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.

Mizuno Wave Run – 16K of concrete

My step-back week is currently every fourth week and involves less running, more cross-training and a long-run of 10 miles maximum. So I thought I would take the opportunity to check-out the Kuala Lumpur running scene and signed up for the Mizuno Wave 16K in Putrajaya 🙂 There’s easy access to KL (via Air Asia flights) from Miri, just over the Brunei border and Purtajaya is a separate town to the South of KL. The weekend also happened to be my 5th wedding anniversary, so my hubby and I combined a long weekend away, some nice meals, catching up with friends, sight-seeing and shopping, with the running race on Sunday.

The previous week had not gone well. During the Wednesday cross-training session, I had completed my 30 minute core/glute work-out and was merrily cycling away on the turbo trainer, when I experienced a sickening ‘pop’ in my right ankle like my Achilles had been hit with a hammer. You would have thought I’d stop immediately, right? Nope! I slowed my RPM, waited for further signs of pain but as there were none, I carried on and completed my 45 min session. It wasn’t until I dismounted that my right leg seemed locked and I couldn’t put my weight on it. After some bum-shuffling downstairs, raised leg, ice and herbal remedies plus a day in heels (I couldn’t walk in barefeet without a dull bruised feeling) followed by a day in MBT trainers where my foot felt fine but tired, I was back to normal. How? I don’t know how. But I decided to collect my tee-shirt and race-number anyway, seeing as I’d paid the entry fee. Note the personalisation of my running forum name “Nywanda”. Sure beats them trying to squeeze my very long real name on the tiny wee bib 🙂P1000661

I spent Friday traipsing about in airports and the local shopping mall – Alamanta followed by an amazing Italian dinner with champagne and a singing group performing at the table. Then on Saturday I had a massage, courtesy of the Marriott IOI resort and felt great. We walked around all day Saturday in the main shopping area, had tea round at a friends and then more shopping into the evening where we met friends for dinner. The foot didn’t feel any the worse for wear, so I decided I would try and run and if there was any pain, well, I could always walk or stop….no big deal. The main goal remains as The Most Beautiful Thing 25K (or ~30K if you believe the route map) in September, although I do have some distance races between now and then, foot health withstanding.

We had met with a very fast looking gent from Greece the day before and shared a cab back from the race-pack collection. We managed to meet up with him again prior to the start at 06:30 in Presint 2. With only 2 out of 3 toilets working near the start, I only just made it to the loo with a slightly queasy tummy before the race started. I obviously started way too far back as we all walked in formation over the start-line and the chip timing shows I have a 3.5 min deficit between gun-time and chip-time. I MUST remember this for future races and avoid weaving through the Screen%20Shot%202013-05-29%20at%204_25_58%20PMcrowd (especially as the change in direction does nothing to help my unstable ankle). The route was through a concrete jungle of government buildings including the Palace of Justice and although there were some nice views over the river and towards the bridge, I kept my eyes focussed on the camber of the road and stayed tuned in to almost every footfall. The water stations were completely overwhelmed with runners when I arrived and I ended up scrabbling for water from the wrong side of the table; there were way too many runners for that one little fold-out picnic bench and the volunteers were frantic. It was every man and women for themselves as I had to almost elbow my way back onto the course! I was a bit hacked off at the amount of “cutters” but by the second water station I had chilled out enough to concentrate on doing my own race, over the full distance and not worry about anyone taking short-cuts. (It IS one of my bug-bears though).

Due to my own sweatiness at the start, I had accidentally pressed YES when the Garmin asked me if I was indoors, so I had no GPS tracking to help with pacing. I was however wearing my heart-rate monitor so I just used that to try and keep steady- let a little rise happen on the uphills and had the following distance splits:

5K= 28.16 / 10K= 58.43 / 16K = 1.38.45 (Official results pending). I struggled a bit near the end as we came over the last bridge, I was feeling drained from having no breakfast and only 1/2 bottle of Gatorade out on the course. With heavy legs I managed a 200m surge at the end and must have passed at least 8 people including two ladies! I have noticed that not many people around my current pace bother with a sprint finish, so I was doubled up at the end whereas everyone around me looked really fresh.

I didn’t get a powerade bar which I was really in need of, just a bottle of water, a box of cereal (random!), a sachet of local brand deep-heat and a very nice shiny medal. I was careful to do some stretches and soak up some of the race atmosphere. I was especially happy to find out that our new friend had indeed been fast and come second overall! I would have congratulated him but he went off for a 12K run before prize-giving. Some folk! Well done MichaelIMG-20130612-03387

For now, I can only focus on keeping the ankle stretched and protected, as I come into the longest distance training segment leading up to the marathon in July and ultra-marathon in August. Next week all being well – 18 mile long-run, hill-work on the roads and…..a physio session.

