Distance Totals

Tuesday, November 14, 2017

5 years of mysterious recurring running injuries due to Quadratus lumborum dysfunction

I have used this blog mostly to relate my marathons race reports. However I feel that writing here my long history with unexplained running injuries, and how I finally identified the root cause of these problems might be useful to other runners who may suffer from similar issues. 

I am that runner who is ‘always injured'. Whenever followers look at my Strava feed and see several days or weeks of Elliptigo rides without running, they don’t even have to ask, as they know that something is wrong and that I am on the shelf for an undetermined amount of time.

I started running in the Fall of 2007 to prepare for my first marathon, the day of my 40th birthday on February 2008. Following this first race I enjoyed a period of relatively pain and injury-free running until the Fall of 2012. However, in November of that year, I experienced the first episode of thigh/upper leg pain which has plagued me multiple times since (Figure 1). From 2013-2015 the pain was localized in the left leg, while in 2016-2017 the pain and injuries seemed to shift mostly to the right medial thigh (with one exception in late 2016; Figure 1). The severity of the pain and the degree to which it affected my running varied depending on the episodes. In 2012 and 2013 I had to DNS the CIM marathon as I was completely unable to run without severe pain. In 2014 I was able to complete CIM but I was not at 100% and the race made things worse, as it took several painful weeks afterwards to recover. In 2016 I hit rock bottom as I experienced the worst two episodes:  first in the Spring of 2016 when I did not run for close to two and a half months due to right thigh pain and missed the Boston Marathon , then starting in October until the end of the year when I suffered a lower left leg injury with extreme pain while walking, probably due to a displacement of the fibula and some issues with the peroneal muscles and ankle ligaments (Figure 1). 

Figure 1: List of Upper and Lower leg running-related injuries suffered from 2012 through 2017

Except for the lateral lower left leg injury suffered in 
Fall 2016, the pain and physical limitations that I experienced when suffering from the thigh issues included:

• Pain in the upper thigh upon leg impact. The pain was not localized to any particular area but seemed to follow a line along the upper leg, and traveled more towards the inside (medial) part of the thigh. The discomfort sometimes included part of the hip or the upper part of the knee but the location pattern of the pain was not always consistent. At the peak of the worst episodes, I could typically take 1 or 2 steps running, but then felt that my hip was completely inactivated and that I was physically unable to run.

 There was usually no pain whatsoever as long as my feet did not leave the ground or a physical support. For instance I could ride my Elliptigo bike all day (in fact, I actually did that during one of theses episodes by completing a 100 mile ride - Tour de OC in May 2016) without any pain. Spinning also did not hurt. I could do squats, deadlifts and other heavy weight lifting on two feet with no discomfort. However if the “injured” leg that had been just loaded with weights left the ground (for instance loading the leg for a single leg romanian deadlift, doing the RDL, and then switching to the other leg), I would immediately experience pain traveling down the upper thigh of the leg that was off the ground. This aspect of the injury was particularly puzzling. In addition, the pain was worse if I was walking with something heavy on the side opposite of the leg that was hurting. However carrying the same load on the same side of the leg that was hurting would normally not exacerbate the pain.    

 The pain was sometimes debilitating enough that I could hardly walk without limping or pain. This was especially true of the Spring 2016 episode when I remember visiting my sister in France and she noticed me limping while walking with her in the streets of Paris. The pain and discomfort did not respond to anti inflammatory drugs (no effect on NSAIDs), nor to cold treatment (I tried ice and cryotherapy sessions without any relief or improvement). In addition it did not respond in a major way to direct interventions on the thigh such as rolling, Gua Sha, Graston, ART or acupuncture. Being in pain and unable to move well while walking or running is psychologically challenging and got to me mentally more than once. Back in 2016 I remember snapping at my wife because I was trying to find relief to that constant pain and was unable to.

 At times when the pain was manageable enough to be able to run, the leg and discomfort actually felt worse when running at slower speed. If I tried to do a sprint or a stride, I could barely feel any pain at all. However slower running seemed to make the issue worse.


