Why I'm Just Now Doing Something About My Back

First, a quick Friday hike update.

Thanks to the City of Boulder's Web site for the photo. As usual, I forgot my camera.

Will, Ruthie and I went to Coot Lake today. This is the same runner-friendly spot where the Boulder-area run for Sherry Arnold was held. Today's weather was the polar opposite of that cold winter morning: warm, dry, breezy. As seems to be our M.O., we didn't really walk very far, but we made up for it in the amount of fun had. This time the fun came in the form of a Golden Lab whose energy matched that of the kids. They took turns throwing his tennis ball into the lake so he could do that lab-otter thing and fetch it. I chatted with his human mom and tried not to notice the fleets of runners out enjoying the day.

I will run a lot--a lot--at Coot Lake and the nearby Boulder Reservoir again when my back is better.

Speaking of my back, I thought it was time to tell you what had gone on with it leading up to last January's spasm that finally sent me to the doc and physical therapy. I know it seemed to come out of the blue and so I wanted to explain why I just started dealing with it.

My back has been hurting since a few weeks before my twins were born. Here's what I looked like then (if very pregnant belly pictures turn you off, look away, scroll down, whatever):

November 2006

My arm is in the way, but just behind it my poor lower back is painfully arched from the forward momentum of that belly. By December 8, 2006, when I delivered Will and Ruth by C-section five and a half weeks early, I was regularly sleeping with two body pillows and weighed 50 pounds more than my usual 125.

Once I'd had the kids, the back felt much better. But I never really got to pain-free. Think about it. My lower abs were shot, not only from stretching during the pregnancy but also from being under-used then and afterwards. My body had grown used to this state of affairs, and my back was now routinely relied on to support the functions the lower abs are supposed to perform. I didn't do anything about this because....who had time? I had two infants and a job. I barely had time to get out and walk or run, much less rehab my abs.

Moreover, as those infants got bigger, there was more carrying them on my left hip so my right arm could do its thing (whether that thing was dealing with the other toddler or holding the phone or punching buttons on the microwave or folding laundry). As the months and years wore on, it became clear that my LEFT lower back was where most of the pain originated.

I didn't completely ignore this state of affairs. Dan and I, thinking it might be the aging mattress on our bed that caused my ongoing issues (some mornings my back hurt so much I had to roll out of bed), bought a new one in 2009. I attended a class called "Lose Your Mummy Tummy" and went to a holistic massage lady, who said all my problems stemmed from scar tissue where my C-section had happened. (Needless to say, I do NOT believe this.)

None of it did any lasting good. And since no one told me running was bad for a back like mine, and since I love running, which at that time was mostly done to keep me sane, I soldiered on with it. My first post-pregnancy race was a 5K when Will and Ruthie were 9 months old. It took me 29 minutes and change. I was disappointed (my 5K PR, set two years before, is 22:34), but not greatly so. At least I was IN a race.

As the years wound on, I kept running like this and ignoring the pain in my back. I did register that it seemed to hurt more with certain strength training moves (100s, a Pilates move, was particularly spasm-provoking), so I avoided doing a lot of core work (a mistake). But I kept entering races and, as I got more sleep with the kids getting older, my results improved despite the ongoing back pain. I even ran a half marathon in 2008, getting it done in 2:06.

But the race times didn't improve as fast as I wanted, and I found myself regressing. In the spring of 2010 I ran the Bolder Boulder 10K almost a minute slower than I had the prior year. This sent me into a depressed spiral. Could it be that my early 30s were really my fastest epoch? Surely not! There are tons of stories of women setting PRs well into their 40s. So I decided it was time to train again for real.

And my back? Well, running wasn't the thing that really aggravated it. Needing a big goal, I decided to go for a Boston qualifying time, started this blog and began training for marathons again. I didn't even consider my back, except to vaguely hope it would just....get better on its own.

I did pretty well until late January, when once again I tried to focus on my core. And you know the rest.

What's the moral of this story? Don't ignore pain. It WILL slow you down, if not right away, then eventually. There are things you can do about it. Yes, these things may take longer than you want and may involve some pain themselves (not being able to run IS painful).

But what we all want is to be able to run until our race is truly over. That's what I'm aiming for now, even if it means BQing by 41 or 42 instead of 40. (I'm still hoping it won't come to that, though. :^) )

Physical Therapy Ch. 4 and Eating Check-In

Today when I arrived at work around lunchtime (Tuesdays are my night shift), I discovered my awesome co-worker Lisa had left a handmade heating pillow for my back on my desk. I took it straight to the microwave and then sat with it for several minutes while catching up on email ahead of my 1 p.m. physical therapy appointment. Big THANK-YOU to Lisa!

Physical Therapy Ch. 4

Cathy went on vacation last week, so today I had my first of three visits with Sue, another therapist at Boulder Center for Sports Medicine. Cathy and Sue were the two therapists my doctor recommended back when I first went about my back, and after just a few minutes with Sue I felt I was in good hands.

Once again, when she checked it, she found my sacro-iliac joint had stayed in place. She also had me lie on my back and tested the strength of both sides by having me resist as she pushed each leg toward the table. The left is still weak, but things are improving (though, as I told her, I still can't get either leg off the ground during those knee lifts on the Swiss ball that Cathy prescribed last week). Then it was time for needling. Sue ranged a little higher in my back than Cathy had, and I can tell I will be a bit sore, which is good.

The only new thing she wants me to do is a dynamic hamstring stretch. Somehow my hamstrings are still really tight despite three weeks of no running. My main focus remains on strengthening the abs and the glutes with the exercises Cathy had given me. I will see Sue again in two weeks and am hoping to show her some real progress the next time we meet.

There were a couple of pieces of really good news. The first is that Sue said I can start to lengthen my aerobic sessions on the recumbent bike provided my pain doesn't worsen. She still wants me doing it only every other day ("I want the joint to get some real rest for now"), but on the ON days I can hammer a little harder and go longer.

