Recovering from AR50M - Trigger Point therapy

Recovering from the American River 50 Mile Run on April 7 has been a great experience for the most part.  I experienced little fatigue, no exhaustion and very little soreness EXCEPT for the front of my right ankle.  In a nutshell, I began having pain on the top of my foot in front of my ankle at about mile 12 of the run. I managed to deal with the sharp pain for the remaining 38 miles with max doses of Ibuprofen and some serious focusing on ankle lift and relaxation. I’d never had this pain before so really didn’t know what to think except that I had some serious dorsiflexion issues exacerbated by my right foot splay.

Right foot splay as seen from the rear - the foot is relaxed, but does not hang straight down

My experience dealing with this pain for the last two weeks has been an interesting journey for me providing me with some valueable insights...so thought I would write about it. 

I iced the front of my foot for 4 days after the race with little relief. I was seriously jonesing to run, had normal energy and felt great within a few days after the AR50M except for my foot.  I was getting desparate to recover from the pain. I had been talking with Mary Lindahl, ChiRunning Master Instructor and one of my bestest friends, about my recovery and she encouraged me to consider that trigger points may be the problem and not necessarily injury.

Trigger Point Therapy Book

I knew Mary had had a great deal of success with trigger points and she was the one who referred me to the book a while back.  I found the chapter that applied to my pain area and discovered the obvious dorsiflexion muscle to be the source of the problem… Trigger points in the muscle belly of Anterior Tibialis are the number one culprit for referred pain to the front of the ankle.  So I started massaging the belly of the Anterior Tibialis, found an excruciatingly tender point (trigger point by definition) and followed the guidelines to massage it.  As I massaged the area, the referred pain on the front of my foot flared!  It was like an electrical current traveled directly from the muscle belly to my foot.  The Trigger Point Therapy Book described this to be exactly the sensation I would feel if the pain was a result of a trigger point.  In general, trigger points are usually in a muscle above the point of pain.  The key is to find which one radiates to the painful area.  Clearly, I had found it.

Within 24 hours the pain in the front of my foot had lessened significantly.  Enough so that I was able to do a hilly 13 mile training run with little, if any pain only 36 hours after I began massaging the trigger points.  I haven’t iced since.  I have continued to massage the trigger points which I’ve discovered to be in the entire length of the Anterior Tibialis muscle.  I’ve also discovered the same ones on the left side so I’m massaging them, too as preventive maintenance/therapy.



Trigger points in Anterior Tibialis Muscle of right leg (that's trail dirt tan)

As a Registered Nurse and believer in traditional medical cures, the use of trigger point therapy is a big shift to believing in something that could work that is not part of that paradigm.  I'm intrigued with the possibilities for me and for others who might be willing to be open to them.   Wow, ice didn't work, but massaging a muscle above the point of pain did.

I know that we’re supposed to be pain free with ChiRunning, and I'm a ChiRunning Certified Instructor.  What could admitting that I have pain or am possibly injured do to my reputation as a credible Instructor?  But I think it would be disingenuous to say that ChiRunning has solved all my problems for someone who wants to run long miles for many hours per week.  I also think that anatomical dissymmetry can contribute to biomechanical problems that eventually lead to pain and injury despite good technique especially if someone is running long distances every week.  I don't know anyone who is anatomically perfect on one side let alone both sides.  As a result of the “tibial torsion” (thank you David Stretanski, CR Certified Instructor, for identifying the problem and assisting me with some corrective exercises), my body is now showing the effects of dorsiflexion after putting in many miles.

ChiRunning has given me the gift of running.  Learning about Trigger Points is keeping me running while I sort out the anatomical problems and focus on the Chirunning focuses that can keep me injury free.

This pain has a message for me and that is to:

• focus on rotating my pelvis more on the left side so it's equal to the right,
• focus on a full foot landing directly underneath me and my center of mass,
• don't over stride by doing the above,
• relax the lower legs more, and allow ankle lift to happen consistently especially on hills
• focus on movement from my center

I'll be running the Escape from Prison Hill Half Marathon on April 28, in 4 days.  It has about 2500 feet of climb.  Most of the uphills and downhills are barely runnable, so it will be challenging to keep relaxed lower legs.  The following weekend on May 5 is the Lone Pine 50K, another hilly trail race. 

