Category Archives: Physiotherapy

First session of the new year

Sun salutations

Sun salutations

Today is the first day of my journey to running a 100 miler. At this stage, that’s my ultimate running goal. The distance is calling me the way The Landy is called by Everest. I’ve spent the full southern hemisphere spring in rehabilitation mode but since this morning my physio and I have switched to ‘moving forward’ mode.

I have to give Paul Trevethan at Body Leadership Australia a big shout out because he’s been wonderful. From the moment I walked into his clinic he listened to my needs, fears and frustrations. He’s responded to my text messages asking for help and he’s squeezed me in when I’ve urgently needed his healing hands. He’s never told me I couldn’t do anything but has been honest about the areas of my body I need to look after (and he’s never said “I told you so” when I failed to listen).

Tonight I did my stretching routine for the first time since October. I also did two rounds through the Hatha Yoga Sun Salutations. I only did them gently and tentatively but it’s a start. I start yoga classes on Tuesday 18 December and have already told my instructor about my SIJ so she’s going to help me avoid exercises that might flare it up.

I have also done three sets of five exercises each of my pilates exercises: setting my stomach, clams, knee raises, rocking my knees side-to-side and hip raises. My core strength is terrible. But I am practicing these basic moves until I start pilates classes on Monday 17th December with my physio’s wife (also through Body Leadership Australia). The great thing about taking pilates classes with my physio’s wife is that she will know my limitations and core strength needs.

My physio is looking at ordering me a sacroiliac joint brace and has taped me up in the interim. It’s all systems slowly shifting into “go”. I’m being careful not to overdo it and will continue to be guided by both my body and my physio. But it feels good to be making the first step towards my 100 miler goal. A goal that might take a while to reach but one that promises an interesting journey.

Taking things easy

I’ve not had much to report the past few days because I’m trying to take things easy. I’ve been working from home so that I can stand at my kitchen bench instead of sitting at my desk. This has been relieving some of the pressure from my SIJ. I have also seen a fantastic lady who does Chinese medicine, including cupping, remedial massage and acupuncture. I think that, combined with my ongoing physio treatment, has helped a lot.

I am no longer in continual pain, having now three specific pain points that flare up with specific activities (such as moving from sitting to standing or riding my motorbike). I hope this is a good sign.

I think my excessive walking the past few weeks is partly to blame for my back not healing as quickly as I would like so I have just been doing a daily 3.5km walk with my partner on flat ground (I am on strict instructions not to walk hills). I have also done a bit of geocaching on my motorbike with short 500m – 1km walks to find caches.

I am hoping to stick with this plan for the next week or two in the hope my SIJ finally settles down. I will have to actually go to the office tomorrow and a few days next week. But I am going to balance this with some work from home time. I am also going to buy myself a fit ball in the hope this encourages me to improve my posture and take walking breaks away from my desk.

All-in-all the current easing status of my back pain has helped to stop the black dog from dragging me away. I am starting to get back in control of my emotions and feel positive again. The decision to focus on adventure racing next year is a good one for me: I love racing and it gives me something healthy to focus on. The thing I have missed the most since my last race on 26 August is the feeling of being a race participant. And I just can’t wait to get that buzz again. Even if it will end up costing me many dollars to enter all those races. It’s still cheaper and more fun than psychotherapy 😉

I hope to have something interesting for you in the coming weeks. My physio is quite keen to get me back out on my bicycle or doing some light running as soon as possible. He’s going to help me work on an improved running technique too, which is super exciting.

 

CT scan results: Good news

I just got my CT scan results. The radiologist found no indication of stress fractures in either shin or my left foot. This is excellent news because it means I can now work towards recovery without having to wait for bones to heal.

Having said that, I am still taking a break from running so that my legs can heal properly. There is definitely a problem with my legs and feet that needs to be repaired. A rest from running and physiotherapy are probably going to give me the best chance of recovery.

At this stage, I am totally taking a break from running and hiking until early December. Then, if I am pain free, I will follow the first 3-4 weeks of a post-stress fracture training program I found online and then blending that into a 9-week Couch-to-5km program. I once read that the biggest risk in running is listening to your aerobic ability because muscles and ligaments take longer to get strong than our hearts and lungs do.

