Follow-up Orthopedic Appointment: This is Not Good

Since my shinsplinty-things seem to be getting worse -- or at least more consistently present -- I'd scheduled another follow-up visit with my Orthopedist.

Here's what I hoped would happen:

My orthopedist confirms the diagnosis of shinsplints and sends me to physical therapy.  I learn a bunch of new stretches and exercises and go on to qualify and probably even win the Boston Marathon.


What really happened:

My orthopedist found that I have good strength in my leg and foot muscles and that -- regrettably -- it's time for us to more seriously explore Exertional Compartment Syndrome as a possibility.  This will involve a huge needle being jammed into my leg muscles both "at rest" and after a long-enough run to induce symptoms (so probably 10 minutes, roughly one mile).  If the test confirms ECS, then my best option is surgery.

Good.  Great.  Terrific.

Basically, Compartment Syndrome is when a fibrous tissue membrane, the fascia, around a muscle is too tight to account for the muscle's swelling during exertion.  (Please consult medical websites for a more scientific description.  I'm -- surprise! -- not a doctor).

Here's a website with a good picture that demonstrates this.  (Note:  DO NOT do a "Google Image Search" for "Compartment Syndrome".  Trust me, it's a lot of gross surgery pictures that make me want to retire from this running thing.)

http://www.physioroom.om/injuries/calf_and_shin/compartment_syndrome_full.php

I'd guess that my problem is going to be in the anterior compartment and lateral compartment on my left leg.

So, bad luck for me.  But, excellent for you, since if privacy regulations allow it, I'm going to have my staff photographers (me and my wife) take some pictures of the compartment syndrome test, and maybe Chris can even be in the operating room taking pictures and interviewing surgeons as they cut out parts of my leg.

The test is scheduled for April 16.  I may push it back if the doctor thinks that the test itself is traumatic enough that it will prevent me from limping through Sole of the City, with some help from anti-inflammatory meds, on April 20.

I'll keep everyone posted as I freak the hell out.

Shinsplints are Stupid. I Don't Recommend Them.

I know I'm a wimp.  I was a wimp in elementary school, when even the younger kids beat me up, and I'm a wimp now.

One of my friends is running a marathon in a couple weeks with four big metal screws in her hip.  Granted, she loves running WAY more than I do.   (By which I mean, she actually likes the running part, whereas I like the finishing the race part and the celebrating afterward part)

Still, it sucks when after one mile it feels like your calves are going to burst, as they did on Tuesday, when I did the walk of shame back to my car, or when after my 3 prescription-strength anti-inflammatory assisted miles on Saturday I didn't have full range of motion in my left foot.

I'm trying to pull my left foot back like my right one.  
It won't go any farther than this. D'oh.


I'm trying, though.  

I realized after the fact that prescription-strength anti-inflammatories, indomethacin, to be specific, were probably the secret to my "success" in both the Kelly St. Patrick's Day Shamrock 5K and the Shamrock 8K.  I have the occasional flare-up of gout, and I take indomethacin to reduce the painful swelling in my big toe, but it also fights inflammation in general, even if gout's not the cause. (I also take colchicine, which treats the gout itself.)  I was having a minor gout flare-up on and off in the week between the two races, and so I realize that I took my gout meds before both of these races.  I'm still confused, though.  I was having good runs (well, except for the fact that I'm still not in good shape!) at the end of February without the aid of any drugs. I'm going to the orthopedist on April 2, but in the meantime I'll probably try to get a few runs in with the help of my meds.

I also put some new insoles in the Brooks Adrenaline.  Between the insoles and the indomethacin, I got 3 miles yesterday, considerable improvement over the 1 on Tuesday.  I'm also doing a ton of calf raises and trying to use weights to strengthen the muscles around my shin, too.   I've now lost 3 big races to shin & calf problems.  This needs to end.

 
                           If nothing else, the purple insoles make the Brooks Adrenaline much more stylish.

Down and Out (Again) in Manchester, PA

It seems like just a few weeks ago that things were looking up.  I had to overcome my own lack of motivation (and I did get out and run again the next day from the "Inertia" entry), but my shins were feeling a lot better.  In my previous blog entry, I described running, slower than usual, but still running, the Shamrock 5K in Baltimore.

Unfortunately, things are really not so good.  Two weekends ago, I went out for a run and had the full-on shinsplint/ankle-swelling/lack-of-motion problem that caused me to shut myself down in October.  I gave myself a few days of rest, and limped through two miles on Thursday before giving up due to calf soreness.  I was suprised, honestly, how well I held up in the 5K.



