Alternative Paths

Today could have went very differently.

  • I could have slept in after waking up in the middle of the night.
  • I could have driven the main roads instead of the winding back roads.
  • I could have driven the back road route that I knew much better instead of the slightly longer back road route.
  • I could have listened to the call to run 7 laps around the subdivision's loop.
  • I could have let go of the artificial call to hit a certain goal mileage every single week.
  • I could have made time yesterday to stay on track with my goal mileage.

Today could have been a normal day, with no ER visit, no loss of the faithful car that I've had for 14 1/2 years, no facing 4-6 weeks off from running.

Instead, I woke up at 3:30am, and sat impatiently until 5am, when I went outside to leave for the gym.

At 5:35am... my car ran off the road and hit a tree.

My haste to be out the door before anyone was awake meant that my wife didn't answer when I tried to call. Had I been injured to the point where time was crucial, I wouldn't have survived. Four cars drove by that lonely stretch of road in the early morning between the time I quit calling my wife to dial 911 and the time when the police officer arrived on the scene.

My daughter, who normally drags her feet and daydreams during the morning routine became all business when my wife told her that they needed to get dressed quickly so that Mommy could go see Daddy who was in a wreck. She's pretty skittish about anything that might be a threat to Daddy or any of the rest of the family. She's just started to calm down after a year of fretting about every little lightning storm after she found out that a classmate's dad was killed by lightning.

My son was blissfully unaware of what my crash meant. He thinks I just made my car "messy". (Honestly, it always is.) I think of my coworker who died when his son was 2, and how my son might have a vague memory of me, but not really know me.

My wife often badgers me about time I spend doing this or that activity. Outside of things that involve money, my "other activities" are what I usually feel the most disagreement between us over. And yet, she is a conscience for me. Is it about me or the family? She keeps me as honest as one person can do for another.

While spending 40 hours per week doing "extracurricular" activities would likely always be an issue, the bigger issue that I must resolve is choosing the right path in context. Not all alternative paths have the same weight across different scenarios.

Lately, I've been so obsessed with not losing momentum with my running that I've failed to recognize context--we're moving, my wife is working extra shifts, etc... In so doing, I have also now managed to lose momentum with my running.

I know that an accident like this morning's could have happened at any time, for any reason. I also may be magically better in a couple of days. However, poor decision making has certainly not helped.

In the meantime, I have at least a few days to reflect a little more closely on what my priorities are. I'm not considering giving up running, or really even backing off of running, or other activities for that matter--but I do need to reconsider my willingness to knock their priority to the bottom at the appropriate times.

I don't need to see if I can survive another wreck that makes a car look like this:

Runners: Careful with the NSAIDs

From Caring Medical - Sports Injuries - NSAIDs: Why We Do Not Recommend Them:

The following statement comes from a well-known sports medicine book that has gone through five printings. "In spite of the widespread use of NSAIDs there is no convincing evidence as to
their effectiveness in the treatment of acute soft tissue injuries." (Bruckner, P. Clinical Sports Medicine. New York City, NY: McGraw-Hill Book Company, 1995, pp. 105-109.)

This is a true statement, but definitely not strong enough. More appropriate would be something like, --In spite of the widespread use of NSAIDs there is substantial evidence that they hamper soft tissue healing.--

In the past, I have used NSAIDs in my marathon training quite regularly. I don't have anecdotal evidence that they hampered healing. My specific problem with taking NSAIDs (generally Ibuprofen) was that I would tend to not be conscious of pain from injury and run through it, causing additional damage which would take longer to heal, which would require additional NSAIDs to relieve the pain from.

In this last build-up of 1400 miles, I have probably taken 2800 mg of Ibuprofen for joint or muscle pain the entire time. Whenever I have, I have made sure to not run during its dose-duration of 4-8 hours, which usually means that I take it before bed or on a rest day.  While this strategy doesn't resolve the slow healing problem, it at least ensures that I do not compound the injury.

Some more discussions of NSAIDs:

My new tactic. 1% treadmill run + -3% incline on cool-down #twit2fit

Streak day 51.  7.51 miles in 1:15:00.

For my last two runs on the treadmills at work, I've actually been using the "cool down" as an actual cool down.  I ran 1 mile in 10 minutes, then reset the treadmill (60 minute session limit) for another 60 minute session at 6.1 mph, at a 1% incline.

When the hour was finished, I jogged the cool down at a -3% incline.  Hopefully, this accomplishes two things:  1) actually gives my muscles a chance to cool down, 2) builds a little quad strength from the downhill running motion.  I've haven't had a major problem with my knees so far, so building up quad strength is not a primary concern, but I figure that any strengthening that I do can help keep it that way.

1 mile in 10 minutes at 1% incline (10'00")

6.08 miles in 1 hour at 1% incline (9'53")

0.43 mies in 5 minutes at -3% incline  (11'38")

RunningAHEAD - Strings_n_88keys's log: View course: 1% Precor 966i, -3% cool down.

Physical Therapy went well #twit2fit

My return to physical therapy after the MRI results was better than I expected.  I've run 18 miles in the last four days and I'm more "motivated" to keep up with my physical therapy exercises.  We're reducing the schedule down to 1 time per week, just to monitor progress.

I do, however, need to add a couple of my stretching routines back in.

