Jo Hadley | Getting to the start line of a marathon is a win in itself! Part 1 – Road to Boston
physio, physiotherapist, injury, sport injury, physio sydney, female physio, runnuing
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Getting to the start line of a marathon is a win in itself! Part 1 – Road to Boston


I have run 11 marathons since 2013 (two of these unofficial)and each one has been completely different in how the preparation went and how the race panned out. My preparation for the Boston Marathon in April 2017 has been no exception.

After the Melbourne Marathon in October 2016 and having completed 3 marathons, 3 half marathons and one 10Km race for 2016, I wisely had a 3 month off season. I used this time to swim  twice a week and run at a nice slow pace to help build up my aerobic base. I decreased my mileage so I could build it back up again and refrained from speed work for the 3 months. In January 2017, I began my Boston training a little early, in case injury or illness delayed my training down the track…it was a good idea as it turned out…as in the end, a lot of things began going wrong.

First up, in December 2016, I suffered a women’s health issue, where I basically had a period for 5 weeks. I kept training, aware that my iron levels were bound to be affected. In consultation with my doctor, I took iron tablets twice a day until the crisis had passed and ensured my diet was iron rich. This issue coincided with my return to speed training in January 2017 and I was left quite dizzy at the end of the initial sessions.

For the past 18 months I had been the full time carer for my mother. She lived with me in my small apartment. Concurrently, I was working less and less and had to take a lot of time off to take my mother to medical appointments. At the time I had two part time jobs, so as these jobs slowly disappeared, I used my savings to study some courses, so I could begin my own holistic therapy and meditation practice. I had just found a room to rent for the first step in my new career plan when my mother began getting quite unwell. I was now spending most of my time at home caring for her and unable to work. To say I was under financial stress was an understatement…despite a few moments where I lost the plot with anxiety and fear, I generally decided to use my meditation training and stay focused on the present…I did not always manage to do this but I got better at it with practice. It was difficult to get out to train sometimes, but I managed to get up early and get the miles in …that was before I got injured. Then being home to care for my mother was easier, so luckily I had to use my exercise bike which I keep largely unused in the corner.

From January to early March the health issues with my mother became so bad that she decided (not me – I was trying to keep her at home) it was time she had to be placed into permanent care, so in early March, after a short but stressful search for a suitable place, which we found by the grace of God (to me it was a miracle how we found this great home so quickly and just at the time I was starting to become overloaded trying to provide care 24/7 and train for a marathon and fit in a few hours work when I could), my mother moved into a hostel, in an aged care facility. This was a very sad and stressful time for us both, as I had become used to telling people jovially that I was a single mother to an 83yo and also the move coincided with the death of my uncle, which also threw my mother into a quicker physical decline. Once my mother was in the hostel, I tried to visit most days, and work some hours, but making sure my mother was setting in well was my first priority. I also had an injury/injuries to overcome.

I was already running 28-30 km for my long runs 10 weeks out from the Boston marathon and I was planning to run a couple of 35 or 37km runs later in my training, but around this time another problem emerged… I run in very minimal shoes and normally have no problems, or I haven’t since I began running in late 2010.  Then one day a friend from my running group asked me if I ever had foot problems with my minimal shoes and I replied, “no!” I swear it was the very next day I began to notice soreness after my runs just under the foot below the 4th and 5th toes on my right foot on the bones after my runs. (In my off season I had deliberately tried to place more weight through my right foot as I ran, because I had been told by a few different sources that I  favour my left leg and it was probably why I had chronic kneecap soreness on this side.) This problem initially went away after 10-20 minutes with my foot on ice but would return after the next run – I was a little concerned but not much, I always have niggles and many resolve quickly and I always run with some left knee cap pain – which I have had for years prior to running.

This right foot pain easily resolved with ice, until the day I was running home from a speed training session, fatigued, I suddenly had to slam my right foot into the hard footpath while approaching a road on a decline. The force of the foot slamming into the hard pavement caused unpleasant pain over the already sore bones. I iced the foot as soon as I arrived home…but from this time on the foot started causing issues and during my next long run of 28km , I was aware of the plantar fascia progressively getting tighter and then I felt the plantar fascia acutely tear near my heel. The pain was so bad it stopped me and I had to limp to a friend’s house for ice and about 3-4 days off running. I know only 3-4 days was not long but my foot responded quickly to ice, constant movement and non-weight bearing exercises whenever I was lying on my couch. By day 4, I could run 9km but feeling as if I was stepping on a rock under my heel with every step. But I could run without the pain worsening and few negative consequences after the run…I iced of course immediately after the run and the ice and non weight bearing exercises again seemed to work wonders. The 4th and 5th toe area bone pain settled as well. I decreased my mileage a lot… somehow I managed complete 20km during a run one week after the injury. But I was easing back a lot on mileage overall and skipping speed sessions.

It was now 8 weeks out from Boston 2017 and I was injured! I was glad I had begun my training early, so I jokingly called it my ‘mid season break”.  I resumed speed training knowing that I was taking a risk, but the foot seemed to let me train quite well, that is, I did my speed sessions as per usual, able to ignore the bruising pain under my heel. After the speed sessions the pain usually worsened and I had to ice and rest from running for a few days.


