What’s (not) been happening lately

So since Chicago Marathon I haven’t run.

My knee is not happy. Straight after the marathon it felt quite battered, a little swollen and very stiff. Walking was fine to an extent but I could feel my knee.

I mean this is to be expected. The week before the race I woke up with a swollen knee and it felt very off and weak. Running 26.2 miles on it is unlikely to make the situation better of course.

But now over 3.5 weeks later the swelling has gone and in general it feels fine to walk but it is still so stiff and when I bend it doesn’t feel great. Kneeling on it niggles it too.

I am really trying not to scream and shout at my body in annoyance. I’m trying not to let this get me down. Of course I’m beyond chuffed that I managed to run Chicago without issue. I didn’t have to stop. I didn’t feel any pain. I did feel limited in how fast I could run for fear of aggravating things, but I remained at a consistent pace and finished.

Believe me when I say, I am so grateful. It could have gone a lot worse. Chicago was the goal of the year and I walked away with what I wanted – the Six Star Medal.

However, I’m still annoyed that after diligently resting nothing seems to have improved over the first week post-race. I haven’t run properly at all. A couple of times I’ve run up the road when walking Alfie to test things (because most of the time my knee feels fine) but then as I’m running I can just tell something isn’t right and it starts to feel uncomfortable and I know it’ll get painful soon.

Annoyingly I can’t quite work out exactly what is wrong. At times it’s like an IT band issue annoying the outside of my knee and feeling tight in my hip. Then other times it’s most definitely the underneath/inside of my knee and achy. I wake up in the morning and it’s very stiff (I sleep on my back and my legs are generally straight most of the night).

What is going on?!

I know I’m such a broken record and it’s laughable that I was deluded enough to believe I had a strong body to avoid the regular injuries I used to encounter when all I did was run.

*Sighs* Don’t be negative, don’t be negative…

I wonder if my hamstring injury is the root to this happening. Over the past few months I’ve avoided some of my usual leg strength exercises (like lunges and squats). My legs I guess have become weaker… my hamstring injury was the other side so perhaps I overcompensated? I could wonder about this forever but it doesn’t change the fact that I cannot run and I don’t seem to be getting better.

I’m seeing my physio tonight and hoping to have some answers. Fingers crossed.

How’s your running going?

Everything I’ve learnt with my hamstring injury

I wanted to write a post about my hamstring tendinopathy experience.

This might be fully pre-empting things but I feel somewhat confident I can write this post and that I’m mostly out of the woods).

The affected area was the top of my hamstring, right below my bum cheek. It wasn’t sharp or stabbing pain, more like a throbbing, dull ache. At the beginning I could feel this while walking, while lying down and especially when sitting. Sometimes I would feel an ache in my lower back and down my hamstring.

Running made it feel uncomfortable so at first I avoided this to let it calm down. Though I saw a very good physio who I heartily recommend (South Physiotherapy), it didn’t really help. I had acupuncture, massages, ultrasound… I still felt the discomfort.

I wanted to write this post because during my hamstring tendinopathy injury I read a lot online which was very negative and without solutions. I realise the spirit of the Internal and forums for health issues is not like a diary whereby people write about their issues, solve them and then go back to update people. When you’re fixed, you don’t go back. You just carry on with life. But I wanted something to put out there that might be helpful to someone like me. I know I’d have found this helpful.

Here are some sources that were useful though and hugely helped my recovery –> this journal article and this blog post.

Obviously I’ll preface this saying that I’m not a physio, doctor, coach or any sort of professional who has more than half a brain. I’m merely explaining how I overcame my issue. Whether it’s the full-on correct way or if it’s just something that works for me, I don’t know. But if you can take away anything from this post (if you have this injury) is that there is hope!

Though there appears to be minimal research out there for hamstring tendionopathy, what the two sources above agree is having a three step approach. The first step is to let the hamstring settle a bit. You don’t want to be doing hardcore leg strength workouts and you should probably stop running, especially avoid any sort of speedwork or hills which will aggravate the hamstring directly.

