Monday, December 11, 2017

My lateral what? Timeline of an injury

Google tells me:

"Cuneiform fractures are quite rare"

"Nondisplaced fractures with a stable tarsometarsal joint can be treated closed with a short leg walking cast for 6 weeks."

"This bone works to support the body while also playing an important role in movement."

"Cuneiform stress fractures - These injuries seem to occur from a similar manner as do those at the base of the metatarsals. Vertical forces are a potential contributor to this injury and may be caused by too much speedwork, hill running (not as often as the speed work), or running on the ball of your foot."

"The 2 forces responsible for cuneiform stress fractures are bending and compression. Bending forces are applied across the cuneiforms due to their location in the midfoot. The medial cuneiform lies in the axis of the first metatarsal and is susceptible to compression-type stress fractures. Body weight passes through this axis, and muscular insertions on each side of the first cuneiform exert strong opposing forces across a small area. The lateral cuneiform is the keystone of the arch with 6 articulations leading to several force vectors across this bone."

x-ray that shows nothing (of course, the
bone I brokeisn't in focus)
On November 14th after months of no diagnosis, pain and no running I finally learned what was broke. I had to have the nurse reread the report because in my extensive pre-diagnosis googling I never suspected a fractured cuneiform. I fell to the ground and started to cry. My biggest fear was that the MRI would show nothing wrong. I finally had a diagnosis!!! After weeks, months of waiting my doctor wanted me to be seen by the orthopedist ASAP. 

Nondisplaced fracture of the lateral cuneiform tarsal bone with mild patchy bone marrow edema at the second and third tarsometatarsal joints. 

Translating my report, it means I have a fracture-fracture (not a stress fracture) and I have a stress reaction at the metatarsal joints that articulate with the lateral cuneiform. 
Knee scooter is a game-changer

Timeline of an Injury

August 9th--during my weekly tempo run, my foot started to hurt. By the time I finished I couldn't walk without limping. (10 miles total)
August 10--urgent care visit. x-rays show nothing.
September 15--urgent care visit. Repeat x-rays show nothing.
October 2nd--primary care doctor, referral to orthopedics and MRI
November 7--MRI
November 14--MRI results indicate fracture
November 15--ortho appt short leg cast for one month
December 14--ortho appointment (hopefully cast will come off! fingers crossed)

I've spent a lot of time thinking about how my injury occurred; if I could have prevented it. I strength trained, I yoga'd,rolled and stretched. I spent time before every run activating my glutes, core, calves. I warmed up. I took my recovery days like a champ. I had regular massages and still went to physical therapy. I had regular appointments with my sports chiropractor for ART. I felt like I did everything right. I didn't have niggles that I ran through and my right foot didn't start to hurt until that fateful run on August 9th.

I don't think it was the amount of miles or my goal. I think, and this is just a guess, it has to do with using a local high school's hard dirt track for all my tempo runs. Regularly running on that hard track for 10+mile runs was not smart. I also think nutrition issues played a role. I was slightly amenorrheic for the past few years and its only recently that everything has gotten back on track. Last month I had a blood test which showed that I'm deficient in Vitamin D and at-risk for injury. I'm also low in Vitamin B12, DHEAS, ferritin, and iron (though, those levels are only "needs work"; some do play a role in bone health). 

I've made changes to my diet and I have started to take Vitamin D supplements. I'm hoping I get good news on Thursday and my cast comes off. I hope I'm cleared to start physical therapy and cross-training. I hope to be able to start running again in January. I love running and I love running lots of miles. 

I have big goals for 2018 and will work closely with my running coach, my strength coach, my physical therapist, my nutritionist and my doctors to have a healthy year. :)

Wednesday, October 11, 2017

The curse of the 4th marathon...

When injured, cheer your friend during
 her international debut
It seems every time I train to take my marathon game to the next level, my body decides to hit the brakes and my season ends. This works out to be every 4th marathon. I can run 3 marathons without injury, but it's that 4th one that gets me. 

It happened in 2015 when I was training for CIM with a goal of a sub-4 hour finish. I was feeling strong, feeling like I could actually do it and *boom*, major quad/IT injury.

I came back from that injury with stronger glutes and a stronger determination and trained for and ran two sub-4 marathons. I followed both of those with a third marathon in which I paced a friend for her first marathon finish. 

