Injury Update #3: Don't Call it a Comeback

In case you missed it, I was diagnosed with a 4th metatarsal stress fracture at the very end of October and survived almost 4 weeks in a boot doing zero exercise of any type. I posted my last injury update in JANUARY about PT and all that fun stuff. 

So I have taken a couple months off of blogging because I finished my last semester of classes for grad school (::woop::woop) and had a month off school completely and working for 2 weeks before starting my clinical rotations. Plus there wasn't much to say. 

I got some longer runs in to run the Love Run Half Marathon in Philadelphia after March which I completely in okay time, but feeling crappy. It was too much too soon. I took a week off afterward because of intermittent soreness in my foot the following week (the foot felt fine during the race and the days after).

This spring was my hardest semester of classes and with being busy it was really hard for me to get into a solid running/workout routine again. I feel like I'd skip/miss workouts and then do a bunch of running, etc. and never get a stable base of 15-20 miles. I'd feel some weird soreness in my healed foot (same feeling of the initial injury almost) every couple of weeks that freaked me out and made me take it easy/off running for a few days (or a week in a couple of cases). I even went back to my ortho in April to talk to him and made him do an X-ray just to try to ease my anxiety.  Yes, he thinks I'm crazy. 

So if you are coming back from an injury, it may not be as straightforward as you think. There will probably be some ups and downs along way. 

Now it's July and almost time to start Philadelphia Marathon training which I'm keeping low-key because I've got my eyes on the dream of being healthy for Boston 2018. I still feel not as fast or fit as I was pre-injury, but I've built my mileage up to all 20-24 miles per week in June. I need to do better at my PT exercises, stretching, foam-rolling still (story of my life? most runners' lives?). 

However I feel like I've been really consistent the past month (not working or being in grad school classes/fieldwork, haha) which has been a great reset.  I feel like I'm at a good place where I'm just okay. All my running buddies who I have talked to in the past 6 weeks are like "so you're healed, now?" or "so you're back to normal now?". I'm not feeling that way, but I'm good. I even ran a 6:06 mile on a whim for the Strava #mymile mile PR challenge so I know the speed and fitness is in me-it just needs to be trained and tuned up. I've been doing some fun runs, having good workouts with friends, and re-fueling like a boss (that never stopped!). I'm running and loving life right now.  

Now off to do some resistance band hip and glute exercises...

#5ummit NECS_MA trail race action shot 

Mental Challenges When Returning to Running After Injury

So I talked about how to survive being an injured runner and then what I was doing to come back stronger after my metatarsal stress fracture, but I think I'm struggling right now with the return to running more than just being injured. So here's my long discussion to talk about it with all you readers. 

I finished the 6 week conservative return to running plan that my PT gave me with no problems, minus some soreness in my recovering foot a couple weeks. That plan which started with run-walk intervals and finished with 30-40 minute continuous runs had me around 10-15 miles per week, mostly on the treadmill.  After the plan I was trying to build up some longer runs outside so I could successfully finish the Philadelphia Love Run Half Marathon for which I was an ambassador. I kept my mileage from 15 building up to just over 20 miles a week with most of mileage come from a longer run on the weekend. I used the progression over consecutive weeks of 7.5 miles, 8 miles, 10 miles, 10 miles, rest, and then the half marathon. 

Happy just to be outside

Obviously my fitness is not where it should be, and I was not feeling great during the half marathon but I finished in a not too shabby 1:45 and change. My foot had been feeling sore when not working out which brought back to mind signs that I felt when I had a stress fracture that week before the race (not on race day or during the race) so honestly I was mostly focusing on how my foot felt during the race because I was so anxious as well as the fear that I was over-doing it. Yes, I've been dealing with a lot of anxiety about my injury recovery and running in general. 

Running is already a mental challenge but adding in the anxiety and fear of being injured has made it even tougher. There are multiple mental challenges that have made returning from an injury really hard for me. 

