Monday, November 24, 2014

No Pain No Gain

I think that people throw around the saying "No pain, no gain" pretty frequently without really understanding what it means. After going through rehab for my foot injury I feel pretty sure I know EXACTLY what the saying truly means to the nth degree.  Several people have asked me about the PRP therapy that I did so I thought I would write a nice little blog post for you to describe it in detail and hopefully answer any and all questions.

First, bones and muscles have a lot of blood flow going to them and as you probably know blood carries your body's healing agents.  This is why muscle injuries and bones can heal much  more quickly than tendons or ligaments which have very little blood flow.

I did several rounds of biopuncture leading up to the September race in an effort to speed along the healing process while stubbornly staying committed to doing the race. Biopuncture is the injection of  biologically active substances which are physiologically regulating. The injections generally also include some sort of pain management ingredient.  These injections while fairly painful at first leave the area pretty numb after a few minutes, the worst injection was into the second metatarsal joint. I think biopuncture is a useful tool if you start treating an injury pretty soon after it occurs but the level of pain I was in coupled with the fact my tendons where essentially fused together meant that biopuncture was not effective in solving my issue.

After my race failure I threw up my hands and told the doctor I would do whatever he wanted me to so that I could get back to full training by January 1st.  He immediately mentioned a boot and PRP.  PRP stands for Platelet-Rich Plasma and is a process by which the doctor draws your own blood, spins it for 14 minutes to draw out the platelets and then injections the platelets into the affected areas.  This process is the most painful procedure I have ever experienced.  Drawing the blood is no problem at all but the needle used to inject them back in is rather large and these injections go much deeper than the Biopuncture. 

Dr Scott at performance health suggested that we do three rounds, each spaced a week apart to really get ahead of things and attempt to aggressively get me back to training.  The first round as scheduled at 10am and I went to work afterwards and that was a HORRIBLE idea.  The pain was intense, white hot pain that made it almost impossible to walk even with the boot.  I promptly changed the appointments for the next two rounds to be later in the day. I highly recommend doing the injections late and then going straight home and putting your foot up.  You are not supposed to take any sort of anti-inflammatory because your body's natural healing involves swelling and let me tell you my foot looked like a Flintstones foot for the better part of those three weeks. The intense pain that limits walking and movement lasted about 24 hours the first time, however it increased with the second and third rounds. With Biopuncture it is important to get the area moving immediately post injections, however with PRP the goal is actually to keep the area pretty immobilized in order to allow the platelets to do their job and repair the area. 

The first round of injections was done on October 13th and Dr Scott said that typically it is 6-8 weeks to notice the gains from the injections, this week is 6 weeks from that first round and I have definitely noticed drastic improvement.  I no longer have constant pain in my foot, however I still am not allowed to do much as far as training. We have coupled the injections with pretty intense manual therapy, which is essentially a very focused, very deep massage.  For me this has been an extremely painful but cathartic process to break up all the scar tissue and fascia that has formed binding the tendons together and keeping my toes from properly moving.  

While this whole process has been extremely painful I am starting to see the light at the end of the tunnel and I even got in the pool on Saturday and swam 1000 meters with the pull buoy, still can't kick but at least I was able to practice!

If you have any other questions that I didn't answer let me know!

Swim: 1000m

Sunday, November 9, 2014

Tenacious D...I mean triathlete...Tenacious Triathlete.

The other day I was talking with a very good friend of mine who shares my passion and dedication for running and it gave me a brilliant idea for a blog.

I have long been called stubborn, strong willed and pigheaded (thanks mom).  While sitting down to write this I looked up some synonyms for stubborn and I picked out a few I really like, tenacious, persistent and iron-willed.  Sure there were plenty of synonyms that have much more negative connotations but for the purpose of our conversation we are going to stick with the positive. Just like in life, if you keep a positive spin on things you will be happier in my opinion.

Being stubborn to a degree is a require trait for any endurance event because your legs will want to quit, your body will be exhausted, your brain will question your motives and you need that small part of you that says, "sorry shut up legs, get over it body and who cares brain." I've been pigheaded since I was a small child and I am sure that made things slightly difficult for my parents but I think they did a fabulous job of fostering my fierce independence while reigning me in when it was necessary. My mom might just describe me as complete nuts now after watching my races, kidding, at least I hope.

Whenever I meet new people they are always amazed when I say my first ever running race was a half marathon and their eyes bug out of their heads when I say I signed up for a half iron having no idea how to swim.  The first thing they always ask is "how did you know you would be ready."  My answer is always, "there was no other option."  It isn't in my DNA to not complete a challenge that I have created.  Now to clarify I always make sure I have the proper lead time going into a race to ensure I have the correct training but I can't imagine signing up and then not doing the work to make it happen.  It isn't to prove something to anyone else and I think that is the important fact, it is for me to show myself that I am capable of the greatest challenges I can find.

This tenacity is why I love my role in helping others achieve their goals and helping them to learn how to be stubborn.  Mental toughness can be trained just like anything else but it is MUCH harder.  Unfortunately being strong-willed isn't always a great personality trait in my current rehab senario and it likely is what caused me to have a harder recovery since I didn't head to the dr at the first sign of pain.

After a month in das boot I moved to real shoes this week and let me tell you that was a HUGE relief as I was so tired of wearing that stupid boot. The physical therapist and the doctor are pleased with my progress after the Platelet Replacement Therapy, which was the most painful experience of my life.  I, however, am frustrated and impatient and trying very hard to not over do things as I wait for the tendons to figure out how to repair themselves and stop constantly hurting.

I'm feeling the pressure of my impending race season and it is making me feel extremely restless to get back to training but I know that pushing too hard right now could cost me months or even a race in the future.  How does one stubbornly rest?  Well they start getting back to strength training slowly while monitoring their foot, they learn to ice said foot three times a day and they read a bunch of books about training.  I've also been doing some mentoring and I volunteered at the NYC marathon which was a fabulous chance to meet some wonderful ladies.  It is a great feeling when people come up to you and say "Oh wow YOU are Katrina! I've heard so much about you!"

Here's to an injury free 2015 and a soon to be productive off season!

Resetting the mile counters to 0 (until I'm cleared to really work out they will stay there)