Tuesday, July 29, 2014
Monday was a planned non-running day. It almost turned into a break in the baby 10K step streak, as we got heavy rain at noon canceling my walk from the office. If I'd been working at home, I could have dressed appropriately and just stripped off the wet clothes when I got back . . . but that doesn't work so well in the office.
Monday was also a mentally depressing day. As I pulled out my work notebook, I saw that I'd left the sheet from the podiatrist visit there. Take a look. There are a couple of diagnoses circled. One of them is "hallux valgus." Google that, and find that this is a bunion. Yes, I can see my foot in the standard pictures, though it looks like my case isn't as bad as the ones used to illustrate the definition. And it doesn't bother me, so not getting any treatment for it seems appropriate.
The other diagnosis is "arthritis/degn/osteo." The podiatrist did not say "arthritis" when I was in his office, but his description of what he thinks is going on with the joints between my tarsals and metatarsals fits. Read a bit on it. Incurable, but manageable. Some of the things the podiatrist is telling me to do are on the standard list of how to manage it. It fits the history. It might be in the "good" foot, tool.
That got me down a bit. This is not something that gets better, you just have to work to make it not get worse. It could ultimately end my running habit permanently. Couple this realization with the foot feeling a bit off from overdoing things on Sunday, and I just wanted to go home after work and rest.
Got home. Saw a bit over 5K steps on the Omron pedometer. Had that baby 10K step streak to defend, so I decided to go walk a gentle 5K. Felt better for moving, and finished more briskly than I started. Got a good night's sleep, and things looked better Tuesday morning.
This morning, the bad foot felt as good as it has since the stress fracture. Running laps in the hall while the steel cut oats took their first shot from the microwave was fine. The cat even stayed out of the way. Calf raises on the step felt better than they had. I moved from body weight to doing them with a 2.5 lb. plate. That's still a long way from the 20 lbs. I was using during half marathon training, but it's progress.
Looked at the 5K Your Way program. Week 2 calls for walk 1, run 4, times 7 for 35 total minutes. I set RunKeeper to the walk 1, run 4 workout and planned my lunch route. Ended up only doing 6 interations of walk 1, run 4, but that felt good. It felt almost like real running, and the 30 minutes covered 3.4 miles.
I was particularly pleased that I was able to back off after being a bit fast the first two running intervals, and hold the last 4 to between 8:00 and 8:30 per mile.
Stretched, iced (another podiatrist recommendation for after every run), and did some paid work. The foot feels good. I could walk on it normally to go grocery shopping this evening.
I feel like I could go out and run an easy 5K and not have any problems. But I'm not going to do that. I'm going to stick to walk 1, run 4 this week. That's today, Thursday, Saturday, and Sunday, with no running on Wednesday or Friday. If all goes well, a week from today I'll try continual running for the first time since the stress fracture.
And yesterday's mental worries? They're still there, but in better perspective. My mother used to tell me, "Getting old is not for sissies." She was right. Stuff is happening that I need to deal with, and ignoring it is the Wrong Answer. So I'll learn to deal with it, and do what I can while dealing with it. Right now, it looks like I can get back to regular running even if I do have arthritis in both feet.
And if I end up having to drive somewhere to run on trails, that isn't the end of the world. Just have to figure out how to work the schedule around it.
Sometimes things look better after a good night's sleep and a nice run.
Sunday, July 27, 2014
In the past week, I've had beautiful spring-like weather for walking and run-walk intervals. The price of that weather is that the grass grew like it was spring. I mowed on Tuesday, and the lawn needed mowing again yesterday.
Except, I didn't mow yesterday. I did my 11 cycles of walk 2, run 2 and puttered around the house running the vacuum and doing minor household chores while waiting for daughter to visit instead of mowing in yesterday's beautiful weather.
I paid for that choice by mowing today in summer weather. The forecast called for scattered thundershowers, with a greater chance in late afternoon and evening. When I got home from church and post-church grocery shopping, it was sunny. I decided it was time to mow. I can run in the rain, but I can't mow in the rain.
Minor detail: I looked at the insert in one of my mowing boots. It didn't look easy to get the Superfeet into the boots without breaking them, and right now I only have one pair of Superfeet. So I mowed without the orthotic inserts. My feet felt fine, but I could tell I'd worked a bit.
I thought about bagging the walk-run intervals, but my step count was only about 7K on the Omron and 9J on the Fitbit. I needed some intentional steps to hit that target of 10K/12K steps. But I don't want to overdo things with that foot.
I compromised. Instead of following the original plan of doing 4.3 miles of walk-run intervals, I settled for a 5K worth with no hills. That turned out to be 32 minutes, or 8 cycles of walk 2 run 2. Toward the end I was feeling the left foot, but I wasn't smart enough to bag the last running interval.
Fortunately, the foot feels better after a couple hours of rest. Tomorrow is a planned non-running day. I will honor that. Tuesday's walk-run intervals will need to fit in the lunch hour, which limits Mr. Testosterone's ability to convince me to extend them.
I don't like the uncertainty of not knowing how much I can do; but it is what it is. Just have to live with it and make the best decisions I can when the decisions have to be made.
