Friday, April 23, 2010

Acupuncture

For quite some time, I've heard that acupuncture can help reduce chronic pain that results from a myriad of maladies.  From what I've read, it looks like the most common uses for acupuncture are to reduce chronic pain that results from conditions like headaches, fatigue, anxitey, lower back pain, arthritis, chemotherapy side effects, and digestive problems (like the Crohn's disease I have).   I've always said to myself "someday I'll try that".  Well, that someday has been over the last month, as I have seen an acupuncturist 4 times (once a week).

On 3/23/2010, the Wall Street Journal's Personal Journal section had a great article about Acupuncture called Decoding an Ancient Therapy.  For a long time, I've been thinking about trying acupuncture.  I've heard that it can help reduce inflammation (which would be great for my Crohn's Disease since I frequently get inflammation).  Also, as I near my next marathon on May 1st, my legs and knees have been very fatigued from training.  I'll try anything that can reduce my fatigue.

First thing I did was call my insurance company to see acupuncture is covered under my insurance.  I found out that it is covered in network at 90% of the allowed claim (or 70% out of network), both after my $250 deductible it met, with annual maximum coverage to be paid by my insurer of $500.  Translation - I pay the first $250, then they pay up to $500.  At a cost of $110 per visit, this will allow me 5 visits a year to be covered by insurance.

Next, I emailed my physical therapist Allison Lind, an elite triathlete and marathon runner (she ran a 2:55) and asked her who she would recommend as my acupuncturist (click here for an article about Allison in this month's Runners World magazine).   It was very important to me to see an acupuncturist with experience working on marathon runners/athletes.  My physical therapist recommended Anastasia Hall, a New York State licensed Acupuncturist.  My physical therapist said that her triathalon team uses Ansastasia, so that was good enough for me.

Over the last month, I've been experiencing two minor injuries.  The first is what we believe to be a strained medial gastrocnemius behind my left knee at the top of my calf.  This injury has been nagging at me for the last 7 weeks or so.  It doesn't hurt when I run, but it bothers me later in the day, usually after I have been sitting at my desk for a while and then get up, when it feels stiff and painful.  After my marathon on May 1st, I will get this looked at by a doctor.  Luckily, it has been getting better.  I believe that the acupuncture has really helped this strain.  The strain is much less painful today than it was a month ago and has made my marathon training less painful.  Anastasia puts one of the needles directly into this area, which is painful intially when the needle goes in to find its place, but then the pain lessens.  Also, I have been getting electrical stimulation to the area, which has been helping.  I like that the needle is under the skin.  It makes me feel like the electrical stimulation is getting right to the source. After the acupuncture session, my calves feel a little tight (which Anastatia told me to expect), but by the next day, they feel great and the pain in siginficantly less during my run.   My friend JS had an injury to this area also (and recently did the Platelet Rich Plasma treatment "PRP" to help her recover, which uses a patient's own blood by reinjecting it into the injured site to speed up recovery) and recommended that I start to do strength training to my legs to strengthen the muscles around this area).  I plan on starting some strength training after my May 1st marathon.  All of my friends that do strength training benefit greatly from it, both from being more healthy but also from getting faster.  Hopefully I will get both benefits too.

My second (and worse) injury is to my right knee.  Not sure what the problem is.  My best guess is that it is sore tendons from overuse caused by marathon training.  It may also be a frayed or slightly torn meniscus (although I doubt it becasue the knee isn't swollen at all).  It may be a tight IT band too, but I doubt it, as I roll out my IT bands every day.  I'll get this looked at after my race.  I've been able to tough my way through the pain 5 days a week during my training, but if this injury would have happened earlier in my training I would have taken more time off.  The acupuncture has been helping my knee, usually for 2-3 days after my treatment, which has helped my marathon training.  The picture I attached shows me getting electrical stimulation to the knee.  In this picture, I have a needle directly inside the area where my pain is when I run.  The electrical stimulation was set to pulse every few seconds, which sent reverberations down my leg and would make my foot twitch each time.  The electrical stimulation felt a little uncomfortable each pulse, nearly exactly like the pain I feel there when I run.  When I was done with the treatement, I had absoultely zero pain in my knee whatsover.  It definitely has helped me.

In addition to acupuncture, Anastatia has introduced me to U-I Oil (pronounced "ooh-eee" oil).  She describes it as "Tiger Balm on steriods".   I love it.  It warms up the injured areas, bringing additional blood and circulation to the area, and noticeably helps my injuries feel a little better.  I will be heavily applying U-I Oil to my legs and IT bands for the marathon.  After using U-I Oil for a week, I tried Tiger Balm to compare the two, and I barely even felt the Tiger Balm.  I highly recommend U-I Oil!

