A Tough Three Months

Three months.  This is the longest time I’ve ever had without being able to do any form of exercise whatsoever, let alone run.  My body is used to physical endurance, but this has been a real test of mental endurance.  As with any injury, it’s the body that is physically hurt, but the mind that really suffers.

Those twelve weeks have taken me through the five stages of injury grief - denial, anger, bargaining, depression and acceptance - although not necessarily in order and with no clear-cut ‘moving on’ from one stage to the next.  You may be thinking “it’s only an injury; there are plenty of people worse off” and yes, there are.  I’ve tried to reason with myself, to look at it rationally, but running is my life, my world and is what I know and love.  I can only equate my feelings to myself, not to others whose lives I don’t know.  Running is part of who I am as a person; it gives me purpose and a sense of self-worth.  No, it’s not the be-all-and-end-all, but it is a huge part of my existence.

My first reaction to this latest injury was disbelief – how could I possibly have yet another stress reaction (a precursor to a full blown stress fracture), my third in two years?  I’d followed all the advice after the previous two episodes; it surely couldn’t have happened again?  This denial stage didn’t last long as an MRI scan revealed that, yes, I did indeed have “osseous oedema of the right ischial tuberosity” and “tendinopathic change of the right hamstrings at its origin” (a literal ‘pain in the bum’ in layman’s terms!).  Although a small part of me questioned whether the scan was right, in reality I knew I couldn’t dispute it, so my emotions turned to anger and frustration. 

I had desperately wanted to run for England in the Anglo-Celtic Plate / British Champs. 100km in Perth, Scotland at the end of March.  Despite winning medals at international level I’ve never won a UK Championship medal and I really wanted to put this right at long last.  To be denied this opportunity yet again was a bitter pill to swallow.  What had I done to be deprived of the chance of a UK medal once more?  How dare my body be injured without my permission!  I also sensed an overwhelming frustration about the amount of time I felt I was wasting with not being able to train or race.  Life is so short and I want to be able to make the most of it.  I feel there are so many opportunities out there and that I have so much more to achieve along with my coach, Les, and I just want the chance to try before it’s too late.  I know how much my running means to Les, too, and I am angry that my body is preventing us from doing the things we want to while we still have time together.  There was anger and frustration, too, about the fitness I’d worked hard to build up but was now losing.  All the effort I’d put in before the injury - the long runs, the track sessions, the tempo runs, the gym sessions – all that was now in vain as I would have to start all over again from scratch.

These feelings of anger and frustration took hold in my mind and mingled with feelings of despair, despondency and hopelessness.  The tears flowed.  I felt I had yet again lost the world I knew and loved, and questioned whether I would ever get back there.  Little things like weight gain all added to my low emotional state.  I have never been as heavy as I am now; never before has doing up my jeans or work skirts been an issue!  And being deprived of all forms of physical exercise also affected my mood and mental state in other areas of my life.  I had no outlet for relieving the stresses of everyday life; no release of those feel-good endorphins in my brain.  I had all that pent-up energy stored in my body; at times I felt like a coiled spring that just wanted to explode.

Eventually, at some point, I started to accept things.  After all, what other option did I have?  My emotions still went round in circles, like a goldfish swimming round a bowl; a perpetual motion of thoughts and feelings.  Some days I could accept things and just get on with life; other days the feelings of anger and despondency returned, like that proverbial bad penny.  I wasn’t idle with all the spare time I suddenly had on my hands; that’s not in my nature.  I put it to good use doing all those things, however mundane, that I don’t have time for when I’m training.  Several bags of unwanted ‘stuff’ went to the charity shop and the tip!  Three of the twelve weeks were spent with Les in Portugal.  This had been booked long before the injury emerged and should have been our annual warm-weather training trip, in preparation for the 100km in Perth.  It would have been a waste of money to cancel, so we went anyway for a holiday.  Luckily, my level of acceptance of the injury was by this time high enough to allow me to have a fabulous time away.  But let’s face it – who wouldn’t enjoy three weeks in the sunny Algarve in February?!  We definitely made the most of our time away, despite not being able to run, and had a great time pursuing our other interests – photography, birding, eating cake, drinking wine!  We met up with our friend (and former training partner) Kay and her husband Trevor who had recently moved out there.  We even discovered several new places to visit, despite this being our 14^th trip!  I savoured the rare opportunity to have a real holiday; a break from everything, including running.  And I can honestly say that I loved every minute, although my light-hearted comments to Les whenever we saw other athletes out running on the trails - “they don’t know how lucky they are” - were perhaps tinged with a dash of envy!

I had also come to terms with the injury enough to be able to go to the 100km in Perth to watch and support the England team.  Les had been coaching one of the other girls in the England team, Mel, and so we went up to Scotland to act as her support crew.  I tried as best as I could to supress my feelings of sadness at not competing and was actually very relieved not to have to get up at 4.00am to have breakfast before a 7.00am race start!  Getting up at 6.00am on Easter Sunday, as we did, was bad enough!  I woke with similar pre-race nerves to as if I was competing, only this time it was anxiety over whether I would manage to hand Mel her drinks / gloves / sunglasses / gels etc. with no mishap!  Having never experienced being someone’s support crew before it was rather nerve-wracking – the responsibility of not wrecking their race!  In actual fact it was great to experience a race from ‘the other side’ and made me really appreciate everything others do for me when I’m racing.  I valued the opportunity to be able to ‘give something back’ and to be able to help others.  I’m so glad I went; I really enjoyed the day and the 8 hours plus went much quicker than I expected them to.  I managed to keep my emotions in check until the very end.  Mel crossed the finish line as first woman, and British Champion, and I was so thrilled for her, knowing all the hard work she had put it, and for Les too.  My tears welled up in happiness for them both, but also, I have to admit, with some sadness that I had been denied the chance to try myself.  It was a very strange mix of emotions.

