Injury - What to do when you can't train....

[Robo]

OK, I think we all realise that training for your Camino is just common sense. Not only does it help you get walking fit, but you get to try out your gear as well.

So what if........you can't walk during your training?

This has happened to me twice now and I've had to adapt my approach to my Camino. And it will shape how Pat and I plan our next Camino.

The Backstory..... Short version. Last year I ramped up my training too quickly prior to my first Camino, and that coupled with too much road walking caused Achilles Tendonitis. So for 6 weeks prior to my Camino I basically could not walk at all.

I got through my Camino with meds, icing, stretching and getting my heavy gear transported. I also had Cortisone shots a couple of weeks before departure.

And I made it.

The tendonitis is still with me. Day to day I can cope with it, but walking any distance is out. This year my wife Pat came with me, and she recently developed Plantar Faciitis! So she couldn't walk in training either.......

But based on last year's experience I knew we would be OK. And also, this year was just a 'shortie' from Sarria to give Pat a 'taste' of the Camino. Which worked, she now wants to do a longer one

So what do you do when you can't train?

Well' you 'train' on the Camino. Not ideal I know, but for us it worked. We both had cortisone shots a week out from the Camino. ( 10 days from our Boots hitting the trail) Having done this twice now, I reckon the shots 'effectiveness' last about 5-6 weeks.

Of course the regime of icing, stretching and approved meds are important too.

But the real key I think, is planning a gradual build up of distance. Apart from her injury, Pat is certainly not a 'walker'. So we started on day one with only 7 kms and gradually built up each day bit by bit.

She felt very comfortable doing 20 by the end of 10 days. And I'm sure if we had been walking a longer Camino, she would build up to 25 kms quite well. That tends to be about my limit before lasting additional tendon pain sets in.

Weight is a key issue as well. And I need to think about that 'outside the box' for our next Camino. We transported all but our day gear. But once Pat was getting comfortable she wanted to carry our extra water one day. 2 x 500 ml bottles.......... That extra Kg was enough to cause quite severe planar pain within a short distance. So I took the bottles off her, and she was fine.

I know if I carry an extra couple of Kgs, my tendon pain increase dramatically. Weight is a key factor.

So what about next time? We might do the CF from St Jean. We can't just 'wing it' like we did this year from Sarria. It's a much longer 'slog' and physical issues will build up over time.

Training. Walking training probably won't be possible other than short walks on soft ground with a very light pack. Because this will be done 'pre shots'. But we will do some general fitness training at home that does not involve walking. Leg strengthening etc.

Meds. Cortisone shots the week before we go. These 'should' last till we reach Santiago. Mine didn't last year. So the last 100 kms was really painful, but I had my shots 2 or 3 weeks before departure I think.

And, under medical advice again, we'll plan a regime of anti inflammatories and pain killers. I'd like to say to be 'used as required'. This year for example, Pat wanted to only use them if really necessary. Hmm. That lasted a day. We need to be realistic.

Pack Weight. I would dearly love to be able to carry our 'full weight' packs. For the flexibility it gives of course but also because having a bag transported just doesn't feel right somehow. But the reality is, that it's unlikely we'll be able to.

But based on our gear this year, I'll easily cut down the weight of gear we are taking. So fingers crossed.

Body Weight! This is where I think we can make a big difference! Me in particular My 'ideal' weight is probably 15 kgs less than I am now . If I can drop that weight it's going to make a huge difference to the strain on my tendons and may even allow me to carry all our gear.

Our next Camino will probably be in 2018. Seems like we have to do a 'proper' holiday next year

So that gives us plenty of time to lose weight and do some gentle fitness training.

I've even started working out the stages, to give Pat a slow build up again. Heck, I've only been 'home' a week.

We'll keep our days below 25 kms once we are 'up to speed' and throw in a couple of extra rest days if required (4 in total). So it's looking like about 48 days St Jean to Santiago!

