Winter Marathon Query

I am queuing up Part Two of my little "Aching Backs" series. This will be the one in which I detail my physical therapy program as it stands right now.

First, however, I need some educated opinions.

Right now, I am signed up for this October 21 race:

I'm not exactly training for it yet, but I guess I'm training to train.

Though I may not be allowed to run at all until mid-July, I'm still planning to run Detroit. But it's probably not realistic to think I can run it fast enough to beat January's Houston Marathon PR of 3:53:28 by at least 10 minutes--which is what I need to do to qualify for the Boston Marathon in 2014.

So I need to sign up for at least one more marathon before I turn 40 on January 21. Given what's going on with my back, BQing before that date (which was the entire premise of this blog) may not work out. But I'm not going to quit trying. (And if I don't make it this winter, I'm STILL not going to quit trying, so don't think that of me!)

My question is this: WHICH winter marathon should I sign up for?

As a sub-4-hour marathoner, I am granted early and guaranteed registration for the Houston race next year on January 13, a week ahead of my birthday. Early registration opens next Tuesday. But a lot of smart runners are signing up for the California International Marathon, a month and a half earlier on December 2. Looking at the course, it's tempting:

Hard to beat that profile....

Here are the pros and cons:

Houston Pros:

1) Six extra weeks to recover from Detroit and train
2) Familiar course--this would be my third time at it
3) Lots of friends in town; the support in January was amazing

Houston Cons:

1) Remember that weather in Boston the other week? Yeah, that's quite possible in Houston, even in January.
2) Not as fast a course
3) I'd have to train over Christmas again; I was hoping not to have to do that this year

CIM Pros:

1) Great course--see that chart again; according to Runners' World, it's in the top five of Boston Qualifiers
2) Good chance of nice weather; average temps are in the 50s
3) No training over Christmas

CIM Cons:

1) Not as much recovery/training time after Detroit
2) I know no one in Sacramento, though I'm sure I'll know some other bloggers running it

Of course, I could sign up for both races. This is also tempting. But it's a lot of money out of my family's till, and I'm not sure I can expect to do three marathons in four months and do any of them well. With my back an unknown variable, I need to do the right thing with this.

What's your opinion?

Oh, Our Aching Backs--Part One

Congratulations to everyone who ran the Big Sur Marathon (especially Kathy!) and the Eugene Marathon yesterday. I was jealous (my second "did not start" since my injury diagnosis, a 15K, came and went on Saturday), but also very happy for all of you.

I also want to say GOOD LUCK to the four hearty (and sleepy) souls who signed up for the May Sleep Challenge with me. We have a tough road ahead of us. It's not May quite yet, but I tried to practice last night and therefore was "lights out" at 9:34 p.m. Instead of falling into blissful slumber until my alarm sounded at 5 a.m., I tossed and turned and got up to use the bathroom and adjusted my pillows until about 10:20, when I finally drifted off. Then I woke up three times in the night for no good reason, finally rising for good at 4:50. At least, given how tired I am right now, I don't think I'll have as much trouble falling asleep tonight.

This week, I have no physical therapy appointment. I'm just keeping my nose to the grindstone with my ab and glute exercises. So I asked some bloggers who I know have experienced my injury--to remind you, it's called sacro-iliac joint dysfunction and it affects your lower back, hips, bottom and hamstrings--and lived to run again to tell their stories via a Q&A.

Tara and Jessica were nice enough to get back to me. Their stories give me hope, so I'm sure they will help someone else with SI issues who might despair, thinking that once your lower back goes there's no return. Tara is now expecting her second child (she ran a half-marathon pregnant in January!) and is looking forward to a big return to PRs after he is born. Jessica, who has three small kids, just took third place in a 10K and in her most recent marathon qualified for the Boston Marathon for the first time with a huge PR.

1. What caused your SI joint issue? (If it was a combo of things, definitely share that too. My issue was mainly caused by pregnancy, but doing too much running too soon afterwards, carrying toddlers, driving a stick shift, sleeping on my stomach and doing the wrong core work exacerbated it over the ensuing five years.)


Tara: My SI issues were caused by having extremely weak, inflexible hips and weak glute muscles.  Now, if I were just sitting around all day, my weak hips and glutes probably wouldn't have been a burden to me, but I trained for three marathons in under a year and did absolutely NO strength work whatsoever.  No squats, no lunges, no hamstring work....nada.  All of that running and no strength work eventually caused my SI joint to become hyper-mobile and my glutes/hips couldn't hold the joint in place.  The joint pulled on my piriformis muscle, which caused me to have piriformis issues, which in turn pulled on my IT band and caused IT band pain. I finally had to pull out of the Chicago Marathon two weeks before.

Jessica: I think my issue was caused by two things: horrible posture habits which were made worse during pregnancy.  When I was a new mom I would carry my babies around on my hip and do a million other things at the same time (put groceries away, wash the dishes, carry the laundry basket etc) - never paying any attention to how I was holding my body.  As a result I had a weak core and my SI joint was completely out of whack.