The first challenge is dealing with soreness and discomfort that may be felt in the recovered foot as the bone heals and is reported anecdotally from runners that it can happen for months or years after the injury.  The bone heals and forms a little callus so it should be strong, but how can I tell if it's normal soreness or pain signaling another injury? I also am extra anxious because my PT has me trying to change to landing on my midfoot instead of heel striking so in my mind I'm putting more force on the front of my foot, when actually I'll be putting less force through my foot all over (which he showed me on the fancy treadmill running analysis at PT). I've read all over the Internet, and it seems it's hard to tell, particularly when you are like me and are focused on it and hypersensitive to every feeling in your feet when running. Honestly I have so much fear of re-injury. 

Obviously if it's sharp pain that is bad and a sign of injury. If you have sharp pain, I'd get yourself checked out, just to be safe. I can clearly remember when I had my stress fracture for about a week the pain was so sharp and throbbing, it hurt to even walk. There can also be phantom pains, which can be sporadic and vary in intensity in the area of the foot that was injured due to calcium buildup at the site of the bone recovery or just mentally induced kind of like PTSD. The possibility of another stress fracture when my foot was feeling sore last week had me in tears. It's hard for me to listen to my body when I'm so sensitive and hyper-focused on every little feeling in my feet. 

4 Reasons Why I'm Using Collagen Peptides {Vital Proteins Review & Giveaway}

Disclosure: I was 2 complimentary tubs of Vital Proteins for review. The giveaway is fulfilled by Vital Proteins. As always, all thoughts & opinions are my own. 

Like me, you may have read or heard of people (particularly in the paleo crowd) taking gelatin for health benefits such as a drinking bone broth. However, you may be wondering what do gelatin or collagen peptides actually do? Gelatin, like that JELL-O stuff?  

Collagen is the most abundant protein in the body, and collagen peptides have the same amino acids as gelatin, however they are just processed differently.

Collagen peptides are hydrolyzed a.k.a. broken down into smaller amino acid chains so they are more easily digestible (I will forever be a chemistry nerd so I LOVE learning about food science). 

I had heard of Vital Proteins from reading about them on various blogs, and then had the chance to talk to the lovely people at the Vital Proteins booth and snag some samples at Natural Products Expo East 2016. Vital Proteins was nice enough to send me a tub of their collagen peptides and collagen beauty greens to try out. 

The Collagen Peptides powder in the blue container come from grass-fed, pasture-raised bovine hides so they are not vegetarian. At first I thought it was a little weird that it was powder from cows, but after that initial moment of weirdness now I love how they are a natural and sustainable source of protein.

The green container of Collagen Beauty Greens contains marine collagen peptides along with greens, probiotics and skin healthy helpers like hyaluronic acid, all in a yummy coconut vanilla flavored powder. 

What Will Make Me a Better, Faster Stronger Athlete in 2017

Hello! I'm still moving along on my return to running plan and am up to running TWO WHOLE MILES. Yes, sarcastically because I have had a couple runs this week where I just want to keep going, but then my mind is like BUT THE PLAN and then I think about how I don't want to be injured or in a boot again so I stop. Being able to run 2 miles is way better than 0 miles. I am still trying to work on changing my running form which is proving to be hard and might not happen, but at least there are things I think of like squeezing my booty to engage my glutes every so often and lean forward a bit to prevent over striding.  

I have been really wary of registering for races even though I have 2 half marathons on the books in the spring because coming back from the injury and getting my mileage up is a slow process. Therefore I am still thinking about 2017 goals (besides not getting injured) as well as what I want to accomplish outside of fitness. So that post will be later. 

There are things I have been doing that I want to continue with as my mileage slowly but surely increases to make me a [harder] better, faster, stronger athlete.  

