What’s the worst that could happen?

I’ve decided to try something new on the blog today: I’m joining Amanda’s linkup for Thinking Out Loud. I’ve been thinking silently for too long; time to set those thoughts free!

Thinking-Out-Loud2

In my recap of the last few weeks’ training, I was pretty frank with my emotions about how training has been going, and I really appreciated your encouraging comments.

My feelings then shifted to guilt. Why should anyone feel sorry for me? I’m training for a marathon, albeit not without challenges, IN PARIS. That’s such a privilege and I’m grateful for it.

So today, I’m thinking out loud about plans and perspective.

Happiness is the difference between expectations and reality (or is it?)

A friend who went to the University of Georgia said this to me to explain why UGA football fans are disappointed with (and fire their coach after) a 10-win season. It made some sense to me. (But I wouldn’t consider it a truth to live by. We would aim low in everything, right?)

I don’t think anyone signs up for endurance events expecting to get injured. Sure, we know there is a risk of injury, but we probably all think we have the super special formula to stay injury free. We expect to be able to go out, train consistently, and perform our best. Expectations.

I have no idea how I made it through my first marathon training cycle without an injury. Luck is the best guess I can venture. I didn’t know any injury prevention secrets I don’t know now. Dumb luck happens, and all we can do is enjoy it.

In reflecting on this, or any other situation that comes with plans or expectations, I don’t think we should feel guilty if we’re upset that reality doesn’t live up to those expectations. Yes, there are horrible diseases and wars in the world. No, that doesn’t invalidate anyone’s disappointment with having a running injury. But keeping it all in perspective is good practice.

What’s the worst that could happen?

Another friend posed this question to me in my mid-20s when I was freaking out about contemplating some challenge at work.

No, really, what is the very worst thing that could happen? Would you lose your job? No?

I’m a perfectionist, so this perspective shook me up. But, it wouldn’t be the way I want it! I might not get an excellent performance review!

My friend sat with me and forced me to come up with the very worst-case scenario, then proceeded to help me see how my hugely-stressful-thing really wasn’t worth the anxiety and stress I was giving it. There’s a big difference between taking pride in your work and letting the pursuit of perfection (or aversion to risk) rule your life. I was in the latter category for a long time.

Now whenever I feel myself getting stressed/frustrated/anxious/fearful, I ask myself what’s the worst thing that could happen. And as far as I can tell with Paris, the VERY WORST thing that could happen is I go to a beautiful city with a bum knee and cheer on my friend who’s running a marathon. I’m pretty sure I can cope with that situation.

I’m still spending a lot of time doing everything I can to keep myself on the marathon training wagon, because an even awesome-er scenario of running a marathon in Paris with a friend is still a real possibility.

St. Jude marathon finish

The moment right after I finished my first marathon. I want that feeling again.

(I wanted to end this post with a 90s-rapper-style shout out to my fellow perfectionists, but I am way too old and CPAish to get the tone right…it sounded sooooo dorky.)

Anyway, let me know in the comments if you’re someone who struggles with the lofty expectations of perfectionism. Do you have any tips to keep things in perspective?

My Recovery from Knee Injury

In a separate post, I described my knee injury that kept me from running for two months earlier this year. I’ve been wanting to write a how-I-came-back-from-injury post for a while, so I’m glad I can now say that my knee feels strong. I’m ready to start real training: I’ve signed up for two half marathons in the fall, and I may run a few shorter races for fun in between.

Weekly Mileage Post-Injury

I began my return to running with a 9-mile week (3 miles x 3 days), on a flat route. I didn’t run on consecutive days, and I added 1-2 miles per week (except on the weeks I added hills, I kept my weekly mileage flat). I added uphills first because they are lower-impact. I walked downhills for two weeks, then added downhill running. As early as week 2, I designated a “long” running day each week, and I built up to 17 miles per week on three days of running a week (runs of 4, 5, and 8 miles).

Since then, I’ve been running four days per week, and my average weekly mileage has hovered around 20 (going as high as 25 and as low as 13 based on how I’m feeling and life). It’s been nice to keep my average running volume around 20 miles per week and feel myself get stronger as the weeks go by.

One KEY aspect of my recovery has been doing an appropriate warm-up before each run. I always begin my warm-up with the first two glute activation exercises described below and leg swings. If I plan to run longer or harder than normal, I’ll add the lunge matrix or do this warm-up routine. I’ve also been foam rolling my adductors before some runs when they feel tight.

