Saturday 31 May 2014

Exercise 4.2

This morning's swim should have gone well as the pool was quiet and I had an empty lane for the first half of my 1km. I tried hard to keep a tidy stroke with entry and exit together with a body roll on breathing. I also attempted to keep a steady pace with minimal pauses. However the end result was slow progress. A little disappointing but perhaps this is one of those backwards steps needed before a step forwards.

Rollering before bed and that was it for today.

Friday 30 May 2014

Exercise 4.1

A rest day, just work and the related walking. That meant that it had to be time for strengthening exercises. I've completed 2 sets of 10 chair squats and 1 set of 10 small lunges - they did pull a little - followed by the stretch routine. This isn't much but does seem to be as much as I can cope with. Whilst walking home I thought how good it would have been to run a little into the Peak District, it was pleasantly warm and the sun breaking through the cloud. Of course I couldn't manage it, or more accurately, if I did it I couldn't repeat it in the next month or so. I must be patient.

Thursday 29 May 2014

Exercise 3.7

I managed a good swim at lunchtime today and feel that I maintained fairly neat form. After work I had my monthly back and shoulder massage - mostly that's to keep work-induced stiffness in check, but today there was lower back ache from back extension exercises at the gym. Now I've just done a basic set of rollering and stretches. Even though yesterday was quite tough on my knees they've felt OK today, just a little issue with the right patellar tendon. So not right, but going in the right direction.

Wednesday 28 May 2014

Exercise 3.6

No swimming today due to too much work and a suspicion that it would tire me out before the circuit. As in previous weeks I ran to the circuit class, walking the downhill sections. Aiming for a high cadence was hard physical work but it is becoming a little more habitual and thus less of a mental effort.

The circuit class included squats and lunges, some of which I avoided and others I kept very small and well controlled. After all of that activity it seemed best to walk home. This was all done without any twinges but once home I had a tiny amount of patellar tendon pain on the right.

Tuesday 27 May 2014

Exercise 3.5

By the time I'd walked downstairs to make breakfast I knew that my quads were tender and my left knee a little rough. It would be wrong to say that it was painful, just rather grumbling. During the day both knees have been fine despite going up and down stair a myriad times and on only one occasion did I detect a twinge. The consecutive run/walk and hike have clearly irritated them a little and I hope another night' sleep will give a bit of resolution.

I had hoped to fit in a swim today as yesterday's class was cancelled due to it being a Bank Holiday. It didn't work out though as I had too much work on and didn't manage to leave on time, by which point I suspected that the university pool would be busy.

Now I must make sure that I do the rollering and stretches. No strengthening exercises though as I think they've had enough trauma for now.

Monday 26 May 2014

Exercise 3.4

The weather forecast predicted a dry morning before heavy, possibly thundery showers in the early afternoon. At breakfast time the sun was shining confirming our plan to hike the eastern section of the Sheffield Round Walk. The woodland was exceptionally green and we had a lovely trip except for witnessing a couple of stout dogs trying to kill each other in a park (we saw them later and they seemed fine so it wasn't as severe as it appeared). That was an undulating 11 mile walk, mostly done without pole, although I did use them on the long Norton Lees descent.

After a picnic lunch on the patio at home I cut the grass and finished just as it started to rain.

After all of this I was aware of my knees and made a point of doing lots of rollering of tight muscles and the usual set of stretches.

Sunday 25 May 2014

Exercise 3.3

I woke up with muscle aches in my shoulders, at least I'm hoping it's just fatigue and slight overload, from yesterday's swim. Most of the day has been wet, and although that's no excuse not to go out I had plenty else to get on with. Late  afternoon I rollered and as the evening came it was dry and a short run seemed in order. I decided that the rain would have made the paths in the woods a bit softer so that would be healthier than road, so long as I walked all of the descents.