Yoga

I was always on this blog talking about how I need to do more yoga and how yoga is so great for runners. Finally completing Yoga Sculpt teacher training at CorePower Yoga and then starting to teach at the Harbor Point studio has been a little blessing. It gave me a nice outlet when I was in the boot and couldn't run. Also teaching has made me do yoga more besides the obvious reason. It helps that as an instructor I get free classes at CorePower (which is AMAZING), but it is also easier to practice on my own before or after I teach as well as take other classes when I am already at the studio. Besides the physical benefits, the mental and spiritual benefits for me have been missed and are much needed when I am busy with school and work. It's always good to be reminded to slow down, breathe, and stay present.  I am finally getting back into yoga and am loving it. 

Injury Update #2: Stress Fracture Recovery Begins

In case you missed it, I was diagnosed with a 4th metatarsal stress fracture at the very end of October/beginning of November and survived almost 4 weeks in an Aircast boot doing pretty much zero exercise of any type. Yup, I did pretty much nothing besides a few workouts during my time recovering. 

What I'm Doing

Physical Therapy
Das boot came off in December after an X-Ray and getting the okay from my orthopedist. I wore an ortho sandal for 2 weeks after the boot to still offer some protection, but could at least get around better. Luckily I was not having any pain in my foot. 

The second week of December I began to see a physical therapist once a week as recommended by my orthopedist. A gait analysis was completed and the body mechanics of muscles involved in running were analyzed.  Not so shocking, but I found out I have weak hips (main problem) and weak glutes. ::whomp::whomp::

But really though. Happy Gilmore, anyone?

Exercises
To help strengthen these muscles I was prescribed weekly exercises to do at therapy and at home daily during with a Theraband. Lots of variations on clamshells, squats, step-ups, lunges, and fire hydrants. This article from Runner's Connect has a nice set of exercises which includes some that I have been doing. These will continue to be a staple in my life to help prevent any injuries in the future. 

Theraband exercises are why PT is short for Pure Torture, right? Just hitting you with some rehabilitation professional jokes. 

How to Survive Being an Injured Runner {Stress Fracture Life!}

Disclosure: I received Mizuno winter gear through a campaign with Fitfluential, LLC. As always all thoughts and opinions are my own. 

I survived 3.5 weeks in a boot due to a  a stress fracture and over a month of not running or working out really at all. This crazy runner lady has not run in over a month. If I can do it so can any injured runner. Honestly being swamped with school and work has made the time fly by.  I still am in a little bit of a funk and just got cleared to seated cycle so I'm hoping to hit the gym and start working on my cardio again this week. Running and working out makes me feel good about myself and is stress-relieving so it has been a difficult transition. Here's some of the ways I found to make an injury bearable. 

How to Survive Being an Injured Runner

1. Catch up on sleep. 

I have been running on fumes for the past 6 months and have been trying to catch up on sleep on the weekends because I was averaging 6 hours of sleep a night during the week. I don't know what caused my stress fracture, but I'm assuming that lack of solid sleep and recovery may have played a factor.  No early morning runs or workouts means an extra hour or so of sleep!

2. Netflix and chill, literally. 

At the moment at least! {source}

I spent lots of time relaxing on the couch, putting my foot and boot up, and catching up on my Netflix queue, guilt-free. Find a new show to binge when you get home from work or school. I'm currently making my way through Parenthood-it's SO good.  

3.  Stay off of social media. 

{Source}

So I Have a Metatarsal Stress Fracture

So this really isn't the thing you want to be given (aka pay for) at the doctor's office as a runner. 

It seems I have a metatarsal stress fracture in my right foot. 

According to OrthoInfo a stress fracture is "a small crack in a bone, or severe bruising within a bone. Most stress fractures are caused by overuse and repetitive activity, and are common in runners and athletes who participate in running sports, such as soccer and basketball." Recovery time for healing is 6-8 weeks. 

