Saturday, October 4, 2008

Saturday: 21 mile bike; 1 mile swim; abs

Lateral Compartment Syndrome.

http://orthoinfo.aaos.org/topic.cfm?topic=a00204 describes it as this:

Chronic Compartment Syndrome

Chronic compartment syndrome is characterized by pain and swelling caused by exercise. It can be a significant problem for an athlete. It gets better when you rest. It usually occurs in the leg. It is occasionally accompanied by numbness or difficulty in moving the foot. Symptoms dissipate quickly when activity stops. Compartment pressures may remain elevated for some time afterwards.

Symptoms

A combination of signs and symptoms characterize compartment syndrome.

* The pain may be intensely out of proportion to the injury, especially if no bone is broken.
* There may also be a tingling or burning sensation (paresthesias) in the muscle.
* The muscle may feel tight or full.
* If the area becomes numb or paralysis sets in, cell death has begun and efforts to lower the pressure in the compartment may not be successful in restoring function.


After spending hours researching possible injuries, I am fairly confident this is what I have and--after going through my training logs for the last few years--probably have had for many, many years. I had always assumed it was the wrong shoes or orthotics, or shin splints, or too much biking, or overuse. But now it's gotten to a point where I can barely run without any pain regardless of rest, shoe or anything else.

If you have been following my progress over the course of this year, I have not been able to get my miles above 30 per week, and still have pain on pretty much every run, and still need to take a week off from running every couple of weeks. What happens to me is that after 1-2 miles, I feel like there is no blood going down to my lower legs--to the anterior tibial muscles. My shins down to my toes then become completely numb and painful and I have no choice but to stop running. It's completely debilitating. The pain lasts another 10-15 minutes after I have stopped running and I cannot flex my ankle or foot. And then it goes away until I run again.

Of course, I will have to go to an orthopedic surgeon to get a proper diagnosis, and unfortunately, the only treatment seems to be surgery. But now that I have researched it and know what compartment syndrome is, I believe I am a textbook case--and it only seems to have gotten worse over the last couple of years. Here is an article on it in Runner's World:

http://www.runnersworld.com/article/0,7120,s6-241-290-291-2859-0,00.html

There is nothing I can do about it at this stage so I am not going to worry about it. As my brother mentioned to me and Charles mentioned in a comment, I think it is a good idea to try and maintain my running fitness by running in the pool. I'll also use the elliptical machine, and then try to get out and run as much as I can leading up to the race, which won't be much. I also may try to do both Ironman Florida and Ironman Arizona as someone else commented.

Right now, I am trying to get my energy back. While I am feeling better, whatever bug I had this past week is still zapping my energy and I am still not feeling 100%--not even close to it. I struggled through a 1 mile swim this morning and then slept all day. But my mental state is much better than it was yesterday.

p.m. 21 mile bike. 1 hour. 225w. 145bpm. At 200 watts, my heart rate was 140bpm--it's normally ~115bpm. At 230w, my heart rate was close to 160bpm, the highest it has been all year at any power--it's normally ~135bpm. I'll get through this though. Better to have this happen now than the week of the race.

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