Category Archives: Medical

Recovery? Don’t talk to me about cross training!

I have been going through what I think are fairly normal MdS withdrawal symptoms.

Getting back from an event which is in such stark contrast to most others, and far removed from anything most of us would experience in ‘real-life’ is bound the have such an impact.

Perhaps less so on those brave individuals in the armed forces, or perhaps civilian firemen, police, etc., who frequently put their lives on the line and who have a familiarity with imposed hardships and the challenges of being out of routine in physically and mentally demanding situations on a regular basis, since I believe that is part of the reason why people want to take up such a challenge.

[singlepic id=710 w=320 h=240 float=right]There is little in ‘normal’ life, in our cosseted modern western routines that can really satisfy what are probably primal urges and instincts to compete with others in physical challenges, where often survival may have been at stake and adrenalin fuelled success would have resulted in the ultimate proliferation of a particular branch of the gene pool.

Sound extreme?

Possibly, but imagine opposing tribes of hunter/gatherers, both chasing after dwindling stocks of wildlife before the onset of the winter season. It is not hard to imagine that the more successful persistence hunters might have successfully ensured the survival of their tribe through the winter while another failed and the impact on them would have been more extreme.

Still, back to the present and my recovery, which I glad to say has ย has been going well and I’veย not experienced any extremes; until yesterday, that is.

I had rather more swelling in my feet that I had realised, but I had been able to run a couple of times last week, and despite singularly failing to wake up for a long run on Sunday, I even managed to swim on Monday night.

Then things started to go horribly wrong. Tuesday’s has now transmuted to my cross-training day, and I duly went to the gym and cycled and did some squats and lunges, and although tough, I thought no more of it. Shortly afterwards I gave blood, and felt none the worse for that either.

However, two days afterwards, my muscles are aching an order of magnitude more than ever they were from 150 miles across the Sahara.

In one of life’s little ironies, I can trek my way through the toughest footrace on Earth without a hint of DOMS, but put me on a bike for 20 minutes and I may as well have been poked with hot needles dipped in vinegar for the last 6 months. The aching is starting to die down now, but I’m seriously considering whether my cross-training sessions will become a thing of the past after this week ๐Ÿ™‚

Sign Off

Almost two years to the day since the operation to fix my broken femur, I paid a checkup visit to the Physio earlier.

I hadn’t seen Stuart at Allen Physiotherapy in Guildford since before we went skiing last year; he is a skier and I am a snowboarder, so we had a little banter about that! However, this visit had been planned for some months, mainly as a checkpoint, with so long in between appointments due to my ever improving ability in the tests he sets me.

20130227-202804.jpgThe main test has been a strength / speed comparison between quads and hamstrings on a hydraulic resistance machine – a strapped in, seated leg extension and curl, using initially both legs, then right and left separately, for comparison.

This is the routine I have been doing every month to two months for the last 18 months or so, since getting back to running. 18 long months, which is significantly easier to look back on, see what has been achieved and reflect upon it, than it would have been to try to reconcile the hill ahead if I had been told at the start realistically this is what I was facing. Ultrarunning is so analogous to the journey through life it is great training – training for life, life from training. As many runners say, if you can see the top of the hill, run, if you can’t, walk; either way, keep moving forward and you’ll get to the other side eventually – just remember there will ALWAYS be another hill ahead at some point while the race is still on ๐Ÿ™‚

Today’s visit had a feeling of closure about it, even before I entered the room though; I was confident in the improvements I have made over the last few months, and unlikely with previous visits, I had no real ‘niggles’ to report or worry about. Indeed, after the success of my recent run along the Thames, I could hardly complain about anything!

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So it was that we chatted and I completed the testing as normal, but everything felt stronger and more complete and balanced, if you will, than it has in the past, and this was confirmed by the figures the machine read out after each of my attempts to break it ๐Ÿ™‚ the key thing here was that the ratio of quad to hamstring was perfect (at least conventionally considered to be 0.6 H/Q) and more importantly the left to right absolute values were within 10% of each other, thereby reducing the probability of any other problems as a result of any imbalance.

So, with successful results behind me, I was signed off.

After two years of steady, consistent running, minimal ramping up, dozens of checkpoint physio sessions, even more x-rays, pool-resistance training, gym strengthening, cross-training and one ultra distance race behind me, I’m now, officially, back on track.

The MdS will certainly prove one way or another how my body, and I’ve no doubt my mind, can stand up to the test of such an adventure for the second time and for now this is my focus, but my plans and dreams for the future are now no longer restricted and my confidence is coming on in leaps and bounds.

Life is good.

After the Trot

The Thames Trot took a bit more out of me than I realised and one week on it’s time for a bit of a post-mortem.

