As the world whirls

I’ve been quiet on the running blog because I’ve been pretty quiet on the running in life. After the three weeks' rest post-VCM, I was getting in 5-6 miles a few times a week, but not being as rigorous or religious about it as I am during training. I continued to suffer the muscle soreness in my lower abdomen/groin, so it was probably just as well that I wasn’t trying to run hard, or run a lot. But I still ran, as it wasn't so bad as to prevent it. Just always there in the background.

Then, Sunday, July 10. Around 4 a.m., I woke up and turned onto my side, nothing unusual, but it felt like I kept going once turned; falling, around and around, the room tilting and spinning wildly out of control. This severe vertigo hung around all day, so that I couldn’t walk without help, and every motion of my head caused the room to tilt and slant and I’d find myself listing or flat on the couch or bed again. Even simply lying with my eyes closed; I could still feel myself whirling -- it was better to keep my eyes open. It was awful; coupled with nausea from the dizziness, it was a pretty bad day. (And very disappointing, as well; it was a nice day out – not TOO hot, not TOO humid, and we had planned a 50-mile bike ride south of the canal, where it's flatter.) Monday was marginally better; I could creep around the house if I had a wall to lean on, or something to grab as I went by, but there was no way I was going to be able to go to work if I couldn’t walk without support. I spent another not TOO hot, not TOO humid day not getting to run in the morning, and instead laying and sitting around the house, reading (I enjoyed that, at least) and being bummed when B got home and went out for an after-work mountain bike ride without me.

Fortunately, I already had a doctor’s appointment scheduled for that week (to talk about the muscular pain) so I brought up this sudden-onset dizziness while I was there. The doctor diagnosed Benign Paroxysmal Positional Vertigo (BPPV) and gave me a list of movements to do with my head (Epley maneuvers) to try to help correct it. Though not disappearing, the vertigo diminished enough over the week so that by Friday I could drive myself again and didn’t need to hold onto or be next to a wall while walking just in case. While it has improved slightly day to day, I still cannot move my head too quickly, or right myself too quickly if I have bent over to pick something up, etc. Any quick, turning/sweeping motion with my head elicits a brief (fortunately not debilitating) spell, just a quick second or three of disorientation, a weird feeling (mostly in my eyes) that things are not steady. I have been doing the maneuvers (and feeling pretty icky during them, as they spur a flash of more intense vertigo), but it isn’t improving as quickly as I’d like. It will “get better with time”, the doctor said; well, my idea of “time” has consistently proved to be much shorter than a physician’s, so I get impatient quickly. BPPV is uncomfortable, even when it is not intense anymore, so I wish it would just stop.

A week after the vertigo started, when I felt I could walk reliably without an attack of disorientation, I thought I would try to run again. Whenever a week goes by and I can't run for whatever reason, I start to get antsy, though this time, a forced week off could've been good for the muscle soreness situation, right? (More about that in a moment.) Early last Saturday, it was already quite warm, but better to get it done early than suffer heat indices near 100 later. I got all ready, really looking forward to a few miles after having been stuck inside sitting around for a week, and walked to the end of the driveway to the sidewalk. I turned to run up the street.

I didn’t even get past my yard. Immediately, with those first three or four steps, the world felt too loose¹ – bouncing too much, scenery going by too crazily. I didn’t feel like I was going to fall over, but it sure seemed like everything was sliding around too much, my head just not right. I stopped after a few strides, hesitantly, then tried again a few strides.

Nope.

Later, I wondered if I ran on the treadmill, would it feel better? There would still be the up-and-down bouncing, but no scenery passing my peripheral vision; it might not be so disorienting. So, Sunday afternoon (while B went out on that long bike ride south of the canal -- I did not yet trust my head enough to ride a bike) I gave it a shot. It was also quite hot out on Sunday, so from that perspective, it wasn’t too bad to have to run on the treadmill. (I haven’t been my treadmill for many weeks, so that felt a little weird itself.) Well, it didn’t feel normal by any stretch, but if I kept my gaze focused at a fixed point on the wall in front of the treadmill, and occasionally touched the crossbar with my fingers to keep myself oriented, it wasn’t too bad. It didn’t feel like the world was as loose around me, it didn’t feel like things were skewing as much. I started out very slow and worked my way up to 8:45 pace, covering five miles.

When I got done, I felt uneasily iffy. Not dizzy, not like I was going to fall over, but my eyes didn’t feel like they had a good, firm grasp on what I was looking around at. My head didn't feel quite right -- a faint disorientation, walking to the kitchen and up the stairs to shower. It didn’t last, but it was uncomfortable. It put me off trying again on Monday. And now it is Wednesday and I still haven’t tried again. I keep hoping that after doing the maneuvers at night, and another day going by, I’ll wake up and feel better, and I mean noticeably better, not this very tiny incrementally better that’s been going on for the last week. So far, I haven’t had that breakthrough.

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While at the doctor last week, after talking about the vertigo which was more pressing at the moment, I explained the muscle soreness, how long I’ve been having it, how it has changed and concentrated itself, and when and where it bothers me. After having me push my legs against her resistance a few ways, she concluded it is likely an issue with the psoas muscles (both sides) and prescribed physical therapy. I was relieved she didn’t mention the words "tear" or "torn" or "surgery". She mentioned there was an outside chance it could be some kind of arthritis or fracture, and to rule that out, she ordered an x-ray of my hips. I had that taken last Friday, haven’t seen the results of it.

