The Rowe Family Blog

This week I’ve run twice and it has been wonderful!  Sure I’m only running 5 minutes at a time but my leg doesn’t ache when I’m done and it’s fine the next day too.  Just 5 minutes of running feels amazing to me right now.  Best of all I finally know that I’m nearly done with this ordeal.  In the back of my mind I knew I’d get back to running in time but I had doubts.  I had doubts about the time frame.  Now I know that, unless I make major mistakes, I’ll be back to normal mileage in another 5-7 weeks.

I have bad news.  I’m not ready to start running yet.  Yesterday I watched the Musselman Half Iron Triathlon.  It was the first half for two of my close friends.  I ran a little bit as a spectator so I could catch them multiple times at transition and I also ran, briefly, with both of them at the ends of the race (bailing before the finish line of course).  Even this tiny bit of running caused discomfort.  I could feel it while I was running and I could feel it when I stopped.  It felt exactly like it has every single time I’ve tried to run on it since the onset of the injury.

Today the site of the injury is sensitive to the touch again — but just barely.  And it feels more sensitive along the bone than it does on the bone.  Thus it is possible that what I’m feeling is just scar tissue breaking up.  I’m not sure.  I’m not sure what I’m going to do.  I guess I’ll probably wait another week before running on it again.  I’m afraid that it won’t feel any different even then but that’s just my pessimism about this whole situation shining through.  I know that stress fractures take 6-8 weeks before you can run on them.  Even then they aren’t healed.  And 6-8 weeks is generally the minimum time.  I’m probably just not ready yet.  It sucks but crying about it isn’t going to make it heal any faster.

The good news that I have to report is that my 60+ mile ride this weekend was pretty good!  I rode alone from my home to the Musselman Half Iron Triathlon.  The route was hilly but I still managed to average about 15.5.mph.  For most any cyclist that is pretty slow but for me, for my bike, and for the route, it’s not half bad.  Plus I wasn’t trying to go fast.  At the beginning of the ride I avoided putting forth much effort because I didn’t want to suffer in the late miles.  Mentally I treated it just like a long run.

Along the ride I met two guys from Holland that were biking from Boston to LA!  Between those guys and all of the atheltes at the Half Iron I should have been motivated.  Instead I felt sad that I wasn’t participating (neglect for a moment the fact that I can’t swim and I’m horrible on the bike and that I can’t currently run without pain).

Lately I have lost my motivation.  I don’t feel like riding my bike.  I don’t feel like learning to swim.  I don’t even feel like trying to run even though I should be OK to start running again.  I don’t care about breaking 3 hours in a marathon anymore.  I don’t know where my motivation went or how/if I can get it back.  I really don’t feel like doing much of anything at all.

Did the injury sap my motivation?  Probably, at least to some extent.  Maybe I’m just tired from poor sleep patterns lately.

According to my calendar and the way my leg feels I could start running any day I want.  But…I don’t want to.

I’m not seeking sympathy.  I’m not reaching out for help.  I’m just documenting this so that later I can look back and see what was going on as opposed to believe my false and incomplete memories.

ps: The title of this post is dumb because it actually means “Why are you Motivation?”

I’ve logged 540 miles on the bike since May 23.  That was exactly one week from the aborted long run that really was the day the injury set in (May 16th for the mathematically challenged).  That makes today more than 6.5 weeks from the initial injury.  Normally a stress fracture of this type would be OK to start running on by now — and mine might be.  However two weeks into the injury (May 28th) I was instructed by my doctor to try a run.  That was a horrible run that resulted in so much pain in one mile that it took me 20 minutes to limp home.  To be a little conservative I’m giving myself extra resting time by considering that day to be the onset of the injury.  It’s been 5 weeks since that day and I haven’t attempted to run at all.

In 1 week I will try to run again.  If it doesn’t feel right I will take an additional week off.

I really have to hand it to runners that are able to stay positive through a stress fracture.  I try to be positive but I’m failing at it.  I’ve tried biking and it’s OK.  It’s better than nothing.  Swimming isn’t going terribly well.  People assure me that it’s “going to click” anytime now but I can’t help but doubt that.

