Unplanned Off-Season Due to Ankle Injury

Unplanned Off-Season Due to Ankle Injury

I was finishing a hard mile repeat workout (6 of 8) on a local neighborhood road one evening mid-January. It was beginning to get dark so as an oncoming car was approaching, I stepped onto a curb to get out of the way and my right foot didn’t catch the curb. My foot slipped off and I rolled my ankle with all my momentum and weight coming down on it. The pain I felt was worse than anything I had experienced before when running on uneven surfaces that may cause the ankles to turn. I could feel (almost hear) something tear, which felt like three pops in a row. The feeling was like that of a flexible plastic straw kids drink with, and stretching it really quick.

I went off the side of the road to remove my shoe, knowing I was probably done with the run. It looked like my foot was already starting to swell and it also hurt to put weight on it so I had a good feeling I had done some damage. Kyle, a close friend and training buddy, was with me at the time and pacing me on his bike. We were two miles from his house so he rode back to get his vehicle to give me a ride back. I hobbled off the road, out of sight, and laid on the ground with my foot elevated on a picnic table, in disbelief with what just happened. I was in pain and doing my best to hold back the tears as I was extremely upset. At this time, I’m three weeks out from my first race of the season which is a Western States 100 qualifier. Qualifying for WS100 is my main goal for the first half of the year and certainly no easy feat. Up to this point my training was going very well and this was my last week before I began to taper for the race.

That evening I reached out to some close friends, my coach, and doctor’s in the area that I visit to get some advice on what to do. I stayed off my feet and basically tended to it by following RICE (Rest, Ice, Compression, Elevation). I submerged my foot in a bucket of ice water which is 10 times more uncomfortable than putting a bag of ice on the injured area. The advice I got was to keep the foot moving in the water to prevent tightness. Another friend, Peter, hooked me up with some crutches that evening so I could get around the next day. The rest of the evening I kept a brace on it for compression and kept it elevated. My coach reaffirmed me that I was in great shape and others have been through the same thing and able to run really good races. It just meant an early taper.

The next morning, I went to Sterling Ridge Orthopaedics & Sports Medicine in The Woodlands (SROSM website) to allow Dr. Hayes to examine my foot and take an X-Ray. Fortunately, nothing was broken and it was a grade 1 sprain which is basically a mild sprain. I was limping which they didn’t like seeing so they gave me an adjustable brace which was much more comfortable than what we picked up from the local drug store. They also scheduled me for a follow up PT session within a couple days.

Later that afternoon I visited Dr. Clouthier at Alternative Health Center of The Woodlands (website). I’ve been seeing Dr. Clouthier more frequently this year, tIMG_5696o address issues early on that may come up from all the mileage. He’s been the guy behind the scenes helping me stay healthy and increase my chances of staying injury free. He did an assessment on my foot and then followed up with ultra-sound around the area, gave me some acupuncture, cold laser therapy, and applied some oils to help with inflammation. Within a couple hours of visiting Dr. Clouthier the swelling was down and I was able to walk slowly without pain. He wanted to see me the next two days to do more ultra-sound and cold laser therapy, as well as some electric stimulation. For the next two weeks Dr. Clouthier and his team kept good hands on me and had me in their office a couple times a week to treat me and accelerate recovery. If you want to know more about these different treatments and how they promote healing, I’ll add a little bit of what I know about each of these techniques at the end of this post. Or you can visit Dr. Clouthier’s site for more about these services offered.(website).

I was back at SROSM Friday morning for my first PT session and met with Physical Therapist, Mark Walker, who was a pleasure to work with. He did some ultra sound and strengthening exercises with me using a resistance band. He showed me how to do these exercises and also gave me a resistance band to take home so I could continue doing them. I then ran on the Alter-G Treadmill which is an Anti-Gravity treadmill that allows you to adjust your body weight. I did three miles at 60% body weight. This gave me a chance to figure out what pace caused the least amount of discomfort. This was about 9-1/2 minutes per mile. The other benefit of using the Alter-G treadmill is the ability to run normal and not over compensate somewhere else, which ultimately leads to poor mechanics and can cause a problem somewhere else.

