A year ago I started on a new running journey. May 2020 is my ultra 1st birthday!
The first weekend in May 2019, I set off on a journey around the Isle of Wight. It was my first ultra marathon and I had no idea what was in store. All I did know was that it was going to be an adventure.
My introduction to ultras feels longer than a year ago. Since then, I have completed 14 ultras for my upandrun campaign, which is on-going. ‘Where shall I go next month?’, is always a fun conversation with myself. With no races, at the moment I continue with solos, or unsupported runs. This means I head off on my own, carrying whatever I need, and get myself from A to B. We are allowed to travel now, so this opens a few options for May 2020.
Once running begins, there is no end point until you decide or have to stop. The next run always beckons. My shoes sit quietly by the back door, waiting.
I have never been particularly interested in times and pace. When I do become embroiled in the figures, quickly the joy fades. My body also starts to hurt more when I push the pace, and not in a way that is sustainable. Long distance suits me, especially on trails. The vibe is different, featuring connection, camaraderie and a sense of achievement by completion.
The relationship between pain and running is an interesting one and an experience I explore with curiosity. I am my own laboratory. Ultras require a mode that keeps going. The next step, and the next and so on. All sorts of aches, pain, thoughts and feelings come and go. It is a roller coaster that mimics life in many ways. This is perhaps why it is a fascinating experiment.
Build trust in yourself
What will appear next, and how will I deal with it? Certainly, completing ultra events gives you a sense of ‘yes, I can and I will’ that you bring forth into your life. The trust in yourself to do a job and reach the end before starting again strengthens enormously. Our habits inform our identity to an extent. If I have the habit of finishing or doing my best with each task, then this is who I am. This is my narrative. The same would be true for running 100k as to clearing the dishwasher.
Over the past few months I have been running a Pain Coaching project supported by GSK. They came to me with an interest in the concept, resulting in a programme that I have been delivering over the past few months. Now we are looking at the data, which at first glance is highlighting the strengths of Pain Coaching for chronic pain. The feedback from the participants averaged 9.3/10. More on this as we mine the data.
These are the gifts I have received for my first ultra birthday. There are more, many more, and they keep coming: the joy of movement, freedom, connecting with space and nature, engaging with a community, and let us not forget the kit….
We started the tour in Johannesburg, then on to Durban and finally to Cape Town. It was a whirlwind. Each event drew local physiotherapists, kinesiologists and other healthcare professionals together for a burst of education, socialising and presentation of the product range.
The organisers and sales teams created a positive vibe, which made the delivery of the pain talks a pleasure. I also had the opportunity to gain an insight into the pain problems that exist in South Africa by talking to the therapists.
We can be optimistic. Our knowledge of pain is expanding at a fast rate directly via pain science but largely from related fields. This was a message I tried to get across.
Therapists can choose to see people’s potential and strengths. Through this lens, the possibilities open up and we can help and encourage patients to shape their own positive futures.
The three days of talks in three cities was energising. It did not prepare me for a mountain though. Or the heat.
For the first 10k I was guided up to Lion’s Head by Nicola from Energy in Abundance. We set off on the trail chatting about life, running and philosophy. The photos tell the story.
Nicola hooked me up with South African ultrarunner Linda Doke for the Table Mountain part of the adventure. Incidentally, Nicola made all the arrangements by email beforehand so I just had to turn up. I would recommend this if you are a runner wanting to explore the area. You’ll be taken safely on the best routes and experience the awesome views.
We set off along the bottom of the mountain to reach the point of ascent. Apparently the weather was to be the best of the season today. It was. The flip side was the heat, which I was not prepared for having come from the English winter. This together with the steep climb took some effort. The reward was the magnificent view and a tin of coke. I love coke on long hot runs. And coffee.
Leaving the cable station and heading off along the stony trail, we also left contact with humanity except for a few lone souls we met. Three in total over the coming hours. It was a rugged and jagged terrain, yet covered with green resilient flora. We stopped to look at some of the plants that thrive on the mountain top.
There was little shelter from the sun. We knew the temperature would be rising so I had plenty of water on board. Of course this warmed up against my body.
When Linda mentioned stopping at the dam for a dip, I couldn’t wait to get my feet in and refresh. What a moment it was, to step into the reddish water, tanned by the fynbos plants beneath the surface.
