38th place, 1:06:51. Not what I had hoped for but not awful. I was out in the pack which was slow, 5:06. I stayed on the pack to about 5 miles going 10:00(4:54), 14:54(4:53), 19:42(4:52), 24:40(4:57). Miles 5 and six I was slower but still felt strong and fairly easy I could feel my coordination threatening a bit so I was thinking a lot about my form and posture but it wasn't impacting my running. I hit 6 miles in 29:39 with a 4:59 mile. Then I started to struggle. My breathing wasn't bad. In fact it was pretty good. A couple of times I would start to feel a bit of strain but not much at all but my legs were heavy and not very responsive. I slowed to a 5:12. I would basically spend the next 5 miles bouncing up and down between 5:06 and 5:12. I would try to push and my legs would just have no fight quickly but since my breathing was good I would be ready to push again a few hundred meters later but it would only take 50 or a hundred of pushing to be slowing again.
Obviously I had hoped for more but I had also been quite sick so I had a feeling sub 1:05 was a big ask. Immediately after the race I was actually feeling pretty satisfied with the effort and happy that I had been limited by fitness rather than coordination which is good.
The more I thought about it however I was a bit more disappointing. Generally speaking as the event doubles in distance I tend to slow by about 5 to 6 seconds per Kilometer. So my 5k road best is 14:20(2:52 per K) my road 10k best is 29:32 (2:57 per K) my half marathon is 1:03:44(3:01 per K- faster course) I felt that before I got sick I was getting close to 1:05:00 but that being sick may have sent me back to where I was in late October early November. Thing is I ran a 14:40 on a fast road 5k in late October. That would point to a ballpark of 1:05:03 to 1:05:25 for the half marathon. That is just ballpark but to end up in the high 1:06's seemed a little crazy. The course and the conditions were perfect.
Thinking about it more I started thinking about my debut half marathon at BAA in 2005. I ran 1:07:28. I have no doubt looking at workouts that I am in better shape today then I was then. The thing is the course in Jacksonville was much more than 30 or 40 seconds faster than the BAA course. I would guess more like 2 minutes.
So now I had two things saying I should have run more in the mid to low 1:05's. So what is the problem? Well first if you are in shape for sub mid 1:05 and you try to run mid 1:04 you will likely blow up a bit and run slower than 1:05mid. But a minute and a half slower? That seems extreme.
I did some digging around on feeling like your not breathing heavy but your legs are holding you back and everything said the same thing. Good aerobic fitness and poor anaerobic fitness.
My first thought was not possible. It was a half marathon that is an aerobic event.
The more I thought about it I began to think it made a lot of sense. When I was sick I continued to run and even do some longish runs but I didn't do any workouts. The only two workout like things I did were 2 miles long at half marathon pace not anything that was going to build up much latic acid to be flushed. Looking back at my training the last time I did a workout that would have involved flushing lactic acid was a half marathon paced tempo on December 5. A month out. Even that wasn't really very anaerobic at all. Really the last workout that would have had a significant impact was my Mona Fartlek on November 30th. One day shy of 5 weeks before the race.
On top of that aerobic fitness is slow to build and slow to retreat but anaerobic fitness is comparatively very fast to build and very fast to retreat.
Still the half marathon is an aerobic event. I kept hanging up on that. So I went looking back at some of the training I had done in the past to see when I had done similar workouts and what the results had been and what the workouts had looked like before similar results. I came across a print out I had made and highlighted of a post by Renato Canova talking about the need for marathoners with very high amounts of slow twitch fiber to do anaerobic work, extensive anaerobic work during MARATHON training! The reason is that though you don't raise the blood PH very high during fast aerobic running the muscles actual are producing a lot of lactate. Your body needs to be using this lactate as fuel, one to reach its full potential but two to keep from steadily building up the PH of the blood and slowing you down. He said this was unnecessary for most of his athletes because as athletes with more fast twitch and a lot of slow twitch B fibers they already naturally processed lactate more then well enough for half marathon and marathon racing.
This hit me in the face. I have never had my muscle fibers biopsied but my assumption based on my speed (58.8 lifetime 400m best) and my predilection towards longer training and racing has been that I am in the high 90% slow twitch fiber range.
I honestly believe if I had raced before I got sick I would have been in the low 1:05's. I also think that low 1:05 is a better assessment of my fitness right now. If I had managed to stay healthy perhaps I could have slipped under with 3 more weeks of good workouts but that was going to be a big ask and frankly not getting sick as a teacher in winter in New England is a big ask.
