Wednesday, 6 October 2010

Bonus Post (the final groin diagnosis)

Didn't intend to post again, but I felt as though I owed it to anyone who stumbles on the blog with the same problems.  I can see from my web stats a lot of people have googled the injury symtoms and found their way here. 

I went to Cardiff, to see Mr Woodward, a surgeon at the Bupa Hospital and after reading my case history and asking a few questions, he said it sounded like a typical case.

He did a quick exam, pressing each side of my groin, as I twisted to each side and coughed.  Straight away he could very clearly feel "a gap" on the right side.  My conjoint Tendon should be attached to the inguinal ligament.  Mine isn't anymore, it's torn off.  Only surgery can fix it.  He recommends an open surgery technique, not keyhole.  a 6cm slice is made, the tendon reattached, and some semi-disolveable mesh is applied to strengthen the area.  The surgery takes about half an hour and he is happy to perform it under a general or a local (nerve block) anaesthetic.  He warned that there is always a danger of infection with mesh and sometimes it has to be removed (though it hasn't happened to him yet).  He also said that for 1 in 10 the surgery doesn't work, so a 90% success rate if you look at it optimistically.  Sometimes he does an adductor tendon release if required, but doesn't think I need it.  The cost of the surgery I am waiting for the quote, but I believe it is just over £2000. 

So, it was indeed Gilmore's Groin (also referred to as other names as well, groin disruption, sportsmans hernia etc).  See the link for a description, which fits like a glove for my symptoms.
http://www.physioroom.com/experts/expertupdate/interview_jerry_gilmore.php

I'm going to get it done on 4th November I think, and worry about the cost when MasterCard send me the bill.  Recovery time is 4-6 weeks if the operation is a success.  I hope to rehab and make a return to running, but there are a lot of possible outcomes (I'm the 1 in 10 who is doesn't work for, or there are other things wrong as well that I find later).  For now, I'll live in hope.  Thank you for all the comments, I wish you all the best too.  Again, thanks to Alex who gave me the surgeon's name.  Six months Injured and the surgeon pinpointed the injury in 30 seconds. 

Take care

Rich

Friday, 1 October 2010

Farewell

Thanks to Alex for sending me details on a surgeon. I don't know if I can be fixed, as we still don't really know what's up with me.  Either way I conscious that my blog for the last 6 months has been a fairly depressing read, not to mention a depressing "write" and constant reminder. So it's time to stop.  Enjoyed the blogging, and know it's helped a few along the way.

I'm not sure what the future holds for me now, on any front, so take care and enjoy your running.

Rich

Thursday, 16 September 2010

Ultrasound Day

It’s yet another thoroughly demoralising day.  I handed over my £423 pounds for a (less than) 10 minute appointment this afternoon.  It amounted to a very very brief exam, which as expected showed no hernia, upon straining.  The doctor said that very rarely does anything show up on the ultrasound, which leaves me to wonder why I was there?

 

From his brief explanation I gathered the general thrust of what he was doing was putting a local anaesthetic into the area by the ilioinguinal nerve, in case it was causing  ‘irritation’.  So, “jab”, in it went and then he said I had 2-4 hours to exercise to try and produce the pain.  I wasn’t at all prepared for that (no sports kit, and middle of the working day).  I got up, paid, left and went back to work.  I had to beg and borrow some sports kit and go to the gym at work; loaned training shoes too big and rubbed the skin off my heels, shorts too big, and no T-shirt.  The Gym at work weren’t very happy about me using the facility whilst under a local anaesthetic, and running topless,  but were eventually persuaded when I convinced them I wouldn’t sue them if I collapsed.  I ran 5 miles and got the same pain as usual, and tried to do some situps, and got the same pain.

 

I didn’t for one second ever consider this nerve had been a serious contender for the problem, so if that’s all today was about then it feels like an utter waste of money, given the doctor there said the ultrasound would unlikely have shown anything up anyway (like a micro-tear).  Until I see the referring-consultant again, next week, I’ll have to give him the benefit of the doubt in case he had something else in mind.  The doctor today just said, usually you have to get surgery to address this anyway. 

 

So, I don’t think I’m any closer to knowing what’s wrong (though in all likelihood it’s a abdominal wall tear I imagine), other than ruling out that one pretty unlikely possibility and emptying my wallet further.  I think I’ve pretty much reached the end of the road of diagnosis, and surgery is the only thing that anyone can offer.  If that’s the case then I’d need to see if it can be done under a local anaesthetic (I won’t have a general), and also if it can be done on the NHS, as I can’t afford a private op.  If (big If) the answer was yes to both, I’d probably be looking at a 3-4 month wait for any NHS surgery, taking me beyond Christmas, and probably several months rehab.  I don’t the answer will be yes to both answers anyway, but we’ll see.

 

It’s over 6 months I’ve been out of action now, and there is absolutely no end in sight.

Tuesday, 7 September 2010

Waiting game

As promised, an update.  I have an ultrasound appointment on 16th September.  Not with the doctor I wanted, who is unfortunately not available for the foreseeable future.  I hope the suggested doctor is as handy with the ultrasound machine.  My referral letter states Ultrasound +/- Diagnostic local anaesthetic injection. I'll be another £500 lighter afterwards, but this is really the last hope I have of any kind of diagnosis I think. I've been doing half an hour of exercises 4-5 times a week, as prescribed, providing a little focus to try and stop myself unravelling, which isn't easy at the moment.

Unlikely I'll have much to say before 16th, so take care until then.

Wednesday, 25 August 2010

...bar the shouting.

I've had another physio appointment since my last post, and a short holiday.  I've have some additional exercises to do, but now I'm just waiting for an appointment (which I had expected to have already happened by now, but the clinic are dragging their heels to be quite honest) for a dynamic ultrasound from a London-based specialist to confirm what I suspect is pretty much a tick in the box, that I have an abdominal wall tear.  This is likely to be a tear in my abdominal oblique muscle on my right side.  This would probably explain why when reproducing the pain for a physio/consultant a sit up with a twist to the left hurts a lot more than just a normal situp.  It's possible that I also have Osteosis Pubis alongside the tear, which could have developed as a result of the subsequent weaknesses that have developed in the area.  My rectus abdominis on my right side has lost muscle mass, as shown in the MRI picture that I put in a previous post.  I' ve been working on my glut max and medius, as well as abductor strength, but to be totally honest I don't think it's going to make a blind bit of difference to me in the short term. 

It's highly likely to be torn and no amount of rest of exercise is ever going to fix it.  I read around and it says this is one of those career-ending potential injuries for sports professionals.  Even this week I read in the news that a couple of UK and England footballers are duffering with groin injuries which have all but ended their careers.  They have been all over the world for operations and not got any better.  This has pretty much left me pondering wether it's even worth going any further down the investigation road at all.  I'm certain it's damaged, and only some attempt of surgical intervention might (and I stress the might) improve it.  Then there is the risk of the operation itself.  Any surgery is risky, and let's face it in my case, this would be pretty much akin to getting cosmetic surgery.  I'm not a professional runner, and as long as I don't aggrivate the injury by running or doing sit-ups then I can live a more or less normal life.  So, I don't really need the operation.  What if I died? My little 5 year old boy with no father, just becuase I was selfish enough to want to be able to run.  So, I can just toss in the towel, not face unecessary risk through surgery and do something else.  Sport of pretty much every kind would be more or less ruled out.  The physio told me the number of people who could run the distances I have done, with the poor biomechanics (leg length difference, curved spine, twisted pelvis) that I have is small.  Most people would have probably given up soon after they started the sport.  I can't think of any good reason to risk and operation at the moment, so it's looking like that's it.

I started running just 4-5 years ago, and then after suffering knee and hip pain discovered I had all these issues.  I had some orthotics which seemed to help, but may just have shifted the problems elsewhere if I think about it.  Every year I have run I've suffered various injuries.  All runners get them, but I've been out for longer than most.  I think it's just my bodies way of saying, "you're not cut out for this, stop it".  I've been doing the exercises but the motivation for doing them is rapidly decreasing.  I'm not even sure I can be bothered today. 

I was away for a few days a week or so ago, in Tenerife, and managed to walk from the coast, sea level obviously, up to the top of the volcano in the centre of the Island at 3718M.  I did this over 3 days and my groin didn't cause me major problems.  I don't for one second think I could walk very long distances, but the odd 10-15 mile walk is within my capabilities I hope, so I think I'll just have to settle for that.  I don't really think there is anyone or anything to blame, it's just the way I'm built; not well enough for my body to suffer continuous overuse in ultra's.  Sadly, I can't even run a few miles now, so I can't even do any shorter distance events.  For the sake of completeness if I do every get a definitive diagnosis I'll post the details here, just in case anyone else ever suffers the same. 

Sunday, 22 August 2010

Ateneo 21 review

Avoid this terrible Spanish language "school".

Whilst working (and injured, so no running) in London I decided to Learn Spanish to fill some time in the evenings.  I go to Spain and it's Tenerife frequently to train, and so it made sense to learn more of the language.  However, I classed myself as a totall beginner and google for langauge schools in London.  I found Ateneo21.

