Tag Archives: injuries

Iontophoresis for runners: What P. Diddy and I have in common

After P. Diddy finished the New York City Marathon in 2003, he credited iontophoresis, or the use of a small electrical current to The iontophoresis patch transmits anti-inflammatory medicine to the site of my ankle sprain last year. transmit an anti-inflammatory medicine, with curbing his knee pain enough to let him complete the race.

I was unaware of P. Diddy’s experience before my doctor suggested ionto, as it’s commonly called, for my IT band two years ago, the first time I received this nifty, noninvasive treatment. I’m receiving it again now for peroneal tendonitis and/or an inflamed posterior tibialis (or, to keep it simple, a cranky ankle), and I’m optimistic it’ll get me over the why-does-it-still-hurt hump.

Here’s how the treatment works: A physical therapist fastens a patch with anti-inflammatory ointment to the spot on my ankle that hurts. Then, she attaches a tiny device that administers a low electrical charge for just a few minutes – since I use the self-contained patch, there’s no need to keep it hooked up to the device for long (another version of ionto uses a large machine to transmit the charge, and takes about 15 minutes). I feel a slight twinge — not pain, exactly, but a little sensation that lets me know something’s going on. I leave the patch on for two hours to let the medicine do its thing. Repeat, essentially, every other day for two weeks.

I like that this is noninvasive and basically risk-free. I like that I’m receiving the treatment on my ankle — since the muscles and tendons are closer to the surface there, my chances of it working are greater. I like that I may have the boniest ankles in the history of ankles for the same reason.

Finally, I like that it’s only one way I’m looking to attack the problem. I’m also doing several prehab exercises given to me by the therapist I worked with yesterday, an enthusiastic woman named Toni. Toni told me she embarked on a prehab program to strengthen her own ankles after multiple ankle sprains clued her in to possible weakness.

She gave me a TheraBand, and showed me how to use by pointing and flexing my foot in all four directions: plantar flexion, like pressing on the gas pedal in your car; dorsiflexion, pulling back in the opposite direction; and inversion and eversion, or pulling the resistance band from side-to-side.With the ionto and the exercises, it can only be a matter of time before my ankles are in good working order again!

Thanks to everyone who commented on my post about managing a runner’s stomach. My next experiment, thanks to your thoughtful and interesting suggestions (other ideas still welcome!), will be oatmeal and a banana. Which sounds pretty delicious, even without the run.

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When should you run again after an injury?

For a month now, I’ve been gloomily telling people I’m laying low, with no

I ran my first "long" run to prep for the Marine Corps Marathon this morning. But I'm keeping my goals flexible.

I ran my first “long” run to prep for the Marine Corps Marathon this morning. But I’m keeping my goals flexible.

long runs or speedwork, until August. This is per my doctor’s suggestions to let my sore IT band heal after a flareup in May.

“August?” asked one of my running buddies the other night. “Like, next week?”

Apparently, time flies when you’re running three times a week, no more than 6 miles per run, and stretching and doing core work like your life depends on it!

So last night, for the first time since my awesome running doc and I formulated a plan that would let me at least try to still run the Marine Corps Marathon on Oct. 25 this year, I pulled out my FIRST training plan to confirm that this is do-able. Long story short: It is. And though it’s not technically August for another two days, it’s time to test the theory.

So this morning, when I headed out for a rare early trail run, I was already thinking: Is this the day I’ll try my first “long” run, an 8-miler that aims to test my not-so-sore-anymore hip?

This was basically a microcosm of the bigger questions I’m dealing with: How will I know if I can run the marathon without sidelining myself for months again? And, writ even larger, when is it OK to run again after an injury?

My friend Kaveh, who’s also signed up for the Marine Corps Marathon, is dealing with the same dilemmas. He skipped his long run on Saturday because, as he describes it, “my shin was killing me with every walking step.”

He asked my opinion about how you know when you’re ready to train again: “Specifically, when you’re training for a marathon and every run seems crucial.”

This is so hard, and so personal, and depends on each individual’s body and goals.

As I learned by watching people literally limp over the finish line with the help of kind, possibly crazy volunteers at the Nashville Country Music Marathon in 2007, it’s certainly possible to run a marathon with a pretty terrible injury. If you’re cool with the risk of a stress fracture or worse leaving you unable to run at ALL for months following the marathon, then push on.

I’m not going to be that person. Kaveh and I both have the luxury of having finished a marathon before, so we don’t have that to prove to ourselves. As much as I feel a desperate urge to test myself again, proving to myself I can run a marathon quickly, being able to run on regular basis means more to me than any finisher’s medal.

I personally find it vital to have a doctor — one who understands and appreciates my running goals — give me the OK to proceed. But my doctor doesn’t exactly hang around the house, waiting for me to ask his opinion on a daily basis, leaving much of the decision-making up to me.