I got treated for these injuries by different practitioners over the years and ultimately recovered more or less quickly depending on the episodes - anywhere from 4 weeks to 3 months. However there was never any “A-Ha” moment when I could feel that the problem was clearly identified and that the treatments resulted in quick improvement. After attending the workshop “Primal Movement Chains” with Perry Nickelston in July 2016, I became more educated with the subsystems that govern body movement and stability. In particular when one of my fellow workshop attendees tested my lateral subsystem (LSS), it was clear that this system lacked stability. It was way too easy for her to push me from the side and destabilize me – as opposed to when she pushed me from the front or the back, in which cases I was rock stable. This clearly indicated that my LSS was deficient. I did not pay much attention to this at the time because I felt I was running normally that summer and did not experience pain but in hindsight, I probably should have been more proactive, which may have prevented some of my later issues. 

The LSS includes (in addition to a few other muscles) the adductor muscles group, hip abductors including the gluteus medius and TFL, and the quadratus lumborum (QL) on the other side of the body (= contralateral) (Figure 2) to provide stability to the body in the frontal plane. When both QLs are activated this leads to an extension of the back; however when only one side is activated, it leads to a bending of the trunk. The LLS is heavily recruited during walking and running, as it stabilizes the body when moving forward, especially when in a single leg stance. 

Figure 2: Muscles involved in the lateral subsystem. Picture copied from one of the Neurokinetic Therapy Facebook posts. 

Recently (September 2017), while suffering from yet another of these episodes I revisited an article by Perry Nickelston emphasizing the importance of this subsystem when evaluating running injuries.
https://breakingmuscle.com/fitness/lower-extremity-pain-check-your-lateral-sub-system

When my therapist (Dr Dawn McCrory at Kinesis) tested my LSS, she found right off the bat that I was completely unstable when pushed from the side, especially when on a single leg stance. She then tested several muscles involved in the LSS and found that my Quadratus lumborum (QL) muscles were not activating properly when tested through the Neurokinetic Therapy protocol. This indicated some deficiency in neural patterning, where my motor control system would not properly activate the QLs. The pattern was not always consistent but usually my right QL was typically inactive, while the left one was somewhat overactive and inhibiting the right one. This dysfunction resulted in the upper body leaning to the left, especially when running, which resulted in instability in the frontal plane, and provided a biomechanical explanation for some of the issues that I had suffered since 2015 (Figure 3). My R thigh was hurting is because the adductor muscles on the right leg were overworking, trying to compensate for my upper body leaning to the left due to the inhibition of the right QL and overactivity of the left QL. Adducting the right leg was the solution that my brain found to stabilize my body while running, in the absence of a properly functioning right QL.

Interestingly, QL dysfunction is typically associated with lower back pain. In my case I never really had any major pain in the lower back - at least anything that felt as bad as what I felt in the legs. I could sometimes feel some low grade back discomfort on the right lower back upon prolonged sitting while driving...which was probably due to my inactive right QL. Retrospectively, I have always had some sort of QL dysfunction based on the testing that Dr Dawn did between 2015 and 2017. However the causal relationships summarized on Figure 3 only became clear during this final episode. 

Figure 3: Compensatory patterns leading to various thigh and lower leg injuries due to the Left/Right Quadratus Lumborum (QL) imbalance.  

Once we realized that the issue was related to dysfunction of the QLs and of the LSS, all the observations listed above, and some additional ones made complete sense:

1- running at slower speed hurt more than sprinting: at higher speeds the LSS is less challenged because of the higher kinetic energy in the forward direction, which de-emphasizes the need for lateral stabilization of the body.

2- running on soft, uneven surfaces (e.g thick grass or rough dirt) hurt more than on smooth pavement: Uneven surfaces offer a greater challenge to the LSS because the constant change of terrain requires the body to laterally adjust all the time, while smooth asphalt is less demanding to the LSS. The only exception to this is if the pavement is slanted, in which case the LSS is challenged constantly on the same side. I tend to run on the left side of the roads most frequently, which may have been an aggravating factor in my episodes.

3- I had taken ski vacations in the midst of some of these episodes (eg winter 2012, 2013). I would typically came back from these trips with less discomfort than before the trip, and being able to run more with less pain. While this could be due to just general length strengthening, I believe it is because skiing is a great exercise for re-educating the LSS. The constant lateral change of position of the body, and integration of the function of the QLs and adductors when the body is on both legs is a great way to reprogram the nervous system to integrate the function of these muscles together, but without the too-high demands of putting the body in a single leg stance (I don’t typically ski on just one leg... :-)

4- Lifting a leg that had previously been loaded with weights hurt, but only when that leg leaves the ground: once the foot leaves the ground, the LSS is heavily challenged to stabilize the body that is now supported by only one leg. If the LSS is deficient,  for instance when the QLs are off, pain will incur because of muscles overcompensating for the QLs.

