Old Man Still running

Really bad pain in the leg getting into work this morning.

Well, here is the current dianosis from the doctor after x-rays.  Well actually first he asked tons of running questions.  He wasn't my regular doctor but he has read Born to Run.  He was nice and said I looked like I was in my 30s and had lots of compliments about my active lifestyle.

1. My bad knee is not yet bone-on-bone.  The cartilage layer looks like it is about half the thickness it should be with a normal knee.   Good news.

2. No stress fracture showed up.  Good news.

3. But, there is an unusual small bump showing up in the layer next to the bone.  This layer is called the Periosteum.  This is a membrane the lines the bone and can do corrective repair to the bone and cause some calcium build-up over time that can be seen on x-rays.  This layer is rich in nerves and if irritated can be very painful.  I believe I have at least a couple spots on my upper shin about two inches below the knee that are giving me great pain.

If you explore this area of your shin (upper, inner), there is no muscle there, but there are muscle attachments from the hamstring and shin muscles.  Something has irritated the periosteum by pulling it or lifting it.  The end-result is something like a shin splint, but the pain is in the bone, not the muscle.

So, it appears that treating it similar to a shin split will work.  Rest and in this case heat treatments.  The doctor recommended that I go see my orotho doctor who could perhaps figure out what is pulling on that area.  He knows that not running 100-milers would certainly solve things but he wants me to continue and so do I.   I'll wait a month so they can compare x-rays and also check out my knee after it recovers some.  My bad knee REALLY got pounded.  The worst I've ever felt by far, but it isn't swollen.  I can feel a little fluid build-up inside, but the pain is on the tibia platform, all weight-baring pain.  I bruised it pretty bad.

This entire problem probably started at ATY around mile 120.  My upper calves became very, very tight and I suspect have some insertion points in that area.  On the other side of the leg my shin muscles also got sore.  During RR100, my lower shin muscle tore a little and swelled up during the first 20 miles. (The pain was nothing compared to my other problems, so I just ignored it.)  So that tells me all those muscles were still too tight and probably pulling on that area big-time.

The doctor assured me that I will run again and felt confident that I will be healed up by Northcoast 24-hour in May.  So, I'll go ahead and put my name in the lottery for Cascade Crest 100.  I will likely pass on Buffalo 100 this year and just run with my son in the 50

Worked from home so I could ice the leg.

Improvements today.  To benchmark my progress, I went out for a "run".  I took my Garmin to measure my speed.   I had to keep the pain under about a "5".   My peak pace was 27:00.  The good news is that is about three times faster than yesterday afternoon.   I was able to "run" 0.2 miles in 7:45.  Good stuff!

The biggest source of pain now is in front of my knee behind the patella, I believe on the Tibia platform.  That is odd because I should have more cartilage there.   I would think that will calm down pretty fast, but I do recall pain near there before running RR100.  

As I was "running" two women came running toward me.  I could not deal with that sight.  I turned my back and headed back in. Little did they know that the old slow-moving cripple is actually the fastest long-distance runner in the city.

I put this on facebook, a Tiny Tim reference. 

Feeling like a cripple today. Someday when I'm gone, I will be sadly remembered by one lone trekking pole by the fireplace (near my belt buckles). God bless us everyone.

p.m. walk with the dog. She was pretty annoyed that I was only going 45:00 pace.  Cut it short as the shin started to complain.

Entered the lottery for Cascade Crest 100.  If I don't get in, I'll likely do Plain 100 again.  I just enjoy both of those more than Wasatch.  Plain is a lot tougher than Wasatch and CCC100 is both tough and amazing variations of trails. Wasatch course is getting somewhat boring after running it both racing, pacing, and training, probably about 6 times now.  I seems to get bored with a race after about six times.  That is probably why I'm not going back to Bighorn or Tahoe Rim this year either.

I've been researching medical papers about my problem.  My main source of worry is the shin pain.  It can be classified as a shin split, but it is unusually high on the shin and now pretty big.  Two muscles send attachments to those areas, both are calf muscles.  So the calf is likely doing the pulling.  Strange because I've had no calf soreness or tightness.  But my calves are probably over-developed and causing grief.  I don't rule out a stress fracture.  New stress fractures often don't show up on x-rays until several weeks later.  But it doesn't matter, the treatment for either a stress fracture and periosteum problems in that area are the same.  Rest and patience.   Cause seems to always point to over-pronation problems.  I know, I know.  That leg is a bother, swings from the hip wrong and seems to be shorter than the other leg. 

I'll start swimming again tomorrow.  Other than that leg, I feel totally recovered already from RR100.   Worst is probably upper body soreness from using the trekking poles for 9+ hours.

p.m.  A walk with the dog.  Top sustained pace today, keeping the pain the same was about 21:00 pace.   That is progress.   I needed to stop several times to bring down the pain.  Brought back memories of the last 40 miles of RR100.

Progress.  No longer a cripple.  Getting close to how I felt a few days after ATY.

I looked very closely at the x-rays again. The bump seen on the x-ray has nothing to do with the pain I have.  The bump is three inches lower, just some a calcified bump on my shin probably from dozens of bumps there.   So I examined the exact area closer for anything, but there is nothing in the four pictures.  Not a mark.   So I think that is good news.   At this point, just rest, let things heal and in a month if it still is bad, I'll seek more advise.  But no surgery would help, just PT.

Now the the pain is going down, I can try to figure out what is putting pressure on the problem area.  Sure enough, it goes up as the heel turns in, over-pronation.  So, I dusted off my prescription orthotics that I haven't used for five years.  I'll get used to using them again.  They will force that foot to pronate better and give some arch support.  Hopefully it will rest that area of the leg better and let it heal.  NO MORE BAREFOOT around the house.  Funny how my downfall has probably been going barefoot so much.

Top speed today walking the dog was 17:30 on soft grass..  Didn't have to stop to let the pain down.  But there is constant pain in the shin.  The knee is improving nicely.  I've come a long way considering a couple days ago I could hardly move without a cane.

I still haven't brought myself to really write a race report.  I have no desire to relive that pain, even in my head.   It was by far the most painful race I ever ran.  And, it wasn't very fun.   The only bright spot is I really enjoyed the kindness and company of my pacers.  Those guys were amazing.

Pool workout.  Had to drag the leg, kicking hurt.  Sunrise was spectacular.  I should have brought my camera.  Did deep massage of the calf and shin muscles with a high-presssure water stream coming out a nozzle in the kiddy pool.  It pounds the calf to mush.  Amazing.  Should help.

Two mile walk with the dog.  Discouraging.  Top pace with a huge limp was 15:00.  Pace with no limp 25:00.  Had to stop to rest twice to let the pain go down below a 5. But there is slow progress each day.  Of course I have those thoughts that I will never run pain-free again, since it has been 41 days now.  My first goal is to walk pain-free again.  That is probably still a couple weeks away.