Wednesday, August 27, 2008

"The show must go onnnnnnnnn......"

I just downloaded Pink Floyd's "Is there anybody out there" album. It's the concert version of the The Wall. I also added their "Dark side of the moon" album for good measure. I don't need any drugs to love these albums and especially The Wall. My IPOD is loaded and ready for action. The question is, am I ready for action? The answer, I have no idea but I got 36 hours of time on the trail to figure it out. Between the concert blaring in ear, me pondering the meaning of life and whether or not this race was a good idea I should have it all figured out when it's over.

We left Utah on Saturday and went to Yellowstone for 3 days. With high hopes of seeing a grizzly bear I didn't really work out at all. Bill and I did one 45 minute run around Old Faithful and as a family we hiked and walked a lot. I did all my mini squats and VMO contractions while standing around looking a geysers or sitting in the car. My knee got better and better each day requiring less and less attention. This was a welcomed distraction from the rehab and might just be what the doctor ordered. Given that we were in the car for a number of hours I got to express my lack of confidence in lining up for Teton's. For me I would rather not start if I am not in to finish. I know how my mind operates and if I give myself an out I will take it in the dark moments of a 100M. After 17 100M races I have only bailed once and I didn't like the after effects. During that race my ego and time goals got in the way of a finish and though it was a great learning experience I don't want to repeat it. As I was wallowing in my insecurity, talking about how even if my knee is good to go do I have the fitness to finish it. The circumference of my left quad is 1.25 inches smaller than 4 weeks ago and my right is over .5 inches smaller. I just couldn't resist measuring them because they look so small....where are those jeans I have been dying to fit into to! Anyway, I don't FEEL like I am in good shape but I really have no idea what kind of shape I am in except I am rested! As I babbled on about my lack on mental confidence Alex just couldn't take it anymore and gave me a pep talk or more like a small lecture....funny I heard my own words coming out of his mouth. It is sort of cool in a 12 year old has more confidence I will finish than I. But, it's also sort of sad that I so quickly lost my confidence and mental toughness...such a fleeting mist.....:). For that reason I am writing this entry because I need to be held accountable to finish this race. I can't let my ego, pride, pain, sadness, anger or anything get in the way of a FINISH! They give us 36 hours to tackle this course and that is plenty of time...I can limp if need to but I won't. I refuse to let my son see me give in or quite because I can't reach a time goal or I get bored with walking.

Almost every other day I have gotten a text message from Kris saying something meaningful about me and what I can do and have done in all aspects of my life. Stacey (my pacer for this race) has emailed, called and questioned my plan. Trisha and Susan have been checking in on me regularly hoping for the best. Micheal and his family supported my rehab and said nothing but good stuff for the whole week they visited. Beast is here on his 70th birthday tackling the 50M race and dragging my family up another mountain. Tom and Annie are coming to hang out with us and watch us run the race annnnnd.....he told me not to leg an egg. :) Soooo, besides the fact that my family expects me to finish my friends also expect me to finish. I am sucker for expectations so that gives me another reason to see it through.

Now that I have convinced myself I MUST FINISH and I know all of you who read this will hold me accountable to my words here.....I HAVE to finish. Today I ran 45 minutes and it was almost completely normal. A couple of 30 minute runs left and it's show time! BTW - The air is thin up here but it is beautiful!

Wednesday, August 20, 2008

Rehab is a full time job!

That pretty much says it all. It truly takes a lot of time to do all the exercises, icing and such but it works. My knee has made significant improvement with the physical therapy. When I first got here I couldn't even walk the downhill of downtown Park City. Getting around and in and out of a car took thought and just the right approach. It was super frustrating to have been slapped silly so quickly. This injury really took me down much more than I could have imagined. It came on so quickly and with such vengeance it actually had me worried I may have done something more permanent. Thinking back on the whole thing from the beginning I believe it started with the fall I took on the 3 corner rock run. Even though the fall was nothing the tork on my leg was fierce and stretched my quad pretty good at the insertions above my knee. The force on my leg was healing up well but WR50M just drove it home leaving me limping and truly out of commission. I think this was a pretty good lesson.

