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10 miles: it's not about the distance.

I had a GREAT 10-mile run this morning. Some of you might have noticed that I did not blog about my 8-mile run last week. Actually it was such a miserable run that I did not want to relive it by writing about it. I did manage to go all 8 miles, and that's all you need to know.

So, I was understandably a little nervous about today's run, especially since it was going to be in the mid-70s with 95% humidity by 6am. Also, I'd gotten a tetanus shot on Thursday morning and can still barely move my right arm, so I was afraid that would bother me too. But I got up early and was on the road by 6:30. It was raining on and off, and I got pretty wet during miles 2 and 3, but frankly, with 95% humidity, I was going to be drenched within a few miles anyhow. I was actually glad that it was rainy because even on a warm humid day, it makes a huge difference not to be running in the direct sun.

By the end of mile 2, I did not feel like I was in the throes of death, as was the case on last week's 8-miler. This seemed like a good sign. In fact, I seemed to sort of hit my stride around mile 4. Everything felt good and I wasn't having to work as hard as I physically could just to keep going. My poor sore arm didn't bother me. I stopped back at home after mile 6 to refuel and take some salt. Those last 4 miles were, well, not exactly easy, but really not that tough. My knees and feet were getting a little tired, but that was all. I was enjoying myself, and by the end, I felt like I probably could have run a couple more miles without too much difficulty. Now, post-run, I'm feeling completely fine other than slightly tired feet, not nauseous and/or wiped out as I sometimes do after long runs.

It took me 1 hour and 45 minutes, which is a 10-and-a-half minute mile pace -- not bad at all considering how much trouble I've been having. The moral of this run: it's not about the distance. Ten miles can be much easier than eight, even in crappy weather, if (a) you go out early enough to avoid being in the direct sun the whole time, and (b) you're feeling physically okay at the time you go out. I feel confident after today's run, which is a great feeling!

A minor concern: I have a small, persistent blister on the inside of my right heel. It's not causing me any pain so far, and my short midweek runs don't seem to bother it, but it expands its surface area a little bit with each long run. I'm concerned that it could cause trouble if it gets much bigger. Will have to look around for some good blister protection.

Discouraged

Well, I've been remiss both in blogging about running and in running itself. When I attempted 8 miles last week on perhaps the most humid warm day I have ever experienced, it did not go well. Within about 1 mile I was pretty sure there was no way I could even come close to finishing. I ended up truncating the route to 6 miles, of which I walked about half. It was just about the least fun run I've ever had, and the first time I have ever tanked so spectacularly on a long run.

I was discouraged after that and not feeling great physically, so I just didn't run for awhile. Also, the weather stayed warm and humid, and it didn't seem all that appealing to go out for more punishment under the exact same circumstances. So this morning was the first time I've run since last Thursday. I went 2.5 miles and purposely didn't wear my watch so that I wouldn't be tempted to push myself at all -- slow and steady was my goal. It felt OK, although not exactly easy.

Technically tomorrow should be an 8-miler, but I'm instead going to do another short run tomorrow and then 8 on Saturday. I just think that diving straight into a long run after a very sedentary week would be setting myself up for another terrible time. Doing another short run first will help me rebuild my confidence a little, which is much needed right now.

7 miles

I made it 7 miles! Gratifyingly, this run was much easier than last week's 6-mile run. I don't know if that's because my training is having an effect or simply because my confidence is growing, but it sure was nice.

The run took me 1 hour 18 minutes, and it was a perfect day for a run -- sunny, cool, and breezy. It actually felt fairly easy for the first half or so. On the way back, my legs were starting to get tired, and by the last couple miles I was working hard. But I managed to fall into that rhythm of "tired-but-methodical plodding along" that can take me very far. Sometime during the fifth mile, I saw a billboard with characters from the Disney movie The Jungle Book, and for the rest of the run, I was silently chanting to myself the mantra of the elephants' dawn patrol: "hup two three four, keep-it-up two three four..." This was a surprisingly effective way to keep a steady pace!

Now I am really looking forward to a rest day tomorrow. :-)

Consistent

Today I did the exact same route as yesterday, and my time -- 26 minutes -- was exactly the same as yesterday too, down to the second. Wow! I may not be very fast, but I sure am consistent.

