Diagnosis: Tibialis posterior strain

Yes, the diagnosis is in and it comes in Latin: tibialis posterior strain.

If you want to be dramatic, you can call it tibialis posterior pain


And no, that doesn't mean I've strained my posterior, thank you.

Unfortunately this condition also travels under another name, which is significantly less impressive and dramatic; Acquired flat foot pain. This makes me sound like i have hobbit feet, so I'm less impressed with this terminology, and shall be referring to my condition in Latin for full dramatic effect.

Tibialis Posterior pain is basically a running injury where the Tibialis Posterior tendon (the one which runs down the back of your calf) can become inflamed, (or partially torn or ruptured in worse case scenarios), causing pain behind the bony prominence on the inside of the ankle.

For those 'not in the know' when it comes to your bio-mechanics, the purpose of your Tibialis Posterior muscle is to make your calf muscles push the foot down during the 'toe off' phase of walking and running, and also to turn the foot inwards. So if a person has a heel that turns out at the bottom (as I do), causing the foot to roll inwards (pronate - see earlier blog on pronated gaits), then more strain is placed on the tendon and it can become prone to injury. Which is how I find myself in this situation. Harumph. Hind sight is a wonderful thing.

Apparently a lot of football players suffer from this as a direct kick to the Tibialis Posterior tendon which can trigger the same condition, something which I am thrilled about. (At last I have something in common with the world of football).

But anyway this problem is more commonly found in runners and is usually a result of over-use.

I've overused my ankle. (This is coming from the guy who used to sit on the side line in Sports and wait for the ball to come to him).

So.. how to cure?

Well, my lovely physio has given me some wonderful advice, and this is where we come back to bio-mechanics.

Bio-mechanics (I am discovering) is increasingly interesting. Bio-mechanics is basicaly the mechanics of your body. it's how all the bits work together.

But the really interesting thing about bio-mechanics is that the problem is never where you think it is. Because of the way tendons, ligaments and muscles criss-cross over your body, often if there's a prob in one area, chances are the solution is in a totally different place.

So i'll give you one guess as to where the real problem is?

Oh yes, you guessed it... it's my butt. My Glute-meds, to be precise.

Now i know my 'glute-majors' are the muscles at the top of my butt / lower back which power my legs, but I had no idea glute-meds even existed, which would problem explain why the physio said mine are in a state of 'deep relaxation'.

So your glute meds are those little muscles which sit on the side of your butt rather than the back of it, and they help control your thighs and stop your knees from wobbling side to side every time you walk / run and your foot hits the floor.

Here they are:

Don't underestimate them just because they're small. You wouldn't be able to walk very far without them.

So, if they're a bit useless, in a coma-related sleep and you're on your 8th, 10th, 13th mile, you can imagine how it might result in a slightly wobbly knee and the ankle beneath it being jarred every time the foot 'hits the ground running'.

So there we go. Mystery solved.

And finally, to build this lovely muscles - which are very important to runners - I have to do exercise like this in the gym.

Oh joy.

but with a little bit of luck, not only will I be able to run without any more pain in the ankle, but I'll also end up with Glutues Medius like this...

2 nurofen and a cup of coffee

It's amazing what you can achieve on 2 nurofen and a cup of coffee.

Some of my best friends will know that this concoction has pretty much been my solution to many of life's problems since the early days at Univeristy when every morning started with a hangover.

Feel like shit? 2 nurofen and a cup of coffee. Got an exam to sit? 2 nurofen and a cup of coffee. Got an early lecture to make? 2 nurofen and a cup of coffee.

In fact I actually remember getting through a funeral of a great

old relative on 2 nurofen and a cup of coffee. Hmmm...

Fortunately over the years I managed to work out that sometimes a good nights sleep, lots of water, not getting drunk every night and a good breakfast is slightly better for the soul that relying on pain killers and caffeine to get through the day.

And so to marathon training, which -as faithful followers of last year's adventures will know- I discovered you just can't do on a crap diet. Caffeine alone will only get you so far (mile 2, to be precise).

And now that Christmas is over, I've finally shaken off that annoying flu bug and I had my little January winter-sun break to Morocco, I no longer have any decent excuses or reasons not to get off my lazy arse and start training again for the London Marathon on 25th April...

Slight problem though... I've buggered my ankle. My left ankle to be precise.

