Stress Reaction

The Diagnosis
After 5 weeks, 4 doctors, 3 x rays, and 1 MRI, the results are in.  They are determining my injury a "stress reaction".  Basically, the radiologist and 2 foot specialists reviewed the MRI and couldn't find an exact fracture site, just an area in the 4th and 5th metatarsals that had some edema, inflammation, and trauma.  If I continued running on it, eventually I would have a fracture in the bone. 

The Treatment
I'm supposed to stay off my foot for a week or so, and use crutches or a walking boot. It could take 6 days to heal, it could take 6 months to heal.  I'm allowed, and encouraged, to cross train.  Then, when I don't have pain walking in my normal shoes for a week or so, I can slowly start adding in running. 

The Cause
The foot specialist says he doesn't know what caused it.  I would love to know the reason so I know how to prevent it in the future.  Since my training has been legit (NOT too much, too soon) and my diet is healthy and well-balanced, the dr speculates that when I had the pain in the ball of my foot, I may have altered my gait.  This may have put undue stress on the outside of my foot, hence my 4th and 5th metatarsals. 

The Good
It is encouraging that there isn't a broken bone.  Which means it should heal faster than a normal stress fracture (6 weeks).  I've also been running for 33.5 years without ANY type of foot pain or injury.  Hopefully this is a one-time fluke and not a regular occurrence. 

The Bad
As previously stated, the doctors and myself don't really know exactly what "this" is, and what caused it.  Therefore, it's hard to prevent it from happening again. 

Phoenix Marathon Race Recap

Marathon #3 is in the books. 

After my foot scare and getting the green light to run, the big worry going into race day was the weather.  All along we had planned on running in sun and heat.  Two storms were headed our way though and there was a 100 percent chance of rain for the Valley of the Sun.  And 15 mph winds.  I was pretty nervous, but then remembered that we have done all of our training in northern Arizona, where wind is an everyday occurrence.  And, who can forget when we ran 12 miles in the freezing, pouring rain on the day of the Christmas Parade?

The night before was very uneventful; drove to Phoenix, made a quick stop at the expo, carbo loaded at Olive Garden, went to the Gilbert house and laid out race stuff, and in bed by 8:30.  I think I slept pretty good until 2:30.  Then I was tossing and turning until my alarm went off at 3:45.  We left the house at 4:15 in time to get on the bus that takes all the runners to the start line at Usery Mountain Pass.

Usery Mountains photo courtesy Arizona Oddities

As the full marathon runners were loading the buses, some guy asked, "Is this the the bus for the fun run?".  Then as we were getting off in the middle of nowhere in the dark and wind, another guy said, "Are we at six flags?"  We had a few good laughs and lightened up a bit after that.  On the twenty minute ride to the start I ate my banana bread and banana and drank a bottle of water.  We hit up the port-a-potties right away, then found a place to sit down to get our wardrobe and gadgets finalized.

 
At this point it started to rain!  We dropped our gear bags off, put on our trash bag ponchos, visited the port-a-potties one last time, and made our way to the start line.  Just as we found the 3:45 pacer the cannons shot off and the race started. 

Miles 1-4 were downhill and easy peasy.  I said adios to Larissa after the first mile and settled in with the 3:45 pace group.  It rained for about the first 20 minutes, but I didn't mind.  It was a nice distraction.

Miles 5-6 were uphill, but I stayed on with my pace group and had a GU.  I couldn't believe how fast it was going by. 

Miles 7-10 I was loving life!  I was so happy to be running and felt great.  I ate half of my PowerBar and was still with the 3:45 pace group.

Miles 11-15 I started noticing some ball of foot pain and it was getting uncomfortable to run.  Not good.  As I passed the half marathon point I checked my watch, 1:51.  Not bad!  I finished my PowerBar and hoped the pain would go away like it did on my 20 miler a few weeks ago.

Miles 16-20 were into a headwind and now the top of my foot started hurting too.  I took another GU and knew my goal time of 3:45 was slipping away. 

Miles 21-25 I was miserable, wincing, and limping. I promised I would drop out as soon as I saw Jason or a medical tent.  But I saw neither and I didn't have a cell phone with me so I just kept trudging along.  I alternated between walking and jogging. 

Mile 26 I was in a sad and pitiful state, but when the 4:00 pace group came up behind me I said, "Oh heck no, not again!" and started running as fast as I could all the way to the finish line. 

I finished in 3:58.

 

 

 

 

 

 

I walked around the finishing line looking for medical help or Larissa, but could find neither so I did the worst possible thing for my muscles and sat down in a chair.  When I took off my shoe and saw what I had done, I started sobbing.



 

Just then Larissa walked up to me and immediately left to get medical help.  The people all around me were freaking out that my foot was broken and offered me ice and Advil.  They brought me a wheelchair to get to the medical tent and that was the most embarrassing thing ever.  How can I possibly run 26.2 miles but need a wheelchair to go 30 feet?  A doctor examined my foot and recommended I get an x-ray.  They gave me some ice and sent me on my way. 

