Several weeks ago, I wrote about overtraining my way into Posterior Tibial Tendonitis (PTT) on my way to attempting my first 50k trail ultramarathon. Then, in a bold move of bravery / stupidity, I ran the 50k anyway. As one might imagine, running 50k didn’t exactly help my tendonitis, so I accepted that my spring running season was going to essentially be one of rehab. Mainly, I rested. I rested until it didn’t hurt to walk. I also did a bit of physical therapy with a licensed practitioner, I strengthened and then Rested, Iced, Compressed, and Elevated (RICE for those who have been there), and I’m happy to report that I’m on the mend.
The Keys to Success
Looking back, there are a few things that have been very effective in my recovery from PTT: shoes, speed, and strength.
First, shoes. I invested in some new running shoes and I started wearing old running shoes in lieu of dress shoes for most of the day. While I’m not one to dole out free advertising, I have a couple of go-to brands for my running shoes. For the last couple of years, I’ve funneled the vast majority of my shoe dollars toward On – the Swiss running company that brings us the Cloudflow. Cloudflow has been my weapon of choice for all of my marathons and essentially all of my training runs. In the height of my training, I’ll put 60-70 miles per week (100k+), so my shoes don’t last a long time. I try to retire them after about 400 or 500 miles, although I’m not fantastic at keeping track. However, for my 50k trail run, I opted to try the Hoka One One Speedgoats. These shoes are gaudy. When I was buying them some young lady walked by and exclaimed, “Why is everyone switching to these geriatric, super soled things?!?” I wasn’t offended. I agreed with her. But I was trying to put in some big miles on a bad wheel. And my goodness, did these things work! So much so that I have since bought a pair of Hoka One One Cliftons, more or less the road version of the Speedgoats. These shoes have been an excellent source of comfort as I work my way back into fitness. I will say that I’m now splitting my running time between the Hoka and the On products, but as I slowly ramped up, the Hoka One Ones were very important to my recovery. I also mentioned that I started wearing old running shoes instead of dress shoes. This was also very important. I now routinely wear a pair of my On Cloudflows that have at least 500 miles on them to and from the office, and unless I have any big meetings, I’ll wear them all day. I have no data on this, but in my mind, the shoes help my foot maintain a good shape so that I’m not collapsing the arch on my flattish feet in my fashionable dress shoes. After wearing my old running shoes all day, my feet feel stronger and ready for a workout.
Second, speed. And what I mean by speed is the absence of it. I have to admit that I am inspired by ultra-athletes like Scott Jurek, Killian Jornet, and Rich Roll. I’ve been a bit of a fan boy and read all of their available advice, which says, “do volume first, then work on speed.” After taking 1.5 months off, I worked as if I was starting over. So now I’m a few weeks into building volume again. At this point I am doing 6-8 mile runs 5 or more days a week, all without compromising my pesky tendon, at least until last week. For shorter runs, I’m wearing my beloved Ons. For longer runs, I’m wearing my “geriatric” Hokas. This really isn’t fair to a shoe that has helped me recover. But they are a tad on the obnoxious side. As far as my actual speed goes, I’m comfortably in the 9+ minute/mile range. At the height of my fitness, I was turning in sub-7 minutes/miles. But now is not the time. I’m simply rebuilding my base level of fitness. And it is working very, very well. I’m finding that my heart rate is lowering by 20 beats per minute at the same pace in just a matter of weeks. So, running is getting easier as I plug away slowly. Now, I will admit that I took a speed detour this past week and set myself back. But that was a learning opportunity too. I have been feeling very good, so I opted to work on a bit of speed this past week. On Tuesday, I did 2+ miles of 30/30 in which I ran hard for 30 seconds (5:30 minutes/mile pace) and then rested for 30 seconds. This didn’t hurt my foot at all, so I decided to hit the “go button” on a shorter distance run at pace. I was targeting 5 miles after warming up. I made it 4 miles at 7:14 minutes/mile, but with some discomfort. In the days following, I was in pain. However, my strict regimen of resting and wearing running shoes throughout my day has helped put me back on track. I’m happy to report that I did a slow 7 mile trail run today with no discomfort. So, I’m experimenting and learning. This helps me focus on my recovery time rather than sit idly by and attempt to wait.
Finally, strength. My physical therapist gave me several exercises to do with bands and such to strengthen the muscles in my foot, ankle, and other parts of my legs. I have somewhat dutifully followed the prescription. However, as previously reported, I have also started rock climbing. When rock climbing, I often have to gain a foothold on the smallest of edges; thereby working muscles in the foot and ankle. I have found this to be extremely useful. I’m not one for weight training for the sake of weight training. I much prefer to do something that has the spillover benefit of improving strength. Rock climbing has fit the bill beautifully and I have built strength capacity for my runs while having a great time learning a new skill. I’m still a novice of course, but that’s ok too. Novices see all kinds of gains in new skills as they put in the time.
OK, so here we have it. I hope you never come down with the dreaded PTT. But if you do, I have 4 key recommendations: 1.) Rest until you can walk pain free, 2.) Give your feet a break with a shoe solution, 3.) Take a break from speed training and come back cautiously, and 4.) Find a way to strengthen the muscles in your foot and ankle in a way that works for you. Of course, I’m no doctor. So work with your licensed professional on your specific recovery plan. However, hopefully my path to recovery can be used as you navigate the tricky path of soothing a savage tendon.
Thanks for reading!