It is certainly possible that there is another problem but if there is it is stranger or more unusual. When I'm in a field in New England and I see a large four legged animal eating grass but I can't quite identify it I'm guessing it is a horse or a cow or a deer. Sure a zebra may have escaped from a zoo but it isn't my first guess.
So where to go from here?
I am taking this week basically off, 4 miles each day with the dog- she still needs to run. Next week I will get back on my 2 week modified complex training system.
Monday-am 4 to 6 Pm 10 to 12
Tuesday am 4 to 6 PM mona fartlek
Wednesday PM 15 to 18 miles
Thursday am 4 to 6 PM week 1 - 3 miles of sprint float sprint, week 2- 2mile to 5k tempo followed by hill repeats
Friday- same as monday
Saturday week 1- 30k to 40k FAST(fundamental tempo) week 2- easy run and 4 to 8 mile tempo run
Sunday- week 1- easy run or easy double, week 2- 22 mile run with last two miles fast- marathon pace.
I will race a couple times probably in February as rust busters and one for sure will be an indoor 5k. I've run sub 15 at least once for 13 straight years and I want to make sure to knock one out early since I'm fit in case I get sick or hurt later in the year.
I might look into a half marathon in March. I really like the distance and I'm glad to be back able to do them. Also a March half marathon gives me a nice chance to check on my theory about the lactic acid being the problem.
Depending on how that goes I would probably look to either a late spring marathon (grandma's?) or to a 5k to half marathon racing season in May and June.
Overall I'm very happy with my fitness coming into this hear and I am excited about my coordination, my ability to stay mechanically healthy, thanks to yoga, and this complex training program because it hits all the systems but the weekday workouts are such that I can get them done around work consistently.
For the last 8 years starting in 2008 my number one goal has been to run a marathon again without losing coordination. For the first time last year this was something I felt was possible. It didn't happen but I made huge steps towards it. I did 4 or 5 real marathon workouts without losing coordination. I did the best long runs I have done since 2007. This year I really want to run a decent marathon. When I was young I had so many crazy life goals. The sort of things that if/when I told people about them would make me seem crazy. I have to a degree accomplished so many of them.
I am so lucky to have Melissa. I am so lucky to have our family. I have checked off so many running goals along the way. But in doing that I have seen a set of those goals that I know for sure are possible and I would like to get them before time runs out. A long time ago I set down some times I felt I could walk away from the sport with satisfied that I had run close to my potential.
I have met some I haven't yet run others. I would love to get in shape to get one or two more before father time starts beating on me too bad.
More than anything I would like to run a fast marathon again. What is fast? That depends greatly on the course. For example I would tell you my debut of 2:15:28 wasn't super fast given the course, one of the fastest in the world and the conditions, near perfect. My 2:14:56 was quite fast considering the course. Anyway you slice it I want this to be 'the year' for the return. That said I also really want to continue to enjoy the huge gains I have made and the ability that I have now to actually race half marathons and to do so many of the workouts that I have missed for so long.
This will be my weekly training and other ramblings during what I hope is my build up to my long hoped for return to the marathon.
Showing posts with label back problem. Show all posts
Showing posts with label back problem. Show all posts
Thursday, January 7, 2016
Tuesday, December 29, 2015
What I've been up to and what is next
I'm on Christmas Break this week so I will try to post a few blogs. If you want the pure training blog that will be next. I'll give my training of the last few months but for this one I'll just talk about what I have been up to since my dnf at Boston in April.
After Boston my recovery was pretty quick. Both physically and mentally. I think that the mental side was key. Keeping control of the leg that long was a huge emotional boost and so I got back to some moderate running after a couple of weeks. However there were some troubles looming for my running.
Melissa and I had decided to sell our town home. We bought it as a short sale at the bottom of the market and the condo market where we were was flattening out a bit while the single family home market was showing no signs of slowing. Our realtor showed us a bunch of comps that told us if we could update our kitchen, very out of date, we could get a much higher price. To max profit we did a lot of the work ourself. This dominated our life. I even had to take a week off from running to get the job done which I NEVER do. Also during this time frame I was more and more feeling run down and exhausted. Even after we finished the reno I just couldn't seem to get the ball rolling. As summer arrived I just was flat as ever. I only worked part time all summer but I wasn't really able to train at all. I was running but only 60 to 80 miles a week most of the time with almost no workouts and almost no races. I ran a 15:17 5k at the York Days 5k on July 26. That is a flat fast course and I had great competition the whole way and actually lost. What was worse is that I was surprised I could run that fast based on what I had been doing. I just kept chalking it up to the stress of selling the house and trying to buy a new one.
