Monday, November 25, 2019

Training log - Week ending 11/24/2019

This week was 25 miles of running, 31 "miles" of pool-running, and a whole lotta shoulder rehab work -- training log is here.

My first week of post-marathon recovery.  Like always, I started it in the pool, and then transitioned to land running.  However, while I normally do a lot of yoga in the first days post marathon, this time I had to hold off until the end of this week, when my shoulder finally felt good enough to fake my way through a class (skipping the planks and vinyasas).

A slight change this time around was my introduction of "medicine running" - this is my term for a short duration (10 minutes or less total) set of walk-slow jog intervals.  You don't build or maintain any aerobic fitness doing this, but it does present your body with a very gentle extremely low risk running stress.  It's just enough to remind the body that you are still a runner, and that the body needs to maintain its connective tissue accordingly.  But it's not going to aggravate any nascent injuries, unless you've got a broken bone sticking out of your leg or similar (in which case, medicine running will be impossible anyway).

I've recommended medicine running to others on a running break, and have used it myself when coming back from injury - it's a good stepping stone between not running and running.  I hadn't used it for marathon recovery before, but the more I thought about it, the more sense it made.  That first run back after a marathon can be rough on the body; this would hopefully make it easier.

So, I did medicine runs on Tuesday-Thursday of this week, before starting to run again on Friday.  And sure enough, Friday's run felt much better than the first run post-marathon normally does.  Of course, that is relative - I was still stiff and sluggish.  Just not awfully so.

I also officially started PT on Tuesday, working with the same physical therapist I use for all my running injuries.  There's such a huge advantage to working with the same PT over time - my PT knows what it means when I say "this hurts" or "this doesn't feel right" - which can mean something totally different when a different patient says it.   He (my PT) also understands my normal level of activity and my baseline strengths and weaknesses - something a new person would have to learn.

I continue to be pleasantly surprised by how quickly my shoulder injury (officially winged scapula due to serratus anterior dysfunction) is clearing up. If you look on the internet (which of course I did - who are we kidding), a winged scapula due to a traumatic blow supposedly takes months to a year or more to recover from.  

And yet, in just a bit over two weeks, I've managed to go from literally not being able to lift my left arm (in order to type, I had to use my right hand to lift and place my left hand on the keyboard) to having nearly full function for daily living.  I still can't grab or place things on a high shelf with my left hand, but I can dress myself, wash my hair, unload and load the dishwasher, pill cats, etc now.

And the gains continue to accrue daily.  Friday morning I couldn't hold a plank.  But...by Saturday I could, albeit for only about 5 seconds.  Sunday I made it 10 seconds.  So all very cool and exciting.  Though I still have a way to go before I can return to the pull-ups, push-ups, rows, and dumbell presses that used to be my norm.  I want to be able to swim again.  I might want to ride a horse again someday.  So this ain't over until those are available to me again.  But we're getting closer.

I think the credit for the so-far-quick-recovery goes to a few things.  

1) Since heavy upper body lifting has been a regular part of my fitness routine for over a decade, I have a lot more strength and proprioception there than the average person, or even the average runner.  Thus I have a better baseline from which to work.  It's similar to how my high level of aerobic fitness means that I can be having a bad asthma flare and still climb a flight of stairs.

2) I have a friend who is a PT, and her advice (plus connecting me to a good orthopedist) meant that I was able to start restoring the arm by doing the correct (gentle) exercises within 24 hours of the injury. Had I simply placed the arm in a sling and let it sit there for a week, I have no doubt I'd be much worse off now.  Motion is lotion (when done correctly). 

3) I'm ambidextrous, but my left arm is my dominant arm. Which made the whole left-arm-not-working thing mildly inconvenient at the start, but also means that it has been easier to relearn the use of that arm.  And, since my default is to use my left arm, I keep testing the limits of that arm in a way that I might not if it was my right arm that was injured.

