The Importance of Rehabilitation

For any athlete – professionals or just weekend warriors – it can be very difficult to come back from a major injury.  I am learning this firsthand.  While out on a training run back in July, I tripped and broke my left big toe.  You might not think that breaking your big toe is any big deal (pardon the pun).  However, the big toes are among the most important parts of our body for running.  We need to be able to push-off using the big toes in our feet.  I am finding not only did I need to allow my broken toe to heal, I also needed rehabilitation to restore my flexibility, strength, and balance.

My doctor did not prescribe any physical therapy when I was released from wearing my boot.  I was told to start walking and building back up to running.  I wasn’t given any exercises to start limbering up all those joints in my foot that had gone on an unplanned vacation.

Without any guidance from my doctor, I did the best I could.  In Pilates the instructor had me doing various exercises that involved my foot.  I would do exercises on the Reformer where I would be raising up and down on my toes, balls of my feet, and on my heels.  I used the foot pedal on the Chair to push down using different parts of my foot.  The problem was my foot had been totally immobile for eight weeks.  Jumping back into intense foot work ended up causing me more problems.  Over the last several months, I developed a severe pain in my ankle as well as tendonitis in my lower leg.  It was increasingly difficult to run and we all know how much I like to run.  I was getting anxious as to whether I would be ready for my next marathon.  It is a biggie – the Boston Marathon in April.

I went to see my chiropractor.  Yes, my bones were a bit out of alignment but my foot lacked flexibility.  The joints weren’t fluid and moving as they should.  My big toe wasn’t bending as it should.  I needed to address this problem quickly.  After verifying that I didn’t have a stress fracture, my next stop was my physical therapist.

My physical therapist got me going on a set of exercises that are improving the strength in my ankle as well as improving the flexibility of my foot.  She also hooked me up with a personal trainer in the clinic who works with patients on more involved rehabilitation.  Both my physical therapist and personal trainer confirmed something that I already suspected.  My running (and walking) gait had changed as a result of my broken toe.  I wasn’t pushing off of my big toe on my left foot.  I was compensating by using other parts of my foot, resulting in an unnatural gait.  My body was totally out of balance.  I was on the road to more serious problems in my ankle, lower leg, hips and potentially also even in my right leg and foot.

The personal trainer used the GravityFit system with me.  The GravityFit system helps you to understand what muscles should be engaged to do things like stand, sit, and squat.  I put on each of the different pieces of GravityFit equipment that provide feedback on my form.  I understood instantly what correct form felt like, when my core was engaged.  Establishing that understanding (and muscle memory) helped me to identify when my form was right and when it was wrong.  With my new-found knowledge, my balance immediately improved.

Once I understood what correct form was, the personal trainer then worked on my gait.  I was putting my weight into my heels when I walked and ran, possibly from an unconscious fear of putting weight onto my big toe.   She showed me the proper way I should be walking and running.  I focused on shifting my weight onto the balls of my feet.  When I took a few running steps, I was able to push-off from my big toe.  There wasn’t pain in my ankle.  Granted the muscles in my foot, ankle and lower leg need to be strengthened but at least now I feel like I am working on getting back to where I was.  More importantly I will be rehabilitating my foot without causing myself more problems.

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This experience with my broken toe has taught me that I can’t go it alone.  I can’t just do things that I think will help me fully recover.  I don’t know much about recovery and rehabilitation.   I was relying on a disjointed patchwork of self-prescribed strategies – massage, Pilates, and chiropractic adjustments – I thought would help me get back to pre-July shape.  I was doomed to failure.

What I really needed was people with the expert knowledge of injuries and rehabilitation to get back to pre-injury condition.  I have that team in place now.  They are giving me exercises to improve my strength, flexibility and balance.  Massages supplement the work the physical therapist does and remain an important part of my recovery.   Everyone knows what is at stake for me.  They are confident that if I do my part, I will reach my goal.

