Monday, February 17, 2014

You're That Runner ...

Day 40.

40 days without a run.

14 days of nothing but the pool and upper body/core work.

I'm starting to get the hang of the crutches. I take the stairs up to the second floor at the gym. I could take the elevator but the effort of crutching up the stairs seems like some of the best cardio I get these days.

My weight is up. In the past 40 days, despite my best efforts, I've put on 6 lbs.

I feel Every. Single. One.

My body feels heavy and woefully out of shape.

This weekend I signed up for a race that I'm unsure I have a chance of finishing. It's 6 months away.

The trip up the stairs leaves me a little bit breathless.

I make it to the top of the stairs (finally) and look around trying to decide where I want to go first.

"Wait, how do I know you? You're ... you're that runner." It takes me a minute to realize that a woman is talking to me. I'm trying to place her but she doesn't look remotely familiar. Am I wearing a race shirt? No. There's nothing about my outfit that screams runner. In what I have (rather cruelly) termed my "injury chub" I can't understand why she would think I was a runner.

She continues, "you run all the time! It took me a minute to figure it out but I see you run by my house regularly. You are quite the runner. You didn't do that running did you?"

"Probably. It's a stress fracture," I reply.

"Well, I hope you heal up quick. It's always nice to see you run by. I hope to see you out there again soon." She flashes a big smile. And I know she means it. For just a minute I can see myself through her eyes. I let go of the idea of the ginormous thighs, the flabby arms, the soft middle. I am a runner. I am a runner solely because I run. Not because of what my body looks like.

We judge ourselves far too harshly. Here I am feeling like anything but a runner simply because I'm going through a brief blip with injury. A blip! In the scheme of things, even if I'm out for a year, I'm still one of the lucky people that will heal.

I haven't ceased to be a runner because I can't run right now.

I don't have to qualify myself as "not a real runner" because I don't run fast.

I don't have to bully myself over a few pounds.

I am a runner. Today, tomorrow, and hopefully far into the future.

Because I run.

Friday, February 7, 2014

Recovery

In July of 2010 my doctor thought I had a stress fracture in my right foot. She ordered me onto crutches and told me no weight bearing activity for three weeks. I made it home from that appointment, called a friend and became hysterical. I don't think she was even able to understand me on the phone. I could barely breathe. The gist of what I was saying "I can't do this. I need to run. I'm not strong enough to handle this."

I'm not strong enough. 

I thought I would break, mentally and physically, if I had to take three weeks away from my drug of choice - exercise.

I refused to accept this diagnosis and treatment. I put on my rigid mountaineering boots and hit the stepmill and bike. I figured if my foot wasn't flexing it could heal. July in Portland isn't exactly boiling hot but it isn't cool either. I wore those boots everywhere for 6 weeks. I followed that with a week long canyon trip in Arizona and Utah. Then I ran for the first time in 7 weeks. Three weeks later I ran the Portland marathon.

Fast forward three and a half years. In that amount of time I found my way in to the world of ultra running - 50k, 50 mile, 100k. Six months ago I finished my first 100 mile race. The 100 miler wasn't so much a race as a march to a finish line. 29 hours and 27 minutes after I started in Squaw Valley, I found some energy and "sprinted" across the finish line in Auburn.

While I was overjoyed to have finished my first 100 and cross that historic finish line, I wasn't happy with my time. I felt I showed weakness on the course. Weakness in the face of adversity.

I wasn't strong enough out there.

I had trouble getting out of bed for weeks after the race. I kept expecting myself to bounce back with a bit of rest, even though I didn't allow myself much of it. Two days after the race I was pushing hard through a 5k. Some would call it "punishment cardio." I didn't feel my performance at WS100 was good enough so I was either out there trying to prove something or punish myself for my perceived failure. I dropped out of the Mt. Hood 50 mile race that took place 2 weeks after WS. My legs just didn't have any strength to them. Just a bit more rest I thought, and then I'll be back.

Three weeks later I was emailing the race director and dropping out of the Cascade Crest 100. There was no let up in my fatigue and I didn't have any interest in death-marching my way through another 100. My goal for my next 100 mile attempt was to actually run as much of the course as possible.

To that end, in September 2013 I picked my next race, the Zion 100. I love that area of the country, I have a good friend that lives close to the start, I could easily make the drive to the race and turn it into a mini-vacation. My last time in Zion I didn't have time to hike Angel's Landing or do a real canyoneering trip, both of which I figured I could accomplish on this outing.

