Category: running


ChiRunning

About a year ago, I signed up for a seminar on the basics of ChiRunning. You might remember that I was only just beginning to feel better at that time, and honestly, I wasn’t sure if I could do ChiRunning. You see, Chi running capitalizes on the momentum you generate by falling forward. Try it: put your feet together and lean forward. Eventually you will reach the point at which one of your feet automatically steps forward. See? You didn’t have to move your foot; it moved by itself. This makes running easier.

Of course, it hadn’t been that long since I had lost my balance while walking and while running, so learning to run by “falling” forward would seem contraindicated. But I did it anyway.

How did it go? In a word, fine! I don’t remember having any trouble at the workshop. The next time I went jogging, I tried the techniques and actually found it easier to run. I covered my usual distance with less effort. Yay!

During the past year I’ve tried to keep ChiRunning whenever I’m jogging. It’s easy to fall back into my old habits since I only took a half day workshop on it. Still, I focus on falling forward and using my body’s momentum to carry me forward…and so far, so good.

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Arrrrggghhhhh!

Good news, bad news. So I announced to the world that I am doing a triathlon, and guess what? I triggered the vertigo! I have not had major problems since March, and NOW, weeks before my triathlon, I managed to trigger it.

Two nights ago I looked up to open the shade on the skylight. I have been able to look up lately, especially if I keep it brief. I had closed the shade against the summer sun a few months ago and didn’t have any trouble. (Maybe I wore my belay glasses then?) Anyway, my wife questioned the wisdom of what I was doing, so I hopped down and let her do it. I felt only a little off and went to bed with no worries.

Yesterday morning I woke up nauseous and unsteady, unsteadier than I’ve been for months. I was supposed to do a bike-run brick with my training buddy, so I tested myself by walking down to the corner and back. I was wobbly enough for me to know I had to stay home. There was no way I would be safe on the bike.

The good news is that today I feel almost back to my “normal.” I did a bike-run brick on my own, and although I was slower on the bike due to residual unsteadiness, I got it done.

I love the fact that my vertigo flares don’t last more than a day or two now. That is very manageable. Hopefully I can keep in the clear until race day!

Dashing

As part of my journey back to triathlon, I registered for a Splash and Dash this summer. You may be familiar with the Aquabike option that many triathlon races offer – that’s where you swim and bike and skip the run. Fewer races have a swim-run combination, but I found one near by and started training.

The day before, as I was gathering my gear, I realized it had been two years since I raced. I had to take a moment to remember the preparations that once felt so automatic. And then there was the swim-run transition. I had been doing that in practice but always out of the back seat of the car. I hadn’t thought through how to arrange my gear on the ground and the exact order I would follow to minimize my T1 time. Ahhhh!

On race day, I put my wetsuit and tiny duffle bag under my assigned space on the bike rack. It was a sparse and lonely-looking transition area, indeed. Over in body marking, I learned that instead of having my age emblazoned on my calf, I would only have S/D for Splash and Dash. That was nice!

Our problem wasn't plastic disks, but the swim was canceled all the same.

This isn’t the beach I was at, but the swim was canceled all the same.

Then the race director came on the PA and announced that the health department had closed the beach due to poor water quality. We had been warned that this was a possibility. For the triathletes, the race turned into a Duathlon (run-bike-run) with a short run taking the place of the swim. For the Splash and Dashers, well, we were left with just a run. It was hot, but I gave it my best shot and did well. At one point I looked down to mess with my race belt and felt a wee bit unsteady, so from then on I kept my eyes up and focused on the feeling of my feet on the pavement. Success!

It was great to be crossing a finish line again. I loved hanging out with the tri teams afterward and feeling like I belonged — even if all I did was run a 5K. I am inspired to pick my next race!

Role of stress

Did you see this blog post about the connection between vertigo and stress? This is the  most salient quote:

In a study by CD Balaban and JF Thayer published in the Journal of Anxiety Disorders in 2001, a review of scientific literature revealed a relationship based on shared pathways that control vestibular function and somatic and visceral sensory information processing. This means that the parts of your brain that help you interpret incoming balance information from your vestibule, a part of the cochlea, also process information that appears to be involved in avoidance, anxiety and conditioned fear. One can be forgiven for thinking that this is not nature’s most perfect design.

And how.

stress_on-land-rover-billing-show-2008-406

I picture this as two cars sharing a narrow road. If they are cars of similar size, then both the balance car and the stress car can fit on the road. If the stress car turns into a semi truck, however, then there is less of the road available for the balance car. Trouble ensues.