Please note! I'm not advocating 'no training' for your Camino. That's plain dumb. But if you can't for some reason, maybe there are alternative ways to prepare and complete your Camino? Just a thought....

 

[beiramar]

To each their own, but if your wife is in severe pain from walking with the additional weight of a liter of water, then it seems common sense to not force it.

In my opinion an injury or some pain shouldn't be a reason to not exercise - but if pain is that severe, even after plenty of medication, you should listen to the signals your body gives you.

 

[C clearly]

Sometimes an extended period of rest is necessary. I had moderate pain in my foot for months last year, but kept walking quite a bit. It was eventually confirmed to be a metatarsal stress fracture and I was told to stay off it for 6-8 weeks. Four weeks of inactivity were clearly not enough. Only by staying off my foot for 6-7 weeks did it heal. Then I started training and a month later I walked the Camino with no trouble. But that's a different type of injury from yours.

My advice would be to focus on daily walking, at whatever distances do not cause significant pain. But get out there almost every day for an hour, for a year, wearing a small backpack!

 

[gerardcarey]

I'll restrict my comments to the actual walking of the Camino.
Less walking each day equates to less stress, therefore less pain.
To ensure a comfortable and enjoyable Camino why not place your daily limit at 20ks or even less.
At an average of under 20ks per day and 4 rest days I saw one group do St Jean to Santiago in 44 days, another in 46.
Next Camino I plan averaging somewhere between 15 and 20ks.
Whatever it turns out to be I can assure you I won't be hurting.
Regards
Gerard

 

[Robo]

To each their own, but if your wife is in severe pain from walking with the additional weight of a liter of water, then it seems common sense to not force it. .

Totally agree. Hence we walked short distances, with minimum weight and only whilst the pain killers were 'in effect'. She did very well.

In my opinion an injury or some pain shouldn't be a reason to not exercise - but if pain is that severe, even after plenty of medication, you should listen to the signals your body gives you.

Again I agree. Though with these injuries, training by walking just makes the injury worse. Hence we walk only after Cortisone treatment.

We obviously need to find a longer term treatment as well, though I have been advised it is not an easy fix.

The point of my post was merely to point out that even with an injury, it is possible to still complete your Camino.

 

[Robo]

My advice would be to focus on daily walking, at whatever distances do not cause significant pain. But get out there almost every day for an hour, for a year, wearing a small backpack!

Yes, that's makes sense. Though I do walk to work and back with a small pack.

 

[Robo]

I'll restrict my comments to the actual walking of the Camino.
Less walking each day equates to less stress, therefore less pain.
To ensure a comfortable and enjoyable Camino why not place your daily limit at 20ks or even less.
At an average of under 20ks per day and 4 rest days I saw one group do St Jean to Santiago in 44 days, another in 46.
Next Camino I plan averaging somewhere between 15 and 20ks.
Whatever it turns out to be I can assure you I won't be hurting.
Regards
Gerard

Sounds like we need to start the 40+ Club Gerard! Have to take more than 40 days to qualify

 

[Wokabaut_Meri]

Sounds like we need to start the 40+ Club Gerard! Have to take more than 40 days to qualify

We were 44 days with no rest days but some <10kms days from St Jean PdP to Santiago and I was carrying an injury from day 1. Lots of time to look around as well as stop and stretch or rest.

Hmmm 40 days has a biblical kind of ring to it.

 

[Robo]

We were 44 days with no rest days but some <10kms days from St Jean PdP to Santiago and I was carrying an injury from day 1. Lots of time to look around as well as stop and stretch or rest.

Hmmm 40 days has a biblical kind of ring to it.

