Injury impact on marathon (SCMM 2014 )training

This is not an uncommon occurrence with regular runners training for an event. All the workouts are going well, one is feeling quite confident of achieving the race goal and then suddenly the whole flow is disrupted due to an injury. Few things can be more frustrating for a runner. The workouts of week 8/16 had gone very well including a 32Km/2:48 long run. However, I had a severe strain in my left glutes and left calf during the week 7/16 intervals (3 x (2 x 1200m) in Kanteerva stadium. And for the first time since May 2013 I did not complete my planned workout and decided to abort  the training   after pushing through the 5th interval. Since then the training has been irregular punctuated by interactions with Dr. Gladson of Attitudeprime.  Of course I am down  both physically and mentally . SCMM is one of the most important events in my running calendar - not least because I have been running it every year since it started in 2004. It is well organised event with fantastic spectator support and I have been lucky enough to improve my FM timing every year. The PB of 3:37:20 in last year's edition got me a place in Boston 2014. The way my training was going  I was looking forward to matching or slightly bettering last year's time (3:35). Now the last few weeks I was not even sure whether I would make it to the starting line. 

I am not able to figure out the cause for this injury. It could be a combination of one or more of the following:

• Muscle fatigue due to doing a tempo run and a fast long run(21K/1:45) within a week of the fastish 50Km at the Bangalore Ultra
• Lack of flexibility due to inadequate and/or incorrect stretching post the workout
• Lack of strength - it has been 8 months since I stopped the strengthening sessions at Manipal hospital(though I am doing  leg curls, leg press and calf press in my apartment complex gym apart from squats and lunges)
• Change of shoes  - I switched to a new Brooks Defyance5 after the ultra - the previous one having put in nearly 1500Kms
• Fatigue due to back to back workouts without adequate rest for recovery - due to travel schedule I ran a 12K tempo run on 1st Dec afternoon within 36 hours of running a fairly fast 32Km on 30th morning

Following is the summary of my workouts the past 3 weeks:

Week 7 of 16

Dec 1  - 12Km/60 mins  tempo run

Dec 3  - 26.5Kms/50 mins cycling

Dec 4 - 5 x 1200m intervals

No long run

Week 6 of 16

Dec 9  - 9Km Tempo run

Dec 10 - 23.38K/45 mins cycling

Dec 12 - 23.4K/45 mins cycling

Dec 15 - 21.2K/1:50 long run (goal was to do 32Km but had to stop due to pain in glutes,hamstring and numbness in sole - all on the left side)

No intervals

Week 5 of 16

Dec 16 23.56Km/45 mins cycling

Dec 19 5k/30 mins easy run

Dec 22 16Km Tempo run

No long run

No intervals

Based on discussions with Dr. Gladson I have decided not to do any more interval training. Though the glutes are better now the left side l does not feel normal and I dont want to take any chances. For the remaining 3 weeks I am going to stay with a tempo run, an easy run and a long run and 1 or 2 cycling workouts. The 32Km long run this weekend , probably on 29th Dec, will be the most crucial run to determine my readiness for Mumbai. I will determine my strategy for the race based on how that goes. In any case I am keen on not missing Mumbai - in the worst case I will not race and will run to finish around 4 hours or so - keeping fingers crossed!

Marathon training post injury lay-off

Injury is a bane of all experienced/regular runners - having to stay away from something that one is passionate about due to injury of all things is a dreadful phase for a runner to go through. But injuries are a fact of life for runners. There are various statistics floating around about running injuries. One popular one is that 70% of runners will get injured in a given year. Of course this is too vague as both the definition of runner and injury can vary. Another way of looking at it is that in most cases there may not be a strict line between being injured or not. The closest a runner(specially one doing Half marathon and longer distances regularly) maybe to being 'injury-free' is when he/she is able to run freely without pain and even then the runner maybe balancing several weaknesses,imbalances, scar tissues etc.

