21 Days

I pretty much always find myself rolling my eyes at blog posts that start off with an apology for not updating recently (I mean, it's not like you owe anyone anything, and highly unlikely anyone has been losing sleep over your absence), so instead I will just say HEY, I am still here and alive and NO, I have not been kidnapped or given up running altogether.

But, it has been kind of a crappy three weeks.

Remember how my most recent post was titled, "I maybe jinxing myself, buuuuut..." and then went on to given an account of my first "real" training week for CIM, post-stress reaction?

Well, it turns out I am super good at jinxing myself.

At the time, I'd been faithfully sticking to the recovery protocol my PT gave me when I had a stress fracture back in January 2014: starting with cycling, then moving to elliptical once that caused absolutely zero pain, and then once I'd been completely pain-free walking around for a week, adding in 30 minutes of walk/run intervals every other day. The progression starts out 3 x (1:00 run/9:00 walk), and then every other day you add one minute of running and subtract one minute of walking for each interval, until eventually you're running the full 30 minutes. (If at any point you have pain during or after, you have to take three days off & go back a step.) I also dutifully kept at my foot arch strengthening exercises to hopefully avoid repeating this entire episode.

All was going well, and in due time I was up to the full 30 minutes with no pain. (Side note: Every time I've been injured for multiple weeks, then finally reached the point for I can run for some non-insignificant amount of time, I'm like, "HOW the hell did I EVER complain about long runs? How can anyone ever complain about having to run MORE??" Gretchen Rubin is 100% correct that if you want to get ridiculous levels of joy out of something mundane, take it away for a while.)

Then I think on my third 30-minute run with no walk breaks, I made it about ten minutes before I started to feel a dull, sickening ache in the injured spot for the first time in weeks. I tried taking some walk breaks and was even freaked out enough that I turned around early. By the time I got home the pain was sharp and bright and I was back to limping.

Basically, I regressed two months in twenty minutes without any warning signs. After that, there was very clearly no question of trying to run again for quite a while.

I'm pretty sure that was the most depressed and hopeless about running I have ever felt. It wasn't just "Oh, look, here I am injured again." It was that, yes, but also "I just had the most brilliant training cycle of my life, got injured, got a miraculous chance at a Plan B that had the potential to result in even better training, except HAHAHAHA JUST KIDDING! You get nothing. Except probably another stress fracture. Oh, and paying for ANOTHER marathon that there's now a 99% chance you won't even be able to run, not even just to finish."

It wasn't just the injury. It was that I did everything right (I think). I followed the rules. I was patient. I switched to a new gym so I could do elliptical work on days I work from home and also elliptical "long runs" on the weekends (GAAAAH DIE IN A FIRE). It was the fact that I haven't been able to truly race something hard for over 2.5 years now because I've constantly been fighting or recovering from some kind of major injury. At a certain point you just get really tired of always being "on the comeback trail" and mustering all your optimism, again, so you can once more choke out the words, "Oh, well, maybe next year."

I don't want to get melodramatic about how bleak the situation was, but MAN, those were some dark days. It made me feel sick to see, hear, or read anything even remotely related to running; needless to say, the thought of writing about it was utterly demoralizing. (Actually, at that point, I wasn't really capable of translating emotions into coherent words, so probably wouldn't have gotten much farther than BAAAAH, EVERYTHING SUCKS, followed by maybe a depressing .gif or two.) So basically, I stuck my head in the sand & ignored the world of running almost completely, except to drag myself to the gym & back for elliptical sessions and strength work in a desperate attempt to maybe not 100% completely lose all the fitness I built up this summer.

And to be honest, it wasn't terrible timing. I've had some big things I've been working on at work and there've been some long days when getting to the gym wasn't even possible. I've had a lot of travel lately. We are planning over 1000 square feet of renovations for our house in the new year, which has been like a part-time job. There have been football games, and Don & I have started rock climbing again.

Mission Cliffs! I climbed a 5.9 on my second day, which I think is actually not at all impressive, but I was still pretty stoked to get to the ceiling without having a panic attack.

So maybe going all-out for CIM was never in the cards. Still, I haven't been able to shake the little voice in the back of my mind whispering that maybe I'll never be healthy enough for long enough to actually run a really good, hard race ever again.

