

are you on Strava? I’m still deciding whether it’s worth the homescreen space on my phone or not.

Something I’ve been focusing on which has helped make the short barely-worth-it runs seem more worthwhile is cadence. I’ve mentioned it on a twitter a few times which piqued a few interests, but I avoided elaborating because it seems so silly and dumb spelled out. Like, sorry if I let you think I had a brilliant miracle training secret or something – you’re going to be pretty let down.

Once upon a time, somebody decided 180 strides per minute was the “ideal” cadence for runners. Like everything else on the planet, there are dozens of variables that could sway that high or low for personalization, but in general, let’s go with it.

I hopped on the treadmill for one of my short (<2 miles) runs, and once I was warmed up counted out steps for 10 seconds. I got 26, or 156/min, at my usual lollygag pace. Not awful, but pretty lopey and la-dee-da. Curiosity (and the challenge, let’s be honest) got the best of me and I spent the rest of the run randomly counting out steps to see how closer I could get to 30 (=180) without employing some ridiculous looking stride. Those horrifying mirrored walls apparently have a use, after all.

gymselfie

useful for more than just gym selfies!

Picking up my knees, kicking my heels a little higher, and really focusing on midfoot strike has gotten me up to 168/min comfortably, and I’m hoping once my overall speed quickens it’ll be even easier to sneak up to that goal of 180. While that number is pretty arbitrary, reaching for it has gotten me to focus on my form and running more like an athlete, which I can’t deny is something my marathon shuffle desperately needed. Not only is a shorter, quicker stride more efficient, but it leaves less room for error while feet and legs are airborne. A whole lot of goofy crap can happen between toe-off and foot-strike, and getting from here to there the quickest and shortest way possible just seems like common sense.

I’m a fan of common sense. I wish there was more of it in the world.

Sarah OUaL

More info on cadence from people smarter than me:

Lessons from Week One on the Injured Reserve

Week one down, 13ish to go. Thinking of this high hamstring tendinosis mandated rehab period as “shorter than a marathon training cycle!” has vastly improved my outlook on sustainable recovery. Well that and all your kind words and promises that it will “just fly by!” Don’t even care if you’re bullshitting me, it helps.

Crowd sourced merciless optimism, for the win!

I’m still kind of getting into a groove on the whole thing – setting days for PT exercises (Mon, Tues, Thurs, Fri (opt), Sat/or/Sun), finding alternate methods of cardio to keep me from fat-blobbing instantly, and starting to toe that magical line Dr AJ talked about that works the body juuust enough without impeding healing. The soft-plan is 1 mile a day until there is no soreness or pain the following day, and slowly building with along same guide. Kind of like the 10% rule for weekly mileage building. I ran for 15 minutes (~1.5mi) on Thursday but had some tightness Friday AM, so I took the day off from running and reset on Saturday with one pain-free mile. It’s that touch-and-go, flirt with the line, listen to your body method that I think is the hardest for recovering runners. Stepping back when it hurts, not pushing too hard when it feels good, and smartly grinding along that Goldilocks “just right” line long enough to hit 100%.

recoverypath

100 Day Rehab Plan Goal: Follow the blue line.

In these last seven days I have learned(/relearned) a few things:

  • Eat Like a Normal Person. Even after decreasing my mileage, I still felt the same level of hunger (or thought I did) from my 45-50 mi/wk days. Whether it’s my body or brain finally realizing we aren’t working as much or as hard as we used to, it’s nice to feel a little more stabilized in the hunger department. Farewell, Runger!
  • Walking is Fun. Not like running fun, and the endorphins aren’t quite as strong, but getting out and moving just for the purpose of moving feels good. No agenda, no expectations, just a little heart pumping.
  • Head-Clearing Exercise. I hadn’t realized how long I’d been dealing with what I’m calling “chronic on-the-run worry syndrome” until I went for a night time walk and came back clear-headed and rejuvenated. Somewhere along the training/injury continuum I stopped being able to “clear the mechanism” (name that movie reference!) and spent the whole run worrying, assessing, calculating, and never really letting go and enjoying the movement. So, thanks, Walking!

photo 4

sad about my crows feet, not the walking

  • Little Things Matter. Has my butt really gotten tighter and shaplier after one week of my ham/glute rehab exercises? Probably not, but in my mind (/warped mirror?) it has! Knowing that they’re doing their part to get me back running, while also bubbling up my pancake ass is motivation enough for me to stick to them.

(yes, I will share the exercises! Once I am good enough at them to be photographed and my butt bubbles a little more)

So on all those notes, I’m heading out for my 15 minute run! Fingers crossed no follow up pain and I can break the 2mile barrier tomorrow!

Sarah OUaL