Strength

As I mentioned in my earlier post, a huge contributing factor to my injury was that my glute muscles weren’t activating when I was running. I had a remarkably similar experience to this Runner’s World author – lying on a doctor’s table, unable to perform the simple act of contracting my glute muscles. I also learned that my right glute was stronger than my left.

Initially, I was given exercises that weren’t very challenging physically, but were to be performed with attention to how and when I activated the muscles involved in the exercise.

1. Prone leg lifts

Lie face-down on ground, yoga mat, whatever suits you. Contract one of your glutes (with my dead butt, this took poking my glute muscle at times). Then once the glute is contracted, simply lift the leg up off the ground 6 inches or so. It’s important to let the glute disengage after each repetition, because this is an exercise to train the brain that the glute should initiate this motion. Perform 10x per leg, 1-2 sets.

2. Glute bridges

glute bridgesLie on your back with your knees bent, feet together on the floor. Contract the abs first (not too hard – about 30% effort), then the glutes. Push up into a bridge position, keeping knees and feet together. Hold for 5 seconds and repeat.

At first, I had trouble keeping my balance, which can indicate either weak hips or that the glutes are not firing. I had to be patient and really focus on the glutes, because my hamstrings wanted to do all the work. A trick that my chiro gave me to “turn off” my hamstrings was to put my weight in my heels and lift my forefeet off the ground. Because brain-training is an important element of this exercise, I was instructed not to become over-reliant on this trick. I used the heel-trick to cue my brain and body to know what the movement should feel like, so that I could perform it for the next rep with my feet flat on the ground.

To begin, I performed 2 sets of 10 repetitions. I also incorporated some hip strengthening work into this exercise by looping a Thera-band around my knees and doing bridge-clamshells. Now that 2 sets of 10 repetitions is pretty easy, I perform the second set alternating between single legs. This is really hard on the left side, so I know I still have work to do.

3. Squats and Lunges

After a couple of weeks of just performing the above exercises (in addition to cross-training, core work 3x/week and hip strengthening 2x/week), we added squats and lunges – classic lower-body exercises that seem to be good for everything! At first, doing lunges put pressure on the injured knee. I worked on this with my chiropractor, and found that the pressure was relieved if I contracted the back glute hard prior to performing the lunge motion. After trying it out, I think the lunge is a more challenging and effective exercise when I consciously engage my glutes and core before performing the motion. I began with 3 sets of 5 per leg, then progressed to 3 sets of 10 per leg. This was really easy with the right leg, less so with the left leg.

Image result for racked kettlebells

Photo courtesy of bodybuilding.com

When I first did a squat in the doctor’s office, my chiro noticed that I was leaning slightly to the right side (favoring the stronger glute) and my left knee buckled in slightly. She had me do squats in the mirror, watching my form carefully. I began with 3 sets of 10 and added weight once that became relatively easy. I’ve found it’s easier for me to keep good form by adding weight in front, rather than a typical back squat. I like doing squats with racked kettlebells, like this guy. Another good option is a pistol (one-leg) squat. I can’t do more than a couple of (shaky) pistol squats on my left leg, so I’m progressing by beginning in a seated position and driving up through my leg to a standing position.

If I could highlight one key thing about my introduction to lower-body strength work, it would be that my chiropractor eased me into it carefully and with attention to performing the movements correctly. It feels great to get stronger, so I’ve upped the strength training to 2-3x/week and doing more complex movements with a trainer – more on that to come!

Mobility

My least favorite thing I’ve been working on is mobility. It’s not glamorous, just doing more of those not-fun things I need to be doing like foam rolling. I’ve been enjoying yoga a lot more since my injury, and I have been practicing 1-4 times per week (sometimes a formal class, other times for 10 minutes in my hotel room).

I have two new favorite mobility tricks: “foam rolling” my calves with my shin, and the “couch stretch” (it’s a long video, scroll to 2:20 for the stretch itself). The couch stretch is an awesome (read: tough) hip flexor stretch. I’ve read that there can be a link between tight hip flexors and inhibition of the glute muscles, so if you’re like me and are trying to get your glutes firing on all cylinders, this stretch could be good to add to your rotation.

I’ve never found foam rolling to be that effective on my calves, and I have found that “The Stick” is awkward to use in that area. So I loved this trick I learned at a Yoga for Runners class at Infinity Yoga, which allowed me to get into those tight spots in my calves for a little tough love. I found some tight spots I wouldn’t have even noticed foam rolling.

