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- 10 March 2009 -
North Pole Marathon
Nicholas Appell is raising money for Springboard UK by running the North Pole marathon on the 7th April 2009. Is he mad? Yes. The North pole marathon involves running around 4.2 km circuit 10 times in -25 to -60 degree temperatures. He wears oversized tennis racquets for shoes and super tight fitting clothing.

The North Pole is not situated on land, but on the Arctic Ocean. He will therefore be running 'on' water … frozen water! He will be running on an ice sheet some 6–12 feet thick above 12,000 feet of Arctic Ocean on the top of the world. The whole course will move with the direction of the Ocean current during the race. Luckily he will not feel it moving. To read more about Nicholas’s injuries and his unorthodox preparation for the race follow his treatment diary below.

9 January 2009
Nicholas presented to Physical Edge with bilateral shin pain from doing too much training in a short period of time. He thought cross training in the gym would increase his leg strength and help his run but he pushed himself so much his shins were injured.

At first his injuries looked like stress fractures. A stress fracture is the end point of a cascade of symptoms such as shin splints and bone reaction injuries. A clinical decision was made by his GP to avoid an x-ray as this would make no difference to the treatment he would receive.

The cause of his shin injuries were very tight calf muscles. This commonly occurs when an athlete over exercises such as cycling, squats, lunges, calf raises, eliptical trainer and running on an inclined surface. Treatment for 6.5 weeks involved acupuncture, icing, deep tissue massage, specific muscle stretching, ultrasound and rest from running however he was permitted to use the elliptical machine as long as he had no pain during or after the training.

25 February 2009
Nicholas was concerned his race was over as he had not run for 6.5 weeks and was only 7 weeks away from the event. He needed to run and against the instructions of the physiotherapist ran twice, 5 miles each time. He suffered from this decision because his shin pain returned after the second run. He had a sinking feeling he would not recover in time but he was determined to make it happen.

1 March 2009
On 1 March 2009 Nicholas ran for 2.5 hours. For a second time this was not discussed with the physiotherapist. Only 6 weeks out from the event he felt he had to get some mileage in his legs. Surprisingly he did not suffer pain from the run. His shins were sore to touch but he was able to walk the next day with no pain. It appeared his shin bones were healing. What an amazing change from the week before.

A new plan was designed and this included resting during the week and only doing his long runs on the weekends. He would continue to cross train and rely on strength to get him through the race. Treatment with Physical Edge would continue twice a week.

5 March 2009

5 weeks to go. Nicholas returns to physiotherapy in dismay. 24 hours after his 2.5 hour run his shins constantly throbbed to the same degree he had at the start of treatment. Even standing still he could feel them throb.

The shin bones felt worse to touch and his lower calf muscles were tighter than normal. It appeared he had a delayed reaction to the run. Treatment involved icing, anti-inflammatory medication and soft tissue massage to his calf muscles.

A joint decision was made to avoid running until the day of the race. He would cross training until then and this would allow his shin bones time to heal properly. How will Nicholas run a marathon on cross training alone and will he be able to run it at all?

11 March 2009
4 weeks to go. Nicholas presents with changeable shin pain. He felt better one day and sore the next with no consistency of symp­toms. Overall his shins had improved but the bone was healing slowly.

He has started the eliptical machine and leg press again. Kinesio­tape was applied to both feet and shins to help unload the pressure on his legs.

There is no indication at this stage that Nicholas will be pain-free in 4 weeks time.

18 March 2009
3 weeks to go. Nicholas continues to rest from running. The kinesiotape did not have a noticeable impact on his leg pains. Any jogging at this stage still created pain.

Will there be enough time for the bone pain to ease in three weeks?

3 April 2009
4 days to go. This is the last treatment before Nicholas heads to the North Pole. He has tried running in his snow shoes on sand and felt slight discomfort in his left shin. He is tender on the inside of his shin bone and requires release of the soft tissues in this region. He has been regularly training for 3 hours in the gym i.e cycling for 1.5 hours and personal training  for 1.5 hours.

Treatment has involved electro-acupuncture and soft tissue re­lease to the inside shin soft tissues, Ultrasound and fascial release to the calf complex.

He is intending to take Ibuprofen for two days before the event and also on the day of the event. He will ice massage the shins if he has the time.

It is a nervous build up to the start of the event as we are not sure how his shins will cope with the running. The bone pain could still change dramatically in the next 4 days before the race. We can only pray that all goes well.

How did Nicholas do in the race? Continue the reading: 29 April 09.