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).

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!

My First Ice Bath

When I trained for my first marathon, many of my marathon runner friends asked me "Do you take an ice bath to help you recover?"  I had never done so before and didn't take one when I trained for my first marathon (the ING NYC Marathon on 11/1/2009).   Over the course of my training, I used ice daily on my knees and feet, but never an ice bath.  I believe that ice is a miracle drug.  Over the years when I have been hurt (particularly while playing basketball), ice has helped me recover quickly.   Over the last week, my legs, in particular my knees, have been fatigued, so I decided to try my first ice bath (which actually ended up being an ice bath last night and another one tonight). 

When I trained for my first marathon, I frequently put my foot and ankle in a bucket of ice to reduce swelling and to help recovery.  Anybody that has ever put their foot and ankle in a bucket of ice knows how painful it is. Getting to 10 minutes is a real challenge. However, the results are always worth it - an even application of ice to the foot and ankle always helped my recovery.

So why do people take ice baths?  The scientific theory is that the ice bath helps to repair microtrauma, or tiny tears in muscle fibers that result from intense exercise (like marathon running).  Some believe that the ice bath will (1) constrict blood vessels and flush waste products, like lactic acid (which often builds up in the legs of marathon runners after long runs), (2) decrease metabolic activity, and (3) reduce swelling and tissue breakdown.  Then, with rewarming after the ice bath, the increased blood flow speeds circulation, and in turn, improves the healing process.   As I did a little research on the web about ice baths, it became clear to me that some people believe that ice water baths are helpful (e.g. world record holder Paula Radcliffe and many other elite marathon runners swear by them), but some studies have shown no benefit from them.

I have considered taking an ice bath from the waist down many times to reduce the inflammation in my legs and knees from long runs.  I'm not sure that the human body is meant to run 15-20 miles every Saturday, so let's see if an ice bath helps my recovery.  My legs have been very fatigued lately from back to back 20 mile long runs the last 2 weekends.  In the book Born to Run, the author talks about ice baths and mentions that the temperature of the ice bath should be around 46 degrees.  "46 degrees?" I thought to myself, this is definitely warmer than the bucket of ice I use.  I also read that some people believe that a temperature even warmer, say around 50-59 degrees, can also have benefits. So, last night, for the first time, I filled my bath tub with cold water (of course throwing in some espon salt too).  I was surprised how cold the water was.  Last weekend, I went to a few stores to try and find a thermometer to measure the water's temperature, but was unable to find one.  I put my foot in the water and it was freezing!!  I remember thinking to myself "this would be great to soak my foot and ankle".  I put some warm water in the tub to warm it up (ok, I'm a wimp, but it was just too cold without warming it up a little), held my breath, and got in the water.  BRRRRRRRRRRRRRRRR!!!!  From the waist down, I went numb.  The first few mintues were tough, but then my body adjusted and after 12 minutes I got out.  I felt great!!!!!  The pain in my legs was gone and when I woke up the next morning, my legs felt much better.

Today, it occured to me that perhaps a Pet store with Fish Tanks would have a thermometer to put in the water.  Sure enough, for $1.79, I found one.  So tonight, after feeling so good after last night's "cold water" bath, I tried it again.  I filled the tub, put the thermomter in, and it read 50 degrees.  Perfect, I thought, we are lucky that the water in our building is so cold.  No ice needed, I decided that somewhere between 50-59 was my target temperature.  Like last night, I put my foot in the water to test its coldness, and it was freezing.  After a blast of hot water tonight, the tub warmed up to 55 degrees.  Perfect.  The temperature felt exactly like last night.  I got in the water.  BRRRRRRR!  55 degrees felt much warmer than 50, that's for sure.  It was painful at first, but I ended up sitting in the tub for 18 minutes.  When I got out, I was totally numb, but my body quickly warmed up and I felt great.  We will see if it makes a difference before and after my 15 mile long run tomorrow.  So far, my verdict is that it has significantly helped me.

 

Chicago Marathon 2010

I just signed up to run the Chicago Marathon on October 10, 2010.  I will use this as a training run for the ING NYC Marathon on November 7, 2010.  Who wants to join me?

Beautiful day and a 20 mile long run

Today, I woke up feeling great.  My knees felt great after my epson salt bath last night and 7.5 hours of sleep.  It was 56 degrees and sunny this morning, a perfect day for running.  I started running at 7:32 AM, which was great because it was bright and sunny out.  I wore shorts and a t-shirt.  My plan was to run 15-20 miles today (my schedule said to do 13 today and 22 next weekend, but I have a lot of things going on next weekend, so my thought was that if I felt good I would do 20 today and 13-15 miles next weekend).   Central Park was packed with runners, definitely the most crowded day of the year (and probably the most crowded I have seen it).  With the NYC half marathon tomorrow, many seemed to be out for an easy run.  Unfortunately, I didn't get in to the NYC half via lottery, so I won't be running tomorrow.  I really wanted to run this race as it starts in Central Park, runs through Times Square, and finishes at Battery Park, running down the West Side Highway.  Maybe next year.

