Patellofemoral pain syndrome = sad face

I was putting it off because I had hoped that if I gave myself enough rest that it wouldn't bother me...

After the Ohio Outside trail race on November 17th, my knee hurt pretty badly the next day. I took care of it the best way I knew how and eventually it felt normal enough for everyday life. But when I tried to exercise again, the pain returned. 

I tried running again this past Tuesday. I walked five minutes, ran two. Walked five minutes, ran two. I felt okay the whole time I was on the treadmill. 

Wednesday morning was a different story. Reluctantly, I called the doctor. 

I met with a physician's assistant instead of my usual primary care physician. Ryan was really helpful. I explained my running lifestyle a little, when the pain started, where it was, and when it seemed to appear. 

I allowed him to flex my knee, hip, and ankle joints, testing for abnormalities. He told me what many other doctors have mentioned: I have extremely "pliable" joints. They're loose. I sprain easy. I haven't slipped a shoulder or anything, but I commonly feel my bones slide around to the point that when I had X-rays once or twice the doctors have retaken them and had me flex different muscles to view the bone positioning.

I'm not a perfect human specimen. I know that.

Without question, I have runner's knee. Ryan didn't have to think twice about it. My pain is above the knee cap and fits all the other criteria like hurting more when I walk downhill or down stairs and feeling like it needs to "pop ." What's crappy is that I've learned that I have a number of criteria that make me more likely to have this and to get it again: 

• I'm female (we tend to have wider hips, thus making the alignment of hips, knees, and feet a bit more challenging) 
• I overpronate (i.e., I have flat feet; no arch to speak of)
• I have weaker thigh muscles than calf muscles

So I can't not be female or not have overpronated feet... but I can work to strengthen my hip flexors and other muscles for alignment, and I can ensure I'm wearing proper footwear for running. And for those pesky thigh muscles? Well, quadriceps, you have met your match. You've got to stop letting those calves carry you.

I have a race tomorrow. The third trail race in the Ohio Outside trail series. I'm sorry to say that I won't be running it. I might walk it, if I'm allowed. I want to complete the series... I plan to rest, do some really gentle cross training (I'm thinking yoga), and do the stretches Ryan the PA gave me so that I *might* be able to run in the Doomsday Dash 5K in Columbus on December 15th. I reeeeeeally want to run that one... not only because it looks freaking awesome, but also because if I don't run it then I won't have run a race in December, which breaks a NINE MONTH RACE STREAK part of my goal to run a race every month, which would really tick me off. Oh, and I paid to run the race so I want to do it. There's that.        

Have you ever had runner's knee or another injury? How long were you sidelined? What did you do to help yourself get over the physical AND mental parts of being injured?

November's End

I took my blog to the depths of purple for Epilepsy Awareness month and it's been fun to bring awareness to this important, but often overlooked, cause.

My sister goes into the hospital next week for a surgery workup for her epilepsy, to see if she can even have the brain surgery to help her with her seizures. If you wouldn't mind sending some good karma, energy, prayers, or whatever you feel is most helpful in her general direction, well, I'd appreciate it.

November is coming to an end, however, and I'll be taking my blog's color scheme and design back in another direction. Just a warning, dear readers. I don't want to frighten you away or make you think I got hacked!

Sayonara, violet, lavender, and purple. We'll see you again next year. As a parting gift, here's a photo of my mother's crocuses, which bloom every spring... even if it's still freezing outside. If these flowers don't say "Hope," then I don't know what does.

Suggested Solutions for the Problem With Food

Yesterday's post about my food problems garnered quite a response from my friends and readers--thank you!

I'm posting the collection of responses so I can not only keep track of them for myself, but to share them with you in case any of you experience some of the same issues. I will be brave and swallow my nausea and post your helpful suggestions. Here goes...

First, I received recommendations from the my Healthy Holidays Challenge group. These are great things I can do to get myself off the ground.

**The HH Challenge leader suggested I look to see if the foods I can handle have anything in common. An unnoticed link might show me a temporary solution.

**I listed things I'm okay with eating and noticed that meat was really not one of them. The HHC leader recommended that I try non-meat protein options like eggs and soybeans so I can get what I need in a way that won't make me feel ill.

**When asked "how veggies are treating me," I admitted that I'm not pushing them on myself like I know I should. (Fruit is easy; vegetables, not so much.) The same gal who recommended non-meat protein options suggested I try making frittatas or spaghetti squash with sauce. I freely admit that I do not know how to prepare either of those things.

