Wednesday, June 30, 2010

2010 Shore Run 5K

Ever since the 2009 Shore Run 5K, when the plantar fasciitis spiked my left heel at the Lake Washington Boulevard/McGilvra Boulevard intersection, I have been on a long road back to race fitness. Having to walk and limp the last two miles to the finish line, in my own neighborhood, was not only humiliating, because this has been my home course for over forty years, but also discouraging because the daily heel pain didn't seem to be getting better. Already covered in my 9/11/09 post, the injury was diagnosed, treated and has been in pretty good shape for the past year. It was a drag going through the drill of getting back on the road, getting my rhythm back, being able to breath normally while on the move, getting past the "heavy leg" point and losing the few extra pounds I had acquired. On the day of April 30, 2010 another gear kicked in and finally I had reached another level of strength and suddenly I was back to my dream world of Willie Boy closing on the former Olympic champion with the crowd willing me forward and into the lead.

The whole time during my comeback I was shooting for the next Shore Run 5K on June 13, 2010 that runs from the Leschi boat basin on Lake Washington to Madison Park, two blocks from my home. The route is one that I have run for years and while being mostly flat still has a substantial hill after the first mile that runs about a quarter of a mile. During my training I had gotten in the habit of pushing the pace on the hill and after awhile the hill became less of a challenge; still a butt-kicking hill but not as daunting.

Then on Monday May 10th after having upped my weekly mileage over the previous three weeks to 17, 18 and 18 miles I set off confidently and rolled my left ankle after having only run a block. I felt like I had been hit from behind and in a flash I thought of having gotten back on the road again, the Shore Run in a month, the work I had put in during my comeback and wondering if  I could manage the pain that was ready to hit the next time my left foot touched the ground. I muttered an oath and continued across 41st Avenue East favoring my left foot as I headed up Garfield Street. It hurt but after a few strides I knew I could manage the pain. On the high/low ankle sprain chart this was a #2 roll. For the next six miles I gutted it out with the pain receding somewhat but always there on every other foot plant.
When I got back home I broke out the family ice bag that is always stored in the freezer for exactly this kind of emergency. After fifteen minutes of icing the outside of my ankle and fifteen minutes on the inside I was gimping around the house OK. Then I downed a couple of aspirin, took a warm shower and was feeling even better because I could tell the injury wasn't going to keep me off the road. That night I wore my handy ankle brace which I had worn religiously during my plantar fasciitis treatment and with an extra pillow supporting my ankle I slept fine. The next day it was black and blue and sore but I put in five tender miles with an uneventful seven on Friday. It still hurt but I was back on the road for the Shore Run.

Because my ankles are skinny (I can encircle them with one hand) I have had a history of spraining them that dates back to playing basketball with my brother Terry when we were kids. Back then a sprained ankle would set me back a couple of hours as it loosened up with our daily running around the neighborhood. Then over the years, as long as I was wearing my high-top Converse All Stars I never seemed to have any problems until I hit the court wearing a pair of my hot new running shoes. (With low tops and no ankle support.) I think I wore them partly to show off the cool looking Adidas or Pumas I had just spent a whopping $30 on along with feeling like the new shoes made me faster and able to jump higher. Whether that was true or not whatever I gained in coolness and perceived athletic benefits I lost in support for my spindly ankles.

I can remember specific ankle spraining occurrences with a cringing grimace:  driving home one night using only my left foot, my right foot blown out in a meaningless park league basketball game; having to walk home to the top of Queen Anne Hill after popping an ankle while running near Gasworks Park; getting lucky and hitch-hiking with a neighbor after biting the dust under the I-90 floating bridge three and a half miles from home; landing on my face in front of the Seattle Tennis Club while running on a perfectly flat sidewalk; and finally tripping on a curb and sliding elbows first in a driveway on E. McGilvra Boulevard.