I took 40 days last year............and had the same thought

 

[Rick of Rick and Peg]

Cycling might help because it is low impact but uses the leg muscles. It would help with weight loss also. Be careful though, there are a few things to watch for so cycling doesn't aggravate the tendonitis. Start at this URL and then check with a physical therapist and a bike shop.
http://www.livestrong.com/article/380290-is-biking-good-for-the-achilles-tendon/

 

[Kitsambler]

Responding to the topic in general rather than to the OP's particular situation:
It's helpful to think about the types of physical conditioning that are involved in a successful Camino experience. So, if you are prevented by circumstances from training in one area, you might still be able to continue training/conditioning in the others.
1) Endurance. This translates to cardiovascular stamina. High-intensity interval training (HIIT) seems to be the most popular general technique. So if walking, add in some hills. If living in the flats, add in some bleacher work. Otherwise, add in a fast one minute of pushing hard/fast every three. If you can't walk, then swimming or cycling work here.
2) Strength. This translates to weight-carrying ability, most especially in the thighs and core muscle groups. If walking, carry a pack with increasing weight. Otherwise apply some of the many exercise routines for these muscle groups available on YouTube, with or without additional weight.
3) Flexibility. Stretching, especially the groin and legs, after exercise is increasingly important as we age. It's especially helpful in reducing the inflammation that can accumulate from daily training, which allows us to continue training.

 

[Stepnote]

I'm reading with great interest, Robo et al, because I was training for the CP beginning September 1... and while I thought I was doing well, apparently I was misleading myself because I suffered a 'suspected stress fracture' in my right foot (in the 'Lisfranc' joint) at the top of the foot. The foot is now immobilized in a large 'boot' (like a cast), and I'm unable to continue training. I have been walking quite a lot over the last few years, and gradually built my training walks up to 10-12 miles/day over the last month. And then, stupidly, I added a full 20 lb pack about 2 weeks ago...but everything seemed fine and I continued my 10-12 miles/day. One day it just popped. Was using poles and it was on pavement. Not sure what happened.

At this point I'm not sure that it will heal well enough in the remaining time for me to be able to walk the CP, but I'm not giving up yet! I want to get cleared by the docs and then start swimming again, at the very least. Hopefully I can start walking again in August. I attribute this whole thing to advanced age (67 this month) and the apparently diminished mental capacity that I have suffered. ha!

So, I can empathize now with those who suffer chronic conditions and to some degree, while I'm bummed it happened, I also feel that this is part of my camino and that if I'm truly a pilgrim I will persevere and rise to the challenge.

thanks to this forum for letting me vent.

and continued thanks to the forum community for sharing so much good information, I have spent many pleasant hours reading and learning from others.

 

[Robo]

Cycling might help because it is low impact but uses the leg muscles. It would help with weight loss also. Be careful though, there are a few things to watch for so cycling doesn't aggravate the tendonitis. Start at this URL and then check with a physical therapist and a bike shop.
http://www.livestrong.com/article/380290-is-biking-good-for-the-achilles-tendon/

Cycling! Have me go to the Dark Side you would .............

Not a bad idea for training though.......

 

[Robo]

I have been walking quite a lot over the last few years, and gradually built my training walks up to 10-12 miles/day over the last month. And then, stupidly, I added a full 20 lb pack about 2 weeks ago...but everything seemed fine and I continued my 10-12 miles/day. One day it just popped. Was using poles and it was on pavement. Not sure what happened.

Pavement is the killer...... On your Camino you will soon learn to find every little bit of surface that is softer than pavement 10-12 miles a day, sounds a bit like you were walking your Camino, before you even got there....

So, I can empathize now with those who suffer chronic conditions and to some degree, while I'm bummed it happened, I also feel that this is part of my camino and that if I'm truly a pilgrim I will persevere and rise to the challenge.

That's the Spirit

 

[Zoula]

So sorry to hear that you hurt yourself Stepnote. I hope you take proper care and recover in time for your Camino. However if you are a little slower, I might catch up to you, lol, since I will start on Sept. 3rd in Lisbon. Get well and see you in September... Bom Caminho!