About two weeks later and having completed a 30km run, I was feeling good at my next speed session, the two pains seemed almost gone and I just had some tightness in my calf, which I thought was way better than the bruising pain from the heel, or the bruising bony pain from the outer toes. I ran fast in my speed session without issue other than a tight calf, but on the slow 6km run home I began to notice a nasty, nasty sharp pain just above my right medial malleolus (ankle bone). I ran a few more days with this pain but it was getting worse each time and the day I decided to do my long run from home to Bronte and around the hills near the eastern suburb beaches to prepare for the Boston hills, this pain became so severe I had to stop.

For the next 2 weeks I reduced my running again and substituted one to two sessions on an exercise bike. The exercise bike unexpectedly re-aggravated my injury in the 4th and 5th toe areas which had subsided and this confused me a little.

None of my standard physio treatments for this medial ankle pain seemed to help much and I was seriously beginning to doubt whether I could even start the Boston marathon. I realised it was a tendinosis of my toe flexors. I assume this tendon issue was because I was running with pain and causing my calf and toe muscles to tense more, thus overloading the tendons. I had thought myself so blessed and lucky that I had managed to treat myself for my other two issues so quickly, but this tendon injury was proving to be difficult and was possibly a marathon ‘ruiner’. I knew the possibility of not even getting to the starting line was getting stronger by the day. I was using all my physio knowledge and my meditation skills, but with little effect. I always eat nutritiously anyway but was now more than ever hoping that the nutrients from my food would help progress the healing of my injured tissues.

food photolil food-healthy-vegetables-potatoes

When I used my physio knowledge, with what my foot was telling me it needed, I then found a treatment for the tendon that worked almost instantly and what was better, I found the other pains improving too. What did I do?

I was on the bus one day on the way to visit my mother when I decided I would try static exercises for my toe flexor muscles in the end range ‘toe off’ position of running. So basically I put my soleus/lower calf muscle on stretch in a lunge position while I placed either my large toe flexor or my toes flexors at their end range of stretch (pushed up against the back of the bus seat in front) and kept the toe muscles statically contracting for as long as I could stand. I could feel the tendon irritation with each exercise, but it was easing the pain and the irritation felt good. After many minutes of performing these static exercises I got off the bus and felt much relief above the inside ankle. This position I used to stretch and exercise the toe tendons ALSO stretched the plantar fascia.

I performed these exercises regularly and within days began running again, but this time in my least minimal shoes, which had a tiny bit of cushioning to accommodate the soreness  of the bones at the base of my 4th and 5th toe (metatarsal heads). I still felt bony soreness near my 4th and 5th toes, but I found that wearing thongs/havaianas  for about 10-15 minutes eased this, so I figured I would wear my Innov-8 shoes for running, they usually are just for casual wear even though I did buy them for running initially. This combination of exercises and shoes allowed me to resume running pain free and with few symptoms post run. I was still sore in the 4th and 5th toe area if I walked barefoot around the apartment, until I warmed up i.e. 5-10 minutes.

Now you would think my problems were over, but no…..

Around this time, late March, I had to have day surgery for a women’s health issue….thankfully my surgeon was a marathon runner and she allowed me back running within 2 days…my surgeon came to talk to me before the surgery and the only thing I cared about was to reconfirm when I could run again….she had told me at our consultation but I wanted to hear it again….I returned to running two days later but I did only 12km as it was also my first run back after my tendinosis injury.

I was nearing the end of my (loose) training program for Boston and overall I had managed only one 32km run and a couple of 30km runs. I felt under prepared. So two weeks and 3 days out from the marathon I ran 21km on two consecutive days instead of a 35km run. I reasoned that two 21km’s would be like running a marathon but with a rest. It was my final endurance training before the marathon…..

I have had to miss other marathons before because of illness or injury and I know I have had some issues but I know many others have suffered far worse than I have this time round…missing a marathon is not the end of the world…but this time I felt much more pressure and fear, as I had spent a lot of money to travel to Boston at a time when I was not earning much income (in my defense, at the time of booking I assumed I would be working at least 30 hours a week by April, as my mother was cruising along quite well last September.) Also Boston is the first overseas marathon where I will have none of my mad marathon running friends with me, nor do I have any friends in the city. I do have an American friend living in Florida but her health and her work commitments could not allow her to ensure me she could meet with me there.  So I was feeling a little vulnerable about heading off to Boston injured and alone, even though my meditation training teaches me to live in the moment and not to project into the future…I still have my times when I catastrophise and fear…but I try to use these thoughts to reinforce my mindfulness meditation training….stay in the now and do what I can…NOW!

I first entered the Boston marathon just because I had qualified to run it…I was not ever really thinking of running it before this…but on this journey towards the start line, I have gotten caught up in the buzz and excitement of the most historical and oldest marathon in the world. Now I am really really really excited to run the Boston course. I am not aiming for any personal best times, just to complete it with a smile on my face…or even a slight grimace of fatigue…it will be an honour to complete the Boston marathon…I have felt the excitement of the organisers of the event even from my home in Sydney.

By the way…if you are reading this….I made it to the start line in Boston!


Read my other blog: Life Lessons Learned from Running Marathons

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