Thursday, January 21, 2010

injury update

Today will be my 4th day of forced rest. The pain when walking has diminished somewhat but I am a long way from even attempting an easy run. I was holding out hope for a miracle recovery but it's not happening and I have officially cancelled my plans to go to Texas this weekend. My weekly mileage since Christmas was 55, 45 and 60 (an average of 53.3 per week). I averaged 38.2 in 2009 but my median mileage was around 42 and had several weeks over 50 so I did boost my mileage and intensity but it's not like I was a complete moron about it. I read an article last night that hyperthyroid conditions can put one at increased risk for tendon injuries. That confirms what I pretty much knew already. The frustrating thing is that I religiously followed my supplement program but did not see any real results. My only hope is that mega doses of Lithium will do the trick. Again, the Lithium that I take is a dietary supplement derived from vegetable culture, not the drug intended for bipolar patients. If I was in balance, I feel that I could run 80 miles a week, clock a sub-18 5K and a sub-3 marathon. I have no aspirations of reaching that level but is 60 MPW and a 3:10 marathon on a downhill course (3:15 for non-asterisk) too much to ask? Sadly, yes it is. All I had to do was avoid injury for another 2 weeks then the risk would have diminished considerably. I would taper for the Mercedes full, which would have been followed by a week-10 days of rest before hitting it hard again. Man, it seems as if everytime I get upbeat for any length of time, I get knocked down. As much as the timing sucks, it actually could have been worse. All those 2-4 day flare ups that I experienced in the last 3 years most likely prevented an overuse injury from occurring sooner. When I was living in Montgomery, my job sucked, I had very few friends and running was the one thing that kept up my spirits. An injury in 2008 or '09 would really have been a crushing blow.
I have read a few horror stories of some runners who have battled achilles issues for years. That frightens me but I must believe that those cases are very rare and in most instances, the athlete tried to run through the injury for a long time. My self diagnosis is non-insertional achilles tendinosis. The pain is localized a few inches above heel near the bottom of the calf muscle. Most runners, I repeat, most runners with this condition recover fully. Half recover in one month or less but the worst cases could take up to 6 months and in a few instances, leave the athlete limited to being a recreational runner. I have been in that situation before. Back in 2001, on my final attempt to make the team in college, I went down with chronic tarsal tunnel syndrome. I was told that my running days could be over and over the next few years, I never ran more than 4 days or 20 miles per week. I've been through much worse so I fully expect to beat this as well.
The best solution is to rest and forget about the Spring racing season altogether. The good thing about road racing is that if you miss and event one year, it will almost certainly be run the next year. My buddy Nick is coming to Birmingham for the Mercedes half and it looks like I will be a spectator. I am really not looking forward to that. Two supplements that may help are manganese, which is important to building strong tendons and lysine, which is involved in collagen formation. My manganese level was in the low-normal range but supplementing can overstimulate the adrenals so it's best to stay away from that stuff. Lysine could be worth a try but is unlikely to be a miracle. I found a site about eccentric calf stretching on stairs and will devote a few minutes a day to this before and after work. I am sure that I will not need surgery but if it does develop into a chronic condition, I am aware of an alternative treatment called prolotherapy, which is a series of injections into the tendon that often results in strengthening of both the affected tendon and surrounding muscles. That will be the last resort if all else fails.


Preston said...

Darn dude, I was wondering where you were this past Wednesday at the TrakShak

L.A. Runner said...

Justin, sorry to hear about your achilles. Keep your chin up, okay?

DR. A. said...

Too bad that prolotherapy is disvussed as exotic when it is 85 or years old woith lots if positive studies. the latest on achilles tendon is worth looking at : Yelland et al.

I have 30 years experience as an MD with prolotherapy. It works really well to regenerate damaged tendons or ligamwnts with new good tissues. I am 40+ years a runner and I get a nother doc to treat me when I need it. And...I have used for Achilles tendons with great success.

Irwin abraham MD