5- Carrying something heavy on the opposite of the leg that hurts is painful, but not if carried on the same side. Perry Nickelston described Unilateral Farmer’s walk (when you carry a heavy charge on one side of the body) as “the Mount Everest of challenging the Lateral subsystem”. No wonder why these would hurt, while lifting double or triple the weight but on both legs would not.

6- The right QL deficiency also explains the apparently unrelated injury that I experienced from October 2016 through January 2017 on the lower left leg, but which was located laterally instead of medially (Figures 1 &3). The pain was very different from what I experienced during other episodes, as this was the only time I felt that something was physically ‘broken’. There was some displacement of the fibula and some issues with my ankle ligaments. The constant leaning of my upper body to the left probably put a lot of stress on the left side upon impact, leading to structural damage laterally on the lower leg (Figure 3). | also had recurring minor episodes with an overactive left TFL – which abducts (ie pulls the leg outwards). Once again, probably a solution that my body found to compensate for the leaning of the upper body to the left (Figure 3)

7- Trying to treat the muscles of the thigh like the adductors was like blowing air in a violin and expecting to hear some music. The adductors overworking were actually a response to my dysfunctional QLs, and hoping to get healthy by just treating the leg had no effect or was just making things worse by reducing the compensatory mechanism that allowed me to stand and be somewhat stable in the absence of functional QLs. 

Once thing which is still puzzling is why these injury episodes seemed to affect mostly the left leg until 2015, and then shifted to the right side for the upper leg/thigh. Back in July 2015, I crashed on my Elliptigo and landed on my right elbow and back, with some damage on my right shoulder. The worst injury episodes actually started after that crash, and it is possible that the accident caused my right QL to overextend or become inhibited by compensation for some unresolved upper back or shoulder issues.

There are other possible reasons to explain why my left QL is typically overactive while my right QL is inhibited. Between 2008 and 2015 I did a lot of my speedwork on the track, and running counterclockwise on the track forces the upper body to lean to the left to counteract for the centrifuge force on the left turns. I also do a lot of my runs on a road loop where I run counterclockwise, which results in 4-5 left turns every mile. The cumulative effect of left turns might have pushed my body into a constant state of leaning to the left. I also realized that I tend to lean left when sitting down, which either contributed to the issue, or was a consequence of my overactive left QL. Finally, years of sitting down in my office probably did not improve the shape of my QLs...

Regardless of the root cause of the dysfunction of my QLs, once I identified the issue I worked on reactivating the right QL, based on the Neurokinetic Therapy protocol and using other LSS exercises (side planks; monster walks; etc..) and I was back to running within a couple of weeks. It is still a work in progress as I know that my right QL is not fully functional yet, and the right hip mechanics does not feel completely back to normal. I am not sure whether I doubt that I will be back to the level of fitness that allowed me to almost break 3 hours at the marathon back in 2015. I also cannot be certain 'beyond reasonable doubt' that my previous injury episodes were also due to QL dysfunction...but it all makes too much sense not to be true, and having found the intrinsic cause of my leg issues over these past five years has been a tremendous relief, and also gave me a plan of action in case these problems appear again in the future.


Gratefully yours,  


Friday, June 12, 2015

Mountains to Beach Marathon 2015: Just 10 seconds away...




After the 2014 CIM debacle, I made the decision to run Mountains to Beach in 2015, since I managed to pull off a good race on that course last year, just a few weeks after a very bad race at Boston. However the recovery from CIM went slower than anticipated. The left thigh issue that plagued me the last few weeks before CIM and during the race became a major issue, with pain on the inside of the leg and elevated heart rate at slow speeds, indicative of deficient mechanics. It turned out that I had developed a left hip weakness, and that my gracilis, one of the long adductor muscles, had compensated for this weakness. The gracilis took a beating during the last training weeks and during the race and finally gave up, leading to pain and flawed running mechanics especially at lower speeds. The end of December and January were spent aggressively rehabbing my left hip, with lateral leg raises, clamshells, and planks 5 times a week, and managing to run 6 days a week, albeit slow and in moderate pain. I made steady progress, and with the consistent hip exercises I felt I was getting healthier every week, with most of the pain gone by early February. I maintained the core/hip routine throughout the training cycle and also lifted weights at least once a week to keep my body from developing weaknesses.