Tomorrow is my long run of the week: 7 miles. I'm a little nervous about whether I'll be able to make it the whole way, but the runs yesterday and today felt good enough that I'm also a little excited.

Gorgeous day

I did a 2.5-mile run this morning and it was my best run in ages: cool, sunny, and blessedly non-humid outside. Took me 26 minutes.

Catching up

I've been falling down on the job of writing about my runs, but there have been some positive developments in the last week-and-change.

As planned, I did attempt a 5-mile run in my regular running shoes two Saturdays ago. I managed to run for 4 of the 5 miles, which I felt OK about. It was not the most fun run ever -- my feet felt big and clunky and heavy in the shoes, and weren't particularly comfortable. I wasn't able to retain much of my technique from the minimalist shoes, because the high-stability heels on those shoes make it almost impossible not to come down on the heel with each step. I was very tired and sore after that run.

So, in a last-ditch effort to find some comfortable way of running while I still have time to train for the marathon, I went to Running Fit in downtown Ann Arbor and got yet another pair of shoes. My goal was to get running shoes that are light, not bulky in the heels, yet provide enough cushioning to allow me to run without hurting my feet -- essentially, to try to get the best features of each of my current pairs of shoes in a single pair. I ended up with a pair of Asics trainers that are super lightweight and comfortable and allow me a lot of flexibility in adjusting my stride (meaning, hopefully, that they would allow me to run in a way that doesn't exacerbate my ankle injury). As I left the store, I remarked to Andrew that I sure hoped they would turn out to be worth the hundred bucks.

That was last Sunday, and then I tried a 2-miler on Tuesday before attempting my weekly "long" 6-mile run on Thursday. (I've decided to switch my long run day from Saturdays to Thursdays, since I don't work on Thursdays and that way it doesn't interrupt my weekend sleeping-in schedule.) Things felt pretty good on Tuesday, although still somewhat sore from the Saturday run. The important thing was that my ankle wasn't hurting. So, on Thursday, I embarked on the long one. Wow, it was hard! I am really out of shape. I was huffing and puffing and my legs were exhausted after just a couple of miles. But, I was determined to make it the whole way, and I did. Afterward I felt a little discouraged because it had been so hard; 6 miles used to be nothing for me. But I kept reminding myself that I was unable to run for three months, I'm carrying around about an extra 10 pounds due to all that sedentary time, and I'm trying to build up mileage relatively quickly, so it should be hard!

I did another 2-mile run yesterday and was amazed to find that I was in no pain at all when I started running. I realized that I've actually conditioned myself to flinch when I take my first few steps because I'm expecting pain! Yesterday there was no pain though, and I actually felt sort of like a runner again. That was pretty cool.

So it's looking good. Now if this terrible humidity would just settle down, I could start really enjoying this. :-)

Back to the regular shoes, maybe

This morning I set out for a short run in the crazy barefoot shoes, not really looking forward to it. Sure enough, my feet were hurting within the first few steps, and I started to admit to myself that it is very unlikely that I will be able to run the marathon in these shoes. I have no doubt that it's possible to build up to that kind of mileage in these or other barefoot-style shoes, but at least in my case, it would take longer than I have before the marathon -- maybe years.

So, after one painful mile, I came back home, changed into my regular running shoes, and went back out for another mile. As Peter Sagal wrote of returning to regular shoes after trying out the crazy barefoot shoes, "It's like my toes have moved back in with their parents." They felt roomy and comforting. That second mile was vastly more pleasant than the first.

Maybe if I run in the regular shoes but focus on keeping some of the technique I've gained from the crazy shoes (particular the idea of the midfoot/forefoot strike rather than the heel strike), I'll be able to run more comfortably without exacerbating my injury. It's worth a try, because I'm supposed to run 5 miles this Saturday and I don't think I could do it in the crazy shoes.