My foot is responding very well to the physical therapy and personal training.  I can see improvements already.  Today I had no pain when I was running hill repeats.  To me that is a huge improvement.  I know my running form was better because I learned what correct form feels like.

My advice to anyone who gets a significant injury is to work with someone who is certified in rehabilitative fitness.  Don’t do what I did and self-prescribe a rehabilitation program that can backfire, causing more injuries.  If you care enough about training for a big event, don’t short change yourself by not getting the expert help you need for rehabilitation.  In the long run, you will bounce back faster and probably stronger.

How important is the big toe for running?  Here is an article that explains just how critical it is  http://www.kinetic-revolution.com/big-toe-extension-running-gait/

The GravityFit program was extremely informative for helping me find my core and use it to improve my balance and work on my gait.  

Mississippi or Arkansas?

img_7395My latest running adventure took me to Greenville, Mississippi for the Mississippi River Half Marathon.  (There was also a full marathon.)  This was the first time I ran a point-to-point race that started in one state and finished in another.  The Mississippi River race started in Arkansas and finished in Mississippi.  You might be thinking I was able to cross off two states with this race.  The rules for the 50 States Endurance Challenge only allow you to count it for one, either the state where the race starts or the one where it ends.  I plan to return next year for the Mississippi Blues Half in Jackson so I counted this for my Arkansas race.

img_7375The closest airport to Greenville is in Memphis.  I flew into Memphis, rented a car and drove down US Rt 61, the Mississippi Blues Highway.   The road took me past Clarksdale, home of the Delta Blues Museum.  If you are a Mississippi Delta Blues fan, Clarksdale should be on your list of places to visit.  Unfortunately, I didn’t have time to stop and visit the museum but I definitely would like to go back.

img_7397Most runners I know look for races with courses that are a flat as possible.  Of all the races I have run, this race course is the flattest.  The only “hill” on the course is the Greenville Bridge, the start line for the half marathon and the halfway point for the full marathon.  The Greenville Bridge is an impressive cable-stayed bridge that opened in 2010.  While we waited for the half marathon to start, runners busied themselves by taking selfies with the bridge towers in the background.  It is a beautiful structure.

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The Greenville Bridge

In one of those “It’s a Small World” moments, I bumped into Colin Wright on the bridge before the race.  Colin writes the Canapeel blog and participated on the running bloggers panel with me in Tulsa, Oklahoma last November at the Route 66 Marathon Expo.  We were pleasantly surprised to see each other again.  He was as engaging and happy as I remembered.

When the race started, we crossed the bridge over the iconic Mississippi River.  It was early in the morning and very peaceful to see the sun peaking through the clouds above the river.  I expected to see barges or other boats on the river but there weren’t any, just birds enjoying the water.

img_7404Although rain was predicted for race day, it never rained but boy, was it humid.   I don’t do well in humidity.   Fortunately,  there were plenty of water stops manned by very friendly volunteers who kept the runners both hydrated and entertained. In addition to the “official” water stops, there were plenty of the unofficial kind.  Continuing the Southern hospitality that I experienced in Jackson, people living along the course were handing out treats like donuts, cupcakes, water, Gatorade, and beer.img_7407

In the finishers tent, they had an impressive spread of post-race food — bananas, oranges, donuts, chips, pizza, water, soft drinks, and beer.   Plus they had massage therapists giving runners seated massages.  I am a huge fan of small races like this because they treat runners very well.  Two thumbs up for this one!

Love the bling - the center of the medal spins!

Love the bling – the center of the medal spins!

I headed back to my hotel to clean up then drove back to Memphis.  It was time for the adventure part of the weekend.  I visited Graceland, the home of Elvis Presley.  Although I am not a big fan of his music, I wanted to see this landmark everyone raves about, particularly the Meditation Garden where he is buried.  It was interesting but not what I expected.

