Recovery from Calf Heart Attack (Archiving the injury)

I'm writing this post to put my experience about this weird running injury involving calf muscles. I wrote about it in my previous post. However, at that time I didn't know that there is a particular term about it, "Calf Heart Attack". The earliest documentation of this injury on web is from a Runner's World article by John Parker. The second article about Calf Heart Attack is much recent from 2019 by Daniel Frey. In first article, John Parker describes calf heart attacks as: 

The calf would get tender, sometimes knotty, after hard training (usually intervals); then a few days later, while out on a run, I'd feel a sharp pain very deep in the gastroc, and bingo, I'd be out of business. 

So I'd take a few more days off, more massage, and then start back. Deja vu all over again. And I found I could repeat the cycle as many times as I wanted, and the injury would just keep popping back up. It was the most frustrating injury I had ever dealt with.

As mentioned in my previous post, this is exactly what happened with me. I was running moderate threshold pace runs (2 km repeats with complete rest in between) with Ashok Pujari on December 29th. I had finished the first 2 km set at 4:50 min/km and was feeling quite relaxed. When I started the second set, within first 200 meters I felt this sharp pain in my calf muscle and I knew this is serious. I stopped immediately and tried to stretch (wrong thing to do when you have micro tear/tear in a muscle). I walked back to base at Gemini building and drove back home. 

Internet is full of misleading information on this injury and the sharp pain sometimes talks about a muscle tear (of various grades). In this injury the muscle tear or micro tear happens quite deep in the calf compartment and as a result there is no discoloration of internal bleeding visible. There is a very tender spot deep in calf that you can probe with you finger if you apply enough pressure. 

I did usual icing and stretching (again wrong) and tried to rehab the calf muscle. The tear/pain felt quite deep in the calf muscle and I suspect it was in soleus muscle rather than gastroc muscle. I also got a massage and visited a physio but not for much help.

Within 2 days, the pain wasn't felt while walking. I gave it complete rest of 8 days and attempted a 7.85 km run (1 week before Tata Mumbai Half). Run felt fine until about 5 km or so it definitely started to bother me on last 2 kms. If you are reading this after encountering this injury, don't try to run like this after mere 6-10 days. It would be wise to follow the rehab procedure described by John Parker & Daniel Frey. 

For advanced runners, there are also some discussion on this issue on Letsrun.com message board. I'm surprised not many runners in India are aware of message boards of letsrun.com

If you are stupid, don't stop at half stupid, go all the way :) So, even though I was injured but showing signs of improvement (between Dec 29, Jan 7 and Jan 15th), I knew I was far from perfect for racing the half marathon on Jan 15th. However, I hadn't set any specific running goals and thought I will take the run in the stride (literally). I didn't want to miss the marquee event for Mumbai runners. 

I joined excited Striders from Thane to Mahim in the bus. I had observed some of the very dedicated runners give their best in training and the atmosphere reminded me of good old days of Houston Marathon. I met up with few friends from Palm Beach Runners (PBR) and started the race. First two kms felt super easy but by 4th km I knew I'm in trouble. I could either drop out and try to locate a taxi back to finish line (as I had checked my bag) or see if I can use my experience to try to finish the race. I knew this injury is cushioned a bit by heel landing so I attempted that and passed 7 km mark. I made a mental deal that if at 11.55 km mark (half way) I'm feeling miserable then I will drop off. Surprisingly, I felt fine although the nagging pain at every step taken by right leg was there. After crossing halfway point, I cajoled my mind to get to 2/3 point or roughly 14 km mark. When, I finished the 14 km mark, the pain definitely started to bother me and I really considered dropping out. However, I didn't want to drop out before the Peddar Road hill on 15th km so I slowed down a bit and passed the crest of the hill. 

Surprisingly, downhill felt easy and I picked some steam and started passing people as I was running quite relaxed by now. By now, I also figured walking to finish will take a long time and I might as well run to the finish. Remember,  I said never do anything half stupid, go all the way :)

I decided to push the pace and hit last 5 kms in (4:53, 4:58, 5:08, 5:06 and 4:49). The crowd support felt really nice as I was speeding up when other runners were slowing down. I finally crossed the finish line and limped the rest of the day. My official finish time was 1:52:41, nothing to write home about but good considering the scenario. I really hated those stairs at CST station as I was limping.  

Next 36 hours, I did feel the effect of the race. I recovered and decided to give full 6 weeks of rehab so the injury gets time to heal. After 6 weeks, today I went for a 2 mile (3.2 km) run today and it felt good. Now, I have to follow a strict routine and ensure I don't rush the miles. I have given myself 12 weeks of slow base building and another 14 weeks of training for my upcoming birthday on 27th August (Sunday). It will be nice to celebrate my birthday with a half marathon. As much as I love quick half marathons and dislike full marathons, next year in Aug 2024, I will be 42 years old. So, is that enough to convince me to run a 42.2 km race closer to my birthday in Aug, 2024? I don't know. I rarely plan out things like that so we shall see.