Marathon Running and TMS

6 years ago, I suffered my 5th and worst bout with TMS since the age of 18. Since then, I have managed to continue the life of a long distance runner. This Sunday, I finished in the top 12% at the 2014 TCS NYC Marathon (my 3rd marathon overall). I am now 42 years old and in the best physical shape of my life. This isn't to say that the journey was easy. Getting TMS under control is hard work. During the past 5 years, my TMS symptoms have ranged from back pain, shoulder pain, knee pain, numbness and tingling in both feet and legs. The good news is that it never lasted for more than a week. I was always able to get it under control and kept running. I often ran through the pain and ended up feeling 100% by the end of my run. There's always the general belief that running for too long or too far is "bad" for you. Keep in mind that I have read, "The Mindbody Prescription" (25 - 30 times), "The Divided Mind", and the Runners World Magazine article "Mind Over Matter" by Marc Bloom (April, 2006). Nevertheless, it's quite possible that I continue to internalize the status quo. I have decided to read, "Born To Run" by Christopher McDougall. This book explores the life of the Tarahumara Indians and how their history shows how all of us are in fact "born to run". That being said, are there any long distance/marathon runners out there who have persevered, run marathons, and continue to deal with TMS 'flare-ups'? What are some of your experiences? What advice would you offer?

 

Congrats on the NYC finish! That was a cold and wet one, Caroline Wozniaki the tennis player ran it for her first in a respectable time and had Serena Williams at the finish cheering her on. You are a marathon reader too MB RX 25-30 times, that must be a TMS record. You may want to read some other TMS books for a different voice or perspective. I feel you can never read too many TMS books (without being OCD about it)--it's like taking vitamins.

Just curious, at what point in your run, (miles or minutes), does your TMS pain go away?

 

Thanks for the encouragement and getting back to me so quickly. Judging by your user name, you must be a tennis player. I used to be a huge tennis player in high school and then stopped. Maybe some day I'll pick it up again.

My pain usually comes when I'm not running. Usually when I'm suppressing something or going through a really difficult time. Sometimes I get pain when running becomes a center of perfectionism as well. For example, when I realized the wind at this year's mrathon was going to be the worst in years...my back started bothering me. I started thinking, "I trained 5 months for a 3:30 finish...now what do I do?" When I reminded myself that I'm not perfect, I adjusted my plan before the start and my pain went away before the gun went off.

When I'm running, my pain is almost always at the beginning. The first 1 - 3 miles and then it goes away.

 

Hi RedRunner, I'm a 44 year old marathon runner and recently did my first half ironman this past September and had a great result. Unfortunately 2 weeks later I came down with one of my worst TMS flare ups in my left hip/upper leg (after an initial flare up in the back of my right knee just hours after the half ironman but that went away). And I still can't run at the moment. I'm a classic TMSer. In the last 4 years I've paid for 8 marathons and only have been able to run 4 of them. My PR is a 3:07:56 (Oct 2013) and my slowest marathon was the Boston Marathon last April at 3:21 (something). So basically I'm a strong runner but my TMS causes me much anguish and grief and causes me to cancel races. I've dealt with chronic TMS shin pain from July 2011 until up to this past September. Luckily it's been off and on and I've learned to manage it after visiting Dr. Segal a TMS doctor in DC back in January 2014.

I believe my newest TMS flare up (hip/upper leg) is due to the fact that I'm no longer scared of my shin and run on it regardless. But this time I am having HUGE difficulty in getting through it. I'm currently working with one of Alan Gordan's therapists on a weekly basis. I am signed up for my first full Ironman in Aug 2015 so I really need to get through this TMS once and for all. I have read all the TMS books and have had consultations over the phone with Steve O, Monte Hueftle, Dr Sopher and even briefly with Dr. Schubiner over the years. So I definitely know this subject well.

The biggest advice I can give is to get over the fear of running or other physical activity. In the past it has worked for me. But right now I'm still struggling with this current flare up and the fear of making it worse if I try to run through the pain. It's been over a month now and I'm dying to run. I'm a mess when I go this long without running. That all being said, I have finally felt some minor improvements here and there. It's still sore to walk sometimes but there are times it waxes and wanes which feels hopeful.

 

Probably concentrating on the present when you run helps to stop the pain.
Focus your mind on your running and it will drive out fears about wind or other things.
Swimmers focus on their breathing, arm and leg movement and coordination.
Divers make a mental picture of the dive they are about to execute.

And feel joyful that you are running at all. Don't challenge yourself to be a perfect runner.

Just enjoy the run.

 

Hi Joyce VT.

