Over training

A light bike doesn't replace good fitness.

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dricked
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by dricked

So about a month ago I was starting to notice my IT bands were getting tight, I had a weird pinching in the tops of my ankles, and the muscles in the fronts of my hips were getting sore. I chalked it up to not riding over the winter and my socks were a little too small. I decided that I would do an easy recovery ride just to keep the blood moving. My legs were still sore after so I took a day off and the following day decided to do some weight lifting, nothing too aggressive or overly heavy. The following day I could barely walk, my feet were swollen, the bottoms of them felt like someone was hitting them with a hammer with each step, and I could barely bend my knees. The Dr. tried to tell me it was gout but I’m 34, 170lbs, and my diet is healthy. Has anyone had this happen? It seems like an overuse injury but I’m wondering if anyone has some tips to speed the healing process. Ice, rest, and elevation are only doing so much.

iheartbianchi
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by iheartbianchi

It would help to know more...when did your current training cycle start, and what has been your weekly mileage since the start? How many days a week? What about intensity? Any big rides?

Keep in mind, there's a difference between what we typically describe as overtraining (fatigue, persistent soreness, high heart rate, irritability, overall weakness, etc.) and injury (although overtraining makes you more prone to injuries). If it's an injury, then we need to identify what the injury is, and how much rest you need.

So we have to do some process of elimination.

-Are you shoes and cleat position and fit correct? Your feet issue may be related to either Morton's neuroma or plantar fasciitis, which is linked to excessive cycling with some poor fit issue.
-Do you run or do some other form of weight-bearing exercise? The pain in your feet reminds me of a stress fracture, but that's not really common in cycling.
-Any dietary issues? Sodium deficiency? Swollen feet can meet a lot of things, but may be a result of sodium deficiency, or some vascular deficiency (i.e. circulation issues). It could also mean you have anemia, but let's deal with the more common possibilities first.
-Sudden weight loss?
-Any other symptoms which may be an indication of some other health issue? Have you had blood work done (CBC)?
-Are we sure it's related to your training?

If it's overtraining, we need to know how hard you overtrained. There's two words you should know: functional overreaching, and non-functional overreaching. The first means you have broken your body down, but not severely, so you will be temporarily weaker but typically come back stronger as your body adapts. Non-functional overreaching is what we typically describe as overtraining. This is the point at which your body effectively shuts down, you are not making adaptions, and you are looking at weeks, or possibly months before your body is ready to accept training again. If it's the latter, sadly there's not much you can do except eat a lot, and take complete rest. Some very mild cross-training may be OK, but you are in a lot of trouble if this is the case.

Let's hope that you are at functional overreach with related injury, then you can manage your recovery process without losing too much fitness. Looking at this as optimistically as possible, it may be that something in each of your hips, knees and ankles are inflammed (probably some of the many ligaments, tendons and bursa in your lower body). This inflammation can hinder blood flow to your feet, which can lead to swelling and pain.

Sorry for playing internet doctor, but I would suggest really stretching your feet and your legs, wearing comfortable shoes, limiting your time standing/walking. Also try massaging your feet / and alternate hot/cold water feet baths. See how you are in a few days. If things aren't improving after a week, seek specialist help. In the end, it may be gout, although you are a bit young for that.
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Conza
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by Conza

dricked wrote:
Tue Jul 16, 2019 4:07 pm
The Dr. tried to tell me it was gout but I’m 34, 170lbs, and my diet is healthy.
Define healthy diet? :o
It's all about the adventure :o .

dricked
Posts: 184
Joined: Tue Jan 09, 2018 1:57 pm

by dricked

iheartbianchi wrote:
Tue Jul 16, 2019 7:32 pm
It would help to know more...when did your current training cycle start, and what has been your weekly mileage since the start? How many days a week? What about intensity? Any big rides?

Keep in mind, there's a difference between what we typically describe as overtraining (fatigue, persistent soreness, high heart rate, irritability, overall weakness, etc.) and injury (although overtraining makes you more prone to injuries). If it's an injury, then we need to identify what the injury is, and how much rest you need.

So we have to do some process of elimination.