The second good piece of news is that she thinks I can still plan on doing the Detroit Marathon in October. She offered no guarantees, but she said she is optimistic right now. Being superstitious, I'm still not going to add the "In Training" badge to this blog. But I'll admit....I'm feeling better about the fall.

Eating Check-In

Things are going well on the eating front. I weighed in this morning at 127.2, and none of my recent weigh-ins have been over 130. I've gone back to fewer-than-daily weigh-ins. The daily thing was driving me crazy. It swung wildly in a five-pound range (Corey had warned me about this--you were right, Corey), which on the "high" days made me feel bad all day. Silly, I know. But sometimes ignorance is bliss. And since the average looks good after three weeks of no running, I figure I'm doing OK enough to not police myself so rigorously.

My Lenten no-sugar-except-on-Sundays thing has also been successful. I credit it with the good weight maintenance so far. But I've not completely lost the craving for sugar. I took Will and Ruthie to a birthday party on Saturday last weekend, and, boy, did that Harry Potter themed vanilla cake look tasty. When Sunday's sweets-OK day arrived, I dove into a Dairy Queen dip cone (I had forgotten how good those things taste) AND a bag of pretzel M&Ms.

With two weeks to go until Easter, after which the spiritual imperative to self-sacrifice won't be there anymore but the physical need to restrain myself still will be, I think it's time I tried something else to get the cravings in line. So yesterday I began a "cleanse" that, as far as somewhat restricted eating goes, will last four days (I'm on day two) and as far as taking supplements goes will last two weeks (also on day two of that).

Now we're still talking about me, hater of diets, skeptic of plans that eliminate whole food groups (unless there's a case of true allergies), so "restricted eating" in my case means only that I'm trying to eat clean whole foods: no packages, heavy on the fruits and vegetables. It also means restricting my eating to set meal and snack times. It does NOT mean fasting, calorie counting, vegan or vegetarian, no-carb, no-fat, no-dairy or no-anything except refined sugar and fake stuff. I am trying to avoid white flours and cut back a bit on my pasta and bread consumption (I love these foods and easily eat too much of them, which I think does contribute to my sugar addiction), but I don't plan to do that forever.

The supplements I'm taking were recommended by Moutain Kait, from the brand Renew Life (I chose the "First Cleanse" product). I'm still not sure I believe all the claims about these supplements, but I'm willing to try them out for two weeks and see how I feel at the end.

How do I feel so far? Not bad! I noticed I didn't immediately want my morning green tea as soon as I woke up like I usually do, and I'm less gassy. I did get a huge headache last night right before bed, my stomach was actively growling around the same time. And today every time I stand up I get head rushes. But I have only two more hard-for-me days and I can up the consumption a little again (hopefully minus sugar cravings; I'd like to skip the Sunday treat this weekend).

And I'll need the calories for those longer recumbent sessions, right?

Book Review: Run to Overcome

I've had this autobiography of Meb Keflezighi for a while, having won it as part of a giveaway from Erin at See Mom Run Far last fall. Though I'd dipped into it here and there, I hadn't really sat down to read it. But when I found out exactly why my back has been hurting and what it meant for my running, I knew it was time to pick it up and read it through.

"Overcoming" is something I think every runner has to acquaint him/herself with at some point. There are the usual difficulties of training. There are life circumstances. There are injuries and illnesses. There are your own demons, and, if you're really good, like Meb, there are outside detractors, too, people who think because you are older or injured that you are slowing down, that you've peaked.

Most runners out there who follow the professional side of the sport know the outlines of Meb's story: how his family arrived in the U.S. from Eritrea after his father made a harrowing trek to Northern Africa and Italy; how Meb and his brothers and sister excelled in school despite having no English when they arrived; how close-knit his family is and how important both his home and his adopted countries are to him. They also know the story of how, wanting a good grade in P.E., seventh grader Meb laid down a 5:20 in the mile run.

I was lucky to hear Meb speak just after he won the Olympic Trials Marathon in January, chalking up a new personal record in the process, and he comes across in this book much the same way he does in person: modest; religious; friendly and inspired. I loved the details, like how he hates ice baths, how he longed for his true love before meeting his wife, Yordanos, at last, how he told his four-year-old daughter that she'd have to earn her first trophy and how during one of his worst injuries he got to know the seniors doing pool aquatics while he was doing pool running nearby.

But another quality that, in person, is made manifest in his running more than his manner emerges in the book as well: this is a person who is intensely driven, eager to prove his critics wrong, someone who takes the worst circumstances (including some nasty injuries) as new inspiration for doing better than he ever has before. He writes:

Winning in life doesn't happen when you overcome just one thing--do or die. It's persevering, knowing that difficulties are bumps in the road, not the end of the world. It's continuing to do the right things, knowing your time will come. After all, you have to conduct yourself like a champion before you can ever win a championship....Whatever you do, then, give it your best. Persevere in overcoming obstacles. When you do, you'll be running to win.

Nobody's path to his or her dreams unwinds without stumbling blocks--even when you are as gifted and driven as Meb. But the unwritten postscript to this book is his triumph in January, his return trip to this summer's Olympics.

These are the words I took away from this book: Patience. Perseverance.

The Spring of....Slow

This was supposed to be the Spring of Speed.

But sometimes the universe doesn't want speed from you.

So you have to switch to slow.

How slow?

Five-year-old slow!

My new plan for spring (besides doing my PT exercises and recumbent bike workouts as faithfully as possible) is to take my kids for a hike every Friday morning.

These hikes are not far (I doubt this morning's added up to a mile and a half). These hikes are not fast (we had to stop so they could climb the tree as you see above; we had to stop for a snack; we had to stop to gather cedar berries--and we were out for only a little over an hour). But this was the second Friday spent this way--and it's fun.

Besides being fun, these hikes are doing wonders for:

1) Getting me some fresh air, which is sorely lacking at the gym. Don't get me wrong, it's a nice gym, and the 30-minute interval workouts are doing more for me than I thought they would...but gyms smell like gyms. They are artificially lit. The only breezes come from fans.

