The "Let's Go 510k": No More Horsing Around with a Toe Injury

And they're off at the Let's Go 510!  Look closely and you can
see me in the middle with the grey singlet
(Photon from Brazen Racing)

I found myself walking up to the starting line of the Let's Go 510 10k thinking, "Just try to finish".  If I ever went to the starting line in any race with the goal to simply finish in any race in my 30+ years of running, I can't remember.  Of course, finishing any distance race is an accomplishment in itself, but I've been fortunate to complete all but one of the nearly thousand races I've ever entered.

The source of my concern wasn't my fitness, the race distance, the course, or the weather conditions.  It was my little left index toe.

For the past couple weeks, I've felt great in my half-marathon training leading up to the Monterey Bay Half-Marathon in November, but my little index toe on my left foot had other ideas.  A couple weeks ago, I'd notice it would be sore at the end of runs.  Then, a few days later, the pain would start to flare up 5-6 miles into a run.    I never gave it too much mind and really didn't do things like ice it down like you're supposed to do to keep it from getting worse.   Before I knew it, it would start hurting after a mile of running and the pain during a simple 6 or 8 mile run would require me to stop every 2-3 miles to flex my toe and let the pain subside a bit so I could manage to get home.  Some time off and sort runs of 2-4 miles helped but it was still hurting. There I was at the starting line of a race I signed up for weeks ago as a tune-up four weeks before the Monterey Half-Marathon.  The idea when I signed up for this race weeks ago was this 10k was be a test of my fitness with four weeks to go before the half-marathon.   Instead, it turned out to be a wake up call on just how bad my toe had gotten and how little I had really done to treat the injury. .  "If you can't run a 10k now, how are you going to do a half-marathon in four weeks?" I was asking myself sitting in my car putting on my racing flats, fifteen minutes before the start.

The crowd was excited enough from the fun atmosphere surrounding Berkeley's Golden Gate Fields horse race track where the race stared and finished.  "Here's goes nothing," I thought as the starting gun went.   I felt OK through the first mile, with just a dull ache in my toe and came through the first mile in 6:03.  A little too fast, but I concentrated on maintaining 6:10 pace as we ran alongside the Berkeley Marina and into Cesar Chavez Park, coming through mile 2 in an encouraging 6:07, the toe increasingly feeling more sore.   A guy in the East Bay spirit of things wearing an Oakland Raiders t-shirt pulled up to me and we battled through the slightly uphill third mile in 6:22, the toe feeling worse but still bearable.  I was actually more concerned with my faltering pace and holding off the Oakland Raiders guy than my toe at that pint and pulled away from him around mile 4, coming through in 6:10.  Not only was I pulling away from that guy, but my toe was actually feeling a little better and I'm thinking, "Hey, I'm going to finish this thing."


That's me on the Golden Gate Field Horse Track.
I'm going to finish!  (Photon from Brazen Racing)

Unfortunately, my reduced fitness due to backing off with the injury showed in the last couple miles, as Oakland Raiders caught and passed me big time just before mile 5, and I struggled through the last mile, slogging to the finish on the Golden Gate Fields Horse Track in 39:01.  But h, that still took 11th overall and first place for the old guys 46-49 age group, and that's still pretty good.

The rest of day I got serious about icing my toe every couple hours and also started applying Zim's Max Freeze, this gel I got as a free sample a fews months ago from the Zim's Max Freeze folks in hopes I would promote it on this blog which I never got around to really testing.  The day after the race, the toe handled an 8 mile training run OK so it looks like I've turned the corner with the toe injury and more diligence, I should get to the Monterey Bay Half-Marathon starting line OK.  And since Max Freeze seems to be part of the solution, I'll say "Thanks Max Freeze".

So time to get this toe thing straightened out and bring on the Monterey Bay Half-Marathon!

Running Thought for the Week: Strength from Running is a Fragile Strength

About a year and a half ago on a run I'd done countless times, I tripped over a small rock or tuft of grass, fell to the ground and dislocated my left shoulder.  Now I've dislocated it again, this time by simply throwing an inflatable ball to my daughter across a pool on a family vacation..  My daughter asked me how long it will be until I can run again.  Like many questions she asks, I don't know the answer.  Maybe four weeks since it took about that long last time.

