Thursday, October 28, 2010

You spoke, I listened. Here is what I have to say.

l wrote a blog post this week about my thoughts on pain and pain management.  As runners we have to know when to keep pushing and when to back off.  The difference between "injury" and "hurt" can be big, and learning to tell the difference is important.  Stopping in time may mean avoiding debilitating damage and a long layoff.  Stopping to soon may mean losing out on how strong mentally and physically you have become.  To paraphrase "Know when to say whoa."

The comment below is a response I received via the Daily Mile.  

I have mixed feelings about this note and another one you posted not so long ago, which was also about hurting and injuries. I no longer agree with the idea that one should run through pain just be tough. I am going to say that if you suspect that you may have a real injury, you should certainly not be running. My goal is to run for life, and I will be very careful not to hurt myself again, just because I thought I was tough enough to run through pain.

The commenter has had his own issues with injury this fall and is doing his best to deal with the situation.  His words knocked me back a bit.  I wondered if I were pushing bad advice.  I wondered if I was enabling injured runners to create worse situations.  After rereading his response I decided to craft my own reply.  Directly to the commenter.  As a friend.  Here is what I wrote:

I think I did qualify some of my statements in the post. If "it" is broken or torn seek the treatment you need. But with two years of running I am learning much about myself and how I need to move to be as free of injury as possible. I don't claim to be bullet proof and cannot claim to eliminate all chance of injury, though I believe I can reverse the course of some injury before the damage sets in.
This is the power and beauty of form development and correction through Chi Running. It is why I recommend Chi Running to anyone that will listen, and to many that should listen.
I too wasted time to injury. I trained for four months to see if I could run the distance. I did and it hurt. Then I began to study form and running efficiency and committed to running smarter. Then one week prior to my first official marathon I felt 'it'. A tweak in my ankle. Nothing at first; just something that was not "right".
As the week progressed I ran less and with more pain. Stubbornly I dragged my family (wife, 2 kids, and my parents) from Myrtle Beach to northwest Georgia to the race. I could barely walk. Then like a moron I decided to shoot baskets with my high school aged cousins. Needless to say, I was done ten miles in the race. One year wasted.
I quit to prevent further damage. The bike medic that called for my ride out said I was smart. His wife ran through an Achilles strain that resulted in a full tear and a year off. I freaked out.
Then weather cancelled the Myrtle Beach Marathon in February. Not an injury issue, but more time wasted.
But what I learned in the wake of the ankle injury and the marathon DNF was invaluable. I returned to Chi Running. I searched for answers. I wanted to know if there was some nugget I missed in the previous six months.
I also began to doubt switching to Vibrams Five Fingers. I loved them and loved the concept but wondered if I were right for them.
I then saw a general practitioner to get a ortho referral. Another waste of time. The ortho was a joke too. Rubbed my ankle. Looked at me standing. But did not want to see me run. Or walk. Or hear my story and how I came to be sitting in his office. He said "you run too much, you don't cross-train (but he didn't ask if...) and you are too old (at 36?)
Prior to the ortho appointment I scoured the Internet. I found sketches of the foot and ankle to see what my problem specifically might be. I located the focus of the pain. I could see the swollen tissue. It was most likely the tarsal tendon, similar to the carpal tunnel in the wrist. But it was swollen and huge. However the ortho said Achilles and that ended the discussion.
Prior to the appointment I also poured through the Chi Running book and website looking for missed technique. I discovered a diagram of leg/foot turnover on the website that told me what I needed to know. I was running off my heel. While I needed to reduce heel strike, I had gone too far in the other direction by running too high on my toes. By running too hard and far with improper form I caused the pain. Now I needed to know if the damage was permanent.
My strength test was a one-legged heel raise. I could do it unsupported with my left foot. The heel could clear the floor and I could stand on my ball with no problem. But my right heel would not lift at all. No strength. All pain.
I hit the neighborhood gym for 5 mile bike rides and light weight training. I would walk (limp) around the neighborhood to keep moving. But I tried to use the form tweak I discovered to slowly get back to running.
And within the few weeks that I learned the missed form point and seeing the ortho