At the end of the summer I got a horrible stomach virus. Already living at the low end of my race weight, 162. I dropped 13 pounds in a week. Obviously some of that was water weight but the point is I was wrecked. During this time I went to the doctor. I see a doctor in Melissa's office. The two of them had been arguing all summer about my vegetarian diet so he ran some extra blood work when I was there. It turned out he was right. I had stripped my body of pretty much all its creatine and was deficient of proteins as well.
So around labor day I began supplementing with creatine and eating meat again. Steadily I felt better. Still easy to exhaust but with a little bounce in my legs. I had a couple good weeks of training and then ran a 31:39 for 12th at the cow harbor 10k but given the conditions, hot, and how I had been doing just a couple weeks before this was a big step in the right direction.
Also by October we had sold our town home and made enough money to pay off Melissa's rather excessive student loans and still be able to buy a single family home complete with fenced in yard for Uta and have less monthly expenses then we had in the town home. A pretty big win all around. Over late September and early October we moved twice, out of our place, stayed in Melissa's parents house and then finally into our new place. Despite this I was doing some decent workouts, though my mileage was low. I raced a few races over this stretch culminating in a solid 14:40 5k, 13 straight years with at least one sub 15, and a 31:12 effort at the USATF-NE cross country championships.
At this point I was actually happier with my training finally coming around and how I felt in workouts, not totally dead, then I was with the racing which though better than it had been was obviously sub par. I had originally planned a late fall half marathon but I decided instead to begin looking for a winter one as I needed to actually train for a little bit.
I found the Jacksonville bank half marathon scheduled for January 3rd. Richard Fannin was putting together a field for this usually sleepy race so I asked to be added in.
I didn't have a ton of time but I was already fairly fit. Most importantly I had been able at this point to do a 25 or 30k fundamental tempo run which was really helping my fitness. I would soon stretch that out to a very strong 36k, about 22.5 miles, at under 5:30 mile pace. In that weeks that followed I did a few decent workouts, a monaghetti fartlek where I covered over 4 miles, a 24:33 8k tempo and a 30:43 10k tempo. Then I got sick and and though I was able to keep running I didn't do any workouts for the last three weeks. Finally Sunday, now a week out from the half marathon, I did a 13 mile run with the last two miles at half marathon pace. I was able to run 9:41 without it feeling too bad so hopefully I'll be alright next weekend. Though in the long run I don't really care if I am or not. I'm healthy. I have found a training cycle that I can maintain around my job and with yoga I am healthy. Also in the last few weeks I have got some exercises that are helping continue the improvement in my posture while running which should continue my progress forward on the coordination front.
Looking to Jacksonville I am aiming to run with the main pace group which is going at 4:55 a mile. The course is flat and with 60 men entered looking for a sub 1:05 there should be just a huge group to hang in with. A sub 1:05 from the front on even a 'fast' New England course is a really tough effort but on a super flat course in a large pack running together it is not nearly as high a bar so I am optimistic that despite my poorly timed cold I have a decent shot at qualifying.
I'm also equally excited that Melissa has had the breakthrough of a career over the last couple of months and I have paced her through some sessions that tell me she is ready for an absolutely huge PB so I figure even if I am not able to slip under 1:05 it should be a good day.
After Jacksonville if I qualify I will do a few marathon workouts. I have done enough fundamental tempo's that I should be able to do some good workouts without any problems. Actually if I qualify I will be quite optimistic about running well in LA. Being a natural marathoner combined with my training if I can hold coordination for the full race, which seems increasingly likely, I should only slow about 5 to 6 seconds per kilometer over the marathon distance. For example I averaged 3:08 per k in my tune up half for the Olympic Trials and averaged just under 3:12 per k in the trials on two courses of similar difficulty. So a 1:04:59 would mean targeting a 2:13:30 to 2:14:12 marathon. I know that sounds crazy but keep in mind the '08 trials was a hilly course. Had it been flat I would have targeted a 2:10. Also even with the loss of coordination I think I would have run 2:11 high or 2:12 low on that day had the course been faster.