Unfun run

Yesterday, I was scheduled to run 3 miles, but I only made it 2. I think this was the first time I've ever failed to complete my "long" weekend run (and 3 miles hardly seems long). But it was possibly the most disgusting weather day I have ever personally encountered (excessively warm and humid, the kind of day where you're drenched 30 seconds after stepping outside) and my feet were hurting as soon as I started running. I just don't know how to run when there is sweat-mixed-with-condensation dripping down your forehead and into your eyes and soaking even your most moisture-wicking exercise clothing (too much information, sorry), and your feet are telling you "STOP!" as soon as you start. So I decided to do the same route I did last Saturday instead of the extended route I had planned.

I don't know what to do about my hurting feet. They don't hurt when I'm not running, and in that sense it seems like a "better" pain than the pain I was having from my ankle injury, which would last all day, even when I wasn't on my feet (and which, incidentally, has mostly gone away since I started running again in the crazy shoes). I guess that makes it seem related to fatigue rather than injury. But, I only did one midweek run last week and still it seems it wasn't enough for my feet to have recovered for the Saturday run. This worries me because it seems like it could easily keep me from being able to build up mileage in the way that I will need to if I'm going to run the marathon.

2 more miles

Today nothing was hurting, so I did another 2-mile run. As soon as I started running, lots of things were hurting, but it all loosened up after about a mile. I definitely experience more soreness at the beginning of my runs in the crazy barefoot shoes than I have ever experienced in regular running shoes, and I don't know whether that's something I should worry about. But it does seem to go away after I've been running for a bit. Today I did not have any metatarsal pain during the run, which was nice.

I've noticed that when my Achilles tendon feels tight during the day, holding a heating pad on it for 5-10 minutes and then stretching it helps a whole lot. I'm thinking I should try doing that before a run, because my Achilles is one of the things that reliably hurts the most when I start running. Maybe getting it nice and warm and loose before I start would help.

Neighborhood walk

When I woke up this morning, my right knee was hurting for unknown reasons. So, instead of stressing it by running, I decided to go for a nice walk. I ended up finding a really charming little residential neighborhood very near to where we live, characterized by adorable houses and lush, tree-lined streets. Fortunately, I had brought my camera along, so I was able to photograph the surroundings! This is what it mostly looked like, which is just astonishingly beautiful to me after 4 years of living in the desert among cacti and sand:


I saw lots of bird feeders, but only one squirrel feeder. This lucky squirrel has a corm:

Apparently, rogue golfers are a big problem around here:

(Apparently they not only discourage golfing here in Ypsilanti, they also don't believe in the Oxford comma. [disapproving frown])

Finally, most of the yards around here seem to be landscaped, and this results in some beautiful (though probably non-indigenous) flowers!


For whatever it's worth, my knee hurt a lot more right after the walk, and then sometime in the middle of the afternoon, abruptly stopped hurting at all. Seriously, knee? Make up your mind.

2 miles

Yesterday I did another 10-minute run, and then this morning I did 2 miles as planned. It was devilishly humid outside both days -- truly disgusting weather to run in. The 2-miler took me just over 25 minutes including a couple minutes of rest in between miles 1 and 2, meaning that I was running at an 11-to-12-minute mile pace. I had expected to be a little slower than that.

When I started out this morning, my left foot was hurting quite noticeably (but not my left ankle! huzzah!). I don't know much (anything, really) about foot physiology, but the pain was in the section of my foot that contains the metatarsal bones. My best guess is that the particular ways in which the feet bear stress when running in the crazy shoes (which are much different than the ways in which the feet are stressed when running in regular shoes), combined with the fact that my left foot and ankle are weaker than normal due to the injury, are to blame for the pain, which I hope was just fatigue. It didn't get any worse, and maybe got very slightly better, over the course of the run. My right foot had a little bit of similar soreness, but not nearly as bad.

One thing I noticed had to do with running technique. I recently read somewhere, though I can't remember where (maybe Barefoot Ted's website? but maybe not there) that when running barefoot-style, you should not be pushing off with your toes; instead, think of each step's impact as simply tapping the forefoot against the ground. A couple of times during the run today, I remembered to remind myself of that and whenever I did, the foot pain was a little less. I'm not sure what minor adjustment that thought was causing me to make to my posture, but whatever it was, it seemed to help.

Time now for a day or two of rest with lots of stretching and ice. I bet my lower calves are going to be pretty sore tomorrow!