Fortunately I have  not to be laid of weeks together due to a running related injury since I did my 2nd Full marathon in 2005. Though I have had breaks from running due tom sickness, travel and even just to give my legs and body some rest. However the 2013-14 running season started with injury woes.. While training for TCS 10K 2013 using the 'Run Less, Run Faster' training program from FIRST I got hit with pain in my left calf/ankle   and I had to consult a sports physio and adjust my goal for the race. A week before the race my right calf got hurt so bad that  I had to abandon my medium pace  training run after 2 Km or so and almost decided to skip the TCS 10K. However, I ended up running the race and while trying to push for around 45 minutes time I tore  a muscle in my right calf. Based on the Physio's advice I took 3 weeks completely off from running- doing light cycling, rowing and stretching to keep myself fit. After the TCS 10K race on 19th of May my next run was a slow 10K as part of the Mother Earth run on 9th June!!

Getting back to training after an injury layoff is quite tricky.One should pick up the pace and distance very gradually however much there is temptation to do otherwise due to the eagerness to catch up on lost training time. If the stressing demands of running are introduced at a rate and volume that the body is not ready for—especially after time off after an injury—it makes recovery difficult and makes the body vulnerable to new injuries due to compromised form. The key for a successful return is allowing the soft tissues to have the chance to adapt. More in this article in Competitor - a great online resource for running. As another article in the same site states:

A  running plan post an injury should be formed strategically based on  the following five factors:

1. 1. The severity of the injury—a stress fracture or injury that required surgery differs vastly from tendonitis.
2. 2. How long one was  sidelined from running.
3. 3. One's  fitness level prior to getting injured.
4. 4. How many years of experience one  have as a runner.
5. 5. Whether one  could cross-train during the  layoff.

Here's another nice perspective - this one from RunnesConnect on how to get back to training after injury,sickness or missing training.

In my  case after some nice easy runs during the week of 10th June to build mileage I started my training for Airtel Hyderabad marathon 2013 with 6 x 800m intervals at Kanteerva stadium on 19th June jumping into week 10 of the 16 weeks 'Run Less, Run Faster' training program. I did not push myself during the intervals which I was doing after a break of over 2 months. The 33Km slow run up and down Nandi hills on June 23rd was the longest run since SCMM in January 2013. Though exhausted at the end of the run there was no pain in either calf - so my injury seemed to have fully healed.

The next 8 weeks of training went off quite well. Was able to do most of the workouts - skipped a couple of tempo runs and a couple of cycling workouts due to travel. Most of the running workouts went well specially the long runs. Also managed to get in two 33Km runs and one 36Km run. And work out for about 15 minutes on the foam roller and do about 45 minutes of stretching at least once a day while not travelling. This was complimented by strength training - rowing, leg press, calf press, leg raises, squats, lunges, step ups 2 days a week.  My weight varied in the range 118 lbs to 123 lbs and body fat dipped just under 10% for the first time ever. Except during the tapering fortnight , when I am going through the usual jitters, doubts, aches and pains, overall I feel well trained , fitter than ever before and ready for my first marathon of the season!! .

TCS 10K 2013 : Decent run despite a torn right calf muscle

Considering that a week before the run on 19th May 2013 I was unsure of making it to the starting line due to a right calf injury, I am satisfied with my 46:56 performance  (bib# 578) in the race with an overall ranking of 189 out of 8137 finishers. The icing was the 3rd place finish out of 191 runners in the 51 to 60 eyars category behind awesome runners Pani and Sid. Running through right calf pain for the last 2 Kms was quite tough. The wonderful capture below around the 9th Km by  Shantanu Singh shows this well.

I literally limped over the finish line with severe right calf pain - thanks to friend and fellow runner Ravi Venkatesam for getting the volini spray from the medical tent in the finish area. After spraying that generously the calf felt much better. 

