Saturday, February 12, 2011

Injuries, Obvious and Not-So-Obvious

I am going to put running related injuries into three general groups and discuss each. Although they relate to any type of running I strongly suspect trail runners encounter there problems with a greater frequency than the average road runner. Our running environment is much more hazardous (perhaps even hostile at times) and we are out there for very long periods of time. Road runners consider a three hour run a killer. I ran 3 hours and 3 minutes last weekend and that including 4 hill repeats for half of that three hours. That was my taper run before the Mercedes Marathon this weekend. Do you know any road runner that does 8 hour training runs building up to a major race? Most ultrarunners do in preparation for a 100 mile race. By the way, I have done no scientific studies and no extensive reading on anything I am about to write. It is all my opinion, and we all know what that is worth! I will post an article later on overuse injuries. It is a real research study.
My three categories of injuries are: The obvious, the not-so-obvious and conditions. I use the term “conditions” because it more accurately described some problems resulting directly or indirectly from running.
The OBVIOUS needs little discussion. If you fall and hit your head on a rock and have to call your wife to meet you at the trail head to take you to the emergency room for 24 stitches, well, that is “obvious.” I was running along the crest of Double Oak Mountain on the blur trail. As I rounded a large cut log, I did not see the small, very solid rock behind it.  My trailing foot caught on the rock and I fell so quickly I could not even get a hand out to slow the fall.  The rock caught me just above the Eyebrow. I was 8 miles from my car so as soon as I recovered from the shock of hitting my head so hard, I called my wife to come get me.  I hiked the 2 miles to the north trail head holding my eyebrow in place.  I was quite  bloody and two pairs of hikers actually passed me and totally ignored me.  I cannot imagine passing someone that is obviously hurt without offering assistance.  (As the second pair passed I actually considered falling on the ground and acting like I was having a seizure just to see what they would do.  I think they would have hurried off.)  The impact traumatized the nerve to that section of my forehead so the injury never hurt, that is, after I got over the stunning effects of the impact.  The left side of my forehead up into my hair is still a little numb.  It was really fortunate that the emergency room physician was my wife’s cousin.  He took the time to stitch it up carefully (24 stitches total) and the scar is almost invisible. The fun part was, this all happened just two weeks before Halloween. Normally, I kept a bandage over the stitches. They were pretty ugly. On Halloween I put mascara on the stitches so they really looked even worse than normal and added a little stage makeup One neighbor kid came by three times, the final time with his mother trying to figure out if it were fake or real. I was back out on the trail the next weekend.

This picture was taken after the finish of the Dizzy Fifties, my first ultra, exactly one month later.  The scar is still very viable just above my left eyebrow. 

Unless you break a bone or tear something (ligament, tendon, muscle, etc.) in your foot, ankle or leg, it will probably not effect you training much, if at all. Well, I guess you need to throw in major shoulder injuries, too. I think I mentioned earlier that while training for the Imogene Pass Run several years ago I fell and broke a rib. I crashed right where I needed to be peaking. I actually sat out one weekend run before jumping right back into running hill repeats. It is probably a good thing I didn't fall again. I did try swimming two weeks later. Not a good idea! I think that about covers the obvious.
The subtle injuries can be much more of a problem. They may be nothing more than a sore ankle or hip that just doesn’t seem to get better. They may start as a slightly twisted ankle that seems just fine after a few minutes. They might start with a new pair of shoes that throw something off in your skeletal alignment. These are the injuries you have to pay attention to because they can cause serious damage before you even realize it. They can sideline you for weeks or even month or cause you problems for years.
A couple of years ago I started a 4 hour run at Oak Mountain. About 2 miles into the run I twisted my left ankle. It hurt, but seemed OK after hobbling down the trail a few minutes. I continued on my planned run to the other end of Oak Mountain State Park. I ran up long climb and 5 miles along the northeast ridge of Double Oak Mountain. Then I started down a long and tricky descent on the blue trail to the North Trail Head. As I started down I realized it was really hurting my ankle but I kept running. By the time I reached the bottom of the hill my ankle was really sore and swelling. I was about 6 miles from my car, the shortest way back, and I had to climb back over Double Oak Mountain. I considered calling Marye Jo but didn't want to alarm her. (The last time I called her to come get me was following the face-plant on the rock that resulted in 24 stitches.) I figured I could make it back. I ended up walking much of the way at least when there was no one around. I made the return trip on the mountain bike trail and it has a lot of traffic. I could not let anyone see me walking, of course. They might think I was just a hiker! When I did get back, my ankle looked like the proverbial “stove pipe.” That is, I no longer had an ankle. I had caused a stress fracture in my ankle and I don't even know when it happened. I was landing on my heal going down the hills because the ankle was hurting so much. I suspect the fracture occurred on that long descent not the when I first twisted it. I should have stopped. Obviously, I missed a several weeks of running. Did I go to the doctor with it???
After I started running again I would twist it almost every time I ran.  Obviously, there was some damage.  Finally a purchased an ASO Ankle Brace from Zombie Runner.  I wore it several months until my ankle felt good again and I stopped wearing it.  The ankle seemed fine and I had no more trouble with it until this year at The Wasatch 100.  Sometime during the night along the ridge above the Canyons at Park City, I twisted it again but so slightly I hardly noticed it.  By the time I reached the Rock Springs aid station at mile 87.3 it was so sore I could no longer run down hill and it was very swollen.  I wisely chose to quit although it was only 12 miles to the end.  Now, I am glad I quit.  It still bothers me a little and I am wearing the ankle brace every time I run.  Probably, if I have gone to a doctor and had it checked out when I first hurt it, it might not be bothering me now.  Next time I will.  Right!!