So, where am I now?  Well, the twelve weeks have come and gone and I’m now following my physio Mark Buckingham’s advice to the letter in my quest to return to running.  We’re trying to get to the bottom (excuse the pun!) of why these stress reactions keep happening.  Mark referred me to a sports medicine consultant who looked at my bone density, bone metabolism and Vitamin D, none of which were such a significant issue to be the root cause of the injuries.  My Vitamin D level, although well in the ‘normal’ range for the general population, was slightly lower than optimum for an endurance athlete, which should be somewhere between 100 and 200 nmol/L, so I’m currently addressing this.  However, this still hasn’t ascertained why the injury keeps recurring, so we’re also looking at correcting a strength imbalance between my right and left legs, specific hamstring strengthening, lower back mobility and tweaking my gait to reduce the mechanical loading on my hamstrings.  A slightly daunting prospect, but if it gets me running again I’m willing to give it a go.  I have total confidence in Mark’s knowledge and expertise.

At the moment I’ve started some ‘easy’ jogging, which is, in fact, anything but ‘easy’!  I feel as though I’ve never run before in my life – my lungs are burning after even a few minutes of jogging and my legs feel like jelly!  My gait is more of a ploddy shuffle and I couldn’t even keep up with my training group’s warm up jog!  I feel overweight and unfit but, more worryingly, there is still pain.  That’s a huge disappointment.  After resting completely for three months, being patient and doing everything I’d been told, I was really hoping for a pain-free return.  However, a further visit to Mark has revealed that it may not be all doom and gloom.  A stiff sacroiliac joint and tight sacrotuberous ligament, which continues into the hamstring tendon, could be to blame for at least some of my current pain.  One of the first things Mark does each time I see him is to check my pelvic alignment and mobility.  Recently it’s been fine, but I do have a history of a rather fickle pelvis, which often seems to stiffen up of its own free will (apparently this is quite common in females)!  So the plan, under Mark’s and Les’ watchful eyes, is to continue slowly building up the running and hamstring strength work in the gym, to see whether the joint mobilisation has had any effect.  Fingers crossed!

Right now I’m feeling a bit more optimistic, but I still have doubts as to whether I will ever get back to anything remotely resembling the fitness I had previously.  I know I’ve come back from injury before, many times, and often I’ve come back stronger.  But this time feels harder; even more of a struggle than usual.  I’ve had longer than ever off, I’ve not even been able to cross-train to maintain general fitness – no swimming, cycling or anything – I’m heavier than ever and I’m not getting any younger!  It doesn’t bode well!  One of the hardest things about injury is the not knowing.  The uncertainty of how long it will take to heal; knowing whether or not it has healed; how long it will take to regain fitness; whether I’ll ever get back to where I was.  That uncertainty is very real for me right now; but it won’t stop me trying.  Providing my body will just give me a chance.  And anyway, Mizuno have just sent me two pairs of super new shoes which I’m definitely not going to waste!

Coping with setbacks and challenges makes us stronger, or so I’m told.  But does it?  Right now I’m not so sure.  I’ve had to cope with many injuries over the years and yes, I’ve learnt a lot.  I’ve learnt patience, perseverance, determination, dedication, diligence, tolerance, the importance of listening to my body and much more besides.  I sometimes feel I’m a bit of an injury expert with all the experience I’ve had!  I do believe the injuries have made me mentally stronger.  But that doesn’t make a new injury any easier to accept or deal with.  It doesn’t make the frustration any less.  You still have to navigate your way through that myriad of emotions and hope you can find your way out the other side.  But just because I’ve found my way out before doesn’t necessarily mean I will again.  Each new injury fills me with the same doubts.  Each new injury means more dreams in tatters.

Despite all this I am trying to remain positive – I really am.  If nothing else, the enforced lay-off has given me chance to do other things and has saved money on race entries and travel!  (Although this has been more than off-set by the costs of MRI scans, Sports Medicine Consultant and physio fees!)  There have even been times when I’ve been thankful not to have to go out running in the cold, dark, wet winter months!  And it has given me valuable experience of seeing a race from the ‘other’ side.  I’ve also managed to win a medal without even running for three months, so that can’t be bad!  It was a lovely surprise when an envelope containing a Midland Masters bronze medal arrived in the post.  The MMAC have a Virtual Marathon and Half-marathon Championship, which is based on members’ best times anywhere, at any time, throughout the year, which is then age-graded.  My time of 2hrs 59.46 in the 2015 Shakespeare Marathon was good enough for an age-graded performance of 80.04% and the bronze medal!

I’m trying very hard to keep everything in perspective.  There are plenty of good things I do still have in my life; plenty to be thankful for.  This injury is just another one of those challenges that life throws at us, and I have to find a way of dealing with it.  Mark told me in his last email that he will never give up on me!  I know Les has faith in me still.  So as long as others keep believing and have faith in me, then I will keep believing and have faith too.