We runners put in hard work day in and day out, and over time, accomplish feats we didn't think we  possibly had the strength to do.  Some of our non-running friends look at us as if we have some kind super powers, but we're just running.   But this tower of accomplishment is built upon a fragile scaffolding and a small break anywhere within it, whether caused by injuries, sickness, freak events, overwhelming events in our personal life, or other events largely out of our control, can happen at any moment, causing the whole tower to come crashing down.   There's not much else to do but start over.  Like it or not, it's what you signed up for the day you decided to be a runner..

The tenacity to overcome the setbacks makes the inevitable rewards even more satisfying.

Ask Ramblings: How much weight is too much to be running?

Our latest running question comes from Pete of Chicago who asks:

"At six feet tall, I've fluctuated up and down between 230 and 300 pounds over the last five years. I run (read: jog) 5K's every now and again. Now in my early thirties, I've been getting a smidgen of recurring knee pain. In general, is there some point where one is too heavy to run? A point at which I should simply focus on my diet (including less craft beer...[sniffle]) and lose weight until it's safer to put the stress of running on my knees? I enjoy running but have become more hesitant recently."

It's great that you've gone at it despite being heavier than a lot of runners, and since you describe the knee pain as "a smidgen", I'd keep my eye on it to make sure it doesn't get worse, but otherwise, I think you can keep on running.  But you definately want to get your weight under control, becasue 70+ extra pounds of weight is putting a lot of extra wear and tear on your knees. 

I asked Pete more about his knee pain, and he added this:

"The knee pain is not exclusively tied to running. If I run or bike for a while, it will be painful/sore afterwards.  If I say, have to stand for 4 hours for a concert, it will be painful/sore afterwards. Then, much less consistently, I sometimes have pain while running, biking, or even something as simple as walking up steep stairs. The pain has not affected my running form at all, so I guess that's good."

I'll let you in on a secret.  Plenty of runners go through some low level of pain similar to what you describe.  I have knee soreness pretty regularly, and the ball of my right foot sometimes starts hurting on runs of 10 or more miles.  Hardly any runner feels like those smiling faces on the cover of Runner's World and other fitness magazines, effortlessly running about in near-orgasmic bliss.  Running is hard work that makes body parts sore.

The trick is to make sure the soreness from running isn't so bad that it affects your daily life, or starts affecting your running form.  Favoring an injury in your running forms is particularly disastrous, as it often leads to unusual stresses on the legs, creating more injuries elsewhere.  Certainly you want to get your diet in order, but if you can to run with a "smidgen" of pain and can both tolerate and manage that pain and still enjoy running, I'd continue to keep at it.   Determining the balance between diet, exercise, career, social life, family, and other important things in your life, such as beer, to discover the weight you will be happiest at is one of those big life questions only you can answer. 

I'd add that since you are past the age thirty, your body is going to take increasingly longer to recover from the pounding of running, and the joints are simply going to get more brittle, so if you enjoy running and other activities, carrying around those extra pounds are going to take a larger toll as you get older which is something you should factor in. 

Finally, runners are constantly breaking down barriers, so if you can overcome the extra weight and still run, congratulations on accomplishing a big part of the battle because you have what it takes to be a runner.    There will always be people out there who'll say you're "too old" or "too heavy" to run.    Don't ever let one of those people be you.

Got a running question? Submit it to Ramblings of a Beer runner via e-mail or a comment to this post and if I use your question, your reward will be my brilliant response, and something to tell your friends and grandkids for the rest of your life.  I'm not a doctor, physical therapist, or coach, nor have played one on TV, but just trying to help fellow runners out, so my advice here for what that's worth.

Sorry, Pete got the last Ortholite insole and currently there's no swag to give you if I use your question.

The old "ice cube in the sock" trick for Achilles Tendonitis

I am grateful for Bay Area Half-Marathon Enthusiast Lauren Olerich of Sugarcoated Sisters for injecting some badly needed dignity to the "Ask Ramblings" forum with her question:
"Have you ever dealt with soreness in your Achilles tendon? While I'm running, everything seems fine. Once the shoes come off (New Balance WR890s), my right Achilles area gives me hell! The day after a run, I hobble around. Strangely, if I'm at home and not wearing shoes, the heel pain doesn't pop up. Any recommendations on how to avoid the pain? (Short of going shoe-less at work, of course!) Any warm-up exercises? Cross-training suggestions?"

