Sunday, September 20, 2020

Training log - Week ending 9/20/2020

This week was 59 miles of running, 1000 yards of swimming and 23 "miles" of pool-running -- training log is here

The spiral taping job continues to work wonders, and I was actually able to put together a complete week.  A complete week of workouts that were about 45-60 seconds slower than where I was a few months ago, but I'm not that bothered.  If I can put together consistent training and stay patient, I'll get back there.  It's the consistency that has been the challenge.


Since the spiral taping job was working so well, I suspected that this might be a re-occurrence of the loose ligaments issue I have in that foot.  Ligaments get stretched out, foot loses its proprioception, and I can't balance on it.  But nope. The doctor confirmed on Monday - the ligaments are still tight.  He sent me for MRIs of my lumbar region and right ankle, which I got on Saturday.


And like anyone else, of course I looked at them when I got home.  But radiology is hard.  Really hard.  I can tell the difference between my foot and my back, but that's about it.  So I'll have to wait until I see the doctor again this Thursday to get his take.



Dailies 


Monday: 7 "miles" of pool-running and upper body weights/core. Foam rolling at night.


Tuesday: 12 miles, including a track workout of 2x(1600, 800, 400 in 6:44, 3:15, 94, 6:32, 3:12, 94).  Recoveries were....very long (longer than the repeat duration) - I'll tighten those up next week.  Followed with leg strengthwork, 500 yards recovery swimming, and streaming yoga.   Foam rolling at night.

;

Wednesday: 9 miles very easy (9:51) with drills and 6 hill strides, followed with 3 "miles" of pool-running and streaming yoga. Foam rolling at night.


Thursday:  7 "miles" of pool-running and upper body weights/core in the morning, followed by streaming yoga; foam rolling at night.


Friday: 11 miles, including a tempo workout of 4x1 mile at tempo effort with 30 second jogs (splits were 6:55, 7:02, 7:12, 7:06).  Followed with full recovery and then 4x~200m (using paint lines on the pavement, so not exact) in 47, 43, 45, and 44 with 80 second recovery after each.  Followed with leg strengthwork and 500 yards recovery swimming. Foam rolling at night.


Saturday: 11 miles very easy (9:30), plus 6 steep hill sprints and drills. and streaming yoga.  Foam rolling in afternoon.


Sunday:  16 miles, structured as the first 5 miles averaging 9:29 pace, the next 5 averaging 8:24, the next 5 averaging 7:34, and then a mile cooldown.  Followed with leg strengthwork and streaming yoga.  Doubled back with 6 "miles" pool-running and foam rolling in afternoon.


Sunday, September 13, 2020

Training log - Week ending 9/13/2020

This week was 42 miles of running, 2000 yards of swimming and 27 "miles" of pool-running -- training log is here

Highs and lows this week.  My energy levels continued to rise all week, confirming that the folate deficiency was a large factor in my struggles.  By the weekend, I felt like the old me, energy-wise: the person who never struggled with the distance of a run; only with the pace of it.


My ankle/hamstring issues continued to frustrate me, though.  I showed up for the Tuesday morning track workout, but was running very unevenly and my hamstring felt a bit nervy, so I decided to skip the workout.


Wednesday I felt a bit more even, so I decided to play with some very gentle 200m repeats on the track.  Just....pick up the pace a little bit for 200m while trying to stay even, then jog for 200m.  Not really a workout - just testing stuff out.  Stuff felt OK.  And then my right ankle (which had been feeling great) decided to seize up on me again.  Really?


So shut stuff back down and headed back in for PT (I was doing PT every other week, but decided my frustration justified an additional appointment).    After talking though stuff, we tried a new taping technique.  A strip of leukotape (which is very sticky and does not stretch) was applied to the medial malleolus of my right ankle (i.e. the inside bump).  The tape was then wrapped up and around the back to outside of my calf, diagonally.   


The point of the taping job was to ensure that the medial malleolus (which is the bottom end of my tibia) would get gently tugged backwards every time I flexed the foot.  This in turn would change the way my ankle flexed as I walked and ran.