My first run to test out the foot was Monday of the following week. I started out at 9:35 pace and gradually got quicker. The first mile was stiff, but midway through mile two was good. I felt a little bit of pain (pulling sensation) a couple times and tried to focus on foot placement. At the end of the fourth mile I had some discomfort at the bottom of my foot so I figured it was enough. It swelled up a little bit afterwards so decided to take it easy the rest of the week. I scheduled an Alter-G treadmill session every other day that week anIMG_5534d was able to get in 5 miles of running at 50% body weight. Adjusting my weight allows me to pick up the pace and I could comfortably run at 7 min/mile. Mark was usually working while I was there and would give me some more exercises to try, and also gave me some electric stimulation to help with the healing process. (link to Alter-G).

By the second week I started to introduce more power-hiking at 15% incline on the treadmill. Power-hiking is a term used in ultra-running for hiking at a fast pace when the incline of the course becomes too steep to run. It is more efficient and can help conserve energy during a race. By the weekend I went out to Huntsville for the Rocky Road 100 mile to pace Kyle for his final loop. He was having some complications (who doesn’t during 100 miles?) and wasn’t able to run anymore so we walked/power-hiked the last 20 miles. It was a chance for me to test my ankle as the 100k race is the next weekend. I slightly rolled my foot on a root within a couple miles and it was enough discomfort to make me realize I’m not ready for any race effort, and susceptible to re-injuring if not careful. It wasn’t an easy decision as I was still contemplating on running a road marathon instead. I’m hardheaded like this and fortunately talked myself out of it and didn’t do anything stupid.

The next race I’m registered for is the Gorge Waterfalls 100k on April 2nd which will be a technical course with a lot of climbing. I continued power-hikes and running on the Alter-G for the third week and then added in some aqua-jogging. Other than the 20 mile walk I was averaging about 15 miles a week for the first three weeks. By the end of the fourth week I was back on the road, and okay as long as I was conscious of foot placement. If I avoided stepping on uneven surfaces with my ankle dorsiflexed, then I was fine. I managed to get a decent week of 52 miles. On the fifth week I was able to introduce more speed and hills into the workout, and also got in a long run of 20 miles. Week six was pretty much back to normal with close to 70 miles but I could tell I lost some fitness and didn’t have the endurance to feel strong at the end of the longer runs. Week seven and eight was a noticeable difference as I felt great during long runs and strong during some marathon intensity workouts. The difference is that I felt I could go longer and sustain these efforts, and also felt recovered by the following day and ready to run again. The pieces are coming together which is helping my confidence and will pay dividends come race day in a couple weeks. I’m two weeks out from my first race of the year and feeling optimistic about 2016.

Although nobody wants to have an injury, the five weeks off gave me a chance to focus on other things that are important to me. I took advantage of spending more time with my family. My son and I taught my four-year-old daughter how to ride her bicycle without training wheels. They also had fun and joined in on the rehab process of me getting stronger by sitting on my shoulders while I did squats. Below are some pictures of our fun times together. I also took the opportunity to get certified for coaching. I attended the Healthy Running Clinic and the RRCA Level 1 Coaching Certification. I began coaching a handful of runners this year and look forward to working with more athletes in the future to reach their goals.

An unplanned off-season can be a good thing if approached with thought and the right mindset. If you happen to experience a setback or know someone else who does, hopefully this post will help you stay focused and remind you that the downtime can be a needed off-season to get healthy, get rest, and spend time with the most important things in life. Hope you all the best and an injury-free year.

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Ultrasound promotes healing by heating the tissue and increasing blood flow. It generates deep ultrasonic waves within the body tissues. A conductive gel is applied to your skin at the area that needs to be treated, and the ultrasound emitter is placed on the area and moved in a slow motion. You feel a warm tingling sensation which is the result of tissue absorbing the ultrasonic waves.

Electrical stimulation also known as TENS (Transcutaneous Electrical Nerve Stimulation), affect the body in many different ways. It can stimulate nerves to decrease pain, stimulate cells to reproduce, and increase blood flow, and improve blood flow of medication through the skin.

Acupuncture is basically inserting tiny needles into the skin at the location of pain and intended to improve blood circulation and provide pain relief. It is also known to increase energy in the body to assist recovery. I’ve been getting acupuncture for the last couple years when I don’t feel right and need treatment.

Cold Laser Therapy was used on me to eliminate pain and reduce inflammation, which overall reduces healing time. The light energy of the laser penetrates through layers of skin to reach the target area and increase intracellular metabolism leading to rapid repair.

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