This morning, I went to my first session of PT. It is not my first time having physical therapy; in 2008, I saw a PT for a foot injury, and then again in 2009/2010, for a sprained PCL and patellar tendon pain after the mountain bike crash in Moab. I am going to the same clinic as I did in those instances, but the therapist I worked with those times is no longer there, so I am working with someone else – he’s not officially “new” to me though. We did meet, back in 2008, and once or twice he worked with me in 2009/2010 when my regular PT was out -- but it’s been a lot of years and a lot of patients for him in between, so I didn’t expect he would remember me (he did not seem to), though I remembered him. I described the issues – where/when/what, etc. and he came to the same conclusion as my GP did: the iliopsoas is all fired up.

We went through a list of specific stretches to improve hip flexor flexibility and then a list of strengthening exercises as well, to go through on my own twice a day. He said I can continue to run, just to avoid hilly routes and to be easy on the pace.

Done and done. I like trail running, but it won't disappoint me too much to stay away from the park for a while to avoid how hilly it is there. I’d like to race this fall, but it’s not necessary, so if it takes several months of easy running and stretching/strengthening to cool down this issue, I’ll do it with no regrets of missing this half marathon or that ten-miler. I was so glad he didn't tell me to be a couch potato (or, actually, a standing potato, as lengthy periods of sitting doesn't help this issue) for a couple months. Now, if this vertigo will just give up its hold on my head, I can go back to running those nice easy flat miles – preferably outside and not on the treadmill. Weather and circumstances permitting, I’ll give it another shot tomorrow morning. I miss seeing the sun rise over the neighborhood trees while I'm looping around the reservoir.


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¹The best way I can describe what this was like is this (I realize that most of you may not be able to relate, but): the scanning electron microscope I use at work, an old Hitachi S4000, needs to have apertures aligned properly to give the best images. While aligning them, if the aperture is out of whack, the image on the screen bounces from side to side, and sometimes in a slightly circular way as well, the focus going in and out; the worse the alignment, the wilder and stronger this motion is. I imagine a bobblehead’s vision to be similar. That’s kind of what the world around me seemed to do when I tried to run outside; bounce and slide and turn, bobblehead-like.

Back at it

I spent three weeks not running after being broiled in Vermont. I usually take at least a week, usually two, but I had some nagging aches and sorenesses that I thought I'd give an extra week to recover -- most concerning was the lower abdomen muscle situation that never really kept me from doing what I had to do (except once), but also that hamstring/leg cramp that happened during the race on top of the usual marathon-induced aches and weakness. I'm usually chomping at the bit to get back on the road after the first week, but this time, I rather relished the first two of the rest weeks, sleeping in to 6 a.m. and changing right into comfy clothes upon arriving home after work, taking time to enjoy my other hobbies. I had to be more disciplined during the third week, telling myself it was better to give it all just one more week at least. I traveled to Iowa during the third week and it felt peculiar not to fill up half the suitcase with running clothes, and to not spend an hour each day traversing the east side, but I obeyed my rest plan.

I did go biking three times during those three weeks -- twice road biking (~20 miles each time) and once mountain biking, which was a lot of fun as I had not been on my Rumor since early last fall. (I hadn't been road biking since early last fall, either, but while I enjoy that pursuit, it's not "fun" in the way mountain biking is.) The first road bike outing was a week after VCM, and at the end, my legs felt very like noodles. I had thought I might like to mountain bike the next day, but my legs were not having it. The next weekend, I hit the trails on the 29er and my legs were less noodly, which was encouraging. Road biking the next day, my legs were more or less fine. I didn't feel any of the aches and soreness that I'd ended the spring's running with.

I thought about taking one more week off running, but from an emotional standpoint, I was ready to run again, and my aches and soreness hadn't bugged me while living my life, so I was willing to test that out too. I set my alarm for 5 a.m. Monday, but my internal clock was on Central Daylight Time, so when 5 a.m. came, it felt way too much like 4 a.m., and I bailed. Instead, I ran after work, which wasn't optimal because it was in the upper 80s, but I wasn't going to be running hard and I thought I'd enjoy a trail run for the first time in a month so I'd be out of the sun. I got home, laced up my Peregrine 5, and headed out.

Almost immediately, the lower abdomen/groin discomfort flared up. Not so as I couldn't run through it, but it was discouraging. Three weeks of rest did nothing to calm that down, it would seem. I ran about an hour, feeling it in the background the whole way. I thought that because I'd run with it for quite some time at the end of the training schedule this spring, how much more could it hurt it to run tonight? My right leg was OK, but not great or normal; I could feel that hamstring still.

I didn't run on Tuesday, because my legs were sore -- quads in particular, calves a little tired-feeling. I guess three weeks is plenty of time for your muscles to forget everything they'd only recently gone through. And not just muscles; I ran quite slow on the trails, but my heart rate was higher for the same pace than it ever was this spring. I thought I might be able to attribute it to the heat, but I ran this morning (70F and humid, not too bad, and so lovely around the reservoir) at a pace that would certainly be considered "easy" but 40-60 seconds slower than the corresponding heart rate would have allowed me to run only a month ago.

The lower abdomen/groin thing felt about the same as my quads did, which is to say not too bad, better than on Monday. The hamstring was OK this morning too, less noticeable. I will run again tomorrow and see how it goes. I feel I am trying to be overly optimistic about the lower abdomen, but that's only because I don't want to sink immediately to doom and gloom conclusions (though that is what I really fear, deep down). I have an appointment with a doctor on July 13 to discuss this discomfort. I made this appointment a couple weeks go. It was the soonest I could get in. Ridiculous.