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The gates to Graceland

I won’t be racing again until April when I run the Boston Marathon.  For the next two months I will be putting all my energy towards staying healthy and getting prepared for the race.  I am running for a charity and I want to give them my best performance.  In the meantime, I have plenty of things to share with you so stay tuned for some interesting reading. 😉

Setting Records in January

Winter is not the time of year I expect to hear about new running records.  But that is exactly what happened in late January.

Ron Hill probably has a big pile of shoes

Ron Hill probably has a big pile of shoes

First there is Ron Hill, a 78-year old former Olympian who lives in England.  Ron was a running streaker who had run at least one mile every day.  During a run in late January, Ron started having pains in his heart.  Ron was concerned about his wife and family so he decided it was time to hang up his running shoes and end his streak at 52 years and 39 days.   I would call Ron the Cal Ripken of running.

Although Cal’s record for most consecutive baseball games played will probably stand for a long time, there are a number of people who could break Ron’s impressive record.  I wrote about the US Running Streak Association (USRSA) a year ago because I was following the running streaks of several runners (Did They Make It?).  In looking at the current active streak list on the USRSA’s web site, I saw 66-year-old Jon Sutherland’s streak is over 47 1/2 years.  As long as Jon stays healthy, he has a good chance of breaking Ron’s streak record in less than 5 years.  In the meantime, I hope Ron basks in the glory of having the longest streak record.  That is one heck of an achievement.

The other records set at the end of January were all associated with the 2017 World Marathon Challenge.  I wrote about the World Marathon Challenge at the end of 2015 (7x7x7).  Participants run 7 marathons on 7 continents in 7 days.  If you think about it, the World Marathon Challenge is also a running streak of sorts.  The only difference is that it ends after 7 days (though I am sure somebody somewhere is thinking about how many days in a row they could run a marathon, if they haven’t tried it already).  When I wrote about this challenge last year, I thought it was a flash in the pan (the price alone would deter a lot of people).  But the number of runners has grown every year with only 9 men and 1 woman in the first year (2015) to this year’s challenge with 22 men and 9 women.

The records set with this year’s participants are impressive.  Sinead Kane from Ireland became the first blind person, guided by John O’Regan, to complete 7 marathons on 7 continents in 7 days.  Guoping Xie set a new world record for women by completing 7 marathons on 7 continents in 6 days 8 hours and 30 minutes.  Nahila Hernandez became the first woman to run an ultra marathon (50K or 31.0686 miles) on all 7 continents in 7 days.  And to think there was a time when women were not allowed to participate in the marathon because there was a fear it would physically harm them.

But the big record was the one set by Michael Wardian, a 42-year-old ultra marathoner who has a day job working as an international ship broker.  From the first race in Antarctica where the windchill sent the temperatures to -30C to the last in Australia, Michael set a blistering pace for each race.  He won all 7 stages of the challenge.  Michael set a world record for the average time for completing each of the 7 marathons – 2:45:57.  Michael’s overall time to complete the 7 marathons on 7 continents was 6 days 7 hours and 25 minutes.

Michael is no stranger to world records.  In 2007 Michael set the record for running the fastest marathon while pushing a stroller with his son in it.  He even finished that race in third place.  In 2015 Michael set the world record for the fastest 50K run on a treadmill in 2:59:49. In 2016 Michael set the record for the fastest runner to complete each of the 6 Abbott World Marathons (Tokyo, Boston, London, Berlin, Chicago and New York) in one calendar year, averaging 2:31:09.

I am not sure what is left for Michael to run.  He has run the most challenging ultra marathons all over the world.  He even ran at the North Pole (in the 2014 North Pole Marathon).  Michael isn’t the type to stay home, running local 5K and 10K races.  In a recent interview, Michael said he likes to do stuff that scares him.  I don’t doubt for a moment Michael has something he wants to try.  No matter what it is, I will be cheering for him.  He is an incredible athlete.

Interested in running 7 marathons on 7 continents in 7 days?  They are currently taking applications for the 2018 challenge.  Visit their website for more information http://www.worldmarathonchallenge.com