4) I'm now working with a good physical therapist who understands my body and personal motivation very well, due to our past history.    So we're doing the exact right exercises for me to keep me on this path.  2-3 sessions with a good PT who knows the patient very well are a far better investment than 20 sessions with a stranger.

Hopefully this progress will continue.  And starting next Tuesday, my 10 day post-marathon make-no-commitments period will be over, and I'll be able to map out my spring racing plans.


Dailies

Monday:  10 "miles" pool-running

Tuesday: 7 "miles" pool-running and a "medicine run" of 8x30 seconds jogging with 30 second walking recovery.  PT for the shoulder in the afternoon.

Wednesday:  6 "miles" pool-running, a "medicine run" of 10x30 seconds jogging with 30 seconds walking recovery, and some core and shoulder work at the gym.  Sports massage in afternoon.

Thursday: very light upper body work, core and shoulder work, 8 "miles" pool-running, and a "medicine run" of 8x60 seconds jogging with 30 seconds walking recovery.

Friday:  3 miles easy (9:19), yoga, and 4 miles easy (8:45).  Foam rolling at night (!!! I could foam roll again !!!)

Saturday: 8 miles easy (8:52), very light upper body work, core and shoulder work.  Foam rolling in afternoon.

Sunday: 10 miles very easy (9:03) plus drills, followed by leg injury prevention work and shoulder work, and then a yoga class.  Foam rolling in afternoon.





Monday, November 18, 2019

Training log - Week ending 11/17/19

This week was 41 miles of running, 16 "miles" of pool-running, and a whole lotta shoulder rehab work -- training log is here.

Just a placeholder for race week.



Dailies

Monday:  7 "miles" pool-running with the belt

Tuesday: 8 miles, including a track workout of 4x800 in 3:02, 3:02, 3:01, 3:02 (recoveries between 2:07 and 2:19).  Followed with light leg injury prevention work.  Sports massage in afternoon.

Wednesday: 4 miles (8:50) plus 2 uphill strides and then some limited strengthwork (what the shoulder would allow).

Thursday: 3 "miles" pool-running, DIY yoga, and a cortisone shot.

Friday:  2 miles (9:09) plus drills and two uphill strides and DIY yoga.

Saturday: 1200m warm-up and Richmond Marathon in 3:03:37

Sunday: 6 "miles" pool-running with the belt.




Sunday, November 17, 2019

Race report: Richmond Marathon, November 16, 2019

I ran the Richmond Marathon yesterday, finishing in a time of 3:03:37, which was good enough for top master female and a top 25 placing.  This was not the time I had hoped to run; this was not the race I had planned to run.   But that's how life is, sometimes.

***

The training cycle for my goal race, the CNO Indianapolis Monumental Marathon, went pretty well.  The taper, less so.  My tune-up half-marathon at Columbus was marred by an ulcerative colitis flare and some allergy/asthma problems.  And then things went downhill from there.

9 days before Indy a tree fell on our house.  It somehow split as it hit the corner of our bedroom, falling to each side of the house rather than crushing us in bed.  Even so, it resulted in a fair amount of damage.  And then the day before I was supposed to leave for Indy (just 3 days out) while on my last shakeout run in Virginia, I was hit by a large pick-up truck while in a marked cross-walk.

It quickly came clear that there was no way I could run Indy.  While the ER ruled out the most severe consequences of the truck hit - no brain trauma, no internal bleeding - I didn't want to get on a plane 24 hours later and discover at 30,000 feet that the ER had missed something.

Plus, practically speaking, I had no idea how I was going to manage by myself in Indy (and didn't want to impose on my friends as they prepped for their own marathons).   I couldn't raise my left hand above my waist either in front or to the side, and assisting it with the other hand was very painful.  (I did confirm that if I bent at the elbow, I could swing the arm back and forth without too much discomfort, so a running motion was theoretically possible).  I couldn't run a marathon if I couldn't dress or undress myself.  Especially a frigid marathon where relying on throwaway layers was an important part of my strategy.

