Neural pathways: running without thinking

As I review my first week of non-running re-hab, I realise that today marks 76 days until TMBT. Eleven weeks, which includes at least another week of full-on physiotherapy related exercise involving Not Running. Then the ever familiar road to recovery, hopefully culminating in a pain free ultra at the end of August and a good solid attempt at the arduous climb that is the ‘short route’ of The Most Beautiful Thing distances.

kinabaluBeing told not to run, even if it’s for the long-term good, is the last thing a runner wants to hear. I had been explaining to my Pilates instructor Jayne that I was sick of the Hamster-wheel of injury, followed by time out for recovery and the never really being able to test myself for fear of re-injury. My current/ ongoing issues are the result of over-training and racing, but the underlying reasons are poor biomechanics and hip stiffness which I’ve traced back to childhood. Jayne suggested an assessment with a physiotherapist who specialises in podiatry and also Paralympic rehabilitation. OK then!

After a video assessment (walking, running, with and without shoes) and various strength and alignment exercises, some interesting issues came out which I’d never heard from previous sports injury professionals:-

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My right leg (which currently carries the afflicted Achilles tendon) is my ‘good’ leg and tracks straight with good pronation, neutral gait and no podiatry issues

My so-called ‘good leg’ on the left is rotated inwarded severely enough that I supinate and run without the use of my big toe! What?!!!!!

If I continue to run longer distances using only the smaller toes of the left foot, it’s likely I will cause stress fractures in these toes, as they are not strong enough for the duty I am giving them, which should really be harboured by the big toe and the second toe. My right leg can only do so much to compensate!

The tightness in my soleus and Piriformis started in childhood and is likely not easily or quickly correctable without suffering injuries down the leg-chain. Orthotics (practically a dirty word in my vocabulary) were suggested to correct the gait.

I can re-train my foot not to dorsi-flex when I run and to correct the S-shape I form during the foot strike (it should really be a outer heel-strike, rolling forward to toeing off diagonally, with the big toe- minimalist shoe and barefoot running fans, please look away now!). This can be done by Not Running and performing repetitive movements to create new neural pathways which the brain and thereafter the muscles, will recognise. In time, I should be able to run more efficiently, without thinking about it.

So in summary, my right side is compensating for the left and the outside of my legs are very strong compared to the inside sets of muscles which are very weak.

Things I already knew were:

  1. higharchMy Achilles is thickened and nodularised, possibly with neovascularity, that is, an increase in the number of blood-vessels in the tendon area; as my bodies attempt to get more healing blood into the area
  2. The tightness of the Achilles is what’s causing me pain and this is primarily caused by very tight calves (years of wearing very high heels won’t have helped). I need deep stretching and lots of rollering
  3. I have high arches, which are fairly rigid and don’t really want to help me out by pronating nicely through the heel-toe pattern, which allows for shock-absorption through the running gait.

Every day I must perform

3 x 15 sets of eccentric calf raises: up and down on the steps, gradually adding more weight. I do this FIVE times a day, every day. I’m currently loading with 2.5 Kg.

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2 x 100 ankle flexes with toes scrunched up. This is to train the ankle NOT to use the toes to lead the movement and to stop me dorsi-flexing thus helping me pronate, not supinate, on my left foot. I do this twice a day; which doesn’t sound like much but it takes a lot of concentration not to use the toes, keep the foot in plantar flexion and I can’t stop my mouth from pursing into a tight frown at the same time! Come ON Neural pathways – form already!

A variety of piriformis stretches including the more traditional post-run stretches as well as some moves borrowed from pilates/yoga.

After all this, there’s barely enough time for Life and Actual race training!

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So, I am breaking in my orthotics, which have been custom built to help me pronate more (!) on my left foot and help my very high foot arches to collapse in the proper way. Increasing the hours every day, I am walking in them and if there is no pain, I can attempt a run on Day 13. I’ve promised myself I will start with a 20 min jog 🙂 After that, I have to schedule an ultrasound to check on the status of the Achilles, which may or may not result in an injection to get rid of the extra blood vessels and yet another two weeks off from running, whilst the swelling recedes. I may have to have this done when I’m in the UK as the procedure is a little specialised and I’m not sure if the local hospitals have the know-how. But I will check. Another two weeks off from running……..(sigh).

Until then, building back up from a 20 minute jog into the realms of what will likely be at least 5 hours of climbing through trails and forest in Sabah, will be a challenge but I hope that my previous mileage PLUS all the swimming, cycling and other cross-training I’ve been doing- coupled with better biomechanics (not to mention my highly renowned mental determination) will allow me to have any amazing experience at TMBT in September. I hope everyone else’s training is a bit more traditional than mine.

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TMBT – the unpaved road unravels

The road to the jungle is by definition, unpaved and so my efforts to gain some more off-road training has had to be upped. After studying my training record, I am still very thin on terrain training and I think this is a great shame, given that I am mere miles away from forest, streams, steep jungle inclines and many other aspects which will be encountered during The Most Beautiful Thing.

