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Archive for the ‘Injury’ Category

I’ve joked in the past about having black toenails…from black nail polish. My flippant attitude about a painful subject for many runners has come back to bite me in the behind (or the big toe, as the case turns out). Yes, I’ve lost most of my left big toenail. But the irony is, it’s not from running. It’s not from running shoes. It’s from wearing a new pair of fancy black flats on my first day back to work in January. You see, the shoes fit fine in the morning, but as I stood on my feet all day at work (in my humble opinion, a good elementary school aide should spend a lot of time walking around the classroom), my feet swelled and pressed my big toenails into the tip of the shoes. I didn’t realize how bad it was until I took my shoes off at the end of the day and felt a horrible stab of pain as the circulation came rushing back into those toes!

Four months later, I could still see a patch of black under my right toenail, but that toenail stayed intact. As I went to trim my left toenail though, one half of the nail peeled off entirely. The nail had separated from the nail bed and a new nail had been growing in underneath the old one for the past four months. It didn’t hurt at all when it came off, although it sure as heck hurts if anyone steps on that toe where it doesn’t have a full nail grown back in yet.

It’s no big deal. I can still run. But now I have a lot more sympathy for runners who battle the dreaded lost toenails.

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Let’s start with the ugly. I sustained a non-running running injury — a foolish slip in the bathtub that sprained my left big toe and affected my ability to run. If you don’t want to see my ugly foot, start scrolling now.

Foot with sprained toe

As a rule, I don’t run through pain that affects my gait in any way, because I know that just causes more problems in other areas of the body. This sprain hurt when I ran but didn’t change my gait and didn’t affect my ability to take on this bad boy:

Hill for hill repeat

Why do hills always look so tiny in pictures and so massive when you’re running up them? I did this hill workout on Wednesday:

1 mile warm up
6 hill repeats (1/3 of a mile up, 1/3 mile down (my favorite))
0.4 mile cool down (usually I’d run a full mile but I had to get home to my kiddos)

I have been struggling to get in my running over the last couple of weeks. It’s hard to get motivated to go out the door when it’s 4 p.m., 40-something degrees out, and starting to get dark. Yesterday I was supposed to do a 7-mile tempo run and I came up with every excuse not to do it until I finally just forced myself out the door. I only ran 5.6 miles before I had to take my youngest daughter to gymnastics, but 5.6 miles is greater than 0 miles (I was a math minor in college, can you tell?) and I was super proud of myself for getting those miles in. I ran the first half (the uphill portion) at an 8:55 pace and the second half (the downhill return portion) at a 7:49 pace. Normally I’d choose a flat stretch for a tempo run but when you live in “the Heights” you take what you get when you run out your door.

And finally, two pieces of good news. About five minutes after I posted this post about how my husband lost his job, I got a call offering me a job as a substitute instructional assistant, helping out the main teachers in special education classrooms in the district. The hours are perfect and allow me to drop off and pick up my girls from school. If I cannot work one day, I can specify that I am not available that day. Supposedly there is enough work to work every day if I want, but we’ll see when the job starts after the holidays.

And Santa heard my wish for an ElliptiGO! My parents gave me one for an early Christmas present! Mike and I drove back out to Hermosa Cyclery on Thursday and picked up my Green Machine, an ElliptiGO 8C!

Normally I would wear a helmet but we just took the ElliptiGO for a quick spin on the Strand at Hermosa Beach to make sure it was assembled correctly.

Normally I would wear a helmet but we just took the ElliptiGO for a quick spin on the Strand at Hermosa Beach to make sure it was assembled correctly.

I love it! It’s super quiet and smooth and frankly right now I would rather ride than go for a run. (Does that make me less of a runner? Or just a girl who loves her new Christmas toy?)

Have you ever sustained a non-running running injury? Do you like hill repeats? What gift is on your wish list?

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Before the REVEL Canyon City Marathon last Saturday, I had a major case of marathon brain. I’ve talked before about how marathon brain is a lot like pregnancy brain — your mind is so full of the big event on the horizon that it blocks out most other rational thinking. I have two good (read: humorous at my expense) examples of how marathon brain made me positively ditzy before the race.

