Monday, October 26, 2009

Swimsuit Season?

My visit to the podiatrist last week went approximately how I'd expected it to, but I'm glad I went anyway. First of all, he was at least familiar with the Pose method and barefoot running and all of that -- so I appreciated being able to have a discussion of the topic with a real live person with some knowledge of the issue (as compared to the orthopedic surgeon that originally diagnosed my plantar fasciitis, who had never heard of the forefoot running approach and could only tell me that a heel strike is the "most stable" for the skeletal structure).

After a lengthy discussion, it came down to this:
(1) Barefoot running is a useful training tool when done on grass for short distances.
(2) The biomechanical effects of the very slight overpronation in my right foot can best be fixed by a proper orthotic.
(3) The arch strengthening exercises and PF stretches/exercises I've been doing are good for any runner to do (more strength in the feet and ankles is better), but will not change the static strength of my foot.

and...this is my favorite part...
(4) The Pose method (forefoot strike) is appropriate for faster running (ie 7 min. miles or faster), but not for slower running, when a heel strike is "more natural."

It took considerable effort for me to understand this final point that he was making, as it didn't make any sense to me. Once I was finally able to get my head around it, I restated it to be sure I was getting it right. He confirmed that, yes, I was understanding him correctly. But no, it still doesn't make any sense to me.

Round and Round We Go
Pod: When we sprint, we all run on our forefoot. (No argument.) That's the natural technique for running fast, he says.  But when we slow down, our natural stride changes, and we don't run well on our forefeet. Thus we adopt a more "natural" technique - a heel strike.
Me: A more natural technique - but more natural in shoes, you mean.
Pod: Yes, of course, you'll never land on your heel barefoot, because your body instinctively knows that will hurt.
Me: Right, so how is it that my body will run naturally, that is, correctly, if I run fast barefoot, but will start running incorrectly suddenly when I slow down?
Pod: Because when you slow down, a forefoot strike produces poor form, and doesn't allow you to run naturally.
Me: But aren't I running naturally if I'm running barefoot?
Pod: Only if you're running fast. 


It is just me or does this sound rather circular? If it doesn't sound circular to you, please, educate me! Of all the things I expected to hear, this was definitely something new. He suggested I do a video gait analysis so he can show me "how unnatural it looks" when a person runs forefoot at low speeds versus high. I told him I don't care how it looks if it's what is good for my body! Are we comparing how it looks against the current prevailing image of what running "is supposed to" look like? Because that seems unlikely to be useful. But perhaps I'm just being a contrarian.

And perhaps I'm oversimplifying his point and the gait analysis will show me something useful. I'm always willing to admit that I don't know what I don't know. Besides, I've already met my insurance deductible this year, and I'm willing to get a little more information from "the establishment" to weigh against the massive amount of information I've been gathering on minimalist running.

All that aside, he couldn't confirm the tendonitis I thought I was experiencing. He couldn't put pressure anywhere on the foot that would indicate that the posterior tibialis tendon is irritated. That said, I realized this weekend that the spot I pointed to when he asked where it hurts was off the mark. The day I went in, the ankle wasn't sore (as the ankle isn't generally sore unless I run too far on it). But over the weekend I went for a bike ride, and that irritated the same bit of my ankle that gets irritated when I run. So I realized that I'd pointed him to the wrong spot, but I'm still guessing its a tendon or ligament in there somewhere.

After the long discussion with the podiatrist, I asked what to do next. Essentially, we spent so much time discussing the background of my PF, barefooting, and related issues, that I need to make another appointment for him to get a better handle on what specifically is hurting me now (with the gait analysis and some other tests) to move forward. Understandable. But since there's no appointment available for all that stuff to happen at the same time until November 13, I'm left pretty much deciding my own course for the next couple of weeks. (He did suggest that I go out and get a new pair of Brooks in the meantime, since I told him that's what I used to run in. But, um. No thanks. He's got a remarkably long way to go to convince me that that's the right course of action.)

Rest/Protection Mode for This Week

That said, the podiatrist outlined the importance of looking at injuries in three stages (1) rest/protection, (2) rehab/recovery, and (3) return to activity. This was not new information, but a good reminder for the importance of not rushing stage 1. So regardless of what this current ankle business is, it makes sense to me that right now (at one week since the serious Green Lake ouch) I'm still in rest/protection mode. I felt today like I might've been able to go out and try to see how a little run might feel. But I've already decided I'm going to wait a second whole week before I try any running at all. I'm also going to stay off the bike, since that seems to aggravate the same part of the ankle. So if I'm going to exercise this week, it's going to be time to buy a new bathing suit (this summer I finally threw away the horribly saggy one I bought in 1989. Yes, seriously). Or maybe I'll just stick to weight training and/or yoga for the week. We shall see.