One thing I've noticed when an ankle sprain falls into the "blowout" stage is that besides the outside tissue, ligaments, muscles and cartilage being negatively impacted the inside of the foot above the arch and below the ankle bone (I don't know what it's called) is jammed together in a compression sort of injury also. As in, the force of the leg bone jamming into the foot does something to the bones that hurts just as much as the outside damage and takes as long to heal. You find that when you stride forward with your heel landing on the running surface your foot rolls forward over your arch with your big toe landing next to be followed by a cascading effect running down your remaining toes. When that compression injury is still healing I have found that as soon as the big toe connects with the running surface stress is transferred back to the sore area above the arch and you tend to favor your foot by running more on the side of your foot to avoid the stress transferred back by the big toe. Got all that? Doesn't matter because anyone who has ever blown out their ankle knows what I am talking about and probably had an unconscious shiver of recognition in my description.

Somewhere along the line, probably after reading an article referencing: SPRAIN, ankle, in Northwest Runner, Runner's World or Running Times, I decided I had to do something about my predilection for for this injury that is a bane to all serious runners. It's not that it's chronic or that I end up in the hospital getting "scoped" or that it's stopping me from running but it just seemed like the issue was something I could deal with and possibly stop from ever happening again. I started cutting out articles and over time integrated my own personal daily regimen for preventing my sprained ankles.

My solution is a series of foot and ankle manipulations and massages that I do every evening before going to bed and every morning before I hit the floor as I sit on the side of the bed. Bending my right knee I take the front of my right foot in my hands and, without resting it on my left knee, I push into my right heel pad with my right thumb and rub back and forth. (The reason I don't rest my right foot on my left knee is that after I had originally started this regimen the outside of my right ankle developed a tenderness that never went away. After figuring out what was causing the problem I didn't see any reason why I had to rest my foot on my knee so I just adapted the method and it has worked fine.) After rubbing the heel for about twenty seconds I work my way up my foot to the arch for another twenty seconds and then continue to the ball of my foot making sure I rub hard enough to feel the bones underneath. Then I take my right foot in my right and rub down the outside of my foot with my left hand and work down the tissue until I reach my heel again. Keeping that same grip, I then rotate my foot in a clockwise motion ten times in an exaggerated slow rotation. When I started this motion years ago I noticed both of my feet would jerk as I rotated them and I remembered reading something about "muscle memory". As I recalled that is where during the rehab you have to "teach" the affected area to work again in it's proper motion. Over time this rotation smoothed out along with the muscles, tendons and cartilage becoming stronger and the joint smoother operating. Then I would finish up by squeezing my achilles tendon between my thumb and forefinger and work my way up my calf and press both thumbs into the muscle and rub up and down and then finish up with a massage back down my calf and achilles. This also had me a little more ready to go in the morning instead of gimping around on my sixty-three year old feet.

So there I was the Sunday morning of June 13th jogging around the Leschi boat basin getting warmed up for the 33rd Annual Shore Run. Since the sprained left ankle of May 10th my training had been going well with my weekly mileage increasing to a max of 18 miles and the intensity increasing along with my dedicated push up the lake hill on every run. I had always looked at hills as a necessary evil during a run or a race but after reading Roy Wallack's terrific niche book Run for Life recently I have been following his advice to use hills as an anaerobic opportunity for your training instead of having to run on a track. The sun was out and with a few clouds it was a perfect day for a race. Since we head north along the lake the sun is behind us, a comfortable hint to a pleasant day.

 Around 8:10 I finished my stretching and jogging and headed for the starting line for the 8:15 gun. As I jogged down the sidewalk bordering the marina area I moved over for a mother and her stroller. Suddenly I was face down on the grass with a stabbing pain exploding in my right ankle. I had rolled my foot over the edge of the sidewalk where it meets the grass! I couldn't help but utter a four-lettered oath as I clutched my right foot in my hands. Someone near me said, "Jeez did you break your ankle?" The work that I had done the past year to come back from the plantar fasciitis; being able to run in the race and getting off my butt were all images that flashed through my mind. Damn maybe if I could get up and start jogging I could shake it off like I did the sprained left ankle from a month ago. I forced myself to my feet and tried to jog down the sidewalk but it hurt too much and I had to stop. I continued to walk toward the Blue Water Bistro Restaurant but the pain was unrelenting. Then the announcer informed the runners that there was two minutes until the start. Trying not to look like a weenie, I limped toward the starting area just in time to see my friend Steve Wood and his daughter Ellie who greeted me cheerfully and said, "Hi Will are you ready to go?" I grimaced and said something like, "Yah, except I just blew my ankle out." They both looked shocked, glanced down at my feet and immediately left me behind as the gun sounded.