***

So Indy was out.  Fortunately, in the next two weeks there were two semi-local fallback options that were solid races, if I could get myself capable of running a marathon.  One was Richmond the next weekend (10 days post-truck hit), the other was Philadelphia the weekend after that (17 days post-truck hit).  Richmond was by far the more appealing race.   I've run Philly twice with awful results. In contrast, though I'd never run Richmond full, I'd run the 8K once and the half-marathon twice, each time with good results.  And Philly was also going to be 6 weeks out from my last 20 miler, arguably too long.

Plus, as I played with the idea of Richmond, stuff just lined up.  Like it was meant to be, if I could just make it happen.

[At this point, I should note just how much I owe to others.  One of my teammates worked her connections to get me seen by one of the best sports orthopedists in the country, who just happened to have a special focus on complex shoulder injuries.  Another discovered that he had forgotten to cancel his hotel reservation for Richmond, which just happened to be in a great location at a great price.  A third friend offered me his partner's parking space for the weekend, so that I didn't have to pay to park.

[And none of this is mentioning the immense support I received from my coach, my teammates, my online running friends, my non-running friends.   And of course, all that Brian did for me starting from the moment I walked through our front door, blood running down my side, introduced him to the guy who had just hit me (talk about awkward openings) and asked him (Brian, not the truck driver) to take over.]

***

The next few days, post truck-hit, were about careful rehab and recovery - doing arm exercises first in a therapy pool and then on land.  And carefully progressing from the elliptical with my arms held stable to the elliptical with my arms gently swinging to running.

And gathering intel about the Richmond course, which ranged from "not as hilly as people say" to "hillier than I expected."  So either way, there'd be some hills.   Clever me, planning on racing a flat course, had intentionally trained exclusively on pancake flat Hains Point.  Ah well, it was what it was.

Running was...OK.  I could swing my arm with not much discomfort if I ran evenly on flat ground.  However, the odd uneven step caused sharp pain underneath the bottom of my shoulderblade, as did running uphill or doing running drills.  Basically I had a comfortable range of motion, but anytime my arm strayed from that limit, I hurt.

More broadly, while it was wonderful to be running, it didn't feel very good - much harder than it had just a week before.  My heart rate was jacked up at paces that were effortless a week before, and my hips (both hamstrings and hip flexors) ached after each run.  I could do all sorts of hip stretches post-run without replicating the achiness, which told me that this was not a new injury, but rather an indication that something was off while I was running.  I also just felt drained - like I had already run a race.

I was pretty sure that all of the above was caused by some combination of a) a very stiff shoulder throwing my gait off and b) systemic stress resulting from the trauma to my body - deep bruises and lacerations are relatively minor things, but still require the body to work to heal them.

I debated whether to run Richmond, and decided I'd see what the orthopedist said.  I thought I could pull it off (the quality of the performance might be in question).  But I wanted to be sure I wouldn't be risking further damage to the arm.

***

My follow-up orthopedist appointment on the Thursday before Richmond went very well.   They were impressed by how much progress I had made with the arm in just a week - I was now able to raise my hand all the way up to my bra line if I concentrated really hard (some people bend spoons with the sheer force of their will; I settle for moving my left arm).

They (the orthopedist and his PA) were fine with my running Richmond in 2 days - they didn't see any risk of further injury to the shoulder.    I was now the proud owner of a winged scapula (there's an Oiselle joke in there somewhere, but someone more clever than me will have to tease it out).  But that wouldn't be worsened by the race.  I could go, run my race, and then start PT.

There was still a lot of swelling in and around the shoulder blade, so we discussed options to bring it down. A large prescription dose of NSAIDS (ibuprofen or naproxen) would have been the normal course of action, but my ulcerative colitis meant that was a hard pass.  Oral prednisone was another appealing option, however oral prednisone is banned in competition.  I had researched cortisone shots, and confirmed that they were legal under USADA.  So I requested one.

