Monday, December 27, 2010

Straight kickin'

What better place to take time off and recover than Hawaii?

Sure, I've been slaving over my graduate school application essays and micromanaging my letter writers, but the weather swings from the mid seventies at night to the low eighties during the day. In other words, absolutely perfect. Plenty of light cloud cover to take the bite off the sunshine, sea breezes in the warm afternoon, pink and orange I making you jealous yet?

I saw a podiatrist in Kailua-Kona after unsuccessfully trying to run the day I arrived, talked to an ultra-extended/psuedo-removed uncle over Skype (he works with professional athletes), and was examined by a family friend who is also a physical therapist.


1. Tenosynovitis in the extensor digitorum longus, the tendon that extends down the anterior of the lower leg and attaches to the toes; it flexes the toes with the foot. The tendon runs through a sheath that spans the ankle and the top of the foot. Tight shoes likely compressed the sheath and irritated the tendon, causing the creaky feeling. That has been resolved with full rest, a prescription anti-inflammatory, and alternating ice and heat massages. Diagnosed by the podiatrist.

2. Minor strains to the peroneus brevis and possibly extensor hallucis longus. The former aids in plantar flexion, the latter is a sort of utility player that attaches to the big toe. Using shoes I've never run in, especially ones with a higher heel to toe drop than I'm used to (zero in the Vibrams!), changes the angles and ranges of motion in the foot - certainly enough to manifest as a strain after 25 miles. These have subsided as far as I can tell, thanks to some self massage, a tennis ball, and hot packs. Diagnosed by the "uncle".

3. High ankle sprain. Diagnosed by all three, this is most surprising, but in hindsight this makes a lot of sense. I couldn't put any weight on my right leg for days without evoking serious ankle pain, and when I did, it felt extremely weak - very obvious signs of a ligament problem. Further, the family friend manipulated both ankles, and found that the tibia and fibula were very mobile in the right ankle. I'm currently in a hard compression brace to allow this time to heal. I may try running around the 1st of January, given that the healing time has been about a month.

Now, pardon me while I work on this Pipeline Porter and fresh passion fruit...

Friday, December 17, 2010

Recent absence

 Wall cloud of a mesocyclone; I think this sums up the last 3 months quite well.

My life over the past three months has become progressively busier, to the point that my short-term memory and sense of time is warped. It's been a combination of several things:

An 18 credit quarter: these are difficult classes, from fluid dynamics to complex analysis, and one of them is a graduate course. It shouldn't be surprising that the amount of work has escalated all the way up to finals week. Now that classwork is done, I've got some time back.

Graduate admissions: I'm applying to five universities; anyone who has had to suffer graduate admissions understands. There is a lot to do, and many schools have very different procedures. Procuring my letters of recommendation took some time and attention, as well.

Research: preparing data and visuals for publication with one professor, while just starting to develop a topic of research with another. Research comes in bursts, unfortunately both of these projects flared right when everything else did.

Running: preparations for the North Face Endurance Challenge, and taking care of myself afterward, is precipitously close to being the last straw to break the camel's back.

There was a mishap in the race that has resulted in some lower-leg pain, specifically in my peroneal and extensor tendons, and their associated muscles. My Treks fell apart midrace (I had ordered a replacement but they never arrived...) and, due to the rain, I couldn't duct tape them back together, so I was forced to run in my f-lite 230's - which I haven't run over 2 hours in. Further, the last ~4 hours of the race was run on often slick, slippery trail, aggravating the problem even more.

I went to my go-to massage clinic and had some deep tissue and cross-friction work done - my calves and lateral leg muscles, especially in the injured leg, were tight and knotted.

With respect to the actual injury, the therapist I saw was certain that the tendons had a mild form of tendinosis. Unlike tendinitis, which is due to an inflammation of the tendon and/or its sheath, tendinosis is a degeneration of the tendon structure. The crepitus (creakiness) disappeared after the massage, so it appears that most of the scar tissue has been broken up. Interestingly, the best treatment for this condition is the application of heat, stretching, and eccentric loading. This is in contrast to tendinitis, where icing and NSAIDs to reduce inflammation is the best route.

My course of action over the next week is to return to running this weekend, very slowly and every-other-day. I will probably go barefoot just to make sure I don't push it.

Race report for TNF50 coming very soon.