Thursday, April 3, 2014

All good things...

Locked down no more.

I was supposed to see my sports med doctor for a follow-up appointment yesterday. He wanted to review the results from the MRI that he ordered just in case. Unfortunately, my doctor called in sick and had to reschedule me (for April 16!!!). This would normally have been an unacceptable delay, but it really didn't matter on this occasion. I completely quit running last Saturday.

When you get an MRI, a generic radiologist reads the images and sends a report back to your doctor. My doctor likes to read his own MRI scan following the full examination to support his diagnosis. After he diagnosed me a couple weeks ago with osteitis pubis and recommended no major changes in my training, I had planned to wait until I saw him again to decide how to approach my future training and recovery. Then last Friday, while I was working in Paris, I received the generic MRI report via email. It stated that my MRI findings were consistent with a non-displaced stress fracture on the left side of my pubic symphysis.

Stress fracture. As much as it sounds like bad news, at some level I was actually relieved. It was also frustrating because I've struggled with an injury for almost 9 months that did not match any of the symptoms of a stress fracture. It never was tender to the touch at the location of the fracture and it never hurt during high impact activities like jumping. It always felt like a muscular injury. Granted, it's very clear that groin injuries are notoriously hard to diagnose. But back to relieved ... I was relieved that there was now a clear issue that I could focus on fixing.

Even so, I admit that part of my mind tried to rationalize that I could keep running until I saw my doctor again. Who knows, maybe he would disagree and say it wasn't really a stress fracture. But, why? Just to keep my daily running streak alive and so I could say I had a streak? If you're going to have an addiction, I guess running is a good one to have, but even this addict knows too much of a good thing is just that.

I spent all day Saturday walking around Paris and riding a boat up and down the Seine, but I'm proud to say that I never ran -- my first day off in over seven years. I will say, if you're going to pick a place not to run, Paris in the spring is a great place to be.  It was an absolutely gorgeous day.

When my doctor cancelled on me yesterday, I was so happy that I'd already made the decision to quit running. It would have been absolute torture deciding what to do for the next two weeks while I waited for my appointment if I had kept running.  But now I'm free.

Where do I go from here? I don't exactly know. But it will be at least a month before you see me running again.

...must come to an end.

Sunday, March 23, 2014

Injury Update

Well friends, it's been a long and slow process, but I'm confident I'm making progress. Since North Face 50 in early December I've averaged less than 30 miles per week of mostly just light jogging on the roads and treadmill. Against my better judgement, I did "race" Mtn Mist 50k in January but I haven't done any races or trail runs since that time. I have continued to jog a few miles every day, but looking back it's probably easy to say I should have completely taken off a couple months. The problem is, the level of pain I've experienced is not indicative of the severity of the injury. I almost wish I had an incapacitating stress fracture that hurt so bad that I had no desire to run. My injury has never been like that. Although limiting, it has always been more uncomfortable than painful. I want to share a few more details in case it would help someone avoid the same injury in the future. 

First, a little background information. This whole story starts sometime last summer when playing with the dog out in the yard I pulled/strained the adductor in my left leg. The adductor is a muscle in the groin that allows you to squeeze your knees together (remember the Thighmaster?). It's also a very important muscle in running, and especially trail running. Unfortunately, I didn't realize the significance of the injury and continued my normal training. It felt like some tendonitis in my groin, but something I thought would gradually heal on its own. It stayed like this for months, but slowly started to cause me to overcompensate and alter my stride. Eventually it started to cause discomfort in my lower abdominals and affected my ability to stabilize myself on trail runs. It really wasn't until October that I really understood the root of the problem, but it was effectively a chronic injury by that point. I rested enough to get through North Face respectably, but ran through some pain, and realized I had to back way off afterward.

Fast forward today and after several months of no real training, I'm 90% there. I never felt that I needed to go to the doctor. I was confident that I had an adductor strain turned sports hernia. Complete rest or surgery...I knew those were really the only options...and I wasn't ready for either choice. But this week I finally decided to go see a doctor just to make sure it wasn't something more serious like a pelvic stress fracture that I needed to know about before I started ramping back up. I got an informal referral with a sports med doc that had experience treating sports hernias. He took an x-ray and diagnosed me with osteitis pubis. 

