I happened to read this article about the time I was going to have my first knee surgery. When I went in for a visit prior to the surgery, I had asked the orthopaedic doc if there was some other alternative to removing part of my medial meniscus, the cartilage that keeps your leg bones separated so the don't grind and provides a cushion. I told him I'd seen an article somewhere that they were growing cartilage then successfully placing it back in the athlete's knee. He got a vague smile on his face and nodded. "Yes, there are some things we might be able to try if you were an elite athlete," he said, "but you're not."
Unless you are in extreme pain and need immediate medical attention, most of us are left to our own wits to figure out how to rehab an athletic injury. When I pulled up lame two weeks ago with a calf pull, threatening my participation in the Bolder Boulder, I was fortunate to have family, friends, and colleagues with all expertise needed to get me rehabed quickly (not easy if the patient is an un-young).
My virtual rehab team formed as soon as I got home after aborting the run during which I injured myself, and my wife suggested I get ice on the site of the pain. I followed her advice then, and for the next couple of days, and that helped keep the pain down.
Then my daughter, who's a nurse and runner, emailed to instruct me to rest it so it would have a chance to heal. It was good advice, but asking a TOJ to rest is like asking a smoker not to smoke. I did stay off it for two days, then tried to get out for a short run, but stopped immediately when the pain increased. She was right-- it did need more rest. Lesson learned. I stopped running.
Then I asked a family practice doc, who's a runner and colleague, what he thought I could do. I was going through exercise withdrawal. He agreed a rest from running was a good idea, but gave me some exercises to do slowly to strengthen the muscles involved in the injury, which I did, and within days could detect an improvement in my range of motion and less pain.
A few days later, I ran into a friend who's a physical therapist, and asked her opinion. I wasn't sure whether the Achilles tendon or calf was the problem because I'd noticed the pain seemed to move a little lower at times. She asked me to take a few steps, then advised me to not run at all until I could walk without limping. She advised me to keep doing what the family doc/runner suggested and also ride my bike to both maintain my cardio-endurance and work the calf in a less stressful way.
Finally, a friend who's a Clydesdale triathlete heard I've been gimpy and also sent an email. He had a serious Achilles tendon injury that put him off his feet under doctor's orders for a month. He told me to stay off that leg, period. Total rest or risk long term injury. When I told him that might be hard to do being a TOJ because I wanted to run the Bolder Boulder and needed to do some preparation, he asked me what starting wave I was in. Turns out he's two waves behind me because it's the one time of the year he runs with his wife. He told me he'd catch me, then tackle me and drag me over to one of the lawn parties that are going on along the course.
Today I ran five miles, slower than I usually do, but fast enough to get a nice workout. My calf felt pretty good, even when I went up the hill where I pulled it. Mostly heeding my rehab team's advice, I haven't run much in the past two weeks. I won't be peaking for this race, but that's okay. I think I'll be able to do it.
I'll either make it into Folsom Stadium or my Clydesdale triathlete friend will catch me and drag me to a party along the course. I told him if he does that, he has to pick a party serving a good dark beer. Either way, I win.
About halfway up, I felt a pain in my left calf. It seemed to come from nowhere. With each step, the pain got worse, and within 50 strides I had to stop and could barely walk. The pain was mid-calf, right where the Achilles tendon connects with the gastronemius muscle. When I bent over and probed it with my fingers, it hurt.
As I limped back to my car, I brooded. I've been fortunate rarely to suffer running injuries. Plenty of others, but not from running. But here I was limping down the road with my favorite race only a few weeks away. I figured the odds of quick recovery by then were slim; by definition, TOJs take more time to heal. I felt sorry for myself and pissed at the bulls on the other side of the fence looking at me as if to say what's your problem, you usually run by?
When I got home, following my wife's good advice, I threw ice in a plastic supermarket bag and wrapped it tight around the calf with the ACE bandage I kept from my last knee surgery over 10 years ago. I followed the RICE protocol for a couple of hours: rest, ice, compression and elevation, which worked. Though it hurt, the pain was tolerable. I looked up my condition on the internet and assessed it as a Grade 1 strain. No big deal, just need some rest.
