With just days to go in 2011, I recently took stock of my training for the month of December. What a blank-ing JOKE. A collection of half-mile, or one mile runs. ("All I ran was ONE ******* MILE?")
After ignoring pain signs through mid-November -- and, arguably, ignoring my calves and heels altogether since last spring -- I became "officially injured" on November 24th. Since then -- over 5 weeks -- I've run a total of 30 miles -- most of which ran the gamut between "tight" or "sore" and bonafide pain in the left calf/heel.
I've been stuck in a cycle of "It hurts, it feels a little better, let's run a little*, it hurts...", from which I've yet to emerge. As a runner, coach and physical therapist, it's downright embarrassing. Here's where I've gone -- sometimes right, sometimes wrongly.
(*a little = as little as four minutes, a maximum of 18 minutes. Never longer than 7 minutes consecutive, over the past month)
My treatment approach has been thus:
1. Do Nothing. Irritated muscles get overly-irritated by excessive stretching, strengthening, massaging and attempts at running. So do nothing! Well, this did not work. I had a severely dysfunctional muscle -- so bound up by thousands of miles of running since last spring that my lower leg was one big grisley chunk of tissue, not a smooth supple muscle-tendon. Every attempt to run on this clunker resulted in a straining on the same weak segment that gave way to begin with.
2. Tissue Remodeling. My boss Jeff began to intervene around 12/8 -- pointing out that I had to remodel that healing, dysfunctional tissue. According to the Tissue Healing Model, all tissues heal with fresh collagen fibers that grow irregularly -- into a jumbled mass, rather than organized fibers. It's up to ME to "re-organize them" -- via stretching, massage, and occasional "challenges" to the tissue -- strengthenen, hopping/light plyometrics, and yes, running.
So that's what I did: three terrific professional massages that clearly pointed out how incredibly dysfunctional BOTH calves were, along with a regular regimen of stretching and hopping.
The problem: BALANCE. Some days -- more often than not -- I over-did it. Soreness crept into a session (usually running), then persisted. And with soreness came favoring -- or BABYING, as I'll call it: me -- either consciously or unconsciously favoring the left leg in EVERYTHING -- standing, walking, and most definitely running.
Which brings me to the third progression in the treatment:
3. SYMMETRY. I met on Christmas Eve with my boss at work (for our under-the-table "coaching for treatment" scheme!) so he could work with me. What he found: egregious favoring of my left leg, with walking, squatting, heel raises, and hopping. Ridiculous!
Our focus NOW is on equal firing of the left leg. And here's why that's important: A poorly-activated muscle is a weak muscle.
Muscles are NOT all-or-nothing. Their degree of strength depends on the number of "motor units" activated. A motor unit represents one nerve fiber that innervates a collection of muscle cells, or a "bundle" -- of which there are hundreds if not thousands per muscle). This is a requirement of life -- otherwise our physical response could not vary. Ever lift a very light object that you thought was heavy (with any ensuing comedy?).
For something as "challenging" to tissue as running -- the constant hyper-loading -> storing -> and releasing of energy that goes into every stride -- you have to have FULL motor recruitment -- or ALL the motor units being activated (to some extent) in your legs. This is doubly important if you're dealing with a muscle-tendon unit that lacks full strength and resilience.
A weak muscle-tendon needs 100% full power, otherwise the pounding forces with excessively strain, resulting in more injury. BUT, if one is tentative, guarding, or "babying", you're telling your brain to DE-ACTIVATE, thus giving LESS power. The muscle-tendon is now weakened further!
And round and round we go: A weak muscle -> an injured muscle -> a favored muscle -> a poorly activated muscle -> a weak muscle...
The answer: Go Hard, or don't go at all. You either make that leap with 100% confidence -- and with it, full muscle-activation, without fear of pain -- or you'll land flat on your face.
And that's where I find myself, for the time being.