Any amateur radiologists our there?

Osteitis pubis is a noninfectious inflammation of the pubis symphysis that causes varying degrees of lower abdominal and pelvic pain. The symptoms are nearly identical to a sports hernia. The doctor also observed that my hip mobility was very limited. He prescribed physical therapy to improve my hip mobility and ordered an MRI just to rule out other possibilities. We are still waiting on the results of the MRI. He did not tell me to stop running, just to not make any big changes in what I'm currently doing.

If you get really curious about my diagnosis you might want to check out this article. It really helps explain why I've struggled with this issue for so long. It will also scare the crap out of you.
Groin injuries can be the most difficult sport injuries to accurately diagnose and treat. Osteitis pubis is a painful, chronic syndrome that affects the symphysis pubis, adductor and abdominal muscles, and surrounding fascia. If misdiagnosed or mismanaged, osteitis pubis can run a prolonged and disabling course. The abdominal and adductor muscles have attachments to the symphysis pubis but act antagonistically to each other, predisposing the symphysis pubis to mechanical traction microtrauma and resulting in osteitis pubis. These antagonistic forces are most prevalent in kicking sports, such as soccer or football.
...or trail running apparently.

The article describes four classifications of the injury with the 4th being the worst. Symptoms of stage IV include pain in the adductor and abdominal muscles with sneezing or walking on uneven surfaces. Check, check. I can proudly say that it no longer hurts to sneeze as it once did. Unfortunately, no one in the referenced study group had stage IV osteitis pubis. The lone stage III athlete required 10 weeks to fully recover. It's all beginning to make sense now.

I've been running competitively since the 7th grade...20 years now. Up until now, I had never had a serious running injury. Although I don't believe the root cause was directly related to running, it clearly became a running injury over time. It's really hard to talk about running and my injury when I am unable to perform like I once did. I have largely withdrawn from the sport and haven't been reading magazine or internet articles like before. On the positive side, I've tried to make good use of my extra time and invest in relationships outside of the sport that I had previously neglected. In any sport I have ever played, I've always been more of a participant and not so much a fan. Running is the same. I want to participate. I want to compete again. 

I'm only sharing this information in hopes that it might help someone else struggling with the same issues. The bottom line is this: If you have a groin or pelvic injury, do not ignore it. The pelvic region is incredibly complex and too important to the running motion to let it get go as far as I did.

I wanted to wait until the MRI results were back to publish this, but I'm heading to Paris for work this week, so I needed to get this post out today. If the MRI changes anything, I'll let you know.

Au revoir!

Tuesday, February 4, 2014

Mtn Mist Race Report

So here's the deal. I'm injured. I strained my groin sometime last summer and didn't think much of it. I continued running normally for months and it gradually got worse and worse. It turned into tendonitis where the adductor connects to my pelvis. Eventually the pain spread up into my abdominal wall in what's commonly called a sports hernia. I didn't really understand the depth of the injury until last October. I backed off for most of the month of November, but I still wanted to give The North Face Championship a good shot in December, so I brought some intensity back into the program and ran through the injury to stay sharp. I actually had a decent race at North Face off my residual fitness, but I knew my current trajectory was unsustainable and I needed some time to heal.

After TNF50, I backed way off. I continued jogging, but did no hard workouts, no trail runs, and my weekly mileage was only in the 20s. I thought 7 weeks of shuffling around would allow the adductor to heal while keeping me sane before Mtn Mist. But progress was extremely slow. Everything I've read about groin injuries and sports hernias indicates they can be very slow to heal, especially if they have lingered as long as mine has. Going into Mtn Mist, I knew I still wasn't 100% and running 31 miles on an untested injury was a risk. The Mist is the only race I would have started -- even though I don't live in Alabama any longer, it's basically my home course, where my trail running career started.  I'd won it 4 times and wanted to get another step closer to a 10-time finisher jacket. I was hoping I still had enough fitness to sneak out the win.