I tried again tonight, and got through only about a mile and a half.  The ankle and shin seem ok, but my calves were really in a lot of pain.  I felt like I would only do more damage if I pressed on, so I dejectedly walked back to my car as I passed by.  My goal had been four miles.  Part of me thinks that I quit too early -- but I don't think there was any way I was getting 4 miles or even three this evening.

Problem:  I'm signed up for an 8K on Saturday.  

I'm hoping that because it's flat as a board and because it's a reminder of my glory days, going past the same Neptune statue that I ran by to finish my first marathon (and one of just two that I've run), that I can drag my carcass through the 8K.  I know it's walker friendly if it comes to that and I know Chris won't let me DNF, too...it's just hard to accept that what seems like relatively minor, lingering injuries are setting me back for so long and that I'm going to bomb at a race that I kicked butt at last year.

So, here's the plan, as such:

1. Continue to try to strengthen the ankle and shin muscles, and work on core.  I'd been doing well at this, but we have not had our weekly personal training sessions the past few weeks due to schedule.  That could be a factor, but I have to do more on my own.

2. Lose some goddamn weight.  I was 20 pounds, at least, lighter when I ran my last marathon.  I have to:
 a. get to the gym more and not rely on running as my sole source of cardio.
 b. EAT LESS  -- No dessert for me until I can run 5 miles.  (I will allow myself dessert on Saturday night if I finish the 8K)

3. Cut back on the race schedule.  When I outlined my race schedule for the year, regular commenter Danny opined that I'd signed up for too many races.  So, revised:

March

• 10 - Kelly St. Patrick's Day 5K, Baltimore, MD. (Done)
• 17- Townebank 8K, Virginia Beach, VA (Too late to do anything about this.)

April

• 13 - Yuengling Light Lager Jogger 5k. Pottsville, PA
•  20 - Sole of the City 10K, Baltimore MD

May -- None.  

June

• 1- Manheim Downtown Development Group: Rock-N-Glow 5K Race, Manheim, PA (Chris is running a half that morning.  I think I can hang at this one.  Plus, it's a crazy one that I can more easily write off as "just for fun".
• 22 - Dreaded Druid Hills 10K, Baltimore, MD. This is 3 whole months away.  While a lot can happen in three months, this is a tough race and I'm glad I didn't sign up for this one yet.

By doing this, it gives me over two months to try get back in shape and decide if I want to tackle Dreaded Druid Hills or not. I'm not signed up for it, so at least I haven't wasted money if I end up skipping it. 

I should, in theory, be able to do some of the Movie Madness 5K in Manchester on April 6, and two now-missing 5Ks, HACC Dash and Armed Forces Day 5K in Harrisburg in May if things are going well -- they are all small races that won't fill up.  I had put a half marathon in June in Philadelphia as a possibility, but I don't think that's even worth considering.  

 

I probably would have been better off, and more motivated/less frustrated, if I'd just started completely over from "Couch-to-5K" back in January.  That still might be my best option, but it would probably rule out Sole of the City. 

In summary, I know there are a lot worse running injuries and a lot of people who are tougher and more dedicate than me out there.  But still, **** you, shins.

Shins...ok?

I'm having a good week of running.  I haven't said that since at least September, and probably earlier than that.

It's only good in my current limited perspective.  The 3.1 miles I ran on Sunday and the 3.1 miles I ran tonight would be 2 of my 3 slowest-ever 5Ks (along with the York Jingle Bell 5K last December).  It's not hard to think back exactly two-years ago, when I ran 10miles effortlessly on Fat Tuesday as my last double-digit run before my first marathon taper.  It's a long away from that in terms of both distance and pace.

But that's not important right now.  What is important is that my left shin felt great.  What's important is that on Sunday I ran through Mt. Wolf, which, as the name implies, is super hilly, and finished my 3.1 without any walk breaks.  I was sore tonight, mostly in the quads, from that run and from last night's session with our personal trainer at the Y, but the shin was fine.  

I still think I'm going to have to defer from the Shamrock Half Marathon in a little over a month.  Adding 10 miles of distance in a month is more than i can do, I think.  But for the first time in a really long time, I can actually envision myself coming all the way back and finishing half marathons, marathons, and Spartan Races (just kidding!) again.

