Sunday, November 4, 2012

Uncharted Territory

I have been incredibly fortunate to have avoided a serious injury throughout my competitive running career. For the last month though, I have been struggling to keep a relatively minor injury from snowballing into something more serious.  The issue is a bit of tendonitis that I think was triggered by a stone bruise that I picked up at UROC.  

Stone bruise from UROC.

The strange thing is that the tendonitis is in a quite different spot than the bruise is the picture above.  The pain is actually on the front of my shin, just above the ankle.  My unprofessional opinion is that all symptoms point to anterior tibialis tendonitis.  That tendon attaches to a bone in the arch right where I got the stone bruise.  I ran for more than a week after UROC with zero pain.  The spot on my arch was tender to touch, but not to run.  But, I think the trauma to that attachment point caused the muscle and tendon to tighten down in an attempt to protect itself.  I ran way too long a week after UROC (but felt really good doing it), and then I felt the tendon above my ankle give way after a Tuesday night track workout a few days later.

Arrow shows where it  hurts now.

I didn't think much of it when it first happened.  I thought it would heal quickly like other nuisance injuries I've had before.  But this hurt pretty good - even just to walk.  I ran real easy and short on it for a few days, and when it started to feel better, I went longer and harder.  That was a mistake.  I made that mistake about 3 times before I figured out that I had to let it get all the way better.

You may have heard that I ran a consecutive day running streak.  I don't like talking about it anymore, because I don't think it's all that healthy, and I really wouldn't recommend starting one to anyone I was coaching.  In periods of low motivation, the streak can be very encouraging, but it's going to be very difficult for me to break off.  So of course, I still ran every day through this injury.  The sad part is that it most likely would have healed faster if I had taken just a week completely off.  Let that be a lesson if you're ever in a similar situation.

Anyway, I finally backed off enough that it got better.  I think I'm about 95% right now and running with no pain again.  I was able to go 20 miles at a nice clip yesterday.  That was the first time in a month I could have finished that run.  

I'm still planning to race JFK, and being less than 2 weeks out now, I don't have the time to hammer myself to make up for lost training (<<another thing I don't recommend).  The good news is that legs should be pretty fresh.  And while I don't think I lost a ton of fitness in the last month, I don't think I'm quite as tuned for JFK like I was last year when I spent all summer and fall training for flat an fast ultras (World 100k and JFK).  I'm most worried about the legs just being a little flat since I haven't been able to exercise them like I normally would.  

I just hope I can keep it interesting this year.  Max King should be the clear favorite to win.  Zach Bitter and myself will probably be duking it out for 2nd place.  I haven't heard of any other top men, but you never know who might show up.  Ellie Greenwood will be there and she'll overshadow us all.

In other news, I'll be heading to a trail running camp sponsored by Team RWB next weekend down in Texas. The camp is targeted at veterans and is aligned with Team RWB's goal of helping to re-integrate soldiers returning from deployment back into civilian life.  Endurance sports is one of the primary tools that the group uses to achieve that goal.  I will be there serving as a coach and mentor along with a bunch of other accomplished trail runners.  It's going to be a great way for me to give a little back to our veterans by sharing my passion for the trails.  I'm sure it will be a lot of fun as well.

That's all for now.  I'll try to keep you up-to-date over the next couple weeks via Twitter (@rundavid1), but I kind of doubt I'll have cell reception down in Texas.


  1. Did you rule out a stress fracture?
    I'm waiting on a bone scan to see if that is what I am dealing with. Try out this symptom checker to see if it is a possiblity.

  2. Cool little tool. Here's what it said: Tibialis Anterior Tendon Sheath Inflammation - The tibialis anterior muscle runs down the front of the shin and then the tendon passes down the front/inside of the ankle. An injury can occur due to overuse, especially when running on hard surfaces.

    I am fairly certain it's not a stress facture. It's not impact that hurts, it's moving my foot even when not bearing weight. For example, moving my toes forward and back like when pressing the gas pedal in the car was one of the most irritating things I could do.

  3. Glad to hear you're back on the road (or trails) and good luck at JFK. Even if things don't go as smoothly as you'd like, you can't take away your performance from last year. Check to see if you have any knots or tender points somewhere on the shin. If you do, that can yank on that tendon by your ankle.

  4. Best of luck on your upcoming race!

  5. Does this fit your symptoms?
    Extensor Tendinitis Explained:
    The muscles affected can be the Tibialis Anterior, Extensor Hallucis Longus, Extensor Hallucis Brevis. Inflammation of the tibialis anterior is most common but inflammation of the extensor digitorum muscles is also possible.
    Causes include:
    • Overuse
    • Badly fitting shoes or shoes that are laced far too tightly causing pressure on the top of the foot.
    • It can also be caused by a change in training methods or running terrain, particularly hill running. Running uphill means the extensor muscles must work harder to lift the foot and downhill they have to work harder eccentrically to slow the foot.
    Running on icy or slippery surfaces can also be a cause.
    Extensor TendinopathyWhat Is It?:The muscle belly of the extensor muscles (extensor digitorum longuns and extensor hallicus lungus) are located deep in the shin, but their tendons pass over the front of the ankle and into the top of the foot and toes. These muscles play an important role in stabilizing the foot and ankle. However, in sports involving running, jumping, or cutting maneuvers the extensor muscle-tendon units can become strained and develop micro tears. Although very small, the body must still repair this micro trauma, and does so by depositing scar tissue adhesions in and around the injured area. Unfortunately, these adhesions make the tissues tight and affect their normal function, leading to altered foot and ankle biomechanics and pain to the muscles or tendons themselves. Signs and Symptoms
    • Gradual onset of pain on the front of the ankle or top of the foot
    • Possible tightness or stiffness in the shin or ankle
    • Pain usually decreases with warm-up or activity, then returns post-exercise
    • Pain is often worse in the morning the day after a workout or training session
    • In later stages both the severity and frequency of pain may increase

  6. Brothergrub, thanks for the info, but it doesn't sound quite like what I had. My pain definitely did not decrease with warm-up, it got worse. But, the good news is that this issue hasn't given me any trouble in over a month. Once I gave it time to heal up, it went away.