Forums >Health and Nutrition>Could I be injured? Is it all in my head? Help, please [update]
Last XC season I felt awful most of the season, was one of the slowest runners, and barely broke 25 minutes for 3 miles. I had pretty frequent pain but the location varied a lot so I didn't feel like I could ever say I had a real injury, and never took a single practice or race off.
In track I was still awful with long runs, but my training ended up being mostly track workouts and I averaged barely over 10 mpw. This was great for me, and I finished with 6:15 mile PR. I was feeling great and PR'ing pretty much constantly.
Now I'm doing preseason training for cross country, and it's not going so well. I'm always way behind. I'm not as fit as most of the other people in my group so it's not surprising that I'm behind, but I'm often really, really far behind. Some days I think it's probably mostly my fault because I'm just plain tired early on into the run and can't maintain the pace, but then other days I wonder if I could have an actual injury.
Take today, for example. I felt good for maybe the first five minutes, if even that. For the next 25+ minutes, my legs hurt a fair amount-- the pain wasn't sharp but it didn't feel like just soreness. Think of the burning sensation you get from trying to touch your toes (or, if you're flexible, reaching as far as you can past them). It's like that except in my achilles/calf area. When I was 30 minutes into the run, the pain went away mostly but my left foot went numb (if there was any time in between the pain and the numbness, I wasn't aware of it). This has happened to me multiple times-- when the pain finally eases up, my left foot will go numb. The numbness lasted for 5-10 minutes.
Not every day is like that, but I feel like days like that are becoming more common for me. The pain almost always goes away within minutes of stopping. I think I usually run a 10 or 11 minute/mile pace for the majority of the run so I'm definitely not going too fast. Sometimes the pain goes away eventually while I'm running, but when that happens it usually takes 2-4 miles, which doesn't help me out much since I'm normally running 3-5 miles.
My coach thinks it's a confidence issue that's preventing me from keeping up, although I haven't really told him how much it hurts. I don't want to be a malingerer. I know that pain is part of running, so maybe I just need to toughen up and deal with it. It could just be all in my head, maybe I'm just subconsciously doing it to myself. He's right that I don't feel very confident, so maybe that's all it is. I just want to know what the problem is so I can fix it. I'm an optimistic person but I'm getting frustrated because I'm always so much slower than I should be but I'm in plenty of pain anyway.
I would greatly appreciate any advice! Thank you!
Did ya run any during the offseason? Could just be that you lack fitness and it will take a while to build back up.
Numb feet can come from many different things including something as simple as tying your shoes too tight. Sciatic nerve from the back can be a cause of leg numbness too. If the pain/discomfort goes away it could be just that it takes a bit of time for your body to warm up. It might be that your XC running group starts out a bit fast and your system takes longer to get warmed up. Could you perhaps get to practice a bit earlier and walk jog a bit for 5minutes to limber up? Don't get down on yourself. You will get faster as the season goes on and you get fitter.
"Shut up Legs!" Jens Voigt
I didn't take much time off in between. I only took two weeks (technically, 13 days) completely off of running between track and XC training and I was doing core most of those days to keep some fitness.
I have been trying to tie my shoes looser but the numbness came back today, I don't know if I'm just not tying them loose enough though. I can get the shoes off without untying them so they aren't super tight though.
We typically do core/strength training for 15-30 minutes before most runs so I'm not sure getting there early to warm up extra is going to do much there.
Thanks for the help!
Awesome
Where on your foot is the tingling exactly? Is it always the same exact parts of your foot?
I don't think my heel was tingling but the sensation definitely went past just my toes and onto the middle of the bottom of my foot. It feels like when my foot falls asleep. Also it's only in my foot and not my leg. I think it's usually the same places although the intensity can vary a little.
runktrun
1. I don't think it's "in your head." I think you are legitimately struggling because of an underlying physical issue, so don't beat your self up about it being "lack of confidence" or toughness, or whatever.
2. You might be out of shape, relative to the rest of your team, but if you can run a 6:15 mile and are slowly working up from 10 mpw, you should see some improvement, not continue to struggle. You obviously have some natural talent and base fitness from track, and I agree that at 10:00 pace, you are already running conservatively and don't need to slow down.
