Sunday 26 April 2015

Next Step - Podiatry

Best foot forward
I had my first appointment with the podiatrist on 9th April.  She wanted to know about what is going on with the foot and leg now, as well as history.  I told her about my training diary from Feb last year and the old ‘footinjury’ from when I fell off my bike.  She examined my feet and watched me walk barefoot a lot.
Flat Feet.
She said that I am stuck with my flat feet.  They can’t be unflattened, it’s just how they are.  However, I can have a bespoke orthotic insert that would support my arches and reduce the chance of future similar injury to the one I have now (Tibialis posterior tendinitis).  However, she said there was no point providing me with an orthotic yet, because my feet would tend to just ‘slide off it’.  There are certain muscles and tendons that I have underused or rarely used at all, due to being flat footed.  This results in overuse of some others. In my case the Tibialis posterior tendon.
Image result for not running sucksSo, she gave me some foot and ankle strengthening exercises to do.  They were not strenuous, but they needed some ‘brain effort’ to do them properly.  It’s important that movement should come from the ankle and she showed me what to look for in terms of being able to see which tendon is being used during the exercise.   I had 3 different exercises, which I needed to do 5 reps, 6 or 7 times per day and then work up to doing 25 reps but only 3 or 4 times per day.
 She also suggested that when I cycle, I need to make sure I keep my foot pointing forward and make sure my knee, toe and ankle are aligned. I had noticed that when cycling, I sometimes caught the inside of my heel on the cog, so I was able to ensure I kept correcting this.
I followed her instructions to the letter – including the instruction to NOT run yet.
Second Appointment
By the time I returned for my second appointment on Thursday 23rd April, I’d mastered the exercises and was delighted that I’d got a lot more movement in my ankle.  The podiatrist was happy with my progress, and then showed me how to do the same exercises but with resistance added using Thera-Band resistance bands.  This is much harder to do correctly – so the brain still needs engaging.  To turn the ankle without turning the leg in is really difficult! She still strongly suggested that I don’t start to run yet.  It’s hard, but I understand the reasoning. I need to improve the strength doing these exercises before I can start putting any impact on it.
So, now I have to go back to 5 reps, 6 or 7 times per day and working up to 25 reps 3-4 times a day.  The first time I did the exercises with the resistance bands was Friday 24th April.  That day, I also spent a lot of time pottering about gardening. I didn't sleep well, because I kept waking up in pain and on Saturday (yesterday), I had really bad pain in the tendon with EVERY step.  It hadn't felt that bad since January.  I was gutted.  I wondered whether it was the increased intensity of the exercises or the pottering in the garden.  I didn’t think I walked around that much, but I suppose it can be surprising – back to the shed for this, over to the drive for that etc.  I have not been taking much pain relief, but yesterday I was taking ibuprofen and co-codomol and rested all afternoon and iced it periodically. I didn't repeat the exercises until just before bed time.
This morning (Sunday, 26th April) it was the London marathon, so I just sat and watched TV until 2.30pm.  My foot and leg felt OK so I did the resistance exercises periodically. This afternoon, I did a little more pottering in the garden, but made sure I didn't do very much.  This evening, I've done some more sitting, exercising and icing.  It seems mainly OK, but I get the odd sudden burst of pain under the (inside) ankle bone.  There is a bit of a soft lump below the inside ankle bone and the bigger that lump is (swollen / puffy) the more pain I seem to get on the tendon above the ankle.
How I Feel