But....Well, it's been 21 days today, I think, which is the longest I've ever gone without posting except for being on vacation for 3 weeks, and things are getting better, and I kinda-sorta have my act together emotionally now, so, what the heck. I figured I might as well stop being a grump and post *something*.

THE STATE OF THE LEG

Something I learned when I had my stress fracture last year was that a lot of doctors are moving away from the designations "stress reaction" and "stress fracture" because it gives the impression that those are two distinctly different injuries which are distinctly different again from the asymptomatic bones of someone who is training just as heavily. Instead, I learned, all these situations exist on a continuum which has less to do with what shows up on a bone scan or MRI & more to do with how functional/painful it is. It turns out that if you take a bunch of pain-free runners who are just starting to increase their training substantially and give them all bone scans, odds are a handful of those scans would look the same as someone a doctor would normally put in a boot for a month, just because of how the training response in bones works. You treat the patient, not the scan. So if someone comes in with symptoms of what we used to call a stress reaction or stress fracture, doctors are now more likely to just call it a "bone stress injury," full-stop, and treat it according to how severe the symptoms seem without attaching an additional label to it.

Which is all to say, I don't know if I had what they'd call a "stress reaction" or a "stress fracture" or if it started as a reaction and became a fracture, but honestly, it doesn't really matter because the treatment is all the same: stop running till it stops hurting. I did try to get a doctor appointment, just to, y'know, cover my bases, but when it was a month wait at both reputable sports medicine clinics, I figured I might as well just pretend I'd gone to the doctor and gotten diagnosed with a BSI and been told all the things I already knew they would tell me and start following the recovery plan they gave me the last time when I really did go to the doctor and get a bone scan and a $25 co-pay.

Same leg, different spot. Last time it was high and outside on the fibula; this time low & inside on the tibia.

Well, clearly, that did not work out for me. So this time, I've decided to wait until, in addition to having not the tiniest inkling of pain with walking/elliptical/karate/climbing/lifting/etc., it feels 100% completely indistinguishable from the other leg in every way. With my first stress fracture, the doctor & PT told me I was good to start the walk/run progression as long as I had no pain with walking or any other impact activity, but they were not concerned that the injured spot was still a little tender as long as it didn't get worse. When I started the walk/run plan this time, the injured spot was still a bit swollen and felt like a big bruise, even though it didn't hurt to walk. I don't know if that had anything to do with the reason I kind of relapsed, but if nothing else, I figure it's just kind of a higher standard of recovery with more time off my leg, which cannot be a bad thing.

At this point, I think it's really close--the bone feels flat again, and if I press reeeallllly hard, there is just the tiniest detectable hint of tenderness, which is really not all that different from the same spot in my other leg. I'm back doing everything normally in karate again with no pain whatsoever, even twisting/torquing movements, which were one of the things that hung me up for the longest before. So, I'm hoping that in just a few more days that leg will feel indistinguishable from the other.

(Also, I finally just caved & made a dr. appointment even though it was a month wait. Hopefully my bone injury will be totally healed by then, but it's with the foot/ankle doctor, so I'm hoping she'll be able to give me some further advice about what I can do with my weak arch to avoid something like this happening again.)

All that said, I think it's still 99% or better that I won't be running CIM, even just to finish. Even if I can start run/walking by next week, that's like six weeks to go from 30 minutes of impact to probably around four hours, which just doesn't seem all that realistic.

THE FUTURE

But all is not lost!

Because I'm still an indomitable optimist at heart, there is a part of my brain that is already buzzing with spring running plans. There are some bright & shiny races on my radar for 2016 that I think are far enough out to be doable (more about that in another post), and I'm trying to use them as incentives to stay patient and follow to the letter any advice or instructions I get from doctors and/or coaches about how to ramp the mileage back up in a way that doesn't just get me injured again. Because I've been keeping up with the elliptical work, I have a feeling I'm going to spend a good chunk of time in that annoying place where the cardio system is in pretty good shape, actually, but the bones and connective tissue that take all the impact have gotten a bit fragile, which will probably mean a very gradual cross-fade from elliptical hours to running hours through the rest of the year.

And that's fine. If I can be up to 8-10 miles by January, I think I'll be in a good place to start working towards some races in the spring.

Fingers crossed.