So, I'll keep massaging and focusing.  The process and learning is fascinating.  And I get to run and be grateful for concepts like ChiRunning (for focuses), Trigger Point Therapy (for resolving pain) and western medicine (for ibuprofen). 

On my short trail run today, I once again thanked God that I am able to run. 

American River 50Mile Race Report April 7, 2012

The American River 50 Mile race is one of the oldest ultras around.  The race is the reverse of the Rock ‘N River 50 Mile race that I finished last October.   

AR50M starts at Sacramento State University and ends at the Auburn Overlook Dam.  The first 27 miles are on the paved American River bike trail where you can run on dirt next to the bike path.  The last 24 miles are on beautiful single track that runs along the banks of Folsom Lake and then parallels the American River and its dramatic cliffs.  The run is a gradual climb from start to finish with rolling trails through oak forests typical of the Sierra foothills.  The trails are rocky, are sometimes deep trenches through meadow areas, and rise and fall suddenly making it necessary to use all the hill running technique you know to lessen impact and improve efficiency. The poison oak is green and lush stretching its healthy green vines right into the trail at hip level! 

It was my second race at this distance and a memorable one for sure.  Each ultra has a theme with many sub plots that create a story making the day unforgettable.  Today's theme was about being surprised and delighted with unexpected outcomes that brought tremendous satisfaction above and beyond the accomplisment of finishing a long run. 

The start was 6 am.  It was pleasantly cool and I wore my lycra/cotton blend shorts, a white sport tech ChiRunning t-shirt, arm warmers, light gloves and a Patagonia long sleeved shirt over all that.  My waist pack carried a nutrigrain bar, 22 oz of half strength NUNN solution, my ipod for use later, my phone and a baggie with ibuprofen and S caps. 

Ron, my training partner and good friend, and I began the run towards the back middle third of the pack, passed a lot of people and ran through the start line nearly a minute and a half after the official start time.  It was dark and some people wore headlamps.  The moon was full and low in the sky over the American River.  It was a beautiful morning.  Soon the light of the early morning revealed white steam rising off the river and a big orange sun sat in front of us as we ran down the bike trail.

Our first ten miles didn’t go by well.  Both of us felt achy.  We couldn’t get in a good rhythm.  We were running too slowly and walking too much.  Ron talked about not even being able to finish – he had been worried that he was seriously undertrained compared to the several previous times he had run this race, and now he was feeling badly way too early in the run.  Around 12 miles, I picked up the pace hoping that he would follow and that it would make us feel better.  He didn’t follow and I slowly pulled away.  I didn't even say good-bye.  I paid for that later!

The first few miles on the AR bike trail

I began to feel better and by the 14 mile mark at Sunrise aid station I was in better rhythm through improved focus on my form.  My dad was watching for me on the bridge just past Sunrise, but missed me going through.  Dave and Carol also missed me.  I had hoped to give them my armwarmers and long sleeved shirt and gloves, but instead had to stuff them in my waist pack and tie the shirt around my waist.  No big deal, but I was disappointed not to see my crew.

A few miles later, I saw Dave and Carol in their cars on the road.  They waved and my spirits rose.  I called Carol and asked her to tell Ron I was sorry for leaving him and not saying good bye.  I knew she would understand because earlier she had reminded me to “run my own race.”

Around mile 19, I recognized Kathy Griest, a Master ChiRunning Instructor.  We had never met in person, I knew her from Facebook and being on the ChiRunning DVD and videos, but we hugged each other like we were old friends.  I invited her to meet me at the finish to celebrate.  An accomplished ultrarunner herself, she made the trip up to the Overlook and greeted me at the finish line.  Wow.

Kathy Griest, Master ChiRunning Instructor, at the finish

I moved through the aid station at Negro Bar, mile 22.4, in good shape barely making the cut off time.  I was feeling pretty good except for the nagging ache in the dorsum of my right foot between my ankle bones.  I had noticed it around mile 14 and knew it would probably be an issue for the whole run.  I took some ibuprofen and focused on a relaxed ankle lift.  