So the Couch-to-5km will probably be a sensible move. I then found a really good 19 week kilometre build-up program that can take me from running about 20km a week to 40-50km a week. I don’t like programs but I like being injured even less. I hope I can discipline myself enough to spend the next 6-9 months building strength and endurance, not only aerobically but also in my legs.

I’m ready to be pain free and am ready to be a consistent runner not someone who relies almost solely on luck, pig-headedness and a sprinkling of natural ability.

Off for bone scans

I’m off to see my doctor on Wednesday morning to ask for a referral to get bone scans. My left foot hasn’t improved so it needs to be checked for a stress fracture. My left shin is starting show signs of trouble so I’m going to ask for a scan on it too. And my right shin, which was responding really well to treatment before I overdid it in the garden 2 weeks ago hasn’t settled since.

While MRIs would be a more appropriate test to check for stress fractures, I don’t want to pay upwards of $280 per scan. I’ve heard from other runners that bone scans can be used to check for stress fractures and that bone scans can be bulk billed through Medicare.

I’ve never been one to do things by halves so why start now.

I’m seeing this holding pattern as an excellent opportunity to develop into a much stronger, fitter and faster runner in future. By taking action now I have a better chance of running into retirement, rather than being a cripple at 35.

This current injury situation doesn’t come as a shock to me. I’ve been expecting it and am surprised I made it through the past 15 months without coming a busta earlier. I’ve had extreme shin splints for 15 years and a bad ITB for over 10. Even after not running or exercising for 6 years, my right shin and ITB still hurt every time I walked.

The ITB doesn’t hurt at all anymore and after my 12 weeks off I know I won’t have to worry about shin troubles anymore because I’m still going to attend my physio to get the underlying causes of the stress fractures fixed. Long story short is that my muscles and joints are ridiculously tight (e.g. my calf is only just 6cm long and my ankles almost don’t flex at all).  Did I also mention I’ve neglected my core? Yoga, qi gong, pilates, weights and swimming are going to make all the difference.

My goal for 2013 is now much more modest. Rather than hoping to run my first 100 miler, I think I will spend:

  • January working on a recovery phase that includes 4min walk / 1 min run combinations
  • February and March completing the couch to 5km program (who would have thought given I’ve run a 50km and marathon this year)
  • April to August doing a kilometre buildup program in which I hope to increase my weekly mileage to 50km and my long runs to 18km.

After that, I’ll find a 50km or 60km race to train for and I will stick to a 20 weeks program to slowly increase my mileage.

It means I won’t run another marathon or ultra until 2014 but it’s the only real way to do it safely. And besides, I’ve now run two ultras and a marathon without proper preparation and I enjoyed them all. Imagine how great I’m going to feel when I am properly prepared for the events instead of being on the verge of physical break down.

Part of the reason I’m writing this is to remind myself later when I get impatient again.

Making lemonade from lemons

Serious food for thought

When I started running again last year, I knew the risks. I also stuck my head in the sand about the extent of my existing leg injuries: shin splints and ITB in my left leg, sharp pains in the arch of my right foot and a spot on my back that no one could touch. I’ve battled through this far (15 months) with my head buried in those tiny grains you find on the beach.

When I decided on the 12-in-12 Challenge my first stop was the physiotherapist. I knew that I couldn’t get through it without getting some attention on my legs.

What I didn’t expect was for my shin and ITB injuries to respond so well to treatment. They responded so well that I forgot about them long enough to overdo it in the garden last weekend. The physio strapped the calf this morning to help it rest and recover more quickly. I’m confident it will respond well to the ongoing physiotherapy and my homework.

I remembered to tell the physio about the pain in my foot this morning. It’s the first time I’ve remembered to mention it (I actually marked the painful spot with a pen before I went in this morning). After poking and prodding my foot, the physio told me he suspects a stress fracture. That’s pretty bad news for me. At the end of our session today, the physio also strapped my foot to help it rest. He’s going to have another look at it on Monday to see how it responds to a week of rest. MRIs are expensive here in Australia so he said he’d prefer to wait to see whether I need to shell out for the test.