 

I wish I had a different ending to this story.  My training partner (who did every single run with me for 18 weeks) ran a 3:34 and qualified for Boston; I limped across the finish line and may never run again. 



 

Best News Ever

Turns out it wasn't a stress fracture after all. 

After a few days of wondering and thinking the worst, I couldn't stand it anymore so I went to a sports med doc.  Luckily I got a physician who is a runner, and therefore sympathetic to runners.  She spent lots of time asking questions and poking and prodding my feet.  Then, she brought in another physician who did the same.  He said that he was "reaching into the very bottom of his bag of tricks" but he thinks that somehow I got a broken blood vessel.  That would explain the bruising and pain.  A lot of the symptoms were similar to a stress fracture, but in my heart I just KNEW that I couldn't have a stress fracture.  I have slowly and safely built up my mileage, I take rest days, cross train, and have a healthy diet.  But I let negative thoughts and Google searches take over.  I was convinced that I wouldn't be running the Phoenix Marathon, or even running at all for a few weeks. 

The sports med docs suggested that I go for a test run and call them if there was any pain to schedule an MRI.  It's amazing what some ice, elevation, and rest can do for an injury.  I ran the happiest 4 miles of my life that night...PAIN FREE! 

I learned a few things from this little experience.

1)  Running is pretty important to me.  I always knew I liked it, but when I thought I couldn't run I can't believe how devastated I was.  This could be a good thing or a bad thing. 

2)  Don't believe everything you read on the Internet.  Everyone has a running blog with their own story.  Just because it happened to another runner doesn't mean it's going to happen to you the exact same way. 

3)  Hope for the best.  When the podiatrist told me, "it could be a stress fracture...or a broken blood vessel", I only focused on the part about the stress fracture.  I should have instead treated it like a broken blood vessel from the beginning.  If that didn't heal, then I should have started considering a stress fracture. 

I can't believe how grateful I am to be able to run 26.2 miles this week!

4th Metatarsal Stress Fracture?



Things were going just as planned during the taper.  I hadn't experienced any more ball of foot pain on any of our runs for the past two weeks.  Tuesday morning I set out for a 3 mile tempo run.  The pace was fast and easy, and I was well rested. 

 

About a mile and a half into it, I felt a pretty strong pain in my foot.  I want to say it was in the top and the bottom and just all around, but it's really hard to even describe where it was.  It hurt bad enough that I considered stopping right there, but being a mile and a half from home I decided to keep running.  I was slowing considerably and wincing by this point, and the pain certainly was not getting any better.  Another mile into it and I couldn't go any longer.  Unfortunately, at this point even walking hurt.  I limped home and was making some moaning/crying sounds.  As soon as I got in the house I took off my shoe and noticed some bruising on the top of my foot going into my 4th toe.  Not to mention it hurt like heck.  Not good.   

 

 

 

This was the first time since I experienced ball of foot pain a few weeks ago that I wore my Newtons.  I don't know if it has anything to do with it, but it seems like they put more pressure on the balls of your feet.  Maybe not my smartest move regarding running shoes? 

 



 

 From my research on metatarsalgia, I knew that bruising on the top of the foot likely meant a stress fracture.  I iced and elevated for the rest of the day and made an appointment with a podiatrist for the next day.  I sent Larissa a text that said, "Have fun running the marathon by yourself."  I don't think she believed how serious it was.

 

The xray didn't show any signs of a stress fracture, but the dr said it probably wouldn't show up for a few weeks when it starts to heal.  (So what was the point of the xray?)  He also said there was a small chance it could be from a broken blood vessel and that I could still run the marathon in ten days.    

 

 

With how much pain I've been in, I highly doubt that.  It's been a constant ache since it happened. 

 

I'm supposed to take a test run in a few days to see if it hurts again, and honestly, I'm gun-shy and don't know if I even want to try. 



 



Injuries Make Me Sad

Apparently I have metatarsalgia.   It's a vague term that means the ball of your foot hurts.  I first noticed it on a recovery run on a Thursday.  Then on Friday we went to the Open House of the new LDS Gilbert Temple. 

It was amazing, but I didn't do myself any favors by wearing high heels.  We had to wait in line to get in and had to go on lots of stairs.  That means there was a lot of time on my feet, with pressure right on the ball of my foot.  I didn't notice any pain at the time, but the next morning at about 5 miles into our 12 mile long run, the ball of my foot started hurting.  By the end it was excruciating and I could hardly walk into my house.  Foot pain was something I wasn't familiar with, so naturally, I started Googling my symptoms.  For the next few days I drove myself crazy trying to find a name for what I had.  No luck.  I ran on Tuesday and about 4 miles in it started hurting again.  So I Googled some more and decided to skip my next two runs and in hopes that it would be better by Saturday.  Just in time for a 20 miler. 

