Diagnosis

I finally have some clarity on why I've been injured for so long and keep failing to get well enough to sustain running for more than just a few days. I had a CT scan on Monday which showed that rather than having a stress fracture of the hard bone on the outside of the tibia/ shinbone, I have a stress reaction in the centre of the bone. From the doctors diagram basically the central section of the bone is made up of a honeycomb/ scaffold - esque structure and is surrounded by the hard bone which forms a ring around it. The honeycomb in the centre of my tibia is cracked in multiple places. These tiny cracks are what cause the pain I'm getting from within the bone whether I'm stationary, lying down or on the move.

Red Section - hard outer bone, blue section - where mine is cracked

So the good news is that I now know what the problem is and the root cause of it which is basically deficiencies in my diet. I've had some blood tests to distinguish exactly what it is I'm lacking in but the doc is expecting it to be vitamin D and Calcium. My bone density is through the floor which means the hard ring of bone around the cracked centre is much thinner and weaker than normal. If I continue to run on it, the cracks will move through the honeycomb centre and straight through the hard outer bone causing a fracture which will take months to heal. So at least it hasn't reached that stage yet. 

The bad news is I'm out of Comrades. There is no way to turn the weak bone and stress reaction around in time to guarantee I won't suffer a fracture by running on it. I could try, but it would be naive to go against the doc's advice and hope that it'll be ok. I can't risk damaging my chances of starting Western States and The Grand Slam.

So from here I get to spend more time on the stationary bike and in the pool and make sure I start eating a lot better. I have a 6 day course of 50,000 (thousand) mg of Vitamin D per day which is apparently enormous and should redress any issues with deficiency and speed the healing of the bone. I am aware that I'm lacking protein in my diet and so I'm making a conscious effort to take in more. 

Travelling to South Africa to watch and not run Comrades is going to be extremely hard to bare but we'll try and enjoy a holiday out of it with 5 days in Cape Town after the race. When I come back it will be time to try the leg out. 

So Western States and the start of the Slam is just 5 weeks away. I'm already aware that race is going to be a mental battle rather than a physical one. With 4 months completely off running I'll be in no shape to take it on, but it's a race I've always wanted to run. On the plus side, being forced to slow down because of a lack of fitness may mean that I pace myself better and keep more in the tank for Vermont, Leadville and Wasatch Front which come so quickly afterwards. 

This last 4 months has been really difficult to get through, I've missed running and racing and there isn't really anything to replace that with. Staying motivated to keep going to the gym which happens to be right by the office, 7 days a week including the weekends has been pretty tough but it will be worth it when the strength in my leg returns to a level where I can run on it safely again. 

4 days of work left before I leave for good and then it's focus 100% on getting to the WS start line ready to go....