In contrast, today's trail featured bluffs 1,000 feet up from the trailhead, the bluest of blue skies, a little wind that took the edge off the July-like sun (anyone else a bit freaked out by this weather? I personally would like a little more precipitation) and the scent of sage, evergreens and a hint of the mountains that were so close we could no longer see them on the horizon as we drove up. Because, ladies and gentlemen, we were ON that horizon.

2) Getting my kids some fresh air. And getting them to explore all the trails I've been waiting five years for them to be big enough to enjoy. In mid-August, they will go to kindergarten. After that, I won't have Friday mornings with them again until they are almost six-and-a-half. And I have to say, watching my tiny slip of a daughter racing ahead of me and her brother on the trail today....it was almost as good as being able to run myself. She asked me today if she could beat me yet. I told her not yet (though of course she CAN beat me because she can run, and I can't).

3) Reconnaissance for the future: when I'm allowed to run again, I want to do a chunk of it on trails. I know road races require road training. But trail running is my true love. You have to stay in touch with the love.

A Spring of Slow was not what I had in mind, not by a long shot. But I'll take it. I think it was meant to be, for more than one reason.

Physical Therapy: Chapter 3

The good news out of this morning's physical therapy appointment with Cathy: my sacro-iliac joint once again stayed in place on its own for a full week, and my long-forgotten transverse abdominus muscle, after a week of me attempting to reacquaint my brain with it, appears to be more in play when I lift my legs while lying down.

So....I have graduated to some harder exercises (though I do have to continue with last week's as well). The new exercises include:

1. Sitting Alternating Leg Raises on the Swiss Ball
Cathy, in demonstrating this, sat right down on the ball, knees bent and back ramrod straight, and lifted each bent knee in turn without any sideways movement or any slumping at all. Me? I sat down and could not get ONE foot, or even a heel alone, off the ground without leaning to the side. So while that deep ab muscle is waking up, it's still pretty sleepy and not ready to do its job. I asked Cathy why I can do a two-minute plank but not this. She said most abs programs emphasize the "high-load" muscles but entirely ignore these deeper muscles and the subtle movements they require.

I'd be really curious to hear from those of you who have a ball at home and can try this. I'm betting most of you will wonder what the big deal is, but there may be some of you who (like me) find this hard. Cathy told me she once treated a professional triathlete with back pain who was so frustrated at not being able to do this that she said, rudely, to Cathy: "YOU can do this. Why can't I?" Cathy apparently is a horsewoman and keeping her abs very strong and stable matters a lot. Tough for even a fit Boulder triathlete (with a weak transverse) to compete with that!

2. Rowing on the Swiss Ball with a "Theraband"--arms bent and then arms straight
3. Biceps curls on the Swiss Ball with a "Theraband"
Again, the emphasis is on straight posture, not slumping, keeping those abs engaged (and therefore my angry back relaxed).

4. Standing Leg Swings
This one is for the glutes. Stand on one leg, holding either a pole or a counter for support, and do leg swings to the side with the opposite leg. On the left side, I could not do this without leaning left. The object is to get to where I can stand and do the lifts with my body straight and tall, feeling it in, as Cathy says in her Australian accent, my "bum."

After she showed me these exercises, I got back on the table for some more needling (the QL and piriformis, along with the sacrum, are still sore, though much better than last week). She got right into the worst part of my back this time, and it already feels better. Tomorrow I have another massage with Kate. And I'm still in the belt. Wearing the belt has eliminated my hamstring pain, and it makes all of my pants feel artificially tight, which is helping me rein in the eating (seriously!). However, I'll be glad when I can start going without it for periods of time, because I also have a permanent wedgie whenever it's on.

Tomorrow is my "on" day with my friend the recumbent bike. I'd really like to go longer than 30 minutes for these sessions, but I'm going to stick to that limit for another week before, depending on how my back is after another week of TLC, asking next week for either more frequent outings or longer sessions on it. Or both. Wouldn't both be awesome?

Thanks to the intervals I've been doing (and some good tunes on my iPod), I'm finding the bike much less boring than I did at first. I do a lot of visualization there. During the fast intervals, I like to pretend I'm Desiree Davila hanging on in the Boston Marathon, picking off Kenyons (hey, a girl can dream!). I also like to picture the Boston finish line, which I know many of you will be crossing very soon (luckies!). But I also just imagine myself running, not particularly fast or particularly slow, just running with the wind in my hair, no pain in my back, no pain at all in fact but instead the pleasure of forward motion, freedom, suppleness of limb, the best kind of solitude, good health and a quiet mind.

It *will* happen for me.

Kristy's BQ: Guest Post #2

Since my blog is about to get really same-y in terms of the workouts I do (repeat three or four times per week: "Today I went and did 30 minutes with fast intervals on the recumbent bike"), and since my friend Steve's BQ story remains the single most popular post on this blog, I thought it was time to bring in some more interesting Steve-like people as guest authors.


First up is Kristy, author of Run the Long Road. Her story is one of my favorites because her first marathon, in 2004, was completed in 5 hours 12 minutes. The more she learned about the Boston Marathon, the more she wanted to qualify--but it wasn't until her ninth attempt that she accomplished her goal. In the seven years since her first 26.2, she never gave up.

Here's her story, in her words--for all of you who think you are too slow for Boston:

Anything is possible…if you want it badly enough.

For me, qualifying and running the Boston Marathon have been dreams of mine for the past 10 years.  I’m sure people thought I was crazy talking about BQing when I was still hours (yes, hours) away from my BQ time. But Boston was always in the back of my mind during every marathon.

Here's what my progression looked like:

Marathon #1:  Marine Corps Marathon 2004 – 5:12
My goal was to finish.  I treated this marathon like a party.  I stopped and chatted with (now-husband) Matt, I stopped for pee breaks, I stopped for stretch breaks.  I seriously spent a half-hour stopping.