Not sure how i did this, but i think it has something to do with running for the bus in crap (but really rather beautiful) shoes. Probably Ted Baker shoes, to be precise. And I think it's fair to say that Ted Baker shoes were not built for running in. Ted Baker shoes are the kind of shoes that look great but let your feet freeze in winter and get too hot in the summer and are certainly not made for running after buses in.

But my Ted Baker shoes look fab, and that's the important thing. See:

Oh no, wait, hang on, wrong pair...

That's better.

Anyway, I digress. It's January and time to get back into running. So my first attempt at proper training was on monday evening, which had to be cut short thanks to the pain shooting up my left leg from the ankle. Not a great start. I limped home feeling rather fat and more than a little pathetic.

At this point I decided to take the very good advice of my friend who's a personal trainer and told me to raise it when possible, rest it as much as possible, cover it in an ice pack if it's swollen and generally don't run on it until it's healed.

So being completely impatient person that I am, I translated this as "rest it for 5 days and then attempt a 12mile run on saturday". Clever eh? Bravo.

Now someone told me last year when I was first training for the marathon that the one thing all runners dread is completely dying (or 'hitting the wall' as it's known) miles from home, or spraining an ankle or pulling a muscle and having to limp miles home

And considering that this could happen half way during a 15 or even 20 mile run... well, that's a long limp / walk home, isn't it?.

Apparently there are a couple of ways of avoiding this, and they are:

a) always carry reserve energy gells on you to drink if you 'hit the wall'

b) plan your running routes so you're never more than 2 mile short cut from home

and c) take 2 nurofen with you on every run in your back pocket, in case of muscular or joint pain.

See where I'm going with this? Nurofen saving the day again.

So today I did exactly that. I did my stretches, drank loads of fluids, ate loads of oats for breakfast, charged up my iPod... and popped 2 nurofen into my back pocket.

And then I did what I often do when I need a kick-start of energy to get me going on the first 2miles... I glugged a shot of coffee and set off.

Unfortunately I got to about mile 3 when i decided to leap (heroically) over a muddy puddle and landed on my left ankle. OUCH. Or, as Homer would say, 'Doh,".

A couple of minutes of pretending i couldn't feel the pain, I had to stop and admit that sometimes I'm a bit of a puddle-leaping fool.

Fortunately though I had those 2 nurofen in my back pocket, not to mention an energy gell. Together they made an interesting mix.

But -amazingly- they dulled the pain down a sufficient amount that I was able to finish my planned run (despite the odd twinge), and do it in a good time too.

12.8miles in 1hr 40 (roughly), averaging just under 9mins per mile and using up a total of 1,600 calories (Garmin fore runner watches are wonderful things, v clever).

Hoorah for Nurofen, that's what I say. Unfortunately as I'm writing this I can feel them wearing off, which is unfortunate. And with it comes a slight throbbing feeling (and not in a good way).

Suspect i might be on the phone to my personal trainer friend again later, who will no doubt tell me to ice it, raise it, rest it and don't run, which I'll interpret as "let's go clubbing and dance to Lady Gaga, yaaaaay".

Which I'm sure will be fine, as long as I take my nurofen with me.

Planning a double-wammy for 2010

So it’s official – I will definitely be running the London marathon again this year. I’ve been lucky enough to secure a place through top charity Children with Leukaemia.

But never content with doing things by halves, I’ve decided to also run New York Marathon as well… again for Children with Leukaemia.

The reason for this being that they are one of the best charities offering runners support and entry into the New York Marathon, and seeing as I’ve secured my London place with them it makes sense to also run NYC with them too and raise lots of lovely cash for sickly kiddies – aiming to raise £2,500. Fingers crossed.

And one of the best things about this particular charity is that they have the official Mr Men and Little Miss running team for the Marathon, which means I could potentially run London dressed like this:

Anyway, this decision has been met by lots of “Are you mad?” comments and the such like. And i must admit, the thought of finishing one marathon only to have to keep training in order to finish another one a few months later is slightly scary.

Especially considering the second part of the training will be over the summer months when it becomes increasingly difficult to find the motivation to run along the river (rather that sit somewhere along the river and just drink cider with your mates).

If there's one thing I learnt last year it's that fitting 4 or 5 runs a week into a regular schedule isn't an easy thing to do, so you essentially have to become a hermit and resist the calls of the pub, bars and all those wonderful disco bars in Soho…

And so to kick off proceedings tomorrow I'm planning my first long outdoor run in quite a while. Aiming for something near the 10 mile mark.

