Ankle saga

In the latest twist with the ankle (haha)– I’ve had a serious allergic reaction to the topical NSAID that was prescribed (Pennsaid).  The odd thing is that it took about a week of application before it blew up.  It first popped up a the beach, so maybe the sun exposure + Pennsaid triggered it, or maybe it was just the amount of medicine applied over time.  Either way, it’s the worst itch I’ve ever had.  😦

It also happened right before I flew to the UK, and I was unable to find any hydrocortisone there (prescription only in the UK, apparently).  All I could do is buy some anti-septic cream, which didn’t seem to do anything, and soak it in epsom salt in the hotel tub.

When I got back the states, I tried hydrocortisone for the weekend, but I went to see my regular doctor on Monday, who prescribed a topical steroid.   In the 16 hours and 3 applications of that since yesterday, it’s not started kicking in yet!  Here’s a photo for those of you that like such things.  It’s not clear how much inflammation is from the allergic reaction and how much remains from the injury.

I have run 20 minutes 4 or 5 times now, and that all feels fine.   But I certainly feel like I’m hindered by the current state of the foot.  😦

 

 

 

Ankle update

Saw the Doctor this morning for my 20 day follow-up.   Lot’s to digest so let me just bullet point it:
  • I was worried yesterday about the base of the 5th metatarsal, so that’s where he started.  It was sore and in general the middle of the foot felt tight and inflamed.  And the base of the metatarsal was sore to pressure.  PT’s resonance test on it was fine, so it was unlikely to be a stress fracture, but I wanted the doc to check it out.  He immediately ruled out stress fracture there, and just called it tarsometatarsal joint inflammation.
  • Main cause of that is not wearing the boot long enough, but worse (in his mind), I was wearing my Luna sandals.  And that’s mostly what I’ve worn the past week or more, other than when on the bike trainer and I’ve put on my bike shoes (not clipless, just platform shoes).  That includes all the walking around Carowinds on Friday, Saturday soccer game and errands, etc.  I did have the brace on for the most part until Sunday afternoon when I stopped wearing it.   And I walked barefoot around the house and on the treadmill when not in Luna’s.  He just pointed out that with barefoot or sandals, the load on the tarsals is much higher, and right now, the foot needs less stress, not more.  So he wants me in a shoe for a while.   I’ve got on my bike shoe right now which is pretty stiff and shouldn’t allow much movement.
  • There is still lots of soreness all over – peroneal tendon, peroneal muscle, ATFL, calcaneousfibular ligament, anterior tibialis, etc.  Some of those are likely due to lack of shoe per above above but some of course due to the original injury.
  • He said if it’s really sore, wear the boot.  (It’s not really sore, in my mind.)  He said the brace is really just for aversion and wouldn’t help much with where I am right now.
  • He mostly wants to see inflammation go down and recommends topical and oral NSAIDs, elevation, massage, maybe a bit of ice.
  • He wrote a prescription for Rayos, a delayed release prednisone, that he said I could take at night, to combat the body’s inflammation.  I’m a bit torn, as I really don’t like taking things like steroids or NSAIDs unless I really have to.  I would take this at night, and the delayed release means it limits the body’s inflammation response which is greatest while sleeping.  I’ll have a think on this and read up on it before making a decision.
  • (I have been doing the topical NSAID 2x per day, but have limited oral NSAIDs unless it’s really bothersome.  I have been taking minerva and using collagen in a shake to try to help with inflammation and speed up natural recovery.)
  • He didn’t say anything about when I could run, just listen to your body, and when there’s no pain, then I can do whatever.  As there’s some pain / discomfort now, I’m certain he was implying don’t run yet, and don’t walk too much yet!  At least not without a more supportive shoe.
  • He did say cycling was fine as long as it doesn’t cause additional pain/discomfort.  I rode 85 miles last week and only feel that’s been a good thing, albeit starting to get boring.  (I’ve only ridden on the trainer, not outside!)
I’m still not too concerned with no running since I have no races until late August.  But even then, I am in this for the long game and want to be running when I’m 70+.  So making sure this heals properly now is key.  I’m most concerned with the possibility of having chronic ankle sprains going forward.  In all my many years of trail and off-trail running, while my ankles have rolled many times, they have never sprained!  So ensuring strength and mobility in all the tendons, ligaments, and muscles, is most key to me right now.
Here are some photos over time:
Day 2:
IMG_0761
Day 3:
IMG_0765Day 7:IMG_0770
Day 13IMG_0783

