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GTN Patches, the Toe, Holiday Racing, and Colin Thomas

Saturday, July 30th, 2016

I’ve almost given up.

On running, that is.

Not really, actually, but it would seem the sensible option.

I’ve had more stalled comebacks than George Best and the Beatles put together.

Quick recap before I stop moaning and go on to topics all runners can relate to.

Recap

I’ve been injured for more than a year-and-a-half now.

I have a chronic left Achilles injury caused by something wrong with my left glute, in turn caused by the way I run (or perhaps my running style has had to adapt to my weak left glute).

There’ve been other injuries too after each failed comeback, the highlight being a three-month right Achilles injury that cleared up in April 2016.

I’ve covered this all in previous posts. But even for a bloke once as obsessed with running as I was, it’s no surprise that even my running blogging has tailed off in recent months (I last posted in early March).

I’d just had an MRI see. Something I’d been shooting for for the past 13 months. Surely this would show me what was wrong with my Achilles once and for all.

So here’s an update on the past five months of my running life.

MRI Results

Sadly the MRI results only told me what I knew already: I have a chronic left Achilles injury.

For anyone unfamiliar with the Achilles tendon, here’s all you need to know.

It is a complete ***** of an injury.

And one you have a chronic one, there’s no easy way back.

I’ve tried everything. And written about it at length.

My best advice, with hindsight, if you get Achilles pain, go to a physio and catch it before it goes chronic.

Colin Thomas

It’s early April 2016 now, I’ve got rid of my right Achilles problem but my left Achilles (even after three months of non-running, more physio, Pilates, sports massage) is still not right.

So –  and I can’t remember how this came about – I met Colin Thomas.

I knew he’d had a long-standing Achilles issue, he’d been a physio, and was a good runner. Added to which he’d just set up in business as a performance running coach.

Colin had also sorted me out with a physio when he worked at BUPA, who basically told me “stop running now”. This was in June 2015 when I’d been blithely trotting along on a dodgy left Achilles for six months (not that I regret that as it was during that period I got my half mara and marathon PBs at Liverpool and London respectively).

And like the harbinger of doom he’s become in my running life, he had similar news for me this time.

Dave, you need to change the way you run if you want to be running for the rest of your life. Sure, you might meet your running goals doing what you’re doing, but you won’t be running in a year’s time.

Now the thing is I don’t listen to many people. But he made sense.

We met monthly April to June. He gave me some good advice.

One thing each time I could really focus on. Here they are:

  • Do 15 eccentric heel drops eight times a day. On a step or on the floor. Don’t raise up with the damaged Achilles. And expect some pain at first. And keep going at them. Don’t give up after a few days like most people. It’s the one thing that works.
  • Don’t run faster than eight-minute-miling for the next three months. Don’t run over 40 miles a week.
  • Focus on drills. Every one mile of your run, do a drill.
  • Do a range of left glute-strengthening exercises, daily.
  • Run more off-road.

This advice was given after a lot of listening to what I’d done to try and get the injury better. He also stuck me on a running machine, analysed my gait, videoed it, and fed back. These were the findings:

achilles chronic colin thomas

No wonder it’s chronic.

  • My left foot plant is a nightmare. The leg goes in at a relatively severe angle but the Achilles is straight.
  • I lean forward too much meaning my glutes and core aren’t firing.
  • My left hip drops down (due to weak left glute area) and my left leg whips round, a bit limp almost.

DS overstride-minDS hip 1-min

So, What Have I Done? Did I Follow Colin’s Advice?

Well, mostly, yes:

  • The eccentric heel drops have helped massively. It’s still chronic but not red. And it’s not as painful. Sometimes I don’t do them but on the whole I’ve tried to stick to this regime and will be doing for the rest of my running life.
  • The three-months-running-slowly thing? Yes, this was good. It allowed me to focus on my form and would have had me going into my marathon training block with a decent enough base. Although I was cursing him at times during this period, it certainly helped, and I do feel my form has improved.
  • The drills: again, good advice. I actually took this one step further and had a word with Bernie Campbell, my coach at Giffnock North. He arranged for me to join Ryan’s training group at track on Tuesdays. So, until my recent toe injury, every Tuesday saw me training with athletes half my age (and that’s being charitable to my age). And I have to say their drills (sprint drills) are fantastic.
  • And the glute strengthening exercises. These are a work in progress. It took a few months to really identify that the cause of my running malaise is the weak left glute; not the Achilles (which is the symptom). Glute exercises are hard work, time intensive, and as yet, despite sticking to them rigidly for the last three weeks, have had minimal impact. My left glute is still naggingly painful 24:7. This is not good, and worrying.
  • I’ve switched from 90 per cent of my mileage on road to 90 per cent on trail. This has not only increased my interest in running but been much kinder on my body.

