Sunday, September 9, 2012

Dealing with Injury

It has been four weeks since my injury really hit home -- to the point I cannot run. (It has only been three weeks since my race, so I only consider myself three weeks into healing/recovery.) Somehow, I managed to get through my 100 mile race despite the injury. Words cannot explain how thankful I am for that. Now I sit here a "broken" runner unable to run and desperately wishing I could. The weather outside is beautiful and fall has always been my favorite season. Instead of running, I am stuck indoors doing physical therapy and cross training while I recover. Pessimistic estimates suggest an injury like mine could take up to six months to fully heal. SIX MONTHS! The first week of this reality was a huge shock and I went into a bit of a funk. I've dealt with injury before, but nothing that couldn't be treated with some anti-inflammtory treatments. I have never been forced to miss more than a few days of running. I had always planned to take some time off at the end of this year to heal and recover, but I was kind of hoping it would be on my terms. Why couldn't it be December through February that I am forced to sit? I wouldn't mind sitting out a few runs when it is 10 degrees and snowing.

Things are finally starting to settle in my mind. I think the turning point was a conversation with a mom on my son's soccer team. She is a physical therapist and has dealt with her share of ultra runners and extreme athletes. I have had half a dozen conversations with qualified people, why did her advice resonate with me? I suppose that it was because her advice was so down-to-earth and no-nonse. It helped that the timing was right and I was ready to "hear the message". The first thing she told me was that tendinosis is a somewhat trendy injury diagnosis. She agreed that is most likely what is happening with my knee. But, there are varying degrees and my recovery time is difficult to predict. She felt like six weeks was a reasonable estimate. Six weeks?! Sweet. Now, I won't hold her to that. But it gives me hope that I won't be shut down all fall and winter. The other thing she told me is to "be nice" to my knee. What? No advice on icing every 6 hours like clock work? No advice on using advanced stretching techniques? No diagnosis of all the ways in which I am poorly designed to run? Just "be nice to it"? I can do that! Her advice was to try lots of things in therapy, but that time would ultimately be the thing I needed most. She also cautioned that every technique out there has many schools of thought. For example, some experts don't believe in anti-inflammatory treatments like NSAID or ice baths because inflammation is the body's way of dealing with injury and overuse. In other words, you are assuming you know better how to treat what is wrong with you than your body. Not likely. In summary, try it all, do what works best for you. But be patient and be nice. I am incredibly thankful for this conversation and the mental shift it allowed me to make.

However, our conversation got me thinking about why dealing with injury is so hard. And I think the thing that stands out the most is that the majority of providers out there are sending the wrong message. They are telling us all how we are broken. They are suggesting ways to fix things that often cannot be fixed, at least not easily. In essence, we are being told to focus on the negative. Here is the message we get: "I am broken. I have tight hip flexors. I strike the ground with my heel. My form is bad. My glutes are too weak. In addition to having to take time off to heal, I now have a six month job of rebuilding myself. In addition to running, I have to find time to do 27 hours of physical therapy and cross training every week." I am not saying that there isn't any truth in that message. But I am saying that the message is delivered all wrong. And, it is often given in a haphazard fashion that is totally unrelated to the process of healing.

When I went to see a doctor about my knee -- before the race took place -- he said "you have big built up quads and they are too tight".  His assertion that was causing knee tracking issues. But I don't have big built up quads. THESE ARE MY QUADS. Jerk. I am not a body builder, they have always been this big. I have run at a pretty damn high level for more than two years on these quads. Maybe my quads are bigger than a typical runner.  And yeah, maybe I need to stretch them more. But, this is who I am. His advice made me really mad because it is useless. It was a stab in the dark at identifying how I am broken in an attempt to explain something that was really simple: I over did it. My body needed time. Overuse, by definition, happens over a course of time. I don't need to fix my tight quads tomorrow. I can work on loosening my quads -- and all the other things that are wrong with me -- slowly and still enjoy running. First, I need to let my body heal. The worst part of this encounter was that he wasn't helping me accomplish my primary goal at that moment, figure out how to get through the race.

I think the answer to the majority of what ails the runner is just time. We all have deficiencies we need to work on. But we can work on them a little each day. The key is to get healthy, by allowing your body to do what it does best. Assist it how you can, but your body knows what it needs. The human body is one of the most incredible things God every created. It is self healing! When you are healthy, be disciplined. Add some occasional stretching to your routine. Use a foam roller a few times a week. Cross train to strengthen those glutes. But you aren't broken. You are just changing. And change happens slowly, over time, with discipline.

The one thing that may be broken is my ego. I got very out of touch with the signals my body was sending me. I tested my limits and pushed beyond them for too long. I need to be a bit more balanced in my approach. That is what needs to be fixed. I can still train and race a high level. Perhaps more recovery and cross training will allow me to be a better runner? It is possible. Make no mistake, I did not get injured because I ran 100 miles. I was injured before I got to the starting line. I got injured because I pushed too hard in training trying to be something that I am not. Going forward, I already have plans to make me a better runner. That plan will include fewer miles, more cross training, more time for recovery, and better use of cycles in training. Trust me, it isn't as dramatic as it sounds. These are just a few small changes that implemented over a course of time will make a big difference.

For now, I will do whatever I can to stay active because I need to exercise. My body craves motion. I will try some different physical therapy exercises and see what helps. I will learn to use a foam roller. And when my body tells me it is time, I will start running again. I hope that is soon, but I have accepted the realization that I asked a lot of my body and it is time to give a little back in the form of rest. And I won't feel bad for myself, because I sure like showing off my new belt buckle. (Yes I wear it!)

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