Tuesday, October 30, 2007

X marks the spot

Injury update:

It's been 72 days since the injury first reared its ugly head, up in Noosa (not that I'm counting!) In that time, I have had x-rays, a bone scan, and today it was a cortisone injection. The problem is the injury is not improving despite the very limited running I am doing - it still aches when I run, aches when I stop and aches in the middle of the night, or when I go down stairs, or just because it can. The periostitis is very localised - I can point to exactly where it is tender. For some reason, doctors and physios take great pleasure in applying some force to this particular spot and then asking, with a straight face, whether it hurts - one look at my face gives them the answer.

So the sports doc poked and prodded again today, muttering about how the symptoms still point to a stress fracture and debating whether I should have an MRI before the cortisone injection. However, we opted for the cortisone injection first, and then if it hasn't improved in about a week's time, I will have the MRI. This injury is going to send me broke!

Naturally I googled 'cortisone' before the visit to the doc today and came up with the following information:

How do cortisone injections work?
Cortisone is a powerful anti-inflammatory medication that occurs naturally in the body to controls and assists normal body functions. When therapists use cortisone to treat tendonitis, bursitis, and arthritis it acts as a potent local anti-inflammatory drug. Cortisone is useful in suppressing inflammation in the short term, and in the long term, dissolving scar tissue, stabilizing the body's defenses, speeding the healing process, and is very effective in causing certain cysts to disappear.

Cortisone is not directly a pain relieving medication, as it only treats the cause or site of inflammation. Your pain is decreased by a cortisone treatment because the inflammation is diminished and this is turn reduces the pain. By injecting the cortisone into a particular area of inflammation, very high concentrations of the medication can be given while keeping potential side-effects to a minimum.

What is cortisone?
Cortisone is a type of steroid that is produced naturally by a gland in your body called the adrenal gland. Cortisone is released from the adrenal gland when your body is under stress, and natural cortisone is released into the blood stream and is relatively short-acting. The absence of cortisone in the body is called Addison's Disease.

Injectible cortisone is synthetically produced but is a close derivative of your body's natural product. The most significant differences are that synthetic cortisone is not injected into the blood stream, but into a particular area of inflammation. Also, the synthetic cortisone is designed to act more potently and for a longer period of time (days instead of minutes).

Are there side effects to a cortisone injection?
Unfortunately yes. Probably the most common side-effect is a 'cortisone flare,' a condition where the injected cortisone crystallizes and can cause a brief period of pain worse than before the shot. This usually lasts a day or two and is best treated by icing the injected area.

Another common side-effect is whitening of the skin where the injection is given. This is only a concern in people with darker skin, and is not harmful, but patients should be aware of this.

Other side-effects of cortisone injections, although rare, can be quite serious. The most concerning is infection, especially if the injection is given into a joint. The best prevention is careful injection technique, with sterilization of the skin using iodine and/or alcohol.

Also, patients with diabetes may have a transient increase in their blood sugar which they should watch for closely. Because cortisone is a naturally occurring substance, true allergic responses to the injected substance do not occur. However, it is possible to be allergic to other aspects of the injection, most commonly the betadine many physicians use to sterilize the skin.

Friday, October 26, 2007


There once was a woman who woke up one morning, looked in the mirror, and noticed she had only three hairs on her head.
Well," she said, "I think I'll braid my hair today" So she did and she had a wonderful day.

The next day she woke up, looked in the mirror and saw that she had only two hairs on her head.
"H-M-M," she said, "I think I'll part my hair down the middle today" So she did and she had a grand day.

The next day she woke up, looked in the mirror and noticed that she had only one hair on her head.
"Well," she said, "today I'm going to wear my hair in a pony tail." So she did and she had a fun, fun day.

The next day she woke up, looked in the mirror and noticed that there wasn't a single hair on her head.
"YEA!" she exclaimed, "I don't have to fix my hair today!"

Attitude is everything.

Be kinder than necessary, for everyone you meet is fighting some kind of battle.

Live simply, Love generously, Care deeply, Speak kindly.......

Life isn't about waiting for the storm to pass. It's about learning to dance in the rain.

Tuesday, October 23, 2007

Motivational Quote of the Day

"It may not be your fault for being down, but it's got to be your fault for not getting up."