The not running part I was really good at. I stopped running completely for seven weeks. In hindsight, I don’t believe I needed to take this much time off had I not aggravating things further with trying to do too much strengthening and rehab at the gym in the early stages. But I read too much online, got carried away and attacked my hamstring with all manners of strengthening, from hamstring curls, Swiss ball bridges, sledge pushes and glute kickbacks. All of which I felt directly in my top hamstring but believed this was it “working” only to find the next few days it was far more niggly and nothing was improving. I also tried to replace running with using the elliptical machine, but this aggravated things too.

What I should have done at the beginning was focused primarily on isometric exercises. These are when you hold your muscle tightly. Nothing moves, but you’re squeezing the muscle. We’re talking static bridge holds. Eventually once I got past my over-enthusiastic gym endeavours and took a step back and focused on the bridge hold, things got calmer. The niggle was still there, but now it wasn’t getting worse or bugging me all the time and the isometric exercises were providing relief.

So, stage one: only do isometric exercises for the hamstring. The best example of this is literally the bridge hold (with a long lever base so it’s your hamstring working not your glute – so push your feet out further from your bum). Increase how long you can hold. Then when you’re solid with that, move to single leg and push the time on that. You can do this just lying on the floor, or you can do (as well as) putting your feet on a raised platform, like a coffee table.

Avoid at all costs: squats, lunges, glute kickbacks, hamstring curls (lying or sitting) and anything that makes the hamstring feel worse the next day. Tendons are a funny thing – it can take 24 hours before you realise you’ve screwed it up. Try and avoid long periods of sitting; get up and move around frequently. DO NOT STRETCH the hamstring. Don’t be tempted. It won’t feel better, it’ll aggravate it. It is literally the worst thing you can do to it.

Stage two is now where you can do a bit more. I found using the lying hamstring curl machine on the affected leg worked wonders. At first I aimed for high reps low weight but actually what really changed the game for me was low reps higher weight SLOWLY (heavy slow resistance).

What you should aim for is a weight that becomes challenging on the 8th rep. Aim for 8-10 reps. Don’t push through pain though! Pain is NOT a good thing. 3/10 discomfort is your marker. Your hamstring should feel tired afterwards but not painful at the time or later.

This is also when you can start to add a bit of running back in (again, no speedwork or hills though). It will still feel uncomfortable but if you have sharp pain, avoid and go back to stage 1. Mild discomfort that doesn’t get worse and that disappears after 24 hours is OK.

During this stage I also focused a lot on improving my adductor strength. I wanted the surrounding muscles to be strong. I used the adductor machine at the gym (that awful machine that people a few years ago used thinking it would zap inner thigh fat). I also laid down, put a medicine ball between my knees and gently straightened my legs out, then drew them back to my chest while all the time SQUEEZING the ball. This is a killer for the adductors and the core.

I still avoided squats and lunges but ramped up my glute work with resistance band walking, clams and heavy hip thrusts. Basically I was gently rehabbing my hamstring while super-powering everything else.

Running was frustrating (for me and everyone around me who had to hear me moan). It was still uncomfortable. Having a physio “re-align” my hips helped unlock me and changing my trainers definitely helped but it was more of a case of being sensible with when I did the rehab and when I ran. And keeping things easy and short – building up gradually. And trusting the process.

So many times after a run I was lost in my negativity and ready to give it all up. I’m very lucky to have such a patient and loving network of support around me. Even my mum, who’s a big supporter of my running but in general doesn’t care for the details, would ask more questions after every run, worrying for me and wanting things to be better. Kyle of course was a pillar of strength for me during this time.

But gradually things got better. My hamstring would niggle less, become uncomfortable later and later during a run. Afterwards it would feel better. I remember when I ran eight miles and that night I felt my hamstring gently throbbing while I laid in bed and I worried and worried. The isometric exercises helped calm things down and acted as a good pain relief. And taking bigger gaps between each run helped. Then long runs stopped bugging me during the night. My body was healing quicker as it adapted.

Stage three is adding back in things like squats and deadlifts. I’m not quite there yet. I think I could add them back in but with Chicago literally round the corner I want to avoid anything that aggrevates my hamstring.