**Another HHC person suggested that I rock smoothies whenever necessary--fruit, yogurt, vegetables, seeds, etc. He also mentioned burritos, which I champion right now because they are simple and I can tolerate, so I will need to pursue this.

The Problem With Food

Last night when my DSL was on the blink, I sat on my sofa and wrote in my journal for awhile. I'm trying to figure out what's getting in the way of my relationship with food right now. It's not a simple one-and-done answer, and I don't expect it to be, but I know that at least a few of my solutions have to come from me.

I'm just not hungry. My appetite tagged along when the dish ran away with the spoon, and it's been this way for quite some time. I had a brief reprieve during which my appetite was insatiable, but this was driven by a medication, so let's forget about that.

Mealtimes come and go, and I think that I ought to eat something. So I do. Let me get this straight--I am eating! I eat. I'm not toying with an eating disorder. (Preaching of any kind can be taken to a pulpit where it is welcomed, thankyouverymuch.) I do eat. Sometimes my choices aren't great though because before I eat food is generally unappetizing or downright nauseating.

So I pick up something easy. Something that I know will go down easy, that I don't have to think too hard about. These are things like bananas and other fruits, a can of soup, a PB & J sandwich, an English muffin, a grilled cheese sandwich, pasta, or

You know what, I just got disgusted even writing that list. This is the problem. There it is, folks.

I don't want a diagnosis...  But I wholeheartedly welcome suggestions on foods that won't make me feel ill, EASY prep foods that I can go to in a pinch, or good-for-you options that are likely to both not make me ill and be easy to prep.

Trail race #2 -or- Flirting with injury

I ran my second run on the Ohio Outside Trail Series this past weekend. Saturday was chilly and my friend Eleanor and I had driven through clouds on the turnpike to get there.

The race itself was better than my first experience with this trail, which had been my first experience with trail running altogether. We walked the hills (super steep) and ran as much as my lungs would allow. The course is two loops and for some reason the second loop was MUCH easier than the first. I actually enjoyed the second loop.

We ended up beating my time (yay!) and that put the rest of the day in a glorious light. We went about our day together, got lunch at Square Cafe (delish!), and even hit the Carnegie Museum. Yes, I was still in running clothes; no, I didn't care that some snobby girl made a comment about my choice of attire. I felt like asking her how many miles she ran that day. :-P

As the day wore on, however, my right knee started bothering me. It was tight, then it popped. Then it was tight, then it wouldn't pop even though it felt like it needed to. When I got home that night, I iced it and elevated it for awhile and went to bed.

The next morning I could hardly bend my knee.

What on earth happened? The worst injuries are the ones you don't remember happening. You can't point at some distinct point in time and say, "Yes, at that time, that thing I did, that is what caused this pain." Worse, it's usually my left knee that bugs me because I smashed it pretty good a few years ago when I fell skiing. (My middle name isn't Grace, okay?)

I did some easy stretching on the floor while my dog kept trying to lick my hands and face alternately, and eventually came to the conclusion that I was going to need R.I.C.E. to get this back into shape. Rest, Ice, Compression, and Elevation. Yeah, standards of healing. So good.

I knew it wasn't good when I took my dog outside and could hardly get down the three stairs off of my porch. Yikes. To the couch! I propped myself up and got to knitting and watching a little SVU on Netflix (don't judge me). I took the ice off in intervals of 15-20 minutes.

I didn't feel any relief by late afternoon, so I took some ibuprofen. A little anti-inflammatory action helped me at least rest without as much pain.

I repeated the ice routine the rest of the night, wrapped my knee up with an Ace bandage for sleep, and by some magical healing miracle, my knee felt fine on Monday morning. I'm hesitant to declare myself fixed... especially when it hurt SO badly that day. I was ready to go to urgent care... I'm taking it easy this week, though, just so I don't do anything to make it worse.

No running--elliptical machine and bicycling only. That little flirt with injury was enough to make me hope and pray that I never incur an injury that will land me on the sofa for much longer than a weekend.

Listening to my body

Howdy. I've been MIA this week, I know. I don't know what it is, but I have been completely uninspired. I've got some stuff happening in my personal life that's taking time away from running, blogging, and such, but I really thought I'd get to blog about last Saturday's race sooner...

Last Saturday's trail race was okay. Not stellar, but not awful. I finished. I decided that trail running isn't my favorite thing. I also decided that I really, really need to work on hills. Not just for my legs, but for my lungs.