My left ankle has been my Achilles Ankle” for a long time. About 14 years ago I steeped on some uneven pavement going downhill while running pretty fast. I rolled my ankle and took a pretty hard fall. As usual I thought I could run through the “minor” twist, so I kept running. When I finally hobbled back to my house the ankle was black and blue and very swollen. That was the start of my ankle problems and that ankle has been very weak ever since. One problem many serious runners have, (I certainly do) is we tend to think we can run through about anything. We also think we can fix the problem ourselves. Some years ago I developed chronically sore knees. I started stretching a little more before runs and that did no stop the problem. Finally, I went to the drugstore and purchased two cheap “Ace Bandage” elastic knee supports. I wore them a few times and the problem seemed to go away. I think I also broke down and purchased a new pair of shoes. It never occurred to go to a doctor to find out why they hurt.
I guess this should go back up under Obvious.
Other than the face-plant, the only time I ever went to the doctor for a run related injury was about 1990. I was on a 15 mile run out through a very rural area near the town I lived in, Tallassee, Alabama. I ran down to a boat launch on an Alabama Power Company Lake called “The Middle Pond” where I turned around and headed back to town. The Tallapoosa River runs right through the middle of Tallassee and there are three lakes built by Alabama Power on the river near Tallassee. One is right in Tallassee and the other two are above it. The top lake is Lake Martin, one of the most beautiful lakes in the Southeast. It covers 44,000 acres and has 750 miles of shoreline. (Just a side note) About a mile from the boat launch there was a dog at a house that always barked and sometimes ran along with me. This time, on the return trip, the dog bit me on the lower part of my calf. It bled a lot but didn't seem to bad. I was about 6 miles from home so I ran on back home. (This was way before pocket size cell phones.) My calf began to hurt quite a bit during the final miles and continued to bleed . I knew I had to go to the doctor to report the bite and be sure the dog did not have rabies. Fortunately, my physician was a friend and member of my daughters Indian Princess Tribe, a wonderful YMCA program for fathers and daughters. He was our “Medicine Man.” At some point I will tell you a hilarious story from one of our camp-outs involving our medicine man and a local hospital, although my daughter does not have fond memories of the even. I always went in the back door of his office, otherwise I probably would not have bothered.
The verdict was that the dog put his K9s completely through my leg. Jimmy told me the wound is exactly the same as if someone had shot me in the calf with a 22. He cleaned it, gave me some antibiotics and told me to keep it up during the day and don't run until it heals. I did take the antibiotics but ignored the rest and kept running. One month later I still had an open would in my leg and fluid was constantly accumulating in my ankle. This time he gave me a shot and said, “ if You want it to heal, you will quit running.” I let it heal this time. The dumb thing about this whole episode was that I had been a “Meeter Reader” for Texas Power and Light in Dallas the summer between high school and college. I had learned how to deal with dogs and was pretty good at it. Any time a dog comes at you appearing vicious, attack the dog yelling like you intend to rip it in half. The results are humorous sometimes. I also learned “NEVER LET A DOG GET BEHIND YOU.” That was my mistake. I had probably run by that dog 50 times or more. It always barked but then settled down and watched me or trotted along with me for a few yards. Never again!


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