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Saturday, April 21, 2018

To Increase Training or Not: Email Advice

HI Dr. Blake, 

It sounds like my insurance company still hasn't confirmed approval for the MRI, which is holding up my treatment. I'm looking into this on my end. In the meantime, the time has crept forward and I'm staring down my race goals for the year. 
Dr. Blake's comment: We are trying to see if it is tendinitis or a partial tear in the achilles tendon which should be treated differently. 

The Broken Arrow 52K sky race has over 10,500 feet vertical gain/loss. It is on Saturday, June 16th. This race is one of two prerequisites in 2018 to qualify for a larger race in 2019. The second prerequisite is a 50K on November 17. And I am registered for the October 4 New York City marathon. 

You cleared me to run a maximum of 5 miles at a time. My current condition is that the Achilles is bearable for these short runs but sore at the beginning and after (it is also sore after resting like sitting). The achilles seems happiest when it is warm, but I have not tested it at longer distances and elevation gain, because I have not yet be cleared for this.  

I am writing to ask if I can be cleared to start training? And to ask if you have advice about the minimum distance and elevation gain I should be able to handle in order to clear the Broken Arrow race challenge. In other words, should I be able to run 13 mi, 20mi, 25 mi at this date without pain in order to run in June within healthy limits? 

I would like to test it and see what it will bear, but I also want to do this in a wise & healthy way. It is still sensitive to touch. I passed up at half marathon race two weeks ago, in order to be conservative in my recovery. Your advice is much appreciated. 

Dr. Blake's Response:
Hey, without the MRI we have to go on your running. The pain at the beginning of your run is fine, but the pain that comes on during a run is not. That is when you that reached the tissue fatigue and more injury can occur. If you finish the 5 miles runs without soreness, and by the time you start running again (typically 2 days later) you have fully recovered, then you can up to 7 miles, after 3 times at 7 you can go up to 9, etc. etc. Hope that makes sense. You first work on distance, then hills, and finally speed. You try to go into a hard, then easy pattern with your running as you challenge yourself. Therefore, every other workout is pushing you somewhat, and every other workout is more relaxed. Rich

PS. Attached is the link to my posting on Good vs Bad Pain to review

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.