A couple rules of thumb, from various doctors, physical therapists and, you know, afternoons spent procrastinating on runnersworld.com:

  • Don’t run if you’re limping. Once your form goes, you can injure more than just the site of the pain.
  • Don’t run if it’s a sharp pain (as opposed to a dull ache) that gets worse as you run. This could mean a stress fracture, and if you run on this, it could get exponentially worse.
  • It’s better to be 10 percent undertrained than 1 percent overtrained, i.e., injured. Err on the side of caution, big time.

There may come a time in my training when erring on the side of caution means giving up on the MCM dream for this year (with a new immediate goal of deferring until 2010). But for now, I’m taking it one week at a time, increasing my mileage slowly, listening to my body and being prepared to be flexible.

So this morning, I did one trail loop of about five miles — about a mile each way to get to and from Rock Creek Park, with three miles of actual trails. Then, I really tuned in to how my body felt. My hip felt loose. My form felt strong. I reversed the loop and did it again for a total of about eight miles. First long run, done!

That’s not to say I’m getting cocky. On my way back, I bought a huge bag of ice from the Giant. That’s right — I took an ice bath after an 8-miler, an uncomfortable tactic usually reserved for only the longest runs. I’ll take one after my longest run every week, continue with my plan to build the strongest core this side of Rock Creek … and just continue to see how it goes.


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Resources for injured runners

Rest. Ice. Stretch and foam roll (yeah, I made it a verb. What?). Pop glucosamine tablets. Pop anti-inflammatories. Get a massage.

I’ve tried all of these remedies to soothe my sore hip. I’ve also spent way too much time searching for helpful tidbits online, and I thought I’d share some of the best links here.

This Runner’s World story provides some great tips for getting your head in the right place, and offers real-world experience from Kara Goucher, who says being injured made her realize that she is more than a runner — she is a person who loves to run. If she can wrap her brain around that, certainly, I can, too.

Other take-aways: Almost all runners — some research suggests 70 percent per calendar year — end up with an injury at some point. Almost all runners recover from those injuries. Stay positive. Focus on recovery, using it as an opportunity to strengthen weak muscle groups. And if it helps, hang out with your running buddies off the road.

Other resources I’ve found helpful:

Runner’s World Injury Prevention Guide: This link takes you to the mother of all injury-prevention pages, with links to everything from exercises to strengthen weak muscle groups to a “What Hurts” database that helps diagnose aches and pains.

Running Times guide to injury prevention and recovery. This offers insights from MDs, professional marathoners and others, and explains why things like ice, massage and stretching help.

This Running Times spread about cross-training explains how cross-training can actually make you a faster runner, starting with an anecdote about how Alberto Salazar qualified for the Olympic team after a two-month hiatus from running, relying on swimming as his primary activity following an IT band injury.

This Amby Burfoot blog post about coping with injuries offers some great tips and insights. Says Burfoot: “We all get injured eventually. Like, 100 percent of us … it’s no big deal, since 100 percent of us also recover from our running injuries.”

Playing the Pain Game from active.com

Have a great injury-prevention link? Share it by posting a comment!

Looking for inspiration to cross-train — or just to train? Read about Runner, triathlete and DC Mayor Adrian Fenty who Men’s Fitness has named in its list of the 25 fittest men.  This is no small feat, considering “fittest” includes Rafael Nadal and Tim Tebow.

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A week of cross-training

My plan: A week of cross-training to allow my hip, which has moved from stubbornly sore to possibly injured, time to heal. I hope to swim, bike and row my way through a running-less week, losing none of my running fitness in the process.

Sound like I’m dreaming? Hey, it worked for Alberto Salazar!

The running legend qualified for the Olympic team in the 10,000m in 1980 after taking a two-month hiatus from running, relying on swimming as his primary activity following an IT band injury.

This, according to a great spread about cross-training in this month’s Running Times. The feature also includes some helpful tips for rowing, which I’ve been trying to incorporate based on suggestions from the FIRST training program.If you’re using an “erg,” as the rowing machines at the gym are apparently called, you may want to read the whole RT story.

The takeaway: According to former college rower Kelly Johnson, who’s quoted in the story, proper technique involves making sure you’re isolating your three major rowing muscle groups, and engaging them in the proper order: your leg muscles first, then your back, then your arms. Also, she says most people find a stroke rate of 18 to 26 comfortable.

I also might give cycling another try. I was pretty hard-core about cycling when I first started my hip-injury recovery, going on enough long rides to purchase two pairs of hideous padded bike shorts. Almost as soon as I bought them, biking became painful, too, and if I’m gonna hurt myself, I’m gonna hurt myself doing something worth the pain — i.e., running. But writing a story for Kickstand magazine, a cool mag about cruiser bikes that debuted this month, may have inspired me to give low-key, easy cycling a try.

My story was about Robin Little, owner of Bikes and Bites, a cruiser-bike rental company, who says: “We’re not doing this as an ‘Oh my God, how are we going to make a living’ venture,” Little said. “We just want to see how a two-wheel cruiser bike can contribute to the betterment of our city. When you’re motivated by passion and fun, it’s always easier to wake up in morning, no?”