The Ateneo 21 website states that it is a Language School. As it transpired it was not a language “school” at all, but one Argentinean lady providing private tuition from her sofa in a small six floor flat in a tower block in Central London. So, the warning bells were already ringing, after clear misrepresentation from the website. I arrived and sat next to one only other student on the sofa, who it transpired had already had 3 lessons, but was back repeating the first lesson as he hadn’t been able to understand anything so far (he told me this afterwards). Without any introduction to the course content or methods I was thrown straight into a world of conjugating verbs, and tenses, and bewildering worksheets with complex Spanish phrases and not a single word on English translation on them. I thought “I must be in the advanced class”, but no, this was in fact the ‘breakthrough A1 beginners class’. I’m a clever guy. I have a well paid job in central London and studied French as part of my degree, but was left bewildered completely in an hour and 15 minutes of inappropriate level of instruction. I learned absolutely nothing at all.

Her next student turned up 20 minutes early and sat in the corner of the room, a further unwelcome distraction. Both me and the other beginner student left the class 15 minutes early, both realising we were wasting our time there. Outside the other guy told me the only reason he had gone back was because he couldn’t get a refund from her. He would not be going back either. He knew he had wasted his money, and had now booked onto a proper course at an actual language school in Regent Street. He had been to 3 lessons and he said they got no better, and he had felt as though he was stupid. He was very relieved to hear that I had thought the same. I had only paid for 12 lessons in advance. I emailed Carolina to complain about her teaching and ask for my second lesson fee to be refunded. Of course I got a reply in which told me to “refer to the terms and conditions on the website regards refunds”. So I threw my money aware. I feel as through the website is deceptive, the teaching very far below the standard we expect in the UK, targeted at an inappropriate level of difficulty, and I suspect just preys upon pre-payment of a (usually 4 weeks - £108) in order to make a living, as students will just cancel and can’t get money back.

The next day, I phoned a well known language school in Central London  to book onto a course.  I cited my experience with Ateneo 21, and questioned first lesson content and ongoing course structure.  I was assured that their first lesson and method are not remotely similar to Ateneo 21's  approach, which they said would, quote “scare off” and “cause a new student to lose confidence”, which is precisely what it did.  I suggest you attend a first beginners level class at a language school, and apply the method to your first lesson.

Do yourself (and your bank balance) a favour and book into a recognised language school, and not this bewildering amateur outfit run from a sofa!

Wednesday, 4 August 2010

The second diagnosis

You may have read last weeks post where I was diagnosed with an Rectus Addominis and Inguinal Tendon injury.  You may have also detected that I was a little pessimistic about my prognosis, and unsure of how just physio was going to fix it.  Well, today I went along to meet my physiotherapist and expected to be ushered in and given a raft of core strength and glut med exercises.  I was wrong.  The physio I think detected that I was a little confused by my diagnosis (it's all the big Latin words!). I guess I really couldn't understand why glut muscle weakness was giving me such specific pain in one small area by my groin.

He did provide a good explanation as to why the diagnosis could be the case, but then decided to take my case history and do some additional tests.  Many of the tests the consultant, who was very thorough, had perfomed last week, but also did a few extra ones.  The room was punctuated with "does this hurt?", "err, no"...."what about this?"...."no, that's ok too"...."and this?..."Ouch!!", for about half an hour.  I think I had been referred to a physio who was really up to date on the latest research in the area; he said was literally months old.  The killer pain-inducing exercise for me is a sit up, especially a sit up with a twist to the left, which aggrivates my right Rectus Addominis where it joins my pubic bone.  At least that's precisely what I told the physio, and demonstrated as such to him.  After several more tests the physio then said, I believe I know what could be wrong and it's not your rectus abdominis.  He squeezed my hips together hard, stabilising them (simulating wearing a pelvic belt apparently), and had me to another sit up. Amazingly, I had no pain.

He said, like others have, and everything I have read, that diagnosing groin pain is very hard because the area is just like spaghetti; everything meets here.  He narrowed it down to two possible diagnosis, saying it was impossible to nail it to one without an expert-guided ultrasound by someone who specialised in this problem.  He is going to refer me to a London specialist who he says is the only person he would send me to, to diagnose it; a doctor who deals with UK elite athletes apparently.  The physiotherapist went on to explain that I did indeed have Glut medius and abductor weakness as identified last week (which he has given me some exercises for), as well as chronicaly tight femoris muscle which I have to stretch.  The combination of all of this weakness and tightness, and the resulting twist of my pelvis (my right foot is currently twisted outwards, visibly), has out undue strain on the area and resulted in the damage (that's my lamens explanation, not the practioners incidentally). 

So, what is it?

Either:- A Conjoint Tendon Tear or an Abdominal Wall Tear. 

So, basically we are back to what I had half diagnosed myself a few months back, a hernia in effect.  Albeit kindly titled a "sportsman's hernia".  The doctor last week had initially diagnosed this too, and then second guessed himself.  The ultrasound may show his gut instinct may have been right first time.  We'll just have to wait and see now.

The specialist I need to see is away on holiday and also has is usually very busy, so right now I have no idea when I will get to see him.  I will however start work on the exercises I have been given.  I'm half clinging onto a vain hope that the diagnosis will change to conjoint tendonitis (you can tell I got home and started googling can't you) and may be resolved with 4-6 months physio.  Sadly, the more likely outcome (I hate to suspect it) is that I need surgery; maybe a surgical repair of the conjoint tendon and posterior inguinal wall, perhaps also an adductor tendon release done as well.  They may as well throw in an obturator nerve release at the same time, and make sure all bases are covered. 

So it's essentially doom, gloom and some extra doom. 

I am seriously considering taking up endurance knitting, but I suspect there are some nasty hand injuries that I could pick up.

Tuesday, 3 August 2010

Diagnosis

Last week I went in London to see a consultant in London about my groin injury, which has all but sidelined me for the last 5 months. It was worrying at the start, as after his initial examination he thought I had a hernia. However, subsequent tests proved otherwise, which would explain why the not few people that have seen me over the last few months have not been able to pin down a diagnosis. I ended up being evaluated over the course of an hour; I understand the appointments are usually 20-35 mins long, so I’m appreciative of the extra time the doctor spent with me.  The headline diagnosis is Right sided rectus abdominis and inguinal ligament injury.

An extract from the report is as follows:

On examination today your single legged balance and single legged stability were poor with a positive trendelenburg test on both sides. Certainly, in your eyes-closed balance the muscle activation of your lower limb was unstable with some over-active peronei and underactive Tibialis posterior. Your hip range of motion on the left was normal with a full active range of motion and a negative FABER and FADIR test. On the right side we were able to reproduce your pain a little on end range flexion and you were tight in right extension although, again, internal and external rotation were normal, FABER and FADIR were negative and these did not reproduce your symptoms. I could find no abnormality in your knees and your foot and ankle range of motion was normal with good power in flexion, extension, inversion and eversion. With respect to your adductors on the left side there was no adductor tenderness or weakness, the pubic tubercle was normal with no inguinal ligament irritation, and the left rectus abdominis and left rectus femoris were normal. On the right side you were tender over the insertion of rectus abdominis into the pubic tubercle but not tender over adductor longus at its insertion. However, the tenderness did extend up the inguinal ligament and there was some irritation over reproducing Tinel's sign over the ilioinguinal nerve. Resisted sit up and resisted rotational oblique sit up reproduced your pain which was not relieved by pressure over the ilioinguinal nerve. Your sacroiliac joints were stiff but not irritable mainly on the left and your lumbar lordosis was flattened but slump test and straight leg raise were negative.

In summary, I think the underlying precipitating factor here is your proximal core and gluteal functional

stability and I think this is the mainstay of our initial treatment. We certainly need to review your orthoses at some point but I think we can do that here at Pure, in terms of a temporary heel raise and deeper heel cup prior to having a formal orthotic review when your pain and symptoms settle down. We need to work on core, transversus and the abdominal insertion at the same time as working on your proximal gluteal control of your hip stability, and I think you are booking in with our Physiotherapist over the next couple of days to make progress with this. We discussed the possibility of a diagnostic local anaesthetic injection over the ilioinguinal nerve and if things fail to progress over the next two weeks that would certainly be my next step.

I had the opportunity to review your MRI films with you and these are really rather unremarkable but confirm the presence of some free fluid around the rectus abdominis insertion. I have not specifically looked at the ilioinguinal nerve or, indeed, the inguinal canal and it is difficult to comment further on these. I am delighted you decided to consult at Pure Sports Medicine and I hope we will be able to rapidly provide you an effective rehabilitation programme and map your rehab back to full distance running over the next four to six months.

So, that’s the verdict. There’s no mention of the micro tear diagnosed by the radiographer from my MRI. So, I hope that is the case and that the non-surgical approach is the right one. He did mention that footballers would typically just take the surgery straight away in an effort to be back playing in 4-6 weeks. However, I’m more interested with addressing the underlying biomechanics and taking a longer time to rehab. This diagnosis effectively writes off the rest of the year, which I had more or less assumed would be the case anyway. I can write off to the end of the year, but would have to be back training after Christmas to build up for an attempt at the Gobi in June, given I would be starting from square 1.  If the physio doesn't work, and I need surgery as well afterwards, then the Gobi could be out.  My orthotics have worn out too, and the doctor only saw the pair I walk in. The ones I run in are in a very sorry state indeed. He mentions getting a change to the prescription, and getting a deeper heel cup, so I’ll have to see about getting that arranged. My first physio appmt is tomorrow. I’m looking forward to starting but if I’m honest I think I’m pessimistic about the outcome of physio intervention alone. I guess I just fail to understand how doing glut and core strength is going to stop my chronic rectus abdmonis and ligament pain. I suspect I’ll end up having the ultrasound guided injection at best, but at worst am still suspicious that I’ll end up having surgery. If anyone thinks they can explain to me how that will cure the pain, then I’d love to know.