Marathon #2:  NYC Marathon 2005 –  4:36
A huge improvement but I should have done some hill work.

Marathon #3:  Marine Corps Marathon 2006 –  4:58
I had a terrible training cycle and my head just wasn’t in it.  I was ready to quit at mile 10.

Marathon #4:  Marine Corps Marathon 2007 – 4:11
I love the MCM!  I was finally beginning to make some progress here.   I was ecstatic with this time!

Marathon #5:  Philly Marathon 2008 – 4:12
Oh, I was pissed about this one.  It was 15 degrees at the start…I never warmed up and my lungs burned since I wasn’t acclimated to the cold yet.  Just awful.

2009:  I took a year off marathoning to get married, buy a house, and honeymoon in Europe

Marathon #6:  Pocono Marathon May 2010 – 4:13
I was livid about this race.  It was much hillier than I thought (this is the sole reason why I always train for the worst case scenario).  I hated the marathon and the course.  I had a great training cycle but hit the wall HARD at mile 19.  Up until mile 19, I was on track for a sub-4:00 but I fell apart mentally.  At this point I was SO SICK of finishing in the 4:1x range.

This is what I consider the biggest setback of the process.  It was the 3rd consecutive marathon where I finished in the 4:10ish range.  I was so sick of that finishing time!  I had trained hard and was really hoping for a sub-4:00.  Looking back, I should have incorporated more hill work.  Mentally, I was defeated.  If I couldn't get a sub-4:00, how was I ever going to BQ?  I took a few weeks to reassess my training as I was already registered to run Steamtown in the Fall.  I worked really hard physically but also mentally that summer.    

Marathon #7:  Steamtown Marathon October 2010 – 3:58
Redemption!  My hard work paid off with a 3:58 finish at Steamtown!  Finally, a sub-4:00! After this race, I knew I could BQ!  This was a great marathon too.  Gotta love the downhills.

Marathon #8:  New Jersey Marathon May 2011 – 3:52

Marathon #9:  Lehigh Valley Marathon September 2011 – 3:43
BQ BABY!

She did it!

How did I manage to shave off 30 minutes from May 2010 to September 2011?  Hard work and determination.  I’m not naturally speedy.  I didn’t run track or cross country in high school or college.  I didn’t hit the running genetic jackpot.  I’m just an average runner who dreamed big.  That’s it.  If I can do it, so can you.

Let’s start with the physical part first.

Know what works for you
When I’m coaching someone, I often tell them that I made every mistake in the book so they don’t have to. I really think I did.  Lots of trial and error.  But it made me a smart runner.  I know what my body can handle and what it can’t.  I know which training plans will work for me and which ones won’t.  I know when to back off and rest and when to kick it up a notch.

Listen to your body and keep a training log.  After each training cycle and race, jot down what worked and what didn’t.  Review often and look for any patterns.

Marathon-paced long runs
I love me some marathon-paced (MP) long runs!   I wrote a post explaining my reasoning for not doing long, slow distance (LSD) long runs here.  LSD does not work for me.  I gave it a fair shot.  My coaching certification is through RRCA and they heavily stress LSD long runs for everyone – beginners to elite.  I 100% agree with LSD long runs for beginners who need to build an adequate endurance base.  But, if you have a time goal in mind, you need to incorporate some MP miles into your long runs.  For the simple reason that practice makes perfect.

Speed work (FIRST training plan)
I used the FIRST training plan for my last 2 marathons (with modifications – I added in some easy runs for more mileage).  I definitely credit it with helping me BQ.  Before the NJ Marathon, I went to the track here and there but I wasn’t consistent.  I’ve now been doing speed work consistently and the results are astounding.  My marathon pace dropped significantly.  And I saw results quickly.

Consistency is key here.  Pick a day each week and dedicate it to speed work.  It’s easiest to do on a track but any flat, paved path (free of traffic) will do.  And don’t think you have to run all-out…that is a misnomer. You can do intervals at 10K or half marathon pace.  For my final weeks leading up to the Lehigh Valley Marathon, I kept my intervals at 10K pace because I found myself overstriding (and subsequently hurting my hamstring) when I did intervals at 5K pace.

2-week taper
This training cycle was the first time I experimented with a 2-week taper.  And I will never go back to a 3-week taper again!  For me, it’s more mental than anything.  I had a good 22-miler 2 weeks before the LVM.  The day of the race I kept thinking that all I had to do was repeat the run that I did only 2 weeks before.  It boosted my confidence significantly.

Before you try a 2-week taper, think about how long it takes you to completely recover from a 20 mile run. If it takes awhile, I would err on the side of caution and stick with a 3-week taper.  You don’t want to have any lingering effects of that last 20-miler come race day.

Train for the worst case scenario
I learned this the hard way during the Pocono Marathon.  Know the marathon course.  Look at the elevation profile.  Ask people who ran the race in previous years (sidenote:  take their advice with a grain of salt.  A big hill to some is a little hill to others and vice versa).  If there are small hills, train for big hills.  It will only help you come race day.

Now for the mental part…

Break it up into small chunks
When I started to get closer to my BQ time, I looked at each marathon as a way to inch closer and closer to my ultimate goal.  My goal for Steamtown was to break 4:00 hours.  Then my goal for NJM was to hit 3:50…and finally BQ (3:45) at LVM.  This made it much more manageable and less daunting.

Believe
Such a powerful word.  Believe in yourself AND in your training.  If you think you can, you can.  If you think you can’t, you can’t.

Be present
This tactic worked well for me at LVM.  Instead of thinking ahead to the later miles (i.e., the last 6.2), I forced myself to focus on the current mile and mastering it.  It can get overwhelming to think of how many more miles you have and how you are going to maintain MP, blah, blah, blah.  It’s a vicious cycle of self-doubt.  If you find yourself going down this road, snap out of it (during the LVM I audibly said “stop”) and regain your focus.