And...even just walking I could feel improvement.  Followed by confidence renewing runs on Friday, Saturday and Sunday, including a very careful hill workout on Saturday that was more about testing stuff then building fitness.  The right ankle felt better, my gait felt smoother and even, and the left hamstring nerviness dissipated, with a weird "catching" sensation in that hip easing.


This looks now like a repeat of a previous issue that I've had - loose ligaments in my bad right ankle mean that bones slip ever so slightly out of position, which in turn means that my right ankle doesn't flex quite right, which results in weird compensation injuries all over the place, including left hip.  The tape is pulling the bottom of my tibia back into position and restoring the proper movement of the ankle.


In the past, I've had injections of PRP and prolotherapy in that ankle to tighten stuff up, with the understanding that the shots are a temporary solution - eventually the ankle loosens up again and I need to get it retightened.  (BTW, surgery on damaged ankle ligaments is a very unappealing option - it runs the risk of making the ankle worse, not better).  


So perhaps it's time to get the ankle cinched back up again.  The only odd thing is that I had my ankle checked back in March by the orthopedist/prolo doctor (when I had my SI joint injected again), and at that time it was fine.  It's very odd that it would worsen so quickly.  But on the other hand, perhaps the folate deficiency accelerated the decline.  I have an appointment with the orthopedist/PRP/Prolo doctor on Monday, so we'll see what he thinks.


Dailies 


Monday: 6 "miles" of pool-running and upper body weights/core. Foam rolling at night.


Tuesday: 6 miles (warmed up for track workout but decided to skip it), 5 "miles" of pool-running, and streaming yoga.   Foam rolling at night.

;

Wednesday: 8 miles with a very relaxed 10x200m with 200m recovery (the "ons" were between 50 and 55 seconds), followed with 3 "miles" of pool-running and streaming yoga. Foam rolling at night.


Thursday:  6.5 "miles" of pool-running and upper body weights/core in the morning; streaming yoga and foam rolling at night.


Friday: 8 miles easy (9:31) and 800 yards of swimming.   Foam rolling at night.


Saturday: 10 miles, including 8 modified Iwo Jima hill repeats - ran 2:11-2:18 up to the top (usually closer to 2:00) followed by 90 seconds jog, a very short 15 second stride, and 90 seconds jog to the bottom.  Followed with leg strengthwork, streaming yoga, and 1200 yards recovery swimming.  Foam rolling in afternoon.


Sunday:  10 miles easy (9:21) and then streaming yoga.  Doubled back with 6.5 "miles" pool-running and foam rolling in afternoon.


Sunday, September 6, 2020

Training log - Week ending 09/06/2020

This week was 38 miles of running and 39 "miles" of pool-running -- training log is here

When last we left off, I had bloodwork pointing towards a folate deficiency and a pending appointment with my primary care doctor to discuss that round of bloodwork plus some stuff he had run.


As it turned out, his bloodwork also showed a normal CBC with no anemia, a significant folate deficiency, and normal vitamin D.  He had also run a full iron panel (not just ferritin) which came back fine, and a test for B12 which was above the reference range (surprising, since I had expected it to be below).


So...he prescribed me a folic acid supplement (1mg, if you're interested).  Which I eagerly started immediately.   (I'm also following up with some other doctors to confirm that the cause of this deficiency is indeed my ulcerative colitis.)


[BTW - important to note here that it can be very risky to decide on your own that you are deficient in something and start supplementing, even if you have bloodwork to support that.  You can go very wrong with supplements, even if they are water-soluable.  For example, in my case it was really important to check the B12 levels before starting folic acid supplements - had I been B12 deficient, supplementing with folic acid could have resulted in permanent neurologic damage.  Always check with a health professional before supplementing.]


 Of course, the big question on my mind was: how long until I feel better?  The short answer is: it depends and my primary care doctor didn't give me a concrete answer - I'm guessing because he couldn't.  The longer answer is in the bracketed paragraph below.