2. Did you see a practitioner (physical therapist, chiropractor, doctor or other) to help you alleviate the problem? (I'm seeing PTs referred to by my doctor, a sports medicine specialist.)

Tara: I went to see a sports medicine doctor for my IT band pain and he sent me to a physical therapist who eventually diagnosed the root cause of my problems, which was that stupid SI joint.

Jessica: The first time I tweaked it, I went to see a chiropractor.  He was more of a "back cracker" and just adjusted me, told me to stop eating gluten, and sent me on my way.  It was frustrating.  When I was pregnant with my third baby last year one day I just went to tie my shoe and - TWEAK - I was in so much pain.  After the baby was born I found a new chiropractor who has honestly been so incredibly helpful to me.  He takes a much more holistic approach with his care - ART, chiropractic adjustments and massage.  He figures out where the imbalances are in my body and gives me exercises to do to strengthen them.  He is really wonderful and I am so thankful.

3. What sorts of exercises/adjustments/other therapy was prescribed? (For me, an SI support belt, regular adjustments and dry needling, massage and various at-home exercises have been my mainstays for eight weeks now.)

Tara: My PT had me doing at home hip exercises, squats, lunges, core work, etc.  I never knew that I had such a weak butt!!!

Jessica: I work with a theraband, do pilates exercises and foam roll every single day.  I also do strength training twice a week.  When I see my doctor (about once a month during marathon training) he will do ART on my super tight spots, STIM [electrical stimulation] and massage along with whatever chiropractic adjustments he feels are necessary at the time.

4. What factor or combo of factors finally got you over the hump with your SI problem? (I, alas, am still not really over mine. Trying to be patient.)

Jessica: Honestly, mostly just becoming so much more self aware and intentional with how I move and use my body.  I became a Pilates teacher two years ago and those exercises have changed my life.  As a busy mom of three I can forget myself easily on a daily basis and try to do too much at one time.  My SI joint will get cranky if I do that and I feel tweaks as a result.  So if I am mindful and I practice Pilates every day, it really helps.

5. Does your problem still flare up? What do you do when it does?

Tara (answering 4 and 5): I find that if I lapse on my strength work, the SI joint pain comes back.  I have learned to recognize the symptoms, which can be pain in the lower back, glute, hamstring, groin pain or a combination of all. I am currently getting ready to enter my 6th month of pregnancy and with pregnancy comes the hormone relaxin, which basically relaxes our joints, including the SI joint.  I am working with a chiropractor to keep my back "healthy" and he initially gave me the Serola SI joint belt, which I used for awhile, but I have been diligent about keeping up my strength work during pregnancy and I haven't needed the belt in the last few months.  I have a feeling that I will forever deal with the hyper-mobile SI joint. I must be diligent about strength work.

Jessica: Yes, it does on occasion.  I have not had a flare up for a year though, which is so wonderful!  If I feel things get tweaky, I will ice, rest and go see my doctor.  I bring more awareness to how I am using my body and try to slow down and pay better attention.

6. Any other advice for people who may be dealing with this? Any advice on how to prevent it happening in the first place?

Jessica: Take Pilates!  I really think it helps so much.  We ALL have imbalances in our bodies, even the strongest most fit athletes in the world.  We have to become self aware and pay attention to how we are using our bodies.  I think this is what has helped me so much.  I used to have issues with my SI on a pretty regular basis, and it was so depressing.  I would be laying on the couch afraid to move as my kids played around me.  I hated it.  I did not want to go through that again and Pilates has really saved me.  Also, find a doctor you really trust - not someone who will just adjust you and tell you to take supplements.  Find someone who wants to help you improve your quality of life.  Someone who "gets" you.  Check in with yourself throughout the day - when you're standing in the line at the grocery store - are you slouching?  Are you jutting out a hip?  Is your core engaged.  Stand tall and breathe.  Relax.  Be mindful and intentional with how you are moving.  And move every day - movement heals!!  You do not have to move fast - just move.


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Thank you, Tara and Jessica! I also want to give a shout-out to Michael, who when I was initially diagnosed sent me a great article with a thorough explanation of this problem and some adjustments and exercises to help alleviate it. I've found these to be a big help in addition to my formal PT program.


In "Part II" I will give you a detailed description of my PT program as it stands right now.

Coming in May: Sleep Challenge

This is me with Ruthie in January 2007. I had an excuse for missing sleep back then.

A co-worker and I were talking a couple of years back about the little quirks and tics of some of the other people we work with. Most of the things we were coming up with were things that annoyed us. I asked her, "I wonder what they would say about us."

"Well," she replied, "you're kind of funny about sleep."

Funny is one way to put it. Obsessed is another.

I love sleep. I've never done any formal or informal testing to try to determine the amount of sleep that's ideal for me, but based on past experience my guess is somewhere around 8-11 hours in a 24-hour period, depending on how much I'm running.