The doctor told me than no amount of rest was ever going to cure this problem, and I’d have to have phsyio, to walking, to running, so I assume that means no running. I’ll find out tomorrow, and maybe go for one short farewell run beforehand, in case that is going to be what’s prescribed.

I’ll let you know how I get on. Have a good week.

Tuesday, 27 July 2010

20 miles to deliberately cause pain!

Later today I have an appointment at a sports injury clinic in London. The Dr that I am seeing specialises in groin pain, and the clinic’s approach is one of looking into the complex reasons that can cause groin problems, rather than going down a ‘quick fix’ surgical route. I’m not under any pressure to get back to my sport within a few weeks like a footballer may be, so I’m happy for long term rehabilitation if it means avoiding surgery. That’s the outcome I’d like anyway. I’ve no idea if they are a contributing factor to my problems, but this weekend I’ve also changed my work shoes. I’ve swapped my pointy fashion shoes for school boy shoes. My uncle told me a few weeks ago I needed some more cushioning under my heels. My current shoes, pictured below (you get some odd looks on a packed train when you start taking photo's of your shoes, I can reliably inform you!), were looking a bit tired anyway, and you can see the destruction of the heel. My foot was always tilting and wobbling in them, which can’t have been any good, regardless of if they contributed to my current woes.





The heels have taken a real hammering haven’t they? Interestingly I didn’t used to heel strike so hard with my left foot, not until I had orthotics in my shoes anyway. I’ll be quizzing the Dr about any contribution the orthotics could have made as well.

These are the new shoes. I haven’t had a pair like this since I was ten years old. They are Clarks (i.e. sensible!) shoes. No heel on them, just a long rubber sole with a lot of in-built cushioning in them. As I say, they may not have caused any problems but changing them makes me feel a little better, and certainly won’t do me any harm.



I ran 3 miles at lunchtime last Wednesday, running with one of the guys from work, one day when I was in the London office. It was just a slow pace run along with Thames. Just enough to remind me that this problem with my groin hadn't gone away, not that I thought it had.

On Saturday my friend Mike asked me to show him the route of an event he is doing in a couple of weeks; well half of it at least. I figured this would put me in a good mess to see the doctor with this week, since the route was 20 miles and included 5000ft of ascent. The route was in the Peak District and took in Castleton, Hollins Cross, Edale, Kinder, Back Tor, Lose Hill, Win Hill and Ladybower. For the first 8 miles I was ok. By 10 miles I was in some discomfort, by 12 miles I was having real problems, and by 15 miles I was walking 100%. I had to walk the last 5 miles, and even that was broken up with a break because even walking caused too much pain by then. Mike noted that I was running with my right foot turned outwards, something I hadn’t noted myself. I know this happens when my pelvis is twisted though. Again, I think this is more evidence stacking up for a biomechanics problems, rather than a trauma causing this. The pain as always seems centred on my lower Rectus Abdominis, but as I run further radiates out into my wider abdomen, upper right inner-thigh, right gluts and lower back. All in all those last 8 miles were very unpleasant, but served the purpose of returning me to a pretty sorry state the following day. Can’t do a sit up, sneezing causes a sharp pain in the area, turning over in bed hurts etc. I was in fact quite content to be hurting so much. Plenty for the doctor to work with today.

For those with some physiology knowledge last week’s MRI radiographer report states “a focal signal increase in relation to the right tubercle, and this does infer there is a small micro tear at the abductor tendon origin here”. I don’t know much about tears in this area. Do they heal themselves? If so, does it really take more than 5 months? What caused it?

Other than the additional loss of muscle mass I showed in MRI photo (last week’s post), the radiographer report doesn’t highlight any other areas of significance, which is good. I’ll let the Dr look at the report and images later, and do his own assessment. I’m not sure how much can be achieved in the appointment today. He indicated if necessary he could do a full biomechanical analysis at SPARC (Sport Performance, Assessment and Rehabilitation Centre) in London. Today, I hope this is the start of a road to recovery. I’m not expecting anything to happen overnight. I realise this is going to take some time to fix. I’ve got no major events until next year, though of course I’d like to do some day-long or weekend events later this year if at all possible.

I’ll let you know how the assessment goes in a day or so.

Tuesday, 20 July 2010

The latest pain theory.

It’s almost 5 months since I picked up a mystery injury, on the long stage of the Atacama Crossing in Chile. I realise I’ve been describing it badly, as a ‘stomach’ injury, when’s it’s nowhere near in reality. It’s groin pain; I get pain just above my pubis bone, where my rectus abdominis attaches, almost central, slightly to the right. I get this pain for a few days following even a short run, and during a run over 10 miles. I can’t get to anywhere near 20, it’s too debilitating. Even walking is a problem after this many miles. The following morning I’ll have pain that last a few days, noticeable turning over in bed, sitting up from a lying position, especially if I twist slightly to the left. It also most worryingly twinges when I sneeze, and the term “right ball ache” applies both figuratively and literally. I have this pain pretty much all day, every day. No amount of treatment of rest or treatment is making this go away.


I reached my tipping point this week, and yesterday phoned up and booked a same day slot on an MRI scanner. Last time I had an MRI it resulted in a confirmation of a meniscus tear and subsequent operation on my left knee. This time I was dropped a good deal deeper into the MRI scanner to scan my groin area. There I lay motionless for 20 minutes, as the machine buzzed away and did it’s thing from all the different angles. 45 Minutes afterwards the Radiologist saw me in his office, and went through the film which they produced to a CD, with the Siemens software which you can zoom through the ‘slices’. Much as I expected he said you don’t have a full-on hernia. Given I haven’t got a tell-tale bulge in the area, this was a given. However, he did say I had lost muscle mass on the right side of my rectus abdominis.ou  I think this MRI slice shows it.  To orient you, this view is me sliced in half, viewed from my feet end.  The top of the picture is my tummy, the bottom of the picture is chopped off, but it did show the cross section of my spine (a circle from this angle).  The two areas I have indicated are my left and right rectus abdominis muscles.  You should be able to see the difference in size.


This difference can be indicative of a tear that has been present for a while If I understood correcttly.  He also then also showed me a bright area of activity on one side of the film, not present in the other, where the muscle joins the pubis bone. He said this could be indicative of micro-tears, which is what I was concerned about.  I can't locate this on the film to show you a picture.  One day's practice doesn't make me a talented MRI scan evauluator I'm afraid.

He then went onto say the words I was worried about which were, it is a possible indication of Gilmore’s Groin. Gilmore’s groin doesn’t really show up on an MRI, but an MRI is used to rule out other causes.  It's as much a clinical diagnosis as one gained from tests. It’s also referred to as Sportman’s Hernia, or athletic pubalgia. It’s not a traditional Hernia, though can later develop into one if left untreated. It could also be something else, there might be another reason for all the symptoms, I just don’t know yet. I’ve now got to see a consultant for diagnosis, and potentially more tests.

I went home and did what most others would and googled Gilmore’s Groin, for it to read like my life story for the last few months. I hope I’m wrong and it’s something else. Prognosis is that physiotherapy to strengthen core muscles has a poor success rate, and usually an operation is required to repair all elements of the issue, usually involving attaching a mesh to strengthen the area. The condition and surgical procedure was pioneered by a London-based Surgeon (Gilmore) who is a Harley Street Doctor. The condition usually affects high level athletes, typically in Soccer and Hockey, where twisting and turning is involved. Clearly running doesn’t sound like a candidate, but I do have a complication of a pelvis which is almost permanently tilted and rotated, I’m theorising here that could be the ‘twist’ factor, if any further investigation reveals this to be the likely cause of my pain. Quite a few well known footballers (Liverpool and Real Madrid) are documented to have both had and recovered from this condition following surgery.

I hope it’s something else to be honest, I type this as another sneeze gives me another sharp twinge of pain. I hope it’s something else, or at worst that a core strengthening regime can fix it. I don’t want an operation. I had the last one under local anaesthetic as I was too scared to have a general. There is no escaping a ‘general’ to repair this one, so I’m desperate to get a different diagnosis.

I’ve now got to weight up my options and wait for advice on who I should see for a diagnosis. I have no idea if a regular consultant will be specialist enough, or I have to see the Harley Street Clinic. For those who don’t know, Harley Street is a famed London street that has all of the doctors, plastic surgeons that are used by the rich and famous. These are some of the country’s top consultant’s, and as a result carry a very high price. I’m not sure even an hour long consultation is within my budget to be honest.

So, I’m fairly miserable at the moment, just sick of being in pain to be honest.

Tuesday, 13 July 2010

Nepal 2011

I’ve not run this last week. After hyper-extending my knee last weekend on the Saunders Mountain Marathon, my knee is still sore and clicking and grinding when I stand and walk. It could take another week or two I guess, assuming it’s nothing more sinister than a strain of my patellar tendon. My stomach isn’t any better either. It’s now getting to the point where I am going to have to consider a CT or MRI to get an accurate diagnosis

However, I evidently remain optimistic of a full recovery since I have entered another race. This one is a long way off though, it’s not until November 2011. I entered it now because 80% of the available places are already taken and I didn’t want to miss out. I still intend to do the Gobi desert next June, but will register for that at a later date. So, what have I entered? Racing the Planet: Beyond 4Deserts – Nepal. Nepal is a place I’ve always wanted to visit anyway, so this is a perfect excuse and a perfect way to visit. What better than a semi-guided 250km foot tour? The course details have not yet been finalised, but the race starts near to Pokhara, via an internal flight from Kathmandu.  Pokhara which is a popular destination for people doing the Annapurna Trail. The race won’t be following the Annapurna Trail itself, which is coincidentally a similar distance, but it will almost certainly take elements of it in. The Trail itself goes to up 5500M, an altitude at which no one would be able to run, and most would be struggling to conjour up more than a very slow walk.  That’s not to say the event isn’t going to be tough as it still states that we will be at altitudes of up to 11,000ft, which is getting on for 3400M. That is a similar altitude to the Atacama Crossing I took part in, in March this year.