Steve Davis

Something’s gotta give

My energy levels haven’t improved.

I went to the gym this morning and while I worked my butt off on the weights I still felt as if I was wading through molasses.

The running is coming along slowly – too slowly for my liking but then I’m not known for my patience. As for the periostitis, there is still some tenderness in one particular area of my shin but I don’t think it warrants a cortisone injection. I see the physio again on Friday and a decision will be made then.

I pretty much flunked the calf flexibility test last week at the physio’s – you know, the one where you stand next to a wall then bend the knee, with the aim of touching the wall with said knee. With my left foot, the distance is about 4cm from the end of my toes to the wall. With my right foot it’s about 2cm.

Now, in case it’s not immediately obvious, I have very tight calves! And this has probably contributed to my injury. In fact, in all likelihood, it’s been the change in terrain since last November that has contributed to the problem as a lot of my running included steeper hills than usual. I have tended to run on the balls of my feet more than usual thus increasing the load on my calves, which over time have become tighter and tighter until *twang* something gave way ie an overuse injury.

Days like these…….

…..are better off spent staying in bed out of harms way!

That was my day yesterday.

I started the day with a ‘run’ of 90sec jog followed by 90sec walk then 3min jog followed by 3min walk and repeat this. I have to say it was the fugliest run I’ve done in a long time. It was like how I imagine running through molasses would be like – hard going to say the least. My energy levels have dipped below the empty mark and yet it can’t be my diet – I am fully loaded on slow carbs ie low GI carbs. And it’s not like I’m over training – 4 runs a week but it’s only a total of 9mins actual running time for each run. I go to the gym twice a week so I hardly qualify as a gym junkie. Hopefully this lack of energy will pass.

Ever heard of the person who sends out a joke email and accidentally includes the whole department in the email?

Trust me, it does happen and I am living proof of it.

Ok, so it wasn’t the entire department but it did go to everyone in one particular building belonging to our department. How did it happen? The person I was forwarding on some joke photos (not risque, thank heavens) has the same surname as the name of this particular building and I didn’t look when selecting the name from the address book – bad, bad move. Anyway to cut a long sad sorry tale short, the motto of this story is to always check the email address BEFORE sending the email (or just don’t send joke emails at all and I’m seriously considering that option!) I sat waiting with sinking heart for emails to come pouring back in but so far only 2. It’s so mortifying…… :-( I’m such a klutz at times.

Yesterday’s highlight (fortunately it wasn’t all lowlights) was attending a work presentation by Ian Kiernan (Cleanup Australia) – a very down-to-earth man who is passionate about the environment and can tell a good story or two. The theme of the talk was leadership and it was a very entertaining hour. The next talk will be given by Dr John Tickell (of the Great Australian Diet and Celebrity Overhaul fame) in November – I am looking forward to it.

Friday, October 19, 2007

Motivational Quote of the Day

"Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending."
Carl Bard

Low GI Diet

Part 2 of Operation Marshmallow to Muscle:

"The Low GI Diet is the safe and healthy way to lose weight with smart carbs. The Australian authors of the bestselling series on the glycemic index, The New Glucose Revolution, explain how choosing low GI carbohydrates—the ones that produce only small fluctuations in your blood glucose levels—can help you feel fuller longer and increase your energy levels, making weight loss achievable and sustainable.

The Low GI Diet includes:
*a 12-week action plan based on smart carbs and smart moves—lose up to ten per cent of your current body weight
*the tools and tips you need to maintain weight loss for life
*delicious recipes, meal plans and a menu survival guide
*the GI tables—with the GI of all your favourite foods.
*Easy to follow, and based on making simple substitutions to the way you eat now, The Low GI Diet will change the way you eat for life."

Is it any coincidence that chocolate is low GI?!!!!! *just kidding - while it is low GI it is also high in saturated fat so all things in moderation!* :-)

Well, I'm almost at the end of the first week of 12 weeks and I have probably eaten more healthily than I have for quite a while. Its a food plan I can live with because it contains a lot of food I enjoy: fruit, vegetables, wholegrain cereals, etc. Portion size is probably my biggest trap and because I am not doing a great deal of running I need to scale down the amount I eat.

