Tuesday, April 07, 2009

The Mystery of a Grade 1 Injury

Mostly I think running is simple: out the door, run about a bit and then return. You can mix things up by going faster or slower, longer or shorter, but that is basically it. When things are going well (i.e. you are running comfortably and there is a feeling of progression) it is the most natural thing in the world. However it can become very confusing when a period of steady running is disrupted by an injury with no definite cause. You know there must be a cause because things do not happen without reason but sometimes it is difficult to identify any changes that would have made the difference. All the obvious suspects are lined up: worn out shoes; you went to long, too fast, the ground was too hard, soft, or uneven; your muscles were too stiff. But sometimes there is no obvious answer.

I hate it when I don’t really have a clue and all I know is the symptom. The injury might not be a big deal, it might be easily worked around, but the fact that something has mysteriously gone wrong really bugs me.

At the moment I have a grade 1 injury ( i.e. “an injury that causes pain after exercise and is often only felt some hours after exercise has ceased” , Noakes, Lore of Running, 4th ed 2001, p749). About an hour after my run my left foot becomes painful, especially the heel, and I can only hobble around. The following day it is usually back down to a residual tenderness that is not a problem. The injury happened out of nowhere but it has been like this for three weeks.

It is not bad and doesn't really get in the way, but my main concern is for it not to escalate up the scale to grade 2, 3 or 4. So at the moment I have put my running into a maintenance phase, where the objective is to not lose fitness, whilst trying to find out what is happening (and of course hoping it gets better). I have thus cut back on long runs (because the heel hurt more after a long run) and run mostly on a treadmill ,to reduce the impact. This of course coincides with the weather getting better and almost inviting you to get outside for a long run. Never mind I can get my outdoor fix by going for a cycle ride. There is always a way round things.

I have to remember that and not get too hung up on any particular plan. I have to adapt to what I can do and acknowledge there is a problem. This is in itself a departure from my normal practice of thinking there is nothing wrong, or it is only a twinge, or t will go away; followed by ‘ this just could not have happened’, ‘why me?’, and then beating my tiny fists on the ground in frustration.

I am determined not to become glum - not to worry about it too much. I am heartened by what I read in the ‘Lore of Running’ which says that “the athlete with a grade 1 injury does not have to be excessively concerned as long as it does not progress…Runners need not fear that a grade 1 injury that has existed for some time will suddenly deteriorate into a grade4.”

Also I rather like the paragraph at the end of the section about the grades of injury:
“The grade of the injury helps the doctor define each athlete’s pain or anxiety threshold. The athlete who seeks attention for an injury only when it reaches grade 4 clearly has a different anxiety threshold from that of an athlete who seeks urgent attention for a grade 1 injury. Obviously the advice given for each type will also differ greatly: a runner with a grade 1 injury requires substantial psychological support; a runner with a grade 4 injury requires psychological analysis of why running is so important that the athlete will only stop when forced to do so.”

I will immediately search for some psychological support – or failing that some chocolate.


Adele said...

Oh no :( Here is some virtual chocolate for you...

Could it be Plantar Fasciitis? If so, have you tried rolling your foot over a ball (though the thought of rolling a tender heel over a golf ball makes me feel nauseous!). Is it something a sports massage might be able to get to the bottom of?

I do hope it passes as quickly as it came.

The Red Rocket said...

Injuries suck. I have this ongoing issue with my ankle from an injury I got when I was 16. I wish I knew then what I know now about looking after my limbs!