The first hill in the race was up a paved hill and, as predicted, I had to stop to begin attempts to *not* pass out. I had already taken preventative measures with all of my asthma medication before the race, but it was cold, the hill was steep, my heart rate rocketed, and I was a goner. My focus was just not passing out... I was listening to my body for cues of what to do next.

I often find that it's moments like this when my goals are whittled down to the very basics that I get stuck in my head and the race becomes a mental game more than a physical challenge. I'm learning quickly that I need to go through a really quick and dirty round of RADICAL ACCEPTANCE before I even take one more step.

The conversation I have with myself goes something like this:
body: *huff, puff*
mind: "Oh, great, you can't breathe again."
body: "Nope." *wheeze*
mind: "Okay, well, we can't run like this."
body: "Nope." *cough*
mind: "You're going to have to slow down to take care of yourself. And that's okay."
body: "Yes, because it's better to not die."
mind: "Right, that's in line with the goal of finishing the race. Not dying."
body: *huff, puff, deep inhale of medication* "Yep."
mind: "You have asthma and it's amazing that you even run. You're slowing down to take care of yourself."
body: "Yes." *deep breath*
mind: "How do you feel now? Ready to keep going? You're doing a good job. You're taking care of yourself."

If I don't take the steps towards acceptance in those critical moments that I am slowing down to care for myself, I slowly begin to criticize myself for being weak or slow, which is really unfair because I would never ever ever do that to someone else who was suffering like I am. So to get OUT of the head game and back into the race, I have to get that conversation going and accept the reality of my illness and what I need to do to treat it and care for myself, then move on with my life.

I am working with my doctors and a health coach to get my asthma under control. I yearn for the day when I can run free like so many of the bloggers and tweeters I follow online. I'm hoping to get things together soon, but I also know that I can't rush. I have to allow my body to get stronger, adjust to medications, and tell me what it needs. It's difficult to do sometimes, though, because I want to be better, faster, and stronger NOW. I've worked to get my body in shape... but my lungs just haven't gotten around to keeping up yet because of my asthma. We'll get there. I know we will because I won't stop till we do, but the struggle is real.

Damage control

I know I need to learn a thing or two about damage control and recovery when it comes to running... I've been athletic all my life, but only recently became a runner, so I don't know the nuances of soreness and aches like I did as a fastpitch softball pitcher.

When I pitched, I knew exactly what would hurt. And I could usually tell why, too. I would strain muscles lining my spine by overcompensating for the directional latitude of a change-up, later requiring a heating pad and a chiropractic adjustment or two. I would extend my leg too far as I lunged forward to deliver the pitch and end up needing some sports cream and ice. I was completely in tune with my pitching arm. It was often sore from throwing as hard as I could for long games. But generally I would rub it down with sports cream and be ready to go the next day. Given: this is all in high school when my body was repairing itself with the speed of a NASCAR pit crew. I don't expect to have that same recovery speed ten years later. (Gosh, was it really that long ago? (Yes.))

Runners World discusses the timing of soreness and aches: on the run and aftershock. I've experienced both, at this point, I think. On the run muscle soreness sets in, well, on the run because you're pushing yourself and even in your awesome running shoes, the cushioning isn't enough to handle all the impact of your body thanks to gravity. Body chemistry and a physiological response get pain going and leave the ache... Careful return to activity and sensible limits for dealing with the pain, if it persists. (And getting to a doctor if it's sticking around too long or getting worse.)

Aftershock is when soreness sets in a few days later. It's the much discussed Delayed Onset Muscle Soreness (DOMS). I've definitely experienced this from car accidents... Runners World says the soreness is from the muscles moving in some new way, despite training and practicing. Makes sense. But when your muscles get feeling better, they really are better than before. The muscle tissue grows back stronger than before. Build and repair muscle, baby!

This makes so much sense. Lately I've noticed some different pains coming on at different times. On shorter, faster runs, I've had some shin pain that feels a lot like my muscle is squished up into a little tube. I've tried stopping and stretching it out, but I'm thinking I may just need to strengthen my legs in that region to help myself. I had my first running-related shin splint right before Pittsburgh's Great Race. I freaked out a little, but did some online research and ended up learning about the wonders of compression socks. (I wore them the evening before, to bed that night, and during the race and I felt no shin pain. It was a miracle because I had been in pain the entire week!)

