Road to Recovery and AZIM!
I’ve written a few race blogs this year and have really enjoyed being
able to document the races and some of the little things that I want to
remember. I thought that it would also be a good idea to write about my
recovery process from plantar fasciitis, especially since it has pretty much
consumed a majority of my year and the entire race season. I am also scheduled to complete my first full
ironman this year and really hope to reach that goal, despite an injury.
I initially began to notice having a slight case of plantar fasciitis
in December, 2011 after trying to make the transition to running in Vibrim Five
Fingers. I had just finished facing a
really great season. I had completed 3
marathons and 2 half ironmans. I
finished off the season with the Philadelphia Marathon (racing in another person’s
name) and had a PR of 3:51. My other PR
was at the Philadelphia Rock and Roll half marathon (again racing in another
person’s name) with a time of 1:48. I
wanted to take the off season and work on improving my running form and thought
using the five fingers would help. I
thought I had made the transition slowly, but began noticing the foot pain
after running just over a mile in the shoes.
I immediately stopped running in them and went back to my trusty Brooks
Defyance. My feet were feeling better
within a couple weeks. I then decided to
get a new pair of running shoes and went with the Brooks Ghost instead of the
newer Defyance model. At first they were
working out pretty good. I was hoping to
try to set another PR at Rutgers Half Marathon in April and started to ramp up
my training toward the end of January, 2012.
I was trying to run 4 days/week: long run on the weekend, 3 shorter runs
during the week (one tempo, one interval, and one recovery/slow run). I began noticing that the pain in my left
foot started to return. I also noticed
that because of the pain during my running that my left hamstring and hip were
also starting to hurt. I figured that
this was a result of possible gait change trying to compensate for the foot
pain.
Once I started noticing pain in my hamstring and hip, I thought I
better nip this thing in the butt before it gets even worse. Because of all my infinite wisdom, I decided
I would just skip the middle man and just go right to a physical therapist
since I knew that is what would be recommended.
I did some research and also at the recommendation from the owner of a
local running store, I chose Kinetic Physical Therapy.
I went to PT twice a week for just under 3 months. The focus was mostly on foot and ankle
strengthening exercises, calf strengthening, and also stretching out the calf
muscle. I do think that the PT helped,
especially when the physical therapist did work on my foot. I would describe it as the ultimate foot
massage, although I don’t think he would be happy with this description. During PT I managed to complete the Cherry
Blossom 10 mile run with a PR and also the Rutgers Half Marathon (not at
PR). I “graduated” from PT with the goal to
continue to do the exercises and stay on the road to recovery.
I started out the triathlon season with New Jersey Devilman, a “half
lite” race. I had bought new Zoot racing
shoes and wore them for the race. They
did not work out and I ended up running on my toes the second half of a 9 mile
run due to heal pain. Needless to say
those shoes were returned (after washing them up from the race). Since I’ve had good results with Brooks, I
decided to get the Brooks Launch as my race shoe. They seemed to be working out well and I used
them for the Eagleman Half Ironman in June.
My swim and bike were great, but run was rough (refer to other race
blog). I continued to train in the
Launch, but the foot pain continued and at times it was difficult to walk after
a longer run. I made the decision that
if the pain continued after the DITR Tri I would call a sports doctor about the
issue. So, after DITR and ongoing pain I
did some research and decided to make an appointment with a doctor from the
Rothman Institute.
I did the research and found a sports doctor that seemed to be a good
fit, Dr. Michael Ross. At my first
appointment in early July he determined that another issue related to running
was some hip weakness. What this means is more PT to work on hip strengthening,
but before that I needed to have an MRI to rule out a stress fracture in my
foot. I have to admit that at this
point, almost 7 months after the pain started, I almost hoped for a stress fracture…..at
least there would be something to fix and a resolution to the pain. After having the MRI, I was fortunate to find
out that there was not a stress fracture.
This meant that the pain was related to an overuse injury. Dr. Ross made some additional recommendations,
to include completing an asthma/breathing assessment and gait analysis. He had said that some injuries below the knee
are a result of exercise induced asthma.
This is because the oxygen primarily supports the larger muscle groups,
depleting the smaller muscles from much needed oxygen and subsequently leading
to injury. He also supported the idea of
working to improve running form, which was an idea I planned to implement.