[longer answer, based on my amateurish reading of medical journals:  folate is involved in many many processes in the human body.  Your body uses it to build healthy red blood cells (RBCs) that are the right size.  Folate also plays a role in many other processes related to both energy generation and DNA replication.


Your normal human body turns over its red blood cells every 3-4 months.  Meaning that if you have damaged red blood cells, it will take that long to get the bad red blood cells completely replaced with better ones.  And while I'm not anemic (so I don't need to wait 3-4 months to fix that issue), based on my very low serum folate it's pretty certain that my otherwise normal blood cells may not have as much folate in them as they should.  (folate is stored in red blood cells - you can measure that level by testing RBC folate. however serum folate is usually a decent proxy for RBC folate).  If that lack of folate means that the red blood cells don't work as well as they should, then I'll need to wait for that to get fixed.


However, also interesting to note that runners are apparently not normal humans.  In fact, endurance athletes, especially runners, tend to turn over their blood cells much much faster.  This is because our vigorous efforts tend to destroy red blood cells before their time, either from being damaged by being in the wrong place at the wrong time (in the sole of the foot during footstrike) or from weathering the turbulence of travelling very quickly through capillaries.  So...our red blood cells get replaced much quicker.  Which has the added benefit of the average age of our red blood cells being younger, which means they do their job better.


So maybe my red blood cells will be replaced with new ones quicker - meaning any effect from not having adequate folate in my current RBCs will be fixed quicker.


And as for the other processes that are not directly dependent on RBCs - hopefully if they haven't been working well, they'll start working better as soon as they have access to enough folate.


Again, no doctor has told me any of this - it's just me and my internet connection.  Take all of the above with a big heaping dose of sodium.


Also worth noting: hematology is fascinating.  I keep wondering if I missed my calling.  And then I run past some bio-chem chart and I confirm that law school was the right choice.]


The good news is that I did start feeling better fairly soon after starting the folic acid supplement.  Friday's attempt at a hill workout felt much much better than Tuesday's even though Friday was warmer and more humid.  Tuesday was before starting folic acid supplementation; Friday was after.  And while Sunday's not-quite-a-long-run wasn't great, it still felt like a big jump forward.


I've also noted a few other things - some nerve pain in my left leg seems to be improving, while the lingering mild nerve pain in my right ankle (which has been there for a long time) is gone.  Yoga classes seem a lot shorter than they used to, and I'm no longer squinting through my reading glasses.  I was about to go see the eye doctor and get my eyes checked, but I'm now thinking there's no need.  


Here's hoping to continued improvement.  I supplemented my minimal land running this week with a lot of pool-running to keep my volume up so that I can come back fairly easily.


Dailies 


Monday: 7 "miles" of pool-running and upper body weights/core. Foam rolling at night.


Tuesday: 7 miles, with two Stafford Street hill repeats (370m hill at 5% incline) in 1:54 and 1:56 (just over 3 minutes jog down after each). Followed with 40 minutes of pool-running and streaming yoga.  Foam rolling at night.

;

Wednesday: 4 miles aerobic (9:36), drills, and 7 "miles" of pool-running followed by streaming yoga. Foam rolling at night.


Thursday:  7 "miles" of pool-running and upper body weights/core. Foam rolling at night.


Friday: 8 miles, with six Stafford Street hill repeats (370m hill at 5% incline) in 1:46, 1:44, 1:43, 1:41, 1:38, 1:35 (just over 3 minutes jog down after each).  Followed with 4 "miles" pool-running and some leg strength work. Foam rolling at night.


Saturday: 7 miles very easy (9:31), streaming yoga, and 5 "miles" pool-running.  Foam rolling in evening.


Sunday:  12 miles progressive (9:41/9:14/9:17/9:33/8:43/8:41/8:24/8:09/8:08/7:53/7:45/7:36), and then some leg strengthwork and streaming yoga.  Doubled back with 5 "miles" pool-running.  Foam rolling in afternoon.