Stage three is adding back in things like squats and deadlifts. I’m not quite there yet. I think I could add them back in but with Chicago literally round the corner I want to avoid anything that aggravates my hamstring. I’ve ramped my long runs up (two 15 milers under my belt) and feel confident I’m heading in the right direction and not putting my hamstring at risk of regression. Obviously 26.2 miles in a few weeks is really going to test things but my plan is to be sensible. Realistically I am terrified and worried of going back to square one. If this wasn’t Chicago I would have canned it.

Basically my advice for this injury is: it will take time to recover. There is no magic pill, no trainers, no massage technique, no amount of icing or medication, no stretching or foam roll battering that will make everything better.

Rest is also not best. During my injury I had friends and family, who were enduring my continual frustrations, saying I should stop everything I was doing. Stop going to the gym. While I will fully admit that there were a number of weeks I shouldn’t have gone quite as ham on the rehab as I did and should not have tried to replicate my running on the elliptical machine, rest would not have solved my issue either. This injury requires rehab which involves strengthening and monitoring. Gently getting into a position where you can actually build your hamstring back up without reaggravating things. It’s a delicate balance.

In terms of cross training, I found the stair machine to be the best thing. Cycling (including spin – which was horrendous for it), the rowing machine and the elliptical machine really didn’t work. But ultimately it’s the strengthening of the hamstring that is the way forward.

Sorry for such a waffle but I wanted to write down my findings for this. If this helps just one other person, then I’m happy.

Good luck!

Game on, Chicago

I really don’t want to jinx things, but it looks like things are definitely getting there with my hamstring.

I obviously need to continue to play things safe and not suddenly be like wheyyyyyy 18 miler booooom. This hamstring injury (hamstring tendinopathy) is one that can easily be triggered again and regress. So I continue to proceed with caution. But *whispers* things are going well.

Daily discomfort is minimal – if it’s even there. Previously when it was at its worst, I’d feel it All. The. Time. I’d feel it walking. I’d feel it lying down. Now it’s rarely ever there. And happily sitting doesn’t trigger it anymore.

Most importantly, running isn’t an awful experience. There were runs at the start (like only a mile or a tester run) where it’d feel so uncomfortable that I’d feel this great stab of fear thinking “I cannot run 26.2 miles like this” and really doubt getting more training done. But now the discomfort is minimal. It’s still there, but every run it gets a bit less.

I ran 12 miles at the weekend and it was a run that gave me great confidence. Yes it did feel uncomfortable towards the end, but not the worst discomfort I’ve felt over this injury.

And the rest of the day it felt fine! Even the next day it felt absolutely fine. My first few runs when I was coming back I’d feel my hamstring discomfort a lot more post-run and that night and the next day, then it would die off again. But now it’s not there anymore.

Running those 12 miles felt like an absolute joy. Listening to a podcast, zoning out, having that time just running for a long time. Yes it was hard (Jesus how did 12 used to feel so easy??) and yes it wasn’t perfect, but it was so much better. I know I’m at that point in the injury lifecycle where it’s going. Every day is better, every run is better.

After speaking with a professional who knows a lot about this injury, he advised upping my hamstring strength routine and planning out my runs in relation to that a bit more sensibly. With the strength I was previously taking the weights very gently on the hamstring curl machine (as to not cause any regressions) and doing about 20 reps at light weight. Now I’ve upped the weight and I do around 10 reps, so it starts to get tough at the last rep. And he gave me a few more exercises to incorporate which focus primarily on my hamstring.

Previously I was very much focused on my glutes. But now I’m focusing on my hamstring (I still work my glutes and the surrounding muscles but the focus of my rehab is most definitely the hamstring now).

Single leg hamstring bridges

Just to be clear though, if you’re suffering from this issue too, you need to have a gentle and gradual build-up. It’s taken me many weeks to get to this point and it was only after talking to this specialist and him checking my strength and mobility that I was given the all clear to fully work the hamstring harder. The first few weeks of this injury you wouldn’t necessarilly do that.

I also asked if he thought me doing Chicago was sensible or if I’d do myself any long term damage. He said as long as I didn’t regress or get worse, Chicago would be fine. This is EXACTLY what I needed to hear. Someone who knows their stuff giving me solid advice. My mind is so much calmer now.