The five dams are entwined in the history of Cape Town. They feel remote, sitting above in stillness like a meditating hermit. Some say that they have been forgotten (read here). A small dedicated museum at northern end of the Hely-Hutchinson Reservoir houses the original steam train. It was closed and did not look like it would open any time soon.
Recharged, dripping and grateful for the simplicity of fresh, cold water, on we went. To the right appeared the sea. As the reservoir had, it looked so tempting. There was the feeling that I could dive off the mountain into the blue. Later and warming up, I thought of icy drinks on the beach that I could see. The sounds from the people on the sand wafted up on the wind, yet we were a long way from any form of significant rest. Linda kept me going. Plodding along. The initial climb had taken a lot out of me.
We made a descent down a gorge towards Hout Bay and Llandudno. We chatted about the latter and how it bears no resemblance to the North Wales version. Both have their charms.
This was a bit of a scramble over loose scree before reaching a more defined path around the peak we were navigating. I had to navigate a few tricky points, expertly advised and encouraged by Linda. To many they would be easily traversed, but with a fear of heights I had some extra sweat to manage.
I realised that I had taken something from the Snowden experience in September. Looking back now, I know that these experiences have pushed the balance towards a greater confidence.
There is much to love about mountains: their strength, enormity, resilience, their danger and unpredictable bedfellow in the weather to name a few. I continue to be attracted to the challenge of ultra trails in mountainous regions. The mystery they offer and the contrast to my local running spots draw me in.
The final push up a long jeep track to us to the edge of the park. Across from the parking lot was a smart looking restaurant and bar. Linda assured me they would serve a smelly, dusty runner, and they did. I sat outside amongst the casually dressed Cape Town diners, mostly families, and enjoyed a pint of icy coca-cola reflecting on a tremendous day of trails.
Big thanks to Nicola for organising the tour and to Linda for guiding me and running at the slowest pace that she has had to endure for a long time!
Contact Nicola here for information about guided runs around Cape Town
Read about Linda’s running here. She also coaches runners.
Considering the need for social distancing, I chose a 5k circuit that I could run twenty times. For variety, I changed direction with each lap.
It was still dark when I set off at 5:08am. I love this time of day. It was so quiet, the sky is just starting to lighten and there were just a few people on their way to work or out walking their dogs. Soon enough the first kilometre was indicated by the familiar sound from my watch. 99 to go. I set my mind to the task, resigned to the fact that there were twelve or thirteen hours to go. There is always some comfort in that.
The day was perfect: a warm sun and a cool breeze. There was no need to carry anything as I could simply grab fuel and drinks on each lap, and even stop for lunch at home. My wife prepared a delicious bowl of plain pasta.
Each time I ran down my street, someone would cheer and clap, shouting out words of encouragement. This gave me energy. There was a purpose behind this run, as there is with each upandrun. Usually I am running to raise awareness of the problem of pain, but this time I was using my legs to show support for the NHS heroes.
No matter what discomfort I was experiencing, I knew that it would ease and that I would be in the bath at the end of the day. However, for our NHS and other essential workers (carers, teachers, delivery people, personnel running the public transport, supermarket staff and more), this goes on for now. The run was about them and showing appreciation for what they are doing to positively contribute to our society.
And so the day proceeded: round and round, legs heavier, strides shorter, but onwards I went. The toughest period was 60 to 80k. I had covered a good distance, but there was still a long way to go.
At 1245 I was interviewed on BBC Radio Surrey by Sarah Gorrell. This was a chance to tell listeners about the run and the cause. It was also a break in the monotony.
A friend who runs jokingly called this the Kingston Hospital Self-Transcendence race after the Sri Chinmoy 3100 that takes place in New York. Runners complete a 3100 mile course around a single block in New York. There is a film about it now: Run and Become. This was my version. A much shorter version.
My sense of time was distorted. I find that this always happens on an ultramarathon. I lose track of time, which is wonderful. I simply focus on the next step. The day begins to blur and soon enough, the end is near.
The final lap approached. For some reason, I was a few hundred metres short and had to take the lower road to loop round and make the 100k total. The neighbours were waiting, and as soon as they saw me coming the cheering and clapping began. It was a super way to end the day.
upandrun 14 is a special one. 100k round the block to raise money for the #NHSHeroes at Kingston Hospital. This shall be the Kingston Hospital Self-Transcendence Race*, my much shorter version of the 3100!