Point is I'm not saying I am fitter than I was in the fall of '07. I am saying the LA course looks faster than the NYC course and it is possible I could run a faster time than I did on that tougher course if I hold coordination the whole way, which I did not in NYC.
The last part is key. Based on workouts leading up to the 2008 NYC marathon I thought I could run 10 seconds per mile faster then I had at the trials the fall before. The NYC course and the trials course were of similar difficulty and I used the same courses and same workouts to get ready as I had the year before only I was running 10 to 12 seconds per mile faster. Thing is the coordination was getting worse and worse and by shortly after 10k I was peg legging and my day was all done except the crying.
There are three keys to running a fast marathon. 1. the general fitness to do so. 2. marathon specific fitness-this is the achilles heel of most americans. You really, even if you are not a natural marathoner, shouldn't slow down more than 5% from your half marathon pace to your marathon pace, if you are properly prepared and the courses are similar. This means a 1:02:14 is equal to a mid 2:10. Think of how many americans run in that range for the half and just how few are sub 2:11. Before people go crazy on me for this look at the top kenyans and Ethiopians of the last decade since switching to the Italian system in the lat 2000's the 5% slow down is pretty standard. Also a guy like Meb has a bigger slowdown but on different courses. He would run 1:01 on a flat fast course then 2:09 at NYC a tough course. Certainly in an apple to apple comparison he would only slow 4 or 5% and he is quite explosive, 27:13 10k. Of course if you are still judging Meb by his marathon PB and not recognizing that he ran his best efforts on tough courses and in tough conditions your a lost cause. Obviously if he had focused his career on rotterdam and berlin instead of Boston, NYC and the Olympics he would have run in the 2:05 range at some point along the way and been sub 2:08 many times.
3. you need to be physically healthy enough to mechanically run up to your fitness for 26.2 miles. This has been my achilles heel. Though over the last 13 months I have begun to see the light at the end of this long long dark tunnel and whether I'll take my first step out of the other side on February 13th or if it will wait a bit longer I feel confident I'll be back in the long race, in a real and effective way, this year.
Hope your well and I'll try to put together a blog of my training tonight or tomorrow.
nate
After Boston my recovery was pretty quick. Both physically and mentally. I think that the mental side was key. Keeping control of the leg that long was a huge emotional boost and so I got back to some moderate running after a couple of weeks. However there were some troubles looming for my running.
Melissa and I had decided to sell our town home. We bought it as a short sale at the bottom of the market and the condo market where we were was flattening out a bit while the single family home market was showing no signs of slowing. Our realtor showed us a bunch of comps that told us if we could update our kitchen, very out of date, we could get a much higher price. To max profit we did a lot of the work ourself. This dominated our life. I even had to take a week off from running to get the job done which I NEVER do. Also during this time frame I was more and more feeling run down and exhausted. Even after we finished the reno I just couldn't seem to get the ball rolling. As summer arrived I just was flat as ever. I only worked part time all summer but I wasn't really able to train at all. I was running but only 60 to 80 miles a week most of the time with almost no workouts and almost no races. I ran a 15:17 5k at the York Days 5k on July 26. That is a flat fast course and I had great competition the whole way and actually lost. What was worse is that I was surprised I could run that fast based on what I had been doing. I just kept chalking it up to the stress of selling the house and trying to buy a new one.
At the end of the summer I got a horrible stomach virus. Already living at the low end of my race weight, 162. I dropped 13 pounds in a week. Obviously some of that was water weight but the point is I was wrecked. During this time I went to the doctor. I see a doctor in Melissa's office. The two of them had been arguing all summer about my vegetarian diet so he ran some extra blood work when I was there. It turned out he was right. I had stripped my body of pretty much all its creatine and was deficient of proteins as well.
So around labor day I began supplementing with creatine and eating meat again. Steadily I felt better. Still easy to exhaust but with a little bounce in my legs. I had a couple good weeks of training and then ran a 31:39 for 12th at the cow harbor 10k but given the conditions, hot, and how I had been doing just a couple weeks before this was a big step in the right direction.
Also by October we had sold our town home and made enough money to pay off Melissa's rather excessive student loans and still be able to buy a single family home complete with fenced in yard for Uta and have less monthly expenses then we had in the town home. A pretty big win all around. Over late September and early October we moved twice, out of our place, stayed in Melissa's parents house and then finally into our new place. Despite this I was doing some decent workouts, though my mileage was low. I raced a few races over this stretch culminating in a solid 14:40 5k, 13 straight years with at least one sub 15, and a 31:12 effort at the USATF-NE cross country championships.
