Is 4 days enough?

So after 4 days of non-running my knee is feeling much better. There is some slight stiffness to it when I wake up, overall I think there's a slight patellar tendonitis. Naturally I've done over 6km of walking each day just to and from work but no other exercise. I'm going swimming soon and hopefully that won't upset it.

The big thing to consider now is when to try a run and how much can I risk? The 40km per week really seems to be a threshold for me. Over 2014 I've ramped up to it twice and each time had to back off. This time I have been more gradual and included a rest week after 2 weeks of effort. I'm disappointed that this scheme hasn't worked out. Maybe this is just a little set back as my knee is not as delicate as it was in spring - I really don't want to over do it and go back that far again.

Being self-critical I know that I have neglected the leg strengthening exercises at home. At the circuit class I have been doing more squats and lunges and managing to get them a little deeper without invoking pain.

Looking online there is a lot if excitement around declined single leg eccentric squats, some articles suggest they are great (note there was 6 week's rest in this study!), others warn off. The whole business of eccentric loading is very unclear from serious literature. One of the physiotherapists I saw last year was keen on eccentric single leg squats without the decline board but then again he encouraged too much loading!

Platelet-rich therapy is up and coming and some authors claim great success. Indeed they may genuinely be successful as many innovative techniques are incredibly sensitive to operator's skill and methodological 'tricks' (indeed I went to Scandinavia to do post-doctoral research specifically to see certain techniques in the hands of experts). Unfortunately it seems that PRT does not offer a reproducible gain.

I am thinking that long term slow loading is the way to go; slower but fewer risks?

Good until 22km

This morning I ran my Dore Moor Half Marathon at a leisurely pace; as before keeping an eye on heart rate. The weather was indifferent to poor. I set off in mist and it was drizzly until Fox House. There it was raining needing hood up an head down. Luckily as I moved towards home the rain stopped. Whether this was due to the loss of height, the shelter from the plantation of just the passage of time I don't know.

My stomach was fine. I ensured I didn't over eat last night and I had just a single slice of toast with tea for breakfast. Some part of that seemed to help. All was good until I was very nearly home when my left knee developed a bit of pain laterally and in the patellar tendon. After more food I walked into town to collect some pre-ordered trousers. This didn't seem to trouble the knee but on the homewards journey it became quite uncomfortable and that remains.

I can't find a spot that's tender to pressure so hopefully nothing serious. It's a great shame as for the last three months I've been making slow, but clear, progress after injury. Although my chart shows this as my first 40km week I did a 'rolling' 50km in Spain so this wasn't an especially heavy week.

Next week is a recovery week, I hope it is.

Hilly intervals

The latest edition of Trail Running magazine included a pull out training guide, as it so often does. The programmes all included hill sessions as an opportunity to improve power but that's something I've not tried. This evening I estimated a stretch on a local street which turned out to be 360m rather than the recommended 400m. That was a fairly good guess. The gradient was 5%, again acceptable.

I did 5 ascents, trying fairly hard after the first time. As a first time I didn't see a need to do the recommended 8. One of the notable things about the plans was their lack of progression. They started with 8 and finished with 8. Maybe one should try harder, or perhaps the same effort would result in better performance? The plans also seemed to be a bit short of rest days and rest weeks, some were less than others but not as much as I seem to need.

Anyway, the hill intervals were OK and my knees survived. A good first step.

No swim

I'd been wondering about today's breaststroke swimming session but in the end it didn't matter. An after 5o'clock work meeting went on much longer than expected, partly because I arrived late for it. If I'd rushed I could have been 10 minutes late for the session but I just didn't have the motivation. This is reminding me very much of being 10 years old when I found excuses to not go to a swim training session where we all got shouted at to push harder. It'll be interesting to see how I feel about next week.

Gastritis

Today's run was spoilt a bit by stomach pain. It appeared around the half way mark and ebbed and flowed until I got home. Eating a bit of Clif bar seemed to dampen it a little. As soon as I got home I took an extra Omeprazole and the pain went - far too quickly for a pharmacological action!

There is some sort of link between running and my gastritis, although there's also something to do with eating largish meals and travelling. Stress is a key factor too. This bout seems to be being a little harder to shake off than previous ones but maybe there is more ongoing stress.

Should I be cutting out breakfast, meals the night before a run, or even stopping running. When I spent a week trail riding on the motorcycle in France I couldn't quite stop the tablets - no running then, but there was travelling.

Some interesting papers to read about poor guts in runners and my interpretation:

• Simons and Shaskan (2005) - Running can aggravate gastritis and Omeprazole is prescribed. Not eating for 3 hours before exercise helps some people. Best to avoid carbohydrate pre-run too.
• Choi et al., (2006) - Runners at 200km/week training bleed into their guts from oesophagus and stomach. H2 antagonists (ie different class of drug to omeprazole) reduce the pathology seen by endoscope and blood loss. Even though I don't train this hard, and don't have lesions (or didn't have) my guts are delicate post irradiation.
• Thalmann et al., (2006) - A proton-pump inhibitor reduce faecal blood post-ultramarathon. Some of the sample already had gastritis.

My take home message from this is that gastritis is fairly common in runners. The studies look at athletes far more active than me but a link is there.

Mostly round

Today's quandary was whether to do a long run or not. It's on the rota but my knees were a little niggly despite 3 non-running days. Despite the mist and drizzle I set off to do the Round Walk in reverse direction and go as far as felt comfortable. As a long run I tried to keep my pulse down although it did creep to 150bpm a couple of times.

Early in the run my left knee felt a bit weak but as I relaxed into it things seemed good and so I kept on going. It was only on the steep descent early in Porter Clough that  it was clear my legs should be given a rest as both quad insertions were slightly sore on the steps down. As the gradient lessened they were OK. Rather than go all the way to Hunter's Bar I turned home via Ivy Cottage Lane.

Plenty of rain last night...

So that was just over 25km. This is my longest run in terms of distance, elevation and time since 1st March. That run occurred during the time of the knee breakdown so I'll have to be careful. Some rest, rollering and hemp protein powder called for now.

Swim for fitness?

I've joined 'Swimming for fitness' at the Goodwin centre as I was a bit unhappy with my progress KES. I'm not sure if it was a good idea or not. It's a stroke per night and today's was crawl, really all I want to do. There were a few tips and then off we went for a couple of lengths prior to next tip or drill. I was one of the weaker swimmers and I was a little reminded of a class I did when I was 10 years old that put me off swimming classes for nearly 40 years. That's not a good recommendation is it? My biggest hesitation about it is that I got very little feedback on my style. Partly this is due to the class size but it also seems to have something to do with the class format.

Perhaps I'd be better in another session? Next week is breaststroke and I'm not sure that I want to do that at all since I've been advised to avoid that stroke to limit lateral loads on my knees. Do I skip the session, let the leader know or just get on with it?