Rehab to Ultra - Part 3

Myoset

Final part of this journey of rehab to running my first ultra.

This is Part 3 and looks at my journey through January to March 25th 2023.

In January I had my rehab exercises updated and included the following:

I continued to use the gym to cross and strenght train and then either did the rehab exercises at home or in the gym. 

 My training plans were uploaded to Training Peaks app weekly by my coach and I stuck to the plans as much as possible. I added comments after every run to the session via app and I received weekly feedback via training peaks and whatsapp.

An example of my sessions in the app

At every physio appointment we discussed how and if I could make the start line of Lea Valley 50km. This was all I could think about and although it wouldn't be the end of the world if I couldn't run it, I would be absolutely gutted. 

 

Qasim then mentioned about a steroid injection offered by Injection Therapy. If I was interested, he would highly recommend this place as it is a  specialised ultrasound guided injection.

I researched like mad about what it is, side effects, lasting effects and everything else you can think of. I then made contact with Munir, practise owner and completed an online form and booked an appointment.

On the 26th January I attended my appointment. I thought the first appointment we would just talk but there was lots more to it. I completed more medical forms, Munir asked me lots of questions about what had happened, any ongoing treatments etc. He then started the ultrasound of both knees for comparison and he talked me through what he could see.

After the diagnosis, I was given an ultrasound guided cortisone injection for pain relief. I was asked not to run for at least 3 days but I should be good to go after this!

I was absolutely petrified as I hate needles! 😪😪 It took alot for me to do this and I just couldn't mentally move forward knowing that it may take years of rehab for me to run 100% pain free. I couldn't bare the thought of this. Running has been my outlet for many years and even more so since losing my mum in October 2021. 

What got me through this was thinking about how my running will progress if the pain reduced and I could just concentrate on rehab and my training.  

This is a photo 12 hours after the injection. You can see the left knee/quad is heavily swollen.

First night after the injection, I could not sleep and had to take pain killers. I had the worst possible night ever! I cried internally!! It takes a whole lot for me to take pain killers. I have to usually be in tears, otherwise I usually just ride out the pain or ache. The next day the pain was all gone! And that was that! Day after day, week after week, I just kept waiting for something bad to happen or the knee pain to return... but it didnt. 

I tested the knee on a very short run on the 4th day. I was actually quite scared to run. Have you every been scared to use something because of a strong fear of it going so wrong? I was petrified to run! Every possibility of things going wrong went through my mind! I walked, then walked some more and then more.  Eventually after 15 minutes of walking, I attempted the run, and guess what it was OK. It did not hurt but I just kept waiting for something to happen.

I felt scared at the start of every run for about 3 weeks. Eventually I just forgot all about it. 🙏🏿

Progressively I felt stronger, continued doing my long runs, home and gym workouts, squats, training felt magical and I started to look forward to running the 50KM.

Continued with my rehab exercises and also added skipping to my sessions which is something I couldn't do before due to the impact. 

Whoever wrote this and left it on the mirror in the gym, could obviously see into the future! 🙏🏿

I started taking this in January and have not missed a day. For many years I have purchased vitamins with good intentions and just was not consistent.  I am so happy that I have been taking these everyday as I definitely feel that they have contributed to keeping my joints stronger.  I sometimes forget that as we get older we need to be more mindful of these things.  

Throughout February and March, I continued to follow my training plan and things progressed really well even the long runs. 

Plenty of nutritious food! This is one of my favourite breakfast - pancake wih blueberries and strawberry 

So this was it. The big day.

 

The biggest smile for making the start line

- 

25th March 2023 means so much. But it was a process. One that was bigger than me. I am so grateful for the amazing support I had around me and also proud of myself for not giving up and being patient. Being injured and the recovery process is extremely difficult and you have to bear in mind that it is not just the physical aspects that you need to repair.

Although I had the injection and the pain is not there, this is only a temporary fix. I must continue to strenght train to keep my knees strong. Failure to do this will send me back to where we was last year and I definitely do not want that. 

With these injections,  you can have a maximum of 3 a year but I do not want ANYMORE! I would prefer to follow my physios advice, eat well and take the multivitamins I need to look after the joints and cartilage. 

The Mental Side Of Coping With Injury

1. Ask for support - Reach out to friends and other runners about the challenges you’re experiencing. Most will empathise with you and might be able to lend advice on some strategies.

2. Invest in yourself - Seeing a private physio can be expensive but I 100% believe in getting a diagnosis of what is actually going on. As much as we can receive great advice from other runners, it is always best to seek medical advice if it is an on going injury.