I decided to rebuild from scratch. Build a solid training plan to achieve this goal and follow it to the letter. Forget about trying to keep up with everyone else, or do what I thought I should be doing, and try a different approach. Mentally I found it tough. I always felt like I should be doing more, more, more. Yet slowly but surely I was seeing improvement with this approach. I had set benchmarks the first few weeks of training. I couldn't wait for the time to come when I got to test myself against those benchmarks.

And then, just like that, that hopeful feeling and that dream of a solid return to the 100 mile distance was gone.

When the doctor called and told me what I already knew, "you have a stress fracture in your cuboid accompanied with a tendinitis in  your peroneal tendon," I felt crushed. For a moment I thought I was going to break down.

"You're not strong enough," I heard in my head.

"But wait a minute. What if I am strong enough? Who is in charge here?"

And just like that, I realized that I was in charge. I could choose to buckle and break in the face of an injury, or I could choose to face recovery the same way I face training and the same way I face a race where everything seems to be going wrong. You put one foot in front of the other and you just keep on moving. Outcomes be damned. You don't quit in the face of an injury just because you know it's going to be hard, just like you don't quit when you are looking up a beast of a hill and know that you are supposed to sprint up it for 20 seconds with everything you have. It's going to hurt like hell, but then it'll be over and in the process you will get stronger. Mentally. Physically. You will get stronger.

What can I do? According to the doctor I can swim. And pool run. Core work. Upper body. Anything that doesn't involve putting weight on my left foot. I guess one legged squats on my right leg are acceptable!

I bought a waterproof iPod to alleviate the boredom of the pool. I got myself a water running belt. I'm hitting the pool daily. I'm trying to laugh at the situation. I can't make my bone heal any faster but I can choose the attitude I bring to recovery.

This time, I choose strength.

Injury Part II: Diagnosis

"What happened?" I was asked as I limped my way into the house.

"I think I just broke my foot."

Right off the bat instinct told me that this was a real injury. Fortunately, or unfortunately as it may turn out, I had a doctor's appointment that morning for another issue. While there I mentioned the foot and my doctor ordered an x-ray. She called me with the results a few hours later. "You have a stress fracture to the 2nd metatarsal. You should get a walking boot and go non-weight bearing for the next three weeks." Well that didn't sound good. But it also didn't seem right to me. The pain wasn't anywhere near the 2nd metatarsal and referred pain in that area didn't seem to make sense. Not being one to take injury or the idea of not exercising lightly I made an appointment with the podiatrist who had done my toe surgery in 2011 to get a second opinion.

I walked into his office with my walking boot 5 days later. After a quick exam he informed me that I didn't have a stress fracture in the 2nd metatarsal. He said the reaction they noted looked to him like "runner's foot" and was likely caused by the high mileage of the previous few weeks. He thought it was likely a strain due to the combo of my high arches and wearing worn out shoes (the run where the injury occurred were the last 6 miles I was planning on putting on those shoes). His advice was to ditch the boot, take it easy for a week and then gradually start back to normal activity. I could bike and swim, but no running or stepmill.

I happily ditched the boot and hit the cross training hard. A week later, while I was walking without any trouble, running was still out of the question. I got a sharp pain if I tried to push off on the left foot. I saw an athletic trainer. She thought I might have a sub-luxed cuboid. I saw a chiropractor to work on the cuboid. Two weeks had gone by at this point and I still couldn't push off on the foot. I called the podiatrist back and he ordered an MRI. Three weeks and two weeks from the date of injury I finally had my answer - a stress fracture to the cuboid in combination with tendinitis in my peroneal tendon.

In layman's terms, I broke my foot.

And that's when I cried.

I was scared. I was frustrated. What did this mean? The 100 miler I was signed up for in two months was definitely out. Would I be healed and trained in time to run a race in June or July? Would I be able to hike and backpack this summer? How would I possibly stay in shape when the only thing I was cleared to do was swim?

My thoughts towards myself turned cruel. "You're weak. You're a loser. If you just tried harder you could push this through this. People are going to think that you're a wuss." Despite the rational part of my brain telling me this was a true injury that couldn't just be "powered through" I tested out the foot again. Push off. Sharp stabbing pain. "I can't do this. I'm not strong enough."

Thankfully I wasn't left to my own devices. A midst my blubbering my partner looked at me, "don't take this the wrong way but you are the only person I know that would think you can power through this. That doesn't even make any sense. Your foot is broken. You don't tough out a fracture. You have to let it heal. And don't be stupid, who cares what anyone else thinks? You have to do what is right for you."

That's when I laughed. He was right. I was being stupid. I wouldn't look at anyone else who was facing an injury this way. I wouldn't call them weak. I wouldn't belittle them. Why should I treat myself that way?

