Training log - week ending 5/24/2020

This week was 35 miles of running -- training log is here.

Things turned around pretty quickly once we identified the cause of my sural nerve entrapment (it was mostly a nasty knot at the top of my calf behind my knee).  A visit to the podiatrist and his visual ultrasound machine gave confirmation that there was no actual injury to my foot - all referred pain.    The prescription was for Graston to that back-of-knee area - which was good since that's what we were already doing.

Since there was no real damage, just pain, it meant that I could ramp things up fairly quickly once I could run without a limp (I would have been much more restrained if this was tendonitis, stress reaction, or another overuse type injury).  

I started with some careful test running on Wednesday, and then built from there.  Interestingly, the more I ran on it, the better it felt, and the better I felt overall.  Nerve pain responds well to activity, and very poorly to rest, in my experience.

One result of this misadventure is that I'm changing up my routine some.  I've really enjoyed my long walks, but it's believed that they are contributing to some of the issues I'm currently dealing with.  Essentially, nearly all of my injury issues eventually trace back to the S1/L5 area or my back - either the injury has a nerve aspect, or the injury has resulted from my gait being off due to weakness from nerve issues originating from that area. (this is not a new thing - I've been told this by pretty much every PT I've ever worked with.

Running places a lot of compressive stress on my spine.  So does walking.  In contrast, swimming and pool-running do not.  In fact, they actually unload my spine.

But....during the pandemic, swimming and pool-running are not available to me, but walking is.  Hence my long walks twice a week when I would normally be pool-running, substituting unloading for compression.

So...the long walks have to end, as much as I enjoyed them.  Instead, I'm going to sub in gentle yoga classes and some "unloading work" for lack of a better term during the time I would be walking (which is the time I used to be pool-running).  The unloading work is stuff like bracing myself on a counter top (or the treadmill) with my hands and letting my torso and legs hang down.  Or laying on my back for an extended period of time with my legs propped up on a sofa.  I'll also do some more focused self-massage, to compensate for the fact I'm no longer getting a deep tissue massage every other week.




Dailies:

Monday:  Streaming yoga and leg strengthwork. Foam rolling at night. 

Tuesday: Streaming yoga and upper body weights/core.  Podiatrist AND PT in the afternoon.  Foam rolling at night. 

Wednesday: 4x0.5 mile jog outside with 1 minute walk recovery, streaming yoga, 2x1 mile jog on treadmill with 1 minute walk recovery, streaming yoga. Foam rolling at night.

Thursday: 4 miles easy on treadmill (9:13), 20 minute break, 3 miles easy on treadmill (8:57), and then a chiro appointment.  Streaming yoga in the afternoon. Foam rolling at night.

Friday:  Streaming yoga and upperbody weights/core, followed by extra selfcare work.  Foam rolling at night. 

Saturday: 7 miles easy on treadmill (9:01), streaming yoga, and 3 miles easy on treadmill (8:55).   Foam rolling at night. 

Sunday: 12 miles on the treadmill, including an imitation Iwo Jima workout - 8 repeats of the following:

-2:00 at a strong effort on a 3.0 incline (the Iwo Jima hill averages a 3% incline)
-1:30 easy effort on a 1.0 incline
-0:30 fast on a 1.0 incline
-1:00 easy effort on a 1.0 incline.

(paces for the 2 minute and 30 second intervals were 30 seconds to a minute slower than previous workouts, to play it safe.)

Followed with leg strengthwork, and then 2 miles very easy outside (9:15) to keep some feel for running on pavement.  Finished with a streaming yoga class.

Training log - Week ending 5/17/2020

This week was 26.5 miles of running and 5 miles walking -- training log is here.

I'd been thinking about when would be the right time to take a break of a week or so, and then life made that decision for me.  

I've had some very slight issues on and off with my left leg/foot - some tightness of the leg and some pain on the outside of the left foot.  Previously, it was fairly easily managed by wearing a toe spreader on that foot when I slept and also making sure my hips were even, with no rotation in the sacro-iliac joint.

That honeymoon period ended on Thursday morning when I woke up and the outside of my left heel felt like it was on fire. Nope, no running or walking for me that day....it was painful enough that it was going to distort my gait and ultimately result in a compensation injury.

I was fairly certain that this was at least partially nerve, if not completely nerve.  The pain was located on the outer bottom and back edge of my foot.  It was too far to the outside to be plantar fasciitis, plus the bottom of my foot wasn't tight.

the red was where it primarily hurt, with 

occasional pain in the blue part.

It was too far back and too low to be peroneal tendonitis, and I could also evert my foot against resistance without any pain.  Couldn't be a bone, since there's really no bone in that immediate area.  

Plus...the pain was burning, moved around some, got worse when I sat, and it felt like I had a lump stuck under my heel when I stood or walked, but there was no lump there.

I started with a telemedicine PT visit (after doing my own diagnostics) to see if we could fix it that way, but it became clear that I needed to be seen by someone physically and yanked on.  So I went in on Saturday for a chiro visit that resulted in a readjustment of my sacrum (which was out), ART on both piriformi (I think that's the technical term), and some Graston on the back of my knee, to the outside.

After getting that work done, it was significantly improved.  The verdict is that this is an issue with my sural nerve, which shoots off from the sciatic nerve and runs down the back of the calf and then on the outside of the foot.  The nerve is getting compressed at the back of the knee at the top of my fibula, and also getting irritated at the s1/sacral area (as part of the sciatic nerve).  Nothing wrong with the foot itself.

I've had nerve issues before, and I know that the answer is to keep active as best you can to keep things mobile, while working to free up the nerve.  Unfortunately, due to the pandemic, all the pools were closed, so I could neither pool-run nor swim.  Had it hurt less, I would have run on it, but it was tender enough to alter my gait, so running was a non-starter.  Walking was no better than running (and possibly worse), and biking wasn't an option since I don't have a bike and I'm not sure that sitting on a bike would be doing my back any favors.

So I sucked it up and sat on my rear end, doing mobility exercises, strengthwork, and streaming yoga (lots of streaming yoga).

The good news is that now that we've figured it out, it's not too hard to fix.  And....since there's no damage to the underlying tissue, I should be able to come back fairly quickly.  And this was honestly probably a great time to take a down week and reset (though I wouldn't normally choose to cut back this much).


Dailies:

Monday: 5 mile walk and upperbody weights/core. Foam rolling at night. 

Tuesday: 12.5 miles on the treadmill, including a mixed workout of 2 short hill repeats (70 seconds at a 4.5 incline), 10 minutes at tempo (6:26), 2 more short hill repeats, 10 minutes at tempo (6:21), and 2 more short hill repeats; 2:30 recovery after each hill or tempo segment. Followed with recovery yoga. Foam rolling at night. 

Wednesday: 6 miles easy on the treadmill (8:47), live streaming yoga, 8 miles easy on the treadmill (8:47); drills and two strides outside. Foam rolling at night.

Thursday: Upper body weights/core in the morning; remote PT and streaming yoga in the afternoon. Foam rolling at night.
Friday:  Streaming yoga.  Foam rolling at night. 

Saturday: Chiro appointment, live streaming yoga, and upper body weights/core. Foam rolling at night. 

Sunday: two streaming yoga classes back to back, followed with leg strengthwork. Foam rolling at night.