I've never been happier to have cellulitis in all my life!

Wonderland was wet & magnificent!  

Wonderland was wet & magnificent!  

Just 10 days ago I competed in a superb event called the Wonderland Run. The 37km (they call it 36km but we all know it's not!) route starting from Halls Gap heads straight up to the Pinnacles, back down the other side and up & over Mt. Rosea before a long sweeping downhill down past Lake Bellfield, before a brutal & wet slog home. All in all over 1300m of ascending, and whilst shorter than the marathon distance that I'm more accustomed to, this took about an hour longer! Hence the last hour I found pretty tough. Constant rain, wet, muddy conditions probably didn't help either, but that's all part of the adventure. To be honest, it was the toughest run I've ever done, very tough on the legs no doubt as a consequence of being much longer than I'd ever run, and much, much steeper than the typical bayside runs that prepare me well for road marathons.

In any case, it was fun (in retrospect) and great to be part of the wonderful trail running community that make these events so much more rewarding than just the run itself.

But lest I digress...

My post Wonderland recovery week was seemingly going well, with a heavy but very easy run on the Thursday, followed by my group session the following morning at the Tan where I surprisingly felt pretty good, particularly on the hills.

However, Saturday morning I noticed some tenderness along the inside of my lower leg and Achilles towards the ankle. Being a rest day, (from running at least; with two young boys there is no such thing as rest) I didn't worry too much, took it easy and figured I'd run it out the following morning on my Long Run. Now with my runner's hat on (as opposed to my coach's or Osteopath's hat), I figured I'd get the long run in before anything further eventuated, which of course it did. It started out just a bit tender, eased up nicely after a couple of kms and I managed 10km until it gradually started to hurt more, and then a bit more. Rather than stop there (as per Osteopath's advice), I continued the run & assessed whether it was affecting my gait. And so I just flattened my foot strike a little more, kept my cadence up and pushed a little less to ease the load through the achilles. It didn't really get any worse so I figured I'd pull up at 18km, where I got into the cold soothing bay water for a good soak for 12 minutes, and start my recovery from there. I've been fortunate enough not to have had too many injuries, rather just niggles that I seem to be able to manage well, and not miss any or much running at all. 

Achilles pain can be debilitating and frustrating if not treated properly.

Achilles pain can be debilitating and frustrating if not treated properly.

Nevertheless, for the rest of the day I just got sorer and sorer, despite applying ice for 15 minutes every 1-2 hours, compression, elevation etc or so it was still there. I wore my Strassburg sock at night, and to bed, as one does at the slightest hint of plantar or achilles tightness or pain; only to discard it sometime through the middle of the night once your toes become red hot from the pressure. ( Warning: the sound of tearing velcro in the dead of night does little for anyone sleeping nearby, and will not be appreciated!). "It will be okay in the morning, but I'll rest tomorrow just in case, in prep for Tuesday's Interval session", were my thoughts.

Next morning started optimistically but not for long, as pain came on rather quickly even with walking. Not to worry too much, some active recovery as I cycled to work should help I figured. Once at work, I began to further assess this Achilles situation?? Surely, it can't be an Achilles injury, not with less than 10 weeks until the NY Marathon?? I mean, just because I ran for nearly an hour longer than my longest run, in steep, wet terrain instead of flat, bayside paths that I've been used to for the last however many years. Surely, that wouldn't explain why my Achilles could have been overloaded and subsequently injured?? But I don't get injured I tell you!!

Well there was that time about 10 years ago that i ran, inspired by Chris McDougall's 'BORN TO RUN' for 2 hours barefoot in the sand at North Stradbroke island after a late night of drinking, that created a horrible case of plantar fasciitis, that i couldn't shake. So I stopped running for about 6 months and took up competitive Mountain Biking instead! But that was ages ago, and just a silly thing to do, regardless of how inspired I was from just having read the book that changed my life.

So I removed my anxiety ridden, catastrophising runner's hat, and replaced it with my Osteopath's hat in an attempt to have some objectivity about the situation, and called in my colleagues in clinic to help me out. A thorough examination to diagnose the complaint revealed some very interesting features ; no pain, thickening, or swelling along the achilles tendon or it's bursa, no heel or plantar pain, no loss of power or strength. Something wasn't quite right if this was an Achilles injury. Further examination of the painful swelling down the inside of the leg, revealed skin sensitivity & pitting oedema further from the Achilles and that's when the lightbulb moment came! Aha....if this was red or itchy I would definitely think that I had a case of cellulitis! This makes some sense too, as I will have repeatedly scraped my lower legs with the soles of my shoes many times on this run, & in the process imbedding into my skin wombat or roo-poop or some similar bacterium present in the mud & rushing waters of the Grampians and it's swampy lowlands, as I dragged my fatigued body about in the wet & muddy terrain. 

Convinced I'd hit the nail on the head, I rushed to the closest GP and managing to convince him also, received my prescription for the antibiotics required urgently to bring this case under control. To be honest I can't say whether it was the weight of the clinical findings that were most convincing or the fact that the treatment protocols & prognosis of cellulitis was a much more favourable option that that of an Achilles tendinopathy that was potentially going to de-rail my Marathon campaign.

Well, I guess time will tell,  which is why the GP also handed me a referral for an Ultrasound to further investigate the Achilles also. 

The moral of the story is of course ;

Don't wonder what it is, don't self diagnose, and don't delay.
Go see your professional health provider that knows about running for a thorough assessment, diagnosis and treatment plan to get you back on track ASAP!

If you have or suspect you have an Achilles injury, here's a link to a very good article to help your recovery.

Strasburg sock; integral to Achilles & plantar fasciitis recovery & management  

Strasburg sock; integral to Achilles & plantar fasciitis recovery & management  

So, it's looking like a week off for me and with a bit of luck & good management, I'll be back for the weekend!

In the mean time, as always, Run Well.

Rohan Armstrong

Passionate Running & Osteopathy