In the big scheme of life of course this is nothing but when something begins to impact your everyday life it becomes something. My leg has been so sore from all the exercises but I am back to running/jogging trails.....yipppeeee. Here is a breakdown on my progress.

Monday - Saw a physical therapist, got a diagnosis, exercises and some ultra sound. - Workout was speed strides on the elliptical. Knee was super sore and I was not putting much weight on it.

Tuesday - Warm up on elliptical for 30 minutes then hit the treadmill at 6% incline to run - was halted by pain and forced back on the elliptical for the remaining hour. The exercises were challenging as my knee was super swollen and sore - iced like a freak.

Wednesday - More physical therapy and they progressed to harder exercises and dug out my IT band even though it didn't seem to present a problem. They ultra sounded and put some anti-inflammatory rub stuff on it. My workout was hill repeats so I chose the road to silver lake which is 3.5 miles and about 2000 feet. Bill picked me up at the top and I was supposed to repeat but the pain was just too much so I called it good with one trip. I was super frustrated as the pain seemed to be worse but the swelling less.

Thursday - Big turning point my kneecap was in the right spot- Woke up with barely any swelling or pain and.........when I looked down my kneecap appeared to have moved back where it belonged! It was an off day and we walked around including downtown and I was able to pretty much walk normal without pain. Some buckling but no sharp zingers. I did all my exercises and iced.

Friday - A planned run up Mt. Timpanogas on the steep side and down the less steep side. Now steep is relative since this climb is 4,500+ feet in 7 miles to 11,500. It is one of the most beautiful places on earth as far as I am concerned. Deborah was aware I might not be able to push or run the down and was fine with that. The hike up wasn't without pain, a few mild zingers and the leg motion was weird as if it didn't want to function. As the hike continued it began to feel more normal but I could see some swelling coming on. The down was a total walk for me. I trotted occasionally but it wasn't going to work. I was happy to have done the 15 miles with only mild pain.
Saturday - HELLO MAGIC TAPE!! Back to the physical therapist who was blown away on how good my knee looked especially after the Timp workout. I too was pumped to still have my kneecap properly seated and have NO after effects from Timp. Today was the introduction of the magic tape! After physical therapy I took the Spiro trail up (about 1,700 feet) to the mid mountain trail and ran/walked that to Silver Lake where Bill picked me up. It is a little over 10 miles. The run was good for about 5 miles and 3+ was straight up. The rollers were painful but the tape did help my mind make the muscles fire. My muscles were quivering afterwards as if in shock. :)

Sunday - Still wearing the magic tape (it stays on for 4 days) Micheal, Bill and I headed out for the same run I did on Saturday. It was harder. My legs were tired and my knee ached but the motion of running was much more normal......a lot less limping and favoring.
After three days of good movement my leg was sore and fatigued but not worse and every day I woke up it was better. Sort of like 3 steps forward 1 step back. I was just so happy to have made so much progress in such a little amount of time. Mostly I happy to NOT be in pain when I walked around doing normal stuff.

Monday - Back to the physical therapist who did all her stuff, re-taped me and said, "It's time to test it, give it a go on the downhills, work through the discomfort and let's just see how it responds". So..,,,,,,,,

Tuesday - BACK TO TIMP! We took the whole family and Micheal, Deborah and I headed up for speed and a run down while they hiked. It was beautiful as usual but the biggest wonder was the mountain goats. We were early on the trail and saw the whole herd. It was something else and very special. GOOD LUCK! That's how I chose to see it. My knee was better and I only had mild pain. I braced it up for the downhill and was able to run about 80% of it. It's a super rock trail and I was slow but it was running. I had a couple of mild zingers and my knee was a bit pissed but I came out no worse for wear. We hiked back up to meet our families who were on their way down. It ended up being a 7000+ day for us but the most amazing thing was our families. They hiked 15 miles to the top of a mountain on rough terrain with no air. Micheals wife Lisa and his daughter Kerry who is 8 plus Bill and Alex who is 12 really kicked butt and persevered on a long 10+ hour day. It was pretty amazing to see the kids remain positive and enjoying the sights.