Might be a bit of a shock to the system, but at least I can then justify filling my face whilst watching XFactor Results in the evening :)

You can sponsor me by making a donation at www.bmycharity.com/jamesrunsLDNandNYC

Any amount, big or small will be totally appreciated by the parents and kiddies who benefit from the charities work. And just to reassure you, I'll be paying myself for any flight and accommodation costs for the NYC marathon, so rest assured any of your cash donated will go directly to the charity.

Feeding & finding the motivation

Now that one has successfully completed one's first marathon (you might have heard about it), it's proving rather difficult to find the motivation to keep running long, long distance.

I did 1 x 5k run this week, and 2 x 8k runs (endurance stylie, so fast, slow, fast, slow) which is great for ones butt muscles (rah!) and getting rid of any puppy fat, but the problem with marathon training is that it kinda raises the bar slightly when it comes to distance and time, so this no longer feels enough, even when not training for a marathon.

But finding the motivation to get back into the longer runs is hard, mainly because whilst I seem to be able to manage my appetite after a short, fast run, the effects of a long, long run goes on for days. Days i tell you. Days of chomping my way through any carb in my immediate vicinity. 

And these are usually BAD carbs, such as Snickers bars which i LOVE. 

Which makes me feel like crap, because i then put on weight (and not good muscle weight, we're talking fat-around-the-middle weight) rather than shedding it, which to me is one of the key reasons to run.

Another problem is that sometimes i'm starving after just a 20min or 30min run, which means my resolve weakens and i speed home and dive into the fridge. 

(The only thing that stopped me from doing this more often during the marathon training was the realization that presumably there weren't going to be loads of fridges en route on the big day, and i was going to have to get used to that, darn it).

So how to manage one's diet? Well, listen carefuly now, coz here's the science part (have always wanted to say that).

Apparently if you've got the glycogen levels in your body right before the run (lots of oats, cereal n boring things not covered in chocolate, cheese or salt), then according to a certain sports nutritionist (quoted in Runners World) that should keep hunger at bay and even mean that "fruit with low-fat yoghurt" might be enough afterwards.

Ha ha. ha ha ha. ha. haaaaaa. 

Oh. Not a joke? Oh. damn. I have to say i have never, ever, ever come in from a long run and thought "ooooh, some fruit and low fat yoghurt, that'll be nice". 

My thought process on returning from a long run is more along the lines of "Toast. Cheese. Butter. Pasta. Cheese. Chocolate. Toast. Now, now, now goddammit, why can't i get enough?"

But interestingly, according to the same nutritionist, the body confuses thirst for hunger. 

Now that's interesting. Never heard that one before. 

And, in addition to this, apparently after a long run you have 20mins to top up your glycogen levels with carbs.

That's 20mins people, not 20hours. 

Something tells me this is where I've been going wrong!

But this makes sense, because for ages (days) after a long run, whilst I'm filling my face with every carb imaginable, i've also been aware of how long it's taken me to re-hydrate ... presumably because i've been too busy filling my face with every Snicker bar under the sun, rather than drinking water.

At the risk of posing a Carrie-Bradshaw type question, suddenly i thought "Could i just be thirsty, not hungry?"

This what is known as a revelation.

Let's pause here to enjoy Sarah Jessica Parker 'acting' a Carrie-Bradshaw styled revelation:

Moving on...

Aforementioned magazine & nutritionist recommends (without a sense of humour) to using a "urine chart indicator" to find out if dehydration is the problem.

That sounds rather messy to me (and certainly not the kind of activity Carrie Bradshaw would participate in), so i think i'll just go on the hunch that dark is bad, clear is good. 

Right? Simple.

Now i know why months ago I overheard 2 runners discussing the colour of their pee.

Hmmmm. I told you the runners world is a strange one.

So watch this space. 

Today's learnings are:

• Oats before
  
• Water after
  
• Carbs in 20mins...
  

... and then stop being a fat knacker and show some self-discipline for Gods sake.

Running to the Beat

Well, for better or worse, I appear to have been well and truly bitten by the running bug.

Determined to not lose my new levels of fitness I've already signed up for some more runs... 

These are:

• 10k Battersea Park run - 13th June (8am - ARGH! Why 8am? I mean, puh-lease)
  
• Run to the Beat Half Marathon - London, sometime in September
  

Run to the Beat (www.runtothebeat.co.uk) is an interesting one, because the entire distance is set to live and recorded music, so in theory should be a great atmosphere. (he says).

Rather alarmingly, whilst registering you have to declare your favourite music, artist and song to 'run to the beat' to.

