Sunday, November 29, 2009

Ignoring the Check Engine Light

I remember when it happened...4 months ago in July during a race that I had trained months for. The El Scorcho 25K midnight race in Fort Worth. I had never run 15 miles before and the race had a reputation for a fast pace and very hot weather (yes, even at mid-night...you folks here in Texas know exactly what I am talking about) so I had trained hard and was ready. In the process, I had changed over to a new type of shoe to help correct a problem called illio-tibial band syndrome that was affecting my left hip and knee. The change seemed to work well and I came into that night feeling strong and ready to go the distance. Well, I went the distance but did it at a price. The change in shoes drastically changed my running gait and as I got further into the night, my ankles and calves got progressively more fatigued. And then, out of the darkness came a rut in the running path that I failed to see in the light of my headlamp. In normal circumstances (daylight and better supported feet) it would have only caused a slight shuffle that I would have thought nothing more of. However, my fatigued right ankle rolled slightly and I stumbled...almost fell on my face...recovered...and then kept on running. At first I felt nothing but, as the miles kept piling up the ankle started hurting. Finally, I was forced to walk most of the last mile due to the pain.

As you can imagine, it hurt quite a bit the next day or two and I did what I was knew I was supposed to...RICE...Rest, Ice, Compression and Elevation. Additionally, I treated it with Cold Laser, Kinesiotape, and FAST Patches from Wei Labs. It is what I recommend to my patients and, of course, it worked. I began to feel better. Within 4 days or so I was walking normally and feeling pain only if I really pushed the ankle.

AND HERE IS WHERE I MESSED UP!

I had 2 triathlons and a half-marathon on the calendar between then and mid-October and I didn't want to stop training. So, I went back to it. I kept the ankle taped but slacked off on the laser and the patches. I also didn't do any significant physical therapy for the ankle. And while it complained a bit when I ran longer miles, my ankle held up through the rest of the summer. In retrospect, my saving grace was probably that I was training in 3 different sports and thus, the cycling and swimming kept me from pounding it in those poorly supported shoes too many times per week.

Well, fast forward to the "off season"...now. Off season really just means no scheduled races right now. It is too cold to swim and cycling requires a lot of clothing to fight the cooler temps. It is easier just to head out the door and run....a good time to start training for a marathon. That is exactly what the plan was...right up until this last week! And BAM! My right ankle pain came back hard. In the back of my mind I knew it would. As my running miles have started increasing over the last month, my ankle has gotten gotten crankier...and progressively earlier into each session. So it wasn't a surprise really when, last week right before Thanksgiving, I had to cut a tempo run short and walk home due to ankle pain. Now, I am forced to take time off of running to treat the ankle properly (I have no choice...it hurts even when I walk now) when I really can't afford to. My goal is to run the Cowtown Marathon in Fort Worth in February (my first full Marathon ever...26.2 miles) and I am on the 3rd week of a 16 week training program. Each week builds on the next so, taking a couple of weeks off to treat my ankle will likely blow my chances of being trained properly for my February marathon.

A consultation with a podiatrist friend of mine has confirmed that I need to go back to RICE, kinesiotape, cold laser therapy and FAST patches (luckily I know a great clinic where I can get all of that done...I hear the chiropractor there is pretty good). But now it will likely require additional physical therapy and some time trying to find the right, supportive running shoe to take care of my condition...posterior tibialis tendinitis. My friend tells me I am lucky I didn't rupture the tendon as happens to many runners that "push through" this type of problem. He has strongly cautioned me against a fast return because doing so will likely cause greater injury and only further my time out of the sport I so love...or even force my retirement from running entirely!!

So, I will be the good patient and do as I am told...rest it, heal it, rehab it and then properly support it as I slowly return to action. Although, I can't help but be angry at myself for all of this...if I had just taken a couple of weeks or so when this first started back in July to PROPERLY treat it, I certainly wouldn't be facing the weeks of time off and rehab work that I have to do now. And look at the consequences...I will likely miss the race that I have had my goals set on for over a year now. Because I didn't take care of the ankle when it was a LITTLE ISSUE...

Well, let me tell you...I see this scenario play out everyday in my office with my own patients! A neck injury occurs or low back pain develops out of the blue but it is manageable...so they treat it a little (a few adjustments, some ice, some Advil) and the pain goes away. And then, despite my repeated warnings, so do they. Off to tackle all that the world has to offer...Too busy to do any thing more for their nagging little issue at the time. However, later when they return to my office once the little nagging issue has ballooned into a problem they can no longer handle, they lament, "I should have taken care of it earlier". It is then that they realize a small amount of time spent doing ALL the right things...for the right amount of time would have prevented the spinal problem from progressing, degenerating and becoming debilitating. Now they are faced with a tremendous amount of chiropractic care and physical therapy costing them much more time and money than it would have initially. And, in some cases, they let it go beyond the point that I can help them.

See, we forget that God made our body as this wonderfully adaptable machine that, if demanded to, will work around and/or ignore small problems (such as injuries, spinal misalignments, illness) for a while. Thus we can continue to occupy ourselves with whatever it is that we are focused on at the time...work, kids, school, vacation, etc. BUT, in order for the body to do this, it must compensate...use joints and muscles inappropriately, bend differently, use more or less energy than usual, rest less, etc, etc. As with any machine that is used in ways it isn't designed for, these compensations eventually cause the body to break down resulting in pain...amongst many other things.

My point to all of this...hopefully it is clear by now. Don't ignore the small aches and pains. If left untreated, they will usually lead to bigger issues that require more time, energy...and yes, money to take care of. Be proactive! Go to the chiropractor early and often to live a long, healthy, break down free live.

I will leave you with a thought that I give to all of my patients: treat the aches and pains that your body throws at you just like the red warning lights that show up on the dashboard of your car...with immediate attention. You know what will happen to your car if you ignore the "check engine" light right? Well, don't let the same happen to your body...pain is a warning sign...pay attention!

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