Thirty Minutes is Better Than Nothing

I've already mentioned my concern about gaining weight due to all this healing downtime.

There's another concern too: that I'm going to be a complete and total grump for six to eight weeks.

Like a lot of people, I rely on running to counter what I think is a genetic tendency to depression. Running has transformed me into an optimist. I don't know how I would have gotten through my teens without the short runs I did with my dad. And I've found that the more I run, the more optimistic, clear-headed and nice I become.

So it was no surprise that yesterday, a day in which I did NO exercise other than my prescribed leg lifts, found me tired, foggy--and grumpy. By the end of the day, when I finally got the kids down, I collapsed myself at 8:35 p.m. My daughter has a cough, and she woke me up at 12:30 a.m. My husband, who has a big project at work, was still there. As I got Ruthie back to bed, I wondered to myself, How am I going to get through this period of such minimal exercise?

Today was a gym day. I didn't make myself wake up early, but as soon as the kids were finished with breakfast, I rounded them up and went. When I got there, I warmed up with five walking minutes on the treadmill. Then I went through my upper-body weight circuit and my leg lifts. And then I got on the recumbent bike for my 30 precious minutes of what I consider "real" exercise.

My back is still sore, but it's much better than two days ago. And it felt nice and supported on that wide high-backed seat. So I hit the workout hard. I had found a pool-running routine by Pete Pfitzinger online. Most of the early workouts in that are about 30 minutes long (unlike the ones in my McMillan Spring of Speed plan, which I've had to set aside for now). The first workout, which I did today, is a five-minute warm-up, followed by two sets of 5 x 1.5 minutes hard with 30 second recoveries and then a five-minute cool-down. Since I can't pool run, my new plan is to do these workouts on the bike.

I kept my eye on my heart rate the whole time and was happy to see that as those fast intervals progressed, it was easy to keep it up in the 140s and 150s. And maybe even better, when I climbed off the bike and wiped it free of sweat, I felt like my usual self was back.

Tomorrow is another day of rest. I'm hoping that I can ride today's endorphins until Saturday morning and that at some point, if I'm diligent about taking care of my back, Cathy will let me do 30 minutes every day and maybe eventually ramp up to a "long" workout on weekends.

It's hard to be patient when you're grumpy. But patience is the key to all of this.

Weight Update: Before the workout this morning, I weighed myself and am happy to report the scale read 128.4. Satisfactory. In the small blessings department, it's good this all happened during Lent, when I'm not eating sugar anyway. I'm hoping that will help.

Physical Therapy--Second Visit

There was good news and bad news out of my second visit this morning with Cathy, my physical therapist at Boulder Center for Sports Medicine.

The Bad News

1) I'm still exercising too much. Last week I went to spin class or rode my bike every day but Sunday. After yesterday's spin class, my back had had enough and went into full spasm. Getting out of bed and into my clothes was actually difficult this morning, so I skipped spin, but still did thirty minutes on the recumbent bike before going to physical therapy. Recumbent bikes look like this (though the one at my rec center is older and clunkier):

I told Cathy all of this, and she gave me a new exercise prescription. I didn't cry this time because I was expecting it--I knew my back wasn't liking the past week's workload. I am to do ONLY the recumbent bike for ONLY 30 minutes at a time and ONLY every other day. I am also still OK to do upper body weight training and the three exercises she gave me today (see Bad News #2).

2) Cathy ran me through a quick series of tests to see if I'm using the correct muscles for certain movements. The answer was, bluntly, NO. When I do side leg lifts, I'm using my quadratus lumborum (QL) muscle instead of my glutes, which are the ones I should be using. Here's a picture of the QL, and yeah, when she manipulated it, it hurt:

And when she had me lie on my back with bent knees and attempt to lift one leg at a time, I could NOT for the life of me use my abs. Instead, I was arching my poor back and using the QL and other muscles in that vicinity. Basically, my brain has forgotten how to call on the correct muscles for these movements.

Running, as you know, involves a lot of glute action because you're lifting your legs up and down, up and down. And it also requires a lot of stabilization that should come from those abs. I've been using the wrong muscles for these key running movements for five years. Cathy put it this way: "You can't be running marathons right now."

My homework for this is three very basic (as Cathy put it, "piddly") exercises: side leg lifts (NOT using my QL), clams (also not using my QL--I was better at these) and the leg pickups, monitoring my lower back lift with my hands. My goal for the latter? To lift my legs without arching my back at all. It's going to be hard given that right now I cannot do it.

The Good News

1) Over the course of the week between last Tuesday's visit with Cathy and today's, my SI joint stayed in place. When she checked it today, it wasn't out of whack as it had been before she popped it back in. So my belt (which I'm in full-time for at least another week) is doing its job, and I didn't mess that up by overdoing it on the biking. This is a good thing because it means that so far I'm not in the vicious cycle of having her put it back in place only to have it come out again over and over and over.

2) Dry needling: it's not so bad! After she showed me the ab exercises, she broke out the needles. I had about eight of them in various spots on my QL and my glutes (she left the sacral area alone--I later got a cortisone patch for that). Here's a video of Cathy herself doing the needling on someone else (a shoulder instead of a back, but it will give you the idea--think of it as a massage, but at the source of the soreness and with a needle).

What did it feel like? Well, it felt weird. The insertion of the tiny thin needle I barely felt, but when she started moving it around, looking for the trigger point, and especially when she found the trigger point, I could feel the muscle twinge, rebound, constrict--and because these muscles are already sore, it wasn't what I'd call pleasant. But it also wasn't painful. I'm sore now, in exactly the same way I've been sore after deep sports massages.

After it was over, she had me rest for 10 minutes with heat on the spots. I'm now supposed to ice the area fairly frequently. Her advice was to stick a package of peas down my pants and leave it there for 10 minutes a few times a day. She also wants me to take 1200 milligrams of Advil every day for four days to kick the inflammation.

