The past five weeks have been mentally exhausting, but also incredibly rewarding as I’ve undergone my injury rehabilitation from plantar fasciitis.
I’ve spent a significant amount of time learning about ultramarathon running as a sport, but also about injury prevention and healing, ensuring that when I come back to running, I’ll be in it for the long-haul.
Unbeknownst to me, I first started my ultra training journey while dealing with the initial stages of plantar fasciitis, which ultimately boiled over to the point of not being able to run at all. It’s now been five weeks to the day since my first day off from an eight-week period of significant training, and I’m slowly starting to feel ready for my return.
So with that, here is every single hard lesson I’ve learned over the past five weeks, and everything I’ve done to ensure I come back stronger than before.
CYCLING & FUELING
My indoor cycling machine has gotten me through some of the most difficult periods in my life – from my broken collarbone to broken toe to torn hamstring all the way to this torrid injury. By nature of being low-impact on the body, particularly on those feet, I’ve been able to hop back on the cycle and hit new personal bests. I’ve continued my speed work on the bike, doing two sessions a week as opposed to the one speed session I was hitting on the roads. This is under the recognition that it’s hard to replicate the type of energy expenditure on the bike otherwise, and wanting to keep those endurance levels as high as possible.
2-3 days of the week are then made up of slow cycle rides and/or other cross-training exercises, helping to aid the recovery process from the harder sessions during the week. But crucially, I’ve kept up my back-to-back long hauls during this period of injury, progressing from back to back 60k rides in my second week of rehab, to hitting my first ever 80k today.
Just like running, it’s been incredible to see just how quickly the ease of these efforts has become, and how I’ve been able to shave off significant time every single weekend. Now in week five of the process, I hit 60k at the 4h10 mark today, when the first had been a meek 4h45, and my previous best had been 4h25. Along the way, I’ve learned more about fueling and what works for my body (at least on the bike), and fared far better with actual, substantial food in my system as opposed to just the normal sugary fruits that I’ve envisioned myself training with on long runs. This doesn’t necessarily mean everything will translate over to the run, but it’s been a valuable learning process of just how much food I can handle when in that tired state.
In fact, the past two weekends have soared to new heights as a direct result of better nutrition, ensuring I’m taking in bucket loads of water, and actually ingesting sugars and salts from real food and not just fruits. I had a fun time today with some homemade beet, cranberry, ginger and passionfruit tea, and a couple of Christmas cookies a friend had made me. I’ve also seen successes with small amounts of chips and salsa, oranges, dried fruits (dates, raisins, apricots), nuts and seeds, and in swapping out water with green tea and coffee. I’ve also tried different moments along the ride to fuel, usually restocking my energy sources three times across the span of the ride.
This is in stark contrast to how I ever envisioned training for an ultra. Famously, I’ve gone the no-food route on my runs since my hamstring injury in 2018, and I’ve completely become accustomed to understanding how to keep pushing on limited resources. But I also think that the lack of proper nutrition and hydration on my longer runs, continuously made my recovery more difficult, and eventually played a role in my injury going from bad to worse.
So the next time I go out there and start to rack up to the back to back 30ks, I imagine I’ll try and at least bring water on the way, and test out a few foods here and there when I hit those longer distances.
While the first time will always be difficult for anything, I can see clear differences from when I took the approach I would with running and ate very little each time I restocked, and to the past few weekends where I’ve taken in actual calories from homemade blueberry-carrot muffins or chips and salsa. My energy at the end of these long-hauls feels like it did when I was peaking below those back to back 30ks before my injury – like I could genuinely keep going. That’s a great place to be, but it also provides evidence for the fact that I should integrate more fuel into my diet pre-run, and in the middle of the act when I eventually return.
Cycling has been a lot of fun though, and I think it’s been important to stay active and to see out activities that get me in that flow state and in the mood I want to be. I feel best about the state of my injury after these long bike rides, and that’s only because of the joy I get out of accomplishing something so wild.
STRENGTH TRAINING & YOGA
I’ve always been a bit lightweight, recognizing that runners don’t need all that much muscle to survive. But in order to survive future injuries, I have made an active effort to improve my strength across the board. Most notably, I’ve focused on my hips, hamstrings, calves and ankles, targeting the areas that are directly related to my foot injury.
But I’ve also been lifting weights to strengthen my entire body, and conducting daily yoga sessions to improve my flexibility. Part of the reason why my body shut off came as a direct result of the check-engine lights that were going on all over my left-side. I had accidentally smashed my plantar on a weight back in August, and this evidently didn’t help. But I had also been suffering from a groin strain since the early days of my return to running faith back in May, and never properly addressed it. After even just a few days this week of flexibility work and stretching, my groin feels at a more flexible place than it has since May. In fact, I’ve even been able to do some core exercises that I had previously sworn off due to the lack of mobility in the area. Simultaneously, my foot feels better. This likely isn’t a coincidence.