1. Starting on hands and knees. cross your opposite shin over the calf that you want to “foam roll.”

2. Press into your calf with your opposite shin. Move the shin around over the calf, and identify trouble spots.

3. For any spot that needs a little more tough love, position your shin over the area and lower your weight into it to create additional pressure. You can hold this position, or you can wriggle your shin around under your weight – whatever feels right!

The photos to the side illustrate each step – some days I can sit with my full body weight on my calf, other days, I can’t. I’ve found that this exercise is most effective when I do some good “yoga breathing” into my calf, and imagine the tightness melting away. Translation: breathe and relax into this movement.

Consistency & Patience

For all of the above, consistency and patience were key. Even though I was back to running a few miles per week in late March/early April, my knee did feel a bit “shaky” for a while. I tried to stay tuned in to how it felt, and definitely got a few “yellow lights” from minor pain that caused me to cut some runs short. For those of you who have experienced a knee injury, you know that recovery doesn’t happen overnight. My knee didn’t feel strong until late May/early June. I’m glad I had great resources to turn to over the course of my recovery, and I’m excited to get back to “real training” again!

Have you ever had a running injury?

What did you find most helpful in your recovery/injury prevention?

Knee Injury: A Breakdown

oprah running quote

I didn’t expect to take nearly two months off from running and blogging when I tweaked my left knee in a 5k race, but injury is an unpredictable beast. I naively believed that I was immune to injury since I did the good core/hip/glute strengthening exercises that runners are supposed to do. As I think about Oprah’s quote, running has been an excellent metaphor for life, because it has given me what I put in most of the time. But there are also times when you do all the things you think you ought to do and the results still fall short, as happens in life.

Most of all, I’m grateful that this injury popped up after the marathon. I have learned a lot from the injury, and I hope the lessons learned will help me be stronger and healthier in the long run.

Breaking down the injury

It took a while to figure out what was actually going on with my knee. I was referred to a great chiropractor who specializes in working with athletes and is an Ironman triathlete. Early on, she did the tests for all the nasty knee injuries – torn ligaments and such – and eliminated anything really serious that could require surgery.

1. Dead Butt

In my first appointment, my chiro tested my glute and hip strength. Thanks to the good exercises, I demonstrated sufficient (if not bodybuilder-esque) strength in those areas. The real surprise came when she asked me to call on my glutes to lift my leg while lying face-down. I couldn’t do it! I thought about contracting my glutes and my hamstring fired instead. Many of you have probably heard of “dead butt,” which is when the glutes just don’t fire. It’s common among distance runners and people with sitting-down-jobs, and is an injury risk factor among distance runners.

2. Poor Range of Motion

My chiro also noticed that my entire lower body was super tight. I had a knot in my left quad, just above my injured knee, that was probably the size of a golf ball. My adductors and IT bands were abnormally tight as well. This problem was totally avoidable – I really don’t like foam rolling or stretching, and don’t do either routinely, even when I’m training hard. Oops.

3. Unbalanced Glute Strength

The third major issue that my chiropractor unearthed was a hitch in my running form caused by a relatively weak left glute, as compared to the right glute. As I understand it, strong glutes provide stability to the running stride, helping the knees to move in straight lines forwards and backwards. My running stride included a slight inward buckling of the left knee, presumably because my glute wasn’t doing its job to keep the knee stable. I also found that this imbalance is causing a hitch in my squat that has been REALLY frustrating to try to counter!

The solution is ongoing, but it predictably involves a lot of glute activation and strengthening exercises, along with flexibility/range of motion work. I’ll write a separate post about all this later.

A frustrating thing about this injury is that it doesn’t fit the common running knee-injury diagnoses, like ITBS, runner’s knee, or patellar tendinitis, so there isn’t a standard course of treatment and recovery. The pain I’ve felt has occurred on the inside of my left knee. It begins as pressure, and progresses to pain if I continue to run through the pressure. My chiropractor thinks that the hitch in my running stride may be causing pressure on my meniscus, and as the pressure persists, it becomes inflamed and causes pain. The activation, strength, and flexibility work I’ve been doing has slowed the pressure-pain progression, and I’ve been able to run 11-15 miles per week pain-free for the past three weeks, with a day of rest between every run. We also think that hills further aggravate my knee, so I’ve walked to a flat area for each run. Next week, I will begin to introduce uphill running (I’ve been told to walk down hills) into my routine to see how my body responds.

Have you ever had a knee or other running injury? 

How long did you sit out from running, and what did it take to get healthy?