3. Find gratitude - Seek gratitude in the things that you can do. A lot of times we focus on the things that we can't.  Believe you me, it makes a huge difference.  You may also encounter and try new things that you will enjoy too.

4. Celebrate - Slow progress is still progress and it is still worthy of a celebration. 

I loved reading this post Maryke Low wrote where she explains the five stages of dealing with an injury.

How to mentally deal with an injury

I would love to thank:

- My friends, family and running community for their continued support

- My physios

- Camino Ultra coaches

- Pretty Athletics for their amazing products which I used throughout my training esp the muscle oil.

I hope you have enjoyed reading my journey to running my first 50km. It has been a journey of learning. I can hand on heart say that I have learned alot about myself and I feel emotionally,  mentally and physically stronger. I will never take for granted the importance of strenght training ever again! 🤪🤣

Always happy to receive any feedback or if you have any questions, do please message me. My inbox is always open. 🙏🏿😊

Rehab to Ultra - Part 2

Hope you enjoyed reading Part 1 of my journey to my first ultra. If you haven't read it,  I would suggest you go back and have a read so that it all makes sense.

This is Part 2 of that journey from September 2022 - December 2022

So I ran The Big Half on 4th September using the run/walk interval of 3/1.

I couldn't have asked for a better race. The method worked really well in the sense of not putting too much pressure on my knee and eleviating fatigue. If you want to find out more about the benefits of interval running, please read my blog post - Does interval running really live up to the hype?

So funny to hear that other people were also using the same device - Gymboss as we could her the ‘beep’ beep’ beep’. At first I thought people were looking at me and was conscious of walking straight after the sound went off so I would wait like 5 or so seconds before stopping but once I started hearing the other ‘beep’ and just started to ignore the others, I just got on and enjoyed the run. 

The next day I booked myself in at Myoset for a Normatec leg recovery session. The leg compression helps to increase circulation, revive muscles, and reduce swelling. It is widely used by elite athletes and consumers throughout the globe. I absolutely love these boots! Wish I could afford them but these sessions are the next best thing. I mean to be fair, I don't have the storage space for them either 😄. 

The compression boots is part of the resources you can access in their recovery lounge. I think the compression boots are affordable:

Taken from Myoset website as of 4/4/23

I soon returned back to rehab work using the exercises as designed by my Physio saved in the app.

 I also continued my sessions in the gym 2-3 times a week. I ran only once or twice a week max on the treadmill. Most weeks it was only once and for only as long at there was no excruciating pain. Please note that there was always some discomfort at the beginning of every run during this time as it took a while for the knee joint to warm up. I always completed warm ups and cool downs too without fail.

1 mile run 

Gym rehab session

Gym rehab session

At my next appointment I spoke to my physio Qasim about running Lea Valley 50km in March and if this was something we could work towards as I had pretty much written off 2022 at this point. I also feel less frustrated if I am working towards a goal.

Qasim was still concerned about the pain in my knee and although we were making some progress, there were days when the pain was constant and I felt like 'would this knee ever get better?' So he wrote me a letter to provide to my GP to request a 2nd MRI scan with the hope in them being more specific with the scan also looking at my tibia.

Thankfully I didn't have to wait too long for an appointment. I received a letter to attend an appointment on 12th September.

Whilst waiting for the results I continued with my rehab and run/walk sessions that I could do. During this period, I removed myself from alot of social runs as I would not be able to keep pace and didn't want to fall out of rhythm with my current set up and risk further injuries.  I either did solo runs, run with 1 or 2 people at a time who were aware of my interval running or a track session where I was in total control.

Exploring the trails - mostly walking with some short bursts of running. Running Vest

Special session with One Track with Steph Twell - track session (run/walk)

Exploring the Greenways with Caro

October London Marathon - loved cheering!

First XC race with Harrow AC. Check out my blog on my reflection on my first season and some tips 

Greenways run courtesy of Camino Ultra. Trails are a perfect mix of running and walking.

Squad race with ON Running at Lee Valley Velo Park with Stronger Together crew

Kendal Mountain Festival in November . 

I had the pleasure of attending the festival with Merrell and then talking on stage with Sabrina and Dan. What an amazing experience to have been invited to do this. Merrell have provided me with some amazing opportunities over the past year and this has to be number 1! 

There were no new finding from the MRI and no injury to my tibia. From this I continued to work with my physio and we progressed with my rehab programme. 