I noticed this correlation a few months ago. I’d been unusually stressed, and a few times I’d experienced momentary vertigo symptoms when talking or thinking about specific stressful triggers. The onset of my vertigo in 2009 and 2013 was preceded by unusually severe stressors, so I had a sense of the relationship between the two, but until now I’d never noticed stress as a worsening factor once an episode of vertigo had already started.

The Vestibular Disorders Association (VEDA) offers many free publications online, and the one on “Controlling Your Symptoms” focuses on stress-reducing strategies such as controlled breathing and relaxation. That is telling. The have separate publications about dietary considerations, vestibular physical therapy, etc., but the most broad article centers on stress.

One of the things that I found most frustrating when this episode of vertigo started last year was that my usual stress-reducing activities were contraindicated. Lying flat on a table for a massage made me dizzy, to say nothing of rolling from front to back. Exercise like yoga, rock climbing, biking, and swimming was difficult–and dangerous when my symptoms flared. Running was tricky, and often I was too fatigued to work out since my body and brain were constantly working to keep me upright. I gradually came to recognize how even the most subtle nausea stilled me in my chair.

But stress is definitely a factor for me. I have to control and reduce it. So I restarted my meditation practice. I joined a gym so I could take a spin class (on stationary bikes – perfect for me). I sought support at home and at work for dealing with my stressors. I turned down opportunities that would make me “too busy,” as I knew that could make me feel worse. I recently began acupuncture, and that has seemed to help, and being able to return to modified yoga with my familiar yoga buddies has been a wonderful boost to my emotional and physical equilibrium. I have some stressors that I can’t control at the moment, so I am focusing on what is within my control. Every day I think about ways to reduce my stress, and I am constantly experimenting to see what works.

What are your most effective stress-reducing strategies?

I finally went running again, and I had a much better experience than last month.*  I am now able to check for traffic while in motion–I don’t have to stop at every curb and corner! To be sure, I still slow down, and I’m not whipping my head around, but I can deliberately turn my head and check without having to stop. I did catch myself not fully turning my head a few times (afraid of triggering vertigo and hedging my bets), and I realize that is not safe. I will work on that. I am psyched that I have regained this skill without having to practice on a treadmill. 🙂  My ultimate goal is to be able to ride a bike (which definitely requires turning my head to check for traffic) and complete a sprint triathlon this season. For the first time, I think it just might happen.

In related news, I’ve restarted swimming with my Swim Buddy. I am staying far, far away from bilateral  breathing because that is what brought my last symptom-free period to an end back on September 6. (I will never forget that day!) Breaststroke is where it’s at for me. I did do breaststroke in a triathlon once, and I don’t recommend it! If that’s what I have to do this season, though, I might voluntarily join a Novice wave so there are fewer people to kick in the face. At the end of my workout last week, I tried crawl stroke with a snorkle. It worked well, and I’m excited to add that into my routine. I hope the body rotation will help with my brain/balance retraining.

I had taken 3 weeks off from rock climbing and was back at it this past weekend — that also went well with no symptoms, and I even did some moderate overhangs. Yoga is also good — still never putting my right ear down or my head straight down, but my downward facing dog is almost “normal” now. A nice change from last fall when I was using a chair for that pose!

I had some disequilibrium last week when I was talking while walking at work. I had this in January, too. When I turn my head and talk or nod while walking, my equilibrium is thrown off. And the past few days I’ve experienced a vague sense of movement after I have been lying in bed for awhile. It’s not the throw-your-hands-out type of motion, but it is definitely motion. I am hoping that it is just my brain re-calibrating as my Vertigo Journey comes to a close.

* My pride prompts me to clarify that I have gone running during the time between this post and that post, but I was using a closed trail that didn’t require me to negotiate traffic crossings!

Running wild

I ran twice last weekend, for the first time since losing my balance during a run last month. Despite carefully monitoring the weather forecast, I managed to catch the period of heaviest rain on Saturday and cut my route short. On Sunday I tried again and got the whole thing in.