99 times out of 100, I think a cortisone shot is an awful idea - people get them to address inflammation from a repetitive running injury.  After killing the inflammation (which is how the body heals) they go out and repeat the very same action that caused the injury.   And then are surprised when the shot wears off that they are worse than they were before.

But I kept thinking that this was the 1 out of 100 situation where a cortisone shot was OK.  I wasn't planning on getting hit by another truck, and I would be racing on a closed course.  And my shoulder was really secondary to running - I wasn't going to be doing any heavy lifting or pushing - I just needed to be able to swing my comfortably.

My coach and the ortho both agreed with my reasoning, and so I got the shot just underneath the lower point of my shoulder blade.  And then, sitting in the parking lot of the ortho's office, I pulled up Richmond on my phone and officially entered the race.   I drove home, kissed Brian good-bye and gave the cats each a pet, and headed down to Richmond.

***

My shakeout run on Saturday felt near miraculous.  As if I had been cycling with a stick stuck in between spokes, and that stick was now gone, allowing the wheels to turn freely.  I jogged two pain free miles in perfect weather, did some mostly comfortable drills, and some blissful uphill strides.  For the first time in a week, running felt like me.  And I started to hope that I might be able to pull off a very good race after all.  Perhaps mid-2:50s wasn't out of reach.

However, I still had to figure out what to wear.  Even after the cortisone shot, there was no way I could get my normal racing team singlet with built-in bra-liner on or off.  I needed stuff that was relatively loose fitting.  Fortunately, I had an older loose team tank top with plenty of room through the shoulders and back.  I also dug up an old sports bra with adjustable straps.  I wasn't emotionally attached to either item, so I could always just cut them off post-race if necessary.

I was flagrantly violating the "nothing new on race day" rule, but oh well.

Richmond was going to be cold, so I needed throwaway stuff for both the corral and after the first few miles.  It was relatively easy to find a cheap front-zip jacket at Target for pre-race, but I couldn't find anything that was both front-opening and light enough to wear for the first few miles before tossing.

So I made my own, taking an old cheap longsleeve shirt, cutting it down the front, and then taping it closed with duct tape.   I would look really odd, but it was frankly one of the least surreal aspects of the last 10 days, so I went with it.
My personal tribute to Sgt. Pepper's Lonely Hearts Club band


***

Race day dawned with perfect temperatures but windy conditions.  A storm to the south meant that we'd face winds of 15 to 25 miles for much of the race, including the crucial miles of 15-21.  My plan was to start conservatively, ease my way up to and then past the 3 hour pace group, and then find people to work with or tuck behind for the headwind sections.

I did my normal pre-marathon warm-up of a half mile easy and then a quarter mile at marathon race effort, took a few shot bloks to top off my glycogen, lined up, and we were off.

From the start, I just didn't feel good.  No pent up energy to control.  Not ideal, but 26 miles was a long way to go, giving me plenty of time to feel better.  I had intentionally started behind the 3 hour pace group, and let them pull ahead - keeping them in sight in the distance.  Let the race come to you.

I was running tentatively and nervously - one aspect of the shoulder I hadn't anticipated was how tricky it made navigating crowds and turns.  There can be a fair bit of mostly unintentional jostling in the early miles of the marathon, and I found myself cringing any time someone passed too close to me.  I ended up hugging the left side of the road, so that anyone passing me would do so to the right.  I also ran the turns wide, rather than hugging the tangents, for a similar reason.

Over the next few miles, my stride eased a bit, and I was able to make my way up to the 3 hour pace group, tucking in with them.  This was good for now, though at some point I'd hope to pull ahead.  I reached to grab my first gel from my side, but it didn't go smoothly.  I can normally maintain marathon pace fairly easily while grabbing a gel, but today it wasn't happening - I was just too stiff.  I managed to successfully extract a gel, but at some cost to my pace.

Fortunately, I had tucked some extra gels into the front of my sports bra, just in case.  I could reach those with my right hand without too much trouble, so I'd rely on those for the rest of the race.