In November I was fortunate enough to be offered to be coached by Camino Ultra by Paula. I jumped for joy and said yes happily! Couldn't have asked for anything more. I mean, being coached by trail and Ultra experts... grateful! 🙏🏿

My plan was personalised and worked around my family life. The sessions were delivered via the Training Peaks app and were a combination of easy runs/easy, Steady, Hard runs, rest days, cross training days and as the weeks progressed long runs were added. 

November consisted of rehab exercises and starting to train for Lea Valley 50km. The start of the training plan was very easy and my coach and I agreed that I would stick to my run/walk intervals of 3/1 which seem to be working well. 

In December as I began to feel stronger I decided to move from a 3/1 to 5/1 run/walk. This felt great and I stuck to this moving forward. It was really important that I ran my easy runs easy (how hard is this?). This is extremely hard! It takes a lot of practise especially as the norm is to naturally speed up as the body gets warmed up and into the running flow. I have to keep an eye on my pace and bring it back at times, which was really important. 

Thank you for taking the time to read Part 2 of my journey to my first ultra. 

Always happy to receive any feedback or if you have any questions, do please message me. My inbox is always open.  🙏🏿😊

Rehab to Ultra- Part 1

Welcome and thank you for checking out my rehab journey to running my first Ultra.

This is Part 1 of that journey from May 2022 - August 2022

My last long run happened on 13th May in Oxford whilst Alice and I were supported to recce (to become familiar with the area) part of the Race to the Stones route which I was planning to run in July 2022. A beautiful run, the weather was glorious. Being out on the trails is what I love the most.  However, the pain in my left knee was too much. I pushed through as much as I could but we called it quits after around 24km. I am surprised I even lasted that long! I probably shouldn't have run that far... hindsight is a wonderful thing 😉

Bugs everywhere! Had a fly stuck up my nose 20 minutes before this. Thought I was going to have a panic attack. So horrid! 

When I got home, I knew I had to get a GP appointment and what I know I needed the most was an MRI to find out exactly what was going on.

Let me take it back a bit. So the initial pain was cause by a fall I had on January 16th 2022 whilst on a social group run in Ruislip Woods with our lovely Black Trail Runners, led by Sonny.

Ruislip Woods social run 

 

I then ran Manchester Marathon in April not feeling 100% but not in any pain as such. Don't get me wrong, I thought with R.I.C.E (Rest, Ice, Compression, Elevation) this would help with my recovery by relieving the pain and any swelling and it would all be better soon. It was actually quite the opposite. 

Here goes the start of my recovery. First thing on my mind was that I definitely was not going to be running 100km in July so I contacted Threshold Sports and asked to defer to 2023. This was the right thing to do. Only thing that annoyed me (more than the injury itself) was that I had to pay £30 late deferral fee after already spending £164.50. £4.50 was administration fee 🙄. I'm saying annoyed but that's putting it mildly. Guess I had no choice but looking at that, you might as well say I paid £200. 

 I receive my MRI report back on 19th May which was delivered initially by a phone call from my GP. I mean getting a call from your GP is not usually good news, right? Well it wasn't good news. My GP read out the findings in the report and ended the call by saying 'let me just be clear,  do not run unless a physio gives you the go ahead '! That was quite scary and felt 'final'.

With that, I made an appointment with Tyler at The Body Therapist in Stratford, East London.  

Tyler demonstrating what could be causing the knee pain

I emailed him the report so he could have a read before hand. Disappointed was an understatement. I met with Tyler and after an examination was given the following:

For 0-5 days:

➡️ Anti-inflammatories prescribed by pharmacist

➡️ Use ibuprofen 10% gel as suggested on the packaging in between oral medication 

➡️ Ice after activity

➡️ Contrast therapy of hot and cold on "non-active days"

➡️ Tubular bandage to wear on active day, but not when exercising and do not wear to sleep.

➡️ Start exercises from home (sent via an app)

For 5-10 days:

➡️ Continue with ibuprofen gel

➡️ Continue with tubular bandage

➡️ Continue with ice after activity

➡️ Continue with contrast therapy

➡️ Try run a 3km, maybe a 5k.

➡️ Exercise at home, in the gym x2 week

➡️ Cross-training at the gym using the bike or stairmaster

I purchased Ibuleve 10% gel which provides max strength pain relief from Amazon.

I purchased Flarin which is a lipid formulation and provide relief from joint pain and inflammation. It was easy on the stomach. I don't like taking pain killers at all let alone for a few days so it was important for me to find something that 'hopefully' was easy on the stomach. 

