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. 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.


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.

1 comment:

  1. Totally agree that it matters to have a PT who knows you. I unfortunately keep hopping around! Between changing insurance and workplaces, I've had to jump around quite a bit. And saying, "It's sore" probably means I have a broken bone, whereas another patient might have a little bruise!