A cold smile.



The start was cold and windy. I was in no mood to take the race out fast. Most everyone thought the frozen course was going to run fast, but a minor course change at the beginning threw off my normal pacing checks. I knew Scott Breeden would be my competition for the race.  We separated from everyone else around an hour into the race. Twenty minutes later, I stopped for a quick pit stop and Scott kept running. At the second aid station, I knew we were really slow. But I didn't feel like I was running slow, I felt totally flat. I was hoping that Scott was just throwing in a surge, and I'd catch back up, but it wasn't to be. I was low on energy, foggy-headed...more like I was at mile 80 of a hundred miler than mile 15 of a 50k.


I went more into a finish mode than a chase mode at this point. The second half of Mist is much harder than the first, so I knew I would need to keep some energy in reserve just to finish based on how I was feeling at half way. I didn't have my normal trail agility and could barely lift my knees. I caught a toe on a rocky section and nearly went down. I caught myself with my Ultimate Direction water bottle and hit so hard that it actually busted it open. It leaked all over my gloves, freezing my hands and pouring valuable calories out on the trail. I had to ditch the bottle at the next aid station and run the hardest section of the course with no nutrition.

I was totally spent after climbing the waterline trail, but I was determined to finish. I shuffled along, continuing to trip uncharacteristically. I proceed to walk the final climb of the race. There was no power hiking here, just a defeated walk. I was checking my shoulder to see if third place was going to appear. In the end, I finished alone in 2nd place, ten minutes behind Scott and 9 minutes in front of third place. I was over 30 minutes slower than the course record I set last year. That's hard for me to fathom. Scott was 20 minutes slower than last year as well, but I think a lot of that was me going out so slow the first half of the race.

Just happy I finished.

My groin injury wasn't a major factor in the race itself, although obviously it severely limited my preparations. Evidently, I underestimated the amount of fitness, sharpness, and trail agility I would lose after 7 weeks of jogging. I knew I wouldn't be in CR shape, but I didn't think I would be 30 minutes slower either. Now I need to continue my focus on getting healthy. I don't think I set myself back too much racing the Mist, but the process is just really slow. I don't have a race on the calendar until Boston Marathon April 21st. I wanted to run the Mad City 100k in early April, but I don't see any way I can get healthy and fit enough to make it worthwhile to run that one now. So my plan is to continue running very minimally and add in core work that doesn't aggravate my groin. If that doesn't work, I may have to take some time completely off so this tricky injury doesn't become chronic.


The course has some beautiful views when it's frozen.

Big thanks to We Run Huntsville for all the awesome pictures!

Thursday, December 12, 2013

The North Face 50 Championship

The hills in the background...that's where we raced.

My 12th place finish at the North Face Endurance Challenge 50 Mile race was the lowest finish in my ultra career...and I couldn't be happier about it. Perhaps this feeling is a result of my low expectations going in, but I also see a lot of positives following the race. Given the level of competition, the setbacks I've experienced this fall, and a course that did not align well with my strengths, I really think I finished just about as well as I could have expected.

I detailed my adductor injury in my previous blog post, so I won't dwell on it here. Suffice it to say that as my injury spiraled out of control this fall, and my training plans for TNF50 had to be abandoned, it was very frustrating. I knew the 10,000ft of climb in the Marin Headlands would challenge my abilities, and so I had intended to spend much of my time preparing for that. But the injury precluded those plans. I only ran hard a few times in the six weeks leading up to the race, giving my adductor as much time as possible to heal. The week before the race I finally felt like I was turning a corner, thanks in no small part to Andy Shetterly at Peak Performance Sports Therapy. I was quietly confident, but knew my fitness would be lacking.

After listening to the rain pour down and the winds howl the night before the race, the weather cleared just in time for the 5AM start. The stacked field left the start line at a surprisingly comfortable pace. A couple early leaders separated themselves, but a large majority of the serious contenders were content to sit and wait. I was bumping elbows with some big dogs the first few miles, but felt like I was running very controlled. The first 7 miles or so was very runnable despite including 1500ft of climb. We flew through this section and gradually became strung out.

