Sunday, January 25, 2015

Good news!! Grab them while they last!!

Wait, what is happening? Good news?? Something like that... may not be very significant in the grand scheme of things, but at least it's a start. Every day that I don't feel injured must be celebrated!!

After last week's stunt in the hospital, I made sure to stay put. I spent most of the weekend on the couch, resting my back as much as I could. I did not have to take any of the Tylenol/Codeine (T3), but continued the Naproxen until Wednesday evening. I skipped all workouts, and I even went for massage therapy on Monday morning. Despite the therapist's gentle touch, it totally made me feel like I got beaten with a baseball bat. Needless to say, I worked from home that day because I needed to remain horizontal. And just like that, come Thursday, all pain was gone!

Gave myself 2 more days to make sure it wasn't just the Naproxen lingering in my system and Friday night I laced my shoes and went out for a run. Well, you know... the sort of runs that I'm doing right now. Went on the same 2.5km loop around the block, but did 2 min run/1 min walk, with the run intervals a little faster than usual. I remember when Zin was recovering from ITB issues, he was told to run a little faster = less pounding. No issues during this run, but my knees felt a little hot afterwards, which I suppose is the new normal.
Next day I spent a good 30min on my roller, plus stretching and smashing all sore muscles. My adductors were a mess, and so were my Gluteus medius. By the way, you'll hear me talking muscles more often from now on because thanks to Jim from 50 after 40 I finally bought a muscle chart. I had no idea it would be so big though... I still need to find a place for it where it doesn't scare my house guests.
That's what I get for not knowing the imperial system...

Alright, last but not least, today I returned to the pool! The workout was mostly speed intervals and for the first time ever I went without having breakfast - I wasn't feeling hungry, and as part of the nutritional coaching that I'm following, I am learning to listen to the hunger cues - so I don''t know if it was in my head or not, but I wondered if I would have done better with some food in my stomach. I managed to go through all the sets though and I was pretty proud of myself. Here's what it looked like (not all times were recorded because I don't measure the kick sets and sometimes I just forget to start the watch again, plus there's the Garmin hiccups).

100m free | 50m pull | 50m kick | 3x50m fist rest 30 | 4x50m desc rest 20 | 50m 85% rest 40 | 100m 85% rest 45 | 150m 85% rest 50 | 150m 85% rest 50 | 100m 85% rest 45 | 50m 85% rest 40 | 100m pull ez rest 20 | 8x25m sprint rest 15 | 2x75 (25kick/25pull/25swim) | 50 breast stroke
And that's about it! Back was a little tired after the swim, hence the blogging opportunity while I lie on the couch, waiting for Zin to come back from his 18km indoor run.

One day at a time, it's all I can afford for now. Thanks to all who sent me words of encouragement and were there for me when I was losing it last week. You guys mean the world to me <3.

Monday, January 19, 2015

One more hiccup

Some good news would be great for a change, right? RIGHT?! Sorry to disappoint, dudes, but you can leave now if you wish. A few more shitty weeks like the ones I left behind and I call it quits. And I'm NOT a quitter, but struggling day in and day out it's getting on my nerves.

I took the stretches seriously, I was working on those like a champ. Was anything getting better? Less pain in my legs or glutes or hips while rolling, stretching, smashing, wrapping? Of course not. Less tightness in my knees? Yeah, right. I GET IT, it takes weeks and months and years... maybe an eternity to feel perfectly fine. But I am tired of trying... Aaaaarrrrghh!!! Can we go back to my body of 2 years ago, please? But I'd like to keep the Ironman if you don't mind.

If only you could hear me screaming inside. It's all muffled and it makes my ears bleed, but it's there. I need a pillow to let it out so I don't scare my kids. Hey, speaking of which, my son told me the other night that he heard me making sounds like in The Exorcist while I was trying NOT to scream too loud while I was in pain with a nerve pinched in my back, and everything else tensed and spasming like I was possessed. Say what? But of course, let's rewind...

Two weeks ago it was all about the bike and body maintenance. I went to 2 spin classes, really tough ones, and I felt really unmotivated to do any strength training, as my quality time with my roller was constantly making me aware of all aches in my body. Add even more pain to the mess? Thanks but no thanks. So anyway, come Wednesday of last week and I finally got out of my frightened stupor and decided to do a strength workout, and even better, make it count. More weight, more reps, it's time to feel the burn again!