The treatment? Three weeks in the boot along with crutches. Then it'll be time to re-evaluate with more imaging. Hopefully that will show that the fracture has healed and I'll be cleared to go back to weight bearing activity.

Injury Part I: The Beginning

In September 2013 I decided it was time to re-evaluate priorities. 2012 and now 2013 had been disappointing years for running and racing. Between health issues and injury I never seemed to find a good groove. While I was lucky enough to get picked in the lottery for Western States 100 and have the satisfaction of crossing the finish line, in total I dropped out of more races in 2013 than I was able to run. A two week trip to Europe in the beginning of September was a forced two week running break. Upon returning from the trip the goal was to start over. I  needed another round of IV therapy to get more iron into my system, so this seemed like a natural time to return to lower mileage, faster turnover, tempo runs, hill training, strength training, etc ... Get quality sleep. Eat well. Rebuild and recover. Then allow myself to build back up to long distances. 

As they tend to do, the injury gods had other plans. While in Europe I started to have pain and numbness down my right leg. I noticed it mostly when I tried to drive. It was a challenge to keep the gas pedal pressed down as I couldn't feel the pedal very well and trying to press down was causing a good amount of pain. On the 10 1/2 hour flight on the way home I started to feel pain my low back. By the time we got to Portland I couldn't wait to exit the plane. The pain was enough of a bother that even though it was the weekend I was lucky enough to I find a chiropractor who was willing to see me on a Sunday.

Upon examination she thought it was likely I had a slightly bulging disc on my right side probably caused by prolonged sitting (the flight to Europe and then home). This was causing the pain, weakness, and numbness down my right leg along with the pain in my back. She gave me some exercises to work on to strengthen my core to alleviate my symptoms. 

Since I was in a build up phase of running the back issue wasn't too problematic. I worked on the core exercises, focused on adding hiking in to my training, and within a couple of months I felt as though the back issue was 90 percent healed. And then I headed in to hill training. I went from 45-55 mile weeks largely run on the smooth surface of the Wildwood trail, to a 22 miler that involved hill repeats. Wham! The pain came back with a vengeance. By the end of the run I felt like begging for mercy.

The next day called for 22 miles on Leif Eriksen. The first 10 miles flew by smoothly, and again things when south. I had to keep stopping to try to stretch my back as the pain and the subsequent numbness and weakness in my leg was causing me trouble.

But I continued on, refusing to alter my training to accommodate my injury. Three more weeks of training, putting in 65 - 80 miles a week. Not high by ultra runner standards, but a step-up in distance for me from the past few months. To keep me going and try to heal my back I saw a chiropractor, and athletic trainer, a physical therapist and an acupuncturist. I felt that the shotgun approach to therapy might make me heal faster.

Yet the symptoms continued to worsen, getting to the point that the numbness and weakness in my right leg and foot was bad enough that I was having to consciously pick up my foot because it wasn't happening automatically. I stumbled a bit more than usual as sometimes I was slow to send the signal to the foot to lift up and I would hit it on a rock, or a root. The stumbles caused spasms in my back. Overall, a bad combo.

I held firm to the "power through" mantra. I'm tougher than this injury. I won't quit just because I have pain. Keep on training and get to the rest week. Back to back's, a trail marathon, speed work, hill work and a through run on Wildwood. During the through run my back, right hip, and leg were complaining by mile 9. By mile 15 I considered calling for a pick-up. At 25 I started to visibly limp. I was still running but there was a definite hitch in my stride. I was thankful to get to the finish and try to stretch my hip and back. It was hard to walk because of the numbness and weakness in the foot and leg.

Then it was time for a rest week. I could take it easy for a week knowing that my legs had gotten some good training over the previous three week block. An easy recovery run on Tuesday, Jan 7 felt good. I had some residual numbness and weakness in my right leg, but overall my legs felt happy. Wednesday the 8th I headed out for another easy 6. I woke early, put on the headlamp, bundled up and headed out into the early morning darkness. 

The first few miles felt good, just your average everyday run. At mile 3.5 it felt as though I had stepped on a rock. A sharp pain towards the back of my foot - the area right in front of the heel. I limped a bit. Shake it off, it's nothing. Another 1/4 mile and I couldn't pretend it was nothing. My foot felt like it was on fire. I couldn't run. And I couldn't bear much weight on the foot. I glanced at my phone. Should I call for a pickup? It was still early and I didn't want to wake anyone so I started limping the 2+ miles home.

I walked in the door and the limp didn't go unnoticed. 

"What happened?"

"I think I just broke my foot."