Report from rehab - IV: injuries connect us

Do not go gentle into that good night
Rage, rage against the dying of the light (Dylan Thomas)

I started writing this blog when I was on top of the world. I had just completed my second half marathon and joined Melkesyre, and my shape was better than ever before. It was intended to be a blog about endless victories, triumphs, and new records, motivational and hopefully inspiring. There have been many posts of this character, but as you know there have also been many many posts about injuries, rehabilitation, not being able to run, and how to recover. Interestingly, the posts that are related to injuries and rehab have perhaps been the most popular ones.

Unfortunately, it turns out that many of us have long lasting injures, and we all make the same mistakes. Friends, acquaintances, and sometimes complete strangers approach me to discuss their injuries, and there are many interesting stories. I had never dreamed of this blog being of help in this way, but I am very happy that it seems to give relief to some people. And it is great therapy for me too,  I learn a lot from every story! Sadly, one common thing in all them is that we all seem to struggle and spend a lot of time and money before we find a therapist who is actually able to help us. Another main ingredient is that we are all easily motivated people who like to push ourselves, but whereas motivational input is easy to get, but we do not get much advice about sensible training and restitution (or perhaps we do, but we choose to ignore it).

Here is the most important piece of information I gathered during this period, which I did not know before, and which explains why we get injured, especially those of us around my age: Muscles and lungs do not age. Then have the ability to improve endlessly; the more you push and train, the stronger your muscles (including your heart) and your breathing capacity will become, and you will get faster and stronger all the time. When an adult increases his or her level of training, this is exactly what happens. It is extremely motivating, and you simply want more of it. As it all seems to be going well, you keep pushing and improving, and feeling wonderful, all the time. So far so good. But there is a backside to the story. Unfortunately, tendons, bands, joints, and ligaments DO age. They do not have the same capacity and ability as the muscles and the lungs. They get harder, stiffer, and brittle as we age, and they cannot always keep up with the intensity of the work. When care is not taken, at some point something gets destroyed and you are injured. This is exactly what happened to me.

I started to feel the first pain at the back of my right thigh in October 2013, about two years ago. I cannot pinpoint an exact trauma, a sudden pain during a single run, it was more that it came gradually, and I could feel a discomfort every time I was running. Still, this was not really a big problem, after I got warmed up I could run fast and long without much pain, and with some massaging afterwards it would go quickly away until the next time. In March 2014, I started to increase my mileage and ran longer and longer, finally participating in Bergen City half marathon in April 2014. Although the injury did not really bother me that much during running, it started to bother me outside of running, like bending down to tie my shoe or pickup something from the floor became increasingly unpleasant. In May 2014, I had an MRI examination, which showed some edema in the middle of right buttock, and I started regular physiotherapy sessions. What happened later is already explained in several blog posts:

• As nothing improved, actually things got worse, I tried many different therapies.
•  During this time, although the pain got stronger, I refused to slow down, and just continued to run.
• Finally the injury climaxed and it was not possible to run anymore; I was forbidden to use my legs for 4 weeks.   
• After these weeks, the HSR therapy started.
• I was allowed to use my legs, but no running! I did a lot of uphill walking and strength training.
• In the summer, I concentrated on swimming as alternative training.
• After the summer, going back to uphill training gave a new boost in the healing of the injury.
• I started to race again; uphill races first, like Skåla Opp and Storehesten Opp.
• To keep myself motivated and amused, I tried out new things, like triathlon and open water swimming.

Now, I am slowly going back to running, and increasing my mileage cautiously. Yesterday, for the first time in several months, I participated in the regular Saturday uphill intervals of Melkesyre. There was no pain, and it simply felt wonderful. So have I fully recovered? No, not according to myself, but my physiotherapist says that my tendon is now strong enough to try out more and more running. I have almost no pain when doing my HSR exercises, and I can do a single leg back plank on my injured leg, and a single leg side plank on my injured side, without pain. There is still some discomfort and stiffness, but Ane says that it is mostly in my head now. My brain is used to sending out pain signals when the injured area is in action, and to be on the safe side it continues to send these signals even when things have healed. The recipe ahead is: try running more, but not more often than every other day. If pain or discomfort, step back, don't do exactly the same thing for a few days, before trying again.

But what should I do in the future to say out of injury? Of course one solution is moderation. Just do not exercise or run that much. I will then not improve that much either, but just being in good (not necessarily the best) shape is good enough for many. But what if you, like me, want to push it to the limits of your muscles and lungs, well then we have to learn to train more sensibly and more smart. Resting is very important, and as we get older we need more rest. I have also finally understood why zone 1 training is important. Not only does it improve your ability to run faster at lower heart rate, but our body also gets an incredible rush of HGH (human growth hormone - which gives us recovery and muscle repair)  during the first 30-40 minutes of a zone 1 session (after than it goes down to more regular values). So, for example, doing a 30 min zone 1 in the morning and a 30 min zone 1 in the afternoon, is better than doing an hour zone 1 at once. We also need days of complete rest; no training of any kind. But how to be able to get enough training and and enough rest? Perhaps training twice some days of the week might be a good way to achieve this? It requires care and dedication, and it would work best if you actually had time to sleep an hour after the first workout of the day. But who in full work has time for that? The most important thing seems to be to not waste time on moderate speed runs of moderate length, they do not improve our form according to professionals. We need long slow runs and short fast runs, or intervals. And not more than two or three real hard sessions a week. So many rules... what happened to the fun of just putting on your shoes and getting out whenever you feel for it? It is still out there, if that's what you want. You simply have to figure out what you want.

Then you will find a way; your own way!