Tentative training schedule

OK, I've created a tentative schedule for my training runs for the October marathon. This is of course assuming that my ankle doesn't cause me big problems when I start getting into distances of a few miles or longer. If that happens, I probably won't be able to run the marathon. But I'm planning for the best!

I'm not bothering to make a schedule for my short mid-week runs, because I learned last summer that I won't follow one. Also, I don't know yet what my work schedule is going to look like, and that will influence how many mid-week runs I'm willing to do; if I have to be at work early enough that running in the morning means running in the dark, I just won't do as many runs. Running in the dark while clutching my little mace sprayer is not one of my favorite things and is tough to drag myself out of bed for.

So this is just for the long weekend runs. I'm thinking I'll do them on Saturdays like last summer, although since I'm not running with a team this year, I could always switch to Sunday if need be. I'm hoping to work up to 22 miles as my longest training run, which is 2 miles more than the longest training run last year with TNT. I don't know if that will turn out to be feasible, especially since I'm starting with such low mileage due to the injury. But if I can do it, I think I will thank myself for it on race day. 6.2 miles between the longest training run and the race length felt like a very large gap last year.

6/5/: 2 miles
6/12: 3 miles
6/19: 5 miles
6/26: 6 miles
7/3: 7 miles
7/10: 8 miles
7/17: 8 miles
7/24: 10 miles
7/31: 11 miles
8/7: 12 miles
8/14: 12 miles
8/21: 14 miles
8/28: 16 miles
9/4: 17 miles
9/11: 19 miles
9/18: 14 miles
9/25: 22 miles
10/2: 12 miles
10/9: 8 miles
10/16: rest, because tomorrow is race day!

So, 2 miles this Saturday, which will be about twice what I did today and I think will feel challenging.

Double time

My 5-minute runs have become pretty comfortable, so today I upped my time to 10 minutes. Felt fine. There was some Achilles tightness again, but it didn't get any worse over the course of the run, so it didn't feel like I was doing myself any damage. My legs were pretty tired by the end of the 10 minutes! It was also really humid outside so I was pouring sweat -- lovely.

So far, so good with the crazy shoes. On my to-do list for today is to outline a training schedule that I'll be able to follow for the next few months, assuming of course that things continue to go okay with the shoes and my ankle. I want to make sure that while taking it slowly I also am building up enough to be in decent shape for the marathon in October.

Running partner

Andrew went running with me today! This is not only unprecedented but also highly unlikely ever to have happened, especially without coercion from me. But yesterday, in an apparent fit of madness, Andrew asked if he could come running with me. It was great to have him along! It was such a beautiful morning that I wished we could have stayed out longer than 5 minutes. But my ankle had been hurting some yesterday, and I didn't want to overdo it. When we first started out today I was having a little ankle pain, but I think it must have just been muscle tightness because it subsided quickly instead of getting worse. That's a good thing!

Andrew did great on his first run and I hope he decides to accompany me on more of them as I slowly build my stamina back up!

Third "barefoot" run

I did another 5 minutes in the Vibrams this morning. My muscles were still kind of sore from the last two runs, but not terribly so and they loosened up with a little movement. I considered adding a sixth minute, but decided that I shouldn't try to push it at all until 5 minutes feels easy. It's tempting to add time because it feels ridiculous to go through all the prep for a run when the prep takes longer than the run itself. (It takes almost 5 minutes just to get the crazy shoes on.) But I know I need to be very careful here or I will likely injure myself.

Good kind of sore

Wow, my legs are really sore today! From two five-minute runs! But it's the good kind of sore. And hey, I only have to increase my stamina about 60-fold in order to get through a marathon...

Second "barefoot" run

When I woke up this morning, I was surprised to find that I had some muscle fatigue in my ankles and lower calves from yesterday's 5-minute run. Fatigue from a 5-minute run?! It was the good kind of fatigue, though -- the kind you get after you've done a challenging run with a non-injured body. I'm really just that out-of-shape, and my body isn't used to the crazy non-shoes. So, since I didn't seem to be having any injury-related pain, I decided to do another 5-minute run today in the Vibrams. The run felt just fine. It does seem odd to go for such a short run; I have to remind myself that it's worth it to spend more time getting ready for the run than actually running. I have not had any ankle pain today, which is great. Tomorrow will be a recovery day.