At this point I was actually happier with my training finally coming around and how I felt in workouts, not totally dead, then I was with the racing which though better than it had been was obviously sub par. I had originally planned a late fall half marathon but I decided instead to begin looking for a winter one as I needed to actually train for a little bit.
I found the Jacksonville bank half marathon scheduled for January 3rd. Richard Fannin was putting together a field for this usually sleepy race so I asked to be added in.
I didn't have a ton of time but I was already fairly fit. Most importantly I had been able at this point to do a 25 or 30k fundamental tempo run which was really helping my fitness. I would soon stretch that out to a very strong 36k, about 22.5 miles, at under 5:30 mile pace. In that weeks that followed I did a few decent workouts, a monaghetti fartlek where I covered over 4 miles, a 24:33 8k tempo and a 30:43 10k tempo. Then I got sick and and though I was able to keep running I didn't do any workouts for the last three weeks. Finally Sunday, now a week out from the half marathon, I did a 13 mile run with the last two miles at half marathon pace. I was able to run 9:41 without it feeling too bad so hopefully I'll be alright next weekend. Though in the long run I don't really care if I am or not. I'm healthy. I have found a training cycle that I can maintain around my job and with yoga I am healthy. Also in the last few weeks I have got some exercises that are helping continue the improvement in my posture while running which should continue my progress forward on the coordination front.
Looking to Jacksonville I am aiming to run with the main pace group which is going at 4:55 a mile. The course is flat and with 60 men entered looking for a sub 1:05 there should be just a huge group to hang in with. A sub 1:05 from the front on even a 'fast' New England course is a really tough effort but on a super flat course in a large pack running together it is not nearly as high a bar so I am optimistic that despite my poorly timed cold I have a decent shot at qualifying.
I'm also equally excited that Melissa has had the breakthrough of a career over the last couple of months and I have paced her through some sessions that tell me she is ready for an absolutely huge PB so I figure even if I am not able to slip under 1:05 it should be a good day.
After Jacksonville if I qualify I will do a few marathon workouts. I have done enough fundamental tempo's that I should be able to do some good workouts without any problems. Actually if I qualify I will be quite optimistic about running well in LA. Being a natural marathoner combined with my training if I can hold coordination for the full race, which seems increasingly likely, I should only slow about 5 to 6 seconds per kilometer over the marathon distance. For example I averaged 3:08 per k in my tune up half for the Olympic Trials and averaged just under 3:12 per k in the trials on two courses of similar difficulty. So a 1:04:59 would mean targeting a 2:13:30 to 2:14:12 marathon. I know that sounds crazy but keep in mind the '08 trials was a hilly course. Had it been flat I would have targeted a 2:10. Also even with the loss of coordination I think I would have run 2:11 high or 2:12 low on that day had the course been faster.
Point is I'm not saying I am fitter than I was in the fall of '07. I am saying the LA course looks faster than the NYC course and it is possible I could run a faster time than I did on that tougher course if I hold coordination the whole way, which I did not in NYC.
The last part is key. Based on workouts leading up to the 2008 NYC marathon I thought I could run 10 seconds per mile faster then I had at the trials the fall before. The NYC course and the trials course were of similar difficulty and I used the same courses and same workouts to get ready as I had the year before only I was running 10 to 12 seconds per mile faster. Thing is the coordination was getting worse and worse and by shortly after 10k I was peg legging and my day was all done except the crying.
There are three keys to running a fast marathon. 1. the general fitness to do so. 2. marathon specific fitness-this is the achilles heel of most americans. You really, even if you are not a natural marathoner, shouldn't slow down more than 5% from your half marathon pace to your marathon pace, if you are properly prepared and the courses are similar. This means a 1:02:14 is equal to a mid 2:10. Think of how many americans run in that range for the half and just how few are sub 2:11. Before people go crazy on me for this look at the top kenyans and Ethiopians of the last decade since switching to the Italian system in the lat 2000's the 5% slow down is pretty standard. Also a guy like Meb has a bigger slowdown but on different courses. He would run 1:01 on a flat fast course then 2:09 at NYC a tough course. Certainly in an apple to apple comparison he would only slow 4 or 5% and he is quite explosive, 27:13 10k. Of course if you are still judging Meb by his marathon PB and not recognizing that he ran his best efforts on tough courses and in tough conditions your a lost cause. Obviously if he had focused his career on rotterdam and berlin instead of Boston, NYC and the Olympics he would have run in the 2:05 range at some point along the way and been sub 2:08 many times.