Sunday, August 30, 2020

Training log - Week ending 8/30/2020

 This week was 41 miles of running and 27 "miles" of pool-running -- training log is here

After last Saturday's long run, I was starting to wonder if there was something else going on besides just heat/humidity/outofshape. I know my limits, I know how to modify for heat/humidity, and I'm pretty good about running at my current fitness level.  So it's very strange for me to crash and burn as if I was a new runner.  So I decided it was time to check on my ferritin/vitamin D, plus basic CBC (complete blood count).  


In the past, I've regularly checked that stuff, using one of those "buy the tests on the internet and then go to your local lab" services, since it usually ends up cheaper than going through my doctor.  So, I shopped around and found a decent package that included a CBC, vitamin D, and ferritin, plus some other stuff I didn't care that much about.  I scheduled the lab appointment for Wednesday.


Then Tuesday's workout sucked.  Yes it was bad weather and I haven't been on the track in a while.  But still - I was running 10-15 seconds slower per 400m then I used to and it felt hard.  And I've also had some very mild nausea that has gone from intermittent to near constant over the past few months.  Plus all the recurring injuries.  


So I dropped a note to my primary care doc, and he scheduled some additional bloodwork and set up an appointment (virtual) for next week to discuss the results.


[and yes, one possible if extremely unlikely explanation could be pregnancy, but that is NOT it.]


I got the first round of bloodwork back this week and....vitamin D was fine, ferritin was surprisingly high for a runner (136) but normal.  The CBC showed no issues with white or red blood cells.  


However, the test also included a serum folate test, measuring for B-9 (aka folate).  And that was very low.  1.7 where "normal" is higher than 5.4 and "borderline" is 3.4 to 5.4.


[if you're wondering, those online blood test request services do send you an alert asking you to consult with your doctor about the result.  Good for them.]


Low folate can result in fatigue and weakness and nausea (check).  And even though folate is available in a lot of foods - green veggies, fortified grains, etc, it also is one of the nutrients that inflammatory bowel disease can block the uptake of - if your intestines are screwy, it passes right through you.  And guess who has an inflammatory bowel disease and also a pool-running blog?


And folate deficiency is also frequently matched with B12 deficiency, which can result in nerve issues and pain.  And guess who has been experiencing multiple nerve issues/injuries this spring/summer and has a pool-running blog?


So...once I got this information, I paused stuff until I can see the doctor and map out a plan.  (his bloodwork tests included B12 as well as a complete iron panel).  From my research, folate is involved in muscle repair.  And you don't get fitter from training hard - you get fitter from training hard and then adapting via muscle repair (oversimplification).  


If I'm limited in my ability to benefit from hard workouts, then there's no reason to do them, and an increased injury risk from forcing them.  Better just to stick to shorter slow jogs, plus some pool-running to maintain volume and a bit of careful weights/yoga to preserve things where they are.  Once I get this deficiency fully figured out and addressed, then I can return to focused training.




Dailies 


Monday: 7 miles very easy (9:40), upper body weights/core and 4 miles easy (9:31). Foam rolling at night.


Tuesday: 10 miles, including a track workout of 2x400, 3x800 in 97, 97, 3:23, 3:17, and 3:17. 75 second recovery after the 400s, 2:50 recovery after the 800s. Followed with leg strengthwork and streaming yoga.  Foam rolling at night.

;

Wednesday: 5.5 "miles" of pool-running and streaming yoga. Foam rolling at night.


Thursday:  5 miles very easy (10:12) and 5.5 "miles" of pool-running.  Foam rolling at night.


Friday: 4.5 "miles" of pool-running and some leg strength work. Foam rolling at night.


Saturday: 6 miles very easy (9:33), upper body weights/core, and 6 "miles" pool-running.  Foam rolling in evening.


Sunday:  9 miles easy (9:21), drills, four hill strides, and then streaming yoga.  Doubled back with 5.5 "miles" pool-running and some leg strengthwork.  Foam rolling in afternoon.