"Not all pain is significant."

The title is a quote from the first chapter of Scott Jurek’s book, Eat & Run. Jurek began the book with the story of his first Badwater Ultramarathon in 2005. In a later chapter, he’ll finish that story, with him winning the 135-mile race from Death Valley to Mt. Whitney, CA in a new course record—after he’d just run and won his seventh consecutive Western States 100 a short two weeks earlier. In this first chapter, Jurek used Badwater to introduce ultrarunning and the pain and everything else these runners endure over those kinds of distances. The chapter began with him lying on the side of the pavement, at Mile 70, puking away. It was 11 in the evening and still 105 July degrees. He then went on to matter-of-factly describe the various types of pain ultrarunners deal with, in vivid detail (e.g., tearing off toenails to relieve pressure from blistering), or ignore. “Not all pain is significant,” but, how does one know which is which?

Towards the end of my Paris morning run in August, after the last main sightseeing stop (Hotel des Invalides) and about a mile from my hotel, I felt something in the left heel. My immediate thought was that it was one of those occasional twinges that I would just run through, and it would eventually go away. I finished that run and had no problem walking quite a bit over the next couple tourist days. Four mornings later, after I'd returned home, I went out for an easy four mile run and immediately felt the pain in the heel. I was hobbling a bit the first few hundred meters but decided to keep going and see. Once I got warmed up, that heel felt better. Or, at least I thought so at the time. For the next two weeks, I pretty much couldn't run. Even walking was not normal. If I'd not run that morning and, instead, allowed my heel to recover from the injury in Paris, might I have been able to resume running sooner than in two weeks? How does one know when to run through pain and when to rest to allow faster recovery? I need more data points.

A running conversation ...

... aka 30-second elevator speech.

At where I work, we have an All-hands meeting semi-annually. At one of these, there was a contest for the best elevator speech to persuade some company's CEO to do X, where X could be almost anything. The following was my entry (though I didn't actually get the chance to present it). Except for the one CEO line, all dialog is by the employee.

Born to run.

[CEO: What?]

You are born to run. We all are. Our ancestors, going way back to the beginning.

They had to be, in order to survive. They ran to catch their next dinner. They ran to avoid being someone else’s next dinner.

Don’t you see? All the employees of this great company were born to run.

Even those who think “to love running” is an oxymoron.

Think what running can do for the company.

Runners are healthier ... lower health insurance costs.

Runners are more mentally alert ... higher productivity.

Runners are more compassionate ... better teamwork.

Runners are better lovers … uh, never mind.

Runners contribute to the company's bottom line.

But, runners need to shower after a run.

And this company does not provide shower facilities.

Shower facilities, with plenty of lockers: a no-brainer for increasing the bottom line.

Running with Ms.Frizzle

One of the catch-phrases of Ms. Frizzle in the TV show, Magic School Bus, is "Look for connections." (Yea, I watched a lot of that show, when my kids were at that age.) Somehow, I was reminded of this by intersections of Sakyong Mipham's book, "Running with the Mind of Meditation," and Scott Jurek's "Eat & Run," even though these intersections are not quite the same as Ms. Frizzle's connections. Still, both relate to what came to my mind, i.e., everything in this world is linked (by six degrees of separation, if you like!). Anyways, here are two examples.

Jurek had an entire chapter about growing up being told by his father that "Sometimes you just do things!" Sometimes, you just can't know; you just accept and persevere. Many years later, Jurek would wonder, during his second Spartathlon, a 245.3 km (152.4 mi) race from Athens to Sparta, whether his father had actually meant, "Try not to think about consequences, just trust in your body and yourself and the universe." Mipham also devoted a chapter on "Just do it," including a reference to Nike's slogan. Mipham focused on how does one just do it. His answer was "with gentleness."

In his book, Jurek wrote about tearing his ligaments at mile 44 of the 2001 Western States 100 and about the importance of the mind in responding to what had just happened. He described his four-step checklist for such occasions, the first step of which is to feel and acknowledge one's emotions in response to the situation, i.e., to get all those emotions out of oneself and out of the way, so one can move on. Jurek won that race with those torn ligaments. Mipham, in his chapter on "How to Deal with Pain," wrote the first step is to acknowledge the pain, and the second step is not to overact, thus separating the pain from the mind reacting to the pain. This way, one can learn from the pain, which then becomes an opportunity to grow.

Now, Jurek did read about Buddhism and Taosim, so, perhaps the intersections of his and Mipham's books, illustrated by these two examples, should not be that surprising. However, I read these two books back to back by chance; so, these intersections are still intriguing to me. I will wrap up by relating a personal experience related to these kinds of intersections, though not related to running. When I was in grad school, there was one semester when I took three courses that were scheduled one after the other: agronomy, soil mechanics, and geomorphology. During one particular day of the first week of that semester, all three professors lectured about the exact same topic (related to basic properties of soil)--but, each from his own discipline-focused lens. In quick succession, I was exposed to the same part of the natural world, but through three different views. I was wowed. ... OK, I guess you had to be there! For me, though, that day definitely was a highlight of my academic career.

Running low on iron?

Well, this is puzzling. Some weeks ago, at the beginning of a blood donation process, where they take some blood from one's finger to do the hemoglobin test, my results were just shy of the minimum level. I was disappointed to have to defer my donation--for the first time in decades of donations. 2-3 months prior, I had my annual physical just a few days after my previous blood donation, and one of the lab results indicated a possible anemia condition. My internist thought there might be a connection between the two.

Just out of curiosity, to see if anemia might be related in any way to running, I googled running and anemia, and, sure enough, there were gobs of related articles out there, including a number of academic peer-reviewed papers. From the few I have read so far, there seems to be agreement that iron deficiency and anemia are more common among endurance athletes than among the general population, and, of the endurance athletes, more common among runners. Various explanations for the higher rates among runners include iron loss through sweating, normal gastrointestinal bleeding during long runs, destruction of red blood cells from all that pounding on pavement ("footstrike hemolysis"), and iron depletion associated with tissue inflammation. The connection between endurance training and iron deficiency anemia, however, remains to be firmly established. As one author questioned, does it make sense that intense exercise, as a normal outcome, reduces the body's capacity to perform intense exercise (by accelerating iron depletion resulting in anemia). Adding to the confusion, there is also the so-called "pseudoanemia," indicated by a low hematocrit value (ratio of red cell volume to total blood volume), which manifests itself in a well-conditioned body due to an expansion of blood volume.

In a recent follow-up lab test, the new results showed the relevant numbers being higher but still lower than normal. My doctor said his money is on blood donation as the likely cause. Me? I am on the fence for now, though leaning towards running as the cause. Although donating blood as the cause of anemia does make sense, it has been several months now since my last donation, and I have no symptoms of anemia. Certainly not fatigue. I am in my last week of training for next weekend's Baltimore Marathon and had a great long run last weekend (last one before the race). Although I have been running all my life, I have not, for the most part, run at the volume that I have sustained since I began training for the 2011 Marine Corps Marathon around June of last year. I have started to take an iron supplement, but I plan to have another conversation with my doctor in a few months to see if the supplement is really needed.