I spoke to the course director who explained some of this, and also that accommodation for the event is more than likely to be in the local tea houses and as well as some camping too.  The race will be supported by Sherpas, who will I imagine be making and striking the camps where applicable. I believe that apart from that, the format will be similar. It is still likely to be self sufficiency, though I imagine that this event will be a little different. I imagine there are tea houses all along the route, so it would be practically impossible to stop people buying bits and pieces if they wished. I read that usually if you stay in a tea house, the cost of the stay is usually very cheap because you are expected to buy evening meal and breakfast, which I assume won’t apply here. I guess RTP will have negotiated that we can stay, and they only provide hot water to us (for dehydrated meals etc). I don’t know this for certain at the moment, it’s a combination of what the race director mentioned at this early stage of planning and my guesswork. I mentioned the course had not yet been finalised, as the course director has yet to make further visits and view some new trails that are opening. He did mention that on one day the intention was for the course to climb up to a popular viewing area of Annapurna itself. Running in an area dominated by 7&8000M peaks will undoubtedly be spectacular, and that’s the main attraction for me to be honest.

Temperatures in November are said to be typically 25-35C in the day, so hot but not desert hot. I expect the main challenges to be the altitude and terrain. There is a possibility the ‘long day’ could be earlier; on day 2 or 3, but again that’s not confirmed at the moment. It sounds an exciting challenge is perhaps the most spectacular area on the planet. If you haven’t already signed up then you’d better do so before it sells out, which is likely to be fairly soon! Plenty of my friends, past 4deserts event competitors are already signed up to, so it’s going to be a great social occasion as well.

I’m looking forward to it, I just need to get myself right in the short term. I hope to maybe take part in a short event in a couple of weeks but it’s all dependant on my knee right now. Have a good week!

Monday, 5 July 2010

Saunders Lakeland Mountain Marathon 2010

I’m aching this morning! A tendon in my ankle is sore, my quads are sore, both IT dnds are, as are both shoulders. Oh, and a knee that is now clicking in an unfamiliar and non too pleasant way.  Feel's like I've done more exercise in 48 hours than you have in the last 4 months. As regular readers know, I’ve been sidelined with a stomach injury which has prevented me from running for an unbelievable 4 months. Last weekend was the first time I managed to run for more than 3 miles without stopping. So, it would be fair to say I was somewhat nervous about turning up to the Saunders Lakeland Mountain Marathon on the back of 1 reasonable training run, which itself I really struggled on. The guy that asked me to run with him in the event Mike, was in complete contrast. He may not have ever done any mountain marathons, but he’s in top condition, after running in fell races for the last 6 months and even running a couple of days support with his friend Steve Pyke, who just got the record for scaling all of the Munros (283 Scottish peaks above 3000ft) in 40 days. Needless to say, if Mike had kept pace with Steve Pyke, I knew I was in trouble! Mike had set the bar high and entered us into “Bowfell”. The toughest and longest team-class apart from “Scafell”.


I did however provide one useful skill to Mike, I’m a reasonable navigator. It’s a skill I’ve really only learned in the last year. 12 months ago, I’d could have just about told you which way was North on a compass. I went on a free navigation course given by a member of the MDS forum, which set me on the road, and then I took part in 2 Mountain Marathon’s last year, my first ones ever. I did, it appeared, have some reasonable talent for map reading. Still it was 8 months since my last event, so I dusted off my compass and this time I had to learn how to plot grid references. I did score classes in the last 2 events, which are clearly marked on the map for you. Here you get a map and a small list of 10 grid references. So, after 15 minutes Googling “how to plot a grid reference I realised it wasn’t too difficult. I downloaded the Saunders 2009 grid references and plotted them on a map to practice. I managed it ok, plotting them all more or less where they should have been. So, I was comfortable I could at least get us from control to control, even if it was going to be at slow pace.

All of my equipment is geared up for week-long desert races and I wasn’t about to go buying anything new for this event, since they are not really my primary focus. So, I would make do with what I already had. I do have some OMM waterproofs, which were both required items, and put to good use this weekend as you will read later. I have my desert racing stove, 1 tiny 15g titanium stand that burns hexamine fuel tablets. That was going to have to do. Everyone else seems to use gas stoves on the events. I have a 30l OMM rucksack, which is ideal for a week in the Sahara, with enough room for a week’s worth of food, but way too big for a couple of days in the Lake District. Again, I can’t justify buying a 15 or 20l pack just for this, so my 30l would have to be used. My sleeping bag was fine, the 8C PHD one was perfect. I took my extra small Thermarest sleeping mat, which at 230g is still twice as heavy as the balloon beds favoured by the Mountain Marathoners. I took my Thermarest compressible pillow too, which at 200g is a luxury I’ve learned I need to do any form of camping. The Saunders organisers had emailed us warning a week or teo ago that the Fells were dry, there was little water to be had, and even the river in the mid camp ran out half way down the field. So, scared to death I packed my most unwise item, a 2l platypus water bladder, and filled it to the brim. This of course instantly added 2kg to my pack weight, but I figured it was better than hunting down muddy trickles on bone dry fells. I put in my dehydrated meal, and some snack bars and nuts too. Finally my tent, which I bought for my ill-fated Tenerife expedition 3 years ago (I’ll mention that later). Anyway, I have a 2-man Terra Nova tent, which weighs a kilo and is a tent used by many MM competitors. I gave Mike the tent pole, the pegs, the cooking pot, fuel and lighter to carry, and I carried the main tent itself. I also packed a substantial first aid kit after reading about an accident from the recent LAMM event in Scotland. So half a kilo of survival bag, bandages, and meds went in the pack, as well as the rest of the required clothes and equipment items.

My pack weighed in at a thoroughly depressing 7kg. My pack weighed less than this for a week in the Atacama Desert including 3000Kcal of food per day! I knew I was geared up for the wrong sport when I saw the teeny tiny packs that everyone was sporting at the Saunders. 

Half of the reason I packed as I did was a comfort thing. I’m super comfortable running in deserts, I know what little I can get away with there and survive. I’m like a fish out of water (bad choice of words give the weather it transpired) in the Fells. Bad weather spooks me. Sounds odd right?  It didn’t used to, but I got into a lot of trouble trekking alone in a remote mountain forest in Tenerife 3 years ago. Like an idiot I had assumed it was always sunny in Tenerife and didn’t check the weather forecast. There was a category 2 (I think they call it an "orange warning" or something) storm warning broadcast, and I was trekking 60km from the sea level to the tip of a 3750m Volcano at the centre of the Island over 2 days. I wasn’t equipped for more than a light rain shower, got scared, disoriented and lost in cloud in a pine forest on an initial steep 2000M ascent. My scant waterproofing failed, and I got drenched in the heaviest rain I am ever likely to experience in my life, wading steeply uphill through a torrent of water flooding down. I got cold and hypothermia started to set in. It’s a long story (in full here), but I made it to a road and stepped out in front of a car to get rescued by some German tourists. My skin had all turned white, my arms looked like a corpses. They drove me to a hotel where I got help, and effectively saved me in the process. It was that experience that brought me down to earth with a bump. I wasn’t immortal, and Mother Nature commands respect. Since then, I have had a fear of being in remote places in bad weather. Both are those are par for the course in a typical mountain marathon. So, my equipment for these events is my comfort factor. I over-pack because I stand a better chance of surviving. The same applies to my navigation. I think I learned so well, because I trust only myself to get me out of trouble. The other reason I’ve done these few Mountain Marathon’s is to face my fears born out of that Tenerife nightmare, and try and get comfortable with bad weather again.  This has been gradually happening.

So, Mike turned up at my house at 5:30am on Saturday morning. I didn’t get back from London until late the night before, so there was no way we could go up and camp the night before the event. I drove us up to Wet Sleddale (of “Withnail and I” fame, for those that have seen the movie). They weren’t messing around when they called it “Wet” Sleddale I thought, on the drive home. We got there at 7:15am, registered and then sat in the car for an hour. I had been an avid reader of the MWIS (mountain weather forecast) for the last few days and so (if it were to be believed) we were in for a fine day on Saturday, potentially rain overnight, but clearing a little in the morning but then definitely some rain showers and higher winds later on the Sunday. Almost everyone was in shorts, including Mike, but I opted to run in tights. Less skin to cover with my expensive P20 once-a-day desert sun block I figured. I also ran in my Raidriders adventure top, a long sleeve white shirt that wouldn’t look out of place under a suit.  Used to best effect fending off fierce desert sun, and showing signs of too many years of use now . I had my OR Sahara cap and sunglasses to complete the outfit. Oh, almost forgot I had to purchase some Inov8 Mudclaw 270 shoes almost a year ago, as they have rubber studs about 6mm long, and regulations for one of the other MM’s I did required at least 4mm studs. The shoes have however seen better days. They are lightweight, minimal cushioning, no frills fell shoes. After a few events in some grim weather they started to slowly fall apart. Again, I was too cheap to buy any new ones for this event, so I used them, holes and all. The registration for the event had been quick and easy, and we were greeted by friendly staff all weekend. I’ve done two other events in the past, and this one ran like the OMM did, in that the organisation was a well oiled machine, and things ran smoothly and well.