I have to confess to sometimes feeling despondent when the pain increases, despite not running and despite my following the exercises to the letter.  I've been told it’s along gradual recovery for this injury.  So I keep settling in and resigning myself to not running for a while.  Mostly I'm OK with it, but now and again, when everyone is talking about running or their latest achievement, I feel impatient to get going again.  It was the Manchester marathon last week – the one I pulled out of.  The guy who I gave my number to – Mark- had a good run.  Mike W cracked the 3 hour mark, Andy B came in under 3:30.  I had pangs of wishing I was running it.  But I'm pleased I withdrew at the early stage I did rather than what happened to Andrew R.  He had some ankle problems during the last few weeks of training, meaning he missed some long training runs.  He was hoping to get a GFA qualification for London at Manchester (3:05, I believe) and even entertained sub 3 hours.  He started well and continued at sub 3 hour pace despite progressively worsening ankle pain from mile 5 onwards.  Eventually, when the pain progressed to stabbing / shooting pain, he had to pull up just before mile 11.  Absolutely gutting. If we felt gutted for him, I cannot begin to imagine how he felt.  Six months of training, not to mention alcohol abstention.  On the surface, he was pragmatic. The training has not been wasted. Lots of achievements this year (PBs at 5k, 10k, HM).  Great pace at the start of the race.  It’s good to note the positives.  But I must admit - if that had happened to me, I think I’d have been in a bad mood for a very long time. 
The Future
It bothers me that the tagline for my blog includes “..... being Fit after Fifty, Feeling Fantastic, Running, Physical & Mental Wellbeing” and yet lately, here I am, writing about being injured and feeling less than fantastic!  However, on balance I'm positive about getting going again and am developing patience, I think.
At the moment, I think I will remain ‘not running’ until the podiatrist suggests that it will be ok.  Then I’ll start with walk-run and build up very gradually. I have had offers from many people who will run with me when this happens – not least from people I have helped to support as they've started their own running journey, so I'm really grateful for that.   I have to have a plan in mind in order to stay motivated.  My plan is flexible because there is one major variable (how well the injury progresses), but it gives me something to aim for:
·         This year.  I’d like to enter the Normanby Hall Ladies 5k on 12th July.  It’s on grass so would be less strain on the feet and legs than on road.  I’d like to get started doing parkruns again.  IF all goes well, I could look at Skegness 10k in November or wait until the CleethorpesNYD 10k 2016.
·         Next year (2016). If all progresses OK, I’ll do some 10ks and start building up to half marathons.  I suppose I shouldn’t be overly concerned about times, but I am!  If I do Sleaford / Isle of Axholme I’d like to do them in under 2 hours.  So I won’t do them at all unless I'm ‘back to normal’ (or better).
·         Year after (2017). If all is still well, I’ll considering starting to train for a spring marathon, without necessarily signing up for one.  There are plenty of spring marathons I could do- Manchester looked good.  I wouldn't mind doing Blackpool again.  There’s Edinburgh and others.  So I could start to train in January, see how it goes and if it seems OK, put an entry in at the end of Feb / early March for a marathon in April / May.
Life outside running.
My job is fairly stressful at times.  Running is my stress relief.  So, in the absence of running, Stress levels can rise easily. To help, I'm getting out on my bike a bit.  It’s OK, but it’s not running. I have to push myself to be bothered.  At least it’s exercise.  My social life also revolves around running and at least I can keep this up and haven’t become isolated.
However, it has made me realise how one-dimensional my life has become.  Work-run-eat-repeat.  Although I only generally ran 3 times a week (more when training for an event), it’s been a massive gap. It’s not just the 3 runs a week, it's having something to focus on: what’s the next event?  What time am I aiming for? etc.
I've reflected on all this a lot and have been able to make some changes in my work  pattern – from mid-May, I’ll be working late on Wednesdays and having Fridays off.  The other thing I need to do is pick up a bit on other things I like to do / would like to start doing.  I know I’ll get back running and will run for many years.  But it doesn't do any harm to have a range of interests, so that if there is a time when one of them is ‘off limits’ life doesn't seem empty.  If interested, you can read more about this kind of thing in Susan Jeffers’  book, Feel the Fear and Do It Anyway –chapter 8, “How whole is your whole life?”

On a completely different subject, ladies, if your run, wear a good sports bra.  Click this --> How much your boobs bounce. to view video.

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