Each month I run an ultramarathon. That is a distance beyond a marathon, typically 45 kilometers plus. This will be the 14th since I started ultras last May.
There are several purposes of upandrun. One is to raise the awareness of the problem of pain that affects millions and costs billions. Another is to help people understand how they can improve their lives. But, upandrun 14 (April) is different.
This month upandrun will be dedicated to raising money for NHS staff at Kingston Hospital, my local one. I am pleased to link up with the Kingston Hospital Charity to steer donations to the people who are caring for the sick and vulnerable. It is vital that the NHS Heroes remain well, and our support will help them and their families.
upandrun 14 for the NHS ~ Kingston Hospital: donate here
With upandrun 14 due, it made me wonder how I could use my legs to make a contribution to the NHS. I thought, why not run around the block?. I stay local, the streets are quiet (easy to keep distance from others) and I could clock up a decent mileage. Initially I decided on 50k but then it seemed like a better idea to round it up to 100. A 5k route times 20. Round and round I will go, grabbing refreshments from my crew (mainly my wife, but she does not know yet).
The Kingston Hospital Self-Transcendence Race is a tongue in cheek version of the Sri Chinmoy self-trancendence race. This is a 3100 race around one block in New York totalling, yep, you’ve got it, thirty one hundred miles. If you fancy that, read here. I’ll be doing a mere 60 odd miles.
The course set, the day chosen (Monday 20th April) and the charity on board, it’s all go. I have a JustGiving page set up and on the first afternoon had donations over over £1000 — great start! To get to £3000 would be fantastic, and maybe more…..
Now to take it easy for a few days.
You will be able to follow progress on Instagram (@paincoach) and Twitter (@painphysio) where I will post pics and vids. Please take part, send messages, share and donate what you can!
* The idea for the name of the run came from my old mate Chris, who actually got me into ultrarunning. Ta!
Recent encouragement to get outside and exercise each day means more people are out walking and running. Hopefully we are all thinking about keeping our distance and going out alone or with a family member only. If you have started running or re-started after a hiatus, you may want to think about how you can gradually ease into it.
Amongst the headlines we are seeing a number of positive stories. These are fuel for hope and keep us going towards a better time, which will come. One of the positive messages from the outset has been the encouragement to take exercise — the benefits are well known (examples below).
Joint and muscle health
Better decision making
Protective against a number of conditions
Being active takes many forms. Two of the most simple are walking and running. We can do this in the house, in the garden, up an down the stairs and around where we live. We can also choose simple exercises using body weight or household items.
Started or starting running?
If you are starting from scratch, you may be best to begin by walking quickly to allow your body and body systems to adapt. There maybe a few aches and pains, which is a typical response to new or different activity.
Casual runners maybe tempted to increase the frequency or the intensity of runs. I’ve seen quite a few people chugging along, panting, puffing and blowing. The 80/20 training rule is a good one to follow — 80% low intensity when you should be able to speak, and 20% high intensity. If you are unsure about how much to push because of known medical conditions or you do not feel confident with what you want to do, you should always take advise from a professional.
Before heading out, easing the body into action with some simple, low strain movements prepare you. Examples include walking on your toes, lunges, squats, and pelvic movements. On return, recovery can include eating and drinking to rehydrate and refuel, together with easy stretches. Much has been written on recovery, but studies have not revealed any particular methods that are musts beyond taking the time to get back to baseline.
There are a number of apps and online resources that give advice on gradually building up your running. A good place to start your reading is Runner’s World.
Enjoy your running and being active
At a time when we are compelled to create a new routine, figuring in movement and exercise will be of great benefit to the way you feel and deal with the situation. Yet we need to be sensible. Gradually building our activity levels to reduce the risk of injury and allowing our bodies to adapt. One of the most important points is that we need to enjoy what we are doing! This way, we will keep it going and build our level of fitness and wellness.
I was very pleased to be asked to speak at the Adcock Ingram Sports Science & Rehabilitation division launch roadshow — a whistle-stop tour of South Africa.