At 8:20 we wandered up to the start, where two nice ladies were handing out free sunblock. I had a bit extra to cover my delicate little ears! We got out maps and ten minutes or so later, we got our list of controls and were off. We walked 20m from the start and like everyone else sat down to plot grid references. We decided just to plot the first few before setting off.

Below is the map. The blue line is day 1 and shows the approximate route we took between the controls (black circles). The red line is day 2, and the small triangles are the controls on that day.  You can view a bigger version of this map here.



We set off walking up a wall and then we set our first bearing for a control near a small waterfall, some 2km away. We were still at low altitude, around 300m, and the terrain was tussocky and slow. It seemed to be somewhat wetter underfoot than I was expecting too? Not too much drama hitting the first Control. We hit the gill (a small river), and just headed upstream 30 or 40m to find the control. It was nice to get the first one bagged ok. The next control was about 2.5km away again, and up over a hill, into a valley then up a reasonably easy climb. We had to navigate between two out of bound areas. If anything we went slightly to the left of where I wanted to come out, but a few minutes lost if any at all, as we hit a good path and then hand-railed along a wall to cross the a river and road in the valley. So, feet wet early on, and they would stay like that for 2 days. We joined a snake of people climbing up a hill, all doing various courses, but happened to be headed the same way for once. We found the control and then had to follow a taped route down and around a farm at Burbanks head the East end of Haweswater.

At the end of the taped route we had our first navigation decision. Head diagonally up hill for 2km or run along a good wide path along side Haweswater until we were closer to the control and then head more steeply up a gill-side for a 200m elevation gain to take us up to 450m. We opted for the latter, so we ran along at a good pace before then heading slowly up through a bracken covered hillside to the left of Four Stones Hill and then up further to the 454m trig. At this stage I set my altimeter to 454M too. I had bought a cheap (£20) altimeter from ebay, the one expense I made for the event, reasoning it was a safety device, and it appeared all of the more experienced teams used them. From the trig I saw the control a ¼ of a km below and we headed down and Mike tagged it. We then headed West, joining a path and climbing up to 600m. I kept an eye on the altimeter and at 600m we took a bearing straight for the next control, which was also around 6oom. We joined the ravine slightly too low, as the control was at the bottom of it, and so we had to head up about 50m to find it. All fairly painless, and no time lost really.

We next had to had to either bear straight for the next control which would have meant a descent, then ascent up a gill, or head up Wether hill along a good path, contouring around some re-entrants before coming at the control from above. Again we took option two, but we didn’t quite stay on the good path for long enough and had to dip in and out of a couple of small ravines to hit the control. Slightly finer navigation would probably have saved us a few minutes, but I’m learning all the time. We plotted the next few controls here, and were a little dismayed that it was about 7km to the next control. We were at 600m in height and faced a pretty horrible and fairly steep climb up 200m to regain the main path and take us up to the top of the mountain “High Raise” at 802M.

We then ran down slightly before heading back up to Rampsgill Head then down and up to the highest point of the weekend 828M peak “High Street”. The high pressure and glorious weather gave panoramic views of the fells 360 degrees in every direction. Sadly I have no photos. I use my iphone as a camera normally, and phones with GPS are banned from the event so I left it in the car. At High Street a couple of other guys doing Bowfell asked if we had any local knowledge and which would the best way to descend to the next control. Neither me or Mike had ever been here but I offered my opinion as to descend East, starting in the saddle between Thornthwaite Crag and Froswick peaks (by Over Cove). I reasoned there looked to be less scree slopes. It was a steep descent anyway, losing 500m in ¾ of a km. The other option would have been to go via Mardale Ill Bell, which we did see others heading towards. Everyone decided to go with my option which turned out to be pretty good I think.

My hill climbing fitness was already showing up to be shockingly poor now , but my descent skills are pretty good. I lead, running down through the short screen slope and then bounding down the grassier slopes below. I assumed everyone was close behind, but glanced back and Mike was more than 100m away, and the other two guys twice as far. Oops. Lesson learned, pay more attention when descending. You should always stay close to your partner in these events. Because me and Mike have only run together a couple of times we don’t really know each others ability of various terrains. I can descend very fast, and Mike can climb very fast! Personally, I’m more envious of Mike's skill! Mike caught up and we continued down. I kept glancing back, but once too often as my foot hit a pot-hole on the steep slope descent and it caused my toe to point up and buckle by knee inwards, the opposite direction to the way it should bend. It made some horrible crunches and noises. I dropped to the ground in pain and sat there hugging my knee, genuinely worried as to what I had done. Mike is a physio and said worst case was you could damage your ACL that way. Best case was that it was a Patellar tendon strain. He said if it was ACL it would swell it within 12 hours and I wouldn’t be able to put much pressure on it. It really did hurt, right under my kneecap, but adrenaline was fuelling me so I carried on, taking it a little steadier.

We got to the next control in a large sheepfold near Kentmere Reservoir. We then headed alongside the reservoir itself and took a bearing diagonally South East up to “The Tongue”. I was beginning to struggle at this point. My knee was obviously hurting, as was my stomach injury. However, I had also neglected to take on much fuel so far, and we were already ¾ of the way through the day. I had drunk plenty of water but only had a couple of chewy bars and was running close to empty. I was feeling slightly shaky, usually a good indicator of low blood sugar. The lack of training in the last 4 months, of course meant no hill climbing either so I was really suffering on steep ascents and Mike was frequently having to stop and wait for me. I was seriously slowing him down on the hill climbing. When we got to the next control, between two knolls, I had to sit down and take 5. I knew I had to force down some calories as I could see the next and final horror climb between Kentmere Pike and Harter Fell. I ate 500 kcals worth of honey roast cashew nuts, upped my water intake. Past experience on long events has taught me that when you feel rough, up your food and water and that fixes most things.

There were a good few teams around at that time and many were taking the most direct line to the control in the next control which involved dropping 100m and then gaining 430M up a nasty craggy side of Kentmere Pike. Knowing full well, I was ascending so poorly on the steeper hills I suggested we contour around to the North maintaining our current height and then tacking a less steep ascent up to “The Knowe” just below Harter Fell. This was still to be a 350m gain and slightly longer, but better in my mind than the more direct option given my current condition. The climb still proved torturous. I was just slow, plain and simple. My cardio fitness was there, but my leg strength has been lost in the wilderness last 4 months.  I was frequently stopping and turning around to drain the lactic acid from my legs, and then climbing more and repeating. We headed diagonally up skirting Drygrove Gill where other competitors were tagging a control on the course there were doing. It proved a useful spot as it was a control for us on day 2.

After what seemed like, and probably was not far off one hour, we got to the top of The Knowe and dropped down off East side of Harter Fell. It was another fairly steep descent, tough on the quad muscles at this point, and my knee was complaining about it as well. I took the descent slightly easier but still a respectable pace, keeping pace with a solo competitor running on the opposite side of a gill from us. We tagged the control and 550M and then followed the gill down to a hard stone footpath which we ran down quite quickly. The path was enclosed, out of bounds either side and we ended up going almost right to the finish, and running through the camp, doubling back to get the final control and then running back the finish. I don’t think everyone was so conscientious of the out of bounds mark and headed through an earlier gate, probably saving 5 minutes but still we followed the route and were happy. We crossed the line in 6:49 I think. In 32nd position. 61 teams were registered to start the event, I guess about 55 actually started, but I’m not certain as the final results don’t show all the teams who withdrew (I know this because I know one team that did withdraw and there results are not on the list).

Mike bought me a can of Coke from the finish, and some milk for his cereal. They told him they had sold out of beer. Seems a little poor that the teams doing the shorter courses get to buy all the beer when they finish earlier in the day; presumably they set no limit per person. That’s one small jibe at the otherwise faultless organisation. I don’t drink anyway, but Mike would have bought some. We set up the tent and filled up our water from the stream. Mike had been refilling his bottles all day, whereas I had just about got by on the 2l water I filled from home. There has been plenty of water in the streams on the fells and the mid camp river was flowing well. I assume there had been lots of rain because the scare stories of dry fells didn’t feature at all. I could have got away with stream refills and saved myself a couple of kilos in weight. I took a 600Mg Ibuprofen for my knee. Mike looked at it and thinks it will be ok. It is likely to hurt for a couple of weeks I think, but hopefully no serious damage done. Mike spotted a couple of his friends who it transpired I had met on a Bob-Graham round support a couple of years ago, and we had a chat about the day and complained about that last hill!

It got quite chilly in the evening and I had my waterproof jacket on for warmth as well as my fleece and hat. We ate around 5:30pm, enjoying some of my awesome Mountain House meals. I import the 'meals for two' (which are meals for 'one' hungry runner) from the States, as the Mountain House selection sold in the UK is very limited indeed and doesn’t have the decent portion sizes or choice.  Hilariously I managed to burn a hole on one of my socks, as well as adding another hole to my already fairly holy fell shoes, putting them a little too close to the stove.  Lucky I wear two pairs of socks, so I was ok for day 2.  We got off to sleep about 9pm, and both slept intermittently all night, as you do when camping.