I won't lie - I struggled. Right off the bat, I had a pretty hard time finishing my first set of "Dumbbell Alternating Shoulder Press and Twist" with 10lb in each hand. But hey, I had been doing these exercises for 3 months, I figured that maybe it was time to be able to complete a set.
If I remember correctly, the most reps I had done with this weight before was 10. But for the first set, I tried maxing it out at 12. The last 4 were a torture. I also had "Plank with Alternate Arm Extension" on the menu:
I did 12 extensions with each arm, up 2 from the previous time. The last 4 were also a killer. I felt like going into child pose and staying there forever once I finished those.

Then I did some side leg raises, where I also increased the reps by 1 from the previous session. Those were not too difficult, but they definitely made my glutes remind me how weak they are.
Then I did some "Bear Crawls", which I also maxed at 15 (up 3 from 12).
In case you don't know how these work, you crawl into a pushup position, then you lower yourself all the way to the ground, take a breath, then you push yourself back up and rewind to the starting position (upright, not shown in the picture above).

In total I did 3 sets of these 4 exercises. In the second and third attempt at the Dumbbell Shoulder Presses, I used 8lb and 5lb respectively because I figured 10lb for max reps was too much. The rest of the sets remained unchanged. It felt hard and I was pretty proud of myself when I finished it. BUT... because there is a BUT...

Right afterwards, I also went on my bike trainer to do 1h of easy spin. I do this all the time on Saturdays with the tri club - that's why they are called StrengthSpin classes after all. Really easy, nice cadence of 90+ rpm. But, because of the late start, I ended up finishing my workouts after 10pm and I decided to skip the maintenance and go straight to bed. And as soon as I lied in bed, I felt the pain on the side of my back like someone just stabbed me. I decided to ignore it because "meh" - for sure it'll be gone by the morning - and I didn't think too much about it.  I didn't have the best sleep that night for sure and in the morning, the pain was still there.

It went worse and worse throughout the day, to the point that I had to go to see the doctor at my workplace, who sent me back to my desk with a Robax Platinum. I kept on taking muscle relaxants that evening and night, because the pain even woke me up in the middle of the night and it was pretty unbearable. Went back to work again, but on Friday night, as I went to bed again, it hit me like a wrecking ball (cue in Myley Cyrus licking a hammer) and all hell broke loose.

Within 1h I could no longer breathe. It was like someone was stabbing me on the side of my abdomen with every. single. freaking. breath. Have you ever been stabbed? Me neither, but sure I never want to. It was the worst pain I've ever been in. If I recall properly, when the nurse asked me how painful it was from 1 to 10 I replied "fuuuuuuuck". That bad.

So Zin took me to the Emergency, where 2h later was given an IV of morphine, along with Gravol and a bag of Saline. I must have spent 2h in drug-land, barely conscious, talking about passing out over and over again... I don't remember much. When all the blood and urine tests came back a-ok around 4am, I was given 2 Tylenol 3 (w/ codeine) and Naproxen to go and that was it.

I spent the rest of the weekend on the couch, aside from a dinner at Queen Mother Cafe, downtown Toronto with Carol and her boyfriend - which I managed to handle pretty well thanks to being heavily medicated. Needless to say, I skipped the alcohol, but I had an amazing dessert.

And here I am again. Waiting. My massage therapist confirmed a shortened QL and nerve impingement, that miraculously went back to normal since. I am not allowed to do any exercises that twist my upper body, including shoveling snow or starting the lawn mower. I feel completely beat up after the treatment and stayed in bed today. Tomorrow may be a better day and maybe one day I can go back to swimming, and biking and running, you know.. all the stuff that keeps me happy. Sounds like a plan?

And kids? Don't try this at home.