During the week, I’ve run a few times, but my legs have definitely been tired. When doing the simplest things, such as climbing the stairs at the Waterloo when rushing for the train, getting moving in the morning, etc., I’ve certainly noticed more fatigue in my legs; more difficult to get them moving!

Muscle Soreness
Muscle Soreness

I’ve run a few times around the London streets at lunchtimes, 5 miles Tuesday, 4 miles Thursday and 6 Miles yesterday, and although the Tuesday run was difficult to get going, by Friday things were getting better. I reckon I’m still 20 seconds or so off my kilometre pace though, but I’m sure by the end of next week things will be back to normal.

Of slightly more concern is an ache in my back which occurred (ironically) after pilates on Monday lunchtime. I generally do pilates, as I’ve mentioned in the past, as I think it is good for core strength. I suspect doing this on Monday, so soon after the race on Saturday, with fatigued muscles, placed extra strain on my lower back which presumably had to work extra hard to compensate. So, this has been rather uncomfortable during the week, although interestingly enough, not just during running, and it is settling down now, with regular application of fisiocrem (which has anti-inflammatory arnica in it).

Of the rest of the aches in my muscles, I won’t give a whole list, but for my records the following are tight or aching during running:

  • Left Adductor
  • Left and Right Quad (Right more noticeable)
  • Left Hamstring
  • Lower Back

 

On the positive side, my Calves and achilles all seem fine, despite the cramps I experienced during the race in those areas, so that at least, bodes well for the mountains and dunes of Morocco.

Interestingly, I have read up on exercise induced muscle cramps over the last few days and it appears the conventional wisdom that the cramps are brought on by dehydration or a lack of sodium in the diet is incorrect. It seems to be more associated with muscle relaxing signals being suppressed, but I haven’t got to the bottom of how to prevent it yet, so I’ll leave that discussion for another post.

Aggressive Tapering

Well, today I completed my final run before my race at the weekend.

Tapering
Tapering

I normally carry out a certain amount of so called ‘tapering’, when the volume, and to a lesser extent the intensity of training is reduced progressively on the run up to a race. The theory behind this is that it allows the body to recover from the hard weeks of training and so be in prime condition for the race itself. As far as endurance is concerned, it takes the body two to three weeks to assimilate and benefit from the physiological effects of long-distance training, soย anything after this will have little impact on a race.

Unless, of course, the race is a training race ๐Ÿ™‚ and then one would only need a couple of days in which to rest and allow ones legs to recover!

Seriously, I did take it easy at the weekend, and have only had a couple of gentle runs this week, so I should be quite well rested by Saturday morning.

So now it is time for a bit of carbo-loading and ensuring I’m hydrated and then the game is afoot (been watching a lot of Sherlock Holmes recently!) and into the lap of the weather gods. The forecast is good at the moment, but the rain over the last few weeks has left the flood plains waterlogged so I’ll be surprised if we get away without any changes to the course.

Popular Session

Back to work after a wet Sunday indoors.

After returning from the wedding we had a lot more chores to do and the day seemed to slip away quite quickly. I found a problem with my iTunes music store as well, so had so spend a little time doing this in the late hours of the evening.

The weather had not improved much by the morning, although I had managed to find my lightweight waterproof jacket to pop in my bag, which came in handy for the 10 minute walk from Bank station first thing. I’m sure this will come in handy over the next few months as the winter approaches ๐Ÿ™

Pilates on a Monday with Mila, is turning into an extremely popular session. So much so that there was barely enough room to stand on your toes and roll down (vertebrae by vertebrae) let alone to stretch sideways, or lay down for the 100โ€™s. It was actually a good session though. Perhaps because in the restricted space, Mila had to improvise the normal routine which gave it a bit of variety from normal. Moves are afoot to add in an extra session from 2:00-3:00 as a trial for the next month at the Virgin Active in Broadgate, although I seriously doubt this is going to be convenient for the majority and it will therefore not be used.

Hamstring

The afternoon went quickly as I normally fill my Monday’s with project status discussions and 1-2-1s with my team and today was no different, now we are back in September and out of the holiday absentee silly season.

Physio was the next order of the day, and after my visit to Mr Elliot last week, it was time to see Stuart for a checkup and test. Everything turned out to be pretty normal, although my left hamstring seems to be stronger, proportionally, than my left quad, which he thinks is what is causing the issue in my ‘butt’ area (my sit bone) He has given me some preventative exercises for this and given me the go ahead to increase mileage again as well as his blessing for the Marathon des Sables!

Then I found that LIz was waiting outside for me, as arranged. She was off to a special talk at church on Mary’s house in Turkey, and I have changed my swimming time to 40 minutes earlier – ordinarily more convenient to actually have a bit of an evening and not get home and have supper at 10:00pm – but today it meant I was taking the children with me to ‘babysit’ from the water’s edge (with me IN the pool that is!) Although sunset is around 7:00pm at the moment, they were keen to play outside in the playground as I was swimming, and so long as I continued to hear the shrieks of delight as they chased each other (ghost games!) I surmised that all was more or less well.

