Injuries: The Meet Cute

Learning to live with injuries:

Injuries, this is a new one for me. I have rarely suffered from niggles as I began to roll and stretch religiously when I started to run more and when distance running became a part of my life. However, it would appear my luck has officially run out. This may be due to a number of things:

Upping the amount of exercise I do daily
Increasing weight amount
Not increasing the time spent on stretching and rolling to match the exercise time increase.
Trying to do too much in the evenings and not spreading out my exercise.
Attempting to do too many varying activities and not focusing on making myself strong in a select few.

Realistically it is probably a mixture of all of these but mainly the last.

The injuries acquired:

Running has not occurred since Coast to Coast back in September. That is 7 weeks of no running by the time I am allowed to try again in 5 days. Anyone that runs knows that 1 week off is enough to deplete your ability significantly so to say I am worried is an understatement. However, it is this worry that transcends into coming back too soon and ending up worse than when you started which is the lesson I have learnt this past 7 weeks.

Where the magic happens and the advice I hate regarding injuries is given.

Coast to Coast left me with tight everything, resulting in a few old ACL niggles arising and making my knees hurt. I had a week of no exercise bar riding the horse and stretching and rolling to loosen everything off. After a week off I felt OK and went back to the gym to start strength training to build up my legs a bit, nothing too drastic, old workouts that had become fairly easy. Over the next ten days, I started to bring back my other hobbies into the mix. Cycling and swim practice was injected into my daily routine also to start building a base for Iron Man training.

Within 10 days of having a full routine, the top of my foot began to hurt. I went to my sports masseur to see what could be done and what was the cause. It was extensor tendonitis.

Extensor Tendonitis:

What Is It: Irritation and inflammation of the tendons on the top of the foot

Causes: Shoes that are too tight, calf tightness, spending long periods on your feet, altered foot biomechanics, walking/running on uneven surfaces or simply dropping a heavy object on your foot

Symptoms: Gradual onset of swelling, bruising and pain on top of the foot. Tender to touch and may be uncomfortable wearing shoes

Treatment Options: Change how you lace your shoes, rest, ice the foot, employ ultrasound, get a course of injections or stretch the calf muscles off.

I opted for changing my laces, stretching out the calves every day and focusing on ankle mobility stretches. However, it was not this that Brett the massage man was worried about. While playing around with my feet he hit a very sore spot at the base of my foot near the heel, the result of him pressing this caused a close call with my foot and his face. I am usually someone that has a very high pain threshold in the massage room! This was clearly another injury that had yet to raise its head.

Plantar Fasciitis:

After prodding around and having a chat, Brett was convinced I had plantar fasciitis. He instructed me to stop exercising immediately bar swimming. We have always joked about me doing too much and getting sore but this time he actually seemed concerned. He explained that if I did not rest I could be looking at months out rather than weeks.

The plantar fascia is a thick, tough, fibrous band made up of collagen fibres, which runs along the sole of your foot. It originates from the heel bone and extends along the bottom of the foot, attaching to the bottom of the toes. It helps to support the arch of your foot and transfers forces across your foot when you walk or run.

Plantar fasciitis symptoms develop if too much strain is placed on the plantar fascia. This is usually from overuse or repetitive actions, causing small tears to develop in the collagen fibres. This results in swelling and inflammation. If the problem continues, it may develop into plantar fasciosis. This means there is chronic degeneration of the tendon rather than inflammation.

Other causes are overuse, tightness in the Achilles and calf muscles, poor footwear, increase in exercise and being female (yes women are twice as likely to suffer).

Advice for preventing PF again:

1) Wear Good Footwear: Flat shoes that provide good cushioning and arch support. Inserts into your shoes to support the arch.

2) Stretching Exercises: regularly stretching the calf muscles and plantar fascia is one of the best ways to reduce the chance of developing the condition

3) Strengthening Exercises: Strengthening the foot, ankle and calf muscles reduce the chance of developing plantar fasciitis

4) Exercise Appropriately: Avoid overtraining, particularly if you are just starting out and try and avoid hard surfaces

The issue was that I already had insoles especially for my arch, I already stretch and roll every day and I have lifted weights and partaken in strengthening exercises for 4 years. So this only left the latter…doing too much too soon.

Learning to rest:

This is the hardest thing to ask someone like me to do. I hate sitting down, I can not stand not doing exercise and I am a springy person. I spent two weeks swimming with a bit of mild cycling on the watt bike and at the cyclo park to keep the muscle memory going. However, for the most part, it was 2 weeks of stretching and rolling. Rehab some may call it. This was a mix of my usual all round body stretches and some PF specific exercises.

After two weeks of stretching and swimming, I went back to Brett who was happy that the pain was less. I started to build up my workload again. I started going back to pole and kickboxing, run club even got a look in for the first time in a month. A few knee niggles arose while doing hill sprints at run club, however, they were rolled and stretched out after and I thought nothing of it. So, I was back to pole, riding, kickboxing and the gym, even running every now and again which felt great, I was finally healed and playing the waiting game had paid off…

The final straw:

Or if you have a niggle that is going to turn into a large issue!