I'm trying Dr. Scholl's Ball of Foot Pads for now.  My foot hurt off and on for the first 5 miles but then seemed to do okay. 

 

And if that isn't enough to deal with 3 weeks before a marathon, might as well throw in some IT Band issues as well.  Oh, and some shin splints. 

 

I haven't had an IT band flare up in over a year so to say it took me by surprise on the 20 miler would be an understatement.  I'm not too freaked out about it yet, because it was just one incident and I have been slacking on my IT band exercises.  Luckily I came across this little gem to help. 

 

My left shin has been bothering me off and on since June.  Again, I've been slacking on my regimen so I need to be diligent about doing that as well (things like rolling my foot on a golf ball, stretching my calves, wearing compression sleeves, ultrasound). 

 

I don't know if this has any significance, but just before all of these injuries started popping up, I got new shoes.  I researched for weeks and finally came to the conclusion that the Brooks PureFlow 3's were going to be my next marathon shoe. 

 I wore them on a few easy runs first, and then the 12 mile run (where the metatarsalgia flared up) and the 20 mile run (where the IT band tightened up).  Note that I did not wear them on my amazing 19 mile run.  It could just be coincidence, but at this point I'm not interested in testing them out any further.  My running store, RoadRunner Sports, has a "90 day wear them and exchange them" policy, so lucky me, I am returning them and getting what has worked for me in the past.  Say hello to the Saucony Kinvara 4

I don't know why I seem to get injured so much.  I feel like I am doing things right (cross training, strength training, easy vs hard days, rotating shoes, and rest days) and yet I still get injured.  Some things are just out of my control, but I am going to do what I can in these next 2 weeks to give my body the best shot at being healthy and rested for the marathon.

-rest and sleep more

-healthy, nutritious food (no processed sugar for the month of Feb.)

-it band and shin splint regimens

-trust in my training

 

 

Triathlon Training Week 3

I had to ease back a little this week because I think I overdid it last week.  The good news is that I only had to set an alarm 1 day this week.  Instead I squeezed workouts in during the day or after work.  The bad news is that I forgot how hard it is to get in a workout in the evening.  There is just too much going on with dinner, homework, and soccer practice.  As much as I would like to sleep a little longer in the morning, I think it's worth it to set an alarm and get my workout done while my family sleeps. 

I only did 1 run this week because I was letting my shin rest.  I've noticed quite a few lumps along the bone so I had one more treatmnent of Graston to try to smooth those out.  I am crossing my fingers that I can finally kick this nagging case of shin splints. 

I closed out week 3 with: 
1 yoga session (1.5 hours)
1 run (8 miles)
2 bike rides (18 miles and 12 miles)
3 swims (2 x 525, 1200, and 1200)

Graston Technique for Shin Splints

My shin splints were just not going away.  I felt like my new stability shoes, orthotics, and calf sleeves were preventing it from getting worse, but that I needed to do something more to heal that area first. 

 

I had a few treatments of the Graston Technique and I think it did the trick! 

 

Here's how my leg looked a few hours after a session.

 

 



 Here's how it looked a few days after a session.

 

Be warned, the Graston Technique is not for the faint of heart.  It hurts like heck while it's getting done.  Think of metal tools digging repeatedly into an area that is already injured.  Plus, it will leave you pretty tender and bruised for a few days afterwards. 

 

But, it's all worth it.  I'm a big believer in this type of healing.  ASTYM healed my chronic IT Band pain, and now hopefully Graston Technique is going to heal my shin splints.  After just a few sessions I can already feel a difference.  



Shin Pain

Shin Pain.  Ain't nobody got time for that. 

About 4 weeks ago I noticed a tender spot when I touched my shin.  Over the next few weeks it turned into a dull ache, but never bothered me during a run.  My immediate thought was shin splints, but then I started freaking out because I've had shin splints a few other times (7th grade track, high school track, and training for my first half) and the pain was always all over and in both legs.  This time the pain was more localized and only on one side.  It was on the inside of my shin, about 3 inches from my ankle. 

After doing lots of research (aka googling) and talking to a friend who is a PT, I determined it was "just" shin splints and nothing more (like a stress fracture).  This would make sense since I tripled my
weekly mileage as soon as I finished P90X2.  Plus I was overdue for a new pair of running shoes.  My chiropractor and PT friend also both immediately suggested orthotics to help shin splints. 

So I immediately cut back on running, even though at this point it still never hurt while I was running.  I also started icing, doing ultrasound, bought compression sleeves, and got fitted for new running shoes and orthotics.

 

 

So far, so good.  After resting my shin for 7 days and trying out all my new gear, the pain in my shin has gone down considerably.  It's not lumpy or tender to the touch anymore, but you can bet your boots I'm going to keep babying it to make sure it doesn't get worse.  I really don't have time to deal with a running injury right now.  I'm having too much fun just running.