What's made the difference?  I think it's that for the first time ever in my running career, I'm really worrying about core strength and working on strengthening my legs.  I have to give most of the credit to Chris for dragging me to her personal training sessions at the Y, and to our trainer, Mike F. at the Harrisburg YMCA, for making us do 6 different kinds of squats in a row, followed by 4 or 5 different kinds of planks.   Though I'm usually cursing him at the time and threatening to kill and/or divorce Chris for dragging me along, it's the only thing I can think of to explain this recovery.  No pain-free runs in a row hasn't happened in a long time, and I should probably downgrade myself to "cautiously optimistic" instead of "dreaming of long distances."

I'm guessing I'll come crashing back to earth soon, but I'm going to enjoy the rare runner's high while it lasts.
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Meanwhile, as sketchy a runner as I've been lately, I've been an even worse blogger.  A couple of entries though that I'd like to get posted "soon":

• The sad yet inspiring story of an injured kitty and his adorable kitty PT. (With cute pictures!)
• 2013 Race Schedule
• Running....From the Police? (Not as exciting or useful as it sounds)

Differential Diagnosis: Part 2 of ?: MRI

I went in for my MRI today.  There's not much more to say at this point, since my doctor hasn't seen the results yet, but that makes a crappy blog entry.

My MRI was scheduled for 8:00am this morning at the WellSpan Imaging Center in York.  First of all...8:00am?  I work from home, and lately it's been all I can do to be out of bed just barely in time to make coffee before starting work at 8:30.  Secondly, I'd never had an MRI before, and I was a little bit nervous.

Fortunately, the people at WellSpan Imaging could not possibly have been any nicer.  (Please note:  I do not yet know what my co-pay is on this.)  They answered all my questions, ran through a checklist to make sure I didn't have anything metal in my body (if you have a pacemaker, you can't have an MRI, for example) and then made sure I was comfortable on the machine before it started MRI-ing me.  

The MRI in question was a 2010 Hitachi Oasis, an open MRI, meaning I wasn't going into an enclosed tube like the thing they were always scanning people with on House.  

Anything that might have metal in it, including all my electronic gizmos had to be put in a locker, so I couldn't take any pictures.  However, the MRI at Wellspan looked exactly like this one (which is at the Carlisle Regional Medical Center):

Because I was only having my shin scanned, I didn't need to be all the way under the dome-like part of it (which I guess is the MRI itself), but really just my head was sticking out, and since the table was raised pretty high, I think I would have hit my nose if I were pushed in any further, making the experience a little claustrophobic.  It really wasn't too bad, though.  My only instructions were "try not to move your leg" and "don't freak out" (really it was "Press this call button if you need anything.")

Once the test begins, the main thing you'll notice is that an MRI is REALLY LOUD, with lots of banging and whirring noises indicating that its scanning.  Luckily, they'd provided me with foam earplugs and big headphones.  I'd requested a rock station, and ended up listening to the greatest hits of U2 through the whole 30-ish minute scan.  I have a friend who loathes U2, and at the beginning of each song I thought "I'm glad I'm not him."  To which I'm sure he'd reply, "I'm not the one stuck in an MRI machine at 8:00am!"

After the scan was over, the technicians lowered the platform down, and warned me that I would be dizzy for a few minutes.  They weren't kidding!  Apparently the MRI stimulates the balance center in the inner ear.  I didn't notice anything (other than how noisy the machine was and how tired I was) during the scan, but I felt a bit off-balance for about 5 minutes after the scan.

So, I learned something today. Just not anything about what's actually wrong with my leg.  Hopefully that's coming soon.

The ABCs of Being Pain Free?

I ran just 10 miles this week, but that's not important.  What is important is I ran 10 miles without a hint of trouble from my shins or varicose vein, and I'm cautiously optimistic that I've found the fix for it.  And by "I've found the fix for it", I mean Chris told me something to try that seems to have worked.

It's writing the alphabet in the air with my toes.  Here's an example that's a little more thorough than what I've been doing:

http://www.youtube.com/watch?v=2X5-6-Puo20

Please note that I can't endorse all the Red Sox stuff in the background, but this seems like a good example.  I've just been writing through the alphabet once or twice several times a day while I'm working or watching TV and before I run.  I've been doing a little better with strength training lately, which may be helping, but I've noticed I didn't have any exercises for the muscles on/next to my shins, which is where I have so much trouble on my left leg.  This alphabet thing seems like it fills that void in my workout routine.