Just before the peak of the second climb I stopped to take a leak. I thought the fire road would continue and I would be able to catch up with my group with little trouble. But the descent was technical and the group seemed to have evaporated in the darkness. To make matters worse, I suddenly realized that my headlamp wasn't very good without all my friends' help. It turns out that my batteries were dying. This was one of my few mistakes during the race. I gingerly struggled down the dark trail as guys like Dave Mackey flew past. At Muir Beach (12.7mi) I stopped briefly to correct my second rookie mistake of the race and applied Vaseline to my nips.

Leaving the Muir Beach aid station I quickly latched on to the shoulder of a runner who passed me as I was waiting on the Vaseline. This runner turned out to be Mike Foote and we began chatting a bit before starting the biggest climb of the day. Mike set a very consistent and manageable pace as we made the 1800ft climb up to the Cardiac aid station. I am still learning how to control my effort on big climbs, so Mike’s pacing was very helpful. It was finally light enough that my dying headlamp wasn’t helping anymore, so I switched it off for the day.

The majority of the ascent occurs in just a mile or two, but the trail continues to climb gently for several more miles. This allowed Mike and I to return to conversation. I’m not usually a big talker during races, but I found Mike really easy to talk to and it seemed to help me settle in to a reasonable effort.  The wind had picked up by now and was blowing into our faces. I wanted to help, but we were still climbing and I didn’t trust myself to manage the pace. Mike and I passed a struggling Matt Flaherty shortly before entering the Cardiac aid station together.

Mike Foote and myself (Photo by Galen Burrell)

I waited a bit for Mike, respecting the fact that he just led that whole climb, then I led the way as the trail flattened out. The wind was quite brutal in this section, so I was happy to still be wearing gloves, arm warmers, a windbreaker and buff. I don’t know how some of those guys ran with bare arms and hands. This should have been a very pretty section of the course, but it was quite miserable for me. In addition to being cold and windy, the trail was very narrow and slightly off camber. This aggravated my groin injury.

This was also an out-n-back section of the course...both positive and negative. Positive in the fact that I found I was only 3 or 4 minutes off the leaders. Negative in the fact that I had to fight two way traffic on the narrowest trail of the day. I lost a big chunk of time at the turn around aid station trying to get my GU powder out of a baggy with frozen hands. Mike didn’t stop at the aid station, so he was long gone by the time I was running again. I gave chase, but hip flexors were not happy. My foot slipped off the soft edge of the trail several times when trying to leave space for passing runners, and that really aggravated my injury even more. I wouldn’t see Mike again.

The descent down to Stinson Beach was nasty...steep, with lots of stairs and switchbacks. All the twisting and turning was increasingly painful and I couldn’t descend like I could have when healthy. I let a couple of people pass without a fight and mentally went from race mode into run mode. I made it down to the Stinson Beach aid station at mile 27.7 where my wife was waiting. I traded my bottle out and told her that I had quit racing, but was determined to finish the race. I was surprised to hear that I was only 5 minutes from the leaders though.

Fortunately, I knew the climb I was about to tackle was a beast because I had a chance to run it this past summer. I was very conservative to start and began hiking the steeper sections. When I hit the stairs, I was hiking almost exclusively. I hiked at least half of the climb back up to Cardiac...anything over 5% grade and I was hiking. I was able to pass someone on this section, and passed through the aid station feeling a little better. I still wasn’t feeling great on the next descent and was passed by someone else. The next section seemed like constant ups and downs. It felt like I was hiking more than I was running.

This would have been a lonely section if not for the 50k runners that were sharing the trail. They gave me something to focus on and chase. I still wasn’t trying to race; I was just trying to get to the next aid station. Around the 37 mile mark I came up on Rickey Gates. He was obviously not having the race he had planned. I ran with him for a few minutes, but a rare flat section allowed my legs to find their happy place again and I slipped away. The flat section was short lived and we started climbing again at mile 40.