It happened again this past August as I was training for the Chicago Marathon with a goal of a 3h:48m finish time. Similar to 2015, it happened as I was feeling strong, fit and believing that I could actually run 26 x 1 mile @ 8:40 pace. Boom. Stress fracture/reaction in my foot. 

This injury didn't happen because of weak glutes/hips. I believe it happened because I was running all of my tempos and pace work on a hard dirt track (10+miles!). I was deathly scared of the pancake flat Chicago Marathon course and not being able to handle the "boredom" of using the same muscles. It also happened because training that takes me to the next level is also going to take me  to the edge.  

Going forward, I will train hard. I will skate the edge. I will run my pace work on the rolling hills of my town and be stronger for it. And I will be very mindful when I start training for that 4th marathon. 

In the meantime, I've tentatively decided to race LA Marathon in March. I've run it 3 1/2 times. I love the course. I like its hills. I love the crowds. I'm not back to running yet, which is why I haven't committed to it. As a back up, I've registered for Mountains 2 Beach in May. In the fall, I will run the Great North Run (deferred this year's entry) in England and most likely the Chicago Marathon (deferred this year's entry). 

Wednesday, August 23, 2017

A freak foot injury results in a training intermission

I last ran two weeks ago today. On that day, during my workout (alternating pace progressive tempo, total of 10 miles) the top of my right foot started to hurt. By the time I finished, I couldn't walk. 

Since then, I've been to a medical doctor, my physical therapist and my sports chiropractor. A stress fracture has been mostly ruled out. The theory now is that my shoes--Brooks PureCadence--were too tight and I also tied my shoelaces too tight the morning of my injury. I've learned that the latest PureCadence model has been running about 1/2 too small. I love my Brooks and have worn PureCadence for years. It now seems I will have to give them up. 

I'm working with my coach and we are maintaining my aerobic fitness using the elliptical machine and cycle. And because 90 minutes on an elliptical machine is boring as heck, I'm working on my mental strength. Bonus!

I tried running this past Monday, but stopped less than a minute in because my foot hurt. I'm trying to be positive and not letting go of my goals.
I know I can run a half-marathon (race day=Sept 10) and a marathon (Oct 8) with sub-optimal training and do well. I'm strong, aerobically fit and my mental strength is a lot better than it was last year. Hitting my paces and having awesome workouts that I never believed I could do has helped that. 

This injury seemingly came out of nowhere. I was feeling fine, no nagging pains or niggles before my foot started hurting. To achieve big goals, you have to take risks and sometimes you get too close to the sun. 

We leave for England soon and that has been a magical place for me to come back from injury in the past.  As Kara Goucher says, "Always believe". 

Tuesday, August 8, 2017

Week 14: Chicago Marathon Training

A quick and dirty low-down on last week's training for the Chicago Marathon. I found out my request to switch to Wave 1 (based on my half-marathon race results) was approved. All that means is an earlier start (by 30 minutes).

I also ran my first 20 miler of this training cycle. This weekend I'm headed for Las Vegas for a Hen Party (bachelorette party, the bride and bridesmaids are flying in from England), I'm curious to see how I do with my training.


Week 14 (July 31-August 6)

Monday: 5 miles, easy (5.5 miles, 9:21/mi).

Tuesday: 8 miles, easy (8.0 miles, 9:42/mi). 

Wednesday: 2 miles warm-up, 3 x 2 miles @8:15-8:20/mi, 800 meter jog, 1 mile cool-down. Ugh. I blew-up the last set, but overall did okay. Nailed the first two sets. 5th work mile I had to stop. Coach Becki told me that was A-Ok. Last work mile was 7:59/mi though. (Avg pace for 2 miles--8:12/mi, 8:14/mi, 8:09/mi) Total miles=10.5 miles, 8:55/mi.

Thursday: OFF

Friday: 10 miles, easy (10.0 miles, 9:53/mi) + my periodic physical therapy appointment to keep things right.

Saturday: 20 mile long run. Oh boy, running 20 miles the day after running 10 miles really teaches me how to run on tired legs! Friends joined me for the first 10 miles or so. (20.0 miles, 9:56/mi).
I forgot my sunglasses when I started my 20 mi
long run at 4:45 am.