The next two days, I rested completely. On the third day, I did a workout with a 35 lb. kettlebell. The calf felt a little sore, but in no way affected the workout. The next day I ran for about 3.5 miles with my wife. I could feel my calf, but it wasn't bad. The day after the run, I did another 35 lb. kettlebell workout and 20 minutes on an elliptical. Again, not too bad.
Then on the sixth day (yesterday) after the injury, I went back to country road for a run. I started with my wife, then, feeling good and ready to push my pace, pulled away after a few hundred yards. Less than a mile into the run, the calf pain came right back at the same intensity as the original injury. I went home and RICE'd it again.
I remembered seeing a good article about "Running Injuries and Aging" by Allen Griffiths in Colorado Runner. He suggested nutrition is key to speedy recovery, especially eating additional protein because most tendons and muscles are made from it. I'm eating more protein.
I also read portions of Nicholas DiNubile', M.D.'s (he's an orthopaedic surgeon) book FrameWork, which is full of useful information about training the muscles and skeleton. Of course, there's an excellent section on injuries, which describes in enlightening detail what happens at the site where a soft-tissue (muscles are soft-tissue, unlike bones) injury occurs, and the amazingly complex biochemistry of the healing process. Once you realize all that's going on, it becomes obvious to a TOJ, even one who subscribes to silly ideas of mind over matter, that the injured area really must rest. Period, no running.
Based on what I see in my training log, I don't think running caused the calf pull. It was the cumulative result of running intervals on concrete, followed by a tough kettlebell workout (to which I'm still adjusting because I've only been doing it a few weeks) that greatly tightened my leg muscles the day before the injury. Then I did no stretching before that run. I will stretch next time before I run after a hard session with kettlebells.
Today, I let my lower legs rest. I jumped on my bike for the first time this spring. I was paranoid about losing my cardio-fitness as I waited to resume running. Biking is mainly a thigh intensive exercise. The calf felt fine. I wore a heart rate monitor and elevated my pulse beyond what I normally do on long runs.
Earlier this week, I was talking to an Emergency Room doctor at work. He asked why I was limping. I told him what had happened. He shook his head and said, "You don't know how often I see people who are pushing it beyond what they normally do. That's almost always when these injuries happen. The less fit they are, the worse it is. You should be okay pretty quickly if you rest it."
I didn't get what he was saying then, but I do now. It would sure be great to run on Memorial Day. TOJ's may be slow, but they aren't stupid. Life's too short for injuries.
A kettlebell workout is challenging, but very effective and simple. It takes some getting used to because the exercises are ballistic, required you to swing a heavy weight, and involve your total body. But I do think they are superior in many ways to barbells and dumbbells that focus on isolated muscle groups. When I finish a workout, I feel a relaxed fatigue from my shoulders to my feet. And I think they are making me stronger.When my children were little kids, we had book of Russian fairy tales, all based on animal stories. What was different than those tales and, say, "The Three Bears," was that they all had unhappy endings. They were cautionary tales of animals with human foibles, which would eventually end with the hero of the story being eaten by another animal or freezing to death. I remember thinking that being raised in a culture like this would make for a tough adult.
In the days of the Soviet Union, the Russian athletic establishment was the embodiment of this Spartan view of life. They were notorious for grueling workouts, harsh training conditions, and applying science to "manufacturing" great athletes. And they did. The Soviets were always top medal winners in the winter and summer Olympics.
After the fall of the Berlin Wall and the dissolution of the Soviet Empire back in the 1980's, the Russian Army and US Special Forces started training under the guidance of Pavel Tsatouline, a Russian solider and conditioning coach. To our embarrassment, the Russian soldiers exhibited better strength and endurance than our soldiers. The former trained almost exclusively with kettlebells.
