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Thursday, 19 December 2024

Cervical Disc Herniation, Learning To Race-Walk And My Return To Ultrarunning

It is January 2023, when I develop an insignificant pain from the left side of my neck to the tip of my shoulder; it feels as if a string is being pulled from each end. I treat myself to a massage and the therapist finds the muscles in the area tight, but following the treatment I feel as good as new. A month later the pain returns, so I re-visit the therapist. In a bid to prevent the pain recurring again, I start weekly visits to the local pool, to include some front crawl swimming to my exercise schedule.

By March I'm in Italy competing in a 6-day running event, which goes really well and I don't experience any pain whatsoever with my neck or shoulder, but by the following day that same dull pain returned.

Back in UK I booked an appointment with a physio to get another opinion, and he suggested taping up the area with kinesiology tape for two days to 'give the muscles some extra support' and allow them a chance to relax. To my surprise it worked and within two days the dull pain had gone.  

Later in April, I was running the 250-miles Thames Ring event, which apart from a bad first afternoon with stomach problems, I managed to turn it around and complete with a personal record for the course. A few weeks later, when I visited the pool for a light swim, I decided it would a good idea to swim breaststroke, to see if it would open my back and perhaps shake off the niggling shoulder pain. After a few laps doing front crawl I decided to do 100 metres breaststroke and whilst lifting my head out of the water to take a breath, I felt a sudden shockwave travel from my neck all the way down to my legs. The sensation was weird but not painful, so I repeated the movement a few times; naively thinking I was helping by 'releasing' whatever was trapped. When I walked back to my car, I noticed pin and needles in my left arm and that my left leg felt really weird, as if the messages my brain were sending it were delayed. The next day I tried to run and it didn't feel right, my left leg felt weird, and from time to time my leg would collapse. 

Not sure what to do I decided to try the local chiropractor. I explained the history and she said that my left side was indeed tight, but that after four sessions with her I would be back doing my usual running. Brilliant I thought! At this stage the pins and needles sensation was on and off, and the leg collapse would cause me issues a few times a day.  

After two sessions with the chiropractor, I spoke to my wife who reminded me that I was covered under her health insurance policy, and urged me to phone their dedicated team for neck and back problems. Initially I was reluctant to call as the chiropractor had assured me there weren’t any major problems and that I'd back to 100% in another two sessions. However my wife reminded me I had nothing to lose by seeking another opinion, so I phoned her health insurance and explained the history to another Physiotherapist. To my shock, they expressed concern that I had possibly herniated discs in my neck, so they would book me in with an orthopaedic surgeon as soon as a matter of urgency.  I was warned that if I were to lose control of my bowels, or experience any numbness in my genital area, that I should go straight to emergency, as she as confident that the hernias could be affecting my spinal cord. 

Within days of that call I was with the surgeon viewing the results of my MRI. The doctor confirmed I had two large herniated discs in my neck, along with spinal cord compression. Initially his aim was to avoid surgery, but he confirmed that it would take 18 - 24 months to heal naturally. When I received this news I felt numb and overwhelmed at my prospects. I left his office without asking many questions, only knowing that we would talk by phone once a month to check if my symptoms were getting worse, that I wasn't allowed to run at all, but I could walk my dog. I walked to the train station and I cried my eyes out. Eventually I rang my wife, and then called my manager to advise him that I should probably see the work doctor before I was allowed back at work (I drive trains for a living). I was completely depressed for the next few weeks, and to make matters worse the work doctor didn't want me near a train until I was better. Which potentially meant 18 -24 months away from work as well – so not only was I unable to do the thing I loved, but I was also worried about our finances.

