Monday, February 13, 2017

Trying desperately to avoid TMTS

Yeah, that last episode of TMTS lasted longer than I expected.  Outside edge of the left foot inflamed and took a long while to cool down.  I increased walking, and pain increased.  I relented, down from four miles to 2.5 to 3.0 miles, and then slowly ramped up -- and down again.  Shooting hoops to measure the impact of nothing other than higher impact.  Finally, this past week, increased walking, chasing the ball on missed shots, yard work, etc., the feet felt good in the morning and not showing any "hotspots".  I needed a plan, and I needed to execute the plan.

The one good thing about being past 55 years is that one has made a lot of mistakes and actually learned from some of them.  Reading instructions before assembling something, for instance, because you don't want to get frustrated by doing it a couple of times the wrong way before reading the instructions -- bypass the failed attempts and not burn-up life-moments with avoidable irritation.  Running is no different.  I have made plenty of mistakes.  I have made so many that I cannot think of one which I have not made.  I have also learned, studied, and embraced the instruction of experts and experienced runners.  My plan needs to be, more than anything, a reflection that I am engaging my brain about what I am doing to my body, based on the experience in failure, success, and learning.

I love barefoot running.  It is the only way I can be sure that my feet are landing the way they should and it makes me think about my form from the ground up.  That's just me.  It is not for everyone, and there is nothing superior about it.  Good running form is good running form whether your feet are shod or naked.  I have a nice S-shaped driveway and it covers more than 100 meters; I have measured the 100 meters with a survey wheel and have mark its points -- the last 50 meters are slightly uphill.  The concrete of my driveway is only a year old and very comfortable when barefoot.  In other words, I have a great running "track" on which to begin.

My TMTS injury occurred when I started with, too much too soon -- and too fast.  I am starting with four 100 meter intervals, doing the workout three times this week and five times (body permitting) next week.  I noticed in my workout today that with increased speed, I also experienced a shift to running unbalanced.  My first interval was at 8 minutes per mile (5 mpk), my last was at 6 minutes per mile (3.7 mpk).  The earlier two intervals showed better balance than the faster (muscles were warmer, felt good) latter two intervals.  This is a focus point -- stay balanced, avoid injury.  All other running metrics were very good.  I felt good enough to do more, but the brain told me to wait and see, making certain to avoid TMTS and the very large steps backwards it carries me.

When I was in France, I went from 0 to 10-mile (16 km) runs in four months -- with lots of weight loss and mistakes.  There is no reason, I must remind myself, to be in a hurry now.  I live in an area where 10-12 mile runs (16-19 km) would be wholly along wooded country roads; woods which have been here a long time and aren't going anywhere soon.  I can afford patience.

Friday, November 18, 2016

TMTS and landscaping

I am barefoot most of the time, both inside and outside of the house.  I have taken the dogs for walks barefoot (1.25 miles. 2 km).  The soles of my feet are quite ready for running.  As I posted earlier, I was very enthusiastic about running my intervals in the driveway.  Excited to be rebuilding.  Then it happened, and I should have known better, did know better but thought I was immune to it, Too Much Too Soon (TMTS).

You see, the soles of my feet are well conditioned for running barefoot.  I am right about that.  I wear pretty much only "zero-drop" footwear (my Xero sandals are my favorite).  I have moccasins for working in the yard which have leather soles -- not the rubber soles.  Even when I am not barefoot, my feet function as though they are bare -- from a function perspective they are unhindered.  The TMTS?  Oh, well, hmmm, that has to do with STRESS LOADING.  Despite all the time I spend in bare feet, the stress load of running is at least 2.5 times that of walking (up to 4X at higher paces), and there is really no way to condition for that kind of loading except by doing so GRADUALLY.  Going from zero to a half-a-mile (0.8 km) of sprint intervals is TMTS, apparently.  I really kind of knew that, but I was hoping I'd get a pass on this one.  I did not.  My feet complained very loudly about it.

I have not spent the time since my last post being idle.  I finished our primary landscaping around our house which involved moving six cubic yards of mulch (4.6 m^3), planting almost 30 plants, trenching drainage, overseeding grass areas, distributing pre-emergent, and leveling places in this new lawn with topsoil.  Physically demanding labor, spending hours per day for a week.  At my age, every one of those days was counted as a workout.  We have the grandchildren this weekend, and all my energy and time will be spent on them.