3) I'm going to see Kate for a massage tomorrow. Cathy says dry needling one day followed by massage the next is pretty much ideal.

My Reaction

1) I don't like not being able to exercise, but even my Eager Mind is conceding that my Exhausted Back deserves the upper hand right now.

2) My task for the next few weeks (aside from doing exactly what Cathy says) will be to watch my weight. This I am nervous about. A week ago, I weighed in at 129.4. That's satisfactory. Yesterday after spin class, however, the same scale, same time of day, read 134.6. That's not satisfactory.

I don't like to be obsessive about the scale, and when I'm running I don't really have to be. I weigh myself once a week. But with the exercise cut so drastically, I'm going to weigh in every day. Today's weight was 132.4. Better....but anything above 130 is an alarm bell that we've moved in the wrong direction. I may even check out the plan in Racing Weight again. I don't care if I get down to what I suspect is my actual racing weight, but I want to come out of this process still safely below 130.

3) Between daylight savings time and a week of getting up early, I'm really tired. The recumbent bike, for all its drawbacks, is always there. I don't plan to set the alarm again for a while.

My Sweet Ride

Before Dan and I moved out of Boulder last year, I was a great bike commuter. It was only 2.5 miles from our home to my library, and I got good at negotiating the bike path in all but the iciest of weather. My trusty steed for the commute?

This little beauty:

Taken before my ride this morning, freshly extracted from the utility shed.

Now I know some of you hard-core cyclists and triathletes may be jealous, so I thought I'd tell the story how I acquired this bike.

For much of my adult life, I got around on my little brother's old Klein. It was a wonderful bike that my brother had left in our mom's garage. When I asked him for it, he said yes. It was light and well-made....and almost big enough for me. But not quite. My brother had gotten it when he was 15, and it was definitely sized for a 15-year-old. Even with the seat jacked all the way up, I was too tall for it. My knees started to hurt when I rode it. So three years or so ago I sold it to a nice 12-year-old boy.

I've never been one to spend lots of money on either cars or bikes. To me, they are transportation, and therefore need only one quality: reliability. I kept my eye on Craig's List, but this being Boulder, where cycling is as serious as running, I almost never saw anything suitably modest. Then one day I was chatting with Lorin, the security officer at my library, and somehow the subject of my need for a commuter bike came up. He told me he had repossessed a stolen bike that no one had claimed and that might be my size. He said the police had given it back to him, so it was free for the taking.

And that, my friends, is how I acquired my sweet ride.

It's a Diamondback, a brand I've heard of, though not as fancy as my brother's Klein. But it was my size and once the gears were replaced it mostly ran fine. It was all I needed to ride 2.5 miles to work and 2.5 miles home. And you can't argue with FREE.

Now having a checkered past does mean my bike has some, um, features that you might not want in a bike. For example, the handlebars:

When Lorin gave it to me, the entire frame was covered in utility tape. The thief had done this to cover up any identifying markings. Dan and I did our best to remove it, but some of it will be there forever. The handlebars are also slightly crooked. The brakes are creaky--the back tire makes a swish swish sound--but they work, and that's all I care about. Finally, the replaced gear system doesn't always hold up on steep uphills and can also be quite noisy, but I figure this just makes me work harder, which I need to do anyway to keep my aerobic fitness up.

It was on this chariot that I embarked on the first long ride of my rehab this morning. It was a gorgeous day, the kind of day you see in late April when spring is well-advanced. The sun was shining, the birds were singing--and packs of Boulder County's colorfully-clad, expensively-equipped road cyclists were out there on the backroads. I had decided to join them. Two hours on the stationary bike on a day like today, where people are meant to be outside, might well have been the end of my tolerance for this "getting better" thing.

A moment of silence indeed! Thanks to I <3 to Run for timely sentiment.

Lucky for me, my ego is accustomed to being knocked down by the athletes around here. As fleets of mantis-like Lance Armstrong dudes wearing rainbow-hued shirts plastered with sponsors' names sailed by me, my bike swoosh-swooshed (the brakes) and click-clacked (the gears). But I think I held my own (and at least I had no flat tires, which would have required a call to the sag wagon). Dan, ever my Zen master in these matters, had said "bad cyclists like us" can expect to go about 10 miles an hour. So of course I wanted to do better than that.

In the end, I put in 30 miles for the two hours. My average heart rate was only 120, the lower end of the range I'm looking for. I'll need to improve on that next week--130 would be much better. I need to find a route with less downhill. But all in all I'm pretty pleased with this as a first go at it.

My plans for this week include taking the bike to a shop for a tune-up and perhaps scheduling a "bike fit." Meanwhile, I have two questions for the veteran cyclists out there:

1) With my history of UTIs (I'm back on antibiotics; another one hit me on Wednesday morning), I'm a little worried about all this sweaty seat time and my girl parts. I changed out of my clothes and showered immediately upon arriving home. Anything else I can do to avoid problems?

2) My knees hurt a bit when I first got off the bike, though they recovered quickly and don't hurt at all now. I *never* have knee issues running. Should I be worried about that? I do not want my "cross-training for rehab" to result in another injury.

I miss running--painfully--but this is do-able. It's much better than being allowed to do *nothing.* If my PT lets me add walking to the mix, I'll feel as satisfied as a benched runner can be.

Here's an inspirational video courtesy of my awesome friend Kathy:

My Last Run and My First Spin Classes

Well, I hope it's not my last run in an absolute sense!

Before I get to the meat of this post, I just wanted to say thank you to everyone who sent me advice, condolences and empathy. I can't believe how many of you have experienced the same back problem. I've got another post queued up where I'll share some of the advice I got and some helpful links. For now, I'll just say....take care of your low back, especially those of you who are, have been or will be pregnant!

The last run I went on, on Monday before Tuesday's interdiction on running, was great. Normally I do hard stuff on Tuesdays and Thursdays, but the PT appointment on Tuesday was at 7 a.m. and I knew it would be hard to do a long hard speed workout, shower, eat a decent breakfast and still make that on time. On the surface front of my mind, I planned to run after the appointment. But a nagging little voice deeper down was already whispering that it might not happen that way.