Friday night after I got home from the expo, I set out all my clothes and race gear for the next morning. I also took my driver’s license and one credit card out of my wallet and packed them in my gear bag. No sense in taking my entire wallet with me to the race, but I at least needed my driver’s license to get there. Packing went well and I had no trouble at 3:30 in the morning throwing on my clothes and getting out the door by 3:50. The problem came when I got home from the race on Saturday afternoon and could not find my wallet for the life of me. I searched high and low all over the house. I retraced my steps everywhere. It wasn’t in my purse. It wasn’t where I’d taken my cards out of my wallet in the living room. It wasn’t anywhere I would ever normally put my wallet, emphasis on “normally.” With my marathon brain, I’d taken the cards out of my wallet and then wandered off to get something else, wallet in hand. Then when I found that something, I put down the wallet. Two whole days later I found my wallet on the dining room table, on top of the sewing basket and underneath one of the kids’ pieces of artwork. What the heck?! I think I’d set my Saucony Bullet Shorts on the table to air dry, and when I went to grab those for the race, I traded them for my wallet.

But the worst evidence of marathon brain came at 3:40 in the morning when I went to put on some Glide to prevent chafing in my, shall we say, “nether regions.” I slathered it on and put the cap back on the container, only to realize it wasn’t Glide I’d just applied, it was deodorant! I was extra fresh for the race. 🙂 You’re welcome, fellow runners.

The "extra fresh" me at the REVEL Canyon City Marathon

The “extra fresh” me at the REVEL Canyon City Marathon

It’s been four days since the race and I feel pretty good. I haven’t been sleeping well though. I thought I’d sleep like a log after the race on Saturday, but I tossed and turned all night. I read somewhere that not sleeping well is a sign of over-training, and I’m sure for me it was a sign of over-exertion at the race.

I forgot to mention that my ankle (that pesky taper injury) didn’t bother me at all during the race. Darn — I can’t blame my lack of PR on that. I feel really lucky though. No lasting problems from the race. I left alone the big blister I got on the bottom of my foot from the downhill running, and it toughened right up after a hot bath. No need to drain it or remove the skin.

Did you ever get marathon brain? What do you do for blisters?

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As I mentioned yesterday, the nagging injuries in my left shin and right groin had put me in a bit of a funk. Show me a runner who deals with injury well and I’ll call her a liar. I aspire to handle injury with grace, but as my husband can attest, that remains a mere aspiration. In fact, half the reason I started this blog was to have someone else (a community of someone elses, in addition to my patient husband) to talk to about running and injuries. Along with running my mouth off (ha ha), I’ve put in place a Happiness Plan. I told myself, “Quick, think about the things that make you happy. Make a list! Put it into action!”

1. Exercise six days a week. Five workouts of running, swimming or cycling, and at least two of weight training. One full day of rest and one day with only strength training. [Note that I have stuck with this plan for the last week, running 20 miles, biking for 50 minutes, and doing several strength training workouts].

2. Get outside for half an hour daily or more. This is a must for me. I am a terrible homebody and my natural tendency is to stay inside, preferably curled up in bed with a good book. At the same time, I recognize that I am happiest when I am out of doors, and if I make the effort to get outside, I’m richly rewarded.

A gorgeous winter (?!) day in Southern California. This was my view on my 50-minute bike ride through the park on Sunday.

A gorgeous winter (?!) day in Southern California. This was my view on my 50-minute bike ride through the park on Sunday.

3. Keep a “to do” list. Each day do the one thing that’s bugging me most (often the very thing I least want to do). Then knock out as many of the others as possible.

4. Keep up with the laundry (that includes putting the clean clothes away!) With five people in the family, including three little girls who love to play dress-up and a few athletes who often go through two sets of clothes and a sweaty towel a day, that adds up to a lot of laundry. If I do two loads a day, I can keep on top of it. A clean house = peaceful mind.

5. Focus on nutrition. Two fruits and seven vegetables per day. Ten 8-ounce glasses of water or other liquids (and that does not include alcohol!) That might sound like a lot of water (and I do know it’s possible to over-hydrate) but I can tell you that it is so dry here in Southern California that I often get headaches if I do not drink enough water. Add on turning on the furnace in winter and it is super dry here even with the rain we’ve been getting lately.

And if you think eating your veggies is a strange part of a Happiness Plan, check out this article from three days ago that confirms that eating more veggies and fruit can make you happier.