Have I ever dealt with soreness in my Achilles tendon?  You bet and it's no fun!  The most effective treatment I've found for it is the "ice cube in a sock trick".  Simply put on a sock, and slip in an ice cube positioned over the sore area and leave it there for at least 15 minutes.  I've found even one treatment can really bring the soreness under control.

You can leave it there longer if you want and I've left it long enough that the whole cube melts.  You can repeat this a few times each day to bring down the swelling, but it's most effective to ice right after your run to keep the swelling down and allow as much blood as possible to repair the damage.

Tight calves will put a lot of pressure on the Achilles tendon, so keep them loose.  This video will help and I also do stretches numbered 4 and 5 here.  You want to be careful doing a lot of stretching with a sore Achilles tendon, so a balm like Icy Hot can help loosen the calves without putting extra pressure on tendon. 

Since you mention that going barefoot seems to lesson the pain, you might want to consider both running and everyday shoes that have low heel raises.  This doesn't seem to be a good time to be wearing high heels.

Good luck and let me know how this works out for you.  And remember, I'm not a professional physical therapist or anything.   Just another guy giving out free advice who hopes you get more than you paid out of it.

Got a beer running question? Submit it to Ramblings of a Beer runner via e-mail, Facebook, Twitter or a comment to this post and if I use your question, your reward will be an Ortholite Shoe Insole, my brilliant response, and potential world wide humiliation on the Internet.

Do It Yourself Doctor Needing Directions

It must be one of those guy things like not asking for directions. Every so often, some part of my body breaks down from running and rather than seeking professional help, I attempt to self-diagnose the problem.

It's inevitable really. If you're trying to push limits, you're going to hit a few breaking points. When that happens, you need to back off and figure out what the problem is so you can fix it. After years of reading books, talking to other runners, and stealing advice from physical therapists whenever possible, analyzing my own personal pains and injuries has become second nature.

For example, I can tell if that pain in my left knee is my reoccurring tendinitis just by the way it feels, which I can take care of with some ice, or if the pain something else that might be more serious and difficult to deal with. I'm often poking around my hamstrings and calves, looking for tight or sore points to massage or stretch out. And there's this irritation in my index toe knuckle that ofter flares up at the end of most long runs. This happens a lot, and if I just give the toe a gentle twist, the joint will emit a soft "pop" and things feel a whole lot better.

Of course, to really figure out what is wrong, you really need to see a professional. But of course, I really do not have the money or time to see one pretty much every week or so as do most people. So lots of runners simply resort to being their own amateur doctor out of necessity, figuring out what the small pains are and working to keep them under control. So when someone asks "Don't you think you should see someone about that?" as they watch me limp around, my stubborn response is "Nope, I'll be fine. This is just part of running." I usually don't need directions, even when I am a little lost about what's going on with my body.

But a couple weeks ago, from both misdiagnoses and overzealous training, I screwed up my right hip real good. Of course, at first I figured the initial soreness was a little strain which I could work out with some stretching. But that really didn't help much. But figuring if I was careful, I could do a couple hard runs before the Santa Cruz Half-Marathon, and then back off, the soreness in the hip would recover in time for the race and everything would be fine.

I don't need to tell you what happened. My right hip got real bad, too bad to run without badly limping around, and my reward for all that stubborn hard work was standing around watching half-marathon I should've been running in. Checking a running book chapter on injuries, my new self-diagnoses on my hip was a stress fracture, which requires about two months of rest, no running to heal. Crap.

So even I finally gave in and had someone look at this who actually knows what he's doing. A genuine doctor. One who knows that the hip is a very strong bone and that stress fractures in it are very rare. Of course, my wife who works in a hospital told me the very same thing a few days earlier, but do you really think I'd pay attention to her on this? The doctor also noticed the two general areas I pointed to where the pain was the worst happened to be the very spots where bursa sacs are located in the hip, which pretty much sealed the deal on it being bursitis. They took hip x-rays anyway, but didn't find anything. Sort like when they x-ray my head.