The good, the bad, and the experimental

The good: I made it to Michigan, along with cat, car, and fiance! The trip was mercifully uneventful and provided a nice rest for my ankle, since there's not much walking around to be done when one is spending 8-to-12-hour days in the car.

The bad: In spite of the rest, the physical therapy exercises, and the boot, my ankle is not really better. Granted, I haven't been able to stay off it as much as I should due to moving, but it really isn't better at all. I can't keep wearing the boot indefinitely, because the boot has become progressively more uncomfortable; there are a couple places where it has to be cinched pretty tightly in order to fit right, and as a result those places have developed chronic bruises that just hurt when the boot is on.

The experimental: I have these crazy "shoes" called Vibram Five Fingers that are supposed to simulate barefootedness while providing a little protection from anything sharp that one might happen to step on. There's been some research evidence recently suggesting that barefoot running is more natural to the human physique than running in high-tech super-supported running shoes (duh) and -- more interestingly -- that it might be associated with a lower injury rate, since running shoes put an unnatural amount of impact onto the heel of the foot. The experience of running in the Vibrams is completely different from running in running shoes; instead of landing on your heel with each step, for example, you land on your forefoot. Yesterday, I thought, "Well heck, maybe I should try going for a little run in the barefoot shoes." I figured that it would at least put a little less stress on my heel and ankle than if I went for a run in my regular shoes. So, this morning I ran for 5 minutes in the Vibrams -- my first run in over 2 months. It felt weird, but good. It didn't hurt my injured side any more than my non-injured side. Now I'm thinking that perhaps these shoes will allow me to start very gradually running again without worsening my ankle problem; in the best of worlds, maybe they would also facilitate the healing of the injury by getting blood flowing the tendon areas without stressing them too much. Maybe not. But if I'm not too sore tomorrow, I'll try doing another 5-minute run in them.

Reboot

Well, it seems I've progressed backward over the last week in terms of ankle healing, so today the physical therapist took me off exercise for the weekend and told me to pretty much completely stay off my ankle if possible for the weekend. If I absolutely have to walk... it's back to the boot. Argh!

She explained a little more about how I got injured, which was useful. When I was training for and running the marathon, there was a lot of wear-and-tear on my ankle tendons (which is normal when you're doing that kind of thing). But after the marathon, when I became sedentary, the tendons weren't getting enough blood to heal properly. Tendons don't have a great blood supply of their own, so they only get access to a good amount of blood if you're moving the surrounding areas (i.e., exercising), which I was not. So, since I wasn't moving, the tendons weren't getting much blood, and they would have needed blood in order to heal. What this means is that in order for them to heal now, they need movement that isn't stressful because that will bring blood to the area. The physical therapist told me that she actually wants me moving my ankle a lot (toe pointing, etc.) but not putting weight on it because it isn't strong enough to handle that yet. That made sense and clarified what I should be trying to do right now.

In the throes of moving

I haven't been at the computer much over the last week because I've been busy selling my furniture, packing boxes, and preparing to move across the country!

Last Friday I had another physical therapy appointment. I'd been doing well and not having pain. The physical therapist had me do about 10 minutes on the recumbent bike and told me I can start doing that in addition to swimming. She also gave me another set of strength training exercises to do (essentially one-legged squats). And, she told me to wean off the boot over the weekend, so that by Monday I'd be completely done with it!

When I woke up on Saturday morning, my ankle was hurting a little. I'm not sure why, since I hadn't started ditching the boot yet. Maybe it was the biking, or maybe I had just spent too much time on my feet the day before. It has kept hurting on and off since then. I haven't done any more biking, just to be safe. I really hope the soreness goes away soon! I had been doing so well and been basically pain-free for awhile until Saturday.