Playing with  burst mode on the camera
I also made a point of checking my cadence a few times and I'm getting into the hang of 180 steps/minute. It feels very rushed! I also tried to keep my feet either side of an imaginary line to avoid my slight cross-over gait. As well as that I was aiming to keep a mid to fore foot strike and drive from my glutes with soft feet

Of course there was rollering and stretches to do at home. Hopefully I won't feel injured tomorrow.

Saturday 24 May 2014

Exercise 3.2

During the walk to the swimming pool I could feel a bit of tenderness somewhere to the side of the left patellar tendon, but not quite ITB soreness. It did seem to fade for the walk home. Swimming went alright, I made quite an effort to start and complete the stroke and this did feel to increase speed but taking a bit more effort. I didn't manage to join the lengths together partly because I was feeling lazy and used the excuse of 'keeping good form' to take pauses and also because the lane contained swimmers of varied speed and it was hard not to be either catching up someone or  blocking another. I was less bothered about blocking than the former as faster swimmers could chose to pass or go in the faster lane.

Even though some of the pauses to let people pass were quite long the overall pace was fairly good which implies that the swum lengths were a little faster than some sessions.

In the evening I did 1 set of 20 each of slow squats, clam and donkey kick followed by rollering and stretches. Just at the end of the squats there was a spot of tenderness around the insertion of my left quad, but very mild.

Friday 23 May 2014

Exercise 3.2

Another day with too much work and stress; enough to make my stomach hurt. We were meeting friends after work so it was quite late before I managed to do a few stretches before bed. Knees were pretty good walking around.

Thursday 22 May 2014

Exercise 3.1

A light day - no swimming even - as there's been a mound of work to do. Until the walk home I'd been unaware of my knees which is a step forwards but even then it was pretty mild. This evening I have managed 20 sets of 20 'sit downs' (ie eccentric squats with load on both legs) and a similar number of small lunges. The double leg exercise is clearly much easier than the single leg stair descent but that's probably advantageous to me presently. After that was rollering and I'll stretch before bedtime.

Wednesday 21 May 2014

Exercise 2.7

Before setting off to work I did a set of 5 step descents but I did take some of the weight off my knees using the banisters. Done like that there were no problems. This evening I ran slowly to the circuit class except for a short downhill section which I walked briskly. In the class I avoided any impact activities although I did do some single leg lunges and squats of very small magnitude. After all of that I chose to walk home. All of this activity has made both of my knees ache a little, hopefully that isn't indicative of damage, more tiredness with a training effect.

Tuesday 20 May 2014

Exercise 2.6

Today's walking hasn't upset my knees at all so I decided to do a very short run. Altogether I went 3.4km with walking all of the sections that were clearly downhill. The 'level' bit was undulating and I took care not to slow myself downhill. Throughout I tried to be very gentle on my feet with no heel striking. I tried to be aware of my potential cross-over gait and made an effort to keep my feet under my shoulders - every so often I felt  tendency to step differently. I also checked my cadence. Early on it was 160 but with a bit of effort I managed 180; but that felt very fast.

Rollering and stretching was fine - a bit of a knot in my left calf. Let's see how things are tomorrow.

Monday 19 May 2014

Exercise 2.5

The physio agreed with me that the tenderness in the quadricpes tendons is decreasing, although she still managed to find a sore spot! After massage of a few tight spots in calfs and quads we revised the technique for the step descents and noted that control of my left knee is far less than my right. I think I was a bit tired anyway.

After a short break I continued to swimming where I was told that I'd lost a bit of form in my stroke. I was shortening both the reach and recovery sections which is supposedly inefficient but this lazy style has allowed me to join lengths together. Being more careful was harder work!


My other blogs have said a bit about my previous seminoma and here I've mentioned my poorly diagnosed stomach pains. Eventually I was referred for gastroscopy (a good overview here) to check for ulcers or premalignant areas. I had the choice of with or without sedation and decided to try without so that I didn't need to be supervised for 24 hours - after all I wanted to go swimming! I'm glad I didn't read all this beforehand.