So here’s my lemons: best case scenario I have a serious soft-tissue injury in my left foot and worst case scenario is that I have a stress fracture. Either way, I’ll be unable to run for 4-12 weeks.

Here’s my lemonade: these are chronic injuries I’ve had for years and I know I’ve found a physio who can help me fix them. Even if my 12-in-12 Challenge is off, I have gained so much confidence in the past two months and know that I have what it takes to run ultra marathons. The injuries are long-standing problems, they haven’t been caused by the ultra running. In fact, if it weren’t for the ultra running I probably wouldn’t have gone to see someone about getting them fixed.

I’m going mountain biking with friends this afternoon. I’m allowed to cycle so long as I take it easy. Tomorrow I will go swimming for the first time in months. I’m still doing Tough Mudder next weekend but will just be doing it for a laugh and will be walking up the hills. It will probably be my final event for the year. That means I have three months to work on endurance by swimming and cycling, strength in the gym and flexibility if I can find an affordable yoga class.

When I can run again I’m probably going to focus on either the Northface 100km trail run in May (solo run) or the Oxfam Trailwalker 100km trail run in June (team event). And this time I’m going to do it right rather than just jumping in. I’m enjoying reading two blogs by runners training for ultras (Run Nature and Run Bike Race) and am inspired by their systematic approaches to increasing mileage and running well, rather than just bumbling through.

I hope the news on Monday is good. But I am preparing for the worst. Either way, I can only grow from the experience.

Rest day ramblings: Physio magic

Magic tools make it possible for me to touch my shin

Like many runners, shin splints and ITB syndrome have been an ongoing battle for me. I first started to get shin splints when I was a junior elite triathlete during the mid-1990s. My ITB became a problem in the late-1990s shortly after I stopped racing triathlon.

The pain from my injuries caused me to stop running from 1998 to 2004; swapping the sport for cycling. But I never really loved cycling like I have always loved running. In 2004 and 2005 I ran again. Every run was excruciatingly painful. But I had a lot of demons to exorcise so I ran in agony until I could no longer run. And then I stopped. Until July 2011.

When I decided to take up triathlon last year, it was because I was too scared to take up running. Scared because I didn’t know how to run without pain. And this time, I wasn’t taking up the sport to exorcise demons; I was taking it up to experience the joy that comes with doing what I love.

Fortunately, I discovered barefoot running, which allowed me to run pain free. But the injuries were still there. I could run without pain but my right shin was still always sensitive to touch and my right ITB would still get tight when I walked with a backpack or ran in shoes. The injuries didn’t get worse but they also weren’t getting better.

Just before the City to Surf Marathon, I went to see a Paul, the physiotherapist at Body Leadership Australia. I’d heard about him through my running club. I didn’t expect much from my first visit, given that I’ve had these injuries for over 15 years. But I was wrong.

Paul assessed my legs and back to identify weaknesses and inflexibility. The short version is that I have very short calves, extremely inflexible ankles and a right leg that doesn’t track straight (I knew that because it whips around so much I can see it when I run). If that all sounds dire, it’s not: I seem to be able to run and there’s no reason for me to stop doing what I love.

I’ve been to see Paul twice and have been doing my homework exercises every day. I press the ball against my ITB trigger points and hook my fingers into the trigger points in each of my calves (I found some in my left leg so decided to work them too to prevent shin splints starting in my ‘good’ leg). I use the foot ease roller on the muscle at the outside of my shins, the three sides of my calves, my gluteals and my ITB. I do my stretches and I am sitting in cold baths after every run that is 10km or farther.

I am excited to announce that for the first time since I was about 17 years old, I can run my hand down my right shin without pain. It’s amazing! I haven’t been able to touch my shin like I am in the photo above in 15 years because it was all swollen and sore (there was a big rock hard lump where the muscle and bone joined). But the swollen lump is already gone and I can feel my legs loosening up.

Here’s to years of pain free running because I’m loving the joy it brings. And I can’t wait until my injuries are fully healed.