-Are you shoes and cleat position and fit correct? Your feet issue may be related to either Morton's neuroma or plantar fasciitis, which is linked to excessive cycling with some poor fit issue.
This actually might be the cause. I moved my clear back/shoe forward on the peddle recently by about 5mm. I was having pain in the arch of my foot and this actually seemed to alleviate it. I have hear moulded inserts in my shoes and they seemed quite comfortable after the move
-Do you run or do some other form of weight-bearing exercise? The pain in your feet reminds me of a stress fracture, but that's not really common in cycling.
No running and I was infrequently weight lifting but I’ve been lifting for years and know my limitations. Always start back slowly so you can still function the next day.
-Any dietary issues? Sodium deficiency? Swollen feet can meet a lot of things, but may be a result of sodium deficiency, or some vascular deficiency (i.e. circulation issues). It could also mean you have anemia, but let's deal with the more common possibilities first.
Maybe sodium deficiency? I don’t salt my food and drink around 2-2.5L of water per day normally. It hadn’t been hot riding and I’m not a heavy sweater. Temperatures were in the high teens
-Sudden weight loss?
None
-Any other symptoms which may be an indication of some other health issue? Have you had blood work done (CBC)?
Only after the issues. Tested for Uric acid levels and that was normal. Was told there was inflammation indicators which made sense because of my feet
-Are we sure it's related to your training?
Its the only thing I can attribute this to. I was feeling normal but slightly sore which was why I deceived to do an easy ride keeping my HR around 150 just to keep my legs moving before they blew up

If it's overtraining, we need to know how hard you overtrained. There's two words you should know: functional overreaching, and non-functional overreaching. The first means you have broken your body down, but not severely, so you will be temporarily weaker but typically come back stronger as your body adapts. Non-functional overreaching is what we typically describe as overtraining. This is the point at which your body effectively shuts down, you are not making adaptions, and you are looking at weeks, or possibly months before your body is ready to accept training again. If it's the latter, sadly there's not much you can do except eat a lot, and take complete rest. Some very mild cross-training may be OK, but you are in a lot of trouble if this is the case.

Let's hope that you are at functional overreach with related injury, then you can manage your recovery process without losing too much fitness. Looking at this as optimistically as possible, it may be that something in each of your hips, knees and ankles are inflammed (probably some of the many ligaments, tendons and bursa in your lower body). This inflammation can hinder blood flow to your feet, which can lead to swelling and pain.
Any fitness I had is gone. I’ve lost 10lbs from being couch/bed ridden. Could barely walk to the fridge. I had to plan my bathroom visits with refilling my glass of water and getting food because getting up/down and walking was agonizing

Sorry for playing internet doctor, but I would suggest really stretching your feet and your legs, wearing comfortable shoes, limiting your time standing/walking. Also try massaging your feet / and alternate hot/cold water feet baths. See how you are in a few days. If things aren't improving after a week, seek specialist help. In the end, it may be gout, although you are a bit young for that.

dricked
Posts: 184
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by dricked

Conza wrote:
Wed Jul 17, 2019 7:23 am
dricked wrote:
Tue Jul 16, 2019 4:07 pm
The Dr. tried to tell me it was gout but I’m 34, 170lbs, and my diet is healthy.
Define healthy diet? :o
Red meat once or twice a week, one maybe two coffees a day, 2-2.5L of water (more with a ride), fruits and vegetables at each meal, recovery protein with greens shake post ride/workout, one cheat meal a week consisting of a few slices of pizza, roughly 4 drinks a week being either a beer or glass of wine with dinner mainly.

Not an elite athlete diet but well enough to not have gout at 35 which is what I was getting at. My diet should have had no problem fuelling the rides I was doing while slowly dropping my body fat percentage down.

jasjas
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by jasjas

So, you ve been to your Doctor who has said you have Gout, perhaps you have? a friend of mine, a keen surfer, has had gout on and off since his 30s.

Why not get a second opinion? no one can diagnose you on here.

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dgasmd
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by dgasmd

dricked wrote: The Dr. tried to tell me it was gout but I’m 34, 170lbs, and my diet is healthy.
First of, Gout as a disease process is not caused by diet. Diet, however, does affect considerably symptoms and recurrence of flare ups!
jasjas wrote:So, you ve been to your Doctor who has said you have Gout, perhaps you have? a friend of mine, a keen surfer, has had gout on and off since his 30s.

Why not get a second opinion? no one can diagnose you on here.
Best advice so far. Second that!

iheartbianchi
Posts: 306
Joined: Sun Mar 24, 2019 9:17 am

by iheartbianchi

Well if your blood work came back fine (smart of you to get tested for uric acid levels), I wouldn't worry too much just yet, because I understand a gout flareup would trigger a rather elevated level of uric acid - but then I question why the doctor said you have gout if he saw your uric levels as normal...

Have your achilles also been hurting? That can lead to heel pain as well...sounds like you just need a week of eating a lot of healthy foods and zero exercise, and then see where you are then. Rushing back too soon can exacerbate the problem. Overtraining is real and can be very serious both physically and mentally.
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dricked
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by dricked

When they did blood work to check for gout I was at my peak flare up. The dr concluded it wasn’t gout but bursitis in my ankle. This doesn’t explain my knees, hips, lower buttocks, calves, bottoms of my feet, and quads being locked up, just the soreness in my ankle.