After a brief assessment and consent I was in the unit. After a spray of topical anaesthetic across my tongue, soft palate and down my throat I had to lie on the couch with legs in a recovery position layout. With a plastic bobbin between my teeth the nurse held my head in position while the endoscope was steered down my throat. I was aware of the device a the back of my throat and was told to 'gulp' to allow the scope to be swallowed into my oesophagus. As the tube went into my stomach they passed air into my stomach to make space and allow a good look round. This made me belch repeatedly and gradually the whole procedure became eye-wateringly uncomfortable. Somewhere in amongst this I grabbed the nursess wrist as she steadied the bobbin and my chin. Really I was clamped to the couch trying to cough, breath slowly, dribbling from my mouth and wishing it would all end. They took a few biopsies which I was surprised not to feel at all (the stomach lining is clearly sensitive as acid can hurt). These made me belch and feel like coughing even more as water was passed down the scope to clean it between samples.

They kept me informed of progress throughout and as the end was approaching the anaesthetic was wearing off. This wasn't painful but I could feel the scope in my throat and was concerned that if they were much longer I'd start reflex retching. Anyway that problem didn't arise as it was over soon. Once sat up and recovering i apologised to the nurse and was told that 'everyone does that'. I was shown the photos (selfies?) and everything looked good - no areas of irritation, bleeding or ulcers. I'll get the biopsy results later. I left very pleased and I'm told I had a wide smile on reaching the waiting room. Glad it was over, a pretty unpleasant 10 minutes!

Sunday 18 May 2014

Exercise 2.4

It's still looking like summer and we did the Devil's Elbow route as a hike (18.7km) including two stops at pubs  - just soft drinks. While at Accelerate last week I bought some Mountain King Trail Blaze poles to support my legs (some supportive words about this model here). Of course there are online shops doing them a little cheaper but I wanted to try out a few lengths and that's the great thing about traditional retailers. Poles made in UK too.

I've always been reluctant to walk with poles as they're something else to trip over but there is a fair bit of evidence, albeit of low quality, that they improve efficiency and reduce leg loading. I didn't find them too much trouble and suspect that I was a little faster going. Hopefully I won't have painful arms tomorrow. The knees feel OK, not perfect, but OK. I think long term they'll stay at home or in the pack, but for now they, and my upper body muscles, can help my delicate knees.

Later I managed 1 set of 10 step descents, a very small niggle was present in the right quadriceps tendon area. Discretion suggested best not to try a second set after a hill walk.

Saturday 17 May 2014

Exercise 2.3

Before bed I did my full set of stretches and that was it. No specific strengthening work but no problems.


Although I'm not running there I am walking in Ecclesall woods and the damp May has been good for the bluebells. I find them very hard to photograph, I wonder if their colour is somehow absent to camera sensors. Anyway, this is a pretty good impression of the woodland at this time of year.

HDR & tone mapped in the woods

VFF test

After many months, despite the ongoing knee issue (or perhaps because of it) I decided that I should give the Fivefingers a quick road test. A run on tarmac was out of the question but a potter in the grassed garden seemed fairly safe.

White legs in strange shoes
I walked around, moved back and forth and side to side for 30 minutes or so. As the shoes warmed up in the sun they softened and felt to fit a bit better. On the grass they felt fine but walking on the concrete paving path the ground felt very solid. After this I was aware of a little calf tenderness and rollered them as soon as I went inside. I can really see the argument that minimalist shoes make you aware of pain and terrain - there's no way I'd run a single step on a hard surface in them at present.

Slow swim

This morning's swim was hard work. From the very first length I knew it was going to be tough. There was someone a little slower than me in the lane and rather than making the effort to keep ahead I paused each length to give them space before I set off. That made me average time even slower than it usually is. I wonder if the combination of a Thursday swim and circuit had made me tired. Whatever, I was in no mood to fight it and went with the flow. At least I've done something.

