Most definitely - but then I'd still be out there eight weeks later!! (I
can't believe I've been off the Trail for eight weeks already. Seems like
only yesterday . . . )
Last spring, I talked with David Horton about his recovery after both of his
epic runs, his 1991 AT speed record and 1995 transcontinental run on roads. I assumed it
would take me even longer to fully recover physically from such a monumental effort
as running and hiking the Appalachian Trail since I don't have the
mileage base he does and I'm not built as sturdily as he is.
It took David several weeks or months to fully recover
from those efforts in the '90s. He still has some residual fatigue from his PCT run this summer,
too. Although he's only a year
younger than me, he's a much stronger athlete than I am.
David recently wrote to the ultra list serve that a few days ago he would
reach 100,000 lifetime running miles since 1977. He has run more than 3,000 miles
every year except one.
Whew! Not many runners, especially ones in middle age, can put in that kind
of mileage year after year. Most of us don't have the physiology to do that.
For the last couple weeks I've been wondering why I'm still don't have my
normal enthusiasm for running back yet . . . I mean, I've been done almost two months. I should
be rested up by now, right?
Wrong!!
I need to give myself more permission to rest. After all, here I am at 56 and this is the FIRST year since I began
running in 1980 that I've done more than 3,000 miles! At the end
of last year, my lifetime mileage was just over 40,000 miles. I'll have another
3,400 miles this year to add to that.
My previous high mileage year - twenty years ago when I was only 36 years old
- was 2,403 miles. That means I've run and walked about 1,000 miles farther
this year than ever before. Ever.
And I wonder why I'm still TIRED and need nine or ten hours of sleep every
night??? Well, duh. I think I'm doggone lucky to have been able to complete the
AT considering the mileage base I had!
Some days I don't even want to run. I feel like I "should" so I can retain a
decent level of fitness, but it's hard to get motivated and out the door. I'm
not much interested in cross-training, either. My legs are doing fine; my heart rate
and breathing are not. Although my resting heart rate is
still very low (mid- to upper 30s), my HR quickly sky-rockets when I'm running, even
after a lengthy warm-up.
So yes, Jeff, I'm sure I still have muscle damage that's healing and even
though I haven't run much in the last eight weeks since I finished the adventure
run, I know I shouldn't be trying to ramp up my mileage too fast. I entered a low-key 50K trail race in
mid-January to give myself a short-term training goal so I wouldn't be a slug
all winter. I plan to build my long runs up to about 25 miles by the end of
December (I'm up to 15 miles now).
I wish more folks who run or hike long trails and do other types of journey runs would address the
after-effects in more detail in their journals. Most folks' journals end rather abruptly, and I'm left
wondering how their recovery went, both mentally and physically. I encourage
those who have done such runs or hikes, even if it was several years ago, to
update their journals so other folks have fewer surprises when they're done.
I've probably lost a lot of readers by now since my adventure is over and I'm
posting entries more sporadically, but in the interest of educating the ones who
are left,
I'll continue to give information that I hope will be helpful to future
long-trail hikers and journey runners.
Of course, YMMV - we're all an experiment of one,
so each person's recovery is going to vary. For example, I assume someone younger
and/or better trained than I was would recover faster than me.
In this entry, I'll describe what measures I took before the run to prevent
likely injuries, what body systems "broke down" during the run, and how
my recovery has been so far.
INITIAL PREVENTION MEASURES
I'm clumsy and injury-prone. At my age, I don't heal as fast as
I used to. Besides training as sensibly as I could in the time I had before this
adventure run, I knew some preventative measures would be necessary in order for
me to complete the whole AT.
I am completely convinced that "maintenance" chiropractic care
and therapeutic massages every three or four weeks have helped me prevent some
injuries since I began running twenty-six years ago. I made sure I continued
them as I trained for this run, and during it. I had two "maintenance" spinal
adjustments and two "maintenance" massages during the AT run, plus three
additional adjustments and another massage to treat the piriformis/sciatic
problem I developed midway through the run.
The two most obvious "weak links" I had were surgery sites in my
left ankle and right foot. I figured if anything prevented me from finishing
this run, it would be one of these two body parts. Happily, neither was a
problem!