Sunday, July 27, 2014
One of the things that I've got back to since the last podiatrist visit is light jogging in my hallway in the morning. I run up and down the hall and living room for one minute while my scrambled egg cooks, and for two and a half minutes while the steel cut oats take their first shot from the microwave. I started back with this pattern last Thursday.
Well, since the last time I was able to run in my hallway I've acquired a cat:
She has become an attention hog. We've been negotiating acceptable ways for her to ask for attention. Batting things on tables around is not acceptable. Jumping up where she shouldn't be is not acceptable. When she does something unacceptable, I remove her from that area and stop paying attention.
But there has to be something that's acceptable and works to get my attention, or the unacceptable behaviors will escalate. What we settled on is, plopping herself down on the floor in my path is OK. Much of the time I'll stop and pet her for a few seconds, and enjoy the resulting purr.
So, back to running. When I started running the hall on Thursday it was new and different. Maya took to running the hall ahead of me, dashing off into the bathroom or a bedroom. That's fine, it got her some exercise.
Today, she plopped herself down smack in the middle of my running path . . . in a spot where I've been known to pause and give her some attention.
I can't yell at her for that. I don't want to kick her and hurt her, or trip over her and hurt myself. So for two and a half minutes this morning, I lived with a slight zig to dodge her. Fortunately, she stayed still enough that this worked. I'll have to figure out what I'm going to do when she decides to reach out and bat at my ankles as I pass.
Still, having a cat is worth while. I may have to modify my routine a bit, I certainly have to vacuum more often, and she is slowly training me to keep a less cluttered house. But that lap full of purr she gives me from time to time is worth it.
Saturday, July 26, 2014
I've heard it said that medical diagnosis is an interative procedure. The doctor looks at the evidence, makes an assumption, and prescribes treatment. Treatment may or may not do what is intended, but typically produces more evidence. The doctor looks at the additional evidence, refines the original assumption, and the cycle repeats. Hopefully, the patient experiences improvement while this is happening.
When things go well, there are few medical issues and what issues there are get resolved smoothly. Things get more complicated with less common issues that are harder to understand, particularly when the patient is not totally aware of what would be relevant to the doctor.
I've been thinking about this on the subject of running injuries. It's not just the doctor who needs to modify assumptions based on new evidence; I need to do this as well.
The first iteration of running injuries was met with advice not to run, or not to run long. That wasn't terribly helpful.
The second time past, I went to a physical therapist. She identified a hip abductor weakness that I had not been aware of. We corrected that, and worked on strengthening my arches. The sound track was that I had low arches, and strengthening them would get my feet back into shape to run, while strengthening my hip abductors and hip adductors plus working on my balance would enable me to better control my foot strike and lessen the chance of a recurring foot problem. That actually worked bout pretty well. On the PT's advice, I signed up for formal half marathon training. I think that formal training made it possible for me to run a half; I would have injured myself training up to it, absent the professional coaching.
The third iteration was a stress fracture of a metatarsal in my left foot. In 20-20 hindsight, I think that foot never healed completely after the 2013 injury. The training got me through by limiting how much I ran and teaching me to run slower. It also aggravated the foot at times by having me do speed work that I wouldn't have done on my own. On the whole, the training was positive; but there were shortcomings. Or, viewed from another angle, my body told me the foot had issues and I didn't understand what it was saying.
Enter a podiatrist to treat the stress fracture. It was a long, frustrating 7 weeks between the initial podiatrist visit and the follow up where I found that the not quite pain I had was no longer a stress fracture. The podiatrist says I have low arches, and he put me in Superfeet Blue inserts to support my foot and keep the arch from overcollapsing.
The podiatrist also said some things I'm not ready to hear. He recommended I give up pure running in favor of training for triathlons. Meh. I can't get excited about doing a tri, and being unable to run showed me that I'm not terribly enthusiastic about training for swimming or cycling. The podiatrist also recommended that I run hills, by which he means trails with softer surfaces than roads, and without a consistent directional camber. That makes sense, but it doesn't work in the winter. So I bargained with him, suggesting I don't do speed work and don't run 5 days a week. He seemed to think that would be an improvement, but I wasn't convinced that we had achieved true communication. There will be more to that conversation at the next podiatrist visit.
The iterative part comes in with the low arches. Hmm. The podiatrist says I have low arches, and wants me to use orthotic inserts to protect my feet. The PT said I have low arches, and wanted me to do exercises to strengthen and rebuild the arch. The approaches are different, according to the different specialties, but the underlying observation of fact lines up.
Another 20-20 hindsight realization: Every time I've tried on a pair of shoes with more arch support than I'm used to, going all the way back to pre-Spark days, it's felt like the left shoe is poking me in the arch. I've bought and got used to some of those shoes, and the phenomenon came to mind when the Superfeet inserts initially felt the same way.
Conclusion: all those shoes and the inserts don't have a higher bump on the left foot; I have a lower arch on the left foot. I can definitely feel the left arch being weaker when I do calf raises the past couple of days. That's no surprise, given that the left foot was held immobile for most of 4 weeks to recover from the stress fracture. But the left foot being weaker goes back a lot longer than that.