Right ankle inversion

I busted up my ankle pretty good on Wednesday May 3rd while scrimmaging with the U13 team I help coach.  I made a beautiful spin move — as I was running across the field towards the right side line, I stopped the ball with my R foot and rolled it 180 degrees back towards the center.  As I reversed direction to go to where the ball was, my R leg got stuck under R2’s R leg, which had just firmly planted at full speed where he thought the ball was going to be.  My full weight at full speed was going the opposite direction, my R ankle was fully planted, and so the ankle inverted.  I heard a snap, but the kids said they did not, so maybe it was one of those “psychological sounds.”

Instantly the R ankle looked like baseball.  Two of the kids had to carry me off the field.  (It was one of the rare times when I was the only adult out there!)  I had to call in other parents to come get me, and they immediately stepped up to get kids where they needed to be, get me to the ER Ortho, etc.

I did feel a bit rushed by the Ortho team.  We arrived at 7:15, they typically close at 7:30, and they had me out the door by 7:45.   The diagnosis was not 100% definitive, but it was “likely not a break” based on the x-ray.  But based on the physical exam, the doc wasn’t 100% sure.  They put me in a boot and set a follow up for 3 weeks later.

Pic on R is night of, L is next morning.

Here’s the pretty colors on Saturday night, 3 days later…

I wasn’t happy with the 3 week follow up, so moved it up to 6 days on Tuesday.  On Monday I had mostly ditched the boot and just wrapped it with either an ace bandage and/or a compression brace.  I also spun on the trainer for 15 minutes which felt really good — I had a lot more mobility after that.

Then I saw the doctor on Tuesday a.m., six days after the initial injury, and here’s what I wrote to my coach:

First, he said he was surprised I wasn’t casted when I came in after the injury, he would have put me in a cast for two weeks immediately and then done a re-eval. Today’s diagnosis is a R ankle inversion sprain / severe sprain of the calcaneo fibular ligament. Likely tore perineal retinaculum and other tissue.

Second, he said I was a week or two ahead of where he’d like me — see #1 above. He’d prefer me still in the boot for another week, but did give me an ankle brace with a lot more lateral support than what I’ve been wearing (compression brace and/or ace bandage). He feels like any lateral movement is going to continue to strain the ligament as well as the perineal muscle. He was able to get a lot of movement in the ankle that shouldn’t be there — i.e. the torn ligament is allowing much too much movement and his concern is that long term if I don’t let it heal properly, it’s like to sprain again and again. I’ve sprained my ankles twice in my life, both in soccer and once almost 30 years ago, even with all the trail running and off trail running (orienteering, rogaining, adventure racing).

Can start PT immediately (appt Thursday already scheduled) with non-weight bearing and advance as tolerated. I could tell he wasn’t 100% sold on me spinning on the trainer already, but said as long as there’s no lateral or fwd/bkwd movement of the ankle, it shouldn’t be an issue. I think since it helped mobility so much yesterday it’s a no brainer to at least continue doing it lightly!

Both oral and local anti-inflammatories prescribed. Massage from toes to above ankle a couple of times a day to help inflammation subside.

So there you go… I’ll start PT in a couple days.  I’ll spin on the trainer as long as it doesn’t cause any discomfort and seems beneficial.  And hopefully I’ll be back soon, and stronger than ever!  🙂Lateral-Ankle-Sprain.png

2017 MST 50k

Last year was my 1st time running this race, and I really didn’t like the course — not enough big hills to power hike!  I.e. I thought it was too runnable.  But this year I knew what was in store and mentally I did not get down as much, grinding out a lot more running than I’m used to.

