Sometimes the pain isn't where the injury is located.
I should have been out on the course running (suffering) with my friends, but instead I was bundled up with a backpack full of water, gels and bananas. I should have been enjoying the brief sunshine and shelter from the wind that the first six miles provided through Center City, but instead I was grabbing coffee and breakfast before heading out to the 10K mark to cheer and get some photos. I should have been running into the headwinds along the river at the halfway mark, but instead I was swapping out water bottles with friends and estimating BQ paces. The next day, the plan was to put on a walking boot.
Philly was supposed to be my first full; my official (unofficial) right of passage into THE Run Club. Training was going well; I was loyally adding 1-2 miles each weekend and I was running longer than I ever had before. My longest was a 15 miler in July that started out planned as 12, I finally agreed to 13, and then turned out to be 15. The last few miles were grueling, both mentally and physically, and I finished the run cursing at the friend that took our group out longer than we planned. I knew it was on purpose, to show me what my body (and mind) were capable of, and I thanked him for it afterwards. It was the same week that I considered week one of my 16 week marathon training program. So even if I was a bit ahead of schedule, it was just the confidence boost I needed.
I toed the line at Bird in Hand Half Marathon for a September tune-up/check-in race. My goal was to PR, and a friend (the same friend) found me near the beginning of the race and was determined to pace me (push me) the rest of the way to a huge personal best. And boy, did he ever. I finished in 1:46 with a huge six minute PR!! I celebrated, and limped back to the car.
It started around mile two. I felt fine during the warm up and I did my typical hip mobility routine. At mile two, both heels started hurting. With every step. Yep, there’s my plantar fasciitis again. I’ve had it multiple times over the past five years. But I kept running, up and down the rolling hills. It’s a beautiful course through Amish Country, and most runners dread the hills and humidity that early September can bring in Pennsylvania. For a majority of the course I was running up against the wall at the fastest pace I could handle, but still enjoyed every minute. If this was a training run and I had felt this pain, I would have cut it short. I had a feeling I was going to regret this, but you know how it goes. The excitement, the adrenaline, the friend that’s pacing you, the urge for a PR. I crossed the finish line and limped for the next few days. The left heel eventually was fine, but the pain in my right heel lingered. Two weeks later I found myself at a sports medicine doc with hopes of getting some answers. This wasn’t just plantar fasciitis; the pain was different. It wasn’t worse in the morning and the pain didn’t get better after the first mile or two of running.
I was sliding into an MRI, convinced I either had a stress fracture in my calcaneus or a torn plantar fascia. Nothing. The report said I was fine. “Unremarkable.” Like I was a piece of fruit.
The hardest part isn’t the injury itself. The hardest part is not knowing WHAT is wrong. I couldn’t run. I was too afraid to bike or do yoga for fear of making it worse, whatever it was. I went to physical therapy twice a week for a month and he focused on strengthening my foot and using the Graston Technique on my heel. Yooouch. At the end of the month, he threw his hands up in the air. Between him and my ortho, we decided to try a walking boot for a couple weeks. No change.
Winter came and I decided to reach out to an orthopedic massage therapist I had heard of on the Runner’s World Podcast. Ironically, I had put it on my to-do list to contact her back in August before the injury when I first heard the episode. Three months after the injury, here I was at an hour-long torture session. I had no idea how tight I was. She worked out my right lateral quad, right lateral ham, and my right calf. Heel pain caused by a problem up the chain? It’s not the first time I’ve heard this, and I probably should have thought about it sooner. By the second session, she sent me out running, slowly, starting at one mile. I ran two miles on Christmas afternoon, and that was better than any presents under the tree. Two weeks later on my birthday, I ran three miles. The next week, the pain came back. Maybe I should have chosen the presents.
I was determined to get answers. I made appointments with a podiatrist, an osteopathic sports medicine doc, a sports chiropractor, and another physical therapist. The answers from some of them were laughable. The podiatrist (from a well-known Orthopedic Institute in the area) told me that humans aren’t meant to run that long without stopping and I quote “What other animal do you see in the animal kingdom out running for 26 miles?” I turned down his suggestion of a cortisone shot. Bye.
The physical therapist was actually my swim coach from 16 years ago and this was one of those moments when I cannot deny that sometimes the stars align and everything happens for a reason. I came across her business page on Facebook and was able to get into her office the next morning. Seeing her has been a game changer. I have now been going to her twice a week for two months. The first month was focused on strengthening my core and posterior chain (especially my glutes), as well as “beating me up” as she calls it. I truly believe that I’m tough and have a high pain tolerance, but she has proved otherwise. I’m literally that person on the table writhing and moaning in pain as she works out my tight spots. Embarrassing. The second month we started running. She checked out my gait and gave me pointers on what must change.
The conclusion: I’m the quad dominant runner with a weak posterior chain. Instead of using my glutes and hams for hip extension, I’m reaching forward and compensating, leading to incredibly tight quads, IT bands and calves that are essentially “pulling” on my heel. I wasn’t foam rolling or cross training before the injury. Typical runner problem. I ran that fatal race in September about 30 seconds/mile faster than I had planned, without a proper taper. My body could not compensate anything else, and it said “no more.” And yet, I ran through it. Again, typical runner problem.
In the two months I’ve seen her, my PT hasn’t touched my foot once since the initial consultation. Yet here I am mostly pain free and running again. Is there a lesson here? Yes. Find a medical professional that you trust and keep them in your back pocket. Even better, find a few. The problem isn’t always the problem, and you need these people in your life to guide you to this understanding. My heel “injury” isn’t actually a problem in my heel. It’s a problem above the heel which led me to over-compensate and create poor running mechanics. The other mistake is looking for THE answer. I was waiting for a stress fracture or a tear to explain my pain. I told my PT that I never had that “Aha!” moment of someone finding and reproducing my pain. That’s because sometimes there is no solitary cause. There are a good 10-15 things that I could improve upon to become a better runner, but that’s for another day and another post.
It’s been over seven months since my injury. I still have a long way to go and I won’t be racing anytime soon, but I’m so happy to be back out on the road where I belong. Injuries suck. There is no nicer way to put it. You can either let the setback make you or break you. I’m 32 years old. I may not be in my twenties anymore, but I still have many years of running to come in my life. And these past months have taught me the tools necessary to #run4days
My goal this fall is to be out on that course with my friends again dodging road apples and racing up the hills in Amish Country. Also, whoopie pies. Because what Amish race doesn’t have whoopie pies at the end?