I ran a rust buster 8k at Brea at the end of February in a relatively mediocre time (31:58). This was my only tune up race, but from there most of the training went fine, the highlight being a solo 10 mile hard tempo run at 6:26 pace at the end of March. I hit a difficult week 4 weeks before the race, with general fatigue and difficulties maintaining paces on the later intervals of my workouts, so my coach decided to backoff and reduce the mileage, leading to a 3 weeks taper instead of the usual two. As a result, I felt relatively fresh during the last week before the race, although that week was very stressful at work and home, with too many events that did not contribute to a relaxing environment. In addition I got a sore throat a week before the race; although it never evolved into a full blow head cold, I was still coughing and having minor congestion the day of the race.

I drove to Ventura on Saturday afternoon, and after picking up my bib at the expo, I checked in at the hotel, and ate my last dinner at a sushi restaurant. I slept reasonably well considering the early wake up (3:10AM), drank a bottle of carbo force, ate two toasts and boarded the shuttle at 4AM. The drive to Ojai was quick and we were dropped at 4:30AM. I used the bathroom a couple of times, and met Duck, a forumite of the RW west forum about half an hour before the start. I jogged a few hundred yards about 15 minutes before the start – luxury of a smaller race - but did not feel the need to warm up too much.
At the start, shortly before 6AM
I lined up two rows from the front line, and at 6AM we were off and going. Having run the race last year I knew what to expect and the topography of the course. First, a loop around Ojai with some inclines and declines, then a steady decline from M8 to M18, and then a flat course to the finish.The first two miles were close to average pace with some very minor rollers (6:52; 6:55). At Mile 2, I saw Robert, my taxman who came to support his wife who was running her first marathon. Miles 3 to 5 were fast because of the downhill on the bike path (6:46; 6:43; 6:44). I felt comfortable, and the downhill made these three miles really easy. I did not try to hit a specific pace but rather tried to keep the HR at reasonable value and save my legs by not hammering the downhill.

Elevation profile with corrected elevation values.

The next three miles (6-8) were harder, because we left the bike path to go back towards Ojai and regain the all the elevation lost. I tried not to work too hard on Mile 6 steady incline and the rollers, keep the HR under control even if that meant a few slower miles (7:04; 7:05; 6:59). Once we were done with that loop, we got back on the downhill bike path and I thought things were going to get easier, based on my earlier pace on the downhill segments at M3-4. However the downhill did not feel as easy compared to the first time we ran on the same section. During that second time on the bike path I saw John Loftus, coach at Run Your Potential who yelled at me to get my attention and took the picture on the left:



In that downhill segment I got dropped by a few runners, including one of the rare females in the group, as they accelerated quite a bit. Miles 10-13 were spent trying to take advantage of the downhill (6:48; 6:54; 6:45; 6:43) but trying at the same time not to hammer it to avoid muscle damage and subsequent leg fatigue. I reached the 13.1 mark at 1:29:45, which gave me confidence that I would finish under three hours, since I was able to run last year’s race with about a minute negative split.

However, around Mile 16, I started to feel some early signs of fatigue. It felt difficult to keep the heart rate above 160, and I wasn’t sure where this was coming from. Early leg fatigue due to the downhill segments? I had taken gels regularly every 30 minutes so it was too early to be low in glycogen, but I was clearly starting to work harder. I tried to increase my leg turnover but this was not effective and I could not maintain this higher turnover for very long. By Mile 18, most of the elevation drop felt negligible, and it became a steady grind to keep pace. In addition, we were reaching the Ventura plain, and the temperatures were now warmer (above 60F) with no cloud cover, making the conditions harder. I doused myself with water at every aid station but the cooling effect was unfortunately short lived. I did not slow down dramatically but it was becoming harder and harder to maintain pace (6:48-6:50). I remember passing a few runners there and maybe being passed by one or two, including one guy in a tri jersey who blew past me finished two minutes ahead of me - I ended up chatting with him at the finish. We were also catching up with slow half marathoners and the bike path was getting more congested. I focused on staying on my race one mile at a mile, bargaining with myself to try and get the mile I was running in at 6:52 or less, before thinking about the next one.