What struck me was your comment about burning in your achilles and calf that goes away almost immediately after stopping. I have a fair amount of experience with chronic issues manifesting as running injuries, though I'm not a health professional. A few things come to mind, some of which posters have already mentioned. First and foremost tell your coach about the pain you experience and ask to see you high school sports trainer. Try to be as specific as possible when describing your aches and pains. If your trainer can't figure out what's wrong, or you follow his/her treatment plan for a few weeks with no improvement, see if you can get an appointment with a sports medicine doctor. Rather than tell you what I think is wrong, here are some issues that may present as you are describing your pain:
- Basic achilles tendonitis/tendonosis (from tight calves, weak calves, poor foot control, etc...work with a trainer or PT to address weaknesses)
- sciatic issues from tight/weak glutes (due to poor core stability, rotated pelvis, etc...again, need to work with a PT to figure out the details)
- Compartment Syndrome - this is basically where pressure builds up in your calves during physical activity and dissipates almost immediately when you stop. The burning calves + eventual numbness in your foot is a red flag. This is rare, but if you don't improve with PT, keep this in mind as a possible diagnosis. Surgery is usually very successful and not too complicated.
- Vitamin or Iron deficiencies - B12 deficiencies can cause neuro issues and muscle spasms and tingling/weakness. Low iron/pernicious anemia could explain why you "just can't keep up." The fact that your issues are localized to your lower legs/feet make me think this is unlikely, but a trip to your family doctor to complain about fatigue and get a blood test might be useful. Complete blood count, B12, Vit D, iron and ferritin are worth looking into as a runner. Iron/ferritin/serum iron/total iron binding capacity gets pretty complicated, but you can pursue that with a professional if anything weird results come back.
I don't think more time off will help because I think your issues require an active intervention, not just rest. Don't be afraid to advocate for yourself. Definitely do seek professional medical help. Good luck, let us know how you get on.
Not running for my health, but in spite of it.
kilkee: Thank you so much, your reply was very helpful!
Do high school sports trainers usually see people over summer? My current training is technically considered private coaching.
I should mention that I have an external tibial torsion in my right foot, which means my foot doesn't line up with my knee. As a result, I run with my foot turned out and although muscle strengthening might reduce it, it is inevitable that I'm going out to run with my foot turned out, short of getting surgery to correct the deformity. It's not severe enough for my doctor to recommend surgery but it is noticeable and if I straighten my foot out then I get a limp. My point being, I have a somewhat odd form that might be contributing to my problems. I also think this might be why my left foot is always the one going numb.
As far as vitamins go, I did have blood work done last year and everything came back good other than vitamin D, which was low. I'll try to be better about taking the supplement my doctor suggested but I don't think that's the issue, since I don't think my vitamin D levels would have changed significantly from track to cross country.
Thanks!
Edit: I'll look into the other conditions you mentioned, to get an idea if they fit my symptoms
Trainers are usually around during the summer, and if you're meeting with your team and your school coach, he/she should be able to get you hooked up with the school's trainer. If your coach is not affiliated with the school, then that might be trickier. You could search for a sport med doctor in your area and go right to them. They will likely see you briefly to rule out anything catastrophic, and then send you to PT anyway.
In the mean time, make what little changes you can, but don't go overhauling your routine all at once. If you change too many variables suddenly, you could really throw off your running and feel worse...or you might feel better but not know what exactly it was that helped! Try foam rolling your hammies, quads, and calves, and roll your glutes over a tennis ball, if you are not already doing so. A couple minutes a day to start. Squats and core stability exercises may help too; you want to get your deep core muscles firing so that your body is stable, and get your glutes accustomed to doing most of the work. Again, a PT who is familiar with runners would be a good resource so you don't learn bad form and bad habits. Best case scenario, that loosens up some fascial restrictions and allows you to move more smoothly and make the most of your slightly asymmetrical form. Your tibial torsion may very well play into your current left calf/foot problems, especially if the right leg is causing your pelvis to shift. You may just have to find a strengthening/neuromuscular training regimen that keeps you as strong and balanced as possible and be vigilant about it.
Ok so I checked and the sports trainer is not available. Does this mean I should get an appointment with a sports medicine doctor?
I don't have a foam roller but I'll try to get one soon, I have tennis balls though. I do core/strength stuff pretty frequently, nearly every day, although I'm not sure it's the right exercises to help. I should definitely add squats, they're difficult for me so I know I should try to work on those.
Thanks again!