Since I had my kids five years ago, I've gotten nowhere near that amount. At first, of course, with tiny babies, there really wasn't much choice in the matter. You get what sleep you can, when you can. But once my kids grew out of that newborn stage, they got to be pretty good sleepers pretty fast. Sure, we have lapses, when one is sick or when my son is on a bedwetting jag. Sometimes they have a nightmare or need help in the bathroom overnight. But mostly we can count on them to go to bed around 7:30 p.m. and sleep until 6:30 or 7 the next morning (my daughter, a morning person like me, gets up with the sun, so this time of year she's up on the earlier side of that).

So why am I still not getting enough sleep (my occasional problem with insomnia aside)?

Because I haven't made it a priority. Once the kids are down, I like to putter on the computer, hang out with my husband (a total night owl--this is the only way in which he and I are ill-matched), read or (lately) do physical therapy stuff that I didn't get done earlier. By the time I head to bed, it's often after 10 p.m. and sometimes pushing 11 p.m.

Now, I think, is a good time to start pushing my bedtime to where it really needs to be: 9 p.m., or 9:30 p.m. at the latest. This is the time that will allow me to rise comfortably for my workouts at 5 a.m. and give me a nice extra cushion on mornings where I don't have to do that.

So my challenge for the long month of May will be to go to bed by 9:30 p.m. on nights when I have to wake up early the next morning, which is usually three or four days per week. It will set up good habits that will carry over when I return to running and training for races, and it will be better for my health overall.

How much sleep do you need? Are you getting it, and if not, why not? Care to join me in May to try and change that?

All you have to do is email me your sleep goal (which may be different from mine) by the evening of April 30 (next Monday). I will check in with you via email every week to see how you are doing. At the end of the month, I'll have a small prize for the person who comes closest to meeting his or her goal.

Physical Therapy Ch. 7

Wow, seven chapters on my physical therapy visits! I never knew I'd be writing such a long (and boring) book.

It's about to get longer, too.

Here's the quick and dirty summary of my appointment with Cathy (back from Australia and all tan):

1. No needling today (I'm glad to have had a break from that)

2. My sacro-iliac joint looked good to her. I'm now allowed to remove my SI belt for four hours a day. I still need to wear it at other times, and most especially when I'm riding the recumbent bike, walking for exercise, doing weight-lifting and doing my PT exercises. As I'm typing this, I'm out of the belt. While I don't miss the constant wedgie, I am missing the support a bit. But I figure that's OK. I'm near the end of the four hours so it makes sense.

3. My abs are getting stronger! Cathy thinks I'm close to being able to do those elusive leg lifts on the Swiss ball.

4. BUT...and here's the big BUT (or maybe I should say BUTT)....my glutes are still far too weak to consider running on them yet. She ran me through some tests that confirmed it: I have a serious case of white-girl butt. This explains many things: why my finishing kick in all my post-pregnancy races has been lacking; why it's so much harder for me to power up hills when I'm hiking; why I tended to avoid lunges and squats in weight training class.

Cathy actually quantified what I'm in for thanks to the weak bottom: three more months of no running (though I may get to hop on the Alter-G sooner). I think it's a good sign that this didn't surprise me much. On a trip last week to the park with my kids, I saw from afar as my son fell off his bike. I ran in his direction...or tried to run. I felt it instantly in my SI joint....and at that moment I knew that, geez, if I can't even jog over to help my crying kid, I probably shouldn't be huffing it around the neighborhood yet (even with lots of walking in the mix).

5. I have new PT exercises for homework. They all involve the glutes. I plan to attack those suckers. Buns of steel, that's what I'm going for. It took me six weeks to get my abs to where they are now (and yes, I'm still working on the abs, too). I know I can expect the same amount of time for the glutes.

So here are my priorities, in order:

1) Do everything necessary to rehab my back. This means a) do the PT exercises the prescribed 3-5 times a week, 50 reps each and building, b) learn to sleep on my sides and back, relinquishing forever my beloved stomach cuddle and c) be vigilant about my posture and lifting technique.

2) Maintain my cardiovascular fitness so it's still intact when I return to running (I know the running muscle strength won't be there--nothing I can do about that). This means the recumbent bike is my best friend. I've even named him Pitbull, after the vulgar-yet-charming-and-certainly-catchy hip-hop dude whose music accompanies me on all my "outings" on this bike. Move over, Mario Lopez--I have a new Latin lover.

3) Maintain my weight. So far, so good on this. But I know I can continue tweaking my diet to include even less sugar and even more fruits and veggies. I'm wondering now if I can even lose a few pounds and finally hit the low 120s. I'll be writing more about this later.

4) Improve my sleep habits. More on this in a later post as well.

5) Do upper-body weight work.

6) Remember that these months away, which are crucial to my long-term health and my abilities as a runner, will someday be just a blip in what I hope will be a lifelong relationship with trails, roads and running shoes. I can and will take as much time as this problem requires.