I slept well enough to feel rested, but woke to intermitted rain drops and higher winds. We popped out heads of the tent to see the clagg (low cloud) was down to about 400M, much as the weather forecast had predicted. Visibility above 400m (and later on much lower) was going to be poor. We had breakfast and some coffee. I took another 600mg ibuprofen before the start and we headed to the start line, collected the grid references and plotted them all. We would face another 400M steep climb over ¾ km up Shipman Knotts straight away. We cleared the start and it started to rain immediately. We were already in our full waterproofs anyway. I hoped I would be ok with a climb so early in the day but I began to feel pretty sick about half way up. The train of people climbing split into two, and I remember earlier thinking we needed to stay left, but the right fork looked an easier climb and there wasn’t much difference in where they bought you out, about 150m apart.

I climbed really quite slowly, Mike frequently having to stop and slow up. I was feeling really nauseous and the wind and rain just compounded the miserable feeling. By the time I got to the top I was almost on auto pilot and was just following a train of people along a wall. I took a bearing and it was right and carried out. I had to stop for a few mins, as I genuinely thought I was going to be sick and wondered how wise an idea it was to start the day in such a poor state. Still I carried on but something was wrong. We were heading upwards and the wall we should have been following was along one contour line (no elevation gain). I checked the bearing again, it was the right one, so we carried on. I stopped twice more and then remembered I had an altimeter, and it showed we were way to high. I studied the map and saw that there were two walls running parallel to each other, one lower down the hill. It was hard to spot under out of bounds marker lines, but I had missed it and we were 150m metres higher than we should be, as well as further North. I have to carry the can for the nav mistake, as I was doing the main navigation. We backtracked and cut down to the right wall, then carried on along it until we found the control. We then had to trudge back up that same 150m height gain to join the path we had left 30 mins earlier. So, half an hour lost due to my slightly poor mental state after feeling sick. Still, the nausea had by now improved even though the weather had deteriorated.

I was expecting showers all day, some heavy, and high winds but certainly not as rough and persistant as it turned out. For the whole day there onwards it was heavy rain and at times gale force winds on the tops. The cloud dropped lower, so we were in cloud for the whole day with visibility down to less than 100m for the most part. This is the weather that shows the men from the boys in navigational terms. I had just been shown to be one of the boys with that early error. The sickness was a factor though,quite possibly bought on by the big dose of ibuprofen.  I just wasn't paying enough attention. After that early major nav mistake my nav was pretty sharp until a couple of smaller errors near the end, despite the awful weather. You do question what the hell you are doing with your Sunday getting lashed by sideways rain and high winds when most sane people and reading the Sunday papers indoors. Me and Mike did however retain our sense of humour all day, as did pretty much everyone we met on the hills. We did see quite a lot of teams heading back down due to the weather, and the results at the end of the day showed at least 10 more teams in our class alone had thrown in the towel on day 2. They were probably the sensible ones!

We headed up and over Kentmere Pike and then to the control that we had passed on day 1, in Drygrove Gill, which it transpired was a control on our course today. It didn’t really make it any easier to find though as we spotted it when we were about 10 metres from it, as the cloud was so thick. A few teams were huddled in the small ravine getting some shelter and putting on more clothes or waterproofs. We saw a good few people who just wore shorts all day long. Obviously hardier men and women than us, in our full water proofs. The next control was 5km away, the first 2.5km of which we had travelled in the previous day. A sharp descent down Harter Fell and then run along the stream to the stone Path near yesterdays finish. I had hoped we would emerge from the cloud as we lost height but we only got as low as 400m and it was of course still there.

We knew we had lost a lot of time with that nav error and so took a slightly riskier route to the next control, a sheepfold off a spur called Brunt Tongue. We timed our pace and walked up the path, crossing a stile and them timed the next 1km to around 425m height. We then took a bearing from where we thought we should be by then, up over Brunt Tongue at 500m and down to the sheepfold. We definitely made up a little time here as other teams had played a slightly longer safe option of staying on the path for longer. I don’t think we made up much, maybe 10 mins. We hit the sheepfold spot on, tagged it and then ran down a well trodden path through marsh and bracken to a bridge by Mosedale Beck at 410m and then along a good path before a steep ascent up to a small tarn at “Howes” at 510m.

The weather was turning worse; heavier rain and the higher wind. It was now very windy indeed on the tops and a fair amount of “lean in” was required at times . We had resigned ourselves to being rained on and blown about all day. Once you resign yourself to that, mentally, the task becomes easier. My OMM jacket did a great job, kept me dry all day.  OMM waterproof trousers didn't.  They failed after an hour or two.  They seemed to soak up rain like a sponge.  When I took them off I swear I could have got half a litre of water or more out of them.  I was a bit surprised at that, since you'd have expectedt better from the brand.

It was at this stage I realised I was coping fine with the bad weather, and the Tenerife demons had not come back to haunt me. Maybe I’ve turned a corner here. Sure, the weather could have been worse, though standing on the tops it felt pretty rough.  It was only 1.5km to the next control, but it needed some good navigation. I seemed to find myself at the head of a group of about 4 other teams who were clearly also after the same control, whether they be on our course or not. Again, we opted to stay high and not follow some others into a valley, just to climb back out of it.

We contoured around, both or our ankles complaining bitterly about it. The other teams behind must have agreed with my, since they were following us. I cling onto the hope that my navigation decisions were half reasonable this weekend.  There was a tough steep climb up Selside Pike (655m) just skimming to the right of the peak and walking above some crags to our right. Upon reaching that top the gale force wind blew so hard that I actually dropped and flattened on the ground. We were quite close to a big drop to the right, and it wouldn’t take much more blow me right off. I got back up and leant hard into the wind staying low until we cleared the top and the highest winds, and dropped into the valley beneath where I spotted the control near the cheerfully named “Old Corpse Road”. I was now feeling strangely good. I had picked up the pace. Maybe my endurance was waking back up at.  In normal ultra races I tend to start to improve at the 20 miles mark. Today, my “ups” seemed to coincide with Mikes “downs”, and vice versa. We’ll have to work on synchronising them!

We set a bearing for the next control with two other teams following and headed over marsh and knolly ground for 1.5km. I impressed myself at walked on compass right to the next control within 5m. The guys behind caught up and said I hope you don’t mind us following you still. I said I didn’t mind at all and we all headed off on the next 3km leg, mostly following a wall to get back to cross path from day 1. From the path crossing we took a bearing to head for a crag top, but ended up about 150m to the right on another crag top. I looked at the compass but reasoned it had to be the other crag. We headed across and the other team with moved off ahead and us waved us to say it was there. I’d just drawn the grid reference slightly too far south and picked the wrong crag, but no harm done there as we had to pass the other crag to get to the footpath down to cross the road in Swindale, much as we had near the start of day 1.

One of the other teams had initially run off ahead, and then stopped to check maps and fallen behind. We didn’t see them again. We were now still in a group of 4 just to close down these last 2 CP’s. The last climb of the day, a 170m pull up to near Talibert Head was completed, everyone feeling it by now, even Mike I think. We followed a wall around a farm and I took a bearing off a wall corner straight to the control which was listed as “a boulder” by a stream. I learned a lesson for another time here. I should have aimed upstream, and not straight to the control. Heading downhill on a contour I must have drifted downhill by 100m.  As we approached the stream we saw other teams heading towards a control 200m further downstream. The other guys started heading that way and I said that can’t be it. The compass “says no” and there is not a boulder there. They seemed convinced and I was swayed by the masses but stated, I am sure it is the wrong control. I was right. Got there and it was not the one we were after, so we spent another 5 mins trudging back upstream to find the right one. I noted we were not the only ones to make the same mistake as a team ahead of us had done the same. I figured another 10 minutes lost there. Even so, one last control left, a little more than 1km away , albeit over the same tussocky marshland from the previous day.

We were all pretty tired by now, and again we started to drift downhill as we headed towards the control, very easy to do I think. One guy from the other team was ahead at this stage and I shouted him back as I spotted the last control about 200m above us. We all headed up there tagged the last one, and all jogged gently down the hill and into the finish another 1km away. The finish was in a large marquee fitted out with tables and chairs. Some food was provided, which was hastily scoffed down and well received. A big thank you for the organisers for doing such a great job this weekend and always being happy and cheerful. I know events organisation is very challenging and to do it well, and still retain a sense of humour is even tougher. Well done SLMM. We had dropped 4 places overall and finished 36th overall. The car park was almost empty, the shorter courses would all have come in earlier and some teams from all classes had quit I guess. In fact only 40 teams from our class finished at all! I drove us home and later plotted the routes you see from that map. We covered 19.5 miles with 5500ft of ascent on day 1, and 17.5 miles and 4950ft of ascent on day 2. Two tough days in the mountains, day 2 made more challenging by the weather. It was a good learning experience for us both, but really showed up just how the 4 months running hiatus has hit my ability.

Today I ache, as I mentioned but my stomach is ok. I think that is due to the lack of running on day 2, and not a miracle cure. I need to get some answers to what is causing the pain and get back on the path to full fitness again.  My knee is clicking a lot, which isn't nice.  Not sure what's going on there, but I hope it fixes itself soon.