Now, my quads were another story.  My quads felt weak (I blame last night's fencing class for this) throughout the run, I've clearly lost some conditioning over the past month, and it was digustingly humid and warm this morning.  A four-mile run (per my training plan) that I wanted to turn into a six-mile run since my shins and ankles felt so great ended up a five-mile run when I felt like I was going to overheat if I went another mile.

So today, I lost the battle.  But for the first time in quite awhile, I think I'm going to win the war and be ready for a fall half marathon and spring full marathon.

And since this post is boring and people come here for the cat pictures, here's Higgy helping me work. 

Shins, Swag, and 10K Friday Ramblings

Thank Goodness It's Friday bullet points, again:

• During my run on Tuesday night, I left the Shuffle at home since I didn't want to get hit by a car.  That left me plenty of time to overanalyze my splits from the Hershey 10K, and even more than before I am wondering if some of the course markings were misplaced.  I didn't have my Garmin, but here are the splits that I remember:
  - 5K: 27:00
  - 8K:  40:48
  -10K:  52:33
  Individually, each of these make sense.  27:00 is a pretty average  5K training time for me (I'm usually faster on race day).  My 8K PR at super-flat Shamrock was 41:40, so to be ahead of that is surprising, but out of the realm of possibilities.  My 10K finish time is in line with where I was at the 8K mark and how I was feeling at that point -- on my tired legs I was back at my usual 10minute-mile pace for the last 1.2 miles. And while it's considerably faster than I what I thought possible in this race (I thought the 54s or 55s was best-case scenario), I ran this very aggressively compared to my only other 2 10Ks (The first was my first time at that distance, period.  The second was the super-hilly Druid Hills 10K).
  
  What doesn't make sense is the combination of the three.  At Shamrock, I hit the 5K mark at right around 25 minutes.  At Hershey, it appears I ran 3K, almost exactly 2 miles, in 13:48.  I can get into into the low 6-minute mile range for one mile, but I'm just not that fast over two.  If anyone reading this ran the Hershey 10K, let me know what you think of the mile markers? (I'm pretty sure that last quarter km, at least, was super-wrong!).
  
  Or, maybe I did run the fastest 3K of my life in the middle of a 10K.  Do not try to bend the spoon — that's impossible. Instead, only try to realize the truth: there is no spoon.
• I picked up our packets for the Sole of the City 10K last night. I admit that I love swag, and this is a pretty nice premium:

 

• My strategy for this race is still to take it conservatively and just have fun.  My legs still felt tired on Tuesday, and yesterday morning's 6.3 mile run at Cousler Park ended with considerable soreness in my left shin.  Not the usual place, this time, but closer to the knee.  I don't think it's serious, because I feel better this morning, but I hope it's not my the new Adrenalines which I really like.  It was cool yesterday morning, but the humidity was oppressive.  I've always felt like the humidity takes a lot out of me and that I feel worse all over after a really humid run, so I'm just going to blame that, hydrate, and foam roll the crap out of it, and whatever happens at Sole of the City happens. The weather sounds like it'll be in the high 60s and either rainy or very humid, so this is not the time to be a hero. Race report on Saturday or Sunday.

Until then, Run Happy or Get Revenge!

The Comeback Begins...

With a wintry mix falling over Central PA, coating the grounds but not the roads, and me waking up (covered in cats) feeling like I'd been hit by a train despite a very good longer than usual night of sleep, I was leaning toward putting my run off till tomorrow.

Instead, Chris (who had a 4-miler today on her training calendar) and I headed up to the indoor track at the West Shore YMCA. And, I'm glad we did.

My plan was to try for two miles. I started out feeling great, it was nice to run again after over a month off. After two miles, I felt good enough to go for three. I was definitely a little bit winded afterwards, and my quads are bit sore but don't feel injured, but I'm otherwise ok.

Shinsplints? Gone.

Mystery bump? No problem.

One mile at this track is 16 laps, and I might have miscounted as I was singing along with Van Halen in my head (I hope it was in my head), but I believe that I ran an even 3 miles or one lap extra in 28:57. Other than being indoors, this run could not possibly have gone any better. This year's Shamrock Marathon is out of the question, but I feel very confident about the spring 5Ks, 8Ks, and 10Ks and trying to destroy the Harrisburg Mile in the Summer.

It is a long way back to being in marathon shape, but it is great to be started on that road.