UH OH.

As friends and followers of my blog will know, my taste in music is fairly trashy at the best of times. But i do at least recognize that this is something which should not be inflicted on other people. This is why iPods were invented, no?

But suddenly I'm presented with an interesting dilemma. 

Either... 

a) Tell the truth and enter fav running song but then run the risk of it actually playing over the darn speakers and causing mortifying levels of embarrassment... 

Or...

b) Blaspheme against the Church of Kylie by claiming some other much cooler artiste as my favourite to run to.

You've got 5 seconds to place your bets on what i did....

Yep, am ashamed to admit I couldn't quite bring myself to run the risk of making thousands of other runners listen to Your Disco Needs You by Ms Minogue, so put in my 2nd favourite running song instead: Freemasons When You Touch Me which -for some reason- is sooo much cooler (if not quite as original and camp). 

Although on reflection, maybe the campness is a close call:

Versus:

Hmmm.

Aaaanyway, my personal view is that it's quite difficult for any song to compete with those drums at the beginning of Yr Disco Needs You for sheer motivating beat. 

As one of my friends quite rightly said, "Remember that theme tune for Rocky when he starts training? Your Disco Needs You is the gay mans equivalent of that"

Interesting point, and one which made me go on to You Tube to compare.

Play the first 10seconds of Rocky, and then play for the first 25 seconds of La Minogue

(As you can tell by the gays bouncing up and down and clapping like seals, it's impossible to claim this is not a motivating song...)

I think my friend has got a point, although there's definitely more effeminate flapping of hands in the Kylie clip. 

Either way, such heretic behaviour (I've been told) means I have to repent and say five Hail Kylies ASAP or run the risk being booted from the church for ever.

And for those of you scoffing at my wonderfully dire & camp taste in music, can i just mention that someone I know who is a personal trainer and an instructor at a spinning class in the city, plays this (worth skipping forward to the 1min-20secs mark for full joyous impact) to get his class motivated on the final stretch. 

'Nuff said. Now that's running to the beat.

Surviving the Post-Marathon Blues

Apparently the few weeks after a Marathon can be just as tough (if not tougher) than the week leading up to a Marathon (when your training plan tends to ease off and you start relaxing more). Because the race leaves you with "depleted fuel stores", "accumulated fluid in the muscles", "dehydration" and perhaps some "damaged muscle tissue" you can end up susceptible to injury and infection and feeling disorientated or even depressed after achieving such a significant running goal. Joyous. To me, this actually sounds like what some of my female have moaned about after giving birth.  (Hopefully this is the closest i'll ever get to that).  So what to do?  Bounce back on prozac?  Eat myself to death?  How does one conter-act this soul-sapping sense of apathy? Well i have to admit that apart from the definite muscle soreness, some weird things are going on. They are as follows: 1) Utterly, utterly knackered. Keeeer-nackered. 2) Going to bed at 21:30 3) Waking up before my alarm - even on a weekday... before 07:13... SHOCK! (This has NEVER happened before) 4) Eating everything. Everything. Don't come too close coz i might bite you. Unfortunatley, in typical James-Style, i'm eating all the wrong things. Doritos? Check! Cake? Check! Chocolate Chip Cookies? Check! Fish? Nope... Chicken? Nope... Wholewheat Pasta? Yeah, rightie... 5) Feel rather lost. a bit bemused and perplexed... what am i supposed to do now? Well that ever-informative magazine Runners World (yes, the one with the hotties on the cover every month) gives some good advice on getting over the physical and emotional pains of recovering from a Marathon.  Usual things: eat lots of protein and carbs, get lots of sleep and if you are going to exercise, make it gentle to ease the muscles back to life. More interesting is the advice on how to fight the post-marathon blues... Their Top 4 are "setting new running goals" at Number 1 (what... 27miles??), "joining a running club" at Number 2 (er, no. the advantage to long distance running is it's the one time in my life where i don't have to talk to anyone), and "experimenting with new exercises" at Number 3 (ha ha ha, yeah rightie). Fortunately advice Number 4 is much more me: 4. Redecorate or get married  Or book a trip to an exotic location. The point is to set an important non-running goal for after the marathon. This way, you'll have something to look forward to after you cross the finish line

Way-hay!! Hence planning a week cruising along the south of france in July with one of my mates, in a convertible car, Cary Grant & Grace Kelly-stylie (without the crash... although with Kate's driving, you never know). Runners World finishes on another remarkable piece of advice which i'm going to include because it makes me feel really good about what I achieved and certainly helps beating off the Post-Marathon Blues, so if anyone else is suffering, just focus on the following (and start booking your summer holiday) ONE LAST WORD Finally, be sure to congratulate yourself on your remarkable accomplishment. Only a tiny fraction of the population is fit enough to successfully complete a marathon - and with the right recovery, you'll be able to run many more in the future.