So going forward I’m running three times a week, one of those being a long run. Though realistically I won’t be going that long… probably 16 miles top. And between that I have set hamstring easy and hard days. So far so good! My hamstring is responding well. It’s getting stronger. The discomfort is getting less.

The thing about this injury is that you have to be patient, be sensible and not neglect rehab. It won’t get better on its own with rest. You have to push it and strengthen it. But it’s a very fine balance of not pushing it too hard and knowing when to back off. I think the past 15 or so weeks have evidently shown this for me! I’m going to do a more thorough post later on how I combatted this (though I don’t want to speak too soon because this could all fall down again!!).

I’ve read a lot of forums and I just want to put something positive into the Internet about this injury because so much of it was doom and gloom and never feeling normal again. I’m not quite back to normal, but eventually (all things being well and me not being an idiot) I hope to provide a bit of positivity from what I’ve learnt and experienced. (TOUCH WOOD!!)

Have you ever had a long-term injury?

Do you do regular strength work to keep an injury at bay?

Decisions, decisions

The Chicago Marathon is now merely six weeks away.

Obviously I’m panicking, do I need to say this? And the question of whether or not to run it still hangs above me. I mean, to be honest I could absolutely leave it until the morning of the race to decide if I’m going to do it or not. Kyle and I will be going to Chicago whatever my running outcome is. The flights and accommodation are all booked. There was never a consideration that we wouldn’t be going so whatever happens we’ll have a nice holiday. That isn’t up for debate.

What is up for debate is me being on the start line. I mean you could argue I should just go and try it anyway. I get no money back by not doing it. Our accommodation is literally a 10 minute walk from my corral. Effort levels of getting there are minimal.

Instead the risk is that by attempting it I will be making my hamstring injury worse because, let’s face it, us runners are stubborn beasts and once we set our mind to a race we will do our very best to run, walk, crawl to the end. And while yes that’s great in terms of making the most of a shitty situation, I could making the situation afterwards, well, more shitty.

The idea of starting and then going “ah you know what, it doesn’t feel that great, I’ll stop” requires a very strong mind. To limp through a race in my opinion is the weaker stance… By recognising that it’s best to stop requires far more strength. And with the adrenaline and thousands of other runners and supporters surrounding me, I don’t think I would be able to. I would push on through.

So I must decide before that day. And ideally, before I get to Chicago so’s not to get swept away with it all if the decision is the worser outcome. But I still have six weeks. So where am I at?

Well, it’s not a great place I have to admit. While my hamstring has definitely improved, it isn’t healed. The everyday niggle and ache isn’t always there. I have days when I barely feel it and running itself is a lot better. I’m not feeling restricted or like it’s such a nag I need to stop. But the feeling of discomfort is still in the background. No run has felt 100% perfect.

Perhaps I’m expecting too much? Perhaps it’s very gradually diminishing but because I’m inside my body every day I can’t tell. Or what if I’m just getting used to the constant discomfort and settling for “it’s not too bad”? I wish I could put myself in my body a few months or weeks ago and compare. Is it better? Or am I fooling myself?

The Wiggle crew I ran the 10 miles with

I ran 10 miles last week (and 20 miles overall). The 10 miles was uncomfortable and the hamstring did nag me, but it didn’t seem to get worse and I could complete 10 miles at a relatively normal pace (for me). Though that evening it ached and the next day it felt worse than before the run. But the next day I was absolutely fine and could barely feel any issues – despite having a two hour car journey to and from Bristol (which would previously feel like hell being sat down for so long).

So then the question is, do I do Chicago if running still feels uncomfortable? If it doesn’t do any long-term damage (this is a question I need answered) and is just an annoying nag the entire time, do I still do the marathon?

Am I being a perfectionist to want my last Marathon Major to be a fun and enjoyable experience – like my other Majors? Can I accept 4-5 hours of discomfort to just get it done? Do I throw away my chance to finish the last Major this year because I want the memories to be amazing? Or do I throw the towel in and have to fly out and do it all again next year (a Friday to Sunday night style affair on my own) because I want the experience to be what I’ve dreamed it would be (or at least, any issues I have aren‘t hamstring-related).