Innovative TensCare CEO Neil Wright asked me whether I would give a series of talks in South Africa (Johannesburg, Durban and Cape Town). He had heard that I bring an ‘edge’ to the topic of pain. I like to think so, but only in terms of challenging out-dated thinking that holds us back. What a great opportunity, I thought. A chance to spread important messages via Understand Pain (UP) and to learn about how chronic and complex pain is addressed in South Africa.
The new Adcock Ingram division was being launched to local physiotherapists, chiropractors and biokineticists, and the theme of the events was pain. How could I resist? Adcock Ingram are engaging with therapists and clinicians in a new way that is generating a great deal of excitement. This is based on creating great relationships and distributing high quality products that compliment rehabilitation, including the range of devices from TensCare.
Both the team putting on the roadshow and the attendees were buzzing! The feedback from the people in the audience was very positive. There was a thirst for quality pain education, and it would be great to follow up with full Pain Coach workshops.
In my experience, TENS is under-used for chronic pain. Whilst TENS will not solve the problem, it can offer relief that helps the journey forwards. As an inexpensive and simple form of self-treatment, it is a good option. The key is that the user understands how it works and how to best use the unit. This can take some time and practice, but with instruction, discovering the right parameters can be found more swiftly.
I shared the stage with Nick Martichenko from Canada. Nick spoke about the use of tape and the understood mechanisms, whilst I focused on pain and pain coaching. I entitled the session ‘The Challenge of Pain’ as a doff of the hat to Pat Wall, the founder of modern pain biology, who wrote a book of that name. It was Wall’s work that resulted in the development of the TENS machine.
Three days, three events
On the road…
The roadshow put on by Adcock Ingram was very high quality from start to finish. They really wanted to make sure that every detail was covered. This was appreciated by the attendees who were most enthusiastic about the event. There was a new precedent being set, and the beginning of a new engagement between Adcock Ingram and therapists/clinicians.
I was particularly impressed by the way that the sales team approached their work. Selected and led by Juan Schaerer and Sheila Keshav, this group has come together in a short period of time. There was a great deal of positivity within the team, supporting each other, and getting jobs done from start to finish. I was privileged to be able to hear some the individual stories about how they came to join the team.
From a pain education perspective the roadshow was a great opportunity to talk about ways in which we can help people understand their pain and move on to improve their lives. That’s the purpose of UP. I hope that everyone else enjoyed their time as much I did. This was a super start and I will be very interested to learn how this story unfolds.
The Programme is now open to anyone suffering persistent or complex pain.
Face to face or Skype ~ reaching across the globe with Pain Coaching to improve lives
As the project has proceeded, I have been making changes to better suit the needs of the participants. Now I am delighted to be able to offer the programme to a wider audience — chronic pain is one of the biggest global health burdens.
Participants will receive 6 free Pain Coaching sessions: an initial conversation to understand the person’s narrative, clarify what is important to them, what they want to achieve and outline the steps forward. The next four sessions focus on practical tools: e.g./ practices, exercises, strategies, habits of peak performance. The final session is a summary and an opportunity to look at ways to keep momentum.
The schedule is pretty packed with talks and meetings, yet there is always time to run. Running gives energy for all else.
Starting in Johannesburg where we arrive tomorrow morning, the Klipriviersberg Nature Reserve looks like a great place to get into nature. The second leg sees us in Durban where we have the beachfront as a backdrop. I went there in 2003 on an England Women’s Rugby tour when I was a team physio. The beach was a place to move our bodies, enjoy the sun and the waves, to recover and relax.
Finally, Cape Town where I have not been before. Many people have told me how great this city is to visit. I can’t wait!
#upandrun 12 route from Gloucester to Bath, taking in the Cotswold Way
I started running along the road towards Birdlip to pick up the Cotswold Way. It was just after 530am, the streets were quiet and I was on my way. The streetlights came to an end as I reached the edge of town and began to climb.
In the darkness with my head-torch illuminated, I could see on-coming cars in the distance and I hoped they could see me. Running along close to the narrow grassy verge, I continually created an escape plan in case I needed to take evasive action. That plan, which fortunately I did not have to use, was simply to dive into the bush. I thought it through what seemed to be every few seconds.
The sun was just starting to rise as Cotswold Way signs appeared, the trail bisecting the road. I turned right onto the path that immediately started winding its way down into the woods. It was soft underfoot, with occasional muddy patches, but perfectly passable and even supporting a steady running pace.