And one of the few times in my life, I'm glad to be wrong. And since bursitis takes maybe a couple weeks to heal, I'm thrilled to say my problem is bursitis. Sometimes, when all is lost, you finally give in to reason over pride, and pull out a map, sometimes you'll find a great shortcut.

It's a pain waiting for a dislocated shoulder to heal

There's nothing better than starting the day with a trail run. I've many mornings running the Belmont Open Space Trails, which lead to a great overlook of San Francisco Bay. This great view is the perfect way to start the day, and having to run up a few hills to get there, the best thing is that this view is earned.

Trail running is good for more than great early morning views. The changes in elevation and uneven terrain are great for developing running strength, flexibility, and balance that simply cannot be achieved on flat city sidewalks and streets. But taking more challenging trail workouts also exposes you to more injury, and last week on the trails, I tripped, stumbled, and fell and in the process dislocated my left shoulder.

I knew my shoulder was dislocated almost immediately after I hit the ground. I tried to raise my left arm hoping it might pop back into place, but it was too painful to raise above a 45 degree angle. My hand felt numb, so I started flexing my left arm in hopes it would create some circulation and feeling. A light headed feeling descended upon me, and so I bent over, dangling my left arm to my side and bracing myself with my good right arm, so I wouldn't pass out from shock. Once I gathered myself, there wasn't much more to do than walk out of the woods and go back home so my wife Linda could take me to the hospital.

Luckily, I knew a shortcut through the trails back home, so it only took about a half hour to get home. And Linda works in a hospital as a speech therapist in head injury rehabilitation, so a dislocated shoulder hardly the worst trauma she deals with on a regular basis. She got the kids dressed, and we all went to the hospital to put my left arm back in place.

My doctor just didn't have the strength to do it. It actually felt good as he pulled on my arm, which loosened up a lot of tightness in it, but he couldn't get it back into the socket. Next, he had me lie face down while they attached weights to my left arm dangling off the side of the hospital bed in hopes of fatiguing the arm muscles over time so the arm would pop back into the socket by itself. When that didn't work, they put me under with the same stuff that killed popstar Michael Jackson, and with my body relaxed and mind totally unaware, finally put my left arm back where it belonged.

Yes, dislocating my shoulder hurt, but really not that bad. And after all, running is about managing discomfort effectively to achieve goals, more succinctly and alliteratively phrased as "no pain, no gain", so the pain of a dislocated shoulder is simply part of running. They got me in a sling, and supposedly six weeks from now, my arm will feel back to normal, but my left shoulder will be more prone to dislocations due to the damage. I'm not supposed to lift things with my arm. When I'll be cleared to run, I have no idea.

A dislocated shoulder is painful, but I can handle it. What I can't handle is sitting around doing nothing, especially since there is not much I can do to make it recover. Not running for a while few weeks is something I actually find a little scary. Before started running at the age of twelve, I was this skinny kid with no self-esteem that everyone seemed to pick on. Running gave me the confidence I needed at this fragile age. I kept at it until there came a point during my first marriage where I nearly stopped running all together, gained 60 pounds, and was generally angry and unhappy. Running got my life back on track, but unfortunately not my first marriage. There's this irrational fear that if I stop running, I'm going to become that timid skinny 12-year old, that fat unhappily married guy, or some hideous hybrid of the two.

I was planning to enter a couple races in October and November, and was starting to gear up from them in my training. Since that looks like that's not going to happen, I've started spending mornings walking for 20-40 minutes instead of the usual run. It not much, but it's better than nothing, and one thing I've learned in 30 years of running is that maintaining a routine being consistent to it is important. For now that routine is morning walks, and sometime I'll get in another walk during the day. I'll build from there.

I will get back up those hills and earn some more great views in the morning. But for now, I walk and wait.

