32K Iroquois Trail Test (ITT)

Large moss-covered slippery fieldstone. Mud. Steep rocky terrain. Two river crossings. Bouldering over a sheer vertical rock wall. Perfect weather. 32K of this for some pretty cool bragging rights in the beautiful town of Kilbride, Ontario. I started counting how many times I rolled my ankle, stubbed my toes, and stumbled and slipped over large stones down muddy embankments, but I lost track. I was proud to not have fallen on my face, unlike one of my old running buddies. Another one of my running partners got lost 4K into the race and ran approximately 26K, but not on the race route. To top it off, she sustained some nasty injuries as a result of the unstable terrain. She found her way back to the starting point in surprisingly good spirits; I admired her positivity and perseverance. Participants followed the white and blue blazes of the Bruce Trail, and a few people ended up running more than 5K in the wrong direction. Of the 97 participants, only 90 people finished the race.

I loved the challenge of the technical elements, and the rocks beautifully broke up the routine of running flats or rolling hills through the trail. I was happy with my time up to 21K, but the

 second part of the race--the most technical aspect--was met with severe cramping of my left calf and some nagging IT issues in my left leg. I chose not to risk injury on an already risky running surface, so I was considerably more conservative with my pace in the final leg of the race. It was not worth it to get injured at this point in the racing season.

Should I enter the ITT in the future, I will pick up my pace in the first leg to conserve energy for the final technical sections, and finish injury-free.

The Natural History of Ankylosing Spondylitis as Defined by Radiological Progression

Radiological status is an important objective endpoint in the assessment of ankylosing spondylitis (AS). This study investigated the disease development of AS using radiological change.

Existing radiographs (n = 2284) of 571 AS patients attending the Royal National Hospital for Rheumatic Diseases were scored retrospectively using the Bath Ankylosing Spondylitis Radiology Index. 

1. Progression of disease was initially examined cross sectionally. Factors associated with joint involvement were examined.
2. Progression of disease was then examined longitudinally for patients with films at time of symptom onset.
3. Rate of progression of radiological change was calculated using longitudinal data of 2 sets of radiographs taken 10 years apart (patient number = 54). The results from this were used to extrapolate backwards to age at first radiological change.

The results of the study demonstrated the following:

• Progression to cervical spine disease was a function of: disease duration, severity of hip and lumbar involvement, and a history of iritis. Lumbar (lower back) involvement was associated with disease duration, age now, and severity of cervical and hip involvement. Hip involvement was a marker for cervical disease and associated with disease duration.
• Longitudinal analysis revealed marked variation among patients with a slow general rate of progression.
• The progression of AS over any 10 year period is linear [first 10 years = 30% (SD 0.3) of potential change, 10-20 yrs = 40% (SD 0.3) change, 20-30 yrs = 35% (SD 0.4) change (p = 0.5)]. Backward extrapolation suggests that the approximate time of first radiological change is at the age of 8 years.

The researchers concluded the following:

•  AS is a linearly progressive disease with about 35% change every 10 years. Spinal involvement is largely an expression of disease duration while the hips become involved in about 25% of individuals and may predict a more severe outcome for the cervical spine.
• Backward extrapolation shows that the disease process may start as young as 8 years of age. However, the time interval between the disease trigger and radiological change remains unknown. 

Authors: Sinead Brophy, Kirsten MacKay, Ahmed Al-Saidi, Gordon Taylor, and Andrei Calin

Source: J Rheumatol 2002;29:1236-43

Tired

I ran 25K yesterday through the towns of Ajax and Pickering. The weather could not have been better; the last 9K was run in the rain, but I never mind the rain as the moisture helps keep my asthma at bay. My stomach was cramping around 14K and continued to do so throughout the run; I was hesitant drinking my liquid fuel because it did not feel that it was getting quickly absorbed. After drinking any fuel, my stomach still felt heavy with liquid sloshing around even after 15 minutes had elapsed.

Today, I am feeling physically fatigued. I was supposed to run 30K, but given my energy level, I will likely weight train at the gym and throw in some plyometric exercises to train my nervous system. I am growing suspicious that my body has unspecified physical limits, which if pushed beyond, will result in an arthritic flare and immediate symptoms of fatigue. It's just an assumption right now, but a recent email from a US physician describing his AS symptoms leads me to believe that this assumption may not be far from reality.

It honestly disappoints me to think that no matter how hard I push myself physically, I am servant to the limits imposed by my arthritis. Not knowing those limits is frustrating; worse yet, who knows if those limits vary daily or under certain conditions. I realize I should feel grateful that I am still physically able to engage in strenuous activity (remember my mental curse of invincibility); however, as a perfectionist who wants to challenge her performance beyond any comfort zone, I hate feeling defeated by intrinsic forces (which I foolishly tell myself I should be able to control). If this sounds like the afflictions of a Type A personality, you're correct; not an easy burden to bear in the least.