Slow progress is still progress

So I've now been swimming two days in a row, and today the physical therapist started me on some strengthening exercises for my ankle. I was able to do the exercises without pain, which is a really good sign! My left ankle is definitely a lot weaker than my right one, but she told me not to mistake the fatigue that comes with exercising it for the pain that would be happening if the injury were flaring up. I'm supposed to do 3 sets of 10 reps, once or twice a day, and keep on stretching and swimming. She also showed me how I can heat up my ankle with a heating pad before stretching in order to help with the Achilles tightness, which hasn't been going away.

I asked her how long she thinks it will be until I can start running. She estimated three weeks, adding that in about another week I could probably start running in the pool. Running in the pool will start to get my body used to running again without placing too much stress on the ankle.

Bonus: if all goes well this weekend, I can ditch the boot on Monday. This is especially nice because Tucson is starting to get HOT and the boot doesn't breathe at all. I am optimistic!

Swimming

I just got back from a swim, and wow, it felt great! Partly it was nice just to be moving my body, since I've had to be pretty sedentary lately, and partly the swimming itself was just really enjoyable. I did 20 minutes of gentle back-and-forth laps, not even putting my head under the water because I was wearing my contacts. It definitely worked out my muscles a little (especially my weak little arms) but wasn't terribly taxing. Now I feel extremely relaxed and fabulous. I can totally imagine continuing to do this even after I'm able to run again. In fact, I'm tempted to go back tonight for another swim, not for the exercise (don't want to overdo it) but just for the nice feeling of being in the water. Yay!

Boot update 3, and swimming fail

I have gotten really good at walking around in the boot. I figured out the other day that if I strap a rolled-up pair of socks into the area of the boot where my ankle bends, the whole thing fits a lot better and my heel doesn't slide up and down. Since that epiphany, I've been able to walk almost normally in the boot without much of a limp. It's still pretty hard getting in and out of my car, but if that's the biggest remaining challenge, I think I'm doing well. My ankle has been aching a lot today, though, and I'm not sure what to make of that.

I've been hard at work all weekend on revisions to a manuscript that I submitted for publication, so I didn't have the opportunity to go swimming (my physical therapy homework to be completed by Wednesday) until this afternoon. I was all set to make a visit to the rec center pool today, late afternoon-ish, when Tucson decided to have a minor hurricane starting at about 3:00pm. Wisely, I think, I decided not to go swimming after all. I will try again tomorrow or Tuesday, weather permitting.

Improvement, maybe

When I woke up this morning and took a few steps, my ankle felt normal (as in, the same as the other ankle) for the first time in quite a while. That seems good, or, even if it's a fluke, at least non-bad.

I've been diligently wearing the boot, doing my stretches, and eating my anti-inflammatory diet. Yesterday I had another dexamethasone treatment with the physical therapist, and my homework is to go swimming two or three times before my next session on Wednesday. The idea is to get my ankle moving in a very non-stressful way. She said that next week, if it's feeling a little better, she'll start having me do some gentle weight-training exercises to strengthen the ankle.

My goal this weekend is to stay off it as much as possible and ice ice ice.

First PT

I had my first physical therapy appointment this afternoon. My ankle had been aching noticeably all morning, so I was really hoping that the appointment would result in my being in less, not more, pain. The physical therapist, Rita, seemed very competent and friendly, and like the docs, she was confident that this wouldn't take very long to heal. She emphasized that it would be important for me to do some cross-training over the next few weeks, something like swimming that would get my ankle moving a little without being hard on it. She said that this will strengthen the damaged tendons without damaging them more, and that needs to happen a little before I can start running again.

She did some diagnostic things and concluded that my tendonitis seems to be both a classic case and highly localized -- both good things. The flexibility of my injured ankle is only a little bit compromised, and the only thing I really couldn't do was stand tiptoe on it. Then she put an anti-inflammatory (dexamethasone) skin patch on the sore part of my ankle for about 15 minutes, had me do some stretches, and iced. My ankle felt good afterward and didn't start aching again for another few hours.

My homework is to do the stretches she showed me twice a day, keep icing in the mornings and evenings when I don't have the boot on, and keep taking a couple daily doses of ibuprofen. If I'm doing better (or at least not worse) on Friday when I have my next appointment, then she'll have me start the cross-training over the weekend. I'm glad everyone seems to think that I will be able to run again soon! I am following to the letter every instruction I've been given.