I walked the 5km in the remade 315s and they seem OK. I can see a scuff mark on the lateral border of the soles already.

Friday 16 May 2014

Exercise 2.2

I walked home form the station and although I was generally tired the knees were OK. The left felt a bit stiff but not much more - and I was carrying a fair few things in my rucsac. Didn't do any stretches or rollering though. I don't miss too often.

So far so good

On the train for the second time this week and knees seem ok after yesterday's punishment. I am aware of the left but no pain. Perhaps having a hemp protein supplement with the evening meal helped?  Some progress maybe but mustn't overdo it.

Thursday 15 May 2014

Exercise 2.1

Inbetween 2 lomg meetings (of varied productivity) I managed a 1.1km swim. Unfortunately I messed up with the counter and lost data but did note that I'd done the 1km in a good time. I was also trying to keep my stroke tidy after the critical feedback on |Monday.

In the evening I ran very slowly to circuits, walking the short descent. I avoided the intense legwork of the first half but still did more sidesteps and small lunges than I'd intended to do. Naturally I walked home, but quite briskly.

As I'd also done 6 stepdowns (there, I've named them) in the morning I went to bed worried that I might have done too much (no pain though).

Wednesday 14 May 2014

Exercise 1.7

A little walking today, I'd hoped to do a swim but no time during work hours and after hours we went to listen to Rosie who was visiting Sheffield as part of a promotional run to promote Phase. She's a great storyteller and has had an unusual life to draw upon for inspirational tales.

Accelerate were promoting the event and provided lovely tea and sales advice and made us feel so at home in the shop. Thank you all.

Tuesday 13 May 2014

Exercise 1.6

Just walking to and from work today. No swim, no additional weight-bearing exercises and certainly no running. Before bed I rollered and stretched. A pain free day but so it should be. On the positive side, it should have been a good day of healing.

Monday 12 May 2014

Exercise 1.5

I've been on a train for almost 5 hours today and not walked very far but even so it's clear that the left knee is struggling after yesterday's steps. It feels generally tired and aches but whilst walking no distinct pain.

During this evening's swim it became apparent that I've started to take a few short cuts in my stroke in the quest for back-to-back lengths. I was told that I wasn't finishing the stroke nor reaching enough. Trying to correct this gave the impression of a more powerful stroke with some well-paced lengths but it was also a bit more tiring and I only managed a maximum of 3 lengths. I didn't suffer from the tingling fingers that troubled me some months ago suggesting that I'm regulating my breathing fairly well.

Sunday 11 May 2014

Exercise 1.4

This morning a set of 10 step descents was fine even though I woke up with stiff legs. During the afternoon we did a 7km stroll which was easy on the legs and gave me the vague thought that things might be improving. On return the right leg was fine with another set of descents but the left leg hurt part way through the set and I stopped at that point; the flexion was a bit restricted even before that. The problem seemed to originate in the quadriceps tendon as before.

Saturday 10 May 2014

Exercise 1.3

Walking into town and back via the swimming pool has been more than enough today. On the hill close to home my left knee became quite sore around the ITB area although it settled quite rapidly. For a while though it had felt tired and had a very mild ache. As far as I'm concerned that means no step descents or short run today. I will do rollering and stretching soon.

The swim was OK, it was subjectively hard work but done at my usual speed and for no greater distance. The pool wasn't even rough so I'll have to keep an eye on this to ensure I'm not heading towards an injury.

Friday 9 May 2014

Exercise 1.2

Having walked to work I did 1 set of 10 step descents and realised that I wasn't flexing my left leg much and that was then being blocked by the calf muscle - hence the apparent tightness. Basically I was guarding the painful bit.

After a day at work and going home I'm well aware of the left ligaments so no descents or run this evening seems the best policy.  A set of 10 squats was fine though.

