Saturday, September 20, 2008

Chronic Exertional Compartment Syndrome

The first time I took up running after college was around 1990. I bought a book by Jeff Galloway and was trying to follow its training program (which included long runs on the weekends). Things were going well for a while but then I had to stop. My calves were not recovering from the workouts. They weren't just sore, I couldn't flex them. It was like something had taken all the fuel out of my calves and they couldn't push anymore. I had to walk funny for a few weeks (stepping up onto a curb while not pushing off sure felt funny) and then they recovered. I ran again but the non-recovery happened again. This time I stopped working out for a few months but the same thing happened again. At the time (I was in my late twenties), I figured that I just could not jog anymore.

Fast forward to 2002 or 2003 and I decide to take up jogging again. I weigh more and am a lot slower but things go well. I can only jog once a week (due to my aforementioned time constraints) but I notice improvement each week. Excellent! I jog on the big street I live on, which includes a good hill at the turnaround for a 3.5 mile jog. I do that for some months and all is well; no problem with the calves (though sometimes I get what I call "floppy foot", which is a weird thing where one of my tibialis muscles wears out and I cannot lift my foot up so well). Then I decide that I am feeling good enough to push past 3.5 miles. As soon as I go past 4 miles, my calf problem comes back. I take a few weeks off and go back down to 3.5 miles and the problem goes away. Hmm. I try a 5k on my birthday in 2006 and, while my calves are just fine, I got floppy foot 2/3 of the way through. Sigh.

This time I do some research on the net and it looks like I have a name for my pain: Chronic Exertional Compartment Syndrome. In a nutshell, the fascia surrounding my calves is not as flexible as it should be, so when my calves try to fill up with blood during exercise the fascia keeps my calves from expanding, which restricts the blood flow to my calves, which keeps nutrients out and waste products in. Treatment? Surgery that slices open the fascia to relieve the pressure. I have not found much information on the downsides to such a surgery but my sister, who used to coach volleyball, said one of her athletes had the surgery done and it helped so much. We'll see.

A bit more digging told me that jogging was particularly hard on calves and that bicyling might be a better exercise. It seems to be so far, though I have yet to go bicycling much past 60 minutes (which was how long 3.5 miles was taking me--I said "a lot slower", remember?) so I don't know how far I can push myself yet (hence my hesitancy to lay out big $$ for a new bike). Now the episode in the nineties made sense because it wasn't until I started doing the much longer runs on weekends that this problem showed up.

In my training schedule for the upcoming year, I want to both bike and swim farther in training than I will in my races. I won't be able to do that with running, though, until I have surgery and I am not planning on looking into that until after the races to see if I am dedicated enough to make it worthwhile. So for now I am just going to deal with it the best I can. That means no running until February, when I have dropped a bit of weight (knock on wood). Then only running once or twice a month and no longer than 3.5 miles. Hopefully putting some hill training in there will make up for the lack of mileage. I do worry how a bike ride followed by a run will affect my calves but I won't be able to find out until I actually do it.

This thing with my calves is the most worrisome part of my training. I really have to monitor them carefully or my training will make them hit the wall. I hate hitting walls.

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