Sunday, January 4, 2015

Trial and error

Today is a better day and I have to write about it before the feeling goes away. Nobody likes reading endless complaints, or so I think. But if you stumble on a pity party like in the previous post, every once in a while, you may feel compelled to comment, to help, to share your story, to empathize. However if you've heard the same story for more than 6 months, I suppose that it's starting to become annoying and you may even find yourself saying "shut up and do something about it already". But as I said, I have been trying and it hasn't been easy, mostly because of all the conflicting expert information that is out there. When you don't know who is wrong or right, you have to be open minded and go through trial and error. Unfortunately for you, my readers, I share (almost) everything as I document all my attempts to returning to a pain-free state of being. Every day I tell myself the same thing - wouldn't it be WONDERFUL if today my knees and hips stayed quiet? I can't wait for that day to arrive, but in the meantime, you have to bear with me as I go through the motions of experimenting with things that make sense to me in a particular moment. Only when one avenue has failed, I move onto another because there is method to my madness.

Let me give you an example: foam rolling. First and foremost, I have to admit that I am lazy. Any good reason not to roll and I'm game. For many months last year I went to see a massage therapist named Antonio. I loved Antonio - his specialty was myofascial release and he knew how to make my aches go away, even though I'd come back home with bruises all over my legs. Yet he always said that I could help myself by rolling more often. And I would always reply... sorry, not today. Eventually I ran out of money and I stopped going. Then my ITBs became more and more problematic, and the pain in the knees followed. But don't get me wrong, I am not necessarily implying that it was a cause and effect - just that I could no longer give my legs as much TLC as before and maybe, just maybe I could have delayed the knee pain if I had continued going to see Antonio regularly.

Anyway, back to foam rolling. My massage therapist would tell me to roll, my coach would tell me to roll, my husband would tell me to roll, and so would many of the people I know - but then I'd come across expert opinions such as these "Your IT band is not the enemy (but maybe your foam roller is)" or "ITB or Not ITB... That is the question" and then my brain would go into a deadlock: what to do, what to do?? It also did not help that I was sent to another massage therapist/acupuncturist and this guy told me that he didn't believe in foam rolling either, especially for ITBs. I respect and trust many of the health professionals that I see and I know that there isn't ONE solution to all issues. But there it was, another reason to NOT roll. And I believed in it 100%. I also believed that the key was in releasing the TFLs and hip flexors and stretching the glutes etc.
Alas here's where I failed because I didn't do those things either.

When I wrote the previous post, I received many pieces of advice and of course some were conflicting. I am always happy to receive suggestions, don't get me wrong, but I ended staying awake until past midnight weighing pros and cons and reading hundreds of opinions that you can find on those websites' comment sections. All articles are interesting, and all opinions carry their weight, but at the end of the day, I have to look at what I already tried and worked (or not) vs what is left to be tried even if some people are passionately against those ideas.

So here I am, holding another list of TODOs in front of me and looking forward to the process, or rather to a different outcome. Someone once said that the definition of insanity is doing the same thing over and over and expecting different results, but as I consider myself sane enough to see the difference between approaches and the value in each of them.

After the initial shock that my IT bands/hips/knees combo is still not operating pain free, I skipped my bike workout because I was scared to make things worse given that my hips were somewhat achy and the rubbing of my left knee cap was puzzling. Just to make it clear, so far I have not experienced the kind of pain I was in last year during the Ironman training months, but the same tightness, pulling and rubbing that I would feel at the beginning of every run. In the past, it would only go worse from there, hence my erring on the side of caution. However today I decided to make another attempt at running, but a little differently. I also bought a new pair of shoes which I wore during my 4km walk earlier this week. I didn't choose the pink but they were $72 so I can't complain.
I went to Cassie Campbell Recreation Center where they have a nice gym with a track and started with dynamic stretches and the usual ABCs of running warmup. Only then I went to the treadmill, where I did 1km of run/walk alternating 1 minute each at 1% incline. Nothing violent and I am not even sure that I ran 1km, but I could not feel anything "wrong" at the end so to speak, so I take it as a win.

Then I did my strength workout, followed by the famous "couch stretch" and foam rolling. Because why not. These are the tools that I'll use in this new trial because I also trust my friends and coaches who I know have been through similar experiences. If it worked for them, maybe it will work for me too. Out of this exercise, I did find a possible causal relationship between my left knee pain and tightness on the hip/leg/whatever.

Let me explain the "couch stretch" with a few images from the very useful book "Ready to Run" by Kelly Starrett.
On the right side, which didn't present any symptoms so far, I can go to step #6 and hold it for 2 min, while on the left side, I can barely get into #3, and then only hold it for 30-45sec at a time with my arms raised on a block. The difference between sides is dumbfounding, but it definitely explains why the left feels tighter than the right, and why it may affect my ITB/knee. Because it freaking IS tight.

