Posterior Tibial Tendonitis and Me: How I got uninjured

by Tabitha Kidwell

It’s taper time! I just did my last 20-miler of my marathon training schedule, so it’s time to rest and recover in preparation for the actual race on June 16th! This will be my 5th marathon, and this training season is the best I have had yet!

When I came to Indonesia two years ago, I intended to run a marathon in Asia and in Australia (which would have brought my continent tally up to 5!) I had spent the previous two years training half- and full-marathons, but I was constantly injured with one thing or another. I was always sore and exhausted after long runs. I had a lingering ankle injury, knee pain, and was always one old pair of shoes or concrete sidewalk away from shin splints. Luckily (luckily?) I sprained my ankle pretty badly within my first month here, and my plans to continue running marathons went out the window.

I got back to that goal this spring, and my training was totally different from the past. No ankle pain, shin splints, knee tendonitis, IT band syndrome, pulled hamstrings, or sore back. I don’t even feel sore after long runs. It was great! How did you do it?!?!?! my injury-prone fellow runners might ask. (Injury-prone runners like nothing more than talking to people about their injuries, so if that does not describe you, you might want to check out right now). Unfortunately, I have no clear answer. I had been so desperate to get better that I was ready to try anything. So now, I don’t know which actually helped. Nevertheless, I think these things contributed to my recovery:

Almost 2 years off/Cross-training
Until I started this training season, I hadn’t run farther than 10 miles, and that break from distance helped a lot. I also started doing triathlons, so kept up aerobic fitness by biking and swimming.

Running slower
The first morning I ran with MIT, the my marathon training club in Columbus, I went to the guy in charge and said “I’m new.” “How fast do you run?” he asked. “Maybe nine or ten minute miles?” I guessed. He sent me to the 9:30 pace group, which I stuck with because I developed a huge crush on the coach. After two seasons, I ended up with an ankle injury and a broken heart. (The ankle took longer to heal.) Those two races are still my half-and full-marathon PRs, so we’ll call it even. I eventually dropped back to the 10:00 group, and now that I am running alone, I do more like an 11-minute mile on long training runs. This is what the experts recommend – you should run long runs one or two minutes slower than your goal pace. I’m not too worried about goal pace (I approach marathons with a pass/fail mentality), but I do know this is a better pace for me.

Healthy living
For better or worse, Indonesia is kinda a buzz-kill. Us foreigners are lucky if we live somewhere where you can buy alcohol, and even then, pretty much all you can find is cans of beer or bottles of Smirnoff ice for $3 apiece in the mini-marts. Indonesia is not a drinking culture, and alcohol is taxed very heavily. I basically have stopped drinking just because I don’t have the opportunity. Compare this to life at home, where I would typically have a few drinks with friends 2-3 times a week.

Massages & Refloxology
Giving up alcohol, I may have just acquired another addiction – I’ve been getting about 2 massages a week. Why not, when each session costs under $10, and there are so many varieties – standard body massage, hot stone, aromatherapy, Japanese chiropractic, body reflexology, foot reflexology, and the magical “cream bath” which is really a deep conditioning treatment for your hair, but also includes an arm, shoulder, and head massage. So I’ve had a massage regimen like that of an elite athlete. I’m all loosened up. The best is foot reflexology, where they dig into your feet and release all the gunk that I imagine builds up there after a few hours of running.

Strengthening & balancing exercises
Since 2009, I’ve spent 15 minutes most mornings attached to a giant rubber band faithfully doing exercises given to me by a physical therapist after I first injured my ankle. I varied it a little and added in other exercises, and, to be honest, slacked off quite a bit once my mileage got high in recent months. But I think I have increased foot and leg strength. I really noticed it when hiking down Mt. Merapi with Katie and Chris a few weeks ago, when I easily caught myself on ankle-turning stumbles that, in the past, might have put me out of commission.

Shoe Inserts
I got ‘em just before my health insurance ran out two years ago, and, given that in Indonesia, I have no shame wearing grandma shoes, I have worn them almost everyday. So my arches are supported and happy. I know that the new barefoot movement advocates less support in order to strengthen feet, so I don’t know if they are helping or not. I’m just going to continue wearing the things until America convinces me that uncomfortable shoes are beautiful and worth the pain again.

Toe Striking

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I’ve started running in Newtons, which encourage you to run with a (currently trendy) toe strike. They have changed my stride when running in regular shoes as well. Some running experts say there is no need to mess with your stride, but all I know is, I am less injured. In fact, the only injuries I could possible link to toe striking are two matching blisters below the ball of my foot where my body created new skin at the spot where my foot now hits the ground. Even if it doesn’t help my running, at least it will make runner-types think I am cool.

3:2 breathing
I read this article in Runners World: I did it. I liked it. If only because counting my breaths gave me something to do on those long runs alone.

Sleeping in this thing

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I noticed that my ankle tended to tighten up overnight, so I invested in this torture device to keep it in a flexed position. This is actually made for Plantar Fasciitis, but it works great for my ankle tendons as well. And is actually quite comfortable. Though, if I ever get a boyfriend, I’ll probably keep this hidden (along with my mouth guard) until I get married. Or have children. Or grandchildren.

It is probably tempting fate to write about how awesome it is to be uninjured going into a marathon that is still over two weeks away. Let’s hope for no motorcycle accidents or ankle twists. I intend to focus the reminder of my training on eating sufficient pasta. Wish me luck!

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