In summary, I think that acupuncture is helping my legs and knees.  It even helps reduce the twitching in my right eye by putting a needle around my toes!  I highly recommend Anastatia.

Note:  The picture in this post shows about 20 needles in my right leg, knee, foot, and IT band while getting electrical stimulation (the needles are a little hard to see, but there are a lot of needles running down my leg from the knee to the foot).

Tuesday, April 13, 2010

Goal: Get to the Marathon Start Line Healthy (not an easy task)

Less than 3 weeks to go for the Wisconsin Marathon in my hometown of Kenosha, Wisconsin on May 1st.   I've been training for this marathon since the first week in January, averaging running over 5 days and 42 miles per week.  Usually 6 miles four days a week with a 15 to 20 mile run every Saturday.  I'm in great aerobic shape (the best of my life) and my training has gone well.  My training times have improved since my first marathon (NYC 11/1/2009), with my long runs usually coming in around 8:35 per mile (I have run 20 miles as fast as 8:23 per mile and around 8:35 per mile at least 6 times during this training vs. my fastest 20 mile training run for the NYC marathon was 8:57 per mile).

Over the last month, my right knee has been sore and I have a strained muscle behind my left knee (at the top of my left calf).  The left knee doesn't hurt when I run (occasionally it twinges, but it isn't painful).  My right knee is the bigger problem.  Usually, it doesn't start hurting until after 4 miles or so, but then it hurts after that, sometimes a lot.  This has been hampering me over the last month and will likely continue to do so until after the marathon.

My knee is getting better but not 100% yet. This morning I ran 5.2 miles at 8:00 per mile pace, so that was very encouraging (this morning I ran without my Garmin GPS watch for the first time which I am going to do more over the next few weeks to focus on how I feel versus my time.  This is a big step for me). My right knee hurt a little during miles 4 and 5, but it didn't slow me down like it has over the last few weeks.  I had a hard time running 8:55 per mile for a 6 mile run a few weeks ago because my knee hurt so badly.

My current goal is to get to the start line of the marathon as healthy as possible.  Injuries are something that every marathon runner experiences.  Here's my plan from now until the marathon (luckily Kenosha is a flat course).

1.  Reduce my mileage - I'm reducing my mileage over the next 2.5 weeks (my marathon is May 1).  5 mile daily runs instead of 6.
2.  No harlem hill until after the race.  While I find the aerobic benefits of this hill to be extremely beneficial, the negative impact on my knee is greater than the aerobic benefit gained.
3.  Ice baths  - over the last 2 weeks, I have taken an ice bath every single night (50-55 degrees for 15-20 minutes).  I plan on taking an ice bath every single day until the marathon.  It really helps me recover quicker.
4.  Roll it out everyday.  I think my right knee pain is not due to my IT band, but rolling it out definitely helps.
5.  Acupuncture once a week (have done it twice now), with electrical stimulation for my knees and calves. I will write a seperate blog post about acupuncture in the future.
6.  No speedwork  - over the last 2 weeks I haven't done any speedwork and will not do any speedwork until after the marathon.
7.  More sleep - I'm trying to sleep more to help heal, so I've been missing the 6am group for the last 3 weeks and am likely not to make it until after my marathon.
8.  Taper - more days off - my last long run is this weekend (15 miles).  I will take it very easy.  Last weekend, I also did a very easy 15 miles at a 9:07 per mile pace (by far the slowest I have run any training run).  I will take more days off over the next few weeks and am looking forward to tapering for the 2 weeks before the race.
9.  Stretch.  Increase my stretching after my runs - I rarely stretch.  Instead, I always walk to Central Park to warm up (0.60 miles) and always walk after my run.  Lately, I have been stretching after my runs and this seems to be helping also.
10.  Physical therapy - I have not gone to physical therapy for this marathon yet (I did 6 weeks for my previous marathon).  I may get some therapy over the last few weeks, but I am concerned that the PT will make me more sore.  Maybe this is foolish on my part. 
11.  Leave the watch behind - focus more on running based on how I feel versus knowing my pace during my run.  Today, I actually looked at my xm radio for the start time and finish time.  That was it.  Pretty cool for me.

What am I missing?  What else can I be doing to help my recovery?  Any and all advice is appreciated!