January 28, 2013

Getting ready to run again after injury

It has been four months since I last ran, a 14-1/2 minute jog on October 1 that ended in pain, just like most of the jogs I did, as cleared and/or prescribed by various therapists, in the prior three months; never before in the 17 years I have been a runner have I been unable to run for 18 weeks.

It has changed me in ways that I will only be able to think about if, and when, I am able to run again. Without knowing whether I one day will be able to become again what I am, a runner, I cannot -- dare not -- think about what that means. It is simply too terrifying to consider.

I am a runner, and cannot not be one. Even when not running, I am and will always be a runner. For my own sanity, I have had to push the runner into the background by allowing her to do other types of exercise, but she knows that I am only doing them so that she can return, hopefully stronger than ever.

My body had made clear that treatments were not the answer to whatever its problem is: it stubbornly refused Active Release Techniques, chiropractic moves, ultrasound, deep tissue - and trigger point massage, and Intramuscular Stimulation (IMS) to provide anything but temporary relief and hope that was quashed in the next jog I was allowed to do.

An MRI showed nothing to explain, or solve, the pain in my heel. Neither my Achilles, plantar fascia nor a stress fracture could be blamed. One specialist thought a missing ligament might be the culprit, though this was dismissed by two other medical experts.

Tired of the medical merry-go-round, I have very much enjoyed a return to training in a new discipline, Bikram yoga, and a couple of old ones, swimming and cycling.

In the past seven weeks, I have done 28 Bikram yoga sessions. Each class has been challenging, each class has been rewarding, both physically and mentally. Each of the 26 postures in the series shows me where I am weak, tight, imbalanced; returning to class and trying again shows where I am becoming stronger, more flexible, slowly but surely syncing the left and right sides of my body.

Bikram yoga is hard work. It takes a lot of focus and mental resilience, yet it also requires the ability to let go, especially of expectations and judgement. As with many things in life, the hardest part is showing up for the 90-minute class -- I feel smashed after each one, in a good way.

It's about listening to the teacher who talks you into and through each pose; the more often you go, the better your body and mind absorb her words, taking you more accurately and deeper into the poses. It's about overcoming mental resistance to do the poses that are hardest for you, varying per person.

Each class I feel a tiny victory, a hip that moves a little better, a pose I can get into for the first time, or a little deeper, or hold a little longer. It's what motivates me to return to the 40-degree heat and work as hard as I can that day; I wholeheartedly believe that Bikram yoga is helping me to bring back that runner. 

And yet I am scared. Increasingly so as February approaches. My heel can now handle three sets of 20 one-legged ankle raises, a threshold a specialist had said would clear me to try a run once I had been able to do them for two weeks in a row painfree.

Since mid December I have been able to walk doggy Luka again daily without worrying about heel pain.

And in the past week I have done two powerwalks, one of 45 minutes, and one of 55 minutes, followed by an hour swim and a Bikram session respectively, without protest from my foot. I do them because of this article Returning to Running After a Stress Fracture or Another Major Injury by Pete Pfitzinger.

"Before you can run you must be able to walk briskly without pain. During walking, your body absorbs forces of about 2 times your bodyweight. This is a stepping stone for determining when the injured bone will be able to handle the greater impact forces of running. When you can walk briskly for an hour without pain, you should be able to try a small dose of running," Pfitzinger writes.

"The impact forces of running, however, are over twice as great as for walking, so the only way to know whether your body is ready to handle running is to run."

And that is exactly my fear; as much as I am looking forward to running again, I am terrified that it might show my body is not ready after all, despite all the promising signs.

Despite the dozens of treatments I have had in these past seven months, despite the four months of complete rest from running, despite all the good advice from the people who have helped me, despite my own hard work on strength and flexibility, despite the fact that I am glad the injury has made me a triathlete again, despite the fact that I am loving the swim squad, and Bikram yoga sessions. Despite the calf raises, despite the powerwalks. Despite the patience, despite the confidence in my recovery.

I am scared to try that first run, and I am in no rush to do so, even as February is only three days away. Even as every single runner running past my office window gets me a little angry, jealous at their ability to run, especially if their face is showing discomfort or boredom instead of happiness and gratitude.

Tonight I'll powerwalk to the pool, 5K from my house along the exact same route I have run so many times. It seems that my powerwalking pace is 9 minutes per K, perhaps I'll take the Garmin tonight to register it more accurately. I want to do a few more powerwalks, and a few more sets of 20 calf raises, before I put my body to the test in miniscule runs of a couple of minutes at a time.

I have been waiting for seven months because I had no other choice, I can be patient for a little longer.


Dr. Paul said...

Great post Margreet!

The discipline you have shown over the past months to remove any stress from the injury is commendable.
As you ease back into it and even if it feel s great remember to keep up the discipline to allow recovery time. I'm sure you will, and if anything comes up we'll be glad to help. Wishing you an amazing February to come,

Paul & Leah

Margreet Dietz said...

Thanks so much Paul and Leah!

Mark Matthews said...

I was looking around at the second round of the amazon breakthrough novel contest, and followed the breadcrumbs here. Just wanted to give a shout out from a fellow runner and writer.

Margreet Dietz said...

Thanks Mark!