Wednesday - Physical therapy again and just one more left before I am on my own. My knee is still good, not much better but not worse. No pain with everyday life stuff and not pissed from yesterday. Due to that I made my decision to go for it at Teton's.

I figure I can make it through the race and not cause myself to take to many steps backwards. It won't be a great performance and I may need to take walk breaks on the downhill to preserve myself. I might even need to dull the pain with Advil but I have enough time to finish. I might even make more progress with my knee by race day. All I can say is the exercises and advice I was given was spot on and worked. It's not easy and not very exciting and honestly quite boring for an adrenaline junkie but it works.

Even though it seems like all I have been doing is obsessing about my knee I haven't. I was actually NOT obsessing rather just doing what I needed and still having a good time. We have been swimming, biking, zip line riding, visiting farmers markets and enjoying vacation with friends. Today we were at a farmers market and there was a girl with a big sign that read, "I Can Fix You". Of course I was drawn right over and signed up for fixing. It was obvious what my problem was with the lovely blue tape all over my leg. If you can't be an olympian you might as well dress like one...... ha, ha, ha. She did reflexology and while I am not sure I can buy into all they claim I went with it, why not???....I have blue tape all over my leg so it's clear I am open to pretty much anything at this point. All in all this has been interesting, challenging and a good learning lesson.

Monday, August 11, 2008

Patellar Femoral Syndrome

I have gotten a professional diagnosis! Pam (aka McKenzie) was right on with her comment, thanks. Last Thursday I had my call with coach (Scott) and told him the dramatic version of my failing knee. He hesitated little before he called it PFS. The good news is this will heal and even more good news is it most likely will turn itself around before Teton's. PFS is a common knee ailment among runners and bikers. I know mine is a result of biking on TOP of my training for Teton's. I also believe running for many hours on bad blisters just drove it home.

The plan: Extremely aggressive VMO stimulation! That means diligent exercises and some as many times a day as I can handle it.

1. Sitting with my back against a wall with my legs straight out in front, place a small ball between the legs in the middle of the quad, squeeze abductors then contract quads...tapping the VMO to make sure it knows you mean IT! This is to be done all day long and even while walking and standing I am supposed to think about contracting this muscle.
2. Pulley attached mini squat for eccentric loading. A strap around the leg just below the knee while the other end of the strap or cable is attached to the a post or if it's a cable it's attached to a weight stack. Step back to create tension then squat focusing on the eccentric phase of the load...when you straighten the leg but do not hyper extend the knee. Do this 3X20-30-40 or whatever I can do.
3. Run at a 5-7% incline on the treadmill. Start very slow, think small steps, knee lift, quick paw-back, do this until I get a zinger in the knee then finish the workout on the elliptical machine.
4. A bunch of exercises for the glute medius to prevent deterioration and to help keep the knee driving forward not diving inward.
5. Ice like a freak.

That is the plan and of course I hit it hard. When I started this on Thursday my VMO would barely respond. It looked atrophied and very week. My run lasted 1 mile on the incline before I got a zinger. Apparently the sharp pain I experience is due to the lack of muscle contraction and the kneecap jams over into a bad spot. By Saturday morning things were looking better; I barely had any swelling or pain while walking. This was so cool and I was able to run 1.5 miles. My VMO was quivering during the rehab. which is good news because at least it's waking up.....hello!

Saturday night I arrived in Utah late and had already planned to meet a few people on the Wasatch course. They needed aid and I would join them to the finish of their run which meant I would run 15 miles. The long drive to the meeting point was a quiet one as I debated whether to give it a go or not. When we arrived I gave the knee a test spin and it was definitely better but not great. I spent another 45 minutes debating with myself and Bill. I cried, I paced, I relaxed, I fought the urge, I gave in to the was exhausting emotionally over a simple run which is sort of pathetic. Logically I knew it would be best to skip the rugged hilly run and continue my rehab but part of me wanted to test it, push it, get over the fear of using it but in the end logic won. Deborah completely understood and encouraged me to NOT run.