Mike enjoyed his first mountain marathon and I’m sure will do more in the future. I can only apologise to him for being so out of condition and slowing him down this time.  He may well do the Rab or the OMM later in year. He’ll need another partner for those though. Dark and White events banned me from their events (they run the Rab) after I heavily criticised the organisation of last year’s event in a blog post on here. I subsequently removed the post so they would allow Mike to compete in their events, even though I would stay banned. Personally, I think you should take a bad review on the chin, admit the faults, and do better next time! It’s the only event in 5 years of doing events all over the world I have ever had so many issues with. I’m quite certain they’ll sort out the problems from last year and run a smooth event in 2010.  SLMM and the OMM both ran like clockwork.

One final note. I mentioned in my previous post that I had half a dozen friends doing Racing The Planets Gobi March (I plan to take part next year); this year in the Turpin Basin in China. I got back last night and checked the final results to read that every single one of them had completed and in some style. Christian Sheister (who I shared a tent with in the Atacama 2009) came 2nd overall! The rest of the people I know from Racing The Planet events too; Lucy, Sam F, Sam G, Diego and Tremaine all finished well. Some of them are doing all 4 RTP deserts this year, so the best of luck to them! One sad note though, a couple of friends have posted updates and blog posts to say a 31 year old US male competitor who collapsed on day 4, died a couple of days later in hospital. I don’t know any details, but we all push ourselves to and beyond our limits in these desert events, and this is a reminder of how dangerous they (and in fact any endurance events) can be. My thoughts go out to his family and friends at this sad time.

Tuesday, 29 June 2010

Last minute training

This coming weekend is The Saunders Mountain Marathon. My friend Mike asked me to partner him in this event a few months ago. Mike has done plenty of fell racing in the past, but this will be his first full mountain marathon. I’ve done a couple of MM’s in the past so we are both relatively new to this. Due to my on-going injury since March, and schedule clashes we have only (ever) been out on a run together once, and that was 2 weeks after the Atacama Crossing in March. That was in the Kipling Caper, the last time I managed to do a distance of more than 3 miles without pain. We decided to try and schedule in one last opportunity to train this weekend just gone, and so Mike found The Staffordshire Moorlands Anytime Challenge, which starts and ends at the Cat and Fiddle pub in the Peak District near Buxton and visits 5 Trig points. You can take any route you choose. The idea behind this was that we practice our navigation skills, rather than try and run it all. This was always going to be the case as I’m just not capable of running these kinds of distances at the moment. The route we took is shown below. The flags are the Trigs.



We actually started the route from Hen Cloud in the Roaches (bottom of the route marked), rather than the Cat and Fiddle pub, so we visited The Roaches trig point first. It was the hottest day of the year so far with temperatures around 30C. Mike carried his event weight rucksack, but I opted to carry just a few kilo’s (mostly water), as I knew I would struggle anyway. We took a steady walk up the Trig point and then plotted our route to Axe Edge trig point. The route was a mixture of footpath and road. Unfortunately we appeared to make a navigation error at the bottom of The Roaches. We didn’t spot a footpath to our right and so continued straight ahead, heading down into a valley. After a few minutes I realised, but neither of us could recall seeing any footpath split, so we decided to carry down and then cut right later. This probably cost us 10 minutes as the terrain was rough (no path), over heather and gorse. Eventually we got onto our intended route and carried on. Returning that way towards the end of the day it transpired than the footpath split was gone. There was some barb wire over a broken wall, so I wonder if a either the path has been diverted (no notice there) or the landowner of a nearby house has illegally removed it. I’ll contact the local council and ask them if a footpath divert was in effect. My ordnance survey map was 1 day old, so I’d be surprised if it was wrong.

Back on the route we climbed out of the valley and onto a road, climbing further until we reached the village of Flash, which boasts as the highest village shops and pub in England. We crossed the busy A road here, over Oliver Hill and then across rough moorland and up to Axe Edge Trig, then down and up over rough moorland to Burbage Edge which sits overlooking Buxton. We had done about 10 miles at this point, and my stomach pain was just beginning to kick in, which was an improvement but nevertheless an unwelcome reminder that I’m still injured, some 4 months after Chile. The most direct route across was across the valley to The Cat and Fiddle and nearby Shining Tor trig point but we came to the decision that although about .6 of a mile further, taking a wide arc on good footpath and quiet roads would be faster, not least because it meant remaining on higher ground, and not losing all the height in a descent to Goyts Moss valley, before a tough climb up to the Cat and Fiddle. Later on at home, I checked this out and it was a good decision, we would have had to climb 300ft more by going direct over the tougher terrain.

When we got to the Cat and Fiddle we decided not to go and tag the nearby (mile each way on a wide and often paved path) Shining Tor trig, due to my discomfort, and would so take a direct route to the next trig at Shuttlinsloe. Normally you would likely drop down from Shining Tor and head up through Macclesfield Forest and approach Shuttlinsloe from the back. It’s a very steady and easy climb this way. However, from where we were we took a direct route down to the base of the next valley down a stony path, which is frequently just like running down a river. However, the current dry spell in the UK had totally dried the river up. We stopped to check our nav and felt a sharp bite on my quad, looking down to see a horse fly cutting into me. I swatted it away but damage was done, and i’ve since grown an extra (not to mention itchy) red quad muscle in the last 24 hours. From there was a short run followed by an unpleasant hike up the front of Shuttlinsloe which gets gradually steeper almost to the point of involving a scramble to reach the Trig. We came down off the top quite fast, but I was already really beginning to struggle so Mike had to slow up significantly for me. We lost all the height we had just gained, then straight back up again, and then lost it all once more as we descended to Gradbach Youth Hostel on the River Dane. From there we ran for the next mile or so then hiked up through the woods climbing back up to Roach End, where I noted the missing footpath. We had taken longer than anticipated, due to my struggle, and so opted not to go back up to Roach End, which would have meant another 10 minute climb on top of the route, and so ran the 2 miles or so back to the cars on the road at Hen Cloud.

I was in quite a lot of pain as I struggled those last couple of miles and was glad to see the car. I had used my entire water ration, and even drank some water that Mike had refilled from a stream en-route. It had been a very long and hot day. I checked the route back home and it was 23 miles in total, from car to car, and had over 4300ft of ascent. Including all the walking I had to do it had taken 5hrs 50 mins. We were happy with our navigation, which was the main aim, though to be fair there were some sections which both of us could have run blindfold.

Next week we will face around 20 miles with about 6000ft of ascent on day 1, and perhaps 15 miles and 3500ft on day 2. I was pretty shattered after the run, my stomach, back and gluts all hurt, and my fitness is a pale shadow of what it was in March. After a days rest my stomach pain wasn’t as bad as it has been of recent, however I couldn't get up out of a chair without using my arms for assist, as I had severe lower back isssues on the left side, causing sharp nerve pain and weakness. It has been locked up in there for months and no one has been able to release it. My pelvis is tilted and rotated permanently, and it’s highly likely that is the central issue to my woes. The torsion is putting stress on my stomach muscles etc and causing me pain. That’s the latest theory anyway. It’s now Tuesday and I can up out of a chair again, but my back is still locked up tight, and my stomach and gluts are sore. I have a sports massage booked in at midday. From what I understand the therapist is in training as an osteopath as well, so he’ll likely try and get my back to release a little. The sad thing is, there is no chance that it will be successful in just one treatment. So, I will go into The Saunders in a pretty sorry state, hopefully patched up enough that I don’t have to pull out before the start line, let alone half way around.

In other news, I’ve sent best wishes to some friends all running in the 4deserts Gobi March event in China right now. Tremaine, Diego, Christian, Lucy, and the two Samantha’s are all taking part. Good luck to them all, I’m sure they’ll do well. That’s it for now. Good luck to me this coming weekend, I’ll put a write up as usual, assuming I’m well enough to go.

Have a good week.

Tuesday, 22 June 2010

Krakow

I've ran a few times since the last post but not a great deal has changed.  I was ok running short distances of about 3 miles, and kept up my daily strectching routine.  All this seems to keep the pain down, though I was still aware of it.  However, I let the stretching slip last week as I had to work in Krakow in Poland.  I was working long days, so by the time I got back I really just had time to eat and then go to bed.  Only on Thursday did I get back to my hotel for 5pm and then decided to go out for run along the river and around the old town walls.  It was my first visit to Krakow and I thought it was a very pretty city.  I'd go back as a tourist I think. I ran about 7 miles.  The following morniang I had the familliar stomach pain which then lasted for a few days. 

I got back home on Friday evening and went over to Doncaster on Saturday morning, to one of my Uncle's chiropractic clinic.  He gave me some treatment, which was some very painful massage on my illiopsoas and also on a few areas around my hip joint.  He also cracked my back and fixed my neck which I have been suffering with for a couple of weeks since falling when running.  I haven't run since then, but plan to run a few times this week, 3-5 miles each time.  At the weekend I plan to do a run with my Saunders Mountain Marathon partner Mike.  We are going to run some kind of anytime challenge in the peak district, from a bunch of grid references, so it should be good practice.  Mike is in very good shape at the moment, so the 20 mile route will be no problem for him.  I however have not run 20 miles since March, so I suspect I'll fare badly!