From my last race... well, I felt like I got hit by a fleet of trucks, to be honest, but to be a bit more specific, here's what hurt:

• my shins
• my calves
• the tips of my toes ("middle" and "pointer" toes; my pointer extends beyond my big toe)
• my right knee (probably from a dog park incident two weeks ago)

I'm glad to have at least a primer in damage control so I can try to make responsible decisions about when to keep going and when to have a rest day, whether I want to or not! And even if I rest, I'll probably try a little massage and stretching to keep things limber while I wait for my body's cell repair team to go to work.

Attacking my asthma

Sunday I ran 5K on the treadmill with nary a cough.

Monday I ran four miles without any trouble.

Tuesday, well, the workout was on my car, not at the gym... It had needed an oil change for awhile and my boyfriend was available, so that's all she wrote.

Tonight I plan to run again. Hopefully five miles. I have one hour to workout and I'm hoping to pop out the five miles I know I can run in an hour.

A month ago, I couldn't do any of this. My outdoor running was a struggle and my races weren't really going that well (my really difficult first group run--complete with asthma attack!, October 20th trail race, October 27th 10k nightmare) So what gives? I mentioned in an earlier post this week that I'm taking a different approach with my asthma medications. I think that's making the difference. Here's what has changed:

• My allergist switched me from Pulmicort to Symbicort (2 puffs 2x/day).
• I gave up on one of the inhalers I was supposed to use prior to exercise (Xopenex) because I didn't really feel it doing anything.
• I started using a spacing chamber with my rescue inhaler prior to exercise.

What's a spacing chamber? It's commonly known as a spacer. It's a weird little tube with a valve. You plug your aerosol inhaled medication (inhaler) on one end, and there's a mouthpiece on the other end. You squirt the medication into the tube and it's just waiting there for you to breathe it in. No breathing coordination required.

My allergist explained that it's a 20/80 split. When you don't use a spacer, 20% of the medicine gets to your lungs and 80% of it is in your mouth. (!!!) But when you use a spacer, 80% of the medicine get into your lungs and 20% of it gets stuck in your mouth.

I may give the Xopenex another try... with the spacer. But I'm skeptical. I've been told it's the same medication as Ventolin (just formulated differently; it doesn't give me the shakes like Ventolin does). Right now, though, I'm thrilled to be able to be running like I was this summer!

Sunday I have a trail race--an 8K... roughly five miles. The autumn leaves are still wreaking havoc on my lungs, but I'm doing my best to endure and to use the tools I have to make sure I can still do the things I want to do!

I workout while I...

A few weeks ago, my schedule was crazy (and it had been for a few months!). I hadn't been working out like I like to, so I was beginning to devise ways to workout while doing other things. I felt like a genius. Here's what I came up with. Feel free to chime in with your own!

I workout while I...

• blow dry my hair. I flip my head upside down and use a round brush to get the underside of my hair dried, so when I'm bent over, I do a few wall squats. Feel the burn! (But don't burn your hair!)

I workout while I...

• brush my teeth. I usually just stand in front of the mirror looking at myself make goofy expressions as I move the brush around to attack any plaque. I decided that was a great time to do some ab and glute squeezes. 

I workout while I...

• wait between puffs of my inhaler. I do two puffs twice a day of my Symbicort and I have to wait at least a minute between puffs. So for that minute, I do wall pushups in my bathroom. 

I workout while I...

• wait in traffic. If I'm at a red light, I'll do some ab squeezes till the light turns green and I'm on my way.

I workout while I...

• work. Because if I sit all day, I'll go crazy. I have a cube-like office (I have a door, but it stays open most of the time), so I usually just do a few wall pushups when I get up to fill my water glass, stretch my arms and legs really well, and challenge myself to maintain good posture when I'm sitting.I also try to get out to go for walks when I can.

How about you? When do you workout outside of your regular workouts?

Building blocks, goals, and recipe templates

This weekend I went shopping with a friend of mine. She's a list girl, like me, but she's very utilitarian with her purchases (not really like me; I like accessories and pretty colors... and lots of them). So the experience of us shopping together was a fun one. We run together, so we had a lot to talk about.

We initially talked about nutrition, then when we were in a clothing store we discussed winter running clothing and layering. Eventually we transitioned back to discussing food. I told her I was trying out eMeals. She liked the sounds of it, but mentioned that a friend of hers was making recipe "templates" that you just plug in ingredients and they should work. I admit that I'm skeptical, but I am willing to try it! I'll give one a shot and let you all know how it turns out!