My climbing legs were shot. My quads were beginning to cramp. I had nothing. I was hiking almost everything. I turned around and looked down the trail and saw someone catching me. He was climbing really well and I knew it would just be a short time before he caught up. As he passed, he confirmed who I was and mentioned that he had run Stone Steps 50k in Cincinnati. I knew this was Peter Hogg from Michigan and I was not pleased to be getting passed by someone who doesn’t live in the mountains. But he passed me with authority, and I had no response. I couldn’t match his rate of ascent. Although I hadn't consciously noticed, I realized later that my adductor was no longer bothering me by this point.

Soon after, a strange thing happened. Peter quit putting time on me before we reached the top of the 900ft climb. I wasn’t really trying to catch him - I thought he had me - but I just kept moving and he started to come back. Although I wasn’t climbing well, I could still descend just fine. Shortly after cresting, I passed Peter back on the descent. I began to believe again and got my racing mentality back. I flew down into the aid station at 44 miles and traded in for my final bottle.

I still had another 600ft climb to survive. Even though I had put close to a minute on Peter on the prior descent, he quickly made it back up on the final climb. I tried to hang to his shoulder, but my quads started cramping again. I knew the race ended on a long downhill and decided my best strategy would be to bide my time and wait for the descent. I caught Peter sooner than expected on a short descent before the last aid station. I was able to hold my advantage on the brief climb into the final aid. It was there I was told someone was less than a minute ahead of me.

I passed Martin Gaffuri while he was stopped at the aid station. I did not need to stop, and probably would have slipped passed unnoticed if not for his pacer. Dominic Grossman saw me come through and alerted Martin to the fact that I was in the 50 mile race. Martin quickly gathered himself and began to fly down toward the finish. He passed me back quickly, but I was content to manage my energy and stalk him from a distance. I suspected I was still descending really well and the two 5:4x miles recorded on my Suunto Ambit confirmed my suspicions. Martin probably had 20 seconds on me as we hit the paved road with less than a mile to go. It was a slight uphill, but I was giving it everything to catch him. Dom kept turning around to see if I was gaining. It didn’t feel like it, but I slowly was closing. With less than 200m to go, I put my road speed to good use and unleashed my final kick. I eliminated the gap much faster than expected and turned into the finish line in 12th place, stopping the clock at 6:57:10.

Chasing Martin (photo by Dominic Grossman)

I know I didn’t start the race completely healthy or fit, but I’m really excited about the outcome. I broke 7 hours in a trail run with over 10,000ft of climb. A year and a half ago, I didn’t even break the 8 hour mark on the Quad Rock course that had just 1,000 more feet of climb. I would have loved to finish in the top 10, but I was just a few minutes behind A-list trail runners like Dave Mackey and Max King. I made a couple small mistakes, but nothing major. And my nutrition...something I usually struggle with...was great. I didn’t take a single gel the whole race, but my all-liquid nutrition plan worked great, and my energy levels were even all day.

For starting with such low expectations, the final product turned out better than expected. And for the first time in a long time, I’m excited again about what I can do in the future.  But first, I’m going to get completely healthy.



The bridge is awfully exciting.


Sunrise from the houseboat.


Sunday, December 1, 2013

Toad, Tussey, and TNF

It's been a long while since I've done a blog post, and I know I'm overdue for an update, so here goes. My last post was a short report detailing the Hood to Coast Relay that I ran at the end of August so I'll pick up there.

Following Hood to Coast, I had business in Seattle so I headed north and spent the next week working in the shadow of Rainier. I spent most of my time working and recovering from HTC, but finally on Friday I had a free day to check out the mountain. I spent about 3.5 hrs on the trail that day and definitely could still feel the beating my quads took from running the downhill 1st leg of HTC a week earlier. Three days later I was home and looking to close out the 7th year of my daily running streak with a bang. I needed 30 miles to hit 30,000 miles total over the previous 7 years. An aggressive goal considering HTC, Rainier and the 446 miles I'd already logged in August. But I pushed through and finished the run without too much trouble.