Reformer pilates – an assault on injury

This week saw another first for me, a session of reformer pilates. And it was surprisingly enjoyable. I had always shunned away from both yoga and pilates, despite knowing that both would help me with breathing, posture, flexability, strength and ultimately, the on-going battle against injury. As you do!

women-pilates-reformer-semi-classNow, I’ll be honest and say that I don’t know much about yoga or pilates; I have experienced a random drunken Hogmanay reveller perform a seal-pose on the livingroom floor of my very small flat but that didn’t exactly endear me to it.

No, I started as part of the ignorant masses, happy to file yoga practitioners under “hippy bean-eaters” and scoffed at the ohm-ing and meditation. This scoffing gradually gave way to feigned interest as more and more of my friends embraced yoga and laterally pilates and the different ‘brands’ of yoga – Ashtanga, Bikram, Hatha, Vinyasa etc. Eventually, as I succumbed to injury and repeated diagnoses along the lines of having a tight this or a shortened or inflexible that, I realised…….I was going to have to check this stuff out.

Yoga – I got as far as googling my nearest class and having a few in-depth talks with Deek (a yogi who had used his knowledge & practises to overcome a broken hip after being told to apply for a wheelchair license) and TARA, herself a competent runner and yoga instructor. It never went any further and I think the terminology along with the mental imagery that “it just wasn’t me” made me body-swerve it.

Pilates – now this seemed a bit more my cup of tea, with the focus on strength and core, or so was my pre-formed opinion. I attended one class. And struggled. And felt the stigma of being in a group where everyone seemed like an expert, whilst I rolled around uncontrollably, with my hands gripped around my ankle. I know everyone has a first time, but I wasn’t feeling the love and so went back to my foam roller, static and dynamic stretches and traditional crunches and planks.

reformerUntil this week 🙂 I was offered a spare place at a one-on-two session with local yogi and Queen of the Flex, New Zealander Jayne who is an ex-runner and has been resident in Brunei for over ten years. [Aside: I met Jayne at a newbies coffee morning and having sworn not to be a complete bore and talk about running, she got me onto subject within 2 minutes of meeting!]. So I was keen to find out more about this pilates business once and for all and take advantage of the kind offer made by EMMA, to buddy up in one of her booked sessions. We met before lunch and drove to Jayne’s home which has a room set-up especially for reformer, with two of the reformer contraptions, including over-head leg/hand pulleys.

2pilatesBefore we started, there was a question and answers session about my exercise background and any injury’s or weak spots: this took some time 🙂 Jayne made some notes and was really nice about leaving the session open as a taster and if it didn’t suit me, fair enough but if I liked it, I could come back for a weekly class. This was good as I felt no pressure either way and entered the reformer room eager to learn more about my weak spots.

Following some clear explanations and extensive demo’s by Emma, we went through a variety of guidelines, breathing and movements. Some went well (although I had very little weight or tension on the machine) and some were a real strain to keep the small ball or ring in place between squeezed knees(!) or to keep my legs under-control. Theresuperfeet_body-alignment were some very bouncy juddering legs, especially when I needed to use my adductors. I was quite wary of using my right (injured) leg on it’s own for weight-bearing exercises but all in, it held out well and I had a very enjoyable session indeed (save for the running capris I’d worn, having a zipped pocket on the back which became increasingly uncomfortable, as we were on our backs on the machines a good part of the lesson).

After almost two hours, I emerged as a complete convert! I still don’t know very much about all the moves and sequences and yes, I am quite prone to breathing out on the in, but I’m sure that’ll come in time. The fact that the piriformis stretch I performed so inadequately during pilates, has already shown benefits is very positive.

stretch pilatesJayne has recommended I have an assessment with a local physio, to see where I’m at with the Achilles and everything else. I had been avoiding this (as basically I probably won’t want to hear what they’ve got to say) but I know I should book some sessions, especially now as I have started increasing my mileage towards the 30K mark. I’m working hard to include core, strength and stretching into my routine and I continue to roller even though it can be excruciating. Frequent massages and strapping is maintaining my form, despite my ankle being achy after a long run. Pilates can surely only help and the reformer pilates seems like something beneficial which I will actually enjoy. Time will tell 🙂

“Love what you do, Do what you love!”