50k training: week 3 (or how to address pain before it becomes an injury!)
There is an impending sense of doom when a runner begins experiencing a consistent pain, particularly if the pain worsens over time. After three days and a near constant pain in the top of my left foot, I was definitely panicking! So last week, training turned into assessing the damage and adjusting my runs to ensure my foot could recover.
Many people are so hesitant to back off their training, despite clear signs from their body that rest is needed. I hope this week can provide a good example of how backing off can pay off dividends later.
Here is the snapshot of the week:
Monday: 5 treadmill miles, 45:11
Tuesday: Rest
Wednesday: 6 miles, 51:49 (enjoyed more Christmas lights!)
Thursday: Rest
Friday: 7.29 miles, 61:28
Saturday: 3 miles, 25:12
Sunday: 5 trail miles, 45:26
When I experience any specific pain for at least two runs in a row, I make a note in my log so that I can review the timeline of a possible injury. I started feeling my foot at the end of week 2, but the pain usually went away while I ran. Given the lack of acute injury (like rolling my ankle, for example), I continued to run. However, my foot bothered me through the whole of Monday's run, and it hurt to walk all of Tuesday.
My concern was that I had a possible stress fracture, so I tried the informal hop test (hopping ten times on one foot. If it hurts too much to do that, you potentially have a fracture). There is another informal test where you hit a tuning fork against something, then put the point of the tuning fork where you have pain. If that hurts horribly, you potentially have a stress fracture. DISCLAIMER: These are examples of informal tests--neither of these tools should be considered diagnostic. Only your doctor can diagnose a medical condition, such as a stress fracture. Please do not use these tools without medical consultation.
I kept off my foot as much as possible. The pain was less on Wednesday, and I finally decided to take some ibuprofen, which got rid of the pain completely. The pain returned only slightly when the medicine wore off, so I tried a run and my foot again warmed up into the effort and stopped hurting. If it had not stopped hurting, I had planned a route where my husband and kids could easily pick me up. There was some pain on Thursday, so I took another day off.
Saturday, my long run was providentially prevented due to an alarm mishap--My toddler changed my alarm volume to essentially silent, so I slept right through it! I was able to sneak in some miles by having my husband drop me off along the way to the grocery store, where I met my family to finish the shopping. I decided to give my foot the break and did not squeeze in more miles. I enjoyed some stress relieving trails on Sunday pain free and have started week 4 of training with a strong, pain free workout.
Those days off may not have added to my fitness, but they likely prevented me from losing out on a whole training block if I had pushed through the pain. I am keenly aware of my higher risk of stress fractures as a breastfeeding mother, but I also know that I am chronically sleep deprived as well, so I am not recovering at the same rate as if I consistently slept. My foot was possibly some strained muscle or tendon that would loosen up during runs because of increased blood flow, but tighten up when I was not using it. Even though the pain has receded, I am considering that too tight laces may have caused it and will be trying a new lacing pattern. Even when we rightly address a pain, deducing the cause and addressing that will have better success for our long term well-being.
To recap, what do I consider when I have a constant or worsening pain while running?
Is the injury acute (clear, recent cause)?
Is the pain sharp or worsening with every step?
Is there a localized pain or is it radiating?
How many days has there been pain (I will generally go to the doctor for any pain that lasts over a week)?
Is the pain interfering with my daily activities, such as walking or caring for my children?
Does the pain worsen with some movements, but not with others?
Does the pain increase, decrease, or remain the same during an easy run?
Documenting various pains over time has had the effect of helping me discern normal training pains from possible problems. It is an imprecise system, so when in doubt, take the day off or trade out a workout for easy running or cross-training. Be careful when consulting with others, but particularly other runners who are known to run through anything. They may be more injury resistant than the average person, or they may simply run through injuries that they should not and be causing more damage. Preferably, being able to make a doctor's appointment with a doctor that is familiar with runners is ideal; following up with a physical therapist where needed is even better so that you can strengthen where there is weakness and have preventative care. The best way to treat injuries is to prevent them!
Well, I hope I have left you with some good advice, or at least a tale of appropriate caution. How do you handle potential injuries? Comment below!
Enjoy your miles this week! I plan to be extra grateful for every step :-)