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!

Learning to Climb

This year, I’ve set some non-running goals for myself. It’s a good thing too. Because of some silly over-training on my part, I’ve come down with posterior tibial tendonitis (PTT). PTT is much less frequently experienced by runners than the dreaded plantar fasciitis, which I’ve also had, but PTT has proven to be just as pesky to get rid of. After 6 weeks of physical therapy, I’m still unable to run any distance pain free. I have learned over the years that in order to maintain my mental stability in a demanding workplace, I need to move. I’ve also learned that I do better when I’m moving outside. Last year in the summer, my cousin, her husband and I hiked to the top of Mount Chocorua and it helped to fuel a whole new fire in my belly.

I have some lofty climbing goals for the year. My cousin’s husband invited me to join his three-person group to summit Mont Blanc later in the year. At 4,810 m (15,781 ft), this isn’t exactly a walk in the park. While my fitness should not (at least before my self-inflicted injury) be an issue, it would be good to get more experienced on trails and in wintery conditions since the top of Mont Blanc is glacial ice year round. So, we have planned a couple of tune-up climbs. This coming weekend, we will – weather permitting – climb Mt. Washington in New Hampshire. While the altitude is not stunning at 1,916 m (6,288 ft), the climb is fairly technical and the weather can get downright treacherous. Some 150 people have died on Mt. Washington since record keeping began in the mid-1800s. As such, I’ve been taking a multi-faceted approach to training.

Getting Vertical

That’s me up in the purple zone. And yes, for you experts, it is an easy course.

Growing up in the foothills of the Appalachians, I’m no stranger to hills. I’ve even done a bit of ill-advised, inexperienced bouldering (rope-free rock climbing) in my youth. But on the whole I have very little experience going vertical. So, I’ve recently been going rock wall climbing at a local gym in town. We are very lucky to live in a metropolitan area with these kinds of options, since the tallest natural peak around me can be measured in the tens of feet. I’m finding that I love climbing. Much like running, it gives me a sense of accomplishment. While I’ll do it when I have to, I sincerely detest machine or free weight training for the sake of weight training. It just does not leave me feeling accomplished. Climbing on the other hand has everything I’m looking for: problem-solving, a great muscle work out, and some elements of cardiovascular exercise as well. I’m sure a seasoned climber would tell you that my technique is terrible, but still, I’m pretty reliably going upward and building in confidence. Even better, my wife agreed to join me on my last trip and it appears that this might be something we can do together. While I don’t intend to do any actual vertical climbing on Mt. Washington or Mont Blanc, getting experience well help me remain confident and sure-footed as we take to steep ascents on higher terrain.

Equipment Test

I learned this year that Mountaineering is chocked full of equipment. Extra stiff mountaineering boots, crampons, trekking poles, lightweight layered clothing, eye protection, and on and on. The acquisition of this long list of surprisingly expensive equipment has turned me into bit of a bargain shopper, as I’ve learned the ins and outs of various websites and specialty stores. Now with a tub full of equipment, I figured it was important to get out and try out some of the gear, as the first time I wear this stuff should not be on the mountain. So, I recently packed up and headed out on my local running trail for a 10k hike while completely over-equipped. I’m sure I was a real sight as I strode around a trail essentially designed for running while dutifully using my trekking poles and carrying a pack replete with ice axe. At least it was a little snowy that day so I didn’t completely look like I was off my meds. Here’s what I learned:

  • Super-stiff mountaineering boots are great for keeping your Posterior Tibial Tendon relaxed. These things are not too dissimilar to a medical immobility boot
  • Super-stiff mountaineering boots are, on the other hand, not great for my outer most toes during long-range hikes on mostly flat ground. Mine were both quite red and quite angry at the end.
  • Trekking poles are surprisingly helpful, especially when precariously balancing on rocks while crossing a stream in sub-freezing temps
  • There are many sharp points on an ice axe that, if not carefully positioned on your backpack, will in fact poke you repeatedly
  • Super-stiff mountaineering boots are also not excellent on ice in spite of what appears to be quite aggressive treads on bottom

Strength Training

I know what I said earlier about strength training, but I’m actually happy to weight train if there is a purpose. As I watched YouTube videos about climbing Mount Washington in the winter, I came realize that I’m in for quite a workout. And since I’m not able to run any sort of distance at the moment, I knew I would need to hit the weights. So, three to four days a week I’ve been working the major muscle groups. Squats, deadlifts, bench press, dips and pull ups have become my friends again along with a bunch of core exercises. For years now, I’ve been running at least an hour a day roughly 6 days a week. It hasn’t left a lot of time for weight training. As one might imagine, I have lost a fair amount of strength and muscle mass. But here’s the other thing I forgot. Weight training makes me ravenous. So now I’m gobbling vast quantities of food that I haven’t needed or wanted and my… ahem… waistline is suffering a bit. I’m resisting pulling the fat pants out of the closet, but I know from experience that I’m getting dangerously close to opening an embarrassing stitch line with one ill-timed stoop to pick something up off the ground. Let’s just hope I can keep my pants in one continuous piece until I can get back to running.

Sense of Purpose… and Impending Death

On the whole, I’ve thoroughly enjoyed the shift in focus from running as I learn new mountaineering skills. It has given me a sense of purpose in my free time since I’m unable to log the running miles that I’ve grown accustomed to. I still have so much to learn, from knot-tying to belaying, to not having an ice axe come loose and stab me in the face. Yes, that last little number was a tidbit I picked up from reviewing the manual for my recently acquired ice axe harness. Apparently, mountaineering is a bit of a medieval sport.

This is absolutely part of the instructions that came with my recently acquired ice axe leash