 

Nasty Herniations 

Over the next 3 months I did some reading into my condition, and from what I read, a nutritious diet and quality sleep would aid my recovery.  The only thing I could maintain control of was the quality of food going in my body and the sleep I was getting. Summer went by and my symptoms slowly disappeared, so the surgeon booked another MRI but warned me that herniated discs recover very slowly despite the symptoms disappearing. To my disappointment the next MRI showed no reduction to the size of the herniated discs.  Up to this point I had been leisurely walking the dog for an hour a day, but I checked with the surgeon to see if I could do longer walks and increase the speed, and he said that it was fine, but to stay on easy terrain like roads and avoid the coastal paths. Luckily, the work doctor also allowed me to start a phased return to work, which gave a sense of normality back to my life and alleviated some of my worry around financial pressure.

Around this time I started a new type of fitness journey - I began researching race-walking techniques online, buying a few books, and messaging friends that race-walk for advice. During September, I noticed a massive improvement in my walking speed and that my one-hour walks were getting longer, and apart from the odd looks and laughs I was getting from the locals I really loved the experience. I started reading the 'Back Mechanic' by Dr Stuart McGill, who describes walking fast as ‘balm for the spine’, which was music to my ears but at the same time I was still worried that I could potentially be derailing my recovery by doing too much, which might lead to an operation - something I wanted to avoid all costs. The operation, called a Fusion, where the discs are removed and a plate is then screwed to your vertebrae next to your spinal cord!

 The 'Back Mechanic' is an amazing book - it explains how the spine works and how to look after it, with advice on posture and suggested exercises including lots about walking. If you are one of many suffering from back pain, then I cannot recommend the Back Mechanic enough! But even if you are not suffering from back problems I would recommend this book to help you avoid any problems in the future.  I read the book 3 times and was really keen to speak to Dr McGill, however he is retired and rarely takes on any consultancy work. However, when searching through his website backfitpro.com, I did find a list of specialists who had trained with him, and that is when I came across Joel Proskewitz who had worked with Dr McGill for over a decade and taught his courses all over the world. It didn't take long before I was writing to Joel's PA to see if he could help me out in any way, shape or form. I received a call from Joel to book an appointment but before that could happen he wanted to see my recent MRI images. During the appointment Joel explained my MRI scan in detail, something the surgeon perhaps didn't have the time to do, he also explained why my herniation was dangerous. He said in a way I had been a lucky, as some surgeons would have operated straight away. We went through all my daily activities and thankfully he confirmed that nothing I was doing would make the herniation worse or derail my recovery. Joel was super professional and he didn't waste one second of our appointment. Although he could not offer a fast track to my recovery, the conversation made me hopeful for the future.

For the remainder of the year I continued speed walking, increasing everything gradually- the dog was happy, and the locals continued to be entertained by my new hobby of ‘mincing’. By the time we went on a family holiday in December to Disneyland in Florida I was covering about 80km (50miles) per week and had improved my half marathon time to 2h44 on an undulating course. I had also walked two marathons, with my best time being 5h42, which made me start to wonder if I could perhaps compete as a walker in 2024. In Florida I was the official bag holder whilst my family visited the rides, as I decided I will never ride a roller-coaster again for the fear of injury.

As we started 2024, I counted down the days until my MRI in March.  Sadly, that January, I saw that the organisers confirmed my favourite race, the 490km Authentic Phiddipides, would no longer exist due to difficulty in finding enough volunteers for such a long course. I remember going to bed really depressed, it really was the end of an era for me, and I fell asleep remembering all the beautiful experiences during my three participations.   Around that time, my friend, Mijaela got in touch to see if I was keen to take part in a 24-hours race in her hometown of Russe, Bulgaria in April, with options of 6 and 12 hours. Well of course I wanted to but I also had to wait for the MRI results and surgeon’s advice in March, and I was aware that I was still far off the 18 – 24 months recovery time. 

In the meantime I carried on learning to race-walk and March quickly arrived. As I drove to see the specialist, I reminded myself to lower my expectations this time to avoid another bout of depression, and that I was doing so great with race-walking, that I had waited 10 months and could wait more! Walking in to the surgeon's office, my hands were really sweaty and my heart was pounding, he had his back to me and was taking a picture of his computer screens with his phone. He turned in his chair wearing the biggest smile and exclaimed: 'How did you do it? I am sending this picture to my surgeon friends, I have never seen it happen before'. In the last few months I had got quite good at understanding the MRI images of my neck, and I could see that two images were identical, but that in one of the images my discs looked great. 

