Sunday, September 1, 2013

The Fitness Conundrum

It is a very fine line between ultimate fitness and injury. Whenever an athlete boasts that they are in the best shape of their life, inevitably they get injured shortly thereafter. I call it the fitness conundrum. In the triathlon world, athletes like Emma Snowsill, Lisa Norden, Paula Findlay and Terenzo Bozzone sustained serious injuries immediately after a seriously awesome performance. At the 2008 Olympics, Deena Kastor broke her foot during the marathon. Before every Olympics and World Championships, hordes of athletes pull out due to injury.

I am now one of those athletes. This summer, I was arguably in the best running shape of my life. My half marathon times improved immensely, I saw times on the track I never imagined I would see again, I floated through my weekly long runs. I was on fire. And then, bam, just like that, I got injured.

The America’s Finest City half marathon two weeks ago was my best race this season. I did not set a PR, but given the course terrain, my overall placing, and the ability of the women who finished behind me, I felt like it was a stellar race. I went out reasonably hard and instead of surviving the last 5k which is predominantly uphill, I charged through that section, picking off women who underestimated the difficulty of this part of the race and went out too fast. I spied a woman up the road and I hunkered down to try to catch her.

As we neared the finish chute, the road pitched downward and we both accelerated. At that moment, I felt a painful twinge in my calf. Fortunately, the finish line was right there, so I did not have far to go on my lame leg. I was thoroughly hobbled and traded my normal warm down run for a chair and a bag of ice.

It was determined that I had a very tight soleus and I had an overly swollen calf to prove it. Over the next few days, my calf seemed to improve. I did my running on the Alter G anti-gravity treadmill, got some deep massage, ultrasound and electrical stimulation. I stretched, sported compression socks, and did my best to facilitate healing.

On Friday morning, I ran 1.5 miles and walked back to gym, knowing what I knew all along. I had torn something. I had two thoughts, as I glumly trudged through that mile and a half. First, if I have an issue that does not resolve within two or three days, it is a big problem not a small one. Two, the initial injury was just so dramatic it had to be more than a seized up muscle.
The good people over at Spine West fit me in that day for a diagnostic ultrasound. I cannot say enough about how accommodating that practice has been to me over the years.

Diagnostic ultrasound is truly an amazing advancement in sports medicine diagnostics. It often negates the need for an MRI and can be performed right in the doctor’s office. An additional bonus is that the results are immediate and in my instance, a direct comparison could be made between my right and left leg.

The ultrasound revealed a small tear in my left medial Achilles tendon. It took a little while to find it, mostly due to the fact that they had to wade through my cracked and wrinkly feet. I’m not kidding! The doctor was appalled by the state of my feet (who isn’t) and could not hold back a remark.
The tear presented itself as a black circle, essentially empty space, where the tendon usually is knitted together. Fortunately, the rest of the tendon is intact and pliable.

The black hole is the tear. This is from Dr. Google. Mine is much smaller.

My initial thought was, “now I am really a runner!” because truly, this is a real runners injury. Over the years I have had injuries that have prevented me from running, but none were actually due to running itself.

The positives are that I do not need to wear a boot, I can still run, albeit on the Alter G and I still might be able to do Twin Cities marathon on October 6.

Ok, mine is not ruptured, and I have 5 weeks not 24 hours...
I have decided that if I am fully healed, I will run the marathon, mostly as an experiment. As a scientist, I want to determine how much fitness I can maintain by running on the Alter G and using the elliptical (as a bonus I get to watch lots of shows on my iPad; today I watch four episodes of Episodes). I do have the luxury of signing up for another race later in the year. However, the people I coach often do not have the ability to choose another race; they have to stick with the plan. You simply cannot decide to sign up for a different Ironman 6 weeks later due to an injury conflict. The outcome of my tiny experiment will give me invaluable information that I can use to help others dealing with an injury. I realize that not everyone has access to an Alter G, but they are becoming more commonly available.

In terms of solving the fitness conundrum? It is definitely a perplexing problem. I hit the gym hard to maintain muscle balance, I was very well rested for this race, I kept my weekly mileage lower this year to accommodate the fact that I was running faster, I never trained through any leg pain, I had no flashing lights to warn me that the system was about to shut down. I suppose if there was a clear cut answer, somebody would have already found it.

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