ANKLES: In 2001 I had surgery on my left ankle
after rupturing the peroneal brevis and longus tendons. Despite physical
therapy, my left ankle will never be the same. I can't raise up on those toes
and the ankle is not as stable as the right one. My foot plant is also
different. Custom orthotics help, but they don't prevent sprains.
Since that surgery I've been wearing lightweight-but-supportive
nylon ASO supports on both ankles when I run on trails. Yes, they probably weaken
my ankles further, but they have totally prevented any further ankle sprains.
I've trashed both ankles so many times over the years. I wasn't about to let an ankle sprain prevent me from
realizing my AT dream.
Bottom line: the ASO braces prevented any ankle sprains
on the AT.
RIGHT FOOT: Last October (2004) I had surgery for two
torn tendons in my right second toe. The pain went undiagnosed until the toe
finally "crossed over" the big toe. I started wearing a metatarsal pad on my
right orthotic to alleviate the pressure on the met heads. I kept one on the
entire AT trek, and even though my orthotics self-destructed two-thirds of the
way through the course and I resorted to using OTC shoe supports, that toe never
gave me any problem. Prevention.
BLISTERS: I also took several measures to prevent
blisters, although those are more of a problem to me on gritty surfaces, like
trails out West, than on trails in the East.
First, I got my shoes in a half size larger than normal. I do
this for 50- and 100-mile races because my feet swell after many hours on the
trail. Larger - but well-fitting - shoes can prevent blisters and black
toenails. Prevention.
Second, I purchased several Injinji "tsoks," socks with individual
toes to reduce the chance of blistering. When I've worn them alone they get
holes pretty fast. That's not good because they are pricey. I learned on the
ultra list that wearing thin synthetic socks over the toe socks helps them last
longer. It's true. I wore five or six pairs of Injinjis all summer and none got
holes. AND I had only two blisters the whole trek.
Last, I had my "foot care kit" with me in the camper and
took a little baggie with minimal blister products with me in my pack every day.
I used several packages of Blist-o-Ban bandages to prevent blisters and
occasionally put Hydropel lubricant on my feet. I never had to tape my feet but
had the products I needed if that had been necessary. Prevention.
FALLS: Most days I used one trekking pole to
help me retain my balance through creeks and on rough terrain. It helped prevent
a lot of falls, but not all of them, as you'll see. It was also useful for lot
of other purposes like weed-whacking and getting spider webs before they got
me. In New England I often used two poles through rivers, down steep inclines,
and over slick bog boards.
PROBLEMS DURING THE ADVENTURE RUN
The injuries I had during the run can be broken down into two
causes: over-use injuries and injuries sustained during numerous falls.
OVERUSE INJURIES: These can be attributed to the sudden
increase in miles and mountains. I tripled and quadrupled my average weekly
mileage on the AT. Even though 50-60% of the miles the first half of the AT were
walking, it was still considerably more distance than I was used to. Having foot
surgery six months before the trek began didn't help, either. I wasn't able to
build my mileage back up again until only four months before arriving at Springer Mountain.
1. My quads were the first to protest. I started having
problems with first one, then the other, lower, outer quad near the knee within
about seven days. This photo with Lynn DiFiore on
Day
10 shows both of us with knee supports!
Downhill running, my strong suit, was excruciating. Within the
second week I started avoiding steep downhills by going southbound
occasionally so I could go UP some of the worst hills - it was easier on my
quads. After about three weeks,
my quads were fine for the rest of the trek.
I attribute this problem to insufficient hill training prior to
the trek. Although I put in as many miles as I safely could after surgery, I
should have done more long, steep hills in training and maybe I wouldn't have
had quad problems right off the bat.
I saw a doctor in Franklin, NC about this problem, mainly to get
something stronger than Ibuprofen for the pain. Celebrex worked wonders but was
too expensive to buy even with insurance, so I ended up taking Naproxen most of
the adventure run. It worked better to alleviate my various aches and
pains than Ibuprofen.
Ice and cold water therapy helped with various sore muscles.
