Back in October I posted about my first injury, which was likely related to a complete lack of anything resembling a post-marathon recovery plan i.e., stretching, icing, soaks, more stretching, etc. You can read about it here: Ouch - Post Marathon Note. At the time, I was not overly concerned about this injury as my training was still a couple weeks off.
When my training started, I didn't get most of the runs in during the first week - I figured it wasn't a big deal as I'd just finished running a marathon (see previous post). Weeks two and three went alright, I manage to get in a few more barefoot runs due to some unexpected warm weather. Week four was going OK until that Saturday, I went out for a scheduled 6 mile run and at about 1.5 miles, my right calf pain was back. Since this had just happened to me, I immediately stopped - no trying to test it out after stretching it as I did the first time. On the following Wednesday, I tried to head out for a short run - I got about 500 feet. Not including that failed test, it ended up being 17 days before I ran again. My first post injury run was 4 miles barefoot on a treadmill, during which time I was hyper aware of every little twang or twinge coming from my right calf. I did a few more miles on the treadmill the following day, then rested for two - so far so good. On that Saturday I ran 8 miles in my V5F Speeds and on Sunday I did 14 miles instead of the 16 as indicated on my training schedule. On the following week I got in all my scheduled runs including a 17 miler - It seemed like I had gotten past the injury.
With 9 weeks left until Hyannis, my schedule fell apart with work obligations and Christmas preparations - I missed two 9 mile runs and only ran 5 miles when my schedule called for 12. With 8 weeks left my week was going OK, though I moved my scheduled 19 mile run to January 2nd so I could celebrate New Years Eve and attend a New Years Day brunch, which lasted most of the afternoon.
This past week I managed to run 50 miles mostly because I ran those 19 miles on Monday. I only ran 3 of my scheduled 5 miles on Tuesday, completely missed my 10 miles on Wednesday, which I had planned on making up on Thursday, but only had time for 7. I got in my scheduled 10 miles yesterday and today, well, today was suppose to be 20 miles, which I was geared up to get done, but I only managed 11.4 miles.
During my run I started to have some pain in my right foot at about mile 4. I continued to run believing that this pain would go away - I had a similar pain in the same spot a few weeks ago while wearing my Merrell Sonic Glove running shoes (another post entirely). I had assumed it was related to running in the Merrells as opposed to barefoot or in some kind of Vibram Fivefingers as I typically do, but that pain eventually went away before the run ended.
However, as the miles passed on today's run, the pain remained persistent. Making the decision to run less than my scheduled 20 mile run was difficult as a part of me was telling me I just didn't want to run 20 miles. This run did feel like it required more effort than the 19 mile run had on Monday. This is not an unfamiliar feeling, your body is designed to conserve energy and to do that it resists any kind of exertion - that's a big part of running longer distances - it takes mental focus to mute your body's desire to remain static. Being aware of this, when I made the decision to change course I didn't really think anything was wrong with my right foot, but I knew as the pain continued it would become more and more difficult for me to override my body's desire to end this run. I also told myself that if the pain went away by the time I got near the end (which would have been 14 miles) I could continue on to get some additional miles in if not the remaining 6. At 11.4 miles, the pain in my right foot seemed to be overriding most other thoughts in my head and I just decided to call it.
When I got home I started to examine my foot and, with the help of a google search, I think I've identified the area of the pain to be at the joint located between my proximal phalange and metatarsal bone of the toe located next to my pinky toe. But, I think there's a possibility that it could be a stress fracture located on the metatarsal bone just behind that joint (Foot Bones). I think I might be seeing the beginnings of some bruising, which, according to more google finds, appears to be a possible indication of a stress fracture. Although that could also be from me pressing around that area to identify the pain. I'll know soon enough.
If it is a stress fracture, well, that means more rest, which does not bode well for the remainder of my training. I can do other workouts (x-ski, bike) to try and build up the endurance needed for the marathon, but the best training for running is running.
When my calf injury reoccurred and my training schedule was off track, I knew I would need to adjust my pace and finish time for the Hyannis Marathon, but I wasn't concerned about not finishing or worse, not even making it to the starting line, now...... Maybe I'm over reacting, but with the way things have been going since Smuttynose, well, I'm not so sure.
So here's what my foot looks like this morning.
So it could be a stress fracture, or something else. Either way I need to let it heal which means time off (again) from running. A poster on Daily Mile suggested alternating hot and cold soaks at 7.5 minute intervals - I'm not sure what that would do, but I've seen similar recommendations for post run recovery (I often to ice bath soaks for long runs). My guess is that by alternating temperatures your body reacts by increasing and decreasing blood flow that has an effect similar to expansion and contraction, which in turn creates a flushing effect - like a said, just a guess. I'll need to look into it a bit more.
I've done a little online searching and my symptoms are a classic indication of a stress fracture, although I'm not experiencing the sharp pain described. I'm probably going to have to get this looked at by a doctor, which is NOT something I want to do. But what's worse than just seeing the doctor is that it seems it can take awhile before I can get the results of an x-ray or worse, if the doctor can't see anything in the x-ray I might need an MRI, which takes even longer to get results - what the hell.
It sounds like the minimum amount of time for a stress fracture to heal is 4-6 weeks followed by a gradual increase in activity (i.e. running). The recommended treatment for a stress fracture is rest and avoid putting pressure on the bone. I don't really think I need to go to a doctor to tell me to rest for 4-6 weeks. The benefits to seeing a doctor is to find out if maybe the injury is something else that maybe doesn't require the rest period and will allow me to run the Hyannis Marathon, or worse, like an actual fracture, although I don't think it is.
As things stand right now - boy I don't like saying this - I have a stress fracture and won't be able to run my next marathon.
I have an appointment with a bone doctor at 4:30 today (Monday).
Last Update on this Post!
OK - The bone doc did an initial exam, asked some questions, and ordered up some x-rays, which they did there. He said nothing showed up on the x-rays that would indicate a stress fracture, but they don't always show up right away on x-ray's or even MRIs. But, he doesn't think it's a stress fracture, he said it could be a burst blood vessel or a bone bruise. I have a follow up with him next Monday. So, while not a 100% "OK", it's pretty good news.
My Hyannis Marathon ambitions - which right now are showing up and maybe completed it with a respectable finish time - are not yet dashed :)