Thank you so much for sharing some of your history and insights regarding TMS. The fact that you have been able to sustain such a level of high-performance is truly inspiring. Hearing about you participating in triathlons in addition to marathons is an idea I have also considered. I say this because keeping a variety may be a good way of not becoming obsessive about running in and of itself. I believe that you will be able to work through your current flareups and perform better than ever at some point.
Thank you for dropping the names of some of the TMS physicians. The physician that I have mainly dealt with is Dr. Rashbaum of the NYU medical center in Manhattan. These visits are very expensive and so I am not able to go as often as I would like. However, it would be a good idea for me to go at some point soon to discuss some of the new flareups that I am experiencing.
I do have a question. Do you bother stretching before and after your workouts? I generally do not do much stretching, because I found that it doesn't usually make a difference. Occasionally I will do some light stretching if I feel tight in certain places. Dr Rashbaum feels that it really shouldn't make much of a difference overall. What are your thoughts?
I have taken ice baths after some 20 or 22 mile runs. I'm not going to lie...they definitely make me feel better afterwards.
Good luck with your training.

Hi Walt.

Very true. I have found that when I get lost in the run and only the run I have no pain or very little of it. It's when I tack on all the other emotional stuff in my life that I feel pain during various runs.

For example at this last NYC marathon, as I was going up Fifth Avenue against the wind at mile 23, I started to think about a very difficult thing that I'm going through. Rather than just focusing on the challenge of getting up the hill, my mind went to a very difficult place. At that moment my legs seized up and I pulled over to the side for 20 seconds and stretched. I told myself, "focus on the run - on the moment...that's it!"
All was good after that and I finished strong. I need to implement more of your advice on a regular basis. I tend to "lump" running in with other things and I believe that's when the pain starts.

 

Yes visits with TMS doctors are usually very very expensive. My last one was $900 for one visit and that didn't include the cost of flying down to DC and back in one day! But it was still worth it to have the courage to run through a very sore shin splint. Without Dr Segal telling me that I was totally fine to train even with the the soreness, there's no way I would have made it to the Boston marathon. Confidence in the diagnosis is huge.

To answer your question I do stretch after I run as a holistic way of taking care of my body. I also do some dynamic stretches and drills before running to warm up the muscles.
Everyone is different and everyone has opinions on stretching. Do what works for you. When training for fall marathons in the past I would sit in cold mountain streams after hard speed workouts or long runs. It is a great way to speed recovery of muscles after a hard run. Even the elites soak in streams or ice baths (Meb used to soak in cold streams). I also used to do massage every 4 weeks as a way to take care of my legs for marathon training. I only stopped when my massage therapist quit to go have a kid. I still can't find someone here in northern VT who's that good. So I believe in doing everything possible as a holistic approach to taking care of yourself when marathon training. Running is good for you. It comes easier for some people than others. Genetics play a big role. But marathon training is tough on the body whether you run a 5 hour marathon or a sub 3 hour marathon. You need to take care of yourself. Keep up the cross training, core/strength work, yoga and eat well too!

Born to Run was a fun read. I read it way back when it came out (5 years ago?). I still have the hard cover copy somewhere. Scott Jurek (famous vegan ultra runner champ) who's featured in the book also has a great book about his story that came out a few years ago called Eat and Run. I'm a vegan so I really appreciate this book.

 

PS - hope I don't sound too much like I'm lecturing . I'm that hard core type A personality who is a perfect storm for TMS.

Hope you get through your recent flare ups! In fact I'm sure you will. Just keep up the good work!

 

Hi Joyce. I don't mind at all. I'm so grateful you took the time to reach out to me. We both sound very similar. BTW..."Eat and Run" is next on my list although I will NEVER become a Vegan. I love meat way too much. However, my most recent marathon training partner is a Vegan and that book was what converted him. He said that book changed his life.

 

I'm 84 and in good health and ate meat most of my life, but avoided fast food restaurants.
In the past few years I've rarely eaten any meat but like chicken, turkey, fish,
and eat veggies and fruit. Eat meat in moderation and you should be fine.

 

Hi RedRunner,

It's always great to get another endurance athlete on the forum. I think there's many more athletes who would be helped tremendously by understanding how pain can be caused by the mind. I myself do multi-sport endurance type of events... runs, swims, cycling. I've ran in some stand-alone marathons, one Ironman, many other shorter distance runs from 5K's up to Half Marathons, and many shorter triathlons such as sprints and Olympic distances. I'm currently training for 2 Half Ironmans in 2015. I haven't done any of those distances yet even though I already did a full Ironman in 2011.