Beals Point is 26.53 miles and I arrived there an hour before the cut off point in about 5 hours, 23 minutes.  Walking through the aid station, I grabbed more peanut butter and jelly sandwiches, orange slices and bananas.  It was definitely going to be a PB&J day!  I felt low despite seeing my dad, Dave and hearing Carol’s “WAHOO!” when she spotted me trotting in.  I knew I might be alone for the next 24 miles and wasn’t looking forward to that.  Dave walked a half mile with me as we left Beals and then slowly trotted up the trail a bit.  He told me Ron was only a few minutes behind.  I was hopeful that he would catch me.

Leaving Beals Point at 26.5 miles

On the trail at last out of Beals around 27 miles

Granite Bay was the next aid at 31.7 miles and like Beals Point, is another spot along the edge of Folsom Lake.  Nearly there, I spotted Dave on the side of the trail.  He told me that Ron was right behind me.  Suddenly, there he was bounding ahead of me on the trail!  Where did he get that energy?  We were glad to see each other.  He obviously had begun to feel better and had picked up the pace to catch me.  We arrived in Granite Bay in 6 hours, 38 minutes, which was only a few minutes slower than my 50K time 4 weeks ago.  Less than 20 miles to go, Ron and I felt the best we’d felt all day.  We ate heartily – chicken soup, lots of 7-up for me, PB& J sandwhiches and orange slices.  More S caps.  Carol brought us Mango/watermelon popsicles and we relished in their sweet, cold moisture as we walked down the trail out of the Granite Bay aid station!  There were some envious runners around us.

Ron and I running in to Granite Bay around 31 miles

Once finished with our popsicles, we began to run.  Ron was feeling good and our pace felt normal and strong.  We were on dirt and it finally felt like the run we’d been waiting for all day.  In fact, Ron took off at a blistering 10 minute pace powering up hills and cruising easily down hill and on the flats.  The trail was rocky and technical and amazingly neither of us tripped.  We slowed at one point.  He looked back and saw I had hung on despite passing many people and running hills that I probably would have walked had I been alone.  “I’m proud of you”, he said, “you’re doing well.”  I told him he was killing me and promised I’d never ditch him again!  He laughed, but I think he was glad that he’d proven to himself and to me that he was strong.  I was happy to be following him because I trust his pace and know his rhythm.

Buzzard’s Cove is the aid station at 34.6 miles.  The volunteers bring food and fluids in by boat on Folsom.  This time they had ice cream cones.  Wow.  I didn’t feel like ice cream, but orange slices, 7-up, coke and of course, PB&J sandwiches were gobbled   We thanked them and left around 7 hours and 35 minutes.

The next miles were fast.  Ron pushed the pace several times and I hung on, inspired by my body’s ability to focus and respond despite my fatigue, the pain in my ankle and the long hours on my feet.  I was running in the present moment;  the trail and moving over it was my universe.  We joked that he was still making me pay for ditching him!  He couldn't believe how good he felt despite his usual achey knees and back, and I was grateful to manage my ankle pain and keep going.

At Horseshoe Bar I called Mary and gave her an update.  She thanked me for calling surprised that I would use the energy.  But her voice energized me and after grazing heavily on, you guessed it, PB&J sandwhiches, orange slices and more 7-up, filling our bottles and downing more S caps, Ron and I took off.

Running down the trail into Rattlesnake around mile 40

We met Dave at Rattlesnake Bar aid station, 40.94 miles.  Dave would run with us to the finish.  We had to drag Ron out of there.  He loves to eat at the aid stations.  I started walking up the trail and Dave continued to coax Ron out of the buffet.  As he left, he turned back to Carol, who was taking video.  He said, “I love you”, then paused and turned again and said, “Will you marry me?”  She said yes and then about three other women’s voices said, “I will!”

