Running: The Continuing Saga of Returning from Tendonitis

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.

Summary Recommendations

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!

Running My First 50k

I started this blog post the morning before attempting my first 50k run. The title of this post very well could have read, “My first ‘Did Not Finish’ (DNF) Race.” As I stated in an earlier post, Taking a Zero Day, I had some setbacks in my training routine running up to the race. Those setbacks lingered. And then lingered some more. My foot never really healed all the way. The most I had run at one time for the 3 weeks prior to the race was 4 miles, and my foot hurt every time. So to think I could make it 31 miles was pretty silly. But, somehow it worked.

Before the race, I took a mental assessment over breakfast of my physical and mental states. Here is what I wrote down:

  • Body feels good, well-rested and ready to work
  • Ankle pain 3 out of 10, worst when I flex the outer part of my foot upwards
  • Thinking about which wheel will fall off first: most likely my ankle, maybe my legs from a lack of running, least likely my cardiovascular system
  • Considering disappointment of being listed on the race results as DNF
  • Thinking about letting down Matt – my friend and running partner – whom I roped into this crazy idea
  • Given that it is a trail race, I cannot walk the required pace to make the cutoff time
  • Realistic probability of finish: 30%
  • Trying to quash the negativity, I am starting affirmations and visualizing a pleasant run in the woods

Then it was time to go. So I stopped thinking and put myself on auto-pilot. I loaded up my truck with my pre-packed supplies from the night before, and drove to the race start in the dark. When I say I stopped thinking, I put all my meditation practice into effect. I stopped assessing and ruminating. I stopped thinking about disappointments and pain. I used the skills I have learned in meditation to go through the motions and accept whatever came. Once at the race start, I continued to go through the motions. I met up with my friend, we made the decision to run light and rely upon the aid stations for food and drinks. Soon it was time to start.

The Rocks and Roots Trail Series at Alum Creek State Park in Lewis Center, Ohio, is one of the best organized I’ve ever experienced. It is a very small race, capped at 400 runners, and it is organized by runners for runners. I highly recommend it if you can get a spot. The leading picture for this post is one of the many stunning views you’ll experience throughout the two 10k loops of this fun and challenging course. So with some quick, no-nonsense announcements and an old-fashioned, “Ready, Set, Go!”, we were off at 8 AM.

I started off limping and then eased into a slow, methodical stride. A funny thing happened. My foot pain spiked early and then within 10 minutes subsided back to a 2 or 3 out of 10. I thought, “I can live with this.” So I just kept going. That’s how it went. Minute by minute, hour by hour, I just kept going. One foot in front of the other. 4 hours into the race, we had completed our first 30k (18.6 miles). If you’re doing the math, these are not fast miles, but that’s OK. We decided that this was a “just finish” race because it was our first attempt at this distance and, given that it was a trail race where we go up and down ravines and hop over downed trees, this was never going to be flat out. At 30k, the course was getting really boggy. There were significant portions of the course where the term “running” simply did not apply. Think, “ankle-deep pancake batter” and you get the picture. For these portions, we slowed to a walk and then picked back up on drier parts of the trail.

Somewhere around mile 29, I caught a root with my bad foot and it sent pains spiking through my leg. So I walked for a bit. My running partner and long-time friend – ever patient – walked along just in front of me, willing me forward. There was no stopping now. I had to cover the two miles back to the finish line anyway. So I walked on and used deep, focused breathing to let go of the pain. Soon I was back to trotting on drier spots and slogging through the mud.

And then it was over. We popped up out of the woods and came down the final stretch to the finish, where 20 or so people were cheering us on. Just over 7 hours of constant movement, and we had done it! Our first 50k. Matt and I crossed the finish line together, just as we had started. I want to be clear here that he could have gone ahead and beat my time by a good 30 minutes. But that isn’t who he is. After getting our medals and picking up our bags, we cheered the next 5 runners down the path. As the post-run chill sank in, we decided to call it a day and head back to our families, exuberant at our accomplishment.

As I put the finishing touches on this post, I feel great. My foot is a little swollen and tender, but I’m able to walk and be productive the day after a 50k (31 mile) race. I accomplished a major 2019 goal on day 6 of the year in the face of adversity. Perhaps I spend too much time on Zen Buddhism in my blog, but I will tell you dear reader that without my experience in sitting meditation, there is just about zero chance I would have attempted this race, let alone finished it. With that said, I also want to recognize the power of the team. Because without my friend Matt running along with me, I would have limped slowly across the finish line wondering what more I had left in the tank. Here’s to friends and zen!

Cheers!