Sunday: 6 miles, easy (6.2 miles, 9:14/mi). Surprisingly, my legs didn't feel as tired. Maybe because I was in San Diego and a new running location. 

Total Weekly Miles: 60.2 miles (9 hours, 37 minutes)
2017 Miles: 928.5 miles 

I've joined the training link up on Eat Pray Run DC. See the link up HERECourtney is training for the Berlin Marathon. :)

Monday, July 31, 2017

My first 60+ mile week ever! Chicago Marathon Training

Which goes to say that it is also my highest mileage week since I started running in 2010. And I still have 10 weeks of training (well 8 really, subtracting taper) until I race Chicago Marathon

Early in the week I completed a run I would have thought was impossible a month ago. Eight miles at speed with out stopping (in a non-race situation). The first four miles were a little bit faster than goal marathon pace (8:30-8:40/mi) and the second four miles were at half-marathon(ish) pace (8:15-8:25/mi). I figured after completing this run, my hardest on my schedule, the rest of the week is just getting the miles in. I'm glad it was scheduled for Tuesday!

Working with Coach Becki Spellman has helped me get comfortable running marathon pace, so after my 2 mile warm-up the first 4 work miles almost felt easy. They were hard and I had to work to maintain pace but I felt okay running them. I've finally learned to ease into pace and not take the first work miles too fast. The second 4 work miles did not feel easy and I definitely had to use mental strength to not give-up. One thought that helped me was knowing how great I would feel once I completed the workout. And I definitely did. This workout pumped me up and made feel like I can run Chicago at the pace I'm training. Splits: 8:32, 8:37, 8:38, 8:39, 8:23, 8:14, 8:16, 7:54. I can't believe I ran a sub-8 mile for my last work mile. I just wanted to get done so I ran it fast. I ran all 8 miles on the track to simulate the "flatness" of Chicago.

Week 13: July 24-30

New shoes for August

Monday:8 miles easy (8.1 miles, 9:27/mi). Jasyoga: Booty Lock Mitigation

Tuesday: 12 miles with tempo-2 miles easy, 4 miles at 8:30-8:40/mi, 4 miles at 8:15-8:25/mi, 2 miles easy.Splits: 8:32, 8:37, 8:38, 8:39, 8:23, 8:14, 8:16, 7:54 (12.1 miles, 8:48/mi). Jasyoga: Quick Hamstring Reset

Wednesday: 6 miles easy (6.1 miles, 9:29/mi).

Thursday: 10 miles-first 4 miles easy, second 4 miles faster (think 20 seconds faster than easy), last 2 miles easy.

Friday: 8 miles easy (8.0 miles, 9:11). New shoes again (same model, new color -Brooks PureCadence). Training for a marathon and 200+mile/months burns a lot of rubber. 

Saturday: 18 mile long run (18.1 miles, 9:48/mi). My legs were super-tired as this was the culmination of 9 days running without a rest day. I was able to push through and run strong to the end. I felt good about this run and this week. Jasyoga: Recovery Boost for Runners.
Long run done! Looking forward to rest day!

Sunday: OFF. 1 hour yoga class at Ritual Brew. Enjoyed my day off!

Total Weekly Miles: 62.4 miles!!! (9 hours, 47 minutes)
2017 Miles: 868.3 miles

I've joined the training link up on Eat Pray Run DC. See the link up HERECourtney is training for the Berlin Marathon. :) 

Monday, July 24, 2017

Chicago Marathon Training: Week 12

With a little help from friends, another 50+ mile week is in the books. Slightly cooler temps helped too. 

Feeling stronger and more confident in my ability to race well on October 8. As of today, the Chicago Marathon is in 75 days--subtracting 2 week taper and rest days means 55 days of training left. I can do this!

Week 12 (July 17-July 23)

Monday: 5 miles easy (4.4 miles, 9:57/mi). I like when I have 5 or less miles scheduled for a Monday. It means I get to sleep in and wake up naturally (for me = 6 am). But it also means I have to cut my run a little short to make sure I'm not that late to work. I also did Jasyoga: 5 minute Quad Reset.

Tuesday: 10 miles easy or really 6 miles easy + 2 miles with 30 seconds stride/2 minute jog + 2 miles easy (10.2 miles, 9:39/mi). First 6 miles with friends; last 4 by myself. This workout really wiped me out. I don't know if it was the running six miles before the reps or just training load fatigue. The reps themselves were no problem. It was the 2 miles easy after the reps. They were a slog fest.