I limped forward and the pain continued to stab into my ankle but I pushed forward trying to convince myself that I could run through the pain. At the entrance to the north Leschi marina parking lot I had to stop and I stepped up onto the sidewalk and began to walk. As I limped forward I realized that if I continued at this pace I wouldn't be home for an hour and that Gwynne and Charlotte, who were waiting for me at the finish line, would probably be ready to send out for the cavalry. I have never in my life not finished a race, they knew it too and would be concerned. With the course closed off to vehicles there would be no way for them to track me down. Gritting my teeth I stepped forward and against all normal reactions I limped forward. Damn it hurt but I knew I had to get home anyway so I forced myself forward, it hurt when I walked so why not try to jog and get home sooner?

The good news is that I continued down Lake Washington Boulevard, the bad new is that every-other step pierced my foot and ankle with pain. Finally I reached the lake hill, my increased fitness keeping my breathing under control but doing nothing for my injured ankle. As I gutted it out the pain became something I was familiar with and not the shocking jolt I had received on the sidewalk. I had reached a rhythm that was inefficient and painful but it kept me moving forward. The rest of the race was an unpleasant blur, my only thoughts were of being able to stop, going home and propping my foot up covered by the family ice bag.

The quick ending to this story is that I was greeted with shock and sympathy by Gwynne and Charlotte, I hobbled the two blocks home, iced my foot and ankle, took a couple of aspirin and a warm shower and drank four beers later that evening. My time was 24:28 for the 5K which far slower than the 21:58 I ran in 2008, but faster then my plantar fasciitis run and walk of 26:30 last year in 2009. Yah look at the bright side, obviously it's faster to limp a 5k than to walk and limp it.

So as of today my running log, which has been my walking/'running log for the past couple of weeks, shows that I took the Monday off after the Shore Run then walked around the neighborhood every day for about a week then gradually inserted longer and longer jogs into the mix. Today in mild/overcast weather my right ankle was still tender but I ran down to the infamous Leschi marina (while cringing at the sidewalk area where I fell)  at an "OK" pace and pushed on the hills. Prior to my five mile run I walked a 1/2 a mile to get the ankle loosened up.

So once again all is right in the world; another treatable injury is healing, I am back on the road, the wind is in my face, the water is lapping at the shore, my breathing has smoothed out and Willie Boy is making his charge over the last mile for the lead.

Monday, June 14, 2010

High/Low Ankle Sprain

Have you noticed how so-called "experts" try to give themselves credibility by changing traditional terms? They think if they say "velocity" instead of "speed" to describe how fast a baseball pitcher throws that somehow they have said something earthshaking or unique, something that a regular person or a layman could never think up. As if a basketball announcer throwing out the word "length" describes a player's attributes better than just saying he has long arms, as two fans would say to each other as they watched a game. And wouldn't you think an announcer who has been calling games for over thirty years would by now know the difference between a curve ball, a slider or a spitball instead of saying "breaking ball". And does anyone know the difference between a "sports hernia" and a regular hernia? I guess having a big strong professional athlete be diagnosed with the same injury that a fifty year old couch potato can acquire from a lifetime of reaching for a bag of chips while he is lifting a sixteen ounce brewski is humiliating for the jock. Do you get more credibility for acquiring the injury while in a stadium being watched by 60,000 fans than you do while sitting on your butt stuffing your face? The last time I looked the guy with the washboard abs and the fat boy are still lying flat on their back, hooked up to an IV and hoping the doctor doing the work has a steady hand for any work being done below the waist. And then there are the announcers who have "to get it right" for their credibility by saying, "Jo Blo has twenty-five RBI this year", as opposed the way we were all brought up saying RBIs or ribbys. I love it when one of the announcers, who's older than me, slips up and calls it the old way without noticing it. I wonder how many twits or blogs or emails they get from geeks, who never played the game, calling them out on their mistake.