There’s no magic wand for me to get back running and it’s hard to assess the effect of specific actions when you’re making a few changes at once.

But Colin’s advice has been rock solid, actionable, and based on a thorough analysis of the problem.

I’d highly recommend him to any competitive runner. His blog is good too.

The Adriano Calcagno Memorial Race

What Colin didn’t recommend was stubbing my toe on a coffee table in rural Italy, trail-running on it for the next 14 days (including a race), then going to Minor Injuries at the Viccy to be told I’d fractured it.

The most beautiful trail running I've ever done. Almost worth the fractured toe.

The most beautiful trail running I’ve ever done. Almost worth the fractured toe.

Mustering for the club race in the hills north of Genoa.

Mustering for the club race in the hills north of Genoa.

Adriano Calcagno

The race itself: free pasta and a bottle of wine for all participants.

This was three weeks ago.

And I haven’t run since.

This is not at all pleasing.

Having spent three months of running at a speed I wasn’t used to, but nevertheless building up to 40 miles a week and getting my bpm down to “actually I’m feeling pretty fit again” the last thing I wanted to do was fracture my toe with 13 weeks to go until the Berlin Marathon.

Then make it worse by running on it for two weeks.

Then be laid up for three.

There was only one thing for it…

Give UP?

Nope.

Join a gym.

Monday morning I was in the Viccy getting the bad news from the nurse. Monday night I was at Eastwood Leisure Centre paddling away on a cross-trainer.

It had been 15 years since I’d seen the inside of a cardio gym.

This, in my running-focussed eyes, was a new nadir. Had it come to this:O).

But I was determined this time NOT to down tools until the injury healed and keep a level of fitness so that when I returned to running in two weeks’ time, I wouldn’t be starting from scratch again.

So six times a week for the past three weeks I’ve done some cross-training, rowing, and assorted glute and Achilles exercises while reading a book.

And What’s Next?

I don’t know.

My toe’s still red. I can feel it’s not right.

Aya.

Aya.

I have four weeks until the Glasgow Clyde Marathon and eight weeks until my target autumn marathon: Berlin. Even if I had a base, eight weeks would be the minimum amount if high-effort training I could do to get anywhere near my marathon target time.

So I’ll definitely do Berlin. It’ll be more of a break and, if I can get this toe better in the next two weeks, and I’m able to get a few weeks’ training in, I’ll target sub-3 and not bother with the usual fat-loading, caffeine-fasting and absence of alcohol.

Not sure about Glasgow Clyde but it’s looking very unlikely other than as some sort of masochistic fun run.

I’m going to keep my gym membership (there’s just too much of the year when I can’t run at the moment and running isn’t everything).

I’ll continue with the glute and Achilles exercises (for general fitness as well as running).

And refocus (running-wise) on London next year, for which I still have a use-it-or-lose-it-this-year champs place.

Oh, and I’ll keep in touch with Colin. Starting with this Tuesday’s event. And excuse the plug but this guy’s well worth listening to, and the other speakers look good too. A must for anyone into marathoning on the south side of Glasgow.

Codicil

I forgot to mention the GTN patches. I haven’t tried these yet. It’s an off-licence (they are usually used to treat angina) medicine.

The idea is the patch attacks the Achilles, hurts it a bit but not too much, causing blood to rush to the affected area (that’s the problem with Achilles and healing, there’s no bloody blood circulating down there).

The blood promotes healing. I’ve heard good things, and after 12 months’ navigating the NHS I’ve finally got them on prescription. But due to the relative success of Colin’s eccentric heel drops, I’ve as yet not applied them to the injury.

If anyone reading this post has any experience of treating Achilles Tendonitis with GTN patches, I’d be keen to get your advice.