Sunday, March 10, 2013

Rest Week in Review

I have officially completed 7 days of NO RUNNING.  Unless you count 20 minutes on the Alter-G treadmill at PT, which I don't.  That means today, sometime between whenever I finish this blog post and when I head out to volunteer at Shamrocks & Shenanigans, I am going to go for a test run on the treadmill!  (I better get a move on though....my clock just ticked over from 1:59am to 3:00am and I'm supposed to be downtown at 6am!)  I plan to go for 2 miles, or until my knee starts hurting in the slightest, whichever comes first.  Not much of a run, but I want to ease back into it.  I only have one week until the Shamrock & Roll 10K, and 2 weeks until the Rock CF Half Marathon, so I can't really afford to make my knee any worse.  If it hurts today within those two miles, I'll go back to not running for a few more days or another week.  I may end up having to walk/jog Shamrock & Roll, but that won't be so bad since Irina and her dog Lucy are coming to that one, so I'll have company.  Plus it will be easier to dress like a fool if I'm not running.

Really, this week of not running wasn't so bad.  I'm starting to really enjoy some of my alternative workouts.  Here's what I did:

Friday:  Aborted long run at 8 miles due to worsening knee pain.  Started one week of rest after this. 
Saturday:  30 minute workout video: (Strong Stride Cardio Strength), plus a variety of a lower body exercises geared at IT band rehab.  
Sunday:  55 minute workout video: (Pilates for Runners), plus a 2 mile walk with the dogs, which started hurting my knee toward the end. 
Monday:  Rest
Tuesday:  20 minutes on the Alter-G treadmill, 30 minutes on the elliptical, and a variety of lower body strength exercises geared toward ITB rehab (at least 20 minutes worth). 
Wednesday:  20 minutes on the elliptical, followed by 46 minute workout video: (Strong Stride, Program 1: Glutes/hamstrings, Quads/hips, Core-on back, Core-plank variations, and Back.)
Thursday:  1 hour swimming and aqua-jogging
Friday:  55 minute workout video (The FIRM: Cardio Sculpt

My "home gym" really got cleaned up, expanded, and used a lot more than usual this week:

Clockwise from top-left: 

1) Aerobic equipment: Treadmill (with a bed sheet on it to protect it from dog hair!), new-to-me elliptical from Jeff's parents, and a stationary bike.  The table in the background with the colored drawers on top of it gets placed in front of whichever equipment I'm using so I can put my laptop on it and watch TV shows on Netflix.  Except for on the bike.  Those little PVC things on the bike handles were added by Jeff so I can put my laptop right on the console of the bike.  The table is off to the side because I had moved it out of the way so I could do a workout video.  

2)  Pull-up bar.  Sad to say this doesn't get too much use.  It's disheartening because I suck at it.  (I still can't do even one).  You can also see some of the exercise instructions I have taped to the wall that I got from Runners World articles, or copied from various running books, such as the Hanson's book, or got from PT.  

3)  Thera-bands, with assist devices (handles, foot loop).  Two are tied around that support pole, one is loose with handles, and I have a few more loose ones for things like tying around my legs to do side steps for hip abductor strength and so forth.  

4)  Free weight and workout video zone.  Stability ball, dumbbells, yoga mat (folded to prevent dog hair contamination!), step box, which can also be made into an incline for things like supine pec flys.  

There was also lots of ice-massage, stretching, foam-rolling, and Aleve-taking.  I got this cool "Cryocup" to use instead of styrofoam cups for icing.  I like it.  You freeze it together and then twist off the end when it's frozen and you're read to use it.  It leaves you with the plastic to hold on to and a nice rounded bottom for the ice massage.  





Tuesday my PT put some KT-tape on my knee, but I took it off pretty shortly thereafter so I could ice it, and never put any back on.  I think it's all a bunch of hooey, personally.