Running was…interesting. Kind of like running on a tight rope. My symptoms have virtually disappeared (naturally, since I have a doctor’s appointment coming up!), so I didn’t expect any trouble when I laced up my shoes and headed out. I quickly realized, though, that something was still off kilter with my proprioception. I didn’t experience the oscillopsia that I associate with horizontal canal, or nausea or any of the usual symptoms–it was just a mild but definitive sense of disequilibrium. I felt safe running, but it also felt a little “dangerous,” not unlike walking on balance beam and knowing you are on solid ground but could fall off at any moment. My uneasiness fluctuated during the run, and when it peaked I focused on how my feet felt on the pavement. I’ve used this technique while hiking, and it gives me a greater sense of stability and allows my stomach to unclench for a moment. I noticed that I felt more unsteady when my rain hood started to encroach on my peripheral vision. Something similar happened last month, when my scarf blew across one of my eyes while I was walking and I subsequently lost my balance.

I still stop at every corner and curb because looking over my shoulder feels too risky. I think I may have to deliberately work on regaining that skill. Maybe I can do that on a treadmill, using the rails for  balance while I practice looking over both shoulders? Boy, that will look weird in the gym!

On December 23 I was thrilled to go for a run with my sister. She started running in 2013, and this was our first time ever to run together. We were less than a quarter mile from her house when I suddenly got vertigo. I stopped in the middle of the sidewalk and spread my arms and legs for stability, then shouted ahead to where she had been pulled by her dog. “Hang on a sec!” I got my bearings and started to jog again–still too unsteady. I told my sister that I would walk home, but after a few steps I realized I needed to hang on to her. It actually felt very natural to ask to hold her elbow, and we walked back to the house.

Here’s what I think happened: while visiting my sister, I did an Epley maneuver using her pillows, which are higher than the ones I usually use. Having more extension in my neck seems to be a ticket to horizontal canal BPPV for me, and indeed for December 24-26 I felt nauseous most of the time. Snapshots from my visit:

  • holding my sister’s elbow as we walked home from an aborted run workout
  • folding a washcloth and kneeling on the floor of the bathtub in order to wash my hair (the shower head was at nose level, and I could not bend or tilt my head to get under it)
  • drinking a wine cooler through a straw to avoid tilting my head back (for those of you wondering: no, alcohol does not seem to be correlated to my symptoms)
  • my dad coming up to me in the kitchen and sweetly asking if I was OK. My wife said I looked bad, and if my dad noticed, too, then I was bad.
  • closing my eyes while watching TV and getting vertigo
  • flinging my hands out to “catch my balance” while playing cards with friends and pretending that suddenly gripping the table edge was just, you know, normal
  • moving around like a stiff-necked robot with my hands constantly on the walls or furniture for reference
  • my wife turning on and off the light over my airplane seat (I couldn’t look up to differentiate the light button from the call button). (For those of you wondering, dehydration–such as that caused by air travel, or alcohol for that matter–doesn’t seem to be correlated to my symptoms, either. I keep looking at this one, but over 11 months of data-gathering, I have no clear connection. Were that that was the problem!)
  • sleeping with my back to my wife for the entire holiday. She tells me that I spooned her in the early morning hours. What can I say? I can’t stay away from her!

I did lots of Epley’s on low pillows and finally felt well on December 27. Noticing how good I felt that day, I was saddened to realize that my family had missed this ebullient, relaxed side of myself when I was feeling so poorly. That hurts. I don’t see my family often, and I am bummed that I was less engaged during their visit. It is harder for me to talk, to think, and to be empathetic when I have strong symptoms. In the moment I notice the change, and to be honest my behavior isn’t that bad, but I am absolutely unable to overcome it.

Cue dark feelings and forebodings….but that is another post.

Recently I started running once a week again, and to keep myself on the straight and narrow I signed up for two road races — a 2.5 mile Turkey Trot and a 3.1 mile holiday run. My Training Buddy is joining me on the 5K, and she mentioned the route has a big hill, so I went on Map My Run two weeks ago to find some hilly routes in my neighborhood. I found some great ones and was looking forward to running that afternoon since the temperature was forecast to be warmer than usual.

I’ve learned that it’s a good idea for me to do a preventative Epley’s after yoga and other specific activities.  Even if I am asymptomatic at the time, chances are that I won’t be asymptomatic by morning, so the maneuver helps corral the otoconia and prevent worse symptoms. All this to explain that I did an Epley’s before my run and ended up giving myself much stronger vertigo than I’d had in months (holding on to the wall while going down stairs, closing my eyes while talking to my wife). I treated twice more and couldn’t get things to clear.  I wobbled through some chores, but finally I gave up and spent the afternoon watching Netflix. So much for my hilly run!