With less than 10 miles to go, our spirits were good and Ron again picked up the pace when a couple wanted to pass us.  The five of us stuck together at a pace that I was pretty sure I couldn’t hold and sure enough after about 20 minutes I asked Ron to slow.  The couple passed us and we continued on at an easier pace.  I swear I'll never ditch him again! 

Last Gasp aid station is a mile or so up the start of THE HILL and only about 2.5 miles from the finish.  Its volunteers are shirtless young male runners with gorgeous bodies.  They would run down the hill towards us, take our bottles and run up the hill and have them filled and ready for us when we arrived.  An enormous source of chi, oh and did I mention they were gorgeous?  Ok, it was a great distraction from this 15% plus hill we just climbed!

We had more climbing ahead of us, not as steep and we started at a fast walk as we left Last Gasp.  For me to keep up with Ron’s long strides I had to ChiWalk at a high cadence or even run.  Ron wanted to go faster and asked me to dig deep and pick it up.  He wanted to pass people in front of us.  I told him ok, but I needed to focus just on my running.  No conversation except to talk about focus.  We picked up the pace.  I ran fast enough that he had to keep focused to keep up with me.  He began to sound like a ChiRunner as he coached me, the Certified Instructor: swing your arms more, chin up, y’chi.  And I chanted, “relax” as I focused on running from my center, rotating my "cotton around the needle".  We zoomed up the hill and passed many people.  Both of us surprised at our speed and power and delighted that we would finish under 12 hours and even break our last 50 mile time of 11:42.

After a steep 50 yard uphill, we turned the corner and there was the finishing chute, loud speakers announcing our arrival.  Our pace picked up to a normal run.  We crossed in 11:40:43.

Finishing!

My dad, Carol, sister and her family were at the finish.  Steve Mackel, another ChiRunning Instructor met me there, too, with Kathy Griest.  I had never met Steve before either, but the three of us hugged and chatted like we were family.  It was so great to see other ChiRunners out there besides me and Ron. 

Cool jackets! And Alaskan Amber!

Ron, me and Dave minutes after finishing

What a memory this day made!  Better yet, the whole weekend ended in a way I least expected.  We all went skiing the next day at Heavenly, proudly wearing our new AR50 finishers' jackets and skiing moguls on the famous Little Dipper.  The Comet Kats were out in force, the sun was bright and the snow perfect!

Skiing Litter Dipper the day after AR50

Ron works the soft moguls on Little Dipper

Dave shows some knee action on the bumps

"Chi Marathon" and tapering for AR50M

I recently listened to Danny Dreyer, Founder of ChiRunning and author of his new book, “Chi Marathon, the Breakthrough Natural Running Program for a Pain-Free Half Marathon and Marathon”, speak at a running store in Asheville, North Carolina last week.  His book, co-authored with his wife Katherine, is a wonderful next step to practicing the ChiRunning form and philosophy.  Since I began studying ChiRunning in July, 2010, I knew that I would need to race in order to fully test it.  With the release of his book, Danny has validated advancing ChiRunning practice through training and racing long distance.

ChiRunning, as many of you know, is more than just learning how to run properly.  It’s about living in those moments during a run where it is more than just putting one foot in front of the other or maximizing fitness.  It’s about moving through space effortlessly and with such ease that your joy and energy is uncontainable and boundless.  I'm sure others have said it more eloquently, but that's my version and I continue to struggle in describing what a huge impact it has had on my mental, spiritual and physical life.

In “Chi Marathon”, Danny and Katherine, write about the basic ChiRunning skills, and then they take it to the next level where the ChiRunning practitioner can refine their skills through training and racing in a half marathon, a full marathon or longer.  Danny writes about the Phases of training, preparation, racing and recovery in ways that have not been described before.  And although many runners, me included, may have preconceived notions of what the following phases mean, the way those phases are described through the eyes of the Master of ChiRunning himself are unique.  By the way, I have heard it said that Danny claims he is not a Master of ChiRunning.  He is a practitioner like we all are.

1.  Phase I:  Vision, Goals and Planning

2.  Phase II:  The Technique Phase

3.  Phase III:  The Conditioning Phase

4.  Phase IV:  The Mastery Phase

5.  Phase V:  Taper Time

6.  Phase VI:  Race Weekend

7.  Phase VII:  Rest and Renewal

I am currently tapering for the American River 50Mile Endurance Run on April 7, my 53^rd birthday, only two days away as of this writing.