Find balance and lost years at the SCORE Clinic

I walked into the SCORE Clinic knowing something was terribly wrong, but not quite sure what it was. My training regimen had degenerated into a cycle of a hard track workouts ending in injury, a two week recovery period, only to injure something else in the next hard workout. This is not training that leads to success in racing, and it was showing. The soles of my running shoes looked like someone whittled outside edges with a pocket-knife, a sure sign of supination. My left hip was noticeably at least an inch higher than my right one. For at least the least nine months, I'd been trying to push through chronic soreness in my upper left knee and soreness on the ball of my right foot, and was now starting to battle left hip strains on top of that.

With things get totally screwed up in an important area of life, and you don't have the foggiest idea what to do about, it's always good to consult a professional. And there's a certain irony to the fact that the SCORE Clinic is just a couple blocks away from my divorce lawyer. And once Dr. Omura of the SCORE Clinic simply watched me try to do a single squat, and he pretty much figured out what the problem was. I basically couldn't do even a single squat, and was rotating my left foot outward due to a weak left hip, and shifting most of my weight to my right foot to protect my weakened left knee and hip. Needless to say, a one-legged runner is at a considerable disadvantage, so Dr. O developed a plan to increase flexibility, get rid of the pain and soreness, and find balance in my running stride.

That all sounds wonderful, but Dr. O accomplished this with techniques a casual observer might think come from a CIA torture manual. A typical session started with electrodes attached to my ailing left knee, producing pulsing electrical current into the knee muscles, causing them to twitch and contract uncontrollably. Then, Dr. O scraped my knee with something like that looked like an enlarged butter knife to break down the adhesions and scar tissue. Then, he performed something called Active Release Therapy where he would apply strong pressure with his bare hands directly on the sore knee or hip with the muscle contracted, and would maintain this pressure as I extended the muscle, literally squeezing out the swelling and damage. The session concluded with a vertebrae popping chiropractic hip and back adjustment, allowing the hips and back to find their natural, optimal alignment.

But Dr. O did more than subject me to a number of teeth gritting situations. He patiently demonstrated some simple stretches and exercises to do at home to flush out soreness, increase flexibiliy, and build up weaknesses. I've seen physical therapists treat their patient's living tissue as if it were some inanimate car chassis, but Dr. O gave me the insight and understanding to know what my problems were, how to fix it myself, and how to prevent it from happening again. These sessions were quite possibly the best investments I've made in running. I've faced many injuries and set backs in my thirty years of running, but dealing with these lingering pains and frustrations over the months with no apparent progress at the advanced running age of 42, I was contemplating hanging up the racing flats for good.

Back when I was young, immature, and naive, I told myself the day I stopped running and racing was the day I died. Life has changed tremendously since then, but one thing that hasn't is the drive to keep running, and train for the next race. Like a lot of runners, running has been my rock. There simply must be some challenge to overcome or a goal to meet to keep me driven, and without this, I become very directionless. The lessons of discipline, persistence, and dealing with success and failure learned from running have guided me well in real life, where success and failure in things like family, career, personal fiances, and social relationships have consequences far more significant than whether or not you take home some cheap, plastic trophy. Running's gotten me through some hard times, when I could briefly escape life's turmoil and burn off frustrations just to get through the day. I simply wouldn't know how to give it up even if I wanted to. Thanks to the SCORE Clinic, I no longer have to make that difficult choice.

Beer Running Tip : A Cure for Plantar Fasciitis is in Your Fridge

Let's face it, injuries are often a part of running, and plantar fasciitis is particularly nasty. If you've had it, you know what I'm talking about. That intense pain under the heel caused by damage and inflammation of the plantar fascia ligament, a common overuse injury runners face. It's tormented many runners, including yours truly. Because the plantar fascia ligament receives so little blood flow, the ligament takes a long time to heal, often weeks, or even months. It's stopped or slowed many a runner in their tracks.

The good news, fellow beer runners, is that relief is no further than your fridge. Just gingerly hobble over to your refrigerator and pull out a cold bottle of beer. Sit down on a chair and slowly roll the cold bottle with your foot using gentle pressure to stretch the plantar fascia ligament, encourage blood flow, and reduce swelling. This technique also works for pains in your arches, too. It's really a proven and recommended technique, but if you insist on consulting medical professionals, you can go here.

Bay Area Beer Runner highly recommends that you seek post-therapy refreshment with a different beer than the one you just rolled around on the floor.