Put A Different RICE In Your "Diet"

"Achilles tendonitis..."

I turned in the direction of the voice.  Valentino, in a voice which seemed almost a laugh, said again, "Achilles tendonitis!" 

"You?"  I asked.

"Yeah, me.  I suspected that's what was wrong.  I could feel it when I got out of bed the past couple of mornings; all the popping noises and such."

"It's a sign we're getting old, man.  Our breakfast cereal is supposed to make noise, not our body," I replied. 

I'm not into schadenfreude, the concept of having joy at the misfortune of someone else, but it did seem a little bit ironic.  Val's also a running coach; he specializes in sprints at the high school and Junior Olympic level.  During my autumn of pain, he would shout angrily when I would limp into the office the day after my own track workouts -- workouts which had intensities or distances too much for my fifty-year-old (still-injured) tendons to endure.

So, Val has appointments with the base medical clinic, the physical therapist, base pharmacy and the like.  But he's going to keep running because he's stubborn...and he hates cross-training.

When runners think about injuries and their treatment, most of them have heard of the mnemonic RICE: Rest, Ice, Compression, Elevation.  While this treatment method works well for the discomfort of soft tissue injuries, it's not a cure, and isn't as effective when we begin to talk about the more common overuse injuries from which runners suffer.

The same mnemonic, RICE, can be used to treat the cause of injuries like achilles tendinosis, plantar fasciitis, iliotibial band syndrome, patellar tendinosis, and the like.  Unlike the soft tissue RICE, this RICE stands for: Reflect, Identify, Correct, Evaluate.

Reflect - stop and think:  Has there been a sudden change in the run/workout routine?  Have I added distance, changed terrain, altered surface, or increased intensity?  When did I purchase this pair of running shoes?

Identify - what are the most-likely causes for the damage?  In the case of overuse injuries the culprit usually begins with "too:"  Too much speed work.  Too much added distance.  Too little recovery.  Too old shoes.  Too many hills.  Too many crowned or bad surfaces.

Also, take the time to identify what sort of exercise you can do to replace running for the next few weeks; you might lose some cardiovascular fitness during this period, but exercise which does not aggravate the present damage will allow blood to continue to flow to the injured area, continuing the healing process.  Anti-inflammatory drugs can be taken to ease swelling but shouldn't be taken to mask pain just so you can go out and run...remember the discomfort/pain is a message that something is injured and needs to heal.

Correct - what can you do to keep this injury from reoccurring?  A lot of overuse injuries are the result of a musculoskeletal imbalance or a muscular weakness, leading to compensation by a connecting part of the body which was unable to handle, or recover from, the increased strain.

Evaluate - is there really a need to train at the level which caused the injury in the first place?  If the root cause of the injury is strictly to do with poor equipment then I would recommend a gradual return to the training regimen where no pain existed.  If terrain, mileage, intensity or surface changes were the cause, then consider very conservative changes or increases, giving the body sufficient time to recover and adjust to the new stress.  If the cause is too little recovery, then you'll have to figure out a way to assist the recovery process either by taking a day off, engaging in "active rest," or implementing modalities like self-massage, massage therapy, compression garments, stretching and so on.

So, when it comes to injuries, you still need to remember the RICE mnemonic, but it's a completely different form of RICE.  Reflect.  Identify.  Correct.  Evaluate.

Wear(y)ing Of The Green

I got to see more than my fair share of green this St. Patrick's Day, when I awakened with the need to clear some accumulated gunk from my sinuses, throat and airway. I am not certain how you feel about breathing, but as a former childhood asthmatic I'm quite fond of the act, especially when I consider the many unsavory, often permanent, consequences of the alternative.

Rather than sit miserably at my office and risk passing whatever bug I might have to my three co-workers, something all-too-common with people who see themselves too indispensible to an organization's well-being, I'll sit miserably at home and risk passing it along to my wife and dog. Poor me, I get to listen to Miles Davis instead of the Diane Rehm Show today.

Suzanne says I probably shouldn't have run last night. There's a part of me which thinks she may be correct. But, it's more likely my gunky, junky throat comes from doing (running) business in a bar, where cigarette smoking is allowed, on Monday evening. Not the 90-plus minutes of easy running, walking and elliptical trainer which I did yesterday. I spent a little too long in a bar with some cigar smokers some months ago, and ended up with the same junky throat a couple of days later. It's a minor setback on the road to recovery, but I know what I did wrong. It's nothing that time (rest, if my dog decides to let me) and good over-the-counter drugs cannot cure.

Sometimes a health issue is an outcome, sometimes a correlation. And often a simple one. We look for the big solutions to what's killing us as a runner or athlete, when all it takes is looking at the smallest part of our daily routine; what we do, eat, drink, or inhabit the other 23 (or less) hours of the day we aren't running.

I'm not certain if that makes sense to the person inhabiting the very big world outside of my stuffy head, but it does me right about now.