Wednesday, May 28, 2014

Hamstring Injury and Recovery

As you know, I injured my hamstring during the 2014 Boston Marathon.  The good news is that it was caused by overuse and was not torn.  The best description of my injury according to my physical therapist/masseuse was a pulled hamstring.  It is more commonly referred to as a hamstring strain.  Simply put, it is a tear of the hamstring muscle fibers.  My hamstring strain is rated as somewhere between a Grade 1 and a Grade 2 strain.  The injury has definitely limited my ability to run at all and walk comfortably.  I wanted to discuss with you what a hamstring strain is and how I am rehabbing it so that I can resume my normal running routine.

Let me start by describing what the hamstring is.  The hamstrings are the tendons that attach the large muscles at the back of the thigh to bone. The hamstring muscles are the large muscles that pull on these tendons.  These muscles help us bend our knees, extend our legs, drive us up hills, and power finish-line kicks.  It is important to have strong hamstring muscles. They also attach up onto your pelvis which is why a hamstring strain can cause some pain in the hip and gluteus maximus area.  As a runner, you need to make sure that your quadriceps are not stronger than your hamstring muscles.  If you don't maintain a balance it can lead to hamstring injuries.

Hamstring issues usually arise because your hamstring muscles are weak.  It is believed that very flexible people are prone to hamstring problems because their overly stretched-out muscles are more vulnerable to damage.  I have been really diligent in my stretching over the years and now wonder if it was a partial cause of my injury.  I am not suggesting that you should skip stretching altogether because it is also known that people who can barely touch their toes or who sit for long periods of time (like me at work) are also at risk for this type of injury. As most of you know when you have tight or shortened muscles you are placing them under greater tension during exercise.  And as I alluded to above, runners' with strong quadriceps can overpower their hamstrings, which sets them up for injury.

What I have discovered in speaking with my physical therapist and reading up on the injury is that treatment of a pulled hamstring is dependent on the severity of the injury. But all of the data I have collected says that the best treatment is to simply rest. As a general rule, if you have a hamstring strain, you can do activities that do not aggravate your recent injury. What I needed to do was rest until I was pain free giving time for the injured hamstring muscles to heal.   Allowing time for the muscle to rest is the first step in treatment of most hamstring injuries. Rest allows the swelling to subside and inflammation to settle down.  If I resisted this treatment, I was sure to prolong my recovery time. 

Secondly, I was going to have  to stretch.  Stretching can begin soon after an injury.  But you cannot, aggressively stretch the area or you will exacerbate the injury. Stretching should be gentle and not painful. What my physical therapist told me was to use the normal stretches that I have been using for this portion of my legs.  She told me to stretch to the point of discomfort but not pain.  This is a very fine line.  You should never have pain while you are stretching -- even healthy muscles.  If you are experiencing pain you need to back off the stretch before you cause an injury.

If you are a runner like me, you should be seeing a masseuse regularly. I also recommend that you find one who is also trained in physical therapy.  This person can help guide you with appropriate treatments for any number of running maladies.  For this injury my physical therapist has been using ultrasound, electrical stimulation, and therapeutic massage.   After 3 session with her, I have been able to resume my running although at a much slower and less impactful pace.  I intersperse some street running with elliptical machines.  Running a slow, easy pace is usually less bothersome than attempting intervals, speed work or hill repeats. She also recommended that I could bicycle, pool run, or swim as good alternative activities. The good news is that I am feeling much less pain now when I exercise. 

What I am now starting to do is strengthening my hamstrings with one-legged hamstring curls (raise the bar with both legs, then slowly lower it one leg at a time) and one-legged dead lifts. I am also including bridges.  This is where you lie on your back with your feet on a chair or exercise ball. Raise your hips, then lift one leg into the air. Slowly lower your hips back down to the floor, using the supporting leg. Return that leg to the ball. Repeat with the other leg.  I am not very coordinated at these yet.  And I have purchased a  foam roller to alleviate tightness before and after my runs. In addition, I will be seeing my physical therapist at least monthly to have her use active release technique (ART) and deep-tissue massage  to keep me on the roads.

It has been over a month since the marathon.  I am happy to be nearly recovered from the injury.  I will need to be a little careful over the next several weeks to make sure that I don't reinjure the hamstring muscles.  Running has become such a huge part of my life and I don't want to lose the ability to run.  I also have to recognize that I am getting older.  Slowing down is a natural part of this sport as you age.  I am just not ready to give in.