Unfortunately, my patience had been in vain. I had spent the weekend at a spa with Mum for her birthday, rest, relaxation and actually behaving and taking a break. This saw me back to the gym to do some conditioning and strength exercises I was more than familiar with. I started with a small 6k cycle and some stretching. Then onto a clean, front squat, push press EMON at 30kg for 10 mins. I have done this exercise a million times, it is my go-to safe exercise. The weight had not been increased nor the reps, nor depth of squat. However, halfway the back of my thigh began to hurt. I ignored it assuming it was my muscle hurting from having three days off and laying around all weekend. Completing the 10 minute warm up I progressed to single leg deadlifts

Or if you have a niggle that is going to turn into a large issue!

The niggle returned in the form of a sharp searing pain up the back of my left thigh whilst performing the first set on this leg. Literally not being able to straighten my leg up and lift the weight, my leg buckled and I fell on the floor. Not good. Again, the weight was no more than I usually lift.

In pure frustration and potentially a degree of tiredness I burst into tears. I am not someone that does much crying, least of all in front of people. I think 2 people have seen me cry in my lifetime, it just does not happen. So from that, you can gauge how angry I was. I had rested, stretched, had massages, stopped running, stop exercising, rolled etc and still this happens. I stormed into the gym office to be met with “go home and rest”.

These were not words I wanted to hear yet again.

Reflection:

When we refuse to listen to previous experiences we only have ourselves to blame when it all happens again!

So I sit here now not really knowing what to do. I have rested and it has not worked. The only thing I can think to try is rescheduling my time to slot everything together better. Potentially doing morning workouts rather than doing it all in the evening for 5 hours. Limiting kickboxing to once a week rather than twice. Riding the horseless. Doing pole every other week rather than every week. Prioritising items in the gym and stop wasting time doing exercises that are not benefiting the three Iron Man disciplines. Breaking down cycling and swimming into manageable chunks rather than brick training so early on.

It would appear as much as I hate to admit it, people are right, I do too much. I need to rest, not one day a week but that plus the evenings. I also need to really think of how I spend my time and prioritise hobbies and exercise every 4 weeks. As Iron Man training steps up other things need to fall at the wayside for a bit. This is not a goal that is going to be conquered while my attention flits from one thing to the other, I need to be focused.

Onward and upwards:

Therefore enter the master plan! I shall be doing no exercise for the next 6 days, bar a 10k OCR I have booked with a friend. We will hobble this or jog if the hamstring is feeling better. Then I shall be starting the Gym Jones ultra marathon build-up workout for 75 days again (I did start but ended abruptly after PF gate). I shall be making the most out of my mornings with a watt bike cycle or a swim for an hour and a half during the weeks. That leaves evenings after the Gym Jones workout to either do pole, kickboxing or play badminton with gym friends. Weekends are reserved for long bike rides, races and riding the horse. This will be re-evaluated every 4 weeks as the workload for Iron Man increases.

Lesson learnt, more is not always best.

Lessons learnt from injury:

If you are going to increase the amount or duration of exercise you partake in, you need to up the rolling and stretching to match.
Shoe insoles, if you run with them, never run without them. You use them for a reason!
Do not try and do all your exercise in the evenings, split it up through the day. Yes, it may result in more showers and more workout gear to wash, but suck it up.
Lay-ins are nice, true. However, exercising in the mornings is a thing for a reason, especially when you already do activities in the evenings.
REST MEANS REST. Not rest from running but still ride the horse and kickbox. When a sports masseur tells you to rest you put all tools down and do nothing!
Do not try to up your swimming and cycling loads at the same time, that is double the strain on your body. Have one ticking along at the same intensity for a week or two while you up the other, then switch. Alternatively up them both but on a small amount. Do no go from swimming half a mile to a mile and cycling 30k to 50k in the same week. That is asking for trouble.
Other hobbies and activities are important to keep you fresh. However, they should not be taking up a huge amount of time and eating into Iron Man training, focus!
Do have a sports massage every now and again. Not only is it a worthwhile MOT it may also uncover any niggles you did not realise you had before they cause serious issues.
If you have an injury stretching and rolling is usually the answer.
NEVER use normal tie up laces if you are covering distance or spending a long time on your feet or in those shoes. They cause severe bruising and swelling on top of your feet. It hurts!
Bobs really is a little gem

Research into injuries and solutions may seem time-consuming but having various perspectives on how to recover is a useful tool.
A strong support system with ample knowledge and no fear to tell you when you are being an idiot is of utmost importance during Iron Man training! Bobs really is a little gem.
Plantar fasciitis can be very serious, with a recovery of many months. Do not underestimate it, treat it with respect and look after yourself.
If you end up with injuries that prevent you from bouncing or running (such as PF) look to swimming to keep yourself ticking over.
If you have even the slightest niggle while working out, STOP! You will only make yourself worse in the long run.
Plan and schedule in exercise and hobbies to ensure you are not trying to do too much also to mentally put yourself at ease.
Feeling tired and overwhelmed by it all? Maybe you are not eating enough, or have too much on your mind, or are not sleeping enough? (further blog to come)
Do dynamic stretches rather than static before a workout, I think this may have been the cause of my hamstring!
If you need to have a cry then cry! This is not an easy task. Not everyone can complete an Iron Man, even less try. Give yourself credit, what you are doing is a huge feat, you are going to have bad days, weeks or maybe even months where it seems you should give up. Just don’t.