In the UK, I could drive for 30 minutes in-land and hit all manners of running surface from muddy grassy slopes, to gravelly trails, to heather clad mountainous fell. Miles and miles of compacted earth along disused railways and many more of asphalt pavements gave me no excuse not to get as many miles of running as I wished.

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Here in Brunei, there are a couple of set-backs which I am trying to compel myself to overcome:

Temperature/timing: the coolest hours are before sunrise and after sunset. However, it’s not very safe or pleasant to run in at dawn/dusk due to

  1. biting insects,
  2. humidity,
  3. drivers using the cycle lanes,
  4. cyclists without lights using the pavements,
  5. men-at-work using the pavements,
  6. huge deep leg-breaking pot-holes on both pavement and road.

The beach gets rids of items 3-6 but has it’s own drawbacks

  1. pitch-black after 6.45 p.m.
  2. trip-hazards from beach debris
  3. camber of the sand sloping up from the waters’ edge
  4. limited exits onto main road
  5. nefarious activities after dark (!!!)

Never-the-less, I am getting out onto hillier routes, namely the Labi Road, which runs from the Seria by-pass turning South, towards the small village of Teraja. This tiny outpost has traditional long-houses, situated very close to the geographical border with Sarawak, somewhere in the jungle beyond the end of the road.

DSC_0632My first venture ended abruptly after less than 4 hilly miles. Following some great long-run planning, involving proper fuel, drink, change of clothes, SPF and other considerations, I ended up ‘sprinting’ towards my car after being pursued by several feral dogs! These mongrel hounds are quite a common sight around Brunei, with families adopting upwards of 5 dogs, perhaps as pets but more likely as protectors! The Labi Road does not receive mobile phone coverage and a bite of any kind would leave me with at least a 30 min drive before we hit the main road and further to go to reach the nearest medical centre. Not something worth risking….but this is really the only hilly area I have found that doesn’t involve full submersion in the jungle!

DSC_0643My second venture went slightly better. No dogs, just the relentless sunshine, 33 degrees Centigrade and high humidity coupled with the threat of sand-flies for any walking sections! My routine for the longer runs was to have my “support vehicle” driven by my husband, park up every mile or so along the road and for me to run to it, rehydrate and get any food or equipment needed before continuing. Although this doesn’t replicate race conditions, it does allow me to concentrate on good quality running without the extra weight of carrying a rucksack or duress from being dehydrated. I feel at this stage of training, I really need to tax my legs with 3-4 hours of running. I will definitely get this during the Mauritius Marathon next month, a key part of my long run and heat training.

And…..STOP PRESS. Before I have time to publish the above, I spend an afternoon having my (on-going) Achilles weak-spot assessed by a very experienced physio and am now resigned to two weeks of NO RUNNING. The assessment (of which I will undoubtedly write more later) uncovered some very interesting facts about my biomechanics and fills in a lot of the unexplained history about why I seem injury prone. This has come at a very pivotal time in my training regime and I am again faced with a choice:

Carrying on running for long durations and ‘maintaining’ my current conditions with rest, massage, acupuncture, bandaging and various liniments including Tiger Balm, Nature’s Kiss Herbal Rub and Chinese sprays OR

address the biomechanical reasons why I keep ending up injured. [Aside: I have been injured for 2-4 months for every 12 months of running, which isn’t a great rate of return for my efforts. I get to a certain level and then have to take time off only to rebuild to a similar level of fitness before I am reinjured…….repeat, repeat].

I really want to be in good shape for TMBT and some of the other endurance events which Malaysia has to offer BUT I have also signed up for (a) a marathon in only 3 weeks time and (b) an ultra-marathon in 9 weeks time. The physio seems OK with me trying to get back on track for (b) but I haven’t exactly told her about (a). I know she would discourage it profusely!

The problem with having to plan events far in advance is that you tend to have the hotels, flights and race entries paid up as you begin training with only the hope that you will complete adequate preparation. I have certainly had to miss a lot of events due to injury over the years but I think I have always been sensible about entering just to enjoy the journey and complete or with the aim of a Personal Best. I have, as yet, never DNF’d (Did Not Finish).

However, as I enter my 3rd day of re-hab and no running, I am pushing the boundariesdont give up of reality if I think I can complete a marathon in under 5 hours, with 2 full weeks off in the 3 week lead-up to race-day. Even taking into consideration that I can and am still ‘training’ with cycling (outdoors and gym turbo-trainer), pool-running and swimming as well as core, pilates, weights and the physios stretches, it’d be a lot to ask to just get through the full 42.2K without detriment. Or is it? I’ve decided to make the full decision after I get re-assessed at the end of this week. For now, my targets are:

  • Do fortnight of running-rest, under physio’s guidance & see what happens
  • Re-assess goals after that

I don’t think this is the end of the road for doing TMBT justice, but I think targets prior to that are definitely in jeopardy 😦 But if it addresses the source of my poor biomechanics it will be worth it in the long(er) run.