So what if this whole mess is not an injury, but just tightness that I need to get rid of to become a "supple leopard"? One inch at a time - poke, listen, address weakness, imbalance, stiffness. There must be a way and I'm gonna find it. I have tools, I have plenty of support and I'm working on my patience every single day. Can I have a yay?

Saturday, January 3, 2015

The Great Comeback Run that wasn't

Since September 13th, the day of my last run in 2014 I had been counting the days until I'd run again. I was told to wait until January to start again. I chose to be patient and not question the decision, even though I had my doubts that this was the right approach. My ITB issues were never an acute "injury", but a gradual change in my body - something that went astray over time. I did not wake up overnight with pain in my knees that's for sure. Something south of my waist is no longer working properly and nobody has been able to tell me exactly what it is. Without root cause, you cannot fix an issue for sure. You keep applying patch after patch, and hoping for a miracle. Assuming that I got to this point because of my poor bike fit, maybe I should have stopped biking altogether. Who the fuck knows. The entire year has been the same violent struggle as in Pink's video "Try". And I did try a lot of things: not running, water running, knee braces, physio, ART, massage therapy, acupuncture. All for nothing since they never brought me any long term relief or "cured" me.

So on January 1st I bundled up for sub zero temperatures, laced up my running shoes that had been sitting in my garage, still muddy from the last race of the season - and with so much hope and anticipation, I hit the road. Gently, carefully, slowly. One mile was all I wanted to run. Out to Tim Hortons and back. I walk there all the time. 11 minutes. Even coming back from other injuries, I never ran under 15 minutes. But 11 was going to be enough for that day, and it should not have hurt.
Yes, if it had been a running injury, THIS RUN SHOULD NOT HAVE HURT. But 1km in, the ITBs started to tighten up, niggle in the left knee appeared. I did not run enough for it to become painful, but it was there, just like I feared. NOTHING has changed since September despite the running interruption, nothing. I came back home, knees were hot as usual. I sat in the chair on the porch, head resting in my hands and at that moment I wanted to sell all my triathlon gear and QUIT everything. I was shaking inside. I was angry, sad, hurt, disappointed. I was DONE. I had a horrible day afterwards, full of tears and despair.

My lovely hubbs was there for me though - and he knows me better than anyone. He asked me how he can help, what he can do for me. I didn't know what to say. I just wanted him to hold me, to be with me. He encouraged me to go in my room and use the foam roller. He said that I should use it every day, which I never do. How many times I foam rolled since September? ONCE. Maybe this is ALL there is. To take care of my 40 yr old body because I no longer get a free pass at playing with endurance sports. He also suggested that I buy a new pair of shoes. Maybe there isn't enough padding in my K Swiss since put on 15lb. Maybe I should stop running on pavement and use the treadmill exclusively until the pain stops coming back to haunt me. Maybe I need a gait analysis and long term physio - but I am not made of money and I don't know who to trust.

Yesterday I went out for a walk. I really needed some fresh air. After 1km, the left knee cap started "rubbing". Against what? No clue... It felt like sandpaper against the bone. Maybe it's not tracking properly. Maybe I need an MRI of both knees and hips. All signs are here to tell me that my body hates me. Today I decided to skip the strength/spin workout because I am afraid. I am back to square one, not knowing what to do, where to go from here. I just wish I had a picture of my body from the inside that had all the answers laid out for me, crystal clear. I am so very tired of trying to find answers, and not having someone who isn't giving me any.

I haven't given up yet - as far as I know, I will do my best to have a "normal" year as a triathlete and runner - but boy, that looks frightening right now. I am not here to scare you away from this sport - I own my poor decisions of not getting a bike fit when I should have, not stretching, not warming up, not using the foam roller, not throwing away running shoes after 500km, not doing strength training, not eating well enough. I suppose it's a warning of sorts, that you have to take care of your body and be very careful what you wish for.

Tomorrow I will try running again. Padded shoes, treadmill, warmup and all. Maybe tomorrow it'll be pain free. Maybe all I need is faith and a bit of patience. The answer must be out there somewhere.