I have overcome a lot of pains and injuries along the way. I've gone through ups and downs. Most recently had a really down year in 2012 where I experienced 3 injuries in the one year. I hurt my shoulder while doing speed sessions in the pool, I hurt my achilles heel while running and my knee while cycling. It was the worst year so far in my athletic endeavors. But today, I'm back to training again with none of those things bothering me. It did take about 18 months to get back to training and one of my own dilemmas that I deal with is not having a TMS doctor that I can go to. So when I get hurt, I can't tell if it's TMS or not and so it takes me a long time to get through it. For instance, my shoulder pain lasted the full 18 months even though my knee and achilles were better after about 6 to 8 months. The shoulder kept flaring up whenever I used it to do an exercise or swim. I couldn't shake the idea that it as a physical problem, even after 18 months. But then someone here on the forum posted that they overcame a shoulder injury that appeared to be almost the same injury I had. He used some mindbody techniques. That seemed to give me the spark that I needed myself to let go of the physical and believe that it was psychological. Within a short period of time, my shoulder completely felt better and allowed me to do many events this year.

For me, my wish is that a TMS doctor that I can afford becomes available to me where I live. For now I diagnose and treat myself and just plug along. I'm thankful that I am able to get over the pains and continue to train, but I just wish I could shorten the timeframes so I am not sidelined for so long. I'm sure Joyce has the same desire regarding that.

Currently, I'm experiencing pain in my right gluteus muscle and a pain on the left side of my left mid-foot. Both don't hurt to the point that I can't run or cycle, but since I don't have a doctor to diagnose me, I fight the fight to believe that it is TMS.

By the way, I've read Born to Run. Great book.

 

Enrique where do you live? I thought you were in the Bay Area, where there are several TMS docs. In my running days I did 13 marathons. I swim some to stretch out for tennis and I've had about four "shoulders". The more I thought of them as TMS, the faster they disappeared. They can persist for awhile, there's no predicting when they will leave, they have a TMS mind of their own.

G'luck!
tt

P.S. If you're in the BA, you may have come across my manager, Kenley Gaffke, he's an elite runner in the 35's, does a lot of team relays and is an officer of the DSE. He won the 94 year old Statuto Race out right that runs through North Beach, that we're all proud of him for.

 

Yep. I'm in the East Contra Costa area. Which TMS docs are you aware of? The challenge I have is to find one that I can afford to go to.

 

Parvez Fatteh, and Bruce Eisenberg in Santa Cruz are TMS MD's. You may want to discuss with a TMS therapist which there are a few of too. They are all listed at the PRACTITIONERS in the wiki's sidebar. As far as cost, TMS is such a small part of a TMS doc's work they may be flattered to here from a sufferer and give you a deal. I've never heard of a TMS doc who didn't discover it from not finding the answer to their TMS pain allopathically, so they can empathize. If it's TMS you probably only need one visit for a dx. Rob a bank, what has your pain cost you so far and into the future? Docs are usually pretty generous about payment, and your ins may cover you for a dozen therapy sessions. If you have any trouble finding one or want to chat PM me and I'll give you my cell.

 

Thanks for the info. I'll check them out.

 

I run marathons and ultramarathons. About 67 so far...most of them ultras. Just completed a 100 miler a few weeks ago. My TMS has run the gamut of most "running injuries" plus back pain. Once I get over the fear and anxiety of pain it usually resolves fairly quickly. But eventually something else crops up. I've found Monte Hueftle's program the most helpful. Although I've yet to kick TMS permanently it seems like each new episode is shorter lived.

 

I run ultras, too- at least I used to run them. I picked up some brutal sciatica in May of 2013, and I haven't been able to get rid of it.

I believed all along it was TMS, but it still remains. Lately, in desperation, I went to a chiro, and he drove his elbow into my R butt to try to loosen the piriformis muscle, which he thought might be putting pressure on the sciatic nerve. That was two weeks ago, and my condition is now twice as bad.

I'm pretty much crippled now, but I do get relief by sitting and lying down. Standing and walking is very painful. Running is out of the question.

I'm meeting with a number of doctors to look at some possibilities. After a year and a half, I just can't take it anymore.

 

You've got my sympathies! Can you find a TMS doc? I used to run marathons then picked up tennis again, now I run in the pool with a floatation belt and find it GREAT and it also tones the whole body due to the resistance of the water. Have you tried that? It takes a few minutes for my butt to loosen up but after that it's full range of motion.

G'luck!
tt

 

Hi, DougBrandt. If the doctors can't find anything structural causing the pain, then it's TMS for sure.
Doesn't look like that chiro was any help.

 

Walt, there's plenty of stuff for which to blame the pain. Herniated L5/S1 for one. I know that TMS docs don't seem to pay much attention to herniations, but the others do, and what do you do at that point?

I've had some communication with Marc Sopher via email, as he's been nice enough to spend some time with me.

The problem is that, even though I believe, I still can't get rid of this thing.

I'm due for an glute injection next week.

TT, Dr. Peter Zafirides practices here in Columbus, Ohio.