Dumbfounded, I asked him how much it had improved by, and when I needed another MRI. 'That's it, it is all gone, you're free, and you don't need another MRI'.  I couldn’t believe it and asked whether I could start running again, and about taking part in the Russe 24 hour race in 6 weeks. After I explained what it involved he told me that a walking race would not be a problem for my neck, but that he wasn't sure why anyone would want walk in circles for a whole day! As for running, I could go ahead but build it up slowly.  When I got in the car I cried again, tears of joy this time. I never expected that, I would have been happy with 50% improvement. My wife was away in New Zealand at the time so I sent her a message with the great news and also told my brother and sister back in Brazil, followed by an email to Joel in London to book a follow up appointment.

 

Whoop whoop! Discs have healed!

I continued race-walking and in the following weeks travelled to London to see Joel. We spent an hour discussing everything that had been going on, my future plans around walking and returning to running, and then another hour at his gym selecting a few exercises to help me with my spine health and endurance. Joel also gave me the thumbs up to walk in Russe, and progressively return to ultra-running.  I spent the night at a friend's house celebrating with a few beers, and the next morning made my way to Paddington to catch my train back to Cornwall, on my way there I got two messages from friends within a short space saying the Pheidipides was back on with a new organisation in charge, who decided that the race was too good to let go of and that they planned to have one in November 2024. I hadn't run a step in 11 months but I decided there and then that I would do everything I could to be at the starting line again. 

At the end of April I arrived in Bulgaria, super excited to race again, but this time as a walker. The vibe was superb in Russe, with an army of enthusiastic volunteers and a great looking track, perfect for walking. There were 30 of us doing the 24, but I was the only walker, which was a bit weird at first but I soon got accustomed to the constant overtaking.  My race was going really well, I reached marathon in around 5h50 then double marathon in less than 12 hours. I started wondering if I could walk 100 miles in 24 hours but by about 19 hours my hips become too sore to walk efficiently so I had no choice but to walk at a pedestrian speed for the rest of the race - in the end finishing just shy of 154km and coming top 10, and beating many runners. I was grateful to Mihaela for the hospitality and for inviting me to her home town, as well as to race director Viro, for accepting my late entry. I remember being half asleep in the back of a taxi to the hotel and feeling really happy inside. I returned to the UK wondering how to start running again and then signed up for the Gloucester 24 hours, which would take place at the end of August. 

 

Waiting to start my first walking race!

In May, I settled for running 1 day and walking 1 day with a day off per week. By June I was running 2 days and walking 1 day and by July, 3 runs followed by 1 day walking. We travelled to Spain in August for a family holiday, where I started race preparations, running twice a day but I erring on the side of caution and dropping the mileage. I was excited again coming to Gloucester, which marked my return as an ultra-runner and it was great to catch up with some of my friends there. Looking back, Gloucester went pretty stress free although I did worry (for no reason) that something bad was going to happen to my spine. I managed to stay on the track for the whole race and covered 107 miles in total. However, I was rusty and I didn't feel confident enough to tackle the over 300 miles in Greece later that year just yet, so I decided to enter the North Coast 110 miles early in Oct, a race I knew well and could really test me.   In preparation for the North Coast I dusted off my trail shoes and started to split my running sessions between road and trail, as well as some walking sessions.

 

Gloucester 24

Soon enough we were off on the north coast of Devon, early on a Friday morning with the beautiful winter sunshine that followed us all weekend. It was late on the first night when I started to feel crappy, mainly my stomach felt unsettled and my legs wouldn’t cooperate. I could have walked pretty fast on the trails but the downside is that once you start walking it becomes difficult to run again. 