I learned about sitting in cold creeks to relive sore muscles at Coach Roy
Benson's running camps in the early 1990s -- it really does help! Cody thought sitting in this creek was a lot of fun on
Day 8,
so he gave me a puppy kiss:
2. I had two blisters in the first couple weeks. One was
under a callous on a slight bunion I have on the side of my right big toe. I
eliminated it by filing the callous down more often and using a Blist-o-Ban
bandage on it for a couple weeks (these are very thin two-layer bandages that reduce
friction). A second blister developed on the side of my other foot,
halfway between the heel and toe. The Blist-o-Bans worked well there, too.
After the third week, I had no more problems with my feet until
I got to Maine. My right little toenail was swollen and sore. I'm not sure
if it was a blister or an infection from all the mud and swampy water I was
running through. Cutting a slit in the side of the three pairs of shoes I was
alternating relieved the pain when I ran, and soaking in Epsom salts in the
evening made the swelling go down.
Considering how far I went and under what conditions (weather,
terrain, etc.), it's a miracle I didn't have more foot problems.
3. The next problem, about four to five weeks into the run, was
swollen, sore lower legs. They hurt on the outside of my leg, just above the
ankle joint, and toward the center. Again, it was one, then the other, not both
legs at the same time.
On
one of our trips home I saw my orthopedist. He ruled out a stress fracture (my
worst fear) and shin splints and determined the pain emanated from a nerve ending. He diagnosed
inflammation or herniation of soft tissue. I was relieved. After a few days of
icing and elevation in the evenings, each swollen leg/ankle got better. I didn't
take off time specifically to let these injuries heal, but kept on running.
This photo is from
Day
90 when my ankle was sore enough to need some ice again:
4. What I would consider the next overuse injury was sore knees
caused by the steepest climbs and descents on the entire Trail in the Whites and Mahoosucs in northern New England near the end of the trek.
I have osteoarthritis in my knees (and probably every other joint in my body).
I'm lucky my knees didn't hurt before then.
Even young hikers in their twenties complained about their knees in the
Whites!
I again went southbound some days so that I climbed up the worst grades instead of going
down them. I resorted to using various other, um, interesting techniques to take the pressure off
my knees when I had to go down steep inclines, like sometimes going down backwards.
It wasn't elegant but it saved my Granny Knees!
When the terrain was conducive to running my knees didn't hurt.
And they stopped hurting within a week or two of my return home. I'm relieved they hurt only
the last six weeks on the Trail and are pain-free now. This was the area of my
body where I thought I might do the most long-term damage. Hopefully, I didn't.
5. The most unexpected overuse injury I incurred was to my arms and
shoulders! I've been doing weight work for 24 of the 26 years I've been
running. Although my arms are thin, I thought they were pretty strong.
Apparently not! There were several factors causing the weakness and pain.
When I encountered those steeper mountains in New Hampshire and
Maine the last five weeks I relied more and more on one or both trekking poles
for stability. I used the right one every day, the left one only occasionally.
I joked that I had a "death grip" on the poles. My right wrist sometimes hurt like I would imagine carpal tunnel syndrome would
feel (I haven't noticed that at all since finishing, though). That whole arm
was weak and sore.
The northern half of the AT has more rock climbing than the
southern half. I frequently had to hoist myself up large boulders or find hand
holds in near-vertical slabs. The very worst was in Mahoosuc Notch early in Maine.
I wasn't used to pulling up my entire body weight and pack with my arms.
Then eight days before the end (Day 141) I had to use my arms
and shoulders to brace myself going through four waist- and chest-deep raging streams. I clung to a rope across the worst one.
After that, my arms
and shoulders were sore enough to make both running and sleeping uncomfortable.
That continued for at least seven weeks afterwards, too.
Bottom line: something, somewhere hurt at least a little bit
almost every day I was on the Trail!
INJURIES FROM FALLS
I kept track of the worst falls in my journal for a while, then
it became tedious and I quit mentioning it because I was falling nearly every day at least
once! Most falls occurred when I was running, sometimes on pretty smooth trail. The
faster I was going the harder I landed. Nine times out of ten I landed on my
right side, usually on my arm. I bloodied up my knees a lot, too, as below on
Day 4
before I even got out of Georgia!