So my fartlek workout--7 two-minute intervals at 10K pace with one minute rest in between--was accomplished on Monday. After a two-mile warm-up followed by some stupid fumbling with the Garmin and my new iPod Touch, I finally got in a groove. My paces for the seven intervals were: 8:23, 8:23, 8:16, 8:22, 8:16, 8:08 and 8:05. The total distance was six miles. None of that will set any records, of course, but after the nasty cold and the UTI it felt good to do something hard and still feel strong.

You already know about Tuesday's news and the sad 40 minutes on the bike at the gym.

Yesterday and today, I woke up to my new routine. All spin class/bike, all the time. The spin class I attend is at 6 a.m. on Monday/Wednesday/Friday and 5:30 a.m. on Tuesday/Thursday. Yesterday's class was fun: the instructor, Sheila, had us in a circle and made us all say our names. During the class, if your name was called, you had to sprint by yourself for 15 seconds while the rest of the class watched. I got called on three times despite my weird name! And today's class, taught by Terri, was also great--lots of "hill" work, sprints, good music. I'm not allowed to stand up or jump, but when everyone else did those things I ratcheted up the "road" to a good leg-burning equivalent.

I'm no stranger to spin class. It's been the Monday morning workout in all three of the plans Greg McMillan has written for me, and before that it was my cross-training of choice under the Run Less Run Faster plan. But I admit I haven't always poured myself into it with the same passion I put into running. That's changed now. I wore the Garmin and kept an eye on my heart rate, making sure it was at or higher than the recommended 120 beats-per-minute threshold for as much of the class as possible. I ignored most of the "recovery" segments. My plan is to lose as little as possible of the hard-earned running fitness that showed itself in Monday's fartlek workout.

Between the climbs and the sprints, I had much less trouble keeping the heart rate up in spin class than I'd had alone on the bike on Tuesday. The one worry I have is that these 45-minute spin classes are too short. At next Tuesday's PT appointment I'm going to see if there's any way I can supplement with something weight-bearing, like hill walking for 30 minutes on my break at work.

Last night I started reading a book I won last fall from Erin of See Mom Run Far, Meb Keflezighi's Run to Overcome. Meb, who I saw win the Olympic Trials Marathon in Houston two months ago, really did overcome a lot to get there. I skipped ahead to the chapter about the pelvic stress fracture that forced him onto a bike and into a pool for several weeks after a disappointing performance in the 2008 Olympic Trials. His coach, Bob Larsen, wrote:

There were a lot of blows for Meb when you add it all up. Here's someone who was running as well as ever till he got sick 10 days or so before the [2008] trials marathon....The second blow is he comes back, tries to get in shape, realizes something is wrong, that it's pretty serious and it's going to take quite a bit of time and effort to overcome.
If you're guaranteed a gold medal, sure, you'd go through all of that. But there's no guarantee with this thing. You're doing it all on blind faith that you're going to come out okay. You've got to have a lot of faith in yourself....

Meb's a great example for me right now. I can still see him sitting up there, the winner of his race, having been through far worse than what I'm dealing with. I want to win my race too. I want to wear my own private laurel wreath. Sitting there on that bike, I see that Boston Marathon unicorn with every sprint, with every tick of the heart rate monitor.

Love the One You're With

On the way to the first physical therapy appointment designed to deal with my unhappy back, glutes and upper hamstrings this morning, I heard the song that's the title of this post. It didn't occur to me that the one I'm "with" for the next six to eight weeks won't be these:

Nope, instead I'm looking at all this all the time:

Yes, it's true. I got the prescription all of us dread: no running. Also no elliptical, no rowing machine, no stair machine, no swimming, no lower-body weight training. Only biking is allowed (but no standing on the bike).

I have sacro-iliac joint instability. According to a good explanation I found online, "under ideal conditions the sacrum is positioned somewhat diagonally between the pelvic bones. With this relationship in place there is maximum stability. With a swayback posture (hyperlordosis) the sacrum tilts downward and forward and becomes more horizontal. The ligaments...are stretched and the sacroiliac joints become unstable and the self-locking mechanism is impaired. The ligaments undergo further stretching, firing the pain receptors. Alternatively, the unstable sacroiliac joints may become locked in an abnormal alignment, maintained that way by resultant muscle spasm producing pain."


The pain described is exactly what I've experienced, on and off, for five years now: "Sometimes the pain goes into my butt and the back of my thigh, but never past my knee.....The pain may involve either or both sides, radiate into either or both legs, usually not past the knee, at the same or different times."

In my case, says Cathy, physical therapist and my new best friend/taskmaster, it goes back to my twin pregnancy--the ultimate time of "swayback posture" for me--and an incomplete period of recovery after it. As you all know, I've mostly ignored my pain because I thought it was just weakness in my core, and that if I could get my stomach muscles back to where they were pre-pregnancy, the back pain would vanish. It was frustrating that core work seemed to make it worse rather than better, but hey! I was running, and the running was going OK, so I just lived with it.

For some reason, it makes me feel better to know that it's not a running injury, that it has nothing to do with bad form or my shoes or how my foot strikes the ground.

But regardless it's not something that I can run through. Running, Cathy tells me, isn't going to help the irritated joint stabilize. Nor can the problem be solved by a cortisone shot or PT exercises. I will probably still have some dry needling done (at next week's appointment) and I will be getting some of that coveted insurance-sponsored massage.

The main tool for this week is this:

The Serola Sacroiliac Belt

During all of my waking hours (and my sleeping ones, too, if I can stand it), I have to wear this little item. I'm wearing it as I type. I'm not going to lie: as soon as Cathy put it on me, my lower half felt about ten pounds lighter. The hamstring pain went away entirely, and the glute and back pain, while not gone, feel much better. It actually takes me back to pregnancy, when I purchased one of those belly support bands and could suddenly walk again without pain.