3. you need to be physically healthy enough to mechanically run up to your fitness for 26.2 miles. This has been my achilles heel. Though over the last 13 months I have begun to see the light at the end of this long long dark tunnel and whether I'll take my first step out of the other side on February 13th or if it will wait a bit longer I feel confident I'll be back in the long race, in a real and effective way, this year.
Hope your well and I'll try to put together a blog of my training tonight or tomorrow.
nate
Labels:
back problem,
coordination,
half marathon,
Marathon,
Melissa Donais,
Nate Jenkins
Sunday, March 1, 2015
Fix You. Part I. Guest Blog by Melissa
Today is another guest blog by Melissa, Nate's wife. This is the first blog in a series about Nate's loss of coordination problem and how it was addressed.
“And I will try to fix you.” - Coldplay
Over the past seven years, Nate’s kryptonite was the “loss of coordination” (also known as the “hip/hammy” problem) in his right leg. It first began at the end of a very hard workout, and he understandably assumed it was caused by the exhaustion and hypoglycemia that happens during these workouts. But then it occurred at 30 kilometers in the Olympic Trials. A year later in the fall, during an attempt at the New York City Marathon, it occurred at 10 kilometers.
By the time I started dating Nate in 2009, he was not able to complete his favorite workouts without losing coordination of his right leg. As a new, cocky nurse practitioner with a background in chiropractic and a former frequently injured collegiate runner, I promised Nate on our first date that I would fix his injury. My no fail plan was to fix Nate and win his heart. Little did I know the lengths he had already gone to trying to fix his injury. I’m lucky he didn’t slap me! (Nate’s a gentleman so he would never do that sort of thing, but somebody should have) Thankfully for me, I won Nate’s heart long before fixing his coordination problem.
Of course Nate had already tried the shiny new tools in my toolbox: kinesio taping, Graston technique, even physical therapy, chiropractic, and yoga. All the techniques that I learned about in school and used on my own injuries had tried and failed. In fact, his injury worsened in spite of these therapies. How meager my shiny new tools seemed. Nevertheless, I was certain that the reason why Nate wasn’t getting better was simply because he didn’t have a practitioner like me on his side! With my brains and resources, surely it wouldn’t be long before Nate was back running marathons.
Nate’s original description of the hip/hammy problem, along with the prolific posts about “loss of coordination in the leg” on the Letsrun.com message board, initially led me to believe that Nate’s injury was vascular in nature. A quick internet search will turn up scholarly articles about vascular abnormalities and occlusions in various arteries that were misdiagnosed as musculoskeletal injuries in athletes. These conditions, though rare, are often misdiagnosed for years and don’t respond to traditional treatments for musculoskeletal injuries (because they require vascular surgery). There was a short stretch of time when I was convinced that this was the cause of Nate’s problem.
While I was researching what vascular specialist to send Nate to, he was training (in vain) for the World Championships Marathon. At the time, we were living in Chestnut Hill (at the 21 mile mark on the Boston course), and Nate planned a workout around the Chestnut Hill Reservoir. He was certain that his right leg would “go” during this workout, so I took it as an opportunity to see what actually happened when Nate lost coordination. I thought for sure I’d be able to see some sort of imbalance in his stride that I could remedy.
Watching Nate run around the reservoir at 5 minute mile pace was like watching any of the great masters work. It was like watching Baryshnikov dance ballet, Yo-Yo Ma play the cello, or Michelangelo paint. That probably sounds like an exaggeration, but to me, watching him was truly a work of art. He made 5 minute mile pace seem effortless. He was in perfect form. Watching him, I knew he could be one of the best marathoners in the world.
Suddenly, without warning, Nate tripped. At first I thought he must have tripped on something, and then I saw his right leg flopping. This wasn’t loss of coordination. This was as if his bones no longer existed and the only thing holding his leg onto his body was the soft tissue. It flopped around like it was a rag doll in a stiff breeze. When Nate describes his leg “going” he often says he’s peg-legging it until he completes his run. This was not peg-legging, this was Nate hopping on his left leg while the right one flopped.