When I hit the rocks in Pennsylvania and was walking more, I
still fell down even when walking. I was getting more and more tired, and more
and more clumsy.
The worst injury I incurred on the whole trip was somewhere in
Pennsylvania in mid-July. I didn't realize how badly I'd knocked myself out of
alignment until Hank Glass, my chiropractor friend from Atlanta, diagnosed the
problem during the Vermont 100 race. It was so bad that I had a 2-inch leg
length discrepancy. It's a wonder I could walk!
In fact, during the race I got to the point where I could NOT
walk. My right leg hurt and then became numb. I recognized it as "sciatica"
from descriptions of the pain that I'd heard and read. After I dropped from the
race Hank gave me an adjustment and explained that the piriformis muscle was
strained and irritating the sciatic nerve.
I saw another chiropractor when we returned to the Trail in
Pennsylvania (photo below). He said I still had the 2-inch leg discrepancy. After two
adjustments and wearing a lumbar support for a week while walking on the Trail,
the pain resolved, my alignment was OK (despite more falls), and I didn't have
any more sciatic pain. When I returned home my own chiropractor said there was
no more leg length discrepancy. That one incident is the only time in my life
that my sciatic nerve has hurt.
Soon after this I fell backwards in a muddy, black creek in New
York. My butt landed in soft mud, but my lower right arm hit a rock hard enough
to cause an immediate "hemotoma," swelling the size of half a golf ball.
See photo below that I took (that's why the angle is so weird!) One of
the hikers who is a nurse warned me to see a doctor that day because I might get
a clot that could be life-threatening. I've had this happen before but never
knew the potential danger.
So I bailed out after only 15 miles on
Day
97 and Jim took me to a clinic where an osteopath checked me out.
Nothing was broken and since the swelling was gone she determined I hadn't
ruptured an artery and shouldn't have to worry about a blood clot. I never did
need the antibiotic prescription she gave me.
A few days later, my right middle finger went completely numb. I
wondered if I'd injured a nerve or blood vessel that supplies that area when I
got the hematoma. I just lived with the numbness and it eventually went away
after I'd been home about six weeks.
Farther up the Trail, I continued to fall mostly on wet rocks,
roots, and bog boards (photo farther below in text). Occasionally I fell
backwards, but mostly on that right side. Here's another bloody arm photo from
Day
127 in Maine:
I'm darn lucky I never broke anything (arm, ankle, glasses,
etc.). I have thin but very strong bones.
There are several reasons I fell so often: I encountered
more rocks and other obstacles than I'm used to, even running in Georgia and
Virginia as much as I have. I became more and more fatigued the farther I went
and was falling even while walking. And my eyesight deteriorated during the
summer.
Huh?
It's true. I noticed that it was getting harder and harder to
focus on the Trail. Some of that may have been fatigue, but I'm convinced my
eyes took a sudden turn for the worse during this trek. I get them examined
every year because of my family history of glaucoma and cataracts. In July of
2004 they hadn't changed enough the previous year to warrant new glasses. By
this July, they had. But I wasn't anywhere near home to get them examined. So I
kept going, even though I couldn't see real well.
I had them checked soon after returning home. The difference is
significant. My current ophthalmologist and optometrist agreed that it is fine
for me to resume wearing contact lenses instead of glasses (not what I heard
while living in Billings). I wore hard lenses and gas perms for thirty-six
years, then glasses the last four. I missed my peripheral vision wearing the
glasses, especially on
trails and driving.
Now I'm comfortably wearing soft contact lenses, I have my
peripheral vision back, and I can SEE better! Hopefully I won't fall so doggone much
any more.
RECOVERY SINCE RETURNING HOME
I finished the Trail eight weeks ago. As expected, I was very
tired and happy to take some rest days. But there were some totally unexpected
things, too.
The last day on the Trail I had an abundance of energy despite
the fatigue I'd been feeling. That was unexpected.
Day 148 started
with a late start, I
had the steepest climb and descent on the entire Trail up and down Mt. Katahdin,
and then I had to run and hike ten more miles to finish up the section between Abol Bridge and the mountain.
