Wednesday, March 2, 2011

Delusions, Optimism, Realism, and Pessimism

For the last month, I have been dealing with a strain and some accompanying tendinitis. After a month, the strain of my posterior tibialis muscle appears to have healed, but the tendinitis simply will not abate. Fortunately, it doesn't hurt most of the time. I can do most everything I used to do, except run more than a 2-3 miles at the most without experiencing some discomfort or pain.

When the problem started, I dealt with it simply by stopping. If it started to hurt, I cut my run short for the day. Then, as time went on, and the problem didn't get any better, I started taking more days off between runs. I started cross training on my bike--no forceful pedal mashing, but just spinning, some errands, etc...  I also walked and hiked a little. Walking, hiking, biking... None of that caused any problems.  But running... That remained a problem.

I went to see a physician, and got a Methylprednisone Pack, and tried to beat down the inflammation with a combination of Methylprednisone and maximum anti-inflammatory doses of NSAIDS, while Resting, Icing, wearing compression socks, and keeping the foot elevated (R.I.C.E) for a week. That seemed to help. They also referred me to a sports physical therapy clinic that specializes in rehabilitation from sports injuries. I had high hopes I would learn something new from this.

I went to a physical therapist. He seemed uninterested in knowing how I actually run, did some bogus strength and flexibility tests that my own research of the clinical and research literature had already told me indicate little or nothing. Incidentally, I "passed" all the tests, but he found ways to suggest the results somehow indicated what my problem was. I left with four more appointments. So, I did my prednisone, and my NSAIDS, took a week off from running, did only a little cross training on the bike, and only a little easy hiking. Then, I did a test run, and the results were very disappointing.

I redoubled my own research efforts and reconsidered the physical therapy approach. After some thought, I cancelled the additional PT appointments because all of the available evidence I could find suggested the  approaches being used and suggested come out no better than R.I.C.E. in well-designed research studies. So, why waste money I don't really have on this kind of PT? If the PT had shown interest in an integrated examination of my gait and biomechanics to determine if there were any obvious contributing biomechanical factors, I may have gone back for more.

So, more resting it would be--seven more days of it, in fact. Then, finally, I had a decent test run. I made it 5K, experiencing only some minor discomfort during the last mile or so. I thought things were looking pretty good. After the run, for two days, I had virtually no discomfort and no pain at all. Then, two days later (today), I went for another test run, and experienced discomfort again within 1/2 mile.

The good news was that none of the discomfort was related to the posterior tibialis muscle, which I take as a sign that my strain is healing/mostly healed. The bad news is that all of my discomfort was in the area of the inner part of the ankle (the tendinitis issue).

So, now I find myself staring another extended period of rest in the face, and little real opportunity to build my condition up for the kind of performance I know I'm capable of on the Colorado Marathon. In fact, if the discomfort doesn't resolve soon, my very participation will have to be reconsidered, which would be a tremendous disappointment.

I'm not one to have delusions about wonderful positive outcomes, and my optimism has it's limits as well. Realism says that I shouldn't expect a Boston Qualifier come May 1, and that I may not be able to even participate. So far, I'm refusing to succumb to the pessimistic hopelessness, but I'm not sure I can hold out much longer. I just want to have a good, comfortable run again.

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