Running a trail is the perfect time to be present. The ever-changing pink sky delivered a backdrop for the unfolding scenery as I trotted along. Noticing the changes in light is something unique to being in the countryside, almost moment by moment. It is easy to miss, especially in a town or city.
It felt like it was going to be a good day. I had a plan for fuelling, learning from previous ultras that it is important for me to keep it regular, so a snack every 10k. I was loaded with bars, Kendall mint cake and other snacks, plus I was confident that I would come across a cosy cafe serving great coffee and offering respite. That didn’t appear for quite some hours though…
Mud, bogs, rain, wind
The trail was starting to become muddy, slippery and skiddy. My Speedgoats were helping me stay upright, although I had to slow my pace to navigate these patches. Over the day, I only fell once, imprinting a sizeable brown mark on my left buttock.
Losing the trail in a small Cotswold village, an elderly couple pointed me in the right direction, warning that the field I was about to cross was steep and very wet. It was. That was the end of having dry feet for some hours.
Rain was forecast, so I was not surprised when I noticed a few drops on my face. Playing it safe, I donned my waterproof. That, was a wise decision. Within moments the rain was coming at me sideways. On off went the showers for the rest of the day, mainly on from what I recall. The wind whipped around me, especially on the exposed hills, resulting in a crouching style of running that probably did nothing except make my thighs work harder. Note to self.
It was not the water from the sky that was slowing me down though. It was underfoot. I was fortunate not to lose a shoe as I squelched my way through and round fields that were utterly waterlogged. The animals I passed looked at me and wondered what I was doing. This was the sense of their expressions anyway.
How grateful I was when a farmer gave me directions along a lane rather than over his field, which did not look like a field. It was more like the top of a moist chocolate cake.
On I went.
The Cotswolds Way is far steeper than I had anticipated. Mind you, I do like climbing a hill. There is great satisfaction on reaching the summit and looking back to see where you have stepped and taking in the scenery. King of the hill.
There are moments along the way when you ask yourself why? Pain, cold, wet, miserable weather are all reasons to stop. They are also reasons to go on exploring and discovering. That’s the beauty of ultra. Rolling with the ups and downs, the successes and challenges, one foot after the next. There is no stopping the stream of conscious experience that continually delivers the plethora of unplanned feelings, thoughts, sensations, sounds and other appearances. Noticing this is being mindful.
And so, after about 13 hours, Bath arrived out of the darkness in the distance. The last kilometers followed alongside the A46. The sun had long gone, replaced by a blackness pierced by red and white car lights. Back into urbanity, running along the city streets towards the pizza and beer that had so clearly formed in my mind.
The day ended at 90k. I am looking at when I can move this on to a 100-miler, the next natural step. My feeling is that a supported run would be best, but we will see. The next #upandrun will be in South Africa where I am heading in a week’s time to give a series of pain talks — read here. The plan is to take in Table Mountain within an ultra of around 50k.
In a week’s time I head off to South Africa to deliver a series of Understand Pain talks. This is a great opportunity to connect with clinicians, therapists and others who work with people suffering pain. Invited by TensCare, we will be working together on this tour to educate, enable and empower people to provide best care for pain.
TensCare: We provide drug-free pain relief for the long-term treatment of chronic pain conditions and the relief of the acute pain during childbirth
One of the main issues and reasons why pain is such an enormous global health burden is the misunderstanding of what it is and how it arises. The predominant approach remains biomedical despite the fact that this model does not deliver solutions. Society needs us to build on our knowledge about pain and offer person-first care: it is the person who feels pain, not the body part.
In brief, I will be talking about the purpose of pain, why it persists and what we can do to help and encourage people to move on and live fulfilling lives in their own unique way. This is using strengths based coaching together with the latest pain and related sciences, focusing on meeting the person’s needs. This is the essence of Pain Coaching, which is a skillset and way of delivering care that sees a person first, not a patient or a list of problems. Instead, we see someone with strengths and the potential to improve their life. We guide and facilitate this growth in a positive way.
My hope and aim as ever, is to bring the latest understanding and thinking about pain to society in a practical way.
Towards the end of the trip I plan to run #upandrun 13 in and around Cape Town, taking in Table Mountain. This is the awareness raising part of the Understand Pain social enterprise work, as I continue with monthly ultramarathons.