Next week I will begin anew.  This time, I will slow my pace (reduces the loading) and continue the intervals.  I will listen more closely to my body as well.  I now know that I get ZERO passes on being foolhardy.  OTOH, with my formerly torn left bicep ready for regular workouts, and my hamstring recovered, I will revamp my exercise routines to be more rounded and complete.

Keep moving!  (just do so, wisely) 😁

Wednesday, November 2, 2016

A Run & Stretch workout, and a PT workout the next day

I  know that I said I would take it slow, and only do two interval sets on my first running workout this week.  Here's the deal: I decided to do the intervals on my S-shaped driveway which is a little more than 100 meters from the garage door to the street.  I have measured it with my surveyor's wheel.  I was excited and started my workout -- the first one on my new Forerunner 630.  The first two sets had some expected discomfort, but less than expected.  I ran sets three and four, and the right leg had warmed up and felt good.  Then it hit me -- in my excitement to do the intervals on my drive, I forgot the heart-rate monitor which also has the tech for the running dynamics!  I admit to being a bit of a fitness-tech geek, but I am only interested in stuff I can really use in my training.  I went inside, put on the monitor, and re-did the four sets, in essence doing the same mile workout I did previously (but about 20% faster this time) which had me hurting for a couple of days afterwards -- but I got my running dynamics on that second four sets of intervals!  LOL!  I did follow-up with a good stretch routine.

The hamstring held up well, though it did voice a light opinion or two the rest of the day.  I awoke this morning, and was in the midst of taking the dog out, making coffee, serving coffee, and cleaning up after coffee when I realized I had no discomfort in the back of my knee.  I was excited for my PT workout!  The PT workout went very well, which included 20 minutes on the Nordic-Track and two sets of bridges and squats, both using the stability ball.  Stretching is a daily activity now, post-workouts.

The new running dynamics of the Forerunner 630 over the old 620 include a ground-contact balance check.  I suggested such a measurement four years ago, and although I do not claim to the the originator of this implementation, I am glad to see the information available.  I am just a little outside the green (good zone), with a 51/49 split favoring the left side, which might have something to do with the right leg issues.  It also measures the economy of the stride, taking a ratio of vertical oscillation (how much one moves up and down during the stride) to the stride length.  I scored very well on that one, as I am a pretty "flat" runner, typically oscillating only two inches (five centimeters)  during my stride.  Having the Forerunner 630 is like having a coach, and good running form is the most important aspect of injury-free running.

A little note on the re-attached biceps:  I did my three super-sets with both arms (one super-set is 10 reps of curls palms-up, 10 reps palms-down, 10 reps of palms-in).  I am glad to say it is time increase the intensity of the workout.  I will probably go with pyramid sets, starting at level six.  The number of reps in a pyramid set is the square of the level number.  I will "build" a pyramid with each type of curl, each type done in concurrent sets.  PT for the biceps is over; I am working out again!

I am looking forward to the run session tomorrow...

Sunday, October 30, 2016

Basketball and rehab...

Basketball is a fast sport, involving rapid acceleration, equally rapid deceleration, twists (knees don't twist, so don't drive to the hoop and twist off the same leg -- don't ask), and a myriad of body-jarring activities seldom associated with rehabilitation of anything.

Shooting hoops, on the other hand, is therapeutic.  Setting up your shot, visualizing the situation and opponent, operating as fast or slow as you like, and then, you take the shot.  Sometimes it is nothing but net, and your fantasy is realized.  Most times; however, if you are like me, it clangs and ricochets in an unpredictable manner, bringing back to the real world in milliseconds.  You need to ascertain the direction of the carom quickly, because this is at your house and there is a slope behind your basketball goal.  If the ball is not retrieved as soon as possible, it will likely hit the slope and be launched into the woods.  Nothing like a walk into the woods to get your basketball to destroy any hoops fantasy for the rest of the day.

In other words, a little bit of hustle is involved, some quick moves, and sometimes a slow jog to get the ball when it has caromed away from the woods.  All are good tests for hamstring tendons on the mend, without committing to a possible TMTS (Too Much Too Soon) violation.  BTW, before going to rehab, the same "shooting hoops" would leave me limping for a day or two.

Next week begins a tighter regime.  I will continue my PT workouts every other day, stretch on all days, and "run" on off-PT days.  By "running" I mean 100m intervals.  Doing eight sets was TMTS before, so now I will start with two sets and build from there.  Gradual progress, healing (not hurrying), rebuilding -- it all takes T-I-M-E.  I need to progress without violating TMTS principles.