My goals going in were to break 5 hours, crack the top 10, and finish before Kelly and Heather could finish the 12 miler (which started an hour later), shuttle back to the car, and drive to my finish.  Of course, beating last year’s time would have been nice, but I knew this year would be much hotter by the end.  I checked and last year my Garmin showed 60F at the finish and this year it was 77F.  That’s Garmin temp and not actual outdoor temp, but I think it isn’t that far off.  Maybe 72 or 73F this year the last hour.

I won’t write a lot…  There’s not much to say.  I jumped out with the top 10-15 runners… I was surprised there were 4 ladies in front of me, but they seemed solid.  After a while I decided to slow down — I definitely prefer to run by myself and not in a group where I got sucked into their speeds vs. my own.

I ran comfortably, and was a bit surprised at my GPS pace — it was a slower than I had hoped.  But I knew if I sped up, it would be a difficult second half, so I just stayed within myself.  I had two hopes:  1) that my GPS was tracking short and 2) there would be carnage up ahead.  🙂  I don’t know this course that well so I wasn’t sure on the GPS, and even at the turn, I couldn’t recall if it was was exactly at the half way point, so I really didn’t know if my GPS pace was right.

At some point on the 1st half I passed three of the four ladies, but didn’t pass anyone else the rest of the 1st half.  I hit the turn and didn’t ask for an update on placing.   After the lollipop it was a bit crowded for a while with both 12 milers and 50k runners still coming in to the turn.  I saw Kelly and a few minutes later saw Heather, and she told me I was in 12th and that there were several “catchable” runners in front.  That was good motivation, but I opted not to run any harder, just to stay strong and steady.  I eventually passed four more runners to move into 8th overall.

I don’t like the look at miles 25 – 31 on the race analysis, but then if you look at the GPS track it definitely started misfiring as it had me in the water, missing the bridge, etc.  And the race stats show I slowed down some on the return, but not to terribly much.  About 7 minutes whereas most others in the top 10 dropped 20 or more minutes.  I guess the heat did get to most everyone.

Food was 3 or 4 vFuels and 3 coconut date rolls.  Other than that I just topped off on water at the aid stations.   I used MAPs the entire race and a few Endurolytes in the 2nd half.

In hindsight, the “C race” marathon 3 weeks prior, in which I ran within 90 seconds of an all time marathon PR, was not quite C race enough.  Recovery from that was hampered by a bit of a L cuboid issue, and the runs I did have all felt sluggish until the final few days before the 50k.  But I’ll take the BQ and the top 10 finish at MST.

I think I’ve come to terms with two things:

  1. Even though I have the Bryce 100 DNF monkey on my back, I am just not feeling the call to go back this year.  I’ve certainly thought I would do that all year, but wanted to hold off on registering until after the 50k.  But right now, the call is not strong enough… And you can’t run a 100 unless there’s a strong call.  At least I can’t.
  2. I seem to much better suited to the 50k-50 mile distance vs. the 100s, at least at this point in my running carrier.  I would probably do well at 100k, too.  The 24 hour times races I’ve run have often been quite strong into the 60’s and even 70’s, but beyond that, I’ve slowed and struggled.  I’ve been consistently running since 2009/2010, after several years post knee surgery where it was quite difficult to run more than 30 minutes a couple times a week.  But that consistency has been a slow progression from 15-20 mpw, to last year’s 32 mpw.  That’s not nearly enough to “run” 100’s well.  I’m not sure what the future holds for 100’s, but at least for right now I want to work on being more consistent with 40-50 mpw weeks and see how that treats me.   As a person with a history of niggles that slow me down quite often, it may be difficult, but I think it’s the right thing to do.

(The strava chart here shows mileage over time, and I do think that some runs in 2013 are missing — that long flat line in April and May can’t be right as I was training for Leadvillle.  I think the migration of runs from DailyMile and Garmin just didn’t take fully!  But either way I know the distance reached that year was certainly not at 2016 or 2015 levels!)