May 5 – 5.20 miles (45:44, 8:49 pace)
May 6 – 6.00 miles (1:00:00, 10:00 pace)
May 8 – 5.70 miles (1:00:00, 10:32 pace)
May 9 – 5.20 miles (45:57, 8:49 pace)
May 10 – 7.10 miles (1:05:33, 9:14 pace)
May 11 – 6.10 miles (1:03:00, 10:20 pace)
May 12 – 5.20 miles (48:11, 9:14 pace)
May 13 – 5.30 miles (1:00:00, 11:20 pace)
May 14 – 6.20 miles (54:02, 8:43 pace)
May 15 – 5.10 miles (58:20, 11:26 pace)
May 16 – 6.10 miles (55:57, 9:10 pace)
May 22 – 5.20 miles (47:55, 9:14 pace)
May 23 – 5.20 miles (49:05, 9:23 pace)
May 24 – 5.50 miles (1:00:00, 10:55 pace)
May 25 – 7.10 miles (1:05:48, 9:14 pace)

Total Miles:  86.2 miles

2014 Total Miles:  895.6 miles

Sunday, May 4, 2014

118th Boston Marathon - Perseverence

After training for 18 weeks, the day had finally arrived for the 2014 Boston Marathon.  It was a sunny morning and the temperature was about 65 degrees when I left my friend's house to head down to the starting line.  I wanted to get there early to make sure I could get through the security around the starting line and to have a chance to meet up with some of my Dana Farber Marathon Challenge (DFMC) teammates.  My friend  dropped me off and I started to walk towards the starting line area.  The security was very tight and I had to go through a checkpoint, be wanded and then turned loose to head over to the church and DFMC Refuge.  I was a little saddened by the need for such high security as it was an indication that this race has been changed forever by the events of last year. 

At 11:00 am, the DFMC team headed out from the church towards the corrals in the starting area.  We were in Wave 3 and Corral 9.  I was about 1/2 mile from the starting line.  As I stood there amongst about 600 other DFMC teammates, I reflected on how hard I had trained leading up to this day.  I was rested and ready.  Leading up to the race, I had avoided watching any of the TV coverage of the anniversary of the events of 2013 because it was just too difficult to watch.  As a former resident of the Commonwealth and a 2 time finisher of this race, I really wanted to be there just to have the chance to be a part of the celebration of this very historic race and to try and help in my own small way to heal the City.  I was filled with excitement which had replaced the deep sadness I had felt only two days before. 

While I was downtown at the race Expo the Friday before the race, it was the first time I had walked around that part of Boston since leaving back in December 2012.  It was a very eerie feeling as it looked like it always does.  The finish line was all set up.  The barricades and bleachers were in place.  It looked exactly like it did on the day of the bombings.  As I walked towards the finish line, I felt an overwhelming sadness take over me.  I was having to hold back tears.  I headed over to the Old South Church right at the finish line to receive the scarf from its members.  They had created the Marathon Scarf project where they collected handmade scarves from all over the country to give to the runners of this year's race.  I collected mine and received a hug and a blessing from the woman.  As I walked away, I had to wipe the tears from my face.  She had told me that they were wrapping me and the other runners with their love and hope for peace in the future.

As I waited for the gun to sound, I also reflected on  the fact that runners have been training for this race for 118 years. This race has been a lifetime goal for some elite and middle of the pack marathoners like myself.  More importantly, this race is and always will be a huge chance for personal victory for everyone who tackles the challenge.  I thought about the fact that a marathon is not just about the runners who participate but it is about the families who sacrifice for their loved ones to train for and run this storied race.  Having run this race twice before, I know that it is mostly about the City of Boston coming together for a celebration of achievement and to show the world what human achievement looks like and showcase what a fabulous place Boston is. 

I didn't actually hear the gun go off.  But I knew it had as the runners started to walk towards the starting line.  I started to walk along with them.  It was good to finally be moving.  As I reached the starting line, I snapped a quick photo and headed off.  The first miles went really well.  I was feeling good and when I checked my pace after the first 5K, I was right on where I wanted to be.  I settled into the pace and figured I had a shot to break 4 hours again.  But I didn't get too excited because I still had 23 miles to go.

By the time I got to mile 10, I was feeling like I could hold the pace for the rest of the race.  I knew I would slow down a little in the Newton Hills.  But at this pace, I would still be able to come in under 4 hours with some time to spare.  My right hamstring was feeling a little sore.  But it was nothing I hadn't experienced in training.  Typically I would feel a dull pain that would subside after a little while.  So I didn't think twice about it and kept going.  I really wanted to get to Wellesley College to see how crazy the co-eds would be this year.