***

I ran more or less with the 3 hour group - getting dropped on some of the uphills (which were a little longer and steeper and rhythm disrupting than I would have liked) and catching up on the downhills.  I still didn't feel great, and as early as mile 10 I toyed with the idea of dropping out at 15 (where I wouldn't be too far from my hotel).  And then I shelved the idea.

I wasn't running this race to hit an arbitrary time standard by an arbitrary deadline.  I was running this race simply to race to the best of my abilities.  And so, as long as there was no indication that I was injuring anything, I was going to finish it.

Of course, a few miles later, around 14 miles, I felt a bit better.  I noted a small pack just a bit ahead of the 3 hour group, so I eased ahead of the group to bridge up to that pack before we hit the notorious bridge at mile 16 (and the accompanying headwind).  It felt risky.  But...I knew I was much more fit than a 3 hour marathon

It was not a horrible idea, but unfortunately the pack fell apart halfway on the bridge.  I backed off the pace to avoid fighting too hard into the wind myself, and soon after found myself enveloped in the 3 hour group again.  Ah well.

I tucked back into that group as we climbed up mile 18, but I was really starting to struggle - this was how I felt at mile 23 of CIM.  I turned my mind off and just tucked into the group for another mile, but soon after they dropped me while climbing a small overpass.

I watched them pull ahead, but I just had nothing left mentally or physically.  Dropping crossed my mind again, and I ruled it out a second time.  No matter how this ended, I was going to finish it.

After a few awful endless miles, I finally hit the notorious downhill finish to Richmond.  I was expecting it to be really painful on my quads, but it wasn't.  I was just numb.

And then I crossed the finish line, noting the 3:03, and saw my teammate Susanna (who had qualified for her second Olympic trials 20 minutes before) waiting for me with my finishers blanket.  The numbness dissolved and I shocked myself by breaking into uncontrollable sobbing.

I think part of it was that I had just been holding myself together for so long, and I could finally let go; part of it was frustration at the sheer differential between what I had trained for and hoped for versus what I had run; and part was that her waiting for me to wrap me in a blanket embodied everything that everyone had done for me over the last 10 days to get me here.

It was over.  It was what it was.  And I could move on.

Splits were:
Mile 1: 7:06
Mile 2: 7:01
Mile 3: 6:51
Mile 4: 6:49
Mile 5: 6:57
Mile 6: 6:48
Mile 7-8: 13:31
Mile 9: 6:46
Mile 10: 6:51
Mile 11: 6:52
Mile 12: 6:49
Mile 13: 6:51
Mile 14: 6:42
Mile 15: 6:41
Mile 16: 7:10
Mile 17: 6:54
Mile 18: 6:52
Mile 19: 6:47
Mile 20: 7:01
Mile 21: 7:14
Mile 22: 7:07
Mile 23: 7:25
Mile 24: 7:33
Mile 25: 7:50
Mile 26: 7:29
last bit: 1:29

***

Even though I didn't run the time I had trained for at Richmond, I have no regrets about the attempt.    If I hadn't run it, I would had always wondered what would have happened - what would I have run?  Could I have pulled off a PR?

And...if you had told me before Richmond that you had looked into a crystal ball, and I was going to run 3:03, and I was going to run it the hard way?  Still no regrets.  Running and finishing Richmond was something that I was able to do, something that was in my control - in contrast to so much else that has happened in the past two weeks.  I can now close this chapter in my life, and move on - to PT, to repairing our house, to dealing with insurance companies and reimbursements.  To eating the chocolate covered bacon that's been sitting at home, waiting for the celebration of a completed marathon.

Pulling ahead of the three hour group before the bridge was, in retrospect, a mistake.  Had I just sat with them, perhaps I would have eked out a faster time or even a sub 3.  Or perhaps not.  I don't think I did anything too stupid - it's not like I threw a surge in, or insisted on holding pace into the wind once my group fell apart. I think my struggles at the end were the result of having no reserves - the healing process took too much out of me.   And had I not pulled ahead of the 3 hour group, I would have always wondered - was I too cautious?  Did I play it too safe?  This way I know.