Interesting video on cross over gait

I've done a bit of googling on Cross Over gait and found that it's amazingly common. Here's a sample webpage with some nice videos:

The whole issue is making me think of swimming. Most people would accept that a swimming teacher or class is helpful or even essential and yet most runners are self taught. OK, so maybe running is very natural and we 'just do it', but over extended distances many people approach their limits and maybe more coaching should be seen as the norm? 

I suppose one problem is that the biomechanics of running are controversial (witness the barefoot movement) and for every supporter of Q-angle you could find a coach or therapist that thinks such concepts are unhelpful, or even fanciful!  In general there appears to be far more agreement amongst the swimming community as to what is effective or harmful.

Thursday 8 May 2014

Exercise 1.1

First day on the stair descents. I'll try to keep a log of how things go.

This morning I did a set of 10 on each leg without problem. I was fine walking around work and commuting. This evening I did the same and felt minor discomfort in the quad tendon. For the last few on each leg I was able to take a bit of my weight by holding above the step and this removed the ill feeling. Notably the left calf was tight too and this felt to be blocking a slow steady eccentric descent. I followed with 10 mini lunges per leg and 10 small squats; these were fine.

Rebuilt 315's

My second pair or Roclite 315s had collapsed within the midsole and yet the uppers were in good condition. I had bought some new ones some months before and rotated between them so as not to become accustomed to one particular heel shape but now this pair seemed too sloping to be sensible to wear. With only 600km of use this is quite costly. Although the third pair could be rotated with a potential fourth pair it seemed more eco-friendly to see if I could get the mid and outersoles repaired. Inov-8 don't sell replacement sole units nowadays although I know that they did in their early days. It is of note that Inov-8 suggested that I might be better off with Trailroc 255 shoes and maybe I'll give those a go when my current 315s nead replacing.

From various online forums it appeared that LSR have a good reputation in resoling fell shoes and after exchanging a few emails I decided to try their service. I sent the shoes from a local convenience store via Hermes which was very good value, far cheaper than the FedEx service offered by LSR. Today the shoes arrived (a turnaround of a couple of weeks as advertised) and they look good.

Freshly repaired
The fell sole looked as though it would wear rapidly on stony trails and tarmac so I asked for the Vibram 'road sole', which has a  hiking shoe like pattern but fairly shallow tread. They cut away visibly damaged EVA and replaced it with a dense material. This might give the soles an uneven compressibility and cushioning but I think that's the least of my worries as it has restored the sole contour. Comparing them to a newish pair of shoes the height and planes look similar so the drop is probably similar to new.

The job was expensive and didn't feel financially sensible as it is around half the cost of a new pair of shoes but it does keep a local company in business and avoid shoe waste. I'm sure that Inov-8 won't approve.

I'll try a run in the shoes but I'm also thinking that I may use to do quick fast trail walk. I'll post agin when I've had the chance to try them out, Hopefully it won't have been a waste of money.

Wednesday 7 May 2014

Two more months

This evening's session with the physio was focussed on recovery and came with the suggestion that it was likely to take another 2 months, assuming that I've had a month already. The tissues are less tender than previously and I reported less discomfort after walking trips implying that healing is taking place. So what do I have to do?
  • 2 sets of 10 very slow single leg descents down stairs repeated 2 or 3 times daily
  • 1 set of 10 lunges - to be very controlled ensuring that knee stays behind ankle, with raised arms to engage more core muscles
  • 1 set of 10 small squats - as above no forward movement of knees, leaning forwards to balance  torso
I should also try to achieve 5km runs per week which should be done on the level or slightly uphill. Descents should be walked. Also the runs to be done ina 3minutes run 1minute walk cycle. There should be at least 48hours between runs. Whilst the step descents are prescribed daily the squats and lunges aren't to be done on run days. The current programme of roller and stretching is to be continued too.

This is quite a programme and I shouldn't continue through pain in any set nor start a set or run if I'm still in discomfort from the previous activity. So really it is a gaol for the next few weeks rather than something to be done now.