How it started
So 6 days after the Chicago Marathon on 10/9 and a couple easy runs, I decided to run the 5K and a leg of the marathon relay (Leg 4- 7 miles) at the Baltimore Running Festival on 10/15/16. It was super fun and the excitement got to me so I ran a little fast. The next day as I took my first steps during my run with the Charm City Run training group I was coaching, I had pain on the bottom side of my foot that did not go away.  In fact it continued to hurt the next couple of day as I took each step walking. It was mostly this pain on the outside of my foot which made me suspect tendinosis, but there was also this achy not sharp pain on the bottom top and heel of my foot that also felt kinda burning sometimes.  

Initial Steps
I took a a bunch of rest days, iced my foot, and used some KT tape to tape it up. It was feeling better later that week by the time of the appointment I made with the orthopedist. I've never had any injuries so I was freaked out and wanted to get it looked at. Things felt good and the X-Rays came back clear. I did a couple shorter runs with my training group (3, 4 miles), and it felt a lot better.  

Monday 10/24 I went for a 9 mile run with a friend, and my foot felt great until just after mile 4 where it was in pain. After the run it was in a lot of pain-no bueno. So I called my doctor and got an MRI scheduled for 10/29. Perhaps for another post, but MRIs are SO weird. 

MRI & Where I'm At Now
The MRI saw some bursitis between my 2nd, 3rd, 4th metatarsals (inflammation between my toes), tendinosis and fluid at my peroneal longus tendon (inflammation in my tendon along the outer edge of my foot), and a 4th metatarsal stress reaction (stress fracture almost in my 4th toe). 

Image from AAOS

My doctor said it's a stress fracture from what he sees on the MRI despite there not being a ton of pain. It hurts more when he presses on it than the next toe but not a ton and way less than there was initially.  Honestly the tendinosis is bothering me on the bottom/side outer edge of my foot more lately.  As a future clinician the science of it all and looking at my MRI was pretty cool. Minus the fact that it was MY foot. 

The doctor think it is just an overuse activity from running and marathon training since nothing else seems glaring wrong. Although we're going to get my bone density tested as a precaution (despite not having the Female Athlete Triad), and in a few weeks I'll go to physical therapy and get my gait analyzed to see if it's something bio-mechanical in how I'm running as well as re-strengthen my foot. I just had my calcium and Vitamin D levels tested with Insidetracker, and both were in the normal range (which I tried hard to make sound legit when I explained to my doctor, haha).  

I got the MRI results on Thursday and pretty much spent all weekend watching Netflix and having a pity party party for myself. There was a lot of sobbing, beers, and some ice cream. Plus reading every Google search results on metatarsal stress fractures and running, of course. 

It just sucks because medical issues cost lots of money and time which I am happy to do to be healthy but still I'm a poor graduate student. Also I LOVE RUNNING, and JUST came off some great races and was finally feeling stronger and faster for the first time in a while. 

Now I feel like I'm going back to square one.

I went to a yoga class (that was actually great) last Tuesday and haven't worked out since. 

For now I'm in the Aircast boot for 3 weeks all the time except sleeping, until I go see my Dr. again and get re-evaluated with some X-Rays to see how its healing. He said for now pretty much just rest unless I can get in a pool and go swimming.  

Feelings About It All
Honestly I go back and forth between being fine and accepting my body-mandated rest period, and then just crying and freaking out. I'm actually really bummed that I can't run the Philadelphia Marathon anymore, but clearly it wasn't meant to be this year.  

Despite this I have a lot of gratitude. It's sucky but hey this all happened after training for the Chicago Marathon and then running a big PR and BQ and amazing race. I'm assuming since it's November it should get colder and take a couple months off from running at the holidays to rest won't be so badly. Lastly (and only second importantly to already getting the PR/BQ), is that I am lucky enough to still have healthcare through my job even though working full-time ish hours during full-time grad school sucks. That means I have a Hopkins sports medicine orthopedist to work with through all this which is awesome. He thinks I should be back to my running self in January/February which is great to hear.

Now I'm that runner who is on #injurydeck and can't run. Bring on the Netflix marathons and stay tuned!

So anyone ever had a stress fracture? How do you stay sane during injuries?