Other notes:

  • We had great temps for the race low 40s with a dew point in the 30s, and an overcast sky.  Just a shame about the wind (16 MPH from the north, with gusts up to 25 MPH)
  • Post race, we went out to lunch, which meant I didn't drive back north until the north bound toll express lanes had opened, allowing me to pay about $6 to avoid the misery that is I-95.
  • What's next?  PT, and then the Houston Half-Marathon in late January.  And no, swapping to the full at Houston in an attempt at redemption is completely out of the question.
  • I was able to successfully undress myself post-race.  No scissors required.  I couldn't undo my ponytail or wash my hair, but that could wait until I got home.
  • Ironically enough, my breathing and GI tract were both great for this race. So woo for that.
  • The chocolate covered bacon was not as good as I had anticipated.  To be fair, it's been sitting in my freezer for a month now.

Monday, November 11, 2019

Training log - Week ending 11/10/19

This week was 23 miles of running, 6 "miles" of pool-running, 500 yards of swimming, 2 hours on the elliptical or arc-trainer, and a whole lotta x-rays and shoulder rehab work -- training log is here.

On Wednesday morning, 3.5 miles into my planned 5 mile run (the last before leaving for Indy), I was hit by a pick-up truck while in a crosswalk.

I'm a planner.  And this was not the plan. 

Amazingly (if I do say so myself), I literally got up and walked away with non-life threatening injuries, though my entire left side was battered with my left shoulder taking the worst of it.  But it very quickly became obvious (if hard to accept) that there was no way I could realistically race the CNO Financial Indianapolis Monumental Marathon on Saturday.  Y'know - the superfast course with fast weather and a 2:55 pace group where I was a member of the elite field.  That one.

[goddammit]

As frustrating as it was, I was also frankly so relieved to be alive that the marathon no longer seemed that big a deal.  And all the x-rays so far (and I've had many) show no indication of broken bones.

But what I did end up with, in addition to a lovely assortment of lacerations and bruises, was a left arm that wasn't working well.  I could use the hand (good) but moving at the shoulder, including lifting my hand above my waist to the front or side, was absolutely impossible.  I just couldn't make the arm move at the shoulder joint on its own - it wouldn't listen to me - and having someone else move my arm was pretty damn painful.

[I should note here, that though I'm ambidextrous, my left arm is normally my stronger, slightly more dominant arm, making its sudden lack of function even more awkward.]

Needless to say, the latter part of the week did not go according to schedule.  Rather than tapering down and hopping on a plane to Indianapolis, I was rehabbing, with my wonderful partner putting his schedule on hold to chauffeur me to various appointments (I couldn't drive the first few days).  Rather than carb-loading, I was protein-loading, trying to give my body as much building material as possible.

And while there was a tiny part of me that wanted to crawl in a hole and cry, there was a much larger part that wanted to take a shot at a marathon to express my fitness, if I could pull it off.  And by "pulling it off" I mean have a decent shot at running a fast time while also being comfortable I wouldn't be making the shoulder any worse or risking anything else.   Marathon running as emotional coping strategy.  And Richmond Marathon, on 11/15, was still open.

So that was the challenge.  While protecting and rehabbing the shoulder, I also had to figure out how to do just enough aerobically to preserve my ability to race Richmond if the shoulder would allow.  I'm unfortunately not one of those people who can shut things down completely during taper - I get stiff and flat.   And my normal cross-training alternatives of swimming and pool-running were out.  (I could _kinda_ pool-run, but only by wearing a belt and crossing my arms). 

So...after consulting with a physical therapist friend, and getting fully checked out by multiple doctors, I turned to the arc-trainer and the elliptical.  To protect my shoulder, I either clasped my hands in a fist and held them at my chest or placed them on stationary handles.