I did it!! The Highs n Lows of the London Marathon

Yes, i survived... and more importantly it was totally brilliant!

I'm going to start this final report by mentioning my good friend Si -has done an amazing 10 marathons- who gave me some great advice on Saturday, day before the Marathon. That advice was as follows:

1) Keep your tank full. It's going to run out during the course of the run anyway, so just keep it full for as long as possible. drink lots of water, lots of lucazade at the free stops and take the energy gells

2) hold your head high, smile and enjoy it. That positivity will earn you at least an extra mile.

That second bit of advice got me through the last 4miles i think.

Sooo, some Highs n Lows:

High Point: Crossing the starting line and the first few miles down to Greenwich - crowds along here were brilliant and really gave the runners a brilliant kick-start

High Point: The music: from the church bells in Greenwich to the brass band at Monument -and a million street bands in between- the music added massively to the atmosphere.

Low point: The high temperatures were a definite low!! The heat made it really hard in places. (And the sun has left me with a hugely unattractive chav-tan in the shape of my running vest... damn!). The blue sky was inspiring though, and i think the weather brought out the crowds but it definitely made the going tougher. Thank God for the showers en route.

High point: Running over Tower Bridge was a definite high. To run across such a landmark on London's history and skyline was just a fantastic feeling. I remember seeing it for the first time when i was a small boy, and for me it's always been at the heart of London, so to run over it as part of the London Marathon (and knowing it was the half way mark) was incredible and a definite highlight.

High Point: Over taking celeb runners Peter & Jordan. For those of you not familiar with our UK celeb-obsessed culture, this is Jordan & Peter ...

Quality couple. Serious respect to them for doing it.

Low Point: running all of Canary Wharf and not seeing any of my friends or family, despite knowing they were out there

High point: realizing that actually just knowing my friends and family were out there supporting me somewhere was enough to keep me going.

High point: Passing a pub in the Isle of Dogs which had Madonna's "Ray of Light" bellowing out of some speakers. never were the lyrics "Quicker than a ray of light, i'm flying, trying to remember, where it all began..." more relevant or motivating. Brilliant timing.

High Point: coming round Canary Wharf and feeling a million miles from home but seeing the 21mile marker and realising the worst was over.

Low Point: seeing a guy my age collapse by the side of the road on the 22nd mile, shaking uncontrollably. (Also i saw waaay too many bleeding nipples. Vaseline people, Vaseline!! It ain't difficult!!)

High point: seeing my colleague Sarah outside a pub in Poplar who gave me a massive shout and cheer and yelled "Don't stop" whilst clutching a lovely cold pint of beer. I remember thinking 'Oooh i want that beer' but she shoved me back into the race before i could let my demons get the better of me...

High point: Seeing Tash on mile 23 and suddenly discovering new energy levels! see pic:

Lowest point: The pain in my legs for the last 5miles was unbelievable. I nearly cried coming down the Embankment when i saw the 25mile marker and realised i was going to do it. fortunately the crowds must've seen the look on my face and shouted me on, which saved me. I remember some guy shouting "James - open you eyes! open your eyes, keep running!". I owe him a drink.

High Point: managing a sprint finish down the Pall Mall in front of Buckingham Palace. was dead chuffed with that - slightly regretting it this morning.

Highest point: crossing the finishing line and collecting my medal

High Point: Discovering that in total the marathon team for Family Holiday Association raised £50,000 which is amazing, so thank you all.

High Point: The London crowds. If you were out there cheering us on, then THANK YOU. Made me realise it's London's marathon.

So - definitely more highs than lows.

All in all, truly one of the best days of my life. Seeing so many people run for charities, putting themselves through hours of hell in order to give something back to other people was just incredible. Add to that the WONDERFUL London crowds and immense feeling of support and good-will, and it all adds up to a brilliant day.

For anyone thinking about doing it, they def should. Going by some of the sights i saw yesterday, anyone can do it. All it takes is a bit of dedication and commitment.

As they say, 'impossible is nothing'...

So let's finish with a shot of me and my medal... Can i get a whoop-whoop?

Here's to next year! (did i just say that?)