Saturday, October 16, 2010

Achilles tendinitis (tendiopathy)

Damn. Two weeks sans running and one week without riding and my foot is doing no better. Looking at common running injuries in view of my symptoms leads me to believe that I've got Achilles tendiopathy. Two things that make a person highly susceptible to Achilles issues are limited ankle flexibility and weak calves. I'm the poster boy for limited ankle flexibility, and based on their size there is no way my calves can be very strong. Also, the heel pain I referenced in a prior post may be right where my Achilles connect to my calcaneus. (Who needs a doctor when I've got books and the internet? I say that only half joking.)

Still, there are two reasons I'm not sure this is an Achilles issue. First up is that the pain in my heel may be a bit below where the Achilles is joined. Second is that I also have dull pain along the top of my foot, though perhaps this could be the result of some other tendon carrying an extra burden to compensate for my malfunctioning Achilles.

My plan for the short term is to ice two or three times a day, start some heel drops (eccentric loading), wear my compression socks to promote blood flow to the Achilles, wear shoes all day (the goal is to raise my heel to take stress of the Achilles), get a massage and/or ART, and give things another week. [FYI: Here's the heel drop protocol.] I'm also going to buy some new cleats for my old trainer cycling shoes and perhaps move the cleats rearward, though I don't plan on riding for the next few days so this is somewhat a moot issue. If I'm not feeling better by next Friday, I'll visit a doctor.

I'm also considering some kinesio-tape and a Strassburg sock, although with so many injury prevention gimmicks on the market it's hard to discern what's actually effective and what's just snake oil. Kinesio-tape would be great if it stabilizes my Achilles enough that I can swim and ride without causing further aggravation.

Another concern I have is figuring out what can I do to stay active. At this point, I'd be fine without running for a month or two if I can still swim and ride. I need some form of physical activity every day! Yet right now even swimming aggravates my Achilles. Maybe I'll do a short swim today and will avoid kicking just to see how it goes.

Taking a bit of a longer outlook, as a former hockey player skate skiing has a strong appeal. If my Achilles issue persists, and if a skate ski boots prevent Achilles movement as I imagine they do, then I'll definitely get some skate skiis so I can get outside this winter. Maybe I will get back to weight lifting and focus on exercises that don't stress my Achilles. This could be an opportunity to focus on strength, flexibility, and all that other boring stuff that many folks say is important to staying injury free.

My biggest fear is that I'm going to be immobilized for months or longer. My second biggest fear is developing chronic Achilles tendiopathy and being constantly injured.

I'm looking forward to my races next summer so much that I'll be extremely disappointed if I can get this issue straightened out in time to be at least moderately fit come summer.

Sunday, October 10, 2010

No riding, no running

Injury Update
Well, my heel has been feeling slightly better, but the rest of my left ankle is pretty messed up. The tendons or ligaments on the top/outside of my left foot and the inside of my foot above my heel are tight and sore. I'm going to take a week off riding and another week off running. I think my morning trainer rides have been too hard too frequently, and that I've over-stressed my ankle by not allowing sufficient time for recovery. Better now than this coming spring... Hopefully swimming loosens everything up and aids recovery.

Great race yesterday. Ironman gets a lot of flack for being as exciting as watching paint dry, but if you're an informed viewer the race is very exciting. Even Stacey enjoyed watching the entire race and was even on the edge of our couch for the last hour of the race. The coverage was actually pretty good, too.

Once Raelert caught Macca at around mile 22 but failed to make a pass I put my money on Macca. Macca seems so stubborn, experienced, and shrewd that I'd take him over anyone else under those circumstances. It wasn't too surprising to see Macca make a move at an aid station, but it was amazing how quickly he dropped Raelert. Raelert must have expended everything he had just to catch Macca.

Preliminary 2011 race schedule:
June 26 -- Ironman Couer D'Alene (celebrating Stacey and my one year anniversary!)
July 10 -- Boulder Peak (haven't signed up yet; perhaps too soon after CdA)
July 17 (?) -- Centurion Cycling Boulder (my first bike-only race)
July 24 (?) -- Mount Evans Hill Climb (my second bike-only race)
August 7 -- Boulder 70.3
September 11 -- 70.3 World Championships (now in Vegas)

I could use another two or three spring or early summer events in the Denver area to fill out my schedule. I'll look for some trail runs and maybe a half-marathon in the spring. Suggestions appreciated.

Friday, October 8, 2010

Still Can't Run...

Heel Issue
After a week off from running, I headed out yesterday for a jog. My foot was feeling pretty good, though admittedly not perfect, and a few minutes into the run I knew it was time to head back. I ended up jogging for just 15 minutes. Despite the week off and the very short jog, I still had more pain than last week.

Without running, my "training" has consisted of a hard trainer ride every morning and then a swim some evenings. On weekends I manage one long-ish ride (circa 3:30). Now with the foot pain remaining I'm considering dropping the intensity and/or frequency of my trainer rides, even though my foot feel fine before, during, and after riding.

I've also started taking some Motrin to reduce any inflammation, icing my heel, and wearing a Zoot compression sock to bed at night. This little injury also has me considering scheduling a monthly massage, as perhaps that'd reduce the likelihood of injury in the future.

I'm not concerned with time off of running since my next event isn't for a long time, but I really enjoy running and want to get back to it.

Kona is tomorrow, as is the University of Michigan v. mid-rate state university football game. My plan is to sync a trainer ride with the IM world champs and put in a 4+ hour effort on the trainer with a fair amount of that at IM effort based on HR. I'll be flipping back and forth between the race and the football game on my computer.

Go Blue!

Next year
Finally, I'm starting to think about my race schedule for next year, and so far I'm definitely doing IM CdA in June and Boulder 70.3 in August. The big news in the world of Ironman is that the 70.3 world champs will be moving from Clearwater, Florida to Las Vegas next year. While I've never been to Vegas and honestly think the town sounds like the worst place on Earth, I'd be tempted to do the race if the bike course is sufficiently challenging that I'd break up drafting. We'll see...