In Russia, kettlebells, used for centuries as counter-weights in farm commerce, were already widely used by soldiers, athletes, farmers and workers to develop and display their strength. Most Russians have always been relatively poor, certainly not able to pay a monthly fee to workout on the Nautilus. So kettlebells kept them strong.
A born entrepreneur, Tsatouline, now Pavel, Inc., found a tremendous opportunity in obese, exercise-starved America, and has created a whole kettlebell franchise with the weights, books, DVDs and trainer certification. There are hundreds of imitators, but he is a credible source regarding how to train with a kettlebell.
His books, though full of solid exercise physiology, can be sort of funny because they are riddled with military macho. Weightlifters are referred to as warriors. He describes the fat-burning aspects of the kettleball as superior to the "dishonor of diet and aerobic exercise." (He reminds me of the testosterone-hyped writers in Men's Health magazine; don't know why the weight-lifter types have such a visceral reaction to skinny marathoners!)
However, Pavel is a master of the kettlebell, which requires a lot of technique to get the benefits and avoid injury. Working out with a kettleball is demanding and different to what I was used to with conventional weights. You use your core muscles to lift and balance a large, unstable (because of the handle) weight overhead with your arm locked. It's important to keep the wrist relatively straight, which can be hard if you do not control the kettlebell well enough to avoid slamming it against your wrist (it hurts!).
You will find tons of video about the kettleball on YouTube, including some that show incredibly strong Russians flipping them around like jugglers. However, be careful because some of the demonstrator in the videos display poor technique.
I plan to incorporate a kettlebell workout at least twice a week. There's no doubt it maximizes overall functional strength, stability, flexibility, and balance. It's perfect if you only have 30 minutes to exercise because in that time you can reach complete muscle exhaustion if you keep rests short between sets.
Now when I think of Russia, I don't think vodka, caviar, Baryshnikov, Tolstoy or Siberia. I think kettlebells.
Sort of like when a human looks at an ape at the zoo and feels a vague sense of kinship, outdoor fitness enthusiasts, which includes many TOJs who trail run, bike or mountain bike, recognize some commonality with these adventurers. We are all physical junkies. And to survive the stunts shown in the festival -- snowboarding down 55 degree mountain faces, kayaking over 100 ft waterfalls, climbing ropeless up 2,000 ft of vertical rock -- require world class athleticism, reflexes and endurance, well beyond what most of us will ever achieve.
Yet, in basic ways, we are very different. For us, extreme danger is an exception, not an end in itself. We risk failure at meeting a physical goal, like running a certain distance or lifting a certain weight. Sometimes danger finds us anyway, like when we get lost or our bodies are over taxed or dehydrated or injured. But mostly it's about enduring pain, sometimes for an extended period of time. Our addiction is the endorphins produced by this prolonged exertion. For many of us, hard exercise is the goal itself.
But for the adventurer, extreme danger is the rule. The possibility of imminent death is at the center of their experience. The spectre of falling thousands of feet off a mountain or drowning catapults many of them into a spiritual dimension. Certainly their addiction is the endorphins, which accompanies any hard exercise, but they also add high doses of adreneline. For them, hard exercise is the means to an end: to complete and survive a very dangerous physical feat.
A sad fact of the adventurer's calling, caught in those I saw last night and others, is that a significant number of people do die in pursuit of their passions. In one excellent film about extreme skiers I saw a few years ago, the narrator of the film was killed as the film was being shot. In one of the films last night, three young, energetic men were shown as they strategized how they would get a the first ascent of a difficult mountain in China. The film maker commented grimly that the three were killed a few days later in a massive avalanche near where the film was shot. In his book Into Thin Air, John Krakauer astutely questioned the motives, including his own, and human costs for these adventures.
But one passion we share is to be outside in beautiful natural surroundings, challenged by terrain and weather. At last night's festival, I saw the love and awe for vast landscapes in the adventurers' eyes as they looked up into the peaks or down into raging mountain rivers. For all of us, it's a thrill to be alive, though some need to fall off cliffs to feel it.