A good session and we were on our way home. To an empty house ๐Ÿ˜ฏ

St Nicolas’ where Liz had gone is very high church and they were praying at the end, hail marys, etc. although they are not Catholic (I was a bit confused about that) and had apparently locked all the doors, so she was a captive until they had finished. Eventually she managed to find her way out though, and of course we assume the doors were closed to keep people out at that time of night, rather that keep the audience in.

What a day!

Checkpoint

Ok.

So I’m a glutton for punishment.

But nobody can accuse me of not trying to achieve high standards. Realistic? Well, only time will tell if that is the case or not ๐Ÿ™‚

18 months ago now, I was supposed to have been entered in the MdS; the fabled Marathon des Sables. Those of you that regularly catch up with my blog may have noticed that I have been rather off form for the last couple of years though, due to a minor incident at Leadville in 2010.

So, ‘story short’ as my Brazillian manager says, I was unable to fulfil my initial desires to complete the MdS in 2011 with Liz (although she managed it admirably, with Greg, Ant and Ben – Liz’s Blog). Having, only a month previous to this MdS, just had my procedure to straighten things out and weld my leg back together, I anticipated (rightly so) that 2012 was also not going to be a feasible option for my competitive nature.

So, back to the present day. Having deferred to 2013, it was incumbent on me to pay the second installment to the travel agents on 1st Sept but I wanted to ensure the constant niggles, aches and twinges that I experience were nothing to worry about. Twinges I can handle, but I am a little more averse to hidden destruction. The only thing to do was to go back to Mr Elliot, in Chertsey, and consult with him on the feasibility, if not the merit, of my current running plans.

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Liz managed to get an appointment for me today, and so we duly trotted off with the little ones in tow, while the elder boys stayed behind for their first Judo lessons of the new term.

Although I had to sign in as a new patient, having been discharged from Mr Elliot’s care over a year ago, he nevertheless remembered me and, to his credit, it was as if I had only left his office yesterday; his only lapse being to confirm the issue was with my ‘left’ hip when ordering an x-ray.

When we got in to see him, he said the x-rays were not good, but clearly showed the original fracture was completely remodelled and the site of the osteotomy while still visible, was heading in the same direction.

Having discussed a couple of other ‘feelings’ which I considered could conceivably be collateral to the recovering fracture, he confirmed there was little chance of these effects being related and, more to the point, there was no real reason why I should not be able to run the MdS. He had heard of the race and although I quipped that type of thing was probably his worst nightmare, he joked that on the contrary, that and ‘motorbikes’ were in the habit of bringing him a lot of business ๐Ÿ™‚

So off we confidently and happily trotted back from Chertsey after this reassuring consultation. After picking up the boys from their Judo lesson, chatting with Pete their instructor about the Olympics and driving home, there was another surprise in store as we walked through the door!

MdS 2013 – Here we go again….!

Joshua has a cycling safety course arranged at school next week and he therefore needed a new bike. A new bike for him and Morgan had been ordered at the weekend, and they had been excitedly asking about the status of the shipping and we had played down the arrival of two large boxes to further expand on the surprise element.

Although we considered going out for a ride, in the end we had to spend quite a bit of time putting wheels and saddles in place and adjusting disc brakes (!) so after they had ridden around the garden for a bit we finished off the evening with a trip to the Britannia for a pleasant supper.

Then it was back home and after getting them settled down, it was time to do the deed! The dreaded second installment – with finger on the ‘PAY NOW’ button online I yet again committed to 6 months of hard training in an attempt to push myself to the limit – hopefully not past it, as I’ll need to ensure that I make it to the start line this time. It will be odd this time as there won’t be anyone there I know; at least not at this stage. Rory and Jen (UltraRace) will no doubt be going, and I’ll no doubt make some friends with whom to share the experience along the way.

The next journey starts here – 29 weeks and counting.

Tentative Steps

Training this week has not gone too badly.

After my visit to the physio I have taken my first few tentative steps back outside with my trainers on. I say tentative because my foot still feels as though it has something amiss; some sort of stiffness in the upper-mid foot, so I have been taking it fairly gingerly. In fact, when I thing about it that could be why I am so slow at the moment, as I am probably favouring my right leg to propel me along the trails, while my left is in a guarded holding pattern around the airfield of full performance.

On Tuesday I did an easy 6km followed by Thursday’s 9km and then did some physio on Friday, with some gym running to warmup and cool down. Everything seems to be hanging in there at the moment, except for slightly stiff knees, which I have been expecting, but so far it not not an issue.

Not massive mileage, but a useful rampup week and a bit of extra distance on my trainers and in my legs and, more to the point, I am planning a long run at the weekend, on Sunday, so we will see how things go during that.