After three Epley’s had no effect, I decided to try the Foster Maneuver. I learned about this new treatment through Annie’s blog, and I must say that my cat LOVES this one. (Watch the video below and imagine a cat weaving around the woman’s arms and legs!) I’ve had mixed results with it over the past two weeks. The good news is that it often gets the otoconia moving when the Epley’s does not, so I’m keeping it in my toolbox and beginning to anticipate when it will be most effective.

That said, I’ve had worse episodes lately and even missed some time from work. I felt fine on Thanksgiving for the Turkey Trot–thankfully, running in and around several thousand people wasn’t a problem, and I kept my balance like a pro. One more run before the 5K next weekend!

Forced Prolonged Positioning

When I trigger posterior canal (PC) BPPV, it clears pretty easily with the Epley’s maneuver.  However, ever since I swam crawl stroke and turned my right ear down about 7 weeks ago, I have been fighting mild HC BPPV.  I asked my PT for advice on how to clear it at home, and she suggested a version of Forced Prolonged Positioning.  (The Lempert or BBQ Roll maneuver is another treatment but not one she recommends for home use.)  I was not keen on spending an hour in one position–heck, I have stuff to do–so I decided to grin and bear it.  But the HC vertigo is sneaky, and I’ve been triggering it with fairly subtle movements like moving my head while I talk and by rubbing my face with my eyes closed (e.g. washing my face at the sink or in the shower).  And then last Sunday I went for a run for the first time in a month, and I was too unsteady to look over my left shoulder to check for traffic.  (Although I didn’t mind the micro-breaks I had to take at each corner!)  So that afternoon I brought up the This American LIfe radio archive, arranged some pillows on the couch, and followed my PT’s instructions for FPP.  I ended up on my left side with my face pointed down into the couch.

It was awkward, to say the least.  My body is never happy when I stay in one position for long, so it was also uncomfortable. With some cautious shifting I lasted for 55 minutes, and I did feel a little clearer afterward (though that might have been from the cat naps I took while stuck on the couch).  Every day this week I’ve continued to have what I’ve come to call “micro-vertigo” when I’m nodding my head in conversation or washing/rubbing my face.  “Micro” seems to fit because the triggers are very small movements and the sensation is short in duration and relatively mild.  It’s bearable, but I’d like to clear it up if I can.

Swim run brick

Yesterday I triggered the vertigo, and even though self treatment and sleeping up on two pillows seemed to solve the problem, my planned bike ride didn’t seem like a wise choice this morning. So for the first time since last season, I joined my friend and frequent training buddy at a local pond for a swim. All it took was a “You should do it” from my wife, and I was digging out my gear.

I haven’t swum in open water since the sprint triathlon I did last July, and I haven’t been in a pool for for at least three months. I wasn’t used to walking on sand, so I minced my way out and edged into the cold water. Turning my head to breathe was definitely contraindicated, so I used my snorkel and stuck to breaststroke and kicking drills. I definitely felt my triceps and hip flexors at first, but after I warmed up, I did about 20 minutes of easy swimming.

Afterward I was beaming! “Training Buddy” is preparing for an Olympic distance triathlon, so she headed out on her bike. I felt so good that I decided to do a short run and rack up my first brick in over a year. The swim had been a great warm up, so I ran easily. I was thrilled to be able to glance over my left shoulder to check for traffic at cross streets – this is one movement that has been problematic when the vertigo is active.

Everything was going well until my penultimate step. As I slowed down and pressed STOP on my watch timer, my left foot hit a partially buried rock, twisted outward, and sent me to the ground. I didn’t have much momentum so I didn’t slide, but I the gravelly path gave me some impressive road rash on my right shin and knee. The ankle hurt after I got home, so I started a regimen of anti-inflammatories and icing.

Ouch!

Ouch!

To be honest, I don’t think I have ever sprained my ankle. (I had to look up the treatment online!) On the occasions when my ankle has twisted, I’ve always been able to catch myself and have never fallen. This time, I was tired from doing a brick with very little training, and that probably contributed to my fall. Although it is tempting to wonder if the vertigo or inner ear hypofunction was a factor today, I think it wasn’t. I blame the damn rock in the path.

I am proud to have done the brick today. Kind of amazed, too, since I haven’t been training. I felt a little more like myself, experiencing the rhythm of training, and feeling pleased at how resilient and strong my body still is.