For each week there are goals: food goal, exercise goal, activitiy goal ie incidental activity, and Food for Thought.
So, for example, the food goal for the week:
Increase my awareness of what I eat and why (now that can be pretty scary!)
Exercise goal:
pretty much taken care of - I jog/walk 4 times a week and go to the gym twice a week
Food for thought: what is the GI of my diet?

In short, this is a meal plan that I can live with.

As it says in the book: "One of the loudest messages in this book - despite its title - is don't 'diet'.
Don't severely restrict food intake, don't skip breakfast, don't skip meals, don't follow fad diets - you are just asking for trouble. Instead, we want you to adopt simple lifestyle 'manoeuvres', only some of which are specific to food. The aim is to maximise your muscle mass (increase your engine size), minimise your body fat (decrease the cushioning ie the marshmallow) and keep you burning the optimal fuel mix for lifelong weight control (high octane energy with built-in engine 'protectants')."

I know, sounds pretty basic, but its amazing how complicated we can make things sometimes.

Dark chocolate acts as aspirin

Dark chocolate acts as aspirin – study
Cocoa contained in dark chocolate may function in the same way as aspirin in preventing heart attacks, according to a new US study.

Scientists at the Johns Hopkins University School of Medicine say that a few squares of dark chocolate each day can reduce the risk of heart attack by almost 50 per cent in some cases.

The researchers said platelets in the blood of dark chocolate eaters clotted more slowly, reducing platelet clumping in the blood. Platelet clumping can be fatal if a clot forms and blocks a blood vessel, causing a heart attack.

Given the high levels of saturated fat and sugar in chocolate, you can obtain the benefits of cocoa on a regular basis without the added kilojoules by having a hot chocolate or iced chocolate drink made from cocoa, with skim milk.

Source: Presentation to the American Heart Association’s annual Scientific Session, November 2006.

Monday, October 15, 2007

Operation Marshmallow to Muscle

This little project (Operation Marshmallow to Muscle) started when I went back to work on 5 September but it fell by the wayside , what with one thing and another. I have refocused and was back into the gym this morning. As part of Operation Marshmallow to Muscle, I am following the Triple Threat Workout by Dr John Berardi, featured in this month's Oxygen magazine.

Apparently our total daily metabolic rate can be broken down into 4 components:
* Resting metabolic rate
* Physical activity level
* Thermic effect of feeding
* Non-exercise activity thermogenesis

If we want to maximally boost our metabolism we need to rev up all 4 of these components, and to do so we need to take aim at 5 main metabolic targets: muscle, afterburn, post-meal metabolism, inefficiency and exercise volume.

The Triple Threat Workout is designed to maximise 4 of the 5 targets. And the workout got its name because it combines 3 types of exercise:
* weight training
* interval exercise
* active recovery cardio

So, for example, a weekly workout could look like this:
Weight training: lower body weights
Interval exercise session 1: 7 to 10 x 30sec high intensity; 90 secs low intensity
Active recovery cardio workout: 60mins of low intensity cardio
Weight training: Upper body weights
Interval exercise session 2: 7 to 10 x 60sec high intensity; 60sec low intensity
Active recovery cardio workout: 60mins of low intensity cardio

I have changed it slightly for the weights session: I do a whole body weights session rather than split it into upper and lower body over 2 sessions. For Monday (today) I do (did) progressively heavier weights and progressively lower reps. For my other weights session I will do lighter weights and higher reps just to mix things up. Hopefully by summer there'll be more muscle than squishy marshmallow!

So that's one part of my planning put into practice. Still to come: future running goals, nutrition plan, study plans/options.........

Well done Macca!!!!!

Winner of the 2007 Hawaii Ironman

Sunday, October 14, 2007


A little bit of what you fancy........

This afternoon I met friends for afternoon tea at where else but KokoBlack! I had a short macchiato and the Belgian Spoil platter. For those not familiar with the Belgian Spoil it comprises a small serve of chocolate icecream, a small serve of choc mousse, a small shortbread biscuit, a small choc muffin, and two KokoBlack chocolates. Yummo! The best thing about it are the small serves, so while it sounds like a lot its not......its just right! Anyway it was a great way to spend an afternoon - with Strewth, Mr B, Kelley and Rachelle. See what you missed Ewen!