I'm not sure how much practical use I can make of this conclusion, but still . . . diagnosis is an iterative process. One of the things PT taught me is that when I have issues, I need solutions specifically for me. Someone else's solution will address someone else's issue, which may not be my issue. So I'll remember that I have a low left arch, and possibly a less low right arch, for future reference. I already know about the abductors and adductors, thought that issue is under control right now. And I don't think I'll hurt anything by rolling out the exercises the PT gave me for the feet, in addition to using the Superfeet inserts.
Life is a learning experience. When it comes to understanding my body, it's also an iterative process. I've just been through a key iteration for understanding.
Oh, and today's status: The plan is to wear the Superfeet inserts for six to seven hours, which included the run-walk intervals this morning. Eleven cycles of walk 2 minutes, run 2 minutes covered about 4.3 miles of a familiar neighborhood route with 3 small hills. This time, I managed the Garmin correctly and got nice graphs showing pace, heart rate, cadence, and ground contact time doing exactly what they're supposed to do for walk-run intervals:
The vertical oscillation was more erratic, without as clear a picture of intervals. That's probably because 2 minutes isn't long enough to really get into a smooth groove for either walking or running.
The objective was to hold the running pace to 8 minutes or a little slower. That wsn't totally successful:
All in all, I'm satisfied with today's effort. The plan for tomorrow is a similar length of walk 2, run 2. Monday will be a non-running day, no matter how much I feel like running. Tuesday I'll re-evaluate whether I can increase the running interval.
I'm still uncertain how much time and distance I can add, how quickly. I hope not to find out how much is too much the hard way. Just have to pay attention to how the foot feels during and after workouts, and judge what to do on subsequent workouts by that.
Thursday, July 24, 2014
It's Thursday, a normal work at home day. The weather at noon was near-perfect for cycling, 72° F with sunshine and a light breeze. I didn't get out on the bike. Instead, I went out to do walk-run intervals.
Bearing in mind my sister SPINNINGJW's advice to adhere to protocol for breaking in the orthotics, I didn't put them on till 9:40, just before a sanity stroll on a morning break. They came back off at 1, after the intervals. I was supposed to wear them for 3 to 4 hours today. Much of that time was sitting, but I had the walk/run intervals too. This should be good.
I haven't run since May 15th, other than the quarter mile I did yesterday. I've had a lot of time to think about it, and I had a plan. I would do my intervals over the course of my standard, mostly flat 5K route from home. I chose intervals of walk 2 minutes, run 2 minutes because I'd been told to start with a quarter mile run. A quarter mile is somewhere around 2 minutes, a little more if I'm good at keeping the pace slow and a little less if I'm not so good at keeping the pace slow. I had it worked out that if I walked a 14:20 pace (which is about what I walked yesterday and this morning) and ran an 8:30 pace, it should take me right about 32 minutes to go 3 miles. I just didn't know what speed I'd walk while doing intervals, and there was considerable doubt that I could hold my pace as slow as 8:30 running.
I spent most of the time paying attention to how my foot felt, paying attention to my pace while running, and enjoying the sensation of being out and moving. Some things have changed, others haven't.
Last year, when I was doing walk-run intervals while in PT, I observed that it was really hard to run slow when I only get to run one minute. I started out with two minutes this year, and it's still hard to run slow when I only get to run two minutes at a time; but I did better than last year. Most of my running intervals were reported at close to an 8 minute pace. None were faster than 7:53, and none were slower than 8:22. That's as good as I was doing on solo long runs before the stress fracture, so I'm satisfied with it.
I'd guessed 14:20 for a walking pace. The first walking interval was slowest, at 14:15. The rest of them ranged from 13:09 to 13:53. Part of that will be running paces bleeding over the edge while changing; but apparently I walk faster for intervals than for a steady walk.
It's still hard to stop running at 2 minutes. It feels like I've just got started and I want to keep going. But I held to the discipline, and dutifully slowed to a walk each time the cue sounded. I was rewarded with a foot that felt as good after the walk-run intervals as it did first thing in the morning.
Good news/bad news: The good news is, I'm into the part of coming back that's getting fun. I like running a lot more than watching paint dry. The bad news is, this is the dangerous part of rehab. There is no bright red light telling me when to stop. I could easily find out how much is too much the hard way. Been there, done that, don't want to do it again.
So I need a plan. My current thinking is to model off the 5K Your Way program. Walk 2, Run 2 worked today. I'll do that again on Saturday and probably Sunday, then increase the running interval (and possibly cut the walking interval to 1 minute) next Tuesday. Days to run will be Sunday, Tuesday, Thursday, and Saturday. Monday, Wednesday, and Friday need to be non-running days. Walking is okay.
And I need to work on keeping that run pace easy. An 8 minute pace is okay, but I should aim for 8:30 because I know I'll be faster than I intend. Right now, I shouldn't be running a 7 minute mile.
Maybe a week from Saturday I'll be ready to run continually; but first, I need to complete the break-in process with the orthotics and see how my foot reacts to being more active than I have been. So far, so good. Now let's not make it worse.
Life is good.
Get An Email Alert Each Time MOBYCARP Posts