2017 ATT Marathon

I added the ATT Marathon to my race calendar pretty late – about a month before the race itself.  I added it as a “training race” (or a ‘C’ race) to prepare for the MST 50k three weeks out.  I’ve been mostly doing single track hilly/mountainous ultras for a while and feel like I’ve lost some speed at a more road like run, and figured I’d be doing a long training run that weekend anyway, so why not?

I met Sarah and David at Lowes in PBO at 5:30, and Sarah’s husband drove us over.   The race states to arrive by 5:30 even if you have a parking pass to guarantee a spot, but we arrived closer to 6.  There were still no issues parking.   It was a bit chilly (42F?) but I opted to leave the vest behind and just run with arm warmers, gloves, and a 200 weight icebreaker tee.  I also had a buff over my ears.  While it was a bit chilly walking to the start and checking in my post race bag, once in the starting corral it wasn’t bad — lots of heat with all the bodies!

My plan was to run out with Mark Manz who was to lead the 3:40 pace group for a mile or two or three, and then speed up and shoot for roughly an 8:00/mile pace avg.   But I didn’t see Mark there so I thought I’d jump in with the 3:35 group.  David was up ahead in the 3:30 group.  About 2 miles in, the 3:35 group was only 10s behind the 3:30 group, so I felt like the pacing was off.  I had come up on David and ran with him for a few.  Once we turned on to the ATT, it’s a slight downhill, and I knew it was time to pick it up.  I passed the 3:35 group and quickly decided to pass the 3:30 group too — I didn’t like being behind a group.

So then I was in no man’s land… I watched the 3:25 group up ahead, but didn’t really close the gap much at all.  Looking at my watch, I figured they were more in the 3:22-3:23 range and was content to just run my race.  There’s not a lot to write about for the middle portion of the race.  It’s like a T, so you go north and turn around, then south and turn around, and then back to the “trunk” of the T and back to the start/finish.  The two turn arounds let me see the various pace groups and other runners a couple times.

I held steady until the south turn around and was really feeling good.  But I recalled from the 2014 race that I imploded from mile 23-25 or so, with the every so slight 1-2% grade really wearing me down.  This time I thought if I could just get over that climb averaging under 8:00 for each of those miles, I’d be pretty happy.  I ended up doing 7:40 or so and it didn’t feel hard at all.

At that point I really picked it up a notch, and finally felt like I was working.  But with just a couple miles to go, now was the time, C race or not.  I knew I’d be under 3:20, and thought briefly I could even go for a PR (3:17).  But alas I had waited too long to have a shot at that!   I finished very strong in 3:18:44 on my watch and had a BQ by 6+ minutes.  I was very pleased with that!

Here’s the pace chart…  So much for 3:40 (8:25) to start!  But it never felt hard.

And the splits for the markers on the course…  Love the negative split and passing 40 runners in the last 10k!

Strava race analysis:

And final results:

Post race photos:

(David ran a 3:31 and was 2nd in the 60-64 age group!)

I’ll update here if I get any other photos from the race photographer…

 

 

Barcelona Day 4:  Montserrat (and back to reality)

Kelly and I got up early and took the subway to the Montserrat train, which was about an hour out of the city.  We had a bit of confusion on the “combined” ticket we had purchased back in town and which stop to get off, and what kind of ride we’d get up the last bit, but we eventually made our way up and down.  I would like to be on top of the mountain when there are less people, as it was a bit crowded, but it was still beautiful.  When we eventually made it back to town, I had to quickly rush off to the conference I’m here for!  Kelly flies home in the morning while I need to stay in town and work a couple of days.

Barcelona Day 3:  Old City Gothic and Gaudi

On the recommendation of my co-worker Larry, we booked a private tour through Runner Bean Tours.  We ended up with the same tour guide he and his family had, Jessi, an ex-pat from Australia.  She was fantastic and gave us a tremendous amount of history as we toured the old city concentrating on the Gothic the 1st half, and Gaudi the 2nd.  Later in the day we were also able to meet our niece Jessi to hangout for a bit as well as have dinner.  She’s in Bracelona this summer on a study-abroad opportunity.