This week was 63 miles of running, 1000 yards of swimming and 18 "miles" of pool-running -- training log is here.
I got my MRI results back this week, and they were surprising. The lumbar area was surprising in a good way - while the MRI wasn't totally clean, it only showed minor stuff that you would expect to see in someone my age. Nothing of real concern.
The right ankle MRI was surprising in the opposite direction. The official summary:
1) Severe tibialis posterior tendonitis with longitudinal split tears involving the distal 9.0 cm, moderate grade at the level of the talus and the calcaneus, with mild tenosynovitis. Small spur along the posterior medial tibial metaphysis, at the tibialis posterior tendon groove which can be associated with PTT dysfunction. Mild tibialis anterior and greater than Achilles tendinosis with low-grade splits.
2) Chronic high-grade anterior talofibular ligament sprain, with at least partial tear. Moderate acute on chronic deltoid and superior medial portion calcaneonavicular spring ligament sprains. Moderate chonic calcaneofibular and mild chronic inferior tibiofibular ligament sprains.
3) Pes planus deformity on this nonweightbearing study.
4) Minimal acute on moderate chronic plantar fasciitis.
I am told that this is the MRI that you would see in someone who is physically unable to run. Which is weird, because I am quite physically capable of running, and have seen notable improvement in the past two weeks. And the ankle hasn't hurt at all recently. This MRI shows someone that shouldn't be able to do a single calf raise, and should have a flat foot with no arch. And yet I do sets of 25 single calf raises, and have a normal arch in that foot..
Normally with an MRI like this, we'd try conservative measures first, like PT and PRP, before going with surgery. Since I'm doing PT, and it's been working, we're just going to stay that course. Which, ironically enough, meant that I didn't change anything in response to this MRI, but just stuck with my normal running.
Put another way - this is not an MRI that says things are about to blow. This is an MRI that says things have already blown. And yet here we are. So I'll just keep on trucking.
This upcoming week I have a musculo-skeletal ultrasound scheduled to get another look at the tendon, and sometime after will likely get a round of PRP in the ankle focused on the ligaments to tighten those up. Surgery is just not on the table at this point, since the surgery is a hard one and may make things worse. And plus, I'm currently running on it without pain, so....
Monday: 6 "miles" of pool-running and upper body weights/core. Foam rolling at night.
Tuesday: 12 miles, including a track workout of 4x1200, 2x200 in 4:59, 4:57, 4:54, 4:58, and 43, 44. . Recoveries were between 2:50 and 3:20 after the 1200s, full recovery for the 200s. Followed with leg strengthwork, 500 yards recovery swimming, and streaming yoga. Foam rolling at night.
Wednesday: 12 miles very easy (9:15) with drills and 4 hill strides, followed with streaming yoga. Foam rolling at night.
Thursday: 6.5 "miles" of pool-running and upper body weights/core in the morning; foam rolling at night.
Friday: 12 miles, including a tempo workout of 3x1.5 mile at tempo effort with 30 second jogs (splits were 10:25, 10:21, and 10:13). Followed with full recovery and then 2x~200m (using paint lines on the pavement, so not exact) in 48 seconds with 80 second recovery after each. Followed with leg strengthwork and 500 yards recovery swimming. Foam rolling at night.
Saturday: 11 miles very easy (9:26), plus 6 steep hill sprints and drills, and streaming yoga. Foam rolling in afternoon.
Sunday: 16 miles, structured as the first 5 miles averaging 9:27 pace, the next 5 averaging 8:30, the next 5 averaging 7:31, and then a mile cooldown. Followed with leg strengthwork and streaming yoga. Doubled back with 5.5 "miles" pool-running and foam rolling in afternoon.