I reached Wellesley College still feeling pretty strong.  My hamstring was still barking a little bit but still nothing major.  So seeing that I was actually ahead of my pace, I decided to wade into the crazy screaming tunnel and get some lovin' from these co-eds.  They did not disappoint.  I high-fived so many girls that my hand hurt.  Several grabbed my shirt and kissed me on the cheek.  I am still not sure why they want to hug and kiss sweaty old guys like me.  But why disappoint, right?  When I got to the end of the college, I looked at my watch to see my current time.  It had taken me 10 minutes to get through that mile.  My pace was still ok and my hamstring seemed to be feeling better.
The next 2 miles went by without an issue.  Unfortunately, the hamstring started to feel sore again as I passed the 14 mile mark.  This time it did not feel normal.  I slowed my pace down a bit to see if it would go away.  I figured if it didn't, I could stop and stretch it out a bit.  I passed the 15 mile mark still not feeling good about my hamstring.  I had 11 miles to go.  I decided to take a 2 minute walk break to let the pain subside and then started to run again.  I wanted to finish this race no matter what.  I started to think that the 4 hour goal was not going to be reached this time.  Regardless, I was going to cross that finish line in whatever time it took.
I could feel my hamstring starting to hurt again as I was approaching the 16 mile mark.  I was hoping that it would go away.  Then I felt a very sharp pain in the upper right rear of my leg.  It felt like someone had taken my hamstring and tied it into a knot.  It was so painful I stopped almost immediately.  I walked a few paces to see if it was going to release.  It became obvious that it was not going to get any better.  I had to make a decision.  Was I going to head to the closest Medical Tent or simply keep going.  I had 10.2 miles to go.  Not being one to accept defeat, I decided to walk for about 5 minutes to see if it would get better.  If it didn't, I was going to run/walk the rest of the way.  I didn't come all this way to take a DNF.  More importantly, I did not want to let down all of my followers and donors.
I trudged on knowing that I had the Newton Hills ahead.  I also knew that with a bad hamstring, I was never going to be able to run uphill.  Without a good hamstring your leg has no power on an uphill incline.  I gingerly ran down the hill to Newton Falls and had the hill up and over I-95/128 ahead.  I struggled up the steep incline.  As I was approaching the halfway point on the hill, I saw Dick Hoyt pushing his son up the hill.  Everyone was cheering him on.  If he could push his adult son up this hill then I could push on as well.  I had to walk the last part of the hill.  As I crested it, I picked up my pace and started to slowly run to the turn at the Newton Firehouse.

As I made the turn the crowds became even thicker and more raucous.  They were cheering us all on with such passion I became energized again.  I tried to run up the first of the 3 Newton Hills.  I just couldn't do it.  My right leg was simply not cooperating and the pain was really strong.  I decided to run for 2 minutes and walk for 2 minutes.  It seemed to work a little as I continued to struggle with the incline.  I reached the base of Heartbreack Hill and it looked like Mount Everest to me.  I started to feel defeated.  Then I heard someone in the crowd shout, "You got this.  Just keep going."  That little encouragement helped me slowly get to the top of Heartbreak Hill and the relief of a flat portion of the course.

I was still having trouble running as the pain was pretty severe.  I found that when I would increase the pace above a walk it would hurt even more.  I would try to run and then would have to walk.  I was visibly limping and the crowds along the course could see it clearly.  I cannot explain how much it meant to me to be given so many shouts of encouragement as I struggled along.  The crowds were so supportive of all of the runners out there.  The heat was causing problems for many of the runners who had been training in very cold winter temperatures.  The heat was not my problem.  But as I struggled down the hill to the turn onto Beacon Street, I could feel the excitement of the crowds increase.  I knew that they would carry me the last 3 miles to the finish.

The last 3 miles up to the turn on to Boylston Street were very painful.  I saw my friend Jenice along the route and she asked if I was OK.  I told her what was going on and that I was going to finish.  She gave me a hug and told me to take it easy.  I had no choice.  I pushed on.  At the 24 mile mark, I came up on another fellow DFMCer who was also struggling.  He said he was suffering from the flu.  He asked me if I wanted to run with him a while.  We would run to a traffic light and then walk to the next light and run again.  I tried to keep up with him but just couldn't.  I thanked him and told him I would see him at the finish line.  He headed off without me.  It was at the recovery zone where I found out that runner was Mike Doherty who I had been corresponding with leading up to the race.  We had never met until that moment. 

At Mile 25 the DFMC cheering section was really going crazy as we approached.  I was really feeling bad and feeling like I was just going to break down and cry.  So I walked over to the barrier and got several hugs from the people and volunteers there.  I thanked them for all the support and then pushed on.  I could see the Citgo sign and knew the turn and "one mile to go" sign was right there. I told myself that all that mattered now was to be able to run across the finish line no matter how much it hurt. I knew I was going to finish which felt good.  The question now was would I come in under 5 hours.  The way I felt, I was not sure.
I made the turn and heard my name.  I turned to my right and saw my friend and fellow Scoutmaster Bill Mills-Curran and his daughter.  I hobbled over to the barricade and he gave me a big bear hug.  I told him what had happened and he told me that he knew I could finish.  I thanked him and told him I would make it.  He gave me  big pat on the back and I headed back onto the course.  The pain was really strong.  I found myself walking more than running at this point.  The crowds were cheering me on.  I could hear them yelling my name and giving me all the encouragement they could muster.