The more vegetables you eat, the happier and more satisfied with life you are. In fact, in one survey, eating seven to eight portions of vegetables was more strongly associated with happiness and overall well-being than employment status. On the whole, the paper concluded that well-being peaks at seven daily servings of fruits and vegetables, but the surveys also showed that people who ate just five servings a day (the amount that the USDA recommends) were as happy–or very nearly so–as people who ate higher amounts.

Love it, but I don’t need a study to tell me that I feel better when I eat better. (Note that the study cannot confirm whether happy people eat their veggies or eating veggies makes people happy. I’m not sure it makes a difference to me — I want to be a happy vegetable eater either way!)

On the whole, my Happiness Plan seems pretty basic and straightforward. I would argue though that it takes living with intention to stay on track with the Happiness Plan, and that’s exactly what I intend to do.

Do you have a Happiness Plan? What are the must-do items on your list? In addition to the five things on my list above, I’d add the one thing I take for granted: spending time with family. The happiest times of day for me are the times I spend snuggling my youngest in the morning before school, or reading to the girls at night.

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It’s been six weeks since my first marathon and during that time I’ve been in a bit of a funk. I loved the marathon experience and I remain glad that I did it. However, the physical and emotional letdown afterward took me by surprise. I knew to expect a little post-marathon depression. Lots of people experience that and it seems pretty normal to me. You’ve focused so intensely on a goal for four to six months, and looked forward to race day for so long, that when it comes and goes you are left at a bit of a loss, asking yourself, “Now what?” Usually those post-race blues are cured by signing up for another race. Yet I did that — I signed up for an 8K and another marathon — and it didn’t work for me.

What’s my problem then? Nagging injuries. The first was posterior shin splints in my left leg. As I recovered from the marathon, the pain in my inner lower leg increased to the point where I worried that I had a stress fracture. You might laugh at how I managed to resolve that question. When my anxiety about a stress fracture reached a peak and I was thisclose to calling a sports medicine orthopedist, I kept feeling around on my tibia to see if I could isolate a point of pain in either the bone or the attached calf muscle. In doing so, I massaged away the worst of the pain and I noticed some improvement. With that discovery, I started doing ice massage on the calf with a frozen water bottle, in addition to doing the calf stretches that helped me recover from plantar fasciitis. I think tight calves contributed to both the plantar fasciitis and the shin splints and I simply need to be dedicated to stretching my calves throughout the day and not just after running.

It’s also possible that the shin splints developed when my gait inadvertently changed to compensate for nagging injury #2. I’m not sure what to call that one. It’s a groin strain injury, located in the hard-to-describe area of the inner back thigh, running from the right buttock crease laterally toward the groin. As best as I can tell, it’s the adductor magnus muscle, and more specifically the “hamstring portion” of the adductor magnus muscle. It’s the muscle used to “adduct” the thigh — move it inward toward the other thigh. I feel it most when I try to balance on the affected leg (for example, when I balance on my right leg to pull on my left pants leg). This injury slows my running pace and, at its worst, affects my gait.

I have used the post-marathon period to cut back on running to see if it would let that muscle rest and heal. However, I found that resting the muscle caused it to tighten up and that increased the pain. There’s a balance in there somewhere — running just enough to stimulate blood flow to that muscle and keep it loosened up while not running so much that it aggravates the strain. Now I have a three-pronged plan in place to heal from the adductor magnus strain:

1. Run moderate amounts at a steady pace.
2. Strengthen the other groin, thigh, gluteal and abdominal muscles to support the adductor magnus.
3. Massage the adductor magnus muscle. This article (which is trying to sell a pain relief patch I know nothing about, but I appreciate its explanation of the groin muscles and trigger points) describes how:

The rear trigger point which causes pain inside the pelvis is found near the inside of the crease at the bottom of the buttock. This is best found and massaged with the help of a sensitive partner, a Thera Cane, or a ball. If using a ball, a lacrosse ball usually works best, but a tennis ball is okay. … In practice, you will put the ball under the crease of the buttock while this leg is resting up on a hard chair or table. … Rather than keeping the leg you’re working on straight … you may find it more comfortable to half-sit on the table on the buttock that you’re working on, while standing on the other leg. If you find any significantly tender points, particularly if they reproduce or alleviate the pain you have been experiencing, do some gentle massage.