It would be worth getting an appointment with a sports med doctor if you feel you've tried conservative measures (rest, rolling, light stretching, quality sleep, sufficient calories, etc) and aren't improving. It sounds like you could benefit from working with a knowledgeable PT as well. As around in your running community for recommendation for a PT who works with runners.
Half Fanatic #846
Walker23 - Your symptoms (numbness for a few minutes in one foot during runs) is what I had. This seriously limited my running , so I saw a sports doctor (orthopedic surgeon who is a team doctor for a major college), who diagnosed it as "compartment syndrome", and which was successfully treated through minor outpatient surgery. I can't even see the 1" scar anymore.
Kilkee is right, this is not a common condition, but don't count on it being CS, because it might be something else. Rely on a sports doc if you can. Good luck with this!
"I don't always roll a joint, but when I do, it's usually my ankle" - unk. "Frankly autocorrect, I'm getting a bit tired of your shirt". I ran half my last race on my left foot!
Update: I talked to one of my coaches and he suggested going in for a free consultation with a (specific) physical therapist. The physical therapist noticed that something about my left foot is off, I don't understand completely but I think it has to do with the arch? Something to do with pronation. (So basically my left foot is weird and my right foot is in the wrong place lol) Anyway, he prescribed custom shoe inserts and said to take 5 days off running to break in the inserts and to come in later this week to check that it's all working right. If the orthotics don't help, he said I can start doing physical therapy and he can refer me to a foot specialist. If that becomes necessary then I'll mention compartment syndrome since that keeps coming up.
I've heard some controversial things about orthotics, like that they ultimately weaken your feet by making you dependent on them, but I think that may not apply in my situation since I actually have a structural issue. I do like the feel of them so far so I'm optimistic, though. I'm a little worried that even if this makes the numbness go away it won't treat the pain but the therapist said he thinks treating the structural issues will put less stress on my legs and help with the pain.
Thanks for the help everybody!
I definitely belong to the camp that is skeptical of orthotics, especially when they were prescribed so quickly...BUT your PT is the medical expert, not me. I would caution you to just be very mindful of how you feel when wearing them and if you are not convinced they're working, voice your concerns. The body is pretty amazing and only seeks to support itself, so I tend to favor PT (muscle energy techniques, proprioception, neuromuscular training...not just boring clam shells) over interventions like orthotics. Do you have to wear them every day in your dress shoes too? You can ask your PT to work with you to strengthen your feet and maximize your own mechanical potential first, then try orthotics once you've corrected what you can by yourself.
Yeah, I definitely agree with you. I will double check with the PT but after they're broken in I think they'll be for running only.
I'm skeptical as well. Provided that the pain isn't being caused by some condition, I do think it's likely that they'll reduce the pain, so my concern is really that it'll weaken my muscles. But then again, running with pain isn't exactly giving me great results either.
If they don't work, then it doesn't matter. If they do work, I'll talk to the PT about eventually weaning off of them or something so I'm not so dependent on them.
Update:
So I took four days off of running and then (following the PT's directions) ran one mile yesterday and two miles today (one mile warmup then stretching and then another mile).
It's too early for me to say for sure, but I don't think the orthotics are working-- at least, as far as the root cause is concerned. I felt a little better than normal but I'm not convinced that it's the shoes-- I think it's just from taking a few days off and keeping the distances that short.
Two things I would note:
- I was confused about where the calf ends and achilles begins. So in my previous posts where I mentioned achilles pain, I'm pretty sure it's actually just my calf, not my achilles.
- I noticed that if I stop moving immediately after running (standing instead of walking), I can feel a burn in my calves and/or shins. I virtually never just stand still after running, I walk instead. While I was running today I stopped for real instead of walking. It definitely hurts for a minute to stand still immediately after running, while walking makes the pain go away faster. This helps me feel more secure in knowing that I probably have an actual physical issue-- if everybody's legs felt that way when they stopped running, I doubt I'd be the only one who never stands still afterwards.
On Tuesday I'll be running 3 miles nonstop, and by then I should have an idea of it the orthotics work or not. I can very rarely make it that far without pain so I'll be able to see what type of pain I'm in (tiredness vs burning). If I don't feel like they're working at that point, I think I'm going to ask to the PT about the possibility of compartment syndrome and see if he thinks it's worth being tested.
Thanks everybody for the help!