Boot update 2

I haven't actually weighed the boot, but if I had to estimate, I'd guess it weighs about as much as my cat, which is to say twelve pounds. So I am walking around with the equivalent of a cat on my leg. No wonder I've been so exhausted the last couple of nights.

Boot update

As of this morning, the unsecured internet connection I use at my house, which I previously could only get by placing my laptop on the floor next to the sliding glass door, seems to work from my desk. This is very convenient timing, since sitting on the floor with the boot is not really possible.

Booted

I was lucky enough to score a sports medicine appointment first thing this morning. After an awesome team of three doctors examined my ankle and asked me a zillion questions, they concluded that I probably have tendonitis (not bursitis). Still, it should have gotten better with the month I just spent resting and icing, and since it didn't, they felt more aggressive treatment was warranted. I explained that I'm about to start training for another marathon and that I'm moving away in three weeks, so it would be really nice if they could fix my ankle quickly please. The head doc said that he was confident that I could be pain-free within three weeks. That was great to hear! They decided to put me in a big boot, the kind you wear for a broken foot, for a couple of weeks and get me some physical therapy too. By immobilizing my ankle, the boot should allow the inflammation to go down. If I'm not pain-free within 1.5-2 weeks, they'll look at giving me a cortisone shot or something similar into the inflamed area to directly target the inflammation. They don't do cortisone as a first-line treatment because apparently there's some evidence that it can slightly increase the risk for tendon rupture.

I feel pretty good about this plan of action. The boot is a little tricky. It's very large (comes almost up to my knee) and heavy and I can only walk very slowly in it. Also, the sole of the boot is pretty thick, so I need to wear a shoe on my right foot that has a little elevation or else I'm uncomfortably lopsided. But I can deal with it for a couple of weeks, no problem, if it allows me to start running again! I don't think I will try to sleep in it, though.

I have my first physical therapy appointment on Wednesday; no idea what to expect. The docs also recommended that until the ankle is completely out of the woods, I adopt a sort of anti-inflammatory diet -- basically, don't eat sugar or things that my body will quickly convert into sugar or drink alcohol. They pretty much said that doing this might possibly help the inflammation go away more quickly, and in any case it certainly can't hurt me. I don't know if there's any evidence that a diet like this actually helps combat inflammation, but I see no reason not to try if there's even a chance it could have me up and running again sooner.

I'm back!

You didn't think you could get rid of me that easily, did you?

It has come to pass that I am going to run another marathon, and also that I am unable to run at the moment. Yes, this is about as contradictory as it sounds. After taking about three months off from running post-marathon, I started running again at the end of January and quickly developed an ankle problem. My left ankle would start hurting after about a half-mile of running -- not horrible pain, but enough that it wasn't fun to run. When it didn't go away on its own, I finally went to the sports medicine clinic at Campus Health Services on March 22. Three doctors examined my ankle and finally concluded that I probably had bursitis -- that is, inflammation of the bursa, which is the fluid-filled sac that provides a cushion between the Achilles tendon and the ankle bone. They explained that it's a self-perpetuating problem: the bursa gets a little bit inflamed from sudden overuse, causing it to get in its own way, causing more inflammation, etc. Their prescription: rest, ice, no stairs, should be better in a couple of weeks. I took them very seriously, and for the last month have followed their instructions obsessively, plus avoided sandals and taken two daily doses of ibuprofen to combat inflammation. Yesterday I got on a treadmill for the first time in a month to see how it's doing. The verdict: not well. It felt about the same as it felt a month ago. What a bummer! Tomorrow I'll call the sports medicine doc for another appointment to see what else they can do for me.

In the meantime, however, the idea of doing another marathon has started to sound good over the last couple of months. So, I entered the lottery to get into this year's Nike Women's Marathon, which is the same marathon I did last year. In order to get into this marathon without Team In Training, you have to be selected through a random lottery system, which they use for fairness because it's such a popular event. I found out on Friday that I got in! This is very exciting, because the marathon last year was such a great experience.

So, here's hoping that within a month, my ankle will be better and I can start training. My plan is to blog about my training like I did last year, because it was a great motivator and a fun way to keep track of what I'd done.