So, I thought I would write a bit about my experience of tapering as a way of reviewing  Danny and Katherine’s book.  Maybe I will write about Phase VI and VII in the next weeks.

Danny writes in the first paragraph of this chapter:  “The main Chi focus during the taper phase is Containment – containing your energy, your enthusiasm, your nerves and your desire for a successful outcome.”

(page 142)

Not an easy thing to do when I’m used to running 50 miles a week and now my longest run has been 10 miles in the last two weeks!  I’m so full of energy that I went skiing yesterday holding myself to two hours and long rests between 20 turns on the sweet steepness of the Chutes at Mt Rose.  Even that energy release barely appeased my fit legs.  I called Mary and chattered on for five minutes about how great the snow was and how good it felt.  She laughed and commented about how much energy there was in my voice.

Intensity and Quality of runs during tapering:

Most runners understand that the tapering phase before a race consists of a decrease in mileage, but not a decrease in intensity and quality.  I like how Danny writes about this distinction:  “… energy is like money in the bank. You only have so much, and the wise person spends that money carefully.  During taper time, you are amassing your money in the bank.” (Page 143). 

My runs have been shorter over the last two weeks, but they are at race pace (for 50 Miles that would be about 10:30 or slower for me.)  Although, I admit I’ve run a few 8’s and 9’s while in Asheville with runners 20 years younger than me!  As Danny instructs, the quality of these runs should be about keeping your body and mind sharp.  It is the time to focus and sharpen the ChiRunning focuses and “to allow all the good energy to be stored in your dantien”.  “The only thing to build in this phase is trust.”   I use positive affirmations that improve trust in me, my training and my fitness.  One phrase I began to use during my taper for the Way Too Cool 50K four weeks ago was, “I am confident in my skill, ability and fitness to run and finish the race strong.”  It was amazing how my nerves were calmed as I built my trust in my training.  I’d never thought about it that way:  to trust myself. 

I’m also very focused on pelvic rotation and relaxed ankles.  More specifically, allowing my left hip to rotate back equal to my right hip in order to ensure that I’m not overstriding on my right side.  I’m also very focused on the light in my dantien that my needle rotates around creating a strong connection to my mind and Y’chi. 

Niggles:

In “Chi Marathon”, Danny describes niggles as those little, unexplainable pains that have not been there before.  They kind of nag at you like you hadn’t noticed them ever before.  Like the funny knee pain I had never felt before in my left knee, I knew this was a niggle and it quickly disappeared after a few tenths of a mile running.

“No funny stuff”

or what I call, don’t do anything stupid!  I did ski yesterday and I did ski the Chutes, very steep runs where a fall would result in a 1000 foot slide with the potential to crash into some big rocks.  But I did it anyway and skied it fairly decent using the danger and risk to focus my mind and move from my dantien, my center.

Pre race diet:

Having a steak tonight.  I do love beef.  Should have stuck to something lighter this close to the race, but it will be ok.  Nothing that I don’t know how my body responds to.  Gathering energy. storing money in the bank, containing my enthusiasm to eat everything in sight.

Pre race planning logistics:

Danny calls it “The big list”.  I call it trying-to-decide-what- to-wear-and-put-in-my-fanny-pack-and- travel-bag.  I’m staying at the Quality Inn in Sacramento; driving down Friday with my training partner Ron and his wife, Carol; picking up our race packets at Fleet Feet; then having dinner at the Spaghetti Factory on J Street.  My dad and Dave have all the logistical information for the aid stations and about what time I will arrive at them so they can cheer me on and offer me stuff the stations might not have.

Finally:

“Realize how much you have cultivated the intelligent athlete, knowing that you can rely on the wisdom of your mind and body to fully enjoy your event.” (page 148)

Thanks Danny for the release of your book during this critical phase of my training!  This race will be another "experiment" as Instructor Candidate, Glen said last week in Asheville. 

I'm ready.