I’m not looking for a diagnosis per say, but curious if anyone’s come across an I jury like this. With my couch time I did some research and found my symptoms to be VERY similar to a tensor fascia lata tear and gluteus minimus tear. I’ve been to a physio clinic for the past couple weeks and they seem to be a bit dumbfounded as to how so much could have happened all at once.

dricked
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by dricked

iheartbianchi wrote:
Wed Jul 17, 2019 4:52 pm
Well if your blood work came back fine (smart of you to get tested for uric acid levels), I wouldn't worry too much just yet, because I understand a gout flareup would trigger a rather elevated level of uric acid - but then I question why the doctor said you have gout if he saw your uric levels as normal...

Have your achilles also been hurting? That can lead to heel pain as well...sounds like you just need a week of eating a lot of healthy foods and zero exercise, and then see where you are then. Rushing back too soon can exacerbate the problem. Overtraining is real and can be very serious both physically and mentally.
Well that was his initial response when I hobbled into his office using my wife as a crutch.

My Achilles’ tendon has been also sore. I basically couldn’t move my ankles without serious pain and a burning sensation. Only in just the last 3-4 days I’ve been able to start trying to stretch. My knees, ankles, and hips were having nothing to do with it and would let me know right away that laying down was all I was meant to do.

I’ve been down and out for over 3 weeks and I’m JUST starting to see the light at the end of the tunnel. It’s definitely hard mentally especially when you’re regularly active and have two small kids that want you to “dad” like you normally do. At this point I hope that by the end of August I can consider getting on the bike again

iheartbianchi
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by iheartbianchi

Yikes - I thought this was recent. Recovering from overtraining can take months, especially if you have injuries to go along with it! But it sounds like you are getting better now and it wasn’t quite so severe. At a minimum for overtraining you are looking at weeks lost, so the fact that its taking you so long by itself isnt cause for too much concern. But do get yourself checked out if you have some doubts or other symtpoms that arent commonly associated with overtraining.

Dont worry too much about lost fitness - you will bounce back faster than you think...just take it nice and slow for your first month or so or you will quickly repeat this nasty cycle.

And long term you should really have your fit looked at and build some basic strengthening and stretching exercises into your routine. Having both your IT band and achilles in bad shape says there are some serious issues going on with either your fit or how hard you are training or both.
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Djakninn
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by Djakninn

dricked wrote:
Wed Jul 17, 2019 4:59 pm
When they did blood work to check for gout I was at my peak flare up. The dr concluded it wasn’t gout but bursitis in my ankle. This doesn’t explain my knees, hips, lower buttocks, calves, bottoms of my feet, and quads being locked up, just the soreness in my ankle.

I’m not looking for a diagnosis per say, but curious if anyone’s come across an I jury like this. With my couch time I did some research and found my symptoms to be VERY similar to a tensor fascia lata tear and gluteus minimus tear. I’ve been to a physio clinic for the past couple weeks and they seem to be a bit dumbfounded as to how so much could have happened all at once.
Could it be that your ankles were problematic, but not to a painful degree, a while back and everything else has been compensating as a result and all these muscles are now jacked up, hence everything "happening all at once"?
I'm a big believer in stretching everyday. Some folks get away with not having to do any stretching or core work, I myself find I have to do frequent stretching to keep pain free.

dricked
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Joined: Tue Jan 09, 2018 1:57 pm

by dricked

Well I do think the pain in my ankles was the beginning of my foot pain I’m not sure it caused me to compensate. I did have pain in my hip flexor area at the same time so maybe they are linked? I’m fairly certain moving my cleats is what started it all and I’ll be going for a proper fit once I can ride again. I’ve had a few fits before and moved things a couple millimeters to be more comfortable but never really moved my cleats much. Once my cleats are setup I’ll investigate my foot pain and correct that as well.

I don’t stretch a whole lot and never really have. I was stretching a bit after I noticed my IT band pain but I don’t think it really helped because shortly after was when everything blew up. I will be stretching more now though to hopefully help prevent future issues

The last couple days the healing process seems to have ramped up quite a bit and I’m walking almost normally now. Hopefully by mid August I’ll be able to get some seat time in again.

AJS914
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by AJS914

I'm glad that you are on the mend. Edema is very serious and can have some serious causes. If this happens again I'd get better doctors to investigate it and figure out why it's happening. This honestly doesn't sound like the result of moving cleats.

dricked
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by dricked

I’ll be going to the emergency room at the hospital if this happens again. My family Dr. has been fired and I’m currently looking for a new one.

I don’t think I’ll every really find out what caused this unless it happens again. I’d rather just move forward and it not happen again but now that what the signs were and I can address it early before I end up in such a bad state.

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