Archive for the ‘Injury’ Category

Patience on the road to recovery

November 9, 2008

In a comment on my most recent blog Jason suggested that my current goal should not be described as ‘speeding recovery’ but ‘ensuring proper recovery’. His choice of words implies the importance of the crucial but daunting virtue of patience.

Mostly I have been patient, but every so often I am tempted to test the limits. It is now a little over three weeks since I suffered a minor tear of my calf muscle. The injury was almost certainly a consequence of increasing intensity of training too quickly. I had introduced some interval training after a period of base building. The first two sessions went well, but then in the third session, in which I planned 6x1km at my estimated 5K pace, I pushed myself a little faster the target pace that I had set myself and had suffered a tear of soleus on the 4th repetition.

After icing for two days and a further day of rest, I had very gradually introduced light exercise, starting with body-weight calf raises while bearing weight equally on two legs; then moving onto calf raises while standing on one leg and gradually building up the number. Apart from a mild setback when I suffered nocturnal cramp after getting dehydrated during a very long flight from Shanghai to London, things progressed well. After two and a half weeks, I had progressed to 3×20 ‘one leg’ calf raises with no trace of discomfort. I then re-introduced running technique sessions that involved running with very short strides covering only a few metres at a time, concentrating on technique. The calf felt good and I was itching to increase the distance a bit. So today, as it was now over three weeks since the injury, I set out to jog a few Km in the local woods.

The day had dawned with a blue sky and brilliant sunlight on the autumn leaves. The dark clouds started to roll in as I set out from home, but it was still an inspiring morning to be out and about. After jogging about 2 Km there was no trace of discomfort in the calf, so I decided to increase pace a little up to what I would estimate is my current marathon pace – around 5 minutes per Km. After a Km, I slowed to a jog for another Km, and as my calf still felt fine, I increased pace up to estimated marathon pace again. However this was a mistake – as I negotiated a boggy patch of woodland I felt a slight but ominous jab in the calf – a few inches about the site of the initial injury but in the vicinity of the site which had been most painful following the ferocious nocturnal cramp I had suffered two weeks ago. I stopped immediately and walked home. Fortunately I had decided to stick to the one Km loop path near to home so I only had to walk a short distance. Now, a few hours later, there is a definite persisting pain at the site damaged by the nocturnal cramp. So my calf is still very vulnerable and I need to remind myself that patience continues to be the prime virtue.

How can I speed the recovery of my calf muscle?

November 1, 2008

As far as I can see, after a few days of RICE, the best way to recover from a muscle injury is to engage the injured muscle in light exercise to ensure that the healing process lays down fibrous tissue predominantly along the direction of muscle contraction, rather than producing a higgledy-piggledy tangle of fibrous tissue, which might require subsequent pruning to allow efficient muscle contraction. The challenge is adjusting the level of exercise so as to promote the desired formation of aligned fibrous tissue without repeatedly tearing the muscle at its point of weakness.

I have not run since tearing my right soleus muscle two weeks ago. Most days I have done either a core strength workout (various forms of crunch, press-ups, dips etc) or light leg strengthening exercises. In the past, in my occasional leg strengthening sessions I have focussed mainly on body-weight exercises while standing on one leg (squats, calf-raises, hip swings etc) but since injuring my right soleus I have mainly done the corresponding exercises while standing on both legs, wherever possible. This places only a light load on the injured leg. Until a few days ago, things appeared to be going well.

At the beginning of this week, I traveled to Shanghai for a meeting. The return flight to London on Wednesday involved one hour of sitting in my seat before take-off, and then twelve and a half hours in the air, followed by a train journey back to Nottingham. Despite drinking only two small glasses of red wine and fairly large amounts of water and orange juice during the flight, I think I became quite dehydrated during the journey.

In the early hours of Thursday morning I awoke with excruciating cramp in my right calf, and a less severe cramp in the left peroneus longus – the muscle that runs down the side of the lower leg. Attempts to massage the cramp away were futile – the mild degree of stretching of muscle fibres during massage only encouraged an even fiercer cramping, so there was nothing I could do except passively planar flex my ankle to lower the tension in the calf and hopefully minimise tearing of muscle fibres, while waiting for the contraction to subside spontaneously. The next morning I had quite noticeable pain in my right calf – mainly in gastrocnemius, but also some discomfort in soleus. Three days later the discomfort persists, so I am not sure when I will get back to running again.