I felt great this morning.  Once again, my early run felt great.  The splits for my first 5 miles, in order, were 8:24, 8:02, 8:10, 8:10, 8:19.  The pace for these miles felt very easy again, and I was forcing myself to slow down for all 5 miles. It is a pretty damn good feeling when I can run these times while trying to run slower and taking it easy.  My average heart rate for the first 5 miles, in order, was 142, 142, 151, 146, 148.  For me, these are outstanding heart rate levels for the speed I was running.  I'm a big believer in my average heart rate being the key to easy (or hard) workouts.   My fitness level is at a level where my heart rate levels are lower, and this, in turn, is why I can run faster and longer at a faster pace.

Today, I ended up running 20 miles.  I ran into my friend BGR and we ran about 5 miles together, which was great (for me from miles 9-13).  Overall, my pace was 8:23 per mile (my previous best was 8:34 for 20 miles) and my average heart rate was 154.  Click here for the splits for each of my 20 miles from my watch (and average heart rate).

I felt great during the run except from miles 5-7, when my right knee was twinging a lot.  It hurt.  It went away after mile 7 (not sure why).  When I finished the 20 miles, I kept moving for about 90 minutes, never sitting down, as my right knee was definitely sore and my legs felt tight.    The knee pain went away after about 90 minutes when my knee loosened up.  I rolled it out when I got home to loosen up an obviously tight IT band and I am icing my knees as I write this. 

We shall see how my knees feel over the next few days (the 2nd day after my long run always results in the most soreness). 

Some Days You Have it, Some Days You Don't - plus a running music playlist

Today I had it.

Over the last 4 days, my body and legs have been feeling very fatigued.  I'm smack in the middle of marathon training for the Wisconsin Marathon on May 1st in Kenosha, currently in week 11 of 17 of training.  On top of my general marathon training fatigue and soreness, my Crohn's Disease has also been very active over the last few weeks, causing added overall body fatigue and inflammation (last night both of my elbows were swollen).  I get swelling frequently in my joints as a result of my Crohn's, which makes it tough for me to discern if my knee pain is due to my Crohn's or my running.  It is frustrating, but I learned long ago to accept and deal with it.  Usually, I run through it.  If it truly is an injury, I can tell when I'm running and will stop so I don't get more hurt. If it is my Crohn's, running actually helps to reduce the inflammation.  Listen to my body today so I can run tomorrow.

This morning, I woke up with 2 sore knees before putting my feet on the ground.  As I always, I wasn't sure if it was my Crohn's or an injury.  When I started walking, I felt fine, no knee pain, so I decided to run, promising myself to stop if either knee started hurting (I've also been having some minor pain at the top of my calf behind my left knee, so I was going to stop if this started hurting too).  As I do every morning, I checked the temperature and forecast on my Weather Channel Iphone app.  It was 52 degrees, the warmest it has been in the morning in 2010.  For the first time, I was wearning shorts and a long sleeve shirt instead of my running pants, 2 shirts, jacket, hat and gloves. 

When I arrived at Central Park, I felt great.  I got about 7.5 hours of sleep last night and 8 the night before, and I could tell (usually I sleep about 6 - 6.5 hours per night).  My knees and leg felt fine.  My plan was to run a very easy loop (6 miles), around 9:00 per mile.  I started slow and by the time I checked my watch around the end of mile 1, it read a pace of 8:11 per mile.  Hmmm, I thought, sure doesn't feel like I just ran an 8:11 first mile....that felt really easy (and it was uphill).  There must be something wrong with my watch, I thought.  At this point, absolutely no twinges in my knees or legs.  I was cranking my XM Satellite Portable Radio on "shuffle songs" for a playlist I created over the last few weeks (I prefer this device to my Iphone because I can listen to the satellite radio or songs I put on an 8 GB memory stick - plus, I like the hour a day that I get away from my phone and emails).  I love listening to music when I run, although I'm well aware that many don't (and many runners despise it for a multitude of reasons - like "it's not pure, running is meant to be done without music" or "it's cheating" or "you can't hear what is going on so you could get hit or run over (to me, this make sense, which is why I run in Central Park when there are not cars there, and if there are, I turn it way down)).  I ran track in high school (hurdles) and couldn't listen to music in track meets, and some runners view each race the same way.  I run to have fun, to stay in shape, and for the runners high.  I'm not out to win.  I'm out to have fun and to get better (hopefully).  I love listening to music but many of my friends find it testable and say "I have enough going on in my head, running without music is the only time during the day that I can escape from it".  I understand both sides and don't judge those that run without music.  I hope people won't judge me for listening to it.   The NYC Marathon rules say "The use of headphones is strongly discouraged", but it doesn't prohibit them.  Last year's Milwaukee Marathon disqualifed one of the top 2 women finishers for listening to an ipod from miles 19-21.  As soon as I heard this, I emailed the race director for the Wisconsin Marathon that I am running, fearing that I wouldn't be able to listen to my music.  The race director said "as long as you don't plan on winning, you can wear headphones".  This past week, a friend and fellow runner sent me this article about a guy who got killed by a plane making an emergency landing on a beach - the article says that the jogger was listening to his ipod while jogging on the beach.  I've been told that the Boston Marathon prohibits headphones.  One of my life goals is to qualify for Boston someday.  If I do, I'll have to find some friends to run with.  Otherwise, I will struggle for 26.2 miles without music.