Committing to the 12-in-12 Challenge

The more I think about my 12-in-12 Challenge, the more I realise how exciting it is. I have been looking for a big adventure for some months now but wasn’t sure how to fit it in with work and home commitments. See, I thought an adventure meant that I’d need to go someplace else for an extended period of time. I was envisioning weeks of hiking some long lonely trail in a beautiful location. But, instead, fate and life have led me to this crazy 12-in-12 Challenge. And I am more excited about it than about the idea of going away alone for weeks or months at a time.

When I first came up with the 12-in-12 Challenge, it seemed like such a simple idea. I just have to put one foot in front of the other for 12 long running events in a year. And that’s what I like about it – the simplicity.

But the reality is, I have to approach this challenge with the same commitment and care as I would approach a thousand kilometre hike. I not only have to make sure I enter the right events, but I need  to ensure my body and mind are healthy enough for the challenge. And that they stay healthy.

Mentally, I know there will be times ahead when I wonder why I took up the challenge. There will be times when I forget what a blessing it is to be able to experience the places my adventure will take me. This is normal. I read a lot of books and blogs by adventurers and without fail, they all have their dark moments. For some, the darkness and hardship take over, while others embrace the hours of discomfort as part of the adventure. I want to be one of the latter group. And by mentally preparing for the hardships and acknowledging they will come, I will give myself the best chance of success.

Emotionally, this adventure is going to take me far inside myself. There is no one else who can run the long lonely miles of a race with me. When the going gets tough, we all shut down to those running around us and enter our own worlds. This is when I need to trust that I’ve come a long way from the anxiety riddled man experiencing deep depression to be the optimistic and peaceful man I am today. I no longer fear the solitude of my thoughts and draw strength from the memories of days gone by. Because I know the elation of success and the euphoria that comes with achieving the seemingly impossible.

Physically, I have a lot to balance. I have greatly improved my diet over the past three weeks. I have shifted from taking most of my calories from sugar, flour and meat to eating a largely plant-based diet that is supplemented by meat. I am eating five serves of vegetables for breakfast every day accompanied by herbal tea fresh from my garden. My lunches consist of vegetarian tortillas or brown rice with vegetables. Instead of eating cakes and biscuits for morning and afternoon tea, I am eating fruit and nuts. Today I supplied morning tea to work but brought in a date loaf instead of a mud cake. It’s a big change and my body feels better for it.

For race days, I have been experimenting with real food nutrition, rather than relying on bars and gels. I have found it works really well for me. I like oat bars with fruit or nut flavours, vegetarian tortillas or burritos, and fresh fruit. They fuel my body for longer, are lightweight and easy to carry, and contain lots of calories. I will probably always carry a gel or two for emergencies or late-race bonking. But they are now my backup not my ‘go to’.

Aside from food, I need to look after my bones, muscles and joints. For the past few months I’ve been receiving post-race massages from my daughter-in-law who is qualified to perform relaxation massage. The difference in my recovery has been astounding.

I have a long, painful history of shin splints and ITB syndrome in my right leg. The pain started between 1996-1998 and has been a constant in my life. It stopped me running for six years between 2005 – 2011 and is one of the reasons I run in bare feet or barefoot-style shoes. I have decided that rather than sticking my head in the sand, I am going to address the issues with my leg in three ways:

  • I am running slower than I might if I were training for triathlon and am trying to focus on technique, rather than on speed. My goals will only require me to average about 8-9kph in my races (6:40 – 7:30 min/kph pace) and I am not afraid to go slower if necessary. Because right now, it’s more important to finish than to get a good time.
  • I have made an appointment with a craniosacral therapist. I used to see him years ago and he helped me a lot, both with my emotional health and with my physical well-being.
  • I have made an appointment with a physiotherapist who is himself a runner and who treats many runners at my running club.

It’s not that I’m injured but I know I need to be sensible and honest if I want to remain injury free.

On a personal level, I am committed to the 12-in-12 Challenge because I am running for the transgender community. I want to show transgender men and women who are early in or struggling with their transitions that there is hope for the future. Our gender histories don’t have to limit our life options nor hold us back in any way. It’s not about success – it’s about being willing to try.

Sure, I might not achieve my goal. But it wouldn’t be an adventure if there was no risk of failure. The important thing is to set a goal, aim high, prepare properly, look after your body and soul, and just get out there and do it without fear of failure.