Once we got out of the bike path into Ventura things definitely got tougher. Mile 21 was run at 6:47 so I was encouraged that I might be able to finish stronger. At Mile 22 I crossed the train tracks and was relieved because I knew I would not have to wait for a train crossing (the runners information mentioned that due to train schedule, runners running between 2:55 and 3:05 may have to stop for trains….). 


Detailed view of the loop from Mile 22 to the finish, with the cross-training train-crossing shortly after mile 22, and the turn around towards the finish before mile 25.
The next miles between the freeway and the ocean front were progressively slower, around 6:55 pace. The course had more turns with some irregular surface, and it was definitely more congested than before, with the sun directly above. I started to calculate mentally how much cushion I had to go under 3 hours...but with each mile clicking at 6:55 or slightly slower I was getting worried that I might not make it. However I really did not have it in me to close faster, as I felt like if I had pushed harder it would have resulted in a blow up in the next mile.  As someone once said, I knew my goose was cooked, it was just unfortunate that it was already well done way before mile 26….

We passed the finish around mile 23 (6:55). During that section I was seeing slow half marathoners on the other side who were running in the opposite direction towards the finish, and it felt like the turning back point to reach the finish line was never coming. My mind was feeling foggy but I was trying to make it one mile at a mile while also trying to catch up some of the marathon runners who were slowing down to help me keep pace. I finally made it to turnaround, and from there we were back on the bike path towards the finish. It was more tortuous and bumpy than I would have liked, with many slow half-marathoners blocking the way, and I could not muster better than a couple of 6:59 miles. I flew by the female runner who had passed me at ~ M11, as well as a couple of others marathon runners who clearly bonked in these late miles. As my Garmin beeped signaling Mile 26, I realized I needed to cover the final 0.2 or change in less than 1min 30s. I knew I was in trouble but gave it all I had to try and finish under 3hrs. About a swimming pool length away from the finish, my Garmin showed 3:00:00…I still kicked hard and was happy to be finally done, but did no excessive celebration when crossing the line in 3:00:09... 
Less than 0.2 mile from the finish..so close, yet so far.

This finish was surprisingly unemotional. I could have broken up since I was so close, needing only 10s to go under 3 hours. I could have been stoked to finally get a personal best by 45 seconds at the ripe age of 47, after two years without any improvement at the marathon (or any other distance). I just felt a dull sense of relief and satisfaction as the race was over and I managed to run a solid race, even if I fell short of my main goal. I will always wonder where in my splits I could have gained these ridiculous 10 seconds...but at least the template for a successful run was there, and I hope I won’t have to wait another two years before improving.
With Rocky from the West forum who PR'ed but just missed a BQ by ~ 1 minute.


Splits:
Interval
Distance
Time
Pace
Avg HR 
Max HR
1
1 mi
06:51.3
06:52
154
172
2
1 mi
06:54.4
06:55
163
171
3
1 mi
06:45.5
06:46
164
169
4
1 mi
06:42.2
06:43
162
165
5
1 mi
06:43.4
06:44
162
165
6
1 mi
07:03.6
07:04
164
167
7
1 mi
07:04.1
07:05
165
168
8
1 mi
06:58.5
06:59
164
166
9
1 mi
06:51.3
06:52
162
164
10
1 mi
06:48.3
06:49
161
164
11
1 mi
06:54.5
06:55
162
164
12
1 mi
06:45.4
06:46
160
163
13
1 mi
06:43.3
06:44
159
161
14
1 mi
06:46.3
06:47
159
161
15
1 mi
06:53
06:53
158
161
16
1 mi
06:50.4
06:51
158
160
17
1 mi
06:48.6
06:49
159
161
18
1 mi
06:48
06:48
161
163
19
1 mi
06:50.0
06:51
162
164
20
1 mi
06:54
06:54
161
164
21
1 mi
06:46.8
06:47
162
164
22
1 mi
06:55.2
06:56
162
164
23
1 mi
06:55.4
06:56
162
164
24
1 mi
06:59.9
07:00
161
164
25
1 mi
06:59.6
07:00
162
164
26
1 mi
06:58.7
06:59
162
168
27
0.27 mi
01:38.6
06:05
166
169