Sadly this injury is not the type of injury (hamstring tendinopathy) that just goes away with rest. Thirteen weeks of not running definitely showed that. Everything I’ve read online and the physios I’ve seen and spoken with have advised that rest is not best. I mean, that’s not to say that running through it is a good idea either. It means rehab and strengthening. And there are set-backs and aggravations and you can be setback weeks (I’ve experienced that a few times!).

I try not to read the forums anymore (you really shouldn’t) but so many people have said they had this injury for months, sometimes years. And even then they weren’t properly over it. It’s a depressing place in those forums and I know not to read too much into it or apply it to me… But when you’re standing on the edge of a big decision, it’s hard not to be dragged down there.

But until things really regress, I just have to keep going. I actually have no idea what to do otherwise. Even without thinking about Chicago, I want to run normally going forward. When it’s been so long you can’t seem to see an end. Will I be running normally next year? At this rate, I don’t know. Yes I’m being melodramatic, pessimistic and pathetic, but it’s hard not to let the panic consume you. When something you so love to do is taken away from you – or tarred in some way – your outlook can be a bit bleak.

Sorry for being so down. I just needed to vent.

What would you do?

My first long run in a while

I would like to write a running-related post that doesn’t refer to my hamstring, but unfortunately that’s not where I’m at.

But it’s not all doom and gloom. I’ve had two relatively successful runs this week. I ran 4 miles on Monday and then 8 miles after work on Wednesday. They weren’t perfect but they’re giving me hope.

The four miles I probably ran a bit too quickly I guess but it felt comfortable and I didn’t push the pace consciously. I was just enjoying being out.

The run on Thursday evening was a bit of a worry to me. I wanted to do it later in the day so my body was more warmed up. And because I stand most of the day at work now as I have a standing desk, I wanted to do it straight after work, rather than drive home and do it there.

Kyle said he’d join me which was nice and it worked out well because we had some time to kill before going to his sister’s house for dinner that evening.

The first two miles felt fine. We kept the pace nice and easy. Though I wanted to relax and chat, I found myself just concentrating so hard on what was happening with my leg that I probably wasn’t that good company to Kyle.

Unfortunately after the first few miles my left knee (same as the hamstring problem leg) started to give me a random pain. We stopped and I stretched and as we started again (my mind literally thinking this was it, it was over) it felt fine again. How random.

My hamstring/glute did start to ache a bit as the run continued though and it didn’t feel particularly comfortable. But it didn’t slow me down or make me change my gait so we pushed on. In fact, it just remained a constant ache the entire way through the run without getting worse.

What really surprised me about this run was that my endurance and fitness felt absolutely fine. Had my hamstring not been feeling uncomfortable I’m almost certain I could have gone on for a good few miles more before I’d start to struggle. This is HUGELY comforting to know. I haven’t run more than four miles for thirteen weeks. So it’s pretty crazy my body seemed fine with it. What’s helped, I’m guessing, is that we weren’t pushing the pace. It was very conversational, despite my moments of intense silent concentration. Kyle was fantastic is keeping me on a tight lease and pulling me back which definitely helped.

I have of course being doing cardio at the gym too, so I’m pleased this has carried over. Doing the stair machine frequently (and up to an hour sometimes once a week) has clearly helped. THANK GOD.

To be honest though, I would give up my fitness and endurance if I could lose the discomfort in my leg. But hey ho. I’m taking comfort from the fact that straight afterwards and today it doesn’t feel worse. Also, when I refer back to my training notes when I’ve previously had this issue I was able to run several long runs with the issue (even up to 17 miles) and it didn’t get worse. Thank god I’m so anal about these things as it helps mentally when I question what I’m doing.

Realistically, I do think it’s going to take time for this to disappear. And as long as running doesn’t hinder that by making it worse, I think I’m OK. I just need to be sensible with the build up, my pace and the recovery of each run. It’s definitely a mind boggling and stressful process but it is what it is. If it gets worse/regresses, then I’ll make some hard choices.

So I continue. A few runs every week, gently building up the miles. Fingers crossed.

How is your training going?

How do you come back after an injury?