Tuesday 7 October 2014

Rehabilitation

Returning home after last Tuesday's hill reps I felt a slight twinge in my left calf, a bit like cramp was about to grip my muscles, but it didn't. That evening I had a good session with the foam roller, was well hydrated and had a good nights sleep.

Wednesday morning takes us on our weekly 6am Dawn Patrol run. Again, a slight twinge was felt in the first kilometre but nothing really. We always warm up slowly and I had no reason to worry...until about 15mins into the run when cramp struck! Ouch and double ouch. I do occasionally get cramp so knew to stretch, walk it out and perhaps try running again. I did try, but no way was my calf having it. I was reduced to a limp and hobble back home. Luckily we weren't too far away.

So what happened?
Well, the cramp was so severe that it actually damaged the muscle. Through testing I know which muscle (soleus if you're interested) so know what actions to avoid (plantarflexion, like when you press on the accelerator pedal in your car). So here's what my rehab has been like for the last week:

Wednesday - acute stage of injury - applying the RICE principle, avoiding all movements that induced pain.

Thursday - still acute, applying ice, resting as much as possible. I did have to go to the shops and while walking very cautiously and slowly I felt the same area twinge quite significantly. It again reduced me to a hobble.

Friday - ice + full rest. As much sitting down as possible plus rolling a ball under my feet - to loosen any tight tissues in the fascial line. Gentle massage from Tim, away from the area, helped to reduce any unnecessary tension building up in any muscles that may have been used to compensate from the injury.

Saturday - as Friday, plus a short 500m very slow and gentle walk on flat ground. In addition to using the ball under my feet I also had a session with the foam roller - but, and this is important, I kept well clear of where the damaged tissues were. If I were to use the foam roller right over the damaged area I would risk re-injury through mechanical pressure pulling the tissues apart.

Sunday - As Saturday. Additionally I could now do full ankle circles with no pain, and very gentle heel drops and raises (3 sets of 10 on each) to keep some movement happening, but not too much. I went for a 500m walk in the morning - no pain, no after effects, so in the evening we walked to a nearby pub for dinner. It was a slow, cautious walk as I could still feel tightness around the healing area, but no pain felt so all good.

Monday - As Sunday - no pub visit but I did go for a gentle stroll. I continued with gentle stretching, rollering and also jumped (cautiously) onto the bike (on the turbo) to test whether cycling induced any pain. It didn't. So, on very easy resistance I span the pedals for 20mins. Another sports massage as before.

There you have it. My rehab so far. Sadly I had to cancel my Running Delights session today, but better to err on the side of caution, even though it feels much better. I shall be going for a longer stroll tonight (or bike ride if the rain doesn't clear up) and then the same tomorrow.

When walking on the flat, and going up and down stairs, I have been doing so very slowly and deliberately. There can be a tendency to keep moving at the same pace as pre-injury, limping along. But, if I had done that then my gait would have changed. Initially I was limping (for about 24hrs), but to avoid significant change to my gait and the potential for muscular imbalances to start I kept walking slowly and in my natural gait.

I have not real idea when I will do a short walk/run to test my leg. It will depend on how the next few days go. Missing a few runs for 1-2 weeks isn't going to affect me too much, but if I return to running too soon I could end up being out for much much longer.

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