But I felt great that day! I could have run more than I did the last ten
miles but I deliberately chose to hike with "Kokomo" for several miles. I knew I'd
finish by daylight so I didn't have to hustle. I was enjoying our conversation, the longest one I'd had on
the Trail with anyone, and I was savoring my last day. I waited until the last
mile or two to run.
Where did all that energy come from?
I'm sure it was adrenaline and the satisfaction of knowing I had
realized my dream. I was finished!!
Then I stopped almost all aerobic activity and my body went
haywire. I got all sorts of unexpected symptoms.
Big mistake.
First off, we sat in the truck driving home for two solid days
from northern Maine to southern Virginia. You know the dangers of blood clots
after an ultra, the warnings not to sit too long in a vehicle or on an airplane?
We stopped to go to the bathroom and walk the dogs every couple hours, but that
was about the extent of our "exercise" those two days. Fortunately, I
didn't develop any blood clots.
When we got home there was plenty to do to catch up: get
everything we'd been using for almost five months out of the camper and into the
house; do laundry; clean up and reorganize several boxes of running gear and
supplies; clean the house we hadn't been in for three months since our last time
there; buy groceries and restock the pantry; catch up on yard work (it took me
several weeks to tame the weeds); schedule several doctor appointments;
and so on. Up, down, up, down the stairs in ad finitum the first
several days.
I had little energy for running or even cross-training. That
didn't surprise me as much as the realization that I didn't even miss it all
that much!
The lack of desire to run was unexpected. The very most
I
wanted to do was get out and walk at a leisurely pace and enjoy the beautiful
late September weather. I had no interest in cycling, swimming, pool running, or
using weight machines.
And half the time, eight weeks later, I still don't!
I didn't expect that at all.
The first eight days I walked a grand total of TWO MILES. The
second week I really upped the ante (!) to twelve miles, then seventeen and
twenty-three. Much of it was just walking, not running. After two weeks, my mind
sort of wanted to run again but my body told me to rest. I listened to my body.
The most I've done in one week since I finished the AT is thirty-three miles.
Meanwhile, other body systems were saying, "What the heck??"
My legs were relatively happy, but my endocrine, hormone, and GI systems went nuts.
Despite years of hormone therapy and no menopausal problems, suddenly I
found myself crying for no reason that I could rationally understand. I was
also somewhat depressed, my face broke out, and I started having
night sweats. I slept fitfully. The timing and consistency of my bowel movements
changed.
I had no problems with any of these things out on the Trail
when I was under a great deal of physical stress. Why now?
I think the main reason was the sudden lack of activity. My body had grown accustomed to a high level of activity and
it . . . stopped.
The sleep disturbances I had for several weeks were also
unexpected. I had nightmares about the Trail that I hadn't had prior to Flood
Day in Maine. I woke up frequently during the night, so I remembered my dreams
better than when I wake up only once or twice. The night sweats were very
annoying and unexpected, too.
And my arms were so sore I couldn't sleep comfortably for about
six weeks. That was not only unexpected but terribly ironic. I mean, I ran and
walked for 2,200 miles and my legs and feet were fine afterwards. It was my ARMS
that hurt! How screwy is that??
Time for another photo. This one exemplifies how precarious the footing was on
some of the bog boards I fell off in New England:
My chiropractor diagnosed the arm problem pretty soon after I got
home. He tested me and said it was unlikely I had nerve damage. He said I
probably had soft tissue damage that would heal in six to eight weeks. He told
me to lay off the upper body weights that caused pain and let myself heal. (My
arms hurt so much I couldn't even do pool running. The pressure of the water was
too great.)
He was right, but I kept seeking answers because I didn't
know yet that he was right.
I got a deep-tissue massage. My arms hurt even worse for a
couple days, then returned to their pre-massage level of pain.
When I saw my gynecologist for my annual check-up he suggested
a thyroid test for the fatigue and soreness. Blood work showed that my thyroid was fine.