I arrived at the check point in Coombe Martin and decided I needed to sleep a little for a reset (I didn't fancy walking the remainder 40 miles) and lay down for 30 minutes on a mat in the village hall, followed by a warm meal. I packed my bag with enough food and drink to last until the next checkpoint and it didn't take too long before I started to enjoy the race again. Eventually the sun came up and I was running well and slowly passing the people that left me behind during the night; the last 10 miles felt pretty remarkable even passing the people on the 50km race. I was greeted by the Justin Nicolas at the finish line who congratulated me on my finish and my return to trail racing. Immediately I felt the confidence to travel to Greece, all my fears had disappeared and I really wanted to be there. Besides the challenge of running 490km I was also desperate to see the small core of volunteers that have helped me in my last three participations. 

 

Beautiful North Coast of Devon

The Authentic Phiddipides Run 2024 (or Double Sparta as I like to call it)

 

If you got this far into this post, you will be happy to know that I spare you from all the details about what went on during my 2024 participation in Greece (more details from this race can be read on my previous participation blogs of 2019 and 2022). What I can tell you is that I saw my favourite volunteers on the way to Sparta and on the return to Athens, and that they were as wonderful as always and they demanded I come back in 2025.

 

On our way to Corinth


Arriving at the Kinetas check point (roughly 58 km left to the finish) on a Sunday afternoon, myself and Tateno from Japan (we had been running together since we left Sparta, nearly 200km), decided we needed a little reset - a 20 minutes nap and something substantial to eat. 

As we left the check point, we found a nice rhythm and a diminishing desire to walk. I dared to ask Tateno how he felt, but it was obvious we were both high on endorphins by now. It kind of became uncomfortable to walk and running felt somehow easier, even on the uphill. My good friend Jean Louis Vidal describes this sensation 'as finding your moped' and once you find the moped it is wonderful, like a drug!

The last 20km of the race is the section I usually hate, running on a busy motorway with pollution and a dusty hard shoulder full of rubbish. I reminded myself that I shouldn't even be taking part and that I should savour the moment whatever the route looked like. Our pace was electric and it didn't take long before we had only 8 km left that, so I suggested we made a quick stop to buy a can of Mythos beer and drink it on our way to the finishing line. We were joined by Vasiliki and her dog Smudge (they had escorted me again two years ago) and soon enough we crossed the line together in 90 hours and were handed more Mythos by the race director, Alkis. 

 

Cold Mythos in hand!


That was a wonderful moment for me for sure. And I was so grateful to share that with Tateno too, we were in total sync for 245km, which is pretty difficult over those distances, but I will remember those last 50km forever. I met Tateno in 2022 at the 3 Peaks race here in the UK and recommended he added the Phidipides to his ‘bucket list’ - I would never imagine that two years later we would be finishing it together. Thanks again Tateno!

This marks the end of my season, a season I didn't think would exist, but one I'm really proud of. I just want to thank all my friends and family who supported me during this time. Shit happens all the time but I am happy I managed to turn it around and learn lots in the process. 

Wishing you all a Merry Christmas and an injury free 2025 season!

Other info:

For anyone interested in improving their spine health, or who is suffering with back problems, please read The Back Mechanic- Stuart McGill. 

If you want to take back fitness to another level I recommend the title 'Ultimate Back Fitness and Performance' also by Stuart McGill. I recommend this to any trainer and therapist too. 

If you are suffering with disc problems and no one has managed to help you yet, or worse, you are thinking of having surgery, then Joel Proskewitz is amazing. He can also help you prepare for surgery and take the right steps to recover from surgery. Joel also runs The SpineXchange, ‘a community of fellow spine patients dedicated to achieve spine health and recovery objectives’.

If you are interested in learning how to improve your walking I recommend 'The Complete Guide to Competitive Walking' by Dave McGovern.

Anyone looking for a 24 hour track event in 2025, check out the Danube 24 in Russe, Bulgaria. I really enjoyed my participation there this year. Nice food, great looking track, awesome volunteers and portaloos by the trackside.