Test Run

After yesterday’s physio session, I should’ve been feeling a bit more positive about today’s test run.

However, after my last two ‘test’ runs had come up with a less than satisfactory outcome I have to say I was feeling a bit apprehensive about running while I still had an ache in my left ankle, but all the evidence seems to support the theory that the orthotics will reduce the stress on the posteria tibia tendon and hence allow the area under strain to rest and repair, so I was happy to give it a chance.

Posteria Tibial Tendonitis

I have been wearing my trainers while walking into work – a short mile from Bank underground station to Liverpool street, and today I had replaced the insoles with the orthotics, so this was their first outing.

They felt a bit strange even when walking and the aches and pains I felt in other places (which conceivably had been there all along, but I’d just not noticed due to my focus on my ankle) were also a bit worrying.

So lunchtime came and I could procrastinate no longer.

It had to be a short one as I had meetings and work to get back for, so I quickly changed and then sped up the stairs from our basement gym to confront my destiny!

My Garmin battery decided not to play ball, so yet again i was wearing my heart strap for no reason but luckily I had my iPhone to use as a backup, not that at this stage I was particularly interested in my pace or time, but mileage is still useful to know.

Throughout the early part of the run, from Hoxton to Islington, my legs felt heavy, but I also felt the inserts doing their work. My running fitness has declined a little, but after a couple of miles I was starting to get into a rhythmn and things felt a touch easier, although I seemed to be running into a headwind for the entire route, which was bizarre since it was almost an out and back.

On the past two occasions I had run, the pain only really became debilitating shortly after stopping, so I was a bundle of nerves for the next 30 minutes or so,conscious of every twinge or twitch which lasted more than a second or two.

Luckily though, none did and touch wood since then all has remained fine.

Physio update – visit 3,457

Monday’s seems to be turning into my Pilates and physio day.

Yet again today I had a lunchtime of stretching and core work in the gym. After only a few sessions it seems to be getting a bit easier which is great, but that doesn’t really help my legs, my ankle or my foot! Not in the way that I need it at the moment anyway.

So, off to the physio it was this evening for another checkup from which I emerged with mixed feelings.

Vasyli Orthotics

I have resisted orthotics for biomechanical issues all the time I have been running with problems I have had over the years, and especially since trying to move more to minimalist footwear to strengthen my feet and improve my running posture and technique over the last 10 months. So it was with a bit of disappointment that I learned from Stuart that my biomechanics are now such that it is likely that is what is causing the problem with the pain in my ankle. It is possible that it is a ligament or tendon (or muscle) related issue (he was hedging his bets given the non-specificity of the ache I have had) down the inside of my left ankle underneath the foot which is caused by over-pronation, which in turn may be caused by my foot turning out slightly, which in turn may be a result of the operation.

The upshot is that I now have some temporary orthotics to support the inside of the foot, which he seemed to indicate are likely to be a permanent requirement.

I hate the idea of that.

I will try them out over the next few weeks and if they allow me to carry on with training by relieving the pressure on my tibialis muscles, I will keep them in my shoes, but I’ll not be keeping them in forever. The evidence to support my need comes in the form of a similar ‘top of the foot’ problem I have had before, so there is a chance it is not related to the op and although this change may have exacerbated the problem, I will do my damnedest to ensure I can run in the near future without any artificial aids!

Wish me luck for tomorrow.

Speak to the Man

After yesterday’s shock news that the Amplatzer Septal defect occluder although seated properly seems to be ‘leaking’ we have obviously been concerned as to what exactly this means.

Liz has discussed with a number of her friends but none have sufficient depth of knowledge in what is obviously a highly specialised area to really be able to offer more than rudimentary comfort and support, which although welcome has not really been sufficient to allay her fears of what might happen, especially after being told worst case it could mean open heart surgery ๐Ÿ˜ฏ

Liz managed to get a call through to Mr Ward’s secretary and left a message with her explaining that she needed to speak with him and needed to discuss her situation. As he is clearly a busy man, Liz wasn’t really expecting a response.

However, at 6:00pm she received a call back from the man himself.

He explained, firstly, that he did not understand why the doctor had asked for the scan at this time, only a month after the procedure to close the PFO, since he would not expect the heart muscle to have fully sealed around the device until at least 3 months after the operation, so everything was as he would have expected at this stage.

He stated that Liz should be doing everything that she felt she needs to do, in terms of her ongoing physical therapy and that he would see her in a month or so, as planned, to discuss and review her case, but a further scan would not be carried out until the three month mark. He confirmed that having reviewed her notes she had nothing to worry about at all ๐Ÿ™‚

I went for a run today and my ankle / foot still seems no better than it was three weeks ago after 8km round the city.

I hope I get similar good news after my next visit to the physio on Monday.