There was a lengthy article in our newspaper about undiagnosed
Lyme disease and its chronic symptoms. I had several of those symptoms and I was
a prime candidate for the disease, which was rampant on the AT this summer. Each
of my symptoms could be explained by something else, but together they made me
wonder. So I saw another doctor in the same practice as the local Lyme expert
(the expert was not taking new patients) and asked her to do the two Lyme tests.
They were both negative. (That doesn't rule out Lyme disease entirely, though, because
either test can have false negatives.)
After six weeks of pain in my arms and shoulders, I went in to
see a PA in my orthopedist's office. Five X-rays showed no bone problems. But he
diagnosed several other problems in my right arm, the one hurting the
most: a possible deltoid injury, right shoulder impingement, and early
adhesive capsulitis. I agreed to a cortisone shot and a few sessions with a physical therapist to work on my range of motion, rotator cuff strengthening,
and scapula stabilization.
And wouldn't you know, that very evening both arms felt better!!
I don't know if it was the cortisone or my chiropractor was right about the
length of time for soft tissue injuries to heal. I was just relieved my arms finally felt better and I could sleep
soundly again (by that time, the nightmares and night sweats had ended).
I saw a physical therapist three times recently and got enough
stretching and strengthening exercises to keep me busy for a lifetime. In
addition to the stress I put on my arms and shoulders during the trek, I also
have a posture problem: I lean forward too much. It's both hereditary and environmental.
Other
family members lean(ed) forward, too. Running doesn't help, nor does sitting at a
computer for hours. My shoulder range of motion is good but I need to
loosen my pectoral muscles in my chest so my shoulders and head will line up straighter.
My mom was right - I still need to "stand up straight
and tall."
So that's my homework - all those stretches. My massage therapist did another number
on me last week to try to loosen up all my arm, shoulder, back, and neck
muscles. I was sore for days from that. She wanted me back in a week but
I cancelled the appointment. I just couldn't face the pain again that soon. I'd
rather run the entire AT over again!!
Seriously, I can't complain too much eight weeks after finishing
the Trail. I'm still fatigued and not able to run as much as I think I "should,"
but I'm not 35 any more and I accomplished so much more this summer than my body
is used to doing.
I no longer have sore arms, night sweats, nightmares, strange
stools, or unexplained crying. My rosacea (adult acne) is better, but not gone
despite the treatment my dermatologist prescribed.
What still bothers me is my lack of desire to
exercise.
I can run comfortably now for one to two hours - if I can just motivate myself to get
out there and do it.
WEIGHT LOSS DURING THE A.T. RUN
I didn't have much excess weight on me when I started this run.
I am 5'9" tall and weighed 143 pounds at the start. I lost about ten pounds. I
loved the way I looked when I got home, with muscles as taut as when I was
peaking at road races eighteen years ago, but I knew it wouldn't be healthy for
me to keep my weight that low - and with so much less activity, I'd feel like I
was depriving myself of food.
I don't pay much attention to weight per se but to how I look
in the mirror and how my jeans fit! I know muscles weigh more than fat. I'm happiest and feel the
best when my tummy is flat and I don't have "love handles" on my hips. That
tells me my body fat is fairly low. When I got it too low in my early running
years I got sick easily. I've learned what my body should look like to feel
good, be healthy, and run my best.
Since I got home I've regained three or four pounds. I'm OK
with that. I don't have to starve myself to maintain this weight and I still
feel "light" when I run. When I build my mileage higher again I can indulge in
more food. Simple as that!
As I mentioned in another entry,
it was a lot easier to increase my food intake when I started on the AT than it
was to reduce it afterwards. That was no surprise.
A corollary is that it was also harder to reduce my food intake when I got done than it was
to reduce the miles I was running. The rest feels good but I still crave
ice cream!
It's been an interesting eight weeks. Although I'm still tired,
most of my post-run problems have resolved themselves. I don't feel like I've
done any serious long-term damage to my body. Time will tell just how much this
run took out of me. At this point, I'm mostly pleased with how I'm recovering.
Maybe I'll be more motivated to run when I
decide what my next adventure will be! (I'll write more about my mental
readjustment phases in another entry.)
Happy Thanksgiving week to everyone,