Anyway I went for a run yesterday *drum roll* This consisted of 4 x 90sec jog followed by 2min walk in between. If I counted the warm up and cool down walks, it came to about 20min in total. Woo hoo! Baby steps...... The important thing was there was no pain during or after the run. However I am taking anti-inflammatories as advised by the sports doc and will be taking them for a week, so this could be masking the pain. But I'm being positive about this - I've turned the corner and on the road to recovery....slowly! (And twofruits you didn't have anything to do with this injury so just ignore Ewen)

I have also been drawing up a plan - new goals for exercise, running, nutrition and life. All will be revealed over the next few days but exciting times are ahead! See what happens when I can't run - I can't not have goals!!!

Finally a couple of photos from last week's whale watching trip.......

Friday, October 12, 2007


Defn: Is generally considered to be an overuse injury that produces an inflammatory reaction and pain, usually along the border of a bone. Most authors agree that the pain is associated with bony periostitis, rather than the previous theory of musculotendinous inflammation

Etiology: Most studies suggest that excessive pronation, foot instability, along with a change in activity, such as type of shoes, or running surface causes increased stretch and eccentric contraction on the tibialis anterior muscle. This causes increased traction forces at the periosteal-fascial junction resulting in periosteal oedema or microfractures of the cortical bone.

Clinical features: Recent studies using MRI scans have revealed what the majority of authors thought - that periostitis occurs prior to the formation of a stress fracture (Anderson, et al., 1997; and Fredericson, et al., 1995). This therefore makes it extremely difficult to differentiate clinically between the two, because of the similar signs and symptoms.

Symptoms: It a condition also exaggerated by exercise and relieved by rest. The pain description can vary from a dull ache to severe pain, especially with prolonged activity. The patient will nearly always confirm that the pain is along the border of a bone.

Treatment: Since most authors agree that periostitis precedes most stress fractures, the treatment is basically the same. The patient must be aware of the implications of developing a stress fracture if activity is not modified. The treatment relies heavily on rest followed by gradual resumption of exercise. Rest can be considered a relative decrease in the offending activity to a level which is comfortable. In the acute phase cryotherapy, ultrasound and physiotherapy are recommended, while the chronic stage involves the use of massage, heat, trigger point therapy, ultrasound, shoe modification, and taping procedures. Orthotics should be prescribed to assist athletes with excessive pronation or abnormal subtalar mobility. Should these conservative measures fail, anti-inflammatory drugs and steroid injections may be of benefit.

Ok, lesson over....

I had a bone scan yesterday and the diagnosis is periostitis. Better than a stress fracture I guess though looking at the treatment, I can't really see the difference! I can try some 'running' ie 90sec jogging followed by walking and repeat this several times. The sports doc looked at me very firmly as she was saying this and then, to add insult to injury, ended her lecture with "so don't go out tomorrow and run for 30min". *sigh* She knows me too well....

If, in a fortnight's time, it is still sore, then I am to have a cortisone injection. Ouch.....

So what have I been doing in the meantime to compensate for no running?

Well, there was a trip to Merimbula last weekend for a spot of whale watching - unreal, amazing, incredible. The weather wasn't great and it was very windy and the ocean was very choppy but to our credit, no-one in our little group threw up. We must've seen around 20 whales - it really was sensational. There was also a visit or two to Truffles, a chocolate cafe. And highly recommended is a little cafe in Nimmitabel called CJ Harveys - and no, I don't have shares in it! But it serves great coffee and food - the toasted chicken panini was to die for. We stopped there for lunch on our way back to Canberra last Sunday.

I visited KokoBlack here in Canberra a fortnight ago - the first time since it opened in June this year. Here is the link: drooling permitted!: http://www.kokoblack.com/ *And girls (and boy), and you know who you are (!),* I'm going there again this Sunday for afternoon tea with friends AND again in a fortnight's time for morning tea with another group of friends! So texting me while I am in my sick bed to tell me you are at KokoBlacks did not have the desired effect of making me jealous....well, ok, a teensy little bit!

So, no running but a lot of chocolate consumption! I'm morphing from Fit CJ into Fat CJ!!!!

Until next time.......

ps Congratulations to everyone who ran the Melbourne Marathon - you did well, given the circumstances some of you experienced. Well done guys, I'm very proud of you.