February 2014: Mileage (and Ankle-geddon)

The month started out great, running wise.  My left calf was a little tender after putting in a 42 mile week (which was odd, because that should have been no big deal), but I was fully confident that it was fine after a rest day.  I did a 4-mile run on the Monday following (it sort of hurt), and a 5 mile run on Tuesday (it really hurt), and then I had to admit something was wrong.

I was pretty calm at first because I still didn’t think it was a big deal. I’ve actually had this kind of calf pain on and off through the years— medial (on the inside) and distal (low) on my left leg.  It usually means that I need new shoes, except this time, I was running in fairly new New Balance Minimus WT 1010v2.  Sometimes this pain means that I am running too much, but a 42 mile week shouldn’t have been enough to trigger it. Either way, this has never been enough to slow me down.

I took Wednesday off, expecting it to be fine, but it wasn’t.  I took Thursday day off, too.  I tried running again on Friday, and that was a huge mistake.  I made it about 2 miles and then hobbled home in tears.  The crying wasn’t because the pain was excruciating, in fact, I could totally have run through it.  I was crying because I realized I actually had been running through it for kind of a long time, and therefore, it was probably a bigger deal than I'd thought. I’d just gotten used to the way my calf felt a little "off" most of the time, and besides, it was such a low-level ache that I could ignore if I thought about something else for a while. 

It dawned on me that I'd been going back and forth with this annoying calf pain at least since the middle of January, when I did an 11 mile run (that I’d intended to be a 15 mile run) and the pain had been bad enough to make me stop.  I iced it and put on compression socks, then the next day it was totally fine.  Or so I thought.

 

Attempted a long run this morning that was so terrible it ended as a mall walk, followed by a child’s birthday party.

— Melissa Ⓥ (@melissa_raguet) January 18, 2014

My big fear was that this was a stress fracture.  My calf hurt, but the pain was so medial and so low that it couldn’t be gastrocs or soleus—if it wasn’t muscle, was it bone?  

This is pretty much where it hurt.  But what was this injury?

 

Ice, Ibuprofin, resting all did nothing.  It seemed to get worse the more days that I took off.  It hurt to walk, though strangely, impact didn’t seem to bother it nearly as much as lift-off.  And it especially hurt when I was going up or down stairs.  It didn’t help matters that during this time frame, we put our house on the market, and I was continually lifting heavy stuff—carrying things down to the basement and putting boxes in the storage room.  

My mileage for February was totally screwed.  Maybe my mileage for the entire year was totally screwed.  Nothing was helping.  Everybody told me to go to a doctor, but what was that going to solve?  A doctor would just say, stop running until it feels better.  And eat meat.  No thanks.  I don’t need a doctor.  I am a doctor.

I finally got out my old anatomy textbooks, and jackpot.  Tibialis posterior. That was totally it.  I had initially felt the pain in my calf, but the problem originated with the tendon, and that was why it wasn’t going away.

I had all the symptoms of Posterior Tibilais Tendonitis spot on.  I started doing more targeted strengthening and stretching exercises that focused on the tendon, including massage and ice massage.  Prior to this, I had been foam rolling my calves, which was probably helpful in a general sense, but not doing much for the injured tendon.  When I first tried to massage the tendon, in the area right behind my medial malleolus, it was incredibly painful just to touch.  But little by little as I kept working the tendon and ice massaging that area, things started to improve.  By about 10 days out, I had more mobility.  12 days out, I could walk and go up and down stairs without pain.  

I finally tried running again (this time in Brooks PureCadence shoes) and at first it seemed okay, but then I couldn’t ignore that there was both medial and lateral pain in my calf and ankle.  It was pretty clear to me that the new lateral (i.e., outside of the leg) pain was a “companion injury” resulting from the altered gait pattern (way over-supinating) I used just to get around the house/get through the day during the worst of my tibialis posterior issues.  This does not worry me so much.  It will go away.  What is much more worrisome is that the tibialis posterior pain persists.  I am cautiously optimistic because at least walking does not hurt anymore, so that’s an improvement, but running is still not possible.  After 2 full weeks, I am wondering when.  When can I run again.

On the one hand, it shouldn’t really matter because I’m not really training for anything (except the Go! St. Louis Marathon in April, which I wouldn’t be that upset about if I had to pull out of).  But on the other hand, I just want to fucking run.  My entire life is on hold right now.  I have no job, I am living in a city I hate, I am waiting to sell the house, yet also I have nowhere to go once the house does sell.  There is absolutely no certainty in anything  right now.  I lay on the couch with ice on my ankle, thinking where did it all go wrong.  I am too exhausted to play with William, too exhausted to clean up the house so that it looks nice when realtors parade through more prospective buyers, who inevitably just turn up their noses because it is too small and doesn’t have walk in closets, or some other bullshit reason.

74.71 miles this month.  226.9 year to date.  Falling short of where I want to be, in every possible way.  But March is going to be better, it’s got to be.

Thanks for reading.