Ironman Training with an Injury

On Sunday I ran 4 miles.  At 9 minute pace.  Pain free.

With just 10 weeks until Ironman Louisville, you'd probably laugh if I told you my Sunday long run was 4 miles.  I, however, couldn't be more thankful.

Exactly 6 weeks ago, months of consistent training came to a rather sudden stop.  My Sunday long runs had been progressing nicely and I finished a 2 hour run satisfied with my pacing and nutrition.  Monday I noticed some soreness in my right hip that felt muscular.  I flew to Providence for a conference that night and on Tuesday morning hit the treadmill for my weekly 10k pace tempo intervals.  My hip was still a bit sore, but after a mile warmup, it felt normal.  Things changed on Wednesday when I woke up with an achy sore hip that was particularly painful each time it extended when walking.  Still thinking it was muscular, I attempted to run an easy 5 miles with a friend that night.  Again, it was sore, but seemed to improve the further I ran.  Little did I know, that would be the last time I ran for 6 weeks.  Later that night the benign ache became a pain in the front of my hip each time I took a step.  It was an eerily familiar pain that ironically dates back 8 years ago when I first began training for triathlons.

2008 Ironman Florida 70.3
My debut race in the swim-bike-run world

The summer before I started medical school I defined myself as an athlete as a runner.  5k and 10k were my preferred distances to race, but more than anything, I loved escaping a busy day to run along the banks of the Chattahoochee River in Atlanta.  Without any signs of an impending injury, my 6 mile run one afternoon ended with a rather acute onset of pain along the front of my hip.  Over the next week I tried running several more times until I had sharp pain with each step and was left with no choice to not run.  X-rays and an MRI followed and soon enough I had a diagnosis - FEMORAL NECK STRESS FRACTURE.

The dreaded black line in a location that isn't so benign.

Without boring you with details, I spent the next 6+ weeks on crutches, including a trip to Hawaii and the start of medical school.  Since I couldn't run, I started swimming and biking, both activities I had never done before.  Out of that injury spurred my interest in triathlons, and less than a year later I crossed my first triathlon finish line at Ironman Florida 70.3.

Flash-forward now to 6 weeks ago, and that exact pain of past injury was fresh in my mind.  Each step I took hurt, pushing off the wall in the pool hurt, and if I tried to stand on the bike and climb it hurt.  Running was a definite no go.  At that point, x-rays and an MRI were the next logical step, but I couldn't fathom spending $1500+ (not even doctors have good insurance!) for a confirmation of a diagnosis that I already felt confident about.  So, I did as I knew I had to with a presumed femoral neck stress fracture - I stopped running.  For a very long 6 weeks.

At that point, Ironman Louisville was 4+ months away, but even still I hated to think about the potential that I'd never make it to the starting line.  Training had been going so well and I had  high hopes for my second-go at the Ironman distance.  After a week of rest, I was back in the pool and on the bike, determined to use the opportunity to strengthen those disciplines.  Training remained consistent, averaging 15 hours per week, and two back-to-back weekends with 100+ mile bikes boosted my confidence in the sport I consider my weakness.  Sunday long-runs were replaced with a second long bike each weekend, and I tried not to dwell on the fact that I couldn't enjoy the pain of a post-bike run with my friends and training partners.  I was diligent about strength training and recovery to rehab this injury and prevent another.  And most importantly, I tried to ignore the voices in my head questioning my ability to finish an Ironman after missing 6 weeks of running.

Conquering a very hot 100 mile ride

This past week marked 5 weeks of no running, and my hip had been pain free with all activities for almost 2 weeks.  In my mind, it was time to start running again.  On Monday I ran a slow 2 miles, and loved every minute of it.  Thursday brought yet another successful run of 2 miles.  Finally, on Sunday I decided to push the distance a bit while maintaining a very conservative pace.  With each step I was paranoid that the pain would return with the next stride, potentially sidelining my running yet again.  But, I finished 4 pain-free miles at 9 minute pace smiling ear to ear, so thankful to be lacing up my running shoes and hitting the pavement yet again.

So race day is a mere 10 weeks from yesterday and there's a bit of a difference between running 4 miles and running a marathon.  I'd be lying if I said I wasn't nervous about how the rest of my training will go.  For now, though, I'm focused on one week at a time.  Small increases in mileage and careful attention to recovery will hopefully get me to the starting line in Louisville with a pain-free hip that's ready to tackle 140.6 miles and cross the finish line to hear - "Crystal Perkins, you're an Ironman!"