Then there is the "high ankle" sprain which I guess is somehow different from the "low ankle" sprain. Yah, yah I know I should Google "sprained ankles" and find out that there are a gazillion types of sprained ankles some of which fall into the "high" and others that fall into the "low" ankle sprain category. Sorry but I don't buy it because the last time I looked I had one joint that I call my ankle that meets right where the two bones in my calf connect to my foot. Also I don't care what all of those bones are called but I do know that if you step on the outside of your foot at the wrong angle and with enough force your ankle is going to twist and at that point it remains to be seen how bad you have sprained it. My experience with fifty-some years of athletics and running tells me that there are four types of sprains, three of which I have experienced and one that I hope I never do.

The first sprain, which I will call the "twist", is when you are cruising along without a care in the world and suddenly as you take the next step you feel your foot teeter for a moment to the outside before it lands in it's customary solid position on the surface upon which you are running. A brief flash of relief shoots through your brain as you realize those morning and evening ankle exercises are paying off and you continue down the sidewalk. The second sprain, which I will call the "roll", follows the same path as the "twist" but here your foot, instead of flattening into it's normal tread, continues the "twist" so that suddenly the weight of your body forces the ankle into an unnaturally exposed position stretching the outside of the foot at an abrupt angle. At that point, as the ligaments, muscles and bones are jammed away and against each other you have a brief moment where you evaluate the damage. The next step on the rolled ankle is the key and at that point you make a quick decision as to if you think you can keep running. Yup it's going to hurt but does it hurt so bad that you have to stop or as you limp forward does the pain abate somewhat and you can deal with it? If you can keep going sometimes the pain will disappear completely or you "suck it up" and at least keep going forward. The "roll" is terrific for the ego because you feel good that you handled the pain and "gutted" it out instead of quitting like a wimp. The third level of sprain I have experienced I will call the "blowout" and it follows the same track as the twist and the roll but usually ends up with the injured runner landing on his face in the middle of the sidewalk. At that point, gaining your feet and running down the sidewalk is usually not an option. From the point of your ankle twisting, rolling and blowing you feel as if an NFL defensive tackle has blindsided you and the next step is waiting for the stretcher to wheel you to the locker room. It's weird to explain it that way but for some reason the unnatural ankle action translates into a sickening domino effect from your foot all the way to your head and then suddenly you are down and wondering how you are going to get home on one foot. The "blowout" means that, because of the pain, you probably can't run, maybe you can walk with an exaggerated limp but in some cases you can't even walk. Whatever happens the key is to keep moving to wherever your destination is because your ankle is starting to swell and it is only going to get worse. Number four in the "hit parade" of hi/low ankle sprains is the break, which I have never experienced, and that is where one of those bones in the foot/leg ankle joint breaks and from there it is a walking cast, a couple of months of healing and then unknown weeks of rehab. They say it's better in the long run to break your ankle then to blow it out because the bones will heal back to normal whereas in a "blowout" the ligaments, cartilage and muscles get stretched into abnormal positions and never really heal back to normal. Well that may be but I NEVER want to break my ankle and my experience is that with regular exercise and a consistent rehab program an ankle can be strengthened so that you are less susceptible to future ankle injuries.    

My regular exercise program involves massaging and manipulating my ankles every morning after I wake up and every evening before I go to sleep. While sitting on the side of the bed I rub the heal, arch and pad of each foot then rotate each foot 180 degrees five times in a clockwise motion then rotate the foot five times in the opposite direction. Then I squeeze my achilles tendon very hard and massage it back and forth and then finish up by moving up my calf and then rubbing back down to my achilles. I've been following this regimen for over ten years and have had a few "twists" but no "rollovers" or "blowouts". That is until May 10th and June 13th which I will recount in my next blog; one big bummer.