July 02, 2013

Returning from injury: running update

Ten weeks ago, on April 30, I began a 32-day Bikram yoga challenge, with the goal to do one Bikram class a day at the studio here in Squamish. I wrote down my intention, "Set my body free so I can run." 

Only a week earlier, I had discovered that my body still could not deal with a 15-minute run. It was a devastating realization that the pain in my heel, which I first noticed in late May 2012 and essentially halted my running for the past year, was still there.

After various treatments which failed to eliminate the pain, I took a 4-1/2 month complete break from running (from October 1, 2012, until February 12 this year), and then eased back into it from scratch—after first building up to a pain-free hour of powerwalking. 

I took 2-1/2 months to build up from four 30-second stretches of running with 4-1/2-minute walk breaks, to three 10-minute stretches of running with 2-minute walk breaks. I had been able to do this twice in the week before I ran 15 minutes on April 22, only to discover the next day that my heel—unmistakably—was sore again.

At first I was angry, upset, and—most of all—desperate: what was it going to take?!

I have always felt, and still do, that there is no reason for me not to be able to run again. After all, there has never been a diagnosis of the injury. The obvious ones for the location of my pain such as Achilles tendinitis, a stress fracture, and plantar fasciitis were all ruled out.

As I calmed down a little, I returned to research and decided that my heel was merely the symptom, not the problem.

I stopped running again and also gave up cycling so I could concentrate on upping the frequency of my Bikram yoga practice to improve my flexibility and strength, particularly by opening up the hip flexors and strengthening the gluteal muscles. I kept my swimming routine.

A week into the Bikram challenge, I had a funny neck twist during swim squad. I stopped immediately. What the heck now?! Swim coach Roseline assured me that it was not a typical swimming shoulder injury, based on where I felt the strain/pain. Initially I thought a few hot baths and heating cream would get rid of the increasing stiffness in my neck that followed but it did not.

While I had trouble turning my head to the left, it did not noticeably affect my Bikram practice (only the triangle pose was somewhat affected) so I was able to continue my 32-day challenge.

After five days, however, I realized my neck was not going to release the tension on its own. I was not sure if the neck issue resulted from swimming (I had done the BC provincial champs swim meet on April 26), or just a 'funny' move, or whether my body was beginning to shift with the daily Bikram classes.

I did know it was time for a deep tissue massage. My swim coach recommended RMT Natalia Finlayson and I went to see her on May 10.

That first treatment made me feel a lot better, though I also knew my neck was not out of the woods and so I stayed out of the pool, as I did not feel like risking a shoulder injury.

Meanwhile, I kept up the daily Bikram routine. And I noticed more flexibility in my right glute and piriformis, both from the daily yoga but also from Natalia's massage on my back, shoulder and neck.

I went back to Natalia on May 13 and she again treated the left side of my neck and back as well as the right hip, glutes and piriformis. She said swimming could work diagonally. She also recommended that I stretch on top of the Bikram routine, as yoga is not a replacement for stretching.

By the third treatment, my shoulder and neck were much better and she spent a lot of time on my right piriformis, which held release a ton of tightness. I had by now told her about my heel injury, or rather symptom.

By May 22, I was back in the pool and felt good enough to swim with the squad for an hour. I decided to stick with the massages, now focused on the tightness on the right side of my hip, quads, and glutes. I could tell that all the hip opening work in Bikram was helped along by Natalia's massages, and vice versa.

After the fourth treatment on May 23, and 23 straight days of Bikram, Natalia encouraged me to try a run again. I felt comfortable with the idea, indeed had felt for a few days that I would be OK to run, and ran two 5-minute stretches, with a 5-minute walk in between on May 24. And I continued from there as per this return-to-running program by Pete Pfitzinger.

In the 10 weeks since my body rebelled after that 15-minute run, I have done 53 Bikram classes—or a little more than five classes each week on average. (That compares with the 50 classes I did in the prior five months, or an average of about 2.5 per week.) I also have had 10 deep tissue massages from Natalia, with the first on May 10 and the most recent one on June 24, a period of six weeks.

Yesterday I ran 35 minutes--in one go--a day after running 25 minutes. Amazing. If I had not experienced it, I would not believe it.

I know that there is more work ahead. More Bikram, more massage, more stretching and more strengthening. After each Bikram class, I do a TFL stretch as well as a piriformis stretch. After each run, I do the stretch routine as recommended in Pete Pfitzinger's Advanced Marathoning. I use the TP Therapy products daily, especially the ball and the Grid foam roller. I also have regular Epsom salt baths.

I am optimistic that this time, after a year of struggle, I am on the road to recovery. Namaste!


stephen said...

I love your tenacity! And your approach is gonna be worth it because I've been down your path and it works. Keep going and don't leave those stones unturned xx

DRL said...

Thanks for sharing that, Margreet, and all the best with your continued recovery! I have no doubt your hope is not misplaced.

Margreet Dietz said...

Thanks so much Stephen!

Margreet Dietz said...

Thanks so much Daniela!