I scheduled the breathing/asthma assessment, but also planned to work on
improving running form. I started doing
a lot of research on run form, specifically the pose method that is supported
by Crossfit, as well as research on shoes that have a more minimal heel to toe
drop ratio. I reconnected with an old
high school friend (Jeremiah Williams) who now owns his own Crossfit gym and
met with him to work on learning and practicing some running drills to improve
form. He supports the Pose method, which
I encourage everyone to learn about.
Without getting into too much detail, the main focus is on proper run
form, higher cadence, and midfoot landing.
After meeting with Jeremiah and learning some drills and strength
training tools to improve my run, I was really hopeful to get this injury under
control. Surprisingly, I also went back
to using my Vibrim Five Fingers for many of the drills and really feel like
they were helpful. I was not running for
distance at this point and was running drills under a mile. Although I was hopeful, I continued to
question whether I would be able to complete my goal at the Arizona Ironman….. As for the breathing/asthma assessment, I was
just above the limit for treating possible asthma. At this point Dr. Ross did not want to prescribe
asthma medication, although I did have some constriction in the small airways
of the lungs.
Training continued, to include biking and swimming and doing the
running drills. The concept of midfoot
running really made sense! I started
back at physical therapy for hip strengthening and continued with the drills. Over
the last 6 months I also did some research on the Newtown running shoe. After many months of consideration, I finally
decided to buy them. They are not cheap,
but they claim to help you land on the midfoot.
I continued my training in the new shoes and doing the running drills. I also returned to see Dr. Ross for the
running gait analysis. He videotaped my
run from behind and from the side in both my Brooks Launch and Newtons. Without going into major detail, it came down
to the fact that I was a more efficient runner in the Newtons!!!! He based this
on my original breathing analysis and my breathing in the Newtons. More efficient means that I can run faster
before hitting my lactate threshold. This
is awesome news….I think I am on my way to improvement!!!!
Now I am starting to think “why didn’t I take these steps to start
with???” and “why didn’t I seek out the miracle doctor from the get go????” But, no use kicking myself in the butt
now. During my run analysis, I learned
that Dr. Ross also does a bike analysis/fit.
Why not keep going with further assessment, especially if insurance is
covering the cost?!?!?! So, I went back
to see Dr. Ross for the final appointment and bike fit. He went through the same baseline assessment of
breathing (as he did at the last two appointments) and this time my baseline
was just below normal. I heard him shout
“yes…that means I can treat you!!!”
Basically he was holding off on prescribing any asthma medication
because I was borderline, but this time I was below the normal limit which
means that medication may actually help with some breathing issues. Onto the bike fit…..He had me on my bike on
the trainer to assess breathing efficiency in my current position and also
videotaped my position from the side.
After evaluating my right leg angle (when fully extended in the saddle),
he made some adjustments to raise my seat and move my saddle forward. Results: less movement in my upper body while
riding in aero and I also became more efficient in breathing with the new
position. During the appointment, he
also took extra time to teach me how to mount and dismount my bike while running
and keeping my shoes clipped onto the pedals.
Dr. Ross has been such a great resource, he spent time to explain the
problems and also discuss solutions. He
was not quick to prescribe a medication and did not tell me to stop running. I feel like I am finally on my road to recovery
from this injury. I realize that I still
have to build up my running and I’m not running my best, but I also have the
confidence that I will complete my first Ironman in November! I will still push to complete the race under
my original goal of 12 hours, but also realize that with the injury I may take
a bit longer, possible 14-15 hours.
Either way…..I will finish! I
know that I am not “out of the woods” just yet, but will continue to work
through it. I must admit that this injury
has been trying, physically, mentally, and emotionally. It may not sound significant, but it has been
tough. I am my own worst critic. I have learned to read and respect my body
more, especially when it is sending me messages. I have also learned about pushing through and
not be defeated (especially self-defeat)!
I have used other stories for inspiration, especially those triathletes
who have overcome more devastating injuries or illnesses to complete races. Two athletes that come to mind are Jon “Blazeman”
Blais and Jordan Rapp. I won’t go into
detail about their individual stories, but encourage you to read about
them. They both have proven that we can
overcome limitations to accomplish our goals!
I’m still not done my triathlon season; still have three more races to
go. Stay tuned…….
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