Wednesday: 8 miles easy (8.1 miles, 9:21/mi). Run felt a lot better then the day before. Jasyoga: Pre-Run Warm Up

Track: We each do our own workout
Thursday: 9 miles with progressive tempo. 2 miles easy + 3 miles at 8:30-8:40/mi + 3 miles at 8:10-8:20/mi + 1 mile easy (9.0 miles, 8:45/mi). I was nervous about this run because picking up speed in the 2nd half is hard for me and I tend to mentally give-up. I went into the run knowing I would really have to work hard the 2nd half. I've been running my marathon-pace and tempo runs on the track to simulate the flatness of Chicago. I live and train in rolling hills. Running a lot of miles without stopping on the track can get a bit boring, but every mile or so I change direction to mix it up. SPLITS: 8:39, 8:30, 8:38, 8:12, 8:12, 8:08. I'm very pleased with my results. Jasyoga: Pre-Run Warm Up

Friday: OFF. I loved this rest day. I didn't do any work. My next scheduled rest day is 9 days from this one. I enjoyed it. :)

Saturday: 16 miles long run (16.2 miles, 9:15/mi). First 4 miles by myself + 12 miles with friends. I had to go to the mall to shop for clothes for a wedding and bachelorette party (e.g. non-running clothes). So for me, this 16 mile run was the easiest part of the day!

Hot & sweaty long run
Sunday: 6 miles easy (6.1 miles, 9:12/mi). My husband had a soccer tournament in Orange County so it was a change of scenery for me and a lot cooler temps than inland. 

Total Weekly Miles: 54.1 miles (8 hours + 24 minutes)

2017 Miles: 805.9 Miles

I've joined the training link up on Eat Pray Run DC. See the link up HERECourtney is training for the Berlin Marathon. :) 

Monday, July 17, 2017

First 50+ Mile Week of this cycle! Chicago 26.2 Training: Week 11

Hot summer running leads to huge fall racing PRs, right? Lately, it seems that all my long runs have been slogs no matter how early I start. At least at this point in training I don't have to worry about pace during my long runs. It's just about time on my feet. I'll enjoy it now because it won't last long. 

I've completed my base-building phase. I've completed my strength building phase. Now sh*t's getting real. I've just completed my first 50+ mile week for the Chicago Marathon. I'm now embarking on my marathon-specific training which means fast finishes at the end of long runs when I'm tired or starting slow and building speed in workouts. This is a weakness of mine and I'm looking forward to improving. 

Week 11 (July 10-16)

Monday: 6 miles easy (6.2 miles, 9:21/mi) Jasyoga: 5-min Hamstring Reset +core

Tuesday: 6 miles easy (6.0 miles, 9:29/mi). 

Wednesday: 2 miles warm-up, 2 x 1 mile @8:15-8:20/mi, 2 x 800m in 4:00 min, 2 x 1 mile @8:05-8:10/mi. 2 minute recovery between each rep. Rep times: 8:16, 8:14, 3:55, 3:53, 7:50, 7:45. I loved this workout. It was tough, it was hard but I pushed through and hit my paces. (9.2 miles, 8:48/mi).

Thursday: OFF. Jasyoga: 5-min Hamstring Reset 

Friday: 8 miles easy (8.0 miles, 9:30/mi). 30 minute Tabata class pre-run and Jasyoga: Power Your Push Off

Saturday: 5 miles easy (5.2 miles, 8:56/mi). Paul ran the first two miles with me. :) Jasyoga: Flexible Running Hamstrings

Sunday: 18 mile long run (18.0 miles, 9:54). Oh boy, was this a slog. It was 73F when we started at 5:30 am. I also probably started the run dehydrated because of drinking beer and not water the night before. My running group and I have had previous discussions. 2 beers the night before a long run = okay. 3 beers the night before a long run = not okay. I will now add this: 3 beers before a long HOT run = super not okay. 

Total Weekly Miles: 52.6 miles (8 hours 16 minutes)
2017 Miles: 752 miles

I've joined the training link up on Eat Pray Run DC. See the link up HERECourtney is training for the Berlin Marathon. :)