Going about this process has clearly improved my physical capacity and flexibility across the board. I have better balance now, even more power in those powerful legs, and have a better understanding of which exercises target which areas of the body. I’m now going to be going back into ultra running in a place where some of my skinny running clothes might not fit quite as well, and I plan on keeping it that way even after I return.
Strength training can always be hard after an intense workout or long run, but I will be making an active effort to continue my hip strengthening & mobility, weightlifting, and the flexibility and stretching work that I had always previously just shut down. The yoga sessions will definitely be staying, as my enjoyment of yoga has only grown since my injury – to the point where I’m doing nearly two half-an-hour sessions a day. All of this work has been quite the process, but it’s starting to pay off in the form of recovery, and will certainly pay off when I ultimately return.
While injuries can be incredibly frustrating, they are also valuable learning experiences. My goal throughout this time has been to learn enough about the nature of my injury that it never occurs again, which has so far been a successful task of all my long-standing injuries.
This has been a particularly valuable one, as plantar fasciitis is the most fickle of injuries I’ve ever faced. There’s no straightforward approach to healing, and there’s not even all that many collective agreements from health professionals and research articles about what leads to effective healing. Calf and hip mobility + strengthening seem to be the only two universal items, and I’ve stumbled upon a few ‘experts’ who have a few common beliefs about the injury based on research that have worked for me too.
Unlike the vast majority of injuries, ice seems to do absolutely nothing for plantar fasciitis after the first few days of the inflammation. I think it’s helped in other areas that have worsened because of the injury (such as my heel, achilles tendon and ankle). But I’m probably of the belief that the ice has only slowed my healing process. This seems to be all the more true given that heat has been the one shining light that makes my pain feel better 100% of the time. There’s been immediate advantages in using pain relief medications and creams, but none long-term. Heat has been the only treatment method that has led to noticeable effects both short and long-term.
Currently I’m just still trying to identify the best ways to apply heat to my heel. My current way of rolling a hot metal water bottle against my foot noticeably pushes my hips into weird positions, and the last thing I want to do is create any imbalances for when I return to running. But heat has worked, and icing everywhere else (such as the calves, hamstrings, hips, etc.) has also achieved some positive results.
Going through this long injury process has also forced my hand into investing in some new pieces of equipment that I’ve been missing for a while – including a better functioning watch, a foam roller, training insoles, running books, and a spiky massage ball. The spiky massage ball is supposed to help with the recovery of the scar tissue, and early signs suggest that it’s been working. The foam roller will last me a lifetime so long as it can survive my strong legs, and this will be an awesome investment for my post-run recovery moving forward.
I’ve learned that insoles don’t necessarily work post-injury, but they might at least help me to continue wearing fancier (but less comfortable shoes) when required. All and all, the injury has clearly forced me to pay better attention to investing in my health, and not just taking shortcuts in my recovery.
I think perhaps most critically, my injury has also taught me about balancing that line between movement being the best approach for recovery in many cases, without doing more damage than good. I’ve spoken before about how I think plantar fasciitis is the most deceptive injury out there, due to the way it disappears with movement (until it completely blows up like mine did). Keeping my feet active and moving has therefore been essential to the recovery process, and a range of dynamic movement exercises have helped in that regard. Long walks haven’t quite gone as planned in my efforts to maintain endurance, but I can still see the progress from where I was on my first attempt to walk on the injury to now.
What I’ve had to learn through my injury is that there are so many things that just seem so counter-intuitive to injury healing, that can actually heal the body. One of those ways seems to be in strengthening the foot, which means time walking barefoot, in uncomfortable shoes, and conducting certain yoga stretches that might even hurt in the moment. All of these items can (apparently) help in the long-run, even if they hurt in the short-term.
For the first four weeks of my injury, I wore indoor shoes everywhere I moved, out of fear of the pain of stepping on my hard apartment floor. But since I started going barefoot again, I’ve had my best week yet. This has coincided with a range of other items that have sped up the recovery, but I think the science is clearly there to support the fact that this isn’t an injury that benefits from being cooped up in shoes.
I think it’s incredibly important to use an injury as a learning process rather than something to lose sleep over, ensuring you can come back stronger in the future.
While this has been an incredibly frustrating five-week period (and the end still isn’t entirely in sight), plantar fasciitis has led to several valuable lessons that I will take with me for months and years to come. I’ve learned more about ultramarathon running as a sport, but also had a unique way to ease into practicing what those longer distances truly feel like, both from an endurance and fueling perspective on the bike. I’ve also learned a lot about injury prevention and rehab, and invested in myself in the attempt to ensure that future injuries stay at bay. So long as I can get back to full health soon, I won’t have lost absolutely everything I built toward between October and November, and can come out of this stronger than ever.
Strava Profile | Rhys Desmond
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