Have you ever experienced post-race blues? Are you currently dealing with any injuries? Ever strained your adductor magnus? Help me!

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If you are suffering from plantar fasciitis heel or arch pain, you might be considering buying a device to be worn at night to stretch the plantar fascia (the connective tissue that runs along the bottom of the foot from the heel to the toes). The plantar fascia contracts overnight and it can be especially painful to take your first steps in the morning. I wore a Strassburg Sock to help me recover from plantar fasciitis and I highly recommend it. The only problem is that the Strassburg Sock and other such devices can be pricey and not everyone can afford them (or in my case, wants to buy two Strassburg Socks for two aching feet!)

I’m not going to teach you how to sew your own version of a Strassburg Sock because (a) patents and (b) laziness. There’s a crazy simple solution that costs nothing if you already have an appropriate pair of knee-high socks in your drawer. Find some that fit snugly around your upper calves. I used a pair of winter ski socks.

Step 1. Put one sock on the affected foot and pull it all the way up to cover your calf.

Step 2. Take the other sock and pull it onto the foot only as far as the arch of the foot (or over the heel if it doesn’t stay on in step 3).

Step 3. Grab the toes of the second sock and pull them back to tuck into the top of the first sock. The second sock should be pulled tight enough to gently bend back your toes. If it hurts, you’ve pulled the second sock too tight and you need to make adjustments.

See how the second sock gently pulls back on the toes?

See how the second sock gently pulls back on the toes?

You might have to experiment until you find socks that have the right level of elasticity in them. You want them snug but not so tight that they cut off your circulation in your calf. I found that this homemade solution worked nearly as well as the expensive store-bought Strassburg Sock. Only occasionally did I have to adjust the socks to keep the tension at the right level. If you can afford to invest in a Strassburg Sock then I say go for it. If you are looking for a simple, no-sew solution, then you have nothing to lose by giving this method a try. It worked for me!

Keep in mind that in addition to wearing a plantar fasciitis sock, you should be taking many other steps to relieve your plantar fasciitis pain. Check out my comprehensive list of stretches, exercises and gear to recover from plantar fasciitis. Good luck!

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The signs and symptoms of plantar fasciitis (plan-tur fashee-EYE-tiss) started out mild for me. About 10 weeks into marathon training, my feet started feeling sore after a run. I could run and walk fine, but a couple of hours after a workout they would feel sore in the arches. With rest they’d improve, but it would come back again after a run. Over a few days, the soreness progressed to a mild burning sensation that got worse the longer I stayed on my feet. Eventually after a week or so, I felt the heel pain most commonly associated with plantar fasciitis (PF). Upon waking in the morning, the inner corner of my heel, just below the ankle, felt sore when I walked. It looked like my chances of running the marathon in another 10 weeks were doomed. Continuing to run through PF can cause the plantar fascia to rupture painfully, requiring the wearing of a boot cast for up to six weeks and in some extreme cases, surgery. The good news is I was able to develop a successful treatment plan and after a couple weeks of cross-training, I was able to get back to running and go on to complete my first marathon in 4:02:39 without any PF pain during or after the race.

Please note that I am not a medical professional. I simply share my experience in the hope that it can help another person bounce back from PF. The other thing I want to make clear is that PF is a tricky injury to treat and it can take some experimentation to figure out what works. What worked for me might not work for you. You need to figure out both what the cause of your PF was (more on that in a minute) and which treatments help you.

For immediate pain relief:

1. Ice. Use an ice pack (frozen peas or corn works well because the packet molds to the foot) with a thin towel to protect the skin, and ice the foot for 15 minutes at a time a few times a day as needed. Just be careful and make sure to warm up the foot again and then do a gentle stretch of the foot (grabbing the toes and gently drawing them back toward you) before walking again. You can also freeze a plastic water bottle in the freezer (leaving room at the top for the ice to expand) and roll your foot on the frozen bottle. That does the double duty of icing and massaging at the same time.

2. Anti-inflammatory medications. There is debate about whether PF involves any inflammation at all (the pain stems from micro-tears in the connective tissue that runs from the heel to the toes) but there’s no doubt that nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen help relieve the pain of PF. Personally I don’t think drugs like Advil treat the PF, they just mask the pain. That’s fine if you’re in a lot of pain but I quickly decided the meds were not necessary.