I also woke up early this morning to do 3.0 miles in 29:30 (9'50" pace).  Day 30 of the running streak, day 7 of the physical therapy exercise streak.

RunningAHEAD - Strings_n_88keys's log: View Workout.

Ran for the first time. 2.16 mi in 18:18 #twit2fit

I intended to go outside to walk 2 miles, despite my back being pretty tight still.  Leaving the gym, I had to decide whether I wanted to bring my iPod Classic (arm band) and phone with me (no pockets).  Doing so would have guaranteed that I wouldn't have run.  However, I left both behind.

I started out at a nice trot, just enough to roll the feet forward for a smooth transition.  By the 0.2 mile mark, I was down to an average pace of 8'53".  By the end of the first mile, I was down to an 8'37" pace.  My second mile was at an 8'14" pace.  My limiting factor quickly became aerobic capacity with lungs and heart.  Much more than 2 miles and I would have hit a pretty hard wall.

Now that I'm finished with the run,  my back (and lingering sinus infection) actually feels better than before.

RunningAHEAD - Strings_n_88keys's log: View Workout.

Don't walk #twit2fit

Don't WalkI walked 1.5 miles on the treadmill yesterday and 2.1 miles this morning outside.  That was enough to fire up some part of my leg on my left side.  So, for the next week, I'm not supposed to walk.  Or run, of course.  Nothing from a standing position.  Bike might be an option, but given the pain when attempted at the physical therapist's office, it doesn't seem very promising.

I bought a heel cushion (insert) for my left heel at the physical therapist's recommendation to see if it makes a difference in walking...  It does, but I still feel the pain.

I can walk without a major limp. #twit2fit

The left piriformis bursa is still pretty ticked off, and I now I have a little left hip flexor pain, but I can mostly walk normally on a 600 mg dose of Advil.  That's pretty good, considering that last week I couldn't hide the limp on Meloxicam, Advil, or even both.

RunningAHEAD - Strings_n_88keys's log: View Workout.

Pushups 8×34, 1x26, 298 total. 12,450 since 12/27/2008.
Bicep Curls (each arm) 10×10, 1×3 - 20 lbs., 103 total. 406 since 2/14/2009.
AROM lumbar alt arm/leg (hip bird dog) w/ball 3x10
AROM hip/knee flx supine 3x10
Ball Crunches 2x20
One Leg Press on Exercise Ball 2x10
AROM lumbar rotn supine 20
AROM hip/knee flx supine 3x10
2x piriformis round robin
1x hamstring stretch supine

Piriformis bursitis

I have not done a very good job of sticking with one of my implicit goals:  stay injury-free.

In fact, I haven't been able to even log mileage at this point.  After a few weeks in physical therapy, I've actually uncovered a second issue--looks like piriformis bursitis.  I guess that means that means that between that and the sacroiliitis, I'm doubling down on the sciatic nerve.  I went to the doctor today, just to confirm via multiple X-rays (I'm glowing now) that I don't have any stress fractures.  The doctor's preliminary thought is no, but he's sending to the radiologist to double-check.  If symptoms don't improve with physical therapy, I'll have a bone scan to have a closer look.

In the meantime, I have several strengthening and stretching exercises to do, plus I can continue the pushups routine.

Reflecting on injury

Here I am, for the second time in about 6 months.  My sacroiliac joint is messed up, and I'm fighting the urge to run.

Okay.  I'm not fighting the urge at all.  I'm trying to pretend that everything is okay, and going out anyway.  That's the way it was on the treadmill this morning.  I set out to run 7 miles at a 9'13" pace.  When I started tightening up, I started speeding up (to 9'05", then 8'57", etc...).  I had to stop at 3.43 miles because of the pain...  Pain in my hip, pain in my piriformis muscle, pain in my right shin, pain in my back (L3?).  Sadly, 9'13" is as hard as 7'55" was 10 months ago.

I'm sitting here wondering if I have a stress fracture in my hip (rather than an SI joint injury).  I'm also sitting here wondering if I have a stress fracture in either of my shins.  I'm probably suffering mainly from 5+ mile ramp ups, which I thought I was in shape for, but I've probably been lying to myself.

What does this mean for me?  I'm going to have to eat like a normal human being and not like some ultramarathoner.  I'm going to have to get on the treadmill and walk at an incline or get on the elliptical.  Maybe I need to walk with the family some.  I'm thinking that I need to write off the spring racing season and take 6 weeks off from running.

Running is such an intense, simple exercise.  All my other options are either more complex or less intense.  I did this for less time than needed in September and about went crazy from the time off from running.

Back to physical therapy #twit2fit

I went back for a little physical therapy today, after logging slightly more miles this January than last January. I've run two strong races (including a personal record in a 5k) in the last two months, so I'm pretty sure that snowice shoveling was a major factor in my sacroiliac injury flaring up again. The high mileage (60 miles in a week) didn't help, but I'm pretty sure that I would have gotten by fine without shoveling ice (and sliding on it).

On the positive side, this injury has "inspired" me to put up with the small muscle exercises that will help keep me healthy in the long run. I don't deal with these exercises well. I prefer hard but simple (running, pushups, sit-ups) exercises over complex (yoga poses, figure four stretches, and all of these exercises).

I did manage 2 sets of 25 situps, and 270 pushups (10x25 + 1x20).