• Acute Taperitis

    by Dr. Neil Feldman
    on Sep 8th, 2016

“Trust thy taper.” It’s a time proven way to maximize your race potential. Not trusting the taper however, is an unfortunate mistake that most novice marathoners and triathletes make in the 3 weeks leading up to the big day. Most training plans build off of a long base of fitness, work through strength, then perhaps speed, and crescendo at 3-4 weeks before race day. The taper begins so that your body is ready to perform to its ultimate ability after building the fitness, strength and speed, and then giving that body a chance to recovery properly. As is usually the case, it’s the mind that gets in the way. You stop running 20 milers or biking a century ride, and next thing you know, you put on a few pounds and feel a little sluggish. The novice then goes out and runs an all-out 10k or bikes 80 miles hard just to prove they still have it. To their amazement and gratification, they DO have it. But it comes at a cost on race day, because by interfering with the recovery process essential to every taper, you lose the ability to go back to that proverbial Well (of fitness) during the race. Novices realize that there is no deep left when they go digging for it at the moment of need. Again, this is time proven and will continue to happen for those who don’t trust thy taper.

The other serious “wrench” that gets thrown into the taper period, and also undermines the body’s ability to recover in the 3 weeks leading up to race day, is something I commonly treat in my Athlete population. It is a condition heretofore to be known as, Acute Taperitis.

Taperitis is an acute inflammation of something in the body that seemingly comes out of nowhere to cause pain and disability that could compromise the ability to do the race. I surmise that the underlying problem is less about a serious physical ailment, but more to do with