For further injury prevention:

3. Determine what caused your PF and take steps to mitigate further damage. For some people the key to what caused their PF is clear. It can come on from being overweight or from repetitive strain due to running or other athletic pursuits. Think about what recently changed for you. Have you added something new to your workouts? (For me the culprit was tight calves from running and the introduction of training on the indoor spinning bike. Standing up on the pedals repeatedly stretched and strained the ligament that runs under the foot.) Has it been too long since you bought new athletic shoes?

4. Switch to cross-training. If you want to stay active to lose weight or continue a running training plan without actually running, consider cross-training activities such as cycling, swimming, and aqua-jogging. I found that while spinning on an indoor bike aggravated my feet, I could cycle on my road bike without problems.

To treat the PF:

5. Do stretches for the feet and calves. Before you get out of bed in the morning (and a few other times throughout the day), do a toe stretch by gently pulling back on your toes. Perform a towel stretch by looping a bath towel under the ball of your foot and gently pulling the towel ends back toward you. For the ball stretch, roll a tennis or golf ball under your foot for up to half an hour a day (I know that sounds like a lot but it’s what’s billed as a “magic cure” for PF in Running Doc’s Guide to Healthy Running: How to Fix Injuries, Stay Active, and Run Pain-Free). Most important for the treatment of PF and prevention of it in the first place (in my opinion), are calf stretches. I don’t mean just stretching your calves after you run. This is so important I’m going to say it in bold: You need to do calf stretches several times a day throughout the day. First do the gastroc stretch, which involves leaning into a wall with your arms outstretched and the affected leg straight back behind you with the heel on the floor (the Running Doc says to turn the foot slightly outward). Lean in and feel the stretch in the upper calf. Do that for 20 seconds, then slightly bend the knee of the affected leg to perform the soleus stretch to stretch the lower calf for another 20 seconds. Alternate those stretches several times. One more note on stretches. I saw lots of recommendations for Achilles tendon stretches (standing on the edge of a stair step and lowering the heels, then raising the heels, and repeating). That absolutely aggravated the PF for me. Here’s a video I found on YouTube that demonstrates three appropriate stretches and then explains why that Achilles tendon stretch is inappropriate (he calls it the Negative Heel Stretch):

Gear that helps:

6. Wear a Strassburg sock or other device. The idea behind the Strassburg Sock is that you wear this sock at night while you sleep to stretch the plantar fascia.

Normally while you sleep the plantar fascia contracts and then when you wake up and stand up, the tight plantar fascia lengthens suddenly and that causes pain. I found that wearing the sock prevents that problem, and I do recommend purchasing the sock. It provided immediate relief of the sharp heel pain I had felt in the mornings. For a less expensive option, follow these directions to make your own no-sew plantar fasciitis sock.

7. Use KT Tape Pro. Without a doubt the one thing that allowed me to keep running as I recovered from PF is KT Tape Pro. Please make sure that you buy KT TAPE PRO rather than the older cotton version which does not stay on as long. If I followed the directions to apply the KT Tape Pro properly, it would stay on for 5 or more days (or until I soaked in a bath or went swimming. It stays on during short showers but I found it could not stand a long soak). The pre-cut kinesiology tape strips are expensive and you want to make them last. Many people apply two strips for the PF application (as directed on the package insert) but I went with three as demonstrated in the KT Tape website:

8. Consider orthotic insoles. Many people swear by insoles such as Superfeet Green Premium Insoles or professional orthotics from a podiatrist. Others argue that such insoles are a crutch that does not really fix the problem in the long term. (Personally I think it’s important for a runner like me to be able to get back into running ASAP and then work on the stretches and strengthening exercises and only then consider running in a more minimalist shoe or even barefoot). Because I had success with the Strassburg Sock and the KT Tape Pro, I never bought insoles so I cannot speak to this one way or the other. (Anyone care to comment?)

Another healing and preventative tip:

9. Do strengthening exercises for the plantar fascia ligament. Once you have reduced the pain of PF you can begin doing strengthening exercises. These include drawing the alphabet on the floor with your toes, picking up marbles with your toes, and scrunching up the end of a towel (pulling in the length of the towel toward you with your toes).

I wish you all the best in healing from plantar fasciitis!

What has your experience with plantar fasciitis been? Do you have any tips for recovering from plantar fasciitis?

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