I'll never forget the first time I ran with the Team for Kids running group before my first marathon (NYC 2009, I raised over $5,000 for Team For Kids).  So here I was, a month away from the 2009 NYC marathon, running for the first time with the Team for Kids group, due to run the last 10 miles of the marathon course (plus 6 before, to Queens over the bridge).  To show you what a small world it is, my friend and former colleague from Goldman Sachs BG was there to run also.  BG, a great singer, and I ran the entire run long together, hung out before the marathon in Staten Island (unplanned, we just ran into each other), and he finished 11 seconds ahead of me for the NYC marathon, despite the fact that we were in different corals for the race and didn't see each other then entire race until running into each other after the finish line.   Before the long training run, I noticed that nobody else was wearing headphones.  Then, one of the Team For Kids coaches walked up to me, looked at my heaphones, pointed at them with a look of disgust on his face, and said "I don't like those things".  I said "what, my heaphones?" and he said "yeah, your headphones".  I was aware of the headphones vs no headphones battle that exists out there.  I wanted to say "I don't give a shi*t what you think, go f*ck yourself.  If I want to wear headphones, I'll wear headphones" thinking that I was the one about to run 16 miles, not you, but I decided to smile and say nothing.   Those of you that know me know how hard it was for me to say nothing. 

Sometimes I listen to audio books, and often I run with friends instead of listening to music, as I find it tough to talk while running and also notice that my fitness level always improves if I can run at a good pace and talk while doing it.  Talking while running also helps me on easy days, as I should be able to talk while running.  If I can't talk easily, then I am running too fast and I slow down.  Click here for a link to the playlist of ths songs that I ran to today.  Next time you are at your desk, hit "play all" and listen to the songs while you work (no need to watch the videos).   Random play came up with some great running tunes today.

During mile 2, I continued to feel great and my run felt very easy.  When I looked down at my watch at the end of mile 2, my mile 2 split was 7:41.  Wow, I thought to myself.  I still feel great and it still feels easy.  Mile 3's split was 7:44, followed by 7:46, and 7:36, with my mile 6 split at 7:57 (I slowed down at the end because my right knee was twinging during mile 6), for an overall pace of 7:50 for the 6.12 mile run.  As I was running, I was thinking "what is causing this to feel so easy?"  Am I getting in better shape, so this pace is getting easier for me (I hope)?  Is it because I'm only wearing shorts and a t-shirt (versus the layers I've been wearing all year)?  Is it yesterday's day off, which helped my recovery?  Is it the warmer weather, causing my body to be warm and therefore faster?  Is it the pump up music I listened to today (I have noticed that I am about 30 seconds a mile faster to pump up music versus listening to audio books or no music)?  Was it the foam roller?  Was it the hot baths I've taken all week?  Was it becasue I've iced my knees all week?

I will never know why, but I'm excited that I ran an easy fast sub 8:00 per mile pace and hope I can do it again soon.  Time will tell.

Listening to my Body

After taking the last 2 days off, I felt very good and strong.  I ran 20 miles on Saturday and have been running 6 days a week for the last month, so I decided to take 2 days off in a row to let my body rest and catch up on sleep (plus getting up at 5am the night of Daylight savings was completely unpallatable to me as it  really would have been 4am).  My plan today was to take it easy, run 8:30-9 pace.  I met the 6am running group and ran with them to Harlem Hill, where they were going to do speedwork up and down the hill.  My right knee has been twinging just a little bit (barely noticeable) and I have been having a little twinging behind my left knee (a little more noticeable), so I decided not to do the speedwork on the hill with the group (my rule is never to do speedwork if my knees are twinging).  I have learned over the last 9 months of running that listening to your body is the key to staying healthy. 

After about 3 miles, I felt great.  The 8 hours of sleep I got on Saturday and Sunday nights, taking the last 2 days off from running, using the foam rolller a lot to roll out my legs, a bath to soak my legs every night (alternating every 5 minutes between having my legs in the hot water and elevating them out of the water to let the blood flow to my knees), and ice on both knees has made me feel great.  I definitely do not feel like I ran 20 miles on Saturday.

During Mile 3 (see my splits below), I felt great and decided to push a little bit.  After mile 4, I still felt great, so I decided to push during Mile 5 to use today's run as a mini tempo run.  After my run, I immediately rolled out my legs with the foam roller as my right knee was twinging from miles 3 - 5 (but didn't hurt at all after) and iced both of my knees for 15 minutes.

Today's run:
0.7 mile warmup to park - 8:37

Mile 1 - 9:13 (ran with 6am running group to Harlem Hill)

Mile 2 - 8:26 (ran with 6am running group to Harlem Hill)

Mile 3 - 7:43 - Harlem Hill, felt great decided to keep pushing

Mile 4 - 7:55

Mile 5 - 7:13

Mile 6 - cool down - easy 9:09

last 0.40 miles - 8:26