In terms of the 3km run that Tyler suggested above,  that was a non starter. I ran for about a minute and had to stop. The pain was there almost immediately.  Disappointed but I knew that this was not going to be a quick fix as hopeful as my physio was.

Consequently returned for several physio appointments whilst following the rehab programme and using the gym to cross train. 

The knee rehabilitation exercises included:

Gym Bodyweight Programme

Quads

- Straight leg raise

- Walking lunges (abandoned due to knee pain)

- Step-up  - heel to floor

Hamstring 

- The Diver

- The Glider

- The Extender

Glutes 

- Cross-over step-up 

- Glute Bridge single leg

- Double/single leg glute bridge

Calves

- Single leg calf raises

- Single leg calf raise with knee bent

Gym Programme

Calves

- Double leg calf raises

- Single leg calf raises 

- Double leg press calf raises

- Single leg press calf raises 

Core

- Twist slam ball 3-9kg

- Dead bug

Hamstrings

- Hamstring curl machine

- Kettle bell swings

- Dead lift

Quads/glutes

- Hip thruster - barbell on hips

- Seated knee extension machine single leg

- Bulgarian split squat

- Single leg press 

- Double leg, leg press

I joined the gym for the first time in about 10 years. Years back I was guilty of joining and attending for a few weeks and then continuing to pay my membership and not attending. I joined my local Pure Gym which was less than 10 minutes walk from home and opened 24 hours a day which was perfect meaning I could go early in the morning before work. The benefit of flexible working! 

Taking the anti- inflammatory (Flarin) was amazing as the pain totally disappeared.  I used to feel every single step when walking up stairs or even bending down to sit. All gone! Felt magical, but after stopping this after a few days, the pain returned.  I knew I couldn't keep on taking pain killers, nor would I want to so I really needed to work with my physio for recovery. 

Due to where the swelling and pain was located (under my knee to the right), my physio believed I also had Pes Anserinus Bursitis. My diagnosis from the MRI is chrondomalacia. To me and you it is also known as runners knee which is when there is a damaged cartilage behind the patella (knee cap). There isn't just one cause and can also be wear and tear. 

I continued these exercises at home and the gym including some cross training on the bike. I was plesantly surprised how well I got on with the exercises and using the gym. As I got stronger through the rehab, I was given permission to start  couch to 5k at the end of July. This had to be the best way as I am so much better when I follow a structured plan. I followed this for 3 weeks and then purchased a gymboss which you can use to set interval times for an activity. 

In June,  I volunteered at the Lea Valley 50km that I was suppose to be running. This would have been my first ultra and part of the training run for Race to the Stones. Also love cheering on others, so it was a beautiful experience with the Camino Ultra family. A great day seeing Alice and all the other finishers smashing out an ultra! So inspirational 🙌🏿 

At the end of June, I had a feeling that I needed more support from my Physio and things just didn't feel quite right so I did some research and came across Myoset. I booked an initial appointment, took along my MRI scan and had a detailed appointment and explained what has been happening over the last few months. Instantly from the assessment it just felt right and a rehab package was put together. Acupuncture was included in the follow up sessions too. This is not my first time having acupuncture but that doesn't make it easier as I don't like needles. I absolutely know the benefits of having it so it just made sense.

I preservered with this new rehabilitation programme and started attending spinning classes at my gym. Absolutely loved this! Omg! It was basically a night club on a bike. The instructor was awesome and I got my friend Gosia to attend weekly with me.

When we weren't at spinning class, I was coaching Gosia as she was training for  London Marathon.  This was a great distraction and I loved it. Always brings me joy helping others.

Gosia at one of our coaching sessions in Victoria Park

Throughout July and August, I did 2 runs a week and continued with my rehab exercises at home and in the gym.  I used the gymboss and set the intervals for 3 minutes running and 1 minute walking. 

I had booked to run The Big Half on 4th September 2022 and was contemplating if I should run it or not. I spoke to my physio and he suggested that I did interval run/walk/run and see how that goes. So from this, I formally started to use 3/1 in my training runs. I made sure to only do shorts runs as I know I can run a half marathon before so this was not a concern. My main focus was not making this injury worse.

With training going well I decided that I would run the race using 3/1 run/walk method also known as jeffing. My friend Ray wanted to join me and this was going to be a new experience for us both. 

Thank you for taking the time to read Part 1 of my journey to my first ultra. 

Always happy to receive any feedback or if you have any questions, do please message me. My inbox is always open.

See you soon for Part 2 😊