As an aside, I was watched doing a few minutes on a treadmill and apparently every 3 steps or so I swing a leg close to, or even occasionally across, the midline. Clearly this puts significant lateral forces on the connective tissues. I'm supposed to try to keep my feet on 2 lines shoulder width apart, but quite how to achieve this without looking down all the time is unclear to me. This webpage seems to show a case a little more marked than me.

At the circuit class I did 1 set of lunges and 2 of squats and walked there and back as I had my commuting rucsac with me. I didn't notice any issues at the time.

Monday 5 May 2014

Short pool

As the swimming class was cancelled due to the bank holiday I returned to Heeley Baths. There was only one lane available and after I'd done a few lengths in it a label appeared stating 'Fast Lane'. There were only 4 of us using it, 2 at a similar speed to me and one much faster. The rest of the pool was too hectic to have done lengths with any degree of reliability.  As I wasn't sure how long the pool was I did 52 lengths to ensure that I'd exceeded the 1000m. On my way out I asked and was told that it is 22.5m.

That gave a total of 1170m and a time of 03:14 per 100m. Shorter lengths seem faster as the are more opportunities for a catch-up-breath and there's a more frequent push off. The main thing was that I managed to keep going on the whole, only delaying a length to let the faster swimmer go past. By the time I finished, there were just 2 of us in the lane.

Now I'm getting the hang of this swimming I must make sure I don't get injured shoulders.

Sunday 4 May 2014

Hiking around Edale

Whilst the knees are too delicate to run I seem to be able to do reasonable hikes without much detectable discomfort. Today we did a loop around the Hope valley including a stop for lunch.

Looking northwards from Win Hill
There were a quite number of people out although not as many as one might expect on a bank holiday Sunday. I'm aware of my left knee especially after 15 undulating miles but I only experienced pain when I sort of banged by foot against a stone. I think this might be progress.

Saturday 3 May 2014

First swimming gadget

Now I've started to be able to string some lengths together and reach a fair total I decided that I needed a gadget to log things! I considered the single minded Garmin Swim and Poolmate but thought that I didn't swim enough. Then I excluded the Suunto Ambit2 in its various guises and the Garmin Fenix2 largely on the basis of cost and that they make far too much of a statement for a beginning swimmer, although they'd be great to record and navigate long trail runs.

Images from the company's websites
A couple of reviews also mention that the automatic counters are quite sensitive to technique and as mine is poor and not very reproducible they seemed a bit risky. The low key solution was a simple waterproof counter from SportCount that's small enough to sit on a single finger.

From the website, the image doesn't show how small the counter is.
On its first use I only failed to trigger the length once and that was evident as that length had twice the duration of the adjacent ones. I also managed to retrieve total time and individual length data from it; features are accessed sequentially using the single button below the display. There are 3 models of counter with different features but the prices are so similar it made sense to get the top model.

On this occasion I copied the data by hand into a spreadsheet, I'm not sure if I'll do that every time but it felt as though I should start off that way! This revealed that my pace was a slow 03:43 minutes per 100m. Somehow at the Goodwin I need pauses between lengths, only of a few seconds, but there nonetheless, I think I find the rough water tiring.

Thursday 1 May 2014

Unsure about progress

Yesterday evening was the circuit class and as planned I ran there and back slowly. I avoided all quadriceps-based exercises and felt fine when I arrived home. Today I've been a little aware of the various tendons around my knee and some are quite tender.

I'm sure that some of the discomfort is linked to use but some might be due to tight muscles. Last night I had terrible calf cramp which has been resistant to stretching and rollering done at odd times through the day.

Movement is in the right direction but it is very slow progress and I do sometimes wonder if I'll ever manage 40km again, never mind achieve 100km. On Monday the physio spoke of a 12 week programme to get back close to where I was. So if I'm lucky, that's 30km by August.