Then in early January I spent a few hours with a certified Chi Running instructor. She reviewed my form and gave me a few other techniques not found in the book. What I did not tell her was how much pain I was in that morning. I was a month from the Myrtle Beach Marathon and feared missing it.
Two weeks later I ran a local 10k to shake things out. I finished under 50 minutes and was pleased with my steady pace. The ortho had said the marathon would be iffy, only if I committed to his plan and advice. But when he would not listen to me I chose not to listen to him.
Anyway, snow caused the marathon to be cancelled. But I witness hundreds of people running the streets that afternoon with bibs pinned on. So Sunday morning I did the same and ran the course. It was cold and windy and difficult but I did it. And the ankle was not a problem. I did develop pretty bad pain in my left knee, from constantly turning to look over my right shoulder for traffic. I stayed on the right sidewalk and had to stay vigilant as I approached parking lots and intersections. The constant torquing really screwed my knee, making the final two miles the most painful thing I have ever done.
Afterward I reviewed the run. I recognized where the pain came from and promised to correct it on the road. I took a few days off then hit the road. Straight ahead. Legs, arms, head and torso aligned properly. Over the next two weeks the pain in my knee lessened and came later in the run. The first day it showed up in Mile Two. After a few weeks it waited till Mile Ten. Then it never came back.
If a runner is earnest in learning proper form and commits to developing that form many injuries can be corrected on the run. That is my experience. Is this good advice for all runners. Probably not. I will concede that point and thanks for pointing it out. But I will also point out that some runners look for any excuse to get off the road. They blame shoes and weather and running surface and anything else imaginable.
I learned that my injuries came from within. Poor form led to poor performance. My current calf injury came from a cool morning with inadequate warm-up. But maintaining my form carried me to two consecutive great performances. And I believe it is why I can run with less pain that I have when walking.
Could your shin splints been avoided. I say yes. Could the subsequent stress fractures been avoided. Again I say yes. Please don't interpret these statements as an attack. I don't know how you run and will not diagnose your condition other than to say you need to "see" how you run when you return.
Have someone photograph your stride. My camera has a burst function where the camera shoots constant shots with the shutter button held down. Family pictures from Sunday revealed some heel striking that I have to work on.
I will close be saying the fixing the form will fix the condition more often that not. I hope you heal soon and fast. I hope you can make up for lost time. I also concede that most people will think it through as carefully as I have.
If you think I am full of shit or a menace to runner tell me. I will have a good laugh, problem agree with you to a point then cheer you on even harder in your recovery.
And I want to thank you for speaking up. I write as a form of self-expression. I want to share. If what I have experienced helps another runner avoid my mistakes then I have not wasted my time. Thanks for reminding me to think of the person that may not be like me, committed like me, or as beautiful as me (did I type that?).
Good luck and no worries. And keep your chin up.
I posted this entry at Stephen's request.  I welcome his candor and ability to deal as a grown-up.  There's a lot of childish behavior on the Internet.

Can't grow if we can't listen. Everyone has something to learn and something to teach. I can't wait to read your responses.

The UnaRunner


  1. Good points Logan. I think, at the end of the day this is a very case by case situaton. I agree with you (and am training myself) to learn to push through the pain OF the run....tired lungs, burning muscles, a brain that won't shut up and keeps screaming at me to STOP! I also agree that proper form will help prevent injuries. However, even with PERFECT form the human body is still suceptable to injury. Individuals have varying recovery times, heck, even varying calcium levels that could mean the difference between strong bones and stress fractures. One needs to be able to differentiate between the immediate pain of "the run" and the beginning stages of a possible over-use injuries. This is why a proper training regimine is also very important. Bill Bowerman's hard/easy principle for example.

    I know many people who have run through what they thought was just a slight nagging foot pain, shin pain, etc only to find out they had a run a tiny stress fracture into an even more serious injury. Had they listened to the pain and not pushed through it they may have only sat out a few weeks and not a few months.

    I like to talk a lot. LOL. Sorry for the long comment.

  2. No worries on the length. You should be there when someone askes if my VFFs are "comfortable". Oh wait. Maybe you have been.

    As for form tweaks nothing is permanent. We have to be vigilant and look out for and deviations. And not be so weak. lol