My goals with the GroupOn-purchased membership are 1) get better at planning meals, 2) get better at planning shopping trips, and 3) get better at keeping staples in the kitchen (and learn what those ought to be--not Velveeta shells and cheese, as I used to think).

So far so good. I sat down with a few weeks worth of eMeals recipes this weekend and highlighted the ones I'd like to try. It's just lil' ol' me, so I don't need to cook every day (leftovers will sustain me just fine, thank you!). I decided on three recipes that are unlike anything I usually make for myself. I made a grocery list, put it in my purse, and went to the gym.

I worked my arms really hard (I can feel it today!) and then ran a good 3.1. I tried a different routine with my asthma medication and it seemed to work much better. (I used the stronger "rescue" inhaler before running instead of waiting until I felt out of breath and needed it.) I was able to keep running for the 30 minutes it took me to get through the 3.1 miles, and that hasn't happened in quite a while, what with the fall air. I was really excited about that. It's a small victory, but I'll take it!

At the grocery store, I stuck to my list. The only extra thing I grabbed was a bottle of Naked juice because it was on sale. I mentally checked it off as a "treat" to myself. The Blue Machine stuff is delicious. It's my breakfast drink for the week. The store was a little crazy (I forgot to check when the Steelers were playing--I unfortunately was in the store right before the game... ugh), but I made it through cheerfully.

First up this week is Sweedish meatballs. I may make those tonight or tomorrow. I'm not sure yet. But I'm excited to try something new!

All is not lost

I finally got my race stats from Saturday's less-than-spectacular run to sync with Nike+. (I had been experiencing technical difficulties.) I am pleasantly surprised to learn that Saturday's race DID set a few personal records for me. They weren't the ones I was expecting, but they are PRs nonetheless.

Get VIOLET

You might have noticed that my blog is now PURPLE. Yes, I shed the green skin this month because November is Epilepsy Awareness Month. The official color is purple, so my blog and Twitter feeds will don the shades of lavender for all 30 days.

Can I have your attention? Please read these few short paragraphs and you will make me so happy...

Here's the deal: you have a brain. Forget the funny little things you might say about people being brainless or peabrained or whatever. If you're a human being living on this planet, you have a brain. And if you have a brain, you can have a seizure.Seems scary, doesn't it? It doesn't have to be. Learning more about epilepsy and educating others is the way to get rid of the terror and mystique surrounding this disease.

People have been afraid of epilepsy and seizures in general for what seems like as long as humanity has existed. In the middle ages, people conducted exorcisms on epileptics because they thought they were possessed by the devil. In World War II, Hitler's corralling of the "unfit" to sterilize or execute included epileptics. In the 21st century, there are many treatment options for epileptics including medication and surgery.

This is personal to me because my older sister has had epilepsy since I was an infant. She had her first seizure when she was two years old and since then she has had good periods and bad periods, but ultimately it's the epilepsy that runs her life... Right now she's exploring surgical options and, while that's scary in itself, it's scary that any seizure in the wrong place at the wrong time could seriously injure her or worse.

In October, everyone is talking about breast cancer. People have become pretty comfortable talking about breasts, and in "Movember" men have taken to discussing prostate cancer. These are both wonderful things. I'm glad that people are taking action to discuss, educate, and promote prevention, detection, and awareness of these diseases. HOWEVER, November is also Epilepsy Awareness Month and, quite honestly, it ought to be a bigger deal than it has been because while only men have prostates and women are most commonly affected by breast cancer (at least people are more likely to picture a woman when they think of it), EVERYONE HAS A BRAIN. Holy cow, can we please talk about epilepsy some more?

I have a few simple requests. I would love it so much if you could do any or all of them:

1. Get purple - Facebook, Twitter, Instagram, your blog... Get some purple out there and tell everyone why you're getting violet.
2. Talk about it - You probably either know someone with epilepsy or know someone who has had a seizure. (Think about the six degrees of separation from Kevin Bacon type of thing--you're never that far from someone...) Open the discussion and talk.
3. Get informed - Read a little bit about epilepsy, how it affects people's lives, how people cope with it, and what to do if someone has a seizure. 
4. Visit my sister's new blog - she just started it, but she will be sharing her stories and I know she would love readers to cheer her on. 
5. At the very least... have a look at this brief list of facts.