Monday, October 19, 2009

I can still ride

When all else fails, I can still ride my bike! I went for a nice hilly ride yesterday in lieu of running since my ankle is still sore from Friday's too-long run. I'm still self-diagnosing Posterior Tibialis Tendonitis with this ankle business, and I think that as long as I stop running as soon as it starts to hurt, I'm ok. But on days like Sunday (and a month or so ago when I overdid it), when I push it too hard simply because it starts hurting while I'm still a mile or so from home/car, and I don't feel like walking the whole final mile, then it's very much not ok. So I've taken the weekend to just rest, ice, and ibuprofin. The arch strengthening (aka PTT-fighting) exercises that were no problem two weeks ago were definitely not doable without pain this weekend, so I didn't do them. See, I do listen to my body mostly-- and the times that I don't, well, whose fault is that, really?

I've made an appointment with a podiatrist at the sports medicine clinic I used to go to (years ago with a previous running injury) to see if my self-diagnosis is correct and just to make sure there's not anything I'm missing. But I honestly suspect this to just be more of the same: back off and RICE while it's painful, go slow and pay attention as I start back up. I'm certainly learning patience, if nothing else.

Friday, October 16, 2009

Sloshing in the Puddles!

5 mi.- kinda (1 mi. BF, 4 mi. VFFs, Green Lake)
It was pouring this morning, but I decided to get out and see what barefoot running in the rain is like. Wet, and cold at the start, but otherwise ok. I started getting a hotspot on the ball of my left foot where I'd mussed with one of my callouses. Note to self: Leave your feet alone! The little bits of dry skin around the callouses wear off easily enough as I run, but if I muss with them and pull them off myself, I'm only removing some of the protection my feet have been working so hard to build. And this leaves me with hot spots the next time I run barefoot. So after a mile today, I decided to put on the VFFs.

On the bright side, there's no worrying about puddles with the VFFs. I was able to slosh right through them! Tell me how that's not just super fun?! I love the rain, and now I love that I no longer have to avoid puddles. I was also pleased to run about 4 miles before my ankle started to feel sore. I thought I'd just walk for a bit and then finish up for a total distance of 5 miles. But if I stop to walk, and then try to start running again, the ankle seems to freak out. Shooting pain with the first two steps. I had to stand there with my foot up in the middle of the path just waiting for it to chill out for a bit, as I couldn't put any weight on it at all. Slowly, slowly I tried walking... and then running, but that didn't last so long. So I walked/ran back to the car.

When I drove home and got out of the car - same shooting pain in the ankle again. I had to just stop and slowly try to adjust the foot to a position where it would allow me to put some weight on it so I could hobble inside. Grr. Glad to have made it 4 miles before having issues. Frustrated to be having issues at all!


(10/13/09) 2.5 mi. VFF (Wedgwood)
Ankle got sore pretty quick, but given the tired foot after the weekend, I'm not terribly surprised. Will try again tomorrow.

Monday, October 12, 2009

Wedding + Heels = Ow

I have always enjoyed wearing high heels for special occasions, perhaps in part because I don't have to wear them every day to work, but even that is difficult these days. I have a great pair of otherwise comfortable heels (Clarks) for my wedding coordination days -- the heel is chunky and they have a nice wide toe box -- but after 6 hours in them yesterday, my feet are pretty pooped. (I wore flatter nice shoes for the pre-wedding running around, but even those have a slight heel.) This is no suprise, my feet always take a beating at weddings, and I don't know that this weekend was any worse.

Guess I'll see how the running goes this week. The wedding went well though. It was my first at the Dome Room at the Arctic Club Hotel. It's a beautiful space, and I really enjoyed the couple I was working with. Good times.

Wednesday, October 7, 2009

Distracted

3.0 mi. BF (Green Lake)
I did manage to get out for one run this week before the wedding I'm coordinating this weekend, but it didn't feel great. Maybe just because my head was distracted with the busyness of the week.

Friday, October 2, 2009

Sidewalks Getting Easier

4.25 mi. BF (Wedgwood)
Well, I'm gradually running longer before the ankle hurts, but not in leaps and bounds of distance. Ah well, slow and steady (emphasis on slow) will work I suppose. I'm noticing that the neighborhood sidewalks are not nearly so challenging to run on anymore. They're not as easy as the Burke or Greenlake by any stretch, and I'm still going quite a bit slower on them than the smooth asphalt, but still I feel it getting a little more comfortable for my feet. Guess those callouses are starting to do their job!

The dead skin on my left blister-turned-callous (the red spot that was under my pinky toe shown in the picture a while back) came off while running tonight - but no biggy. I didn't notice it until I got home and the skin beneath is completely fine. Now that both those spots are back to newer skin, I'll just keep an eye on them as they start to callous back up again (sans blisters this time, I hope).