The Saunders event is the weekend after this one, so I'm not going to be in particularly good shape for this event, but there isn't much I can do about it.  I'll just have to turn up and do what I can.  Neither of us have done this event before.  I have only done a score class event twice before, and this isn't a score class event.  This is where you get given a list of about 8 grid references and have to go and tag each of them in order in as quick as time as possible.  You then do another course the following day and the culmulative times are added together.  Hopefully the weather will be ok, but you just never know with mountain weather.  I've got to get a few bits of kit together for the event, but most of it I have already.  I'll let you know how this weekend training goes.  It may go so badly that I realise I just can't enter the event at all, that's how bad the injury is unfortunately.  When I did the last 20 mile event about 3 months ago, it was all I could do to walk in the end, and on this event I have to do the same the next day.  So, this weekend will be quite a test.

Have a good week.

Tuesday, 8 June 2010

I'm still alive

You might have thought otherwise in the 2 months since the last past. As those last few said I have some kind of stomach injury that I picked up in the Atacama. I ran once, two weeks after the event in mid March and then didn't run again for 2 months, assuming whatever it was would have gone. I was wrong. So that was a month ago and after 3 miles I got the same stomach pain, and had to stop. I thought it was a strain of my rectus abdominus, but this seemed pretty unlikely with no improvement after 2 months. I saw a physio at work who was, frankly, an utter waste of money. Her expert diagnosis was, I quote, "Well it could be a lot of things but it's definitely muscular".
Yeah thanks for that; that was well worth £50...
I started to wonder if it was my back referring pain to my stomach so I saw a local chiropractor. My back needed some attention anyway as it was very tight. The chiro said my illiopsoas muscle (a deep stomach muscle) was very tight. It's a very tough muscle to get at, and incredibly painful to work on. He's had a couple of goes at that as well as my back in the last month. My friend Mike, who is a physio where I live said he'd have a look at me, and he believes it is my hip flexor. He's given me some treatment in the last couple of weeks, at the same time I've been having the chiropractic. Between the two treatments I think I am starting to improve. I have run a few times, just 3 miles each time. The following morning though I have still been getting stomach pain. It's very low down above my pelvic bone, just above to the right. It hurts if I sit up from lying down, and it hurts if I lift my right leg. The pain usually dulls after a couple of days rest.

Last weekend I went camping in Wales. I climbed Cadair Idris, which is a mountain near Dolgellau. The weather was terrible, with heavy rain and low cloud. There were no views from the top (supposed to be very impressive on a good day). Instead I could see about 20-30m, and that was it. The substantial summit shelter (with a roof!) was very welcome. I was in full waterproofs at this stage. It happened that it was the day of the local fell race from the town to the top and back, so there were people running up to the trig with shorts and singlets on. Brave people! It was a 10.4 miles course they were running with about 900m of ascent, which the winner completed in about an hour and a half. I was just walking and only doing about 6.5 miles in a horseshow route on the Minfford path, though the same amount of ascent.

I camped that night in the Lleyn Peninsula where there is very little mobile phone cover in places. I got a waft of a mobile signal at 8am and then had to drive 6 miles to get a signal, responding to a text from my (5 year old) son's mum to call me, sent at 00:45 saying I needed to call her.  They had been travelling back from Wales themselves the previous night when they were involved in a head on collision with a drunk, and uninsured driver, who had tried to overtake another driver on a blind hill, in the dark in poor weather conditions. To make it worse he was also already banned from driving. They are alive through a mixture of luck (they were in a loaned car and not their own little Smart car) and the quick reaction of my Son's Mum to brake to almost a stop. The pictures of their car are sobering, even the police can't believe they survived. Anyway, they escaped with cuts and bruises, and minor injuries. The other driver was breathalised and then arrested. He's in court on Friday to enter a plea, let's hope they lock him up when he gets sentenced.

After being reassured they were ok, and there was nothing I could do I did then stay for the rest of the weekend. I did a 20 mile route on the Sunday, with a couple of small hills (less than 600m ascent overall), and managed to run the last 7 miles.



I did pay for it in stomach pain the next day. I have been doing daily stretching, so stretched out in the morning sufficient to allow me to complete an 8 mile circular walk from Beddgelert, climbing Moel Hebog and 2 or 3 neighbouring mountains afterwards, returning through Beddgelert forest.


I ran 3 times in the week, again only 3 miles each time, with plenty of stretching in between. On Saturday I went for a trail run in my road shoes (foolish), slipped and fell hard on my back with my neck at a funny angle, to an unpleasant crack. I got up, established that I could turn my head left and up, but not right or look down. I figured I'd locked a facet in my neck. It was very painful but I elected to run on since I was almost half way through the run. I got back having completed 10k, and iced my neck, but already knew that it was going to do little to east to pain. Mike came around to give me some more treatment on my back and stomach. Better news is that on Sunday I had less stomach pain. I slept very badly on Sunday, the slightest turn of the head causing a lot of pain. I got a cancellation appointment with the chiropractor early on Monday and put my neck back where it was supposed to be. I'm now on Diclofenac for a few days. It's still sore but I can now turn my head again. Hopefully I'll be up to running on Wednesday or Thursday.


So, I've had some rough times over the last couple of months. I just hope that this is just my hip flexor and it will go away with all this treatment.

One reason Mike has been treating me is that he is my teammate in the Saunders Mountain Marathon in a month's time. It's being held in Sleddale which I've never heard of. It's somewhere near Shap, in the Lake District, apparently. We are entered into the Bowfell Class which is one of the tougher classes I understand. Minimum distance is 15.5 miles and 1800M of ascent on day 1, and 11 miles and 1000M of ascent on day 2. It's likely that we will do closer to 20 miles and 15 miles respectively, I suspect. I've only taken part in a couple of mountain marathons, so I'm really very much a newbie to them. This is Mike's first, but he has had a lot of fell running experience, and is in much better shape than me right now. He completed the Helvellyn Fell Race a couple of weeks ago, and did a 19 mile Paddy Buckley support leg last weekend. Needless to say, the last time I ran more than even 7 miles was more than 3 months ago, in Chile!

All I can do for now is keep running short distances, to hopefully prevent this injury getting worse, and try and muddle my way through the Saunders. 3 months ago I was at peak fitness, but that's all gone. My recent attempts to run just 3 miles have illustrated that. So right now, normal service is not yet resumed, but I'm trying to work through it. I'll keep you posted. Have a good week.

Tuesday, 20 April 2010

Still no running

I haven't got a lot to report other that I still haven't done any running. In fact I went to Chester for the day at the weekend and a 40 minute walk around the city walls was enough to give me sufficient stomach pain to want to stop. I've done some self diagnosis (everyone's an internet doctor these days aren't they) and have come to the conclusion that I must have a Rectus Abdominus strain. This page illustrates perfectly the location of the pain. After reading the description it's apparent that I have most likely got a second degree strain. Taken from the article: "As a general rule, grade one injuries should be rested from sporting activity for about 3 weeks and grade two injuries for about 4 to 6 weeks. In the case of a complete rupture, the muscle may have to be repaired surgically and the rehabilitation afterwards will take about 3 months.

Well, It's been 5 weeks since the Atacama, but I aggravated the injury 2 weeks later on that LDWA event. Anyway, it's pretty clear that even 3 weeks total rest from exercise hasn't helped, so I am hoping another week or two might see it get better. If it doesn't then I guess I could face the possibility that I full-on tore it (hernia), but I don't want to think about that possibility at the moment. It does bother me. Even as I sit still on the train right now, it feels uncomfortable. Let's just hope another couple of weeks rest do the trick.

Have a good week.

Tuesday, 13 April 2010

Out of order

I’m unable to run at the moment. It’s been a month since the Atacama Crossing. I forgot to mention that in the last couple of days of the event I had some stomach pain when I was running. Especially on the last 10k stage. I think had the race continued for another day afterwards I could have been in real trouble. Every time I swung my right leg forward I would get a sharp pain in my very low right abdomen. Even walking around after the event for a couple of days was uncomfortable. I took two weeks off running completely when I got back. Then a friend asked if I wanted to go take part in an event in the Peak District exactly two weeks after I got back. I figured whatever strain I had would have healed by then. The first 10 miles of the event went fine, but the pain came back and got progressively worse for the next 10 miles, to the point where I would have to drag my right leg well behind to get some pain relief. Even walking eventually hurt just as much. We still finished the event in a respectable 4:15, even with 3000ft of ascent. However, had the race been any longer and I would have had to walk the rest and with gritted teeth. I had some sports massage a day or so after, but it made no difference to be honest. A few days later and the pain eased off when walking, but I still get a twinge sometimes; perhaps turning over in bed or bringing myself up to a seated position from lying down. Basically when some muscle is activated in a certain way I get pain. It’s now two weeks after the event and I still can’t run. I think I broke into a jog for half a dozen steps for some reason or another the other day and felt the pain straight away. So, whatever it is, it hasn’t gone away. I had to go to the doctor anyway last week with a bad case of food poisoning. I lost 10lbs over 4 days and just wanted to check I hadn’t picked up anything nasty in Chile. I’ve since recovered from the food poisoning, but I did take the opportunity to ask the doctor about my injury. As soon as I told him it was through sport, he didn’t even bother to examine me. He just said that I would have to pay to go to a sports injury clinic, but it was probably just a strain. It amazes me that If I was 25 stone, obese and smoking myself to death, then the NHS would be more than happy to pay to have my stomach stapled or for an expensive course of anti-smoking treatment, but as soon as you mention you’ve done something through being healthy then it’s your own fault and we’re not interested.


The doctor’s guess of a strain may well be correct, but it’s taking a long time to heal. I have no idea if it is indeed a strain or something worse, but right now I still can’t run and have no idea when I will be able to.