And, of course, swimming. Here’s what I’m hoping the next several days look like:

Today: Swim 3,000 yards, lift (only exercises from my old physical-therapy routine for legs)

Friday: Swim 3,000 yards

Saturday: Lift, swim 4,500 yards (last long-ish swim before the Bay Bridge Swim!)

Sunday: See if Steve will take a long bike ride with me, or row 30 minutes

Monday: Swim 3,000 yards

Tuesday: Try running again. If my hip still feels as bad as it does now, it’s time to see the doctor again.

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Review: Massage at Still Point in Takoma Park

I am more than a big, walking hip flexor. stillpoint2

So says Fanny Mandelberger, with whom I’d booked my birthday massage yesterday. She explained this after I asked her to work solely on my hip and ankle during our one-hour session at The Still Point in Takoma Park.

As a human, I know this whole-person approach is the only real way to approach any sore spot. But as a runner, I sort of just wanted someone to rub my sore spots. I was skeptical.

I shouldn’t have been. Mandelberger, with 25 years of experience, can tell based on where you’re tight and knotty what you do for work, whether you’re right- or left-handed and whether you grind your teeth. She’s a master at honing in on the source of pain, which is often not where the massage recipient thinks it is. She spent a large part of my massage working on my lower back, which I hadn’t realized was such a mess.I also hadn’t realized it would lead to a remarkably pain-free hip, which is maybe the best birthday gift I could have received.

Even the atmosphere of Still Point, located in Old Town Takoma Park, lends to healing, starting with the waiting room, a peaceful, curtained nook with Buddha-themed artwork and complimentary tea.

The healing feeling continued even as I was walking out the door, as Mandelberger offered a few quick words of advice about posture, teeth-grinding and creating calming space in my mind before darting off to her next lucky customer.

Rates at Still Point are reasonable: 30 minutes for $50, 60 minutes for $80, 90 minutes for $115. I don’t know about your household, but that still makes this an occasional treat rather than a regular appointment.

Mandelberger understands this, and recommended a few cheap fixes:

Using a foam roller to work out soreness in tight iliotibial bands. A lot of gyms have these, or you can buy one for about $15 from Sports Authority.

Try miracle Balls: fist-sized balls that help with self-massage for the back. Available at Borders in downtown Silver Spring.

Self-massage with Muscle Massage Balm from Big Dipper Wax Works. The menthol and camphor will soothe sore muscles. The essential oils make it smell more like a cup of chai and less like a hospital, unlike other muscle rubs (ahem, BenGay). Seven bucks will get you a small vat of it, and it’s sold at Still Point.

How do you get your massage fix? Do you have a favorite massage therapist in the area, or a favorite self-massage technique? Let me know by posting a comment.

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Cortisone shots a fix for my swollen ankle?

I’m trying not to stare at my ankle.

This morning, my doctor gave me a cortisone shot to try to quell the swelling and pain that’s been nagging my ankle since I twisted running it in Rock Creek Park back in December. He told me it would take two weeks to work. Still, I keep looking down, expecting it to have transformed somehow, like a green, knobby, growling Hulk hand for feet.

Nothing  momentous has happened yet. And when it does, it will likely (hopefully) be in the form of the swelling slowly going down rather than my foot swelling up and turning green. But a Hulk foot would be SO cool, huh?

The only bad news: no running until the weekend (Dr. Pereles, a marathon-runner himself, winced when he told me, and asked: “Can you do that, do you think?”). I wasn’t planning on tapering before the 10-mile Broad Street Run on Sunday, but I guess I am now, which could be a good thing.

I’m also disappointed I’ll miss two Pacers fun runs, as I missed last week’s runs while I was in Florida. I’m especially bummed to miss tonight’s route — an awesome-looking trail run through Rock Creek Park. Yes, I see the irony here.

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Drugs to take

Got your attention, didn’t I?

Runner’s World uses this tag line when recommending supplements and other (legal!) drugs for runners, and it always makes me giggle. Or maybe it’s pills to pop. Either way, I use it today as a way to let you know that if your doctor offers you a Medrol Dose Pack for a running injury, you should accept. Then, you should hug her, because this stuff REALLY works to knock down inflammation from a sports injury.

It’s a six-day course of corticosteroids that has you take six pills the first day, five the second, and so on. A sports orthopaedist prescribed it for me last week for my creepily swollen ankle , which stems from a clumsy move in Rock Creek Park last December and has continued to bother me off and on since.

I’d searched some message boards for testimony from other runners about Medrol, and found a few who reported improvements after four days. I hadn’t seen any improvement at all after three days, so I was skeptical.

Yesterday, after a tough 7-mile hill run through northern Silver Spring, I checked out my ankle, and was shocked to see that it looks like an ankle again. I can’t say the swelling’s all gone, but it’s pretty darn close.

So seriously: Medrol Dose Pack. If you’re struggling with a running injury that involves inflammation, ask your doctor about it today (cue cheerful music, cheesy actors running through a sunny park without pain).

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