This morning I had an appointment with a physical therapist. Scott recommended I see one to be sure I am doing all the exercises right and maybe add some hands on feedback. Bill found me a great one here in Park City. This is a good place to be with a knee injury because of all the skiing, knees are a speciality. I was excited to get someone to poke and prod at my knee and make sure I was doing all I can to heal it quick.

Before my appointment I headed down to the gym for my routine and workout. I got all set up and was able to run 3 miles!!!! Big day for me. :) I probably could have run further but felt very mild pain so I jumped.....I mean dismounted slowly and got on the elliptical for the rest of my workout. I got me heart rate pumped today for over 1 hour. I spent another hour doing weights and the rehab. stuff then it was off the see the doc.

The PT poked, prodded, slid, pushed, thumped and jostled my knee cap and all surrounding areas. She smiled and said, "Your going to be fine"! She said my three days of rehab. was spot on and my knee is almost mended. She put me through a battery of tests, workouts, ultra sound, stretches and ice. She recommended I come back Wed. and Fri. but by then I should be good to go. She said some of the same things Scott said, like;

1. Doing nothing is the worst thing you can do.
2. AGGRESSIVE VMO stimulation is way to rid yourself of this and resume training.
3. You will be fine for your race.

I am still not banking on Teton's but I am optimistic. When I can run anything on trail, up and down I will feel better. I think that day is nearing. Until then I am getting my cardio and tempo stuff done in a creative fashion. I am running/walking uphill (3.5 miles) at AT then having Bill drive me back down and then repeating. I am on the elliptical doing strides. I think I can stay in shape but without the long descents I feel nervous that my legs will not hold. Maybe all this strength training will be good stuff. One thing is for VMO will be strong. :)

Thursday, August 7, 2008

The longest taper or......

no race at all! My knee is not doing very well. I guess my adaption theory is out the window on this one. I was able to get through WR50M and it really wasn't at the forefront during the race. When I got home I was sidelined for 4 days by those nasty blisters which you would think would be good news for my knee. When I started back running it was like someone was stabbing me in the knee on the inner portion of my patella tendon. Along with the pain came a lack of mobility. My leg simply would not run. It's almost like the area between the quads and calf are not working together and the knee is just left dangling. I limped for a good 7 miles then called it good. My knee cap is riding high and the tracking process is hampered. I guess that's the cause of the sudden sharp pain....when the kneecap tracking gets out of alignment. Here's what I have been doing:

1. Massage - My quads are hammered at the insertion to my knee, especially the medial.
2. Deep tissue release - From Dr. Tollenaar which helps a lot in getting the kneecap back in it's spot.
3. Icing like a freak! 20 minutes on and 2 hours off. The knee is just not that swollen but is a bit.
4. VMO stimulation: Sitting with my back against a wall, legs straight out in front, aggressive flex of the quads, hold for 5 seconds, off for 10 seconds, repeat 10 times twice a day.
5. Rubbing some magic ointment on it waiting for the majic to HAPPEN!!
6. Pouting but hiding it least I think so.

So..........Is my race in jeopardy??? Most definitely! If I can run at all I will go and do it, most likely slow but I am on board. As it stands today, I can't run. The pain is not an ache that Advil will mute. It's has more to do with the lack of function once it gets zinged...the mobility of my leg is very compromised. I am open to suggestions folks! I am bummed and sad about the race but am not giving up yet. I am not one of those people who can turn a frown upside down so I am not even going to try and fake myself won't work. Let's say I heal up or get over my unknown problem and can run the race. It will be the longest taper EVER! What happens to someone who goes to run a 100 miles when the last long run they have done was a month prior? Well, I guess I will get a new experience if that it the case. We are leaving for vacation in UTAH on Saturday and will be gone through the race so I will be there no matter what....running or helping my friends run it. I have a long run planned on Sunday with some folks from Utah and that will be the final test before I decide.

What will I do if I can't run???? Well, I have a plan B. It doesn't involve my bike because that is not helping my knee right now and I can't really do any biking unless it's on a flat surface that requires no straining. I'll fill you in on Plan B if I need to go there but I will stay focused on the task at hand.