At the same time, I was working on the shoulder - starting by walking in a shallow water pool (the water supported the weight of my left arm) while using my right hand/arm to grasp the left arm and move it around.  From there, I moved to exercises on land - I placed my left hand on my kitchen island, and let my fingers walk the arm out and back in.  Plus lots of icing to bring down the swelling (because of my ulcerative colitis, I can't take NSAIDS).

All very humbling - a week ago I was doing presses with 35 pound dumbbells.  And now, I can't envision doing a pressing motion with my unweighted hand.  But, you have to train where you are, not where you wish you were or used to be.

Over a few days of careful rehab, I got to the point where I was comfortable trying to run.  I have a fairly low arm swing, so I don't need that much range of motion or strength in the arm to run.  Test runs on Saturday and Sunday went well - good enough to build confidence that Richmond would happen if the doctor signed off.  [I will NOT race Richmond if there is a possibility that it will make anything worse or create a new injury.]

So that was the good news.  Unfortunately, independent of the arm, I didn't feel great on Sunday - just stiff, sluggish, flat.  But I think this is not that surprising.  I've had to cut out a LOT of my daily routine - I can't even do a plank, let alone swim.  I can't foam roll, since I have to brace with my shoulders in order to do that.  And my DIY yoga mobility routine has been out of bounds, though I'm now able to do some of it again, as long as I clasp my hands to my chest.    Plus, the physical and emotional strain of the past few days has to have taken its toll on my reserves.

Hopefully, now that I'm able to at least run again, some of that flatness will go away.  I'm thinking that with a few more short runs before Richmond, I'll feel sharper.  And if I work hard at it, I should be able to restore and top off my reserves over the next week.


Some observations from this experience:

  • If you slam your Garmin hard enough, it will stop automatically.
  • 8:30 am on a weekday is a great time to go to the ER.  No wait at all.
  • If you can't raise your hand above your waist, you can still put your long hair in a pony-tail or bun by doing "standing forward fold" pose from yoga.  It just won't look very good.
  • If you're ever going to have a non-working arm, it's best to have a collection of button down shirts.  If you are like me, and despise button down shirts with a passion, and live in sportsbras, close-fitting tank tops, and long sleeve technical shirts, then you have a problem.    In that event, I recommend that you save at least one old stretched out super thin strap bathing suit.  Because you'll probably be living in that thing plus sweat pants for a few days.
  • When donning said stretched out bathing suit, or a coat, put the injured arm in first.  Correspondingly, when taking off a coat or stretched out swim suit, the injured arm comes out last.
  • If you are going to get majorly bruised and scraped up, the last week of marathon taper is a surprisingly good time to do it.  I am amazed how quickly the superficial stuff has healed.  I suspect that it's because my body was stocking up on all sorts of resources to throw at a marathon, and it just threw those at this instead. 

Dailies

Monday: DIY yoga and 6 "miles" pool-running.  Foam rolling at night.

Tuesday: 7 miles, including a track workout of 3x800 in 2:58, 2:54, 2:52 (recoveries of 2:13 and 2:28).  Also 500 yards recovery swimming.  Sports massage in afternoon.

Wednesday: 3.5 miles (8:54) followed by x-rays.

Thursday: Off except for shoulder rehab exercises.  And more x-rays.

Friday A total of 60 minutes on the arc-trainer, mostly with hands clasped in front of chest.  Added in 4x3:00 hard with 1:00 easy to remind my body that we're not done for the season yet.  More shoulder rehab.

Saturday: 2.5 miles very easy (8:43) to test shoulder and then 60 minutes on the elliptical at easy run effort, with hands on stationary handles.  More shoulder rehab.

Sunday:  10 miles aerobic, split as first 5 easy (8:19), second 5 moderate (7:08).  Followed with some careful leg injury prevention work (all stuff that didn't need arms).  More shoulder rehab.