 

[Wokabaut_Meri]

I'm reading with great interest, Robo et al, because I was training for the CP beginning September 1... and while I thought I was doing well, apparently I was misleading myself because I suffered a 'suspected stress fracture' in my right foot (in the 'Lisfranc' joint) at the top of the foot. The foot is now immobilized in a large 'boot' (like a cast), and I'm unable to continue training. I have been walking quite a lot over the last few years, and gradually built my training walks up to 10-12 miles/day over the last month. And then, stupidly, I added a full 20 lb pack about 2 weeks ago...but everything seemed fine and I continued my 10-12 miles/day. One day it just popped. Was using poles and it was on pavement. Not sure what happened.

At this point I'm not sure that it will heal well enough in the remaining time for me to be able to walk the CP, but I'm not giving up yet! I want to get cleared by the docs and then start swimming again, at the very least. Hopefully I can start walking again in August. I attribute this whole thing to advanced age (67 this month) and the apparently diminished mental capacity that I have suffered. ha!

So, I can empathize now with those who suffer chronic conditions and to some degree, while I'm bummed it happened, I also feel that this is part of my camino and that if I'm truly a pilgrim I will persevere and rise to the challenge.

thanks to this forum for letting me vent.

and continued thanks to the forum community for sharing so much good information, I have spent many pleasant hours reading and learning from others.

Ouch! I feel your pain, I really do. Yet another pilgrim for our Healing Camino.

Coming back from a navicular stress fracture I can also fully empathise. Lisfranc stress fractures can unfortunately be caused by low impact. Immobilisation in a boot is no fun. I was non weight bearing for 2.5 months and the road back to full walking has been a long one.

As @Robo says, you will soon become expert at seeking out soft surfaces. Once you are in rehab, walking in water buoyed up by an aqua belt is a fantastic way to regain strength and fitness as is any form of Aqua therapy. I also walked in the sea which aided with the inflammation that restricted my efforts at the beginning.

Given your age (very close to mine!) it might be useful to discuss a bone density scan with your GP if you've not had one done. This can be a contributor to stress fractures.

Once you're up and walking, you'll never take it for granted again and you've already gained an appreciation for those who are permanently mobility impaired.

I wish you speedy healing and a return to a future Camino.

Go Well!

 

[bunnymac]

Ouch! I feel your pain, I really do. Yet another pilgrim for our Healing Camino.

Coming back from a navicular stress fracture I can also fully empathise. Lisfranc stress fractures can unfortunately be caused by low impact. Immobilisation in a boot is no fun. I was non weight bearing for 2.5 months and the road back to full walking has been a long one.

As @Robo says, you will soon become expert at seeking out soft surfaces. Once you are in rehab, walking in water buoyed up by an aqua belt is a fantastic way to regain strength and fitness as is any form of Aqua therapy. I also walked in the sea which aided with the inflammation that restricted my efforts at the beginning.

Given your age (very close to mine!) it might be useful to discuss a bone density scan with your GP if you've not had one done. This can be a contributor to stress fractures.

Once you're up and walking, you'll never take it for granted again and you've already gained an appreciation for those who are permanently mobility impaired.

I wish you speedy healing and a return to a future Camino.

Go Well!

I would really recommend getting to or closer to your ideal body weight before starting your trip. I walked three years in succession. I carried about 8% less body weight in the second year than the first. The difference it made was staggering ( or not staggering). The third year I returned with a much better fitness level but I had regained body weight. I felt every kilo despite my much improved fitness.

 

[Wokabaut_Meri]

I would really recommend getting to or closer to your ideal body weight before starting your trip. I walked three years in succession. I carried about 8% less body weight in the second year than the first. The difference it made was staggering ( or not staggering). The third year I returned with a much better fitness level but I had regained body weight. I felt every kilo despite my much improved fitness.

Yes ideal body weight does help joints and endurance particularly on a long walk such as the Francés.

My problem is not going too far under that and balancing more weight bearing exercise to maintain bone density against not over stressing the previously fractured bone as I return to full endurance trekking.

 

[Stepnote]

thank you all for the kind and thoughtful words. the hardest part right now is the inactivity, but then I have the Forum for some good arm-chair walking!

Bom Caminho, Steve