Monday, December 15, 2014

CIM2014: When slaying the dragon is just not good enough


In 2012 and 2013 I signed up for CIM and ended up not being able to start the race because of two different injuries. As a result of these two consecutives DNS, CIM became a psychological roadblock for me, and I told myself after the second injury that I would never sign up for that race EVER  AGAIN! Then this year I decided to run a marathon before the end of the year to try and salvage my racing season. However, no race other than CIM seemed to be working for my schedule. I am not overly superstitious, but it took  some time before I finally hit the registration button, knowing my heavy past with that race. The training cycle became about “slaying the CIM dragon”, as Multi22, one of the sub-3 forumites pointed out, and to stay healthy enough to step the start line. 

My overall training went fine. I ran a 1:26:47 half marathon 5 weeks before the race, which McMillan calculated as an equivalent of 3:02:38, but my workouts put me around 6:48-6:52 pace at marathon pace heart rate, which gave me hope that I had the fitness to go under 3hours. Only issue, I started to feel some left thigh ache the last two weeks before the race. This ache slowly faded in the few days before the race so I wasn't overly concerned about it. I flew to Sacramento on Friday, and hit the expo Friday afternoon. I got to meet Kim Conley, saw the BQ bell and the CIM wall where all the runners names were written.  

With Kim Conley


  The next morning I drove the course and realized then the rolling nature of the course, as there was virtually no flat portion between the start and mile 16-18. This worried me a bit knowing that I did not do my MP runs on hills, just some tempo intervals and hill repeats.
Short uphill at Mile1
Elevation profile, note the absence of continuous flat segments until ~ mile 18
I slept very poorly the night before the race and woke up at 3:30 without the alarm. I drank a bottle of Carboforce, ate two muffins with honey, showered and got ready to board the bus. I saw Dave in the line and we rode the bus together with his buddy from Seattle. Once arrived, I hit the portajohns right away to take care of business, after which I saw John Hill, who ended up running a blazing 2:38 that day. He  complained to me that he forgot his Garmin and was forced to run with a clunky set up with his phone. Had he told me so before hand I could have loaned him one, as I brought three with me being paranoid with technology failure...I then hung around the start area; it was surprisingly empty until maybe 10-15min before the race, at which time people started to congregate.

At the start, keeping warm about 45 minutes before start time

I kept my throwaway clothes until 10 minutes before the start and took care of business one last time in my empty Gatorade bottle, unbeknownst to people around me, thanks to my warm-up pants. I threw away pants, fleece and hat, lined up several rows from the front and at 7am sharp we were off.

Right away it felt difficult to reach sub-3 pace. I found myself surrounded by the 3:05 pace group. This was oppressing as I did not have much running space, and I thought that they had no business running that pace, as I clocked the first mile at 6:55. It was only after the second mile that I was able to detach myself from the group and get some breathing room. At that time I started to realize that the course was relentless. The hills were not bad or steep, but there were very little to no flat segments, once I was done with a short uphill there was a downhill that I needed to be careful not to hammer. This isn’t the type of course I am comfortable with, as I like to get into a rhythm, dial in marathon pace and forget about it. I focused on running the tangents, which sometimes meant that I was all by myself on one side of the road, while the pack of runners around me just followed the curves and the runners in front of them.
In the early Miles, in front of the 3:05 pace group
The first 5-6 miles were a net downhill and I was a few seconds over sub3 pace for these miles. However once we hit more even rolling miles with approximately equal up and downhills, my pace slowed down a bit and I started digging myself into a hole. At that time I was thinking that I should be going faster but the effort felt maximum for a marathon and I was afraid of blowing up in the second half. I had a small 10 oz bottle onto which I had diluted 5 gels and I used it to take “gels” at Mile 4, and Mile 8. I looked at my split crossing the half, and my Garmin showed 1:31:38. I then realized that it would be really difficult to get under 3 hours considering the deficit I had built. I took another “gel” at the half.

Around mile 14, I seriously considered dropping out. I told myself that there was no point in continuing, as I was going to beat up my legs for no reason. I had no interest in another BQ, nor in anything else than a sub-3 hour time, and it made little sense to finish. Then I thought of my kids, and that it would set a terrible example for them, as I always tell them to finish what they started. I also thought that I finally got a chance to start that race after two consecutive DNS, and that I owed it to myself to finish, just to put a closure on my bad history with CIM and finally “slay the CIM dragon”.