I gave myself a much needed down week, but jumped in a local 6 hour race 2 weeks later. I knew I wouldn't be "racing" anyone, but used it as a workout and ran 6:30 pace for 43 miles on a flat 1.4 mile paved loop. My fitness was was solid, but something was a little off. I pushed through.

By this point, I knew the World 100k was canceled, so I rushed to switch gears from flat 100k training to more of a focus on hills in preparation for Toad 50k, Tussey Mountainback 50 mile and The North Face 50 Championships. I hit the treadmill several days later for a set of simulated hill climbs. A little more than two weeks later I'd be racing the Toad 50k in Canada. The treadmill climb workouts highlighted some discomfort in my groin, but it wasn't enough for me to skip the upcoming 50k.

Held just outside of Toronto, Run for the Toad 50k was the Canadian 50k national championship race. While I wasn't eligible for that honor, the race had assembled a strong field of Americans to come run the race as well. There was a significant amount of prize money available, especially considering the course record bonus, which I felt was in reach. But I knew it would be tough to win, because a guy named Verrelle Wyatt who had run 2:57 for a road 50k was going to be there. I don't have that kind of 50k speed right now. I might not even be able to run his Caumsett split of 2:28 for a marathon. This was a trail race, but it was quite flat. I would have stood a better chance against Verelle if it were a 50 miler or if there was more elevation change, but that wasn't the case.  

To his credit, Verrelle went out very controlled on the first lap out of the four but I was right there with him. He took off on the 2nd loop and I let him go, hoping I'd see him again. I was hovering around 4th or 5th place at this point, but felt in control. Nearing half way, I rolled my ankle really bad on a manicured dirt road with just one rock in the wrong place. I never seem to twist my ankle on the technical stuff, just when I don't think I need to be paying attention. This took me the better part of a mile to hobble off and get back to my regular stride. I chipped away at everyone else for the remainder of the race, but I never caught Verrelle. I finished 2nd and even broke the old CR by a few minutes with a 3:18, but couldn't hang with Verrelle's time of 3:14.

I was pretty trashed after the race, and the ankle I rolled hurt quite bad running the following day. But I also learned at Toad 50k that a strained adductor was at the root of my groin pain. I believe I injured my adductor way back in May or June and it has just slowly grown worse. I could now no longer ignore the injury, but I hoped only light running for two weeks would allow me to compete at Tussey.

I felt good enough to start Tussey and ran with Zach Bitter for almost 32 miles before my ankle/foot injury forced me to stop. I didn't know exactly what was wrong with it, but it hurt and was getting worse flying down those long hills at 6 min pace. Thinking it could be a stress fracture, I pulled the plug. Matt Flaherty ran a great race and ended up winning with a new course record. And just a couple weeks later, Zach Bitter went on to run the fastest 50 miler since 1981 (the year I was born).

This is going to sound odd, but my ankle/foot injury healed frustratingly fast after Tussey. After hurting for 2 weeks, I was nearly pain-free in just a few days. My adductor injury, while less acute during the race, ended up being a much bigger issue following my effort at Tussey. I finally realized that my groin wasn't going to heal if I kept running hard on it. I continued running easy everyday, but cut my weekly mileage lower than any point in the last 7 years. I did this for over 3 weeks and began massage therapy as well.

A couple weeks ago, even though I knew I wasn't completely healed yet, I decided that I would try to do some late preparations to TNF50 to a) test the adductor to ensure it was strong enough to run 50 miles, and b) attempt to prepare for the climbing that I would face in the San Francisco. Some runs have been good, others not so great. I think I can finish the race and have enough residual fitness to have a respectable showing, but it certainly won't be the fitness that I intended to bring when I decided months ago not to race JFK and focus on TNF50.

I'm going to give it a go, enjoy the single track, and just take what my body gives me Saturday. At this point, I'm just happy to be running. This may not be the type of injury that forces me to completely quit running, but I think it's safe to say this is the most significant injury I've had in my running career.

And if you're following TNF50 this Saturday and see me back in 30th place or so, don't worry, that would be a respectable finish given how incredibly stacked this race will be.

P.S. It's great to be an Auburn Tiger! WDE!