Friday, October 14, 2016

Back to PT workouts (and attempt running again, later)

Well, the back of knee pain returned, and with it pain in the biceps femoris tendon.  Low level pain, somewhere between a one and a two, but pain just the same.  It felt better the following day, but lingered afterwards. 

I went back to the PT workouts, and it "stimulated" the injured areas, as before I was able to get to "0x0" (no pain before/after workouts).  I need to continue these workouts until I get to "0x0" again, and then, rather than use just normal high-level activity to evaluate, continue until I have put four to six such "0x0" workouts together before I run again.  Running puts about 2.5 times the body weight in strain on the legs, so I need to keep this in mind, increasing the intensity of the PT workouts after I reach the first "0x0" workout.

I will end on this note: The intervals on which I did run felt great.  Sure, I could feel the pain in the back of the knee again, but it just felt great to be moving like that again.  It motivates me to be more dedicated and thorough in getting back to the running state again.

Monday, October 10, 2016

First Run (after PT)

Today I ran.

It was an interval workout, 100m X 100m for 2 km, but I ran.  The pacing played somewhere between 8:30 and 11:15 minutes per mile.  I was careful to maintain form and cadence, making corrections to insure I was centered and not favor one side over the other.  Running with my Vibram ELX, I was paying close attention to foot strike.  My cadence remained between 180 and 185 spm, and my vertical oscillation averaged just under 5.0 cm.  Not bad form since I have been out of running since November 17, 2015.

Now the results of this acid test.  I still have pain, discomfort, behind the right knee, in distal tendons of the hamstring muscle complex (HMC).  It is not a debilitating pain, and it caused no change in my running mechanics or walking mechanics post-run.  I stretched both legs after the workout.  The discomfort is still there, so I shall see tomorrow whether or not it recovers.

I did not go from the chair to the run.  I have been able to escalate my activity levels in recent days, peaking at 18,000 steps three days ago.  I had a couple of lighter activities days before the run.  Pain levels were "0 x 0" -- no pain before or after activities.  With that in mind, I thought an easy interval run would be the next level of activity.  I had no intention of doing sprints on the "run" portions of the workout, and wanted to keep it to a slow jog.  I guess the beautiful morning and exuberance in the opportunity to run put me on a faster than "slow jog" pace.  Nonetheless, I knew the running portions would load the hamstring area and back of the knee more than any PT I had done to date.  I felt the loading during the run; I feel it after the run (three hours later).

I have to sow some grass seed today which involves a bit of walking on slopes.  I will monitor the pain level to ascertain the degree of recovery which I receive during normal activities.  I would love to run tomorrow, but I think the wiser thing is to use tomorrow for a PT-type of workout and evaluate before taking the next run.

Coming back will be slow, I know.  The distal tendons of the HMC will need to strengthen, and that will occur through gradual increases in loading.  I need to re-build my aerobic base, which will take about four months.  The light running, with continuation of stretching and rolling, should get be back to full strength soon.  At least that is the plan.

Thanks for coming along.

Sunday, September 25, 2016

The formal PT phase is over...

...and now it is up to me alone.

CIGNA has decided that I will have to finish on my own, and I cannot say that I entirely disagree with their decision.  My progress has been very good, and although the pain level is not yet at zero, it will be the strengthening which will take me the rest of the way.  The ASTYM therapy has, perhaps, reached the point of diminishing returns, as is inevitable, anyway.

My therapist has given me exercises to complete -- some daily and some every other day.  Eccentric loading is still painful, and I expect it to improve through exercise.  My first evaluation score, made upon my first arrival, was 14, meaning I was in a lot of pain and very limited.  My second evaluation score, made two weeks ago, was a 63 out of a possible 80.  My therapist was working on a plan to get me to 80 points -- full restoration of range of motion, activities, and zero pain when we got the news that CIGNA said I would have to finish solo.  I have her plan in hand, and now I must execute.  I do have recourse with CIGNA should I not get to that "80" in a month or two.

I am working toward having both my arm and my hamstring at 100% by year's end.  I hope the hamstring can be ready for running by November 1, 2016.  I can work on building the aerobic base via exercise bike and cross-country skier until I am strong enough to use a real bike.  One-legged squats will let me know when I am ready for running.

The quest for wholeness and wellness continues...