I'm done with PT.  It was costing me a $20 copay every time I went, assuming my treatment plan and everything was covered by my insurance.  I went 6 times, so that's $120, although so far, only 4 visits were approved, so it could end up costing me more than that.  Honestly, I don't think it made any difference, or if it did make a difference it was NOT for the better.  They didn't give me that many exercises to do, and everything they did give me I was able to find online, and then some.  I have access to professional journals through my employer, so I can read scientific articles from "The Clinical Journal of Sports Medicine", for example, which I trust more than a random dude who may or may not stay up to date.  Not that I blame him.  As a nurse, I know how impossible it is to stay up to date with the current research on every single condition that could walk through the door, so I don't expect my doctors or physical therapists or whatever to be all-knowing, without having to do some research first.  Patients are motivated to learn everything possible about their specific condition (for obvious reasons), and tend to expect their health care professionals to be aware of every single "fact" or article that they themselves have ever read (regardless of how questionable the source of the information may be).  On the other hand, ITBS is very common, so I would expect their knowledge of that to be a little higher than some of the more obscure conditions.

Here's my main complaint: when I went in last Thursday, the PT really dug into my knee, right where it hurt, with his thumbs.  For "soft tissue mobilization" or "removal of adhesions" or something like that.  It hurt really bad.  And ever since that day, my knee has never been the same.  That's when it got way worse.  The next day is when I had to abort my long run due to the pain, and initiated my 7-day rest.  The whole idea of digging into an area of acute inflammation related to friction didn't make that much sense to me, intuitively.  Then I found this:



Basically, they were having me do things from all three phases all at once.  I was still having acute pain and inflammation, and he was digging into the tender area and making it worse, I think.

From the same article, there was this:

"Local ITB massage around the femoral epicondyle has not been shown to be effective, and a recent Cochrane review concluded that there was insufficient evidence to support the use of deep transverse frictional massages. Friction is a significant factor in ITBFS development, and it would seem prudent to minimize any extra local friction as part of the treatment."

I was specifically told by my PT to do deep transverse massage on my own at home.  Needless to say, I didn't.  Not after all the pain I had as soon as he did it for me.

Like I said though, I'm not mad at him.  I'm not a physical therapist, and maybe this article is too old (2006) and there's newer research since then.  Still, I don't trust them, and that's the most important thing.  If it comes down to it, I'm not an elite runner.  I can take time off to heal completely.

In fact, I feel better, stronger, and fitter in general when I more cross-training and strength training.  I forgot how much I love the combined cardio and strength workout videos (yes, that includes step aerobics).  It's a great workout, and it's fun, and it goes fast.  I like the ones that alternate cardio with targeted toning, versus trying to do both at once, and ending up not doing either very well.  It's been awhile since I've done a combined cardio/strength video, since when I'm running and spinning, I've usually gotten all the cardio in that I need, so I do strength-only videos, which are way less fun.  Or I just do my own exercises using free weights and body weight with no external cueing, which is even LESS fun.


The main reason I hate to rest from running is that it impacts my numbers.  I have been trying to get into higher weekly and monthly mileage, and running less obviously isn't conducive to that.



In the table to the right, 2/10-2/16 was the week I took 3 days off and started to going to PT.  If I hadn't done that, my February mileage would have been about equal to or higher than January's 123.4, despite the fewer days in the month.  2/17-2/23 was basically pain free and back to normal, until 2/28 when I swear the PT guy ruined my knee with his thumbs.  Then 3/1 was the day I had to shave 6 miles off my long run due to the pain, which again left me under 30 mpw.  I'm not looking forward to seeing March's total after a whole week off, and then a slow ramp back up (assuming I CAN ramp back up).  3/3-3/9, you can just ignore that 2.3 miles at 8:34 pace.  That was on the Alter-G. I probably should have recorded it as something other than a run so it wouldn't falsely skew my pace data.

Really, I'm just going to have to let it all go.  I don't have any mileage goals this year, so I'm going to have to stop caring if I have to keep my weekly and monthly mileage low.  I have been aiming for a minimum of 25 mi/week and 100 mi/month, but I'm just going to stop looking at that.  It's okay.  If higher mileage gets me injured, then who needs it.  Again, I'm a recreational runner.  If I can't handle more mileage then so be it.  Hopefully, keeping it low and adding in all the workout videos and cross training will at least not make me slower.  If I'm lucky, it might even make me faster.

Time will tell.

For now, it's 4:30am, so I have to hurry up and get this test run and workout in and then head downtown to volunteer for Shamrocks & Shenanigans.  I'll let you know how it all went tomorrow.  I'm optimistic about the test run.  For the past 2 days or so my knee hasn't been burning at rest, so that's a good sign I guess.

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