And what is it about humans and making things worse?  I’ve been quite knowingly doing things that aren’t good for me but doing them anyhow.  For example I haven’t been eating right.  Eating comfort foods is a common way to deal with stress.  I’ve been doing that.  I haven’t been getting enough sleep.  I’ve skipped some bike rides or cut them shorter than I should.  I seem to be intentionally sabotaging myself.  It’s easy to explain comfort foods — they give you pleasure.  But the other behaviors don’t really give you pleasure or very little.  Perhaps I’m trying to make matters worse so that I can hit “rock bottom?”  The funny part is that none of this is serious!  I’ll recover from my injury.  I’m making a mountain out of a mole hill.  Missing running isn’t serious, not really, but it feels like it is.  Maybe someone with a real problem can come by and smack me.

Yesterday I went for a medium length (well, medium length for me at least) ride.  I did 37 miles and averaged out a very good pace for me on my ancient bike.  My leg muscles have noticeably adapted to biking.  I was able to ride hard for a relatively long time and it wasn’t my legs didn’t give up on me.  It’s amazing how quickly the body adapts.

I also put the aircast back on.  After one day of not wearing it my ankle felt strange, possibly painful just walking on it.  I don’t know what to think about that.

Last night I took the stupid aircast off.  I tried to keep an open mind about the whole thing but more and more I’m convinced that the aircast is snake oil…or at least not applicable for tibial stress fractures. OK, OK, at the very least the aircast didn’t work for me.  Maybe it works for other people but I’m doubting it.

I’ve been looking into the possibility of using an Exogen ultrasound bone stimulator.  I don’t have enough information at this point and I’m afraid this might be snake oil too.  The last thing I want to do is have insurance pay for another useless treatment.  As I type this I think I might not bother with the bone stimulator.  For one thing you need a prescription.  For another plenty of people heal just fine without one.  I’m not a pro athlete.  My livelihood doesn’t depend on running.  My sanity might but my family won’t starve because I can’t run.  I need more information.

I just did a quick search on pubmed.com (one seriously awesome site for searching medical research texts) and found some interesting hits (with full text!).  One study, which doesn’t seem to be a study since I don’t see a control group mentioned, has a positive outlook on LIPUS (low intensity pulsed ultra sound) in accelerating the healing of bone fractures.  Another study, which appears at first glance to be well executed (double-blind, randomized, used a placebo device in the control group) found no statistical difference out of a group of around 100 patients.  This sounds like the aircast all over again.

If it sounds too good to be true it probably is… but not always.  I think in this case it’s too good to be true.  I’ll stick with the tried and true method to return to running.

Monday morning I marched back to the doctor’s office for my appointment to go over the results of the MRI.  They informed me at the desk that I didn’t have an appointment.  I knew I did and luckily they were able to fit me in anyhow.  Later that day I confirmed that I did have the correct appointment day and time as it is clearly written on the appointment card I was given.  That’s really beside the point.  Mistakes happen.  What’s important are the MRI results.

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“Very atypical distal tibial stress fracture”  That’s what the doctor wrote on the script for the MRI.  I don’t like being atypical.  If I had a typical tibial stress fracture I would have been running by now.  But the truth is that I don’t know if I have a stress fracture.  As I said from the beginning half of my symptoms indicate a SF and half do not.  I have localized pain on the bone where most tibial SFs occur (and most SFs are tibial).  The pain came on rather abruptly.  I was running on a new surface and my intensity had increased.  The pain increases in the evening and a bit in the morning.  On the other hand I can hop without pain and that should cause serious pain (the vibration through the bone makes a SF hurt).  Also the pain disappears rather quickly.

For the last two weeks I’ve been treating this as a tibial stress fracture and have diligently worn the aircast leg brace.   With that brace I should have been running unrestricted in 3 weeks.  Unfortunately I feel like I haven’t made any progress.  I am pretty confident that I would be in extreme pain if I ran for just 1 mile.

Both the doctor and I are confused.  He took x-rays yesterday and they showed nothing out of the ordinary.  X-rays rarely show anything for a stress fracture until they have started to heal.  Even then many x-rays don’t show the fracture.  So the doctor ordered an MRI.  I was lucky enough to get the MRI done last night.  I won’t know the results until Monday afternoon.  The technician wasn’t allowed to show me the images.  He claimed it was illegal.

I repeated the “Day 2″ of the recovery plan again last night.  It went pretty much like every other time I’ve tried to run in the last 4 weeks.  It felt OK but started to be noticeable.  By the end of 1600m (and that’s only running 200m at a time for a total of 800m running and 800m walking) it was achy.  It ached for at least 30 minutes after the workout.  It aches this morning as I type this.  It is tender to the touch again.

My hope in a quick recovery is almost gone.  I am 99% certain I won’t participate in a Fall marathon this year.