Once I made peace with myself and decided to finish, I felt better for another two-three miles. I clicked miles at a regular pace, focused on my effort than on the pace itself and started to catch up with some runners. Around mile 18 the pace began slightly more difficult to sustain. I kept plugging but it felt harder, even if I was still passing other runners. I took my last two “gels” at Mile 17 and 20 and threw away my empty gel bottle, just to feel more comfortable.
In the last miles, grinding towards the finish
At mile 21 we reached a bridge which is considered the last “hill” of the course. It wasn’t much of a hill but I passed several runners who were walking or jogging. Once we entered the city, the course was completely flat – finally – but at this point the legs became fatigued, with some muscle twinges on the left quad - the muscle area that had bothered me the last few days before the race, and on the right foot. My breathing became more labored, and the heart rate went slightly up, which was a clear indication that I was working on fat and that my glycogen was getting low. The last miles went by relatively quickly. I passed lots and lots of runners there and did not get passed. Around mile 23 I felt I still had a bit left in the tank but did not want to push harder because of the muscles twinges in my left leg and also because I felt I did not have much to gain at this point as I wouldn’t PR anyway. I still let it all go after mile 26 to close fast and blew past several other runners in that stretch. I crossed the finish in 3:02:26, with a 1min10 seconds negative split, glad to be finally done with that race.

Crossing the finish
Once I crossed the finish and got my sweat bag back, I looked around briefly to see if there was anyone that I knew, but I really had no desire to talk with anyone. I sat down on the steps of the Capitol and broke down in tears. I felt that I had wasted 5 months of training for nothing in return, and no improvement compared to last year. I was left considering why once again I wasn’t able to reach my long time goal. Maybe I wasn't in sub-3 shape - according to the McMillan calculator I ran at my fitness level. However my runs at MP heart rate indicated otherwise. Did I go out too conservatively in the first half? I don’t think so based on my HR values but I will never know what would have happened had I forced the pace to 6:50s. At any rate I wasn’t prepared for the rollers. I did some speedwork on hilly terrain but most of my MP runs were on a flat loop for logistical reasons. So while I might have been in sub-3 shape on a flat course, the rollers took more out of me than I thought because I wasn’t prepared for them. In addition, I did not do as much weight training as I did before OC in 2013, and I was also heavier for this race than I was before, which all combined to make it a more difficult race. I should be happy with running my second fastest marathon, with a decent negative split, but this isn't what I was looking for, and I will finish this report with this quote from a friend, who summarized well my race: 
“looking at your splits - it looks amazing and well executed. Being objective you must acknowledge that running 26 miles at sub-7 pace is insane. It really is you know. But I also understand the feeling that it's not good enough…”

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Split
Distance
Time 
Pace
Average HR
MaxHR
1
1 mi
06:55.7
06:56
160
x-malfunction
2
1 mi
06:59.5
07:00
165
168
3
1 mi
06:52.6
06:53
165
169
4
1 mi
06:56.7
06:57
164
169
5
1 mi
06:58.7
06:59
163
167
6
1 mi
06:56.2
06:57
165
167
7
1 mi
07:00.5
07:01
164
168
8
1 mi
07:04.4
07:05
163
168
9
1 mi
07:07.0
07:07
163
167
10
1 mi
06:53.8
06:54
163
166
11
1 mi
06:54.1
06:55
164
169
12
1 mi
07:00.2
07:01
163
166
13
1 mi
06:57.8
06:58
161
166
14
1 mi
06:53.1
06:54
162
166
15
1 mi
06:55.3
06:56
162
167
16
1 mi
06:51.6
06:52
165
169
17
1 mi
06:51.0
06:52
163
166
18
1 mi
06:59.6
07:00
162
165
19
1 mi
06:57.1
06:58
161
165
20
1 mi
06:56.8
06:57
162
166
21
1 mi
06:59.4
07:00
163
167
22
1 mi
06:54.0
06:54
165
171
23
1 mi
06:56.0
06:56
166
169
24
1 mi
06:56.2
06:57
165
169
25
1 mi
06:52.4
06:53
166
170
26
1 mi
06:49.9
06:50
168
172
27
0.33 mi
01:59.3
06:02
173
180