Thursday, 27 March 2014

Running with a potentially serious injury...

As runners (and sports people in general) we all get niggles and pains and, although annoying, it is possible (with some changes to the training scheduled and intensity of runs) to continue training. It may mean taking a few days (possibly a week or two out) but on the whole there is little disruption to the wider picture. I've had my fair share of these, but there are occasions when injuries can just knock you out; stop you in your tracks; hurt your body; and basically fuck with your confidence. I've had these types of injuries before. Most notably with my right knee a couple of years' ago when I was out of action for 10 months with a knee injury. It was a horrible period that I never want to repeat. Nevertheless, although the current injury to my ankle is not as severe as the knee (when I tore my cartledge), the outcome of pain is the same.  

After seeing the doctor numerous times and having an x-ray, I was told I had posterior tibial tendonitis. At first glance some readers may say "well that's not too bad Mike; rest, recover and then get back running". However that is not the whole picture.

My 2014 running schedule only finishes in August. I have a number of key long distance races lined up, which I am trying desperately to train for. Taking time out to rest the tendon (2 -3 months) is not an option. I would miss the whole season. Although I'd be back running before the season ends, I won't be fit enough to run these long races. My doctor understood this when I told him, so he sent me to see a physio. So after almost a month of not running I saw the physio and she indicated that I could run; that it wouldn't make the problem worse; and that in the meantime she would help me strengthen my tendon. This was just the news I wanted to hear. I had been very depressed for almost (as my Facebook friends will testify!), and so to get the news that I could now run was a huge relief.

No sooner had I left the room than I went out for a short 10km run. It felt good to be running - however the Silverstone Half Marathon (my first race of the season) was only 2 days away, and there was no way I was fit enough to run that. I could easily run the distance, but my time would be slow, and I figured it was too far to travel just to plod around the track. I was gutted but needed to think of the bigger picture this year - the marathons and ultramarathons. I did a couple of more tester runs and the foot felt fine. Yes, I can feel the pain when not running - but when I am running, and as long as my foot is stable and relatively flat on the floor, then I can run.

The "Hills & Cleres" - 20k hilly route
The following week I gave it a real test. On the Friday evening I ran a hilly 20k; this was followed on the Saturday morning with another hilly 20k (same route); and then on the Sunday morning a mixed elevated 17.5k. Although my general fitness left something to be desired, the tendon seemed to hold up fine and I didn't suffer any after-effects. I must stress once again that I am running on an injury, but managing it the best I can. 

The "Hills and Cleres" is a slow route due to the number of long (but gentle) hills. At one point you are running up hill for approximately 6k. Not great if you are suffering from a small injury to an Achilles tendon (which is what I am, on my left foot. Despite this, I really enjoy this route - especially when running it at night.

Wash Common - Thatcham Loop
The 17.5k run described above is a nice loop between Wash Common (Newbury) to Thatcham and back (via Greenham Common and the Kennet Canal). A fairly pleasant run. My tendon felt fine, and I had some fun running through knee-deep water along the canal due to the flooding. The water was freezing and it certainly woke me up that Sunday morning! The run up Andover Hill at the end wasn't as bad as I thought it would be...
Wash Common - Thatcham Loop Elevation

So having demonstrated to myself that I can still run, I revisited the physio to give her the good news. However, after I explained what I'd done and how I felt, she then hit me with some bad news - news I really did not want to hear!

It seems that when I left her office the first time, she then spoke to a consultant in London who advised that I did not run until I'd had an MRI scan. There is a risk that by running I could rupture the tendon. When asked what this meant, she simply told me: you won't be able to move you ankle or walk; will need an immediate operation; this will then be followed by 10 months of intensive physio, whereby I won't be able to put any weight on the foot for at least 2 months, meaning no driving or going to work. This thought scared me! It also shocked me and I became instantly depressed again! In theory the MRI scan would determine if I'd compromised the structured of the tendon. If yes, then I need to take time off from running or risk a rupture; if no, then I could continue as is. Suffice it to say I was totally depressed when I left her office.

I cannot afford an MRI scan privately, and even if the doctor were to refer me, there is no guarantee I'd get one on the NHS and, even if I did, there would be a 4 month waiting list (which would wipe my season out should it come back in the all clear). So now I had a decision to make - and a bloody big one!!!

I'm one stubborn fucker, and I've come too far and trained too hard, and come through a number of shit obstacles this year not to run the Manchester Marathon. I therefore made the decision to try and get an MRI on the NHS and in the meantime to listen to my body but continue training (all be it reduced training). As soon as the tendon feels sore I will stop training. If I am racing, then I will stop as soon as I feel a twinge. I know every step I take is a risk....but my running season this year finishes in August (which is not long away). The longer races (ultra-marathons) and races off-road are going to be more tricky, as they punish the feet and ankles. However I've decided to take one race at a time, whilst also realising that my training will be curtailed (i.e., won't be able to put in as many miles as I should).

Let the risk taking begin..... wish me luck, as I'm going to need it!

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