Injury Update

I have now seen 3 separate medical types about this injury. The good thing is that I know what is wrong. The bad thing is the injury is unlikely to clear up before the IM race in Holland. Basically, my Anterior Tibialis is damaged. It seems that this was caused by my poor ankle stability, which was agravated by the increase in my long training runs.

My ankle stability on my right leg is good. This is due to the 2 years of eccentric loading that I have completed to keep my Achilles Tendon injury at bay! My left side (current injury leg) ankle stability is woefully bad and inflexible. This was very visible when doing some body mechanic tests.

The message here is that what we could get away with when we were younger, we cannot now! As we get older (I am 47 in 2 weeks)we need to segregate training time for body mechanics maintenance - core stability, leg and foot strengthening. I had foot problems at the beginning of the year so I obviously have a weakness in that area.

I read this Blog Post, which is quite specific on the type of body mechanics sustainment training that should be completed as routine training (thanks to the Re: Massage Therapy Blog)

5 ways to prevent Tibialis Anterior pain…
Tendinitis, muscle soreness, compartment syndromes, shin splints and stress fractures are things that haunt most runners and can keep you on the sidelines for weeks and months at a time . But it does not have to be like that! Research shows exactly how the muscles in the ankle and lower part of the leg function during running, and provides clues about how to keep the areas between your knees and your feet injury free. This post is about your poor tibialis anterior muscles, the ones that work hardest during running. Strengthen them by carrying out the following five exercises:

Stand about a foot away from a wall with your back to it and your feet directly below your hips. Lean backward until your buttocks and back touch the wall and then, while keeping your heels on the ground, flex your ankles so that your toes rise as high as possible towards your shins. Let your feet sink back so that they almost touch the ground, and repeat this action 15-20 times (the reps increase over time). On the descent, do not let your feet actually rest on the ground, which would give your tibialis anterior muscles too much of a rest between flexion’s. Treat the ground as if it was an eggshell, too much pressure would crack it
After a moment’s rest, try a slightly different tibialis-anterior exercise. This time, from the same basic body position, flex your ankles so that your toes ascend as high as possible, but do not let them move more than an inch towards the floor on the downswing. Quickly move your feet up and down within this one-inch arc for 15-20 repetitions (adding more reps later), and then rest for a moment
Once you’ve become adept at the first two exercises over a period of several weeks, you can move on to an advanced exercise. For this, keep your back and buttocks against the wall again but stand on only one foot at a time while carrying out No. 1 above. Position the foot slightly to the inside of the hip
You can also work on the anterior tibialis muscles while jumping. Again, try for quickness rather than height as you jump, but this time “dorsiflex” your ankles each time your feet leave the ground (i.e. try to pull your toes up to your shins on each ascent). 20 jumps should be about right for your first effort, with the total increasing over time
A fifth exercise is to walk on your heels for 20 metres or so. This heel walking can follow the walking, skipping and jogging routine described above.
Overall, these five exercises have helped many athletes afflicted with shin splints. Another strategy, designed to simultaneously strengthen all five calf and shin muscles, is to run barefoot on a somewhat uneven but soft grassy surface, such as a well-maintained athletic field or a golf fairway. Start cautiously, though, with no more than a half-mile on your first barefoot effort, adding an extra quarter mile during every third subsequent run. The ultimate aim of these exercises is to fortify your feet, ankles, shins and calves so that injuries are unlikely. However, injury prevention won’t be the only outcome. As you progress, your ankles become as powerful as rocket boosters and your feet will act as mini-trampolines. (Or so they say!!)

Currently I cannot do these rehab exercises because I still have pain - doh. The physio I saw on Monday said as much also - no point in rehab as any routine will just break down the muscle etc to build back stronger. So any rehab stress will still be in the injury when I race.

So, basically, there are 2 options: withdraw from the race or dose up with pain killers and deal with the rehab over the winter. As I will miss the entire Tri season next year due to a military detachment, I will attempt the race and use how ever long it takes to rehab to return in 2013 fresh and faster. . . . . cough! Then, in 2014 it is into the 50 -54 age group! So that is the long term goal: rip up the 50 - 54 age group. How scary is that! Age 50!!!! Where is my zimmer. . . . . .