After seeing significant improvement in my back problems following several osteopath treatments I then had a bit of a relapse. At the time I couldn't figure out what the cause was, but guessed it to be down to a number of things, one of which was the hilliness of the terrain where we were on holiday in Salcombe (I only done two 5m runs, but they gave me incredible DOMS!).
Additionally, from shortly before we went on holiday I had been dealing with a mild case of Achilles tendonitis, that I presumed was a side effect of my back issues.
When I returned I had an osteopath session, which confirmed that my back had indeed, unexpectedly, deteriorated significantly. Positively it responded very favourably to that first session.
My osteopath also commented on some extreme swelling in my lower legs. It would appear that the cause of the swollen legs may well be due to two causes - the first is my asthma medication, which I discuss in more detail, below, and the second appears to be a reaction/intolerance to chillies that has developed relatively recently (as those who know me will know, I really love chillies, so this is annoying to say the least :-( ).
A warning on Asthma medication.
I have been on a high dosage of an inhaled corticosteroid for a number of years, occasionally topped off with an oral corticosteroid if my symptoms were particularly bad. It appears to be only recently that the effects of longer term usage of inhaled corticosteroids has become sufficiently apparent to be more readily noticeable, though it has not, as of yet, worked it's way down to the relevant medical personnel in the front line (at least in my experience).
I have had discussions twice within the last 18 months or so with an asthma nurse about some of the side effects I felt were due to my medication, but these were dismissed out of hand as they weren't referenced on the literature. It turns out long term side effects don't appear to get listed on some medications, so if you are being prescribed something that you are likely to need to take for a while, do look into it a bit more closely than just reading the leaflet.
After the previous osteopath session I decided to try go without my steroidal medication to see what effect, if any, it had. Additionally, as I am due an asthma review shortly I figured it would be a good time to see if the medication was still necessary to manage my asthma.
At the same time, I also began to look around for some information on the long term effects of inhaled corticosteroids. What I found was eye-opening to say the least.
Amongst others, the ones relevant to me were (from what I found and what my osteopath told me), along with my thoughts:
1) Weight gain/inability to lose weight - for a runner this is a major issue, particularly if the cause is not something you can control. I first noticed this last year before the Berlin Marathon when my weight was considerably higher than normal several months out and I found it particularly difficult to get to anywhere near racing weight.
2) Swollen lower legs due to water retention - at it's worst this can make running painful and will, additionally, inhibit recovery due to increased muscle damage.
3) Swelling in the lower back region - this will affect running in a number of ways, including the fact that increased pressure on the lower back area will reduce the amount of power and drive available to the legs, something I have most definitely noticed.
4) Delayed wound healing - traditionally I have normally healed from cuts and scrapes much quicker than average (my wife nicknamed me Wolverine because of how quickly I generally heal), but this has most not been the case over the last while. Definitely a case of (wh)Y Man?, rather than X-Man.
5) Symptoms of thyroid problems due to adrenal suppression - my GP actually ran blood tests because I was exhibiting some symptoms of thyroid problems, but my thyroid function was ok, which is, apparently, consistent with a steroidal cause.
6) Sleep issues - I have been having more and more broken sleep over the last 6 months or so, and could not figure out why.
7) Raised blood pressure - only slightly, but in itself it was unusual as my blood pressure was always on the lower side of the standard 120/80.
8) Tendon/ligament (i.e. connective tissue) related issues - see below for more on this.
From my initial understanding, the problem with steroids is that they accumulate in the body over time, and, I guess, when they eventually get to a high enough level the symptoms become more and more noticeable. I suppose at some stage the accumulated steroids reach a kind of critical mass and that's when you start to experience the kind of things like tendonitis and see the other symptoms occurring on a more frequent basis. My osteopath gave me some very enlightening examples/explanations of this last night.
What I had noticed is that I was having problems running a lower volume of running than previously, irrespective of the pace (in fact, the slower I ran the more issues I had, possibly due to the extra time on feet combined with the swollen lower legs).
Even more noticeable is that I am less able to manage even the volume of training that I was managing just one year ago. Bear in mind here we are simply talking about quantity, not quality, though I am, additionally, less able to recover from quicker running, so it's not even as if it could be down to an increase in quality work making me more tired.
So, the question is, where to go from here?
Well from a health perspective, there is no option other than to avoid the steroid based medication. I am hoping that I can manage my asthma simply by using my relief inhaler, combined with some other changes that I am currently looking into (specific foods, exercises, etc).
From a training perspective it is simply a case of finding the best training based on my current circumstances and then running as well as I can from that. I suspect this will require a better ratio of number of runs to total mileage, as well as a more even spread of mileage across days to try and ensure I don't do considerably more on one day than the next.
Likewise, the quality runs I do will have to be carefully managed to ensure I am getting the best out of my training without putting an unnecessary load on my body. This will mean, for starters, having to stop the longer tempo runs that I so like and respond very well to.
Additionally, some of my quality running will very much have to be unplanned (i.e. if I feel good on a given day then I take advantage of it).
All in all though, if things are as they appear, as I improve I should be able to increase the volume of my running in both quantity and quality terms over time as my body rights itself, so fingers crossed!
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