9th December 2013

It's now less than 11 weeks until the Caracas marathon, and 13 weks until the 7 marathon project is complete.  But my left foot hurts.

It's been niggling for months, but what started as referred pain from my left hip (which has troubled me a bit for over a year now), became much inhibition of muscles around the hip, altered gait patterns and especially an altered awareness in the left leg, nerve signs all through the back of the left leg and now seems to be plantar fasciopathy.  I think a few other factors contributed to it - like using low drop Spira Stinger shoes as part of a shoe study, but the shoes were a little large, felt odd, and I think caused more problems in the 12 weeks I wore them (only for speed and recovery runs, never the long run).  

The hip problems (a significant neural / dural component to the problem, as well as sacrotuberous ligament and may be some other structures around there, very high up in the back of the leg and the medial parts of the buttock) caused a lot of issues, with pain inhibition and apparent weakness or slow initiation of my glut medius, glut max, glut min and subsequent overactivity / compensatory patterns from iliacus, psoas, TFL, piriformis and hamstrings.  Full and moderate hip flexion werre very painful, sitting would aggravate the pain, and it behaved a lot like a hamsting tendinopathy, except that the proximal hamstring itself was non tender, except for perhaps a very medial / anterior portion that was almost impossible to reach.  

My weekly yoga session dropped off, such that I've been 20 times in 9 months, only 6 times from late June to early December.  The flexed positions hurt too much, made the hip worse afterwards, I struggled to get into lunge positions, let alone hold them strongly and the balance on my left leg was affected.  And that, I think, has not been so good for the rest of me, especially as I used it as my main stretching and conditioning work.  I have also managed to steadily gain some weight since the 12 hour run in July, so that can't be helping my foot (all that load, every single step).

I've done exercises - strength, stretch, coordination, had physio of a couple of different sorts, including some cranial sacral work, chiro and massage - especially for the long adductors and hip flexors.  I've addressed every weird little part of this problem.  I stopped sprinting hard during the middle part of the year, to avoid overstriding.  I stopped yoga.

Crunch time really came last week, when after a short run in the hills with a friend on Wednesday, I really really hurt.  On Thursday morning, I was up bright and early (it was cold!! only 8 degrees that morning - in December!), headed out to run, walking and limping while the watch found the satellites.  As I was limping, I figured I'd walk until it loosened up.  It was over a kilometer of slow walking (a bit embarrassing having all these morning brisk walkers striding on past) later, I decided a walk back home was best - running on it now that it didn't make me limp was not going to help.  So home, hip strengthening exercises, taping the foot up, and being more diligent with massage and stretching.  I didn't run for the rest of the week, and after 4 days of being taped, it is feeling a little better.  I limp for less time in the mornings, I am doing better on my calf raises (just flat for now - from a step in another few days), and yoga has felt better in the last week (a good sign for the hip).

Fingers crossed I can get back into the swing of things properly in the next week or so.  2 marathons in 2 weeks is going to be a challenge, and I'd like to be very well prepared for it.