This isn't to say I felt completely happy when I walked out of the clinic. In fact, I had a good messy bawling session in the car, decided to go to spin class right then and, when I got to the gym where I thought the class was happening and found out it wasn't, broke down crying again at the front desk. I managed to put on my big girl pants and get on the bike for 40 minutes on my own (the equivalent of the 40-minute recovery run I would have been doing today).

Afterwards, feeling sweaty and therefore much better, I apologized to Matt, the guy at the front desk, for breaking down in front of him. Matt is one of those chiseled Boulder types, a coach, triathlete and runner who spends his summers in Kona. He told me he totally understood, that he was sidelined recently himself for a couple of weeks with a freak back injury and had his own breakdown the weekend that happened.

While on the bike getting sweaty, I had decided that my plan for this period of being sidelined will be to stick as close as possible to the workouts in my running plan--but do them on the bike. So, for example, this weekend's 90-minute progression run (first third easy pace, second third medium pace, third third medium-hard) I'll mimic on the bike in both duration and intensity.

I shared this idea with Matt. He said it sounded good. He said the key thing about running is the superior aerobic fitness it builds. "That will be the hardest thing to get back," he said, "so do whatever you can on the bike to get your heart rate into the zone where it's working as close to as hard as it does when you're running. When you come back to running, your legs will feel weak--that muscle strength comes back fast. But the aerobic fitness can take a really long time once you start running again if you don't work hard on it."

This makes total sense to me. So I'm going to dig out my old Polar heart rate strip and wear it on the bike, and work to keep the heart rate above 115-120 (Matt said that's where the benefit will arise, that you don't gain that much more by pushing it higher). I'm also going to stay indoors for this. Biking outside is more fun, but I can't afford any "coasting downhill." Staying inside will assure I'm working hard the whole time I'm at it.

Which brings me to my other issue with the stationary bike: boredom. A 40-minute run outside? Paradise. Too short. But the 40 minutes on the bike today felt like it would never end. So I'm going to do as much of it as possible in spin classes. For the first time, I'm glad that the longest runs planned for the next few weeks never topped two hours.

So, yeah. Add me to the DL list. The half-marathon on April 15 isn't likely to happen.

A good attitude will be really important. I'm cultivating that in two ways. One, by trying to see this six- to eight-week period from the perspective of my 65-year-old self, who of course will be fit and running races and doing all this with a nice, steady sacro-iliac joint. It's best for the long term.

The second attitude adjustment is this: On the drive out from the clinic, I saw a guy running in a Boston Marathon shirt. Cathy agrees with my doctor that fixing this will make me faster. Solid back=solid running. That's what I'm hanging on to.

How Not to Plan for and Execute A Long Run

This morning as I sat in our family’s second car wondering how to remove my soaked bra without committing indecent exposure, it occurred to me: I should know better at this stage of my running life.

I’ve been training for races on and off for 17 years. The races I’ve trained for in the last year and a half I’ve been pretty serious about.

The programs I’ve followed for these races all include a long run almost every weekend. Ahead of these long runs, there are certain behaviors and preparations I know I can make that will make the long run experience much more enjoyable. And on the day of the long run, I also know there are certain safety precautions I should take to give me peace of mind and prevent uncomfortable situations.

This weekend, I exhibited none of those behaviors, made none of those preparations and took none of those precautions.

So here, in the hopes that I can prevent this ridiculous situation from happening to someone else, is a list of the things I did and didn’t do that made today’s two-hour long run such a miserable experience:

1)      I wasn’t careful about what I ate the night before. This one isn’t necessarily a huge problem, if I don’t mind a stop or two in a handy bathroom or Port-a-John during the run the next day. If I don’t want to stop, because, oh, say, I might not be able to get to a bathroom in time, I need to rein in the eating and stick to certain kinds of safe foods.
2)      I started late. It was for the best of reasons, to deal with the kids’ breakfast and thus give my husband a little time to sleep in. But when I start later than 7:30 or 8 a.m., I’m already hungry. This sets up bonking, even on runs of only two hours.
3)      I wore neither gloves nor hat. I didn’t need them during the run—it was over 40 degrees. But afterward, when I was standing outside NOT running, that felt a lot colder, especially when the sun went behind the clouds and an innocent-seeming little breeze kicked in.
4)      I brought neither a house-key nor a cell phone. I figured, hey, it’s a two-hour run and I’m doing it around town and I will never be very far from home. I knew my husband was taking the kids out. It didn’t occur to me that he might actually…..lock the door. Which he did. Which I discovered only when I returned home, desperately needing a bathroom, some dry clothes and something to eat.
5)      I brought nothing to eat or drink after the run. I had never before tested how it feels when you don’t refuel during the magical window of 30 minutes after. Now I have. It doesn’t feel good.

So here’s what I learned from today’s experience:

1)      Eat like I’m running long the night before, even when running long isn’t the longest long ever, even when friends are over, even when Dan makes his homemade pesto.
2)      Get out the damn door as soon as that sun wakes me up.
3)      If the weather is at all cold, at least bring gloves and a hat even if I don’t wear them. You never know.
4)      Bring the key all the time and the cell phone if I know I’ll be coming back to an empty house.
5)      Keep healthy fuel in the glove box of both cars. A LaraBar in that situation would have been great. (Lucky for me there was a bottle of half-frozen water in the car.)

In case you’re curious, I did manage to get my wet shirt and bra off in the car without scandalizing the neighbors. Not for nothing did I attend seven years of Catholic school, where getting the uniform off as quickly and discreetly as you could after school was a high priority.

The bathroom problem wasn’t so easily or neatly solved. Suffice it to say, my camping skills came in handy once again. (And yeah, we do know some of our neighbors, but not well enough to ask to use their guest toilet while holding my knees together.)

At least we hadn’t locked the car. It was nice and warm in there….for the full hour and a half I waited for Dan and the kids to return.