Ravi and I left Domlur Layout at 6am by car and after parking at UB city we reached Kanteerva stadium by 620am. There were hardly a handful of runners in the category A section(finisher in less than 50 mins within the previous 2 years) at that time. At 630am the World 10K men racers took off at a blistering pace. Soon thereafter the area was buzzing with runners - many of them familiar. After using the restroom one more time I went down the steps to a position close to the gate to the tracks. At about about 7:19am (by my Garmin) the gate was opened and all runners rushed out tot he start line. The pushing and jostling was much less compared to the previous two years - though it was still there specially with the corporate challenge runners also joining the category A runners at the same time. (I understand it was much worse for the category B and Category C runners - their gates were opened a few seconds later). The race started at 7:21 within a few seconds of my getting to the start line. I was able to get a good start and clocked the 1st Km in 4:07 much faster than planned. Ran at a good pace till Km 4  clocking an average of 4:16/Km - the gradient after the turnaround at Ulsoor slowed me down considerably and the pace gradually fell. By the half way mark I knew that sub 45 was not going to be possible and soon thereafter also vanished any thoughts of a beating my previous PB of 2011. The last 4 Kms were really tough as the right calf pain steadily increased. Surprisingly, my usual left calf and left glutes niggle did not show up this time. I have always found it difficult to sustain a fast pace in the shorter races - My goal was to ensure that I finished sub 50 and as close to 47 mins as possible. I was doubly relieved to cross the finish line around the 47 min mark. As has been my practice at the 10K race I consumed water 3 times during the run all in the 2nd half. I felt the weather was quite ok.

After hanging around in the finish line a bit - stretching and getting photographed - drove to Konark for the wonderful breakfast hosted by Nagaraj Adiga (aka 'godfather'). It was great to exchange thoughts with fellow runners and also an opportunity for more pictures. Got back home around quarter past 10am - well fed but a bit worried about the right calf.

A day after the race I discovered that the right calf had swollen quite a bit. In general the right leg was quite sore even more so than after a typical marathon. Next day when I found some internal bleeding below the ankle it had me really worried. The ultrasound scan of the calf area (recommended by Doc Gladson of Attitide Prime) revealed ' a partial tear of the proximal muscle fibres of soleus with associated hematoma'. The soleus is one of the 3 muscles that form the calf muscles. A hematoma is defined as a collection of blood or a clot that has accumulated outside of a blood vessel. The blood has leaked from a ruptured artery, vein, or capillary and then seeps into the surrounding tissue. 

The only solution for such an injury is to ice the area and stretch lightly frequently and stay off from running for a few weeks. After a complete break for 5 days I did some cycling over the weekend. After a week the swelling in the ankle has gone but there is still a dull pain while walking or going down the steps. Depending on how it goes I hope to restart running the week of 3rd June and after a couple of weeks of light training start the formal training for Hyderabad marathon towards the end of the month!!

TCS 10K 2013?

I am quite under-prepared,physically and mentally for the 6th edition of  Bangalore's  world 10K run that is less than a week away . With just 4 running workouts since 18th April training has been minimal. While the usual stress in the left glutes,calf and sole has been nagging me for the last few weeks I have also been having a problem with my right calf since the 1st of May. On 5th May I had to abandon my  fastish 16K run after a 48mins/10Km with stress in both the calves. I literally limped back home. This is the first time ever that I had an issue with my right calf. When I had to give up on the  medium pace  run yesterday that I was doing after a break of 5 days after a Km or so with acute pain in the upper right calf I was completely shattered. It looked like it would be prudent to skip this year's 10K and train for the Hyderabad marathon after recovering from the injury. An injury like this at the beginning of a running season is a real dampener - I have been unable to avoid being depressed the last couple of weeks. Not being able to run the 10K to plan was bad enough, the possibility of the injury impacting the marathons targeted for the season and that beating my BQ time by 2:40 may not be sufficient to get me a place in Boston 2014 made it much worse.

Despite  uncertainty of whether I would make it to the start line on 19th May I collected my running bib from Koramangla indoor stadium on 11th May morning. And then went to show my right calf to Dr. Gladson of Attitude Prime. It looks like the calf pain may be due to a weak plantar fascia not being able to strain of my running pace. As per Gladson it is not Planatar Fasciitis - a very common injury among runners. And I should be in a reasonable shape to run the 10K after exercising the plantar using a  golf ball  a few times a day for the next few days.

Hope to make it to the starting on line on 19th May and keep my streak of running the world 10K if the easy  training runs on 14th and 16th May go well.While I had changed my goal to Sub-45 or to at least beat my 2011 PB of 45:57 now I will be satisfied if I can keep it below 50 minutes though I know I am in shape to do sub 45. My strategy will be to get a good start(a challenge by itself considering 11,000 runners are expected to participate and the organisers have been unable to enforce discipline in the starting area to have runners assemble and start based on their previous finish times) and try and sustain  sub 4:30 minutes Kms as long as possible.