I started to cry. I cried because seeing this happen to him was just as shocking and hard as seeing him get shot. He was being cut down in his prime, and it was inexplicable. I also cried because I knew this was not a problem that I personally could fix. This problem was so much bigger than me. But I promised myself I would never give up. It might take all the brain power that God gave me, but I would research and find someone or something that could fix this.
If you take a step back and think about what was happening to Nate, the answer is very clear: the motor nerves, the nerves that cause the muscles to fire, were essentially shut off. They were shut off from the hip, which meant the most likely place for the pinched nerve was the spine.
The next step was to obtain an MRI of Nate’s spine. I remember sitting in a friend’s kitchen holding the films up to the light while on the phone with Nate’s chiropractor (the amazing Mika Tapanainen in Wellesley-Hills) explaining what I saw. What was very clear to me was that Nate had a herniated disc in his lumbar spine. Mika had been expecting this as well, given the lack of improvement with all the other treatments.
It was amazing to see such a frank disc herniation on film and to know in my gut, “that’s the problem”. I figured the herniated disc must be pushing on the motor nerves going to Nate’s right leg, and that was the cause of his problem. Nate actually had arthritis throughout his spine, and several other herniated discs as well, but these were higher up in the spine, up in the thoracic spine. I could clearly see the problem in the lumbar spine. Now we just had to address that particular herniated disc. I thought for sure in a year Nate would be competing at the highest level in marathons.
With my background in chiropractic I knew the statistics for failed back surgery so I researched spine surgeons very carefully. I asked to meet with some of the higher ups at the hospital I work for to ask their honest opinion about spine surgeons in the Boston and greater Boston area. I am still shocked these people made time for me and I’m so appreciative that they were willing to give me their honest opinions.
Two doctors were mentioned as the best of the best. One older, seasoned spine surgeon with thirty years of experience, and a new up and comer who showed great promise. I chose the seasoned professional, who promptly referred Nate to the up and comer, honestly telling him that the up and comer had “the best hands he’d ever seen.” I am thankful that the seasoned professional was humble enough to refer Nate to the person he felt was the best man for the job. That’s something that’s not always easy to do, especially with the egos that can form in medicine. It’s also the mark of a good surgeon when they know when not to cut.
The seasoned professional may have also realized that Nate’s case was a can of worms. He may have been saving himself from that. Most people who have a herniated disc have a lot of neuropathic pain. They complain of sciatica, they have numbness and tingling that radiates from their glute into their toes, and the pain is persistent. These people struggle to do even basic daily activities because they are in so much pain. Nate had some sciatica, but he did not have severe pain symptoms. In fact, his sensory symptoms were rather mild. The disc wasn’t affecting the sensory nerve, it was affecting the motor nerve, but in the vast majority of cases it’s the sensory nerves that are impacted. The up and coming surgeon was hesitant to perform any surgical intervention because he was initially not convinced that Nate’s problem was caused by the herniated disc. Without classic symptoms, this surgeon could potentially open Nate up and Nate would be no better off than he was before the surgery. No surgeon wants that on their record.
Moreover, traditional spine surgeries often result in spinal fusion, where metal rods are screwed into the spine to hold various segments in place. If Nate wanted to continue running at a high level, he would not be able to have a spinal fusion. There are also newer, inter-spinous devices, used to hold open the space where the disc was herniated, thereby relieving pressure from the nerves. However, these devices are fairly new and the up and comer surgeon was not confident in their performance in someone with Nate’s mileage.
That left a third option: remove the disc and lamina (bone) and don’t fuse, don’t put anything else in the spine. Just leave it. This would never be recommended for your average patient, but it was the only solution that would allow Nate to continue running competitively. It would mean that his core strength would become paramount. His upper and lower body would effectively be held together by his muscles alone. If, years down the road, he neglected his core strength he would need to return for a spinal fusion.
This is the first part of a three-part blog. Just like the Lord of the Rings trilogy, you have to wade through two more long stories before you get to the end! Remember, it took Nate seven years to “fix” the coordination in his leg. Thankfully, it shouldn’t take you that long to read the three blogs. Next one is scheduled to be posted on Tuesday!
Part 2 here http://nateruns.blogspot.com/2015/03/fix-you-part-ii-guest-blog-by-melissa.html
Labels:
back problem,
coordination,
herniated disc,
injury,
Nate Jenkins
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