I finally made the turn onto Hereford and knew I had less than 1/2 mile to go.  I was really hurting and the incline up to Boylston was difficult.  I walked up the hill towards the turn.  The crowds were now so thick you could barely see any individuals.  The sound of their cheering was almost deafening.  It was almost as if they were willing us on to that finish line.  When I finally made the turn and could see the finish line about 3/10 of a mile ahead, I started to slowly run to the finish.  I was hurting.  I stopped to walk for a minute and I heard my name again.  There on the left were two of my running friends Josh Martin and Jess Andra.  They called me over.  They were genuinely concerned for me.  Josh gave me a huge hug and told me I was rocking this race.  Then Jess gave me a big kiss on the cheek and told me to get out there and finish this up.  I thanked them and headed off.

Their encouragement and the raucous crowds pumped me up and I slowly ran towards that finish line.  I had taken in all the sights and sounds of the last 10 miles and was so happy to be able to finish the race no matter how much pain I was in.  As many signs along the route said, “This is our f’n City” and “This is our f’n Finish Line”.  All of these thoughts were running through my head as I approached the finish line.  I could hardly breath as I got closer and closer to the finish line.  I could feel the tears welling up in my eyes.  In hindsight, I know this was caused by a combination of emotions brought on my all of the memories of what I saw on the news last year and the pain of those last miles.  I crossed the finish line under 5 hours.  My official time was 4:57:09.  I had persevered and somehow still come in under 5 hours.

While there is a small part of me that is disappointed in my race results, I am so proud to have been able to finish the race.  It is most likely my last Boston (unless I qualify). I forced myself to drink in the sights and sounds of those last 10 difficult miles. The Boston crowds were so supportive as they always are but this year was definitely different.  The crowds were thicker and louder.  The shouts of encouragement to me personally were amazing. I can tell you that Boston is definitely back and stronger than ever.  I am so proud of all of those who came back this year to finish the race that they were not allowed to finish last year because of a truly senseless act of violence.  I am also proud to have been able to finish despite the injury. 

Dean Karnazes wrote the following:
The Marathon is not about running, it is about salvation. We spend so much of our lives doubting ourselves, thinking that we’re not good enough, not strong enough, not made of the right stuff. The Marathon is an opportunity for redemption. Opportunity, because the outcome is uncertain. Opportunity, because it is up to you, and only you, to make it happen.
There is no luck involved in finishing the Marathon, the ingredients required to tackle this formidable challenge are straightforward: commitment, sacrifice, grit, and raw determination. Plain and simple.
I as reflect back on my 3 Boston Marathon experiences, I know that I have the right stuff to set a PR, finish on an extremely hot day and persevere after an injury.  Each finish symbolizes the reality that no matter how hard you train or prepare the outcome is uncertain.  No matter what, I know that I am a marathoner.  I will carry each of the 8 marathons finishes with me for the rest of my life.  I also now know that this last race was and hopefully will always be my most difficult.  I also know that I have the raw determination to finish what I start no matter what obstacles may be placed in my way.  I also have the distinct honor to have raised over $37,000 for Dana Farber this year.  And most importantly on April 21st, 2014 I was Boston Strong!

26345
Frumkin, Ted
52
M
Scottsdale
AZ
USA

5k
10k
15k
20k
Half
25k
30k
35k
40k
0:28:18
0:55:33
1:22:32
1:51:14
1:58:23
2:22:34
3:01:40
3:45:19
4:34:01
Finish:
Pace
Proj. Time
Offl. Time
Overall
Gender
Division
0:11:20
4:57:09
4:57:09
26930
15201
2175

The DFMC Team
 Apr. 14 – 6.10 miles (52:45, 8:39 pace)
Apr. 15 – 5.10 miles (43:52, 8:36 pace)
Apr. 16 – 6.20 miles (54:02, 8:43 pace)
Apr. 21 – 26.40 miles (4:57:09, 11:10 pace) – 118th Boston Marathon
Apr. 28 – 3.10 miles (28:10, 9:05 pace)
Apr. 29 – 4.20 miles (35:29, 8:27 pace)
May 1 – 5.10 miles (45:15, 8:49 pace)
May 2 – 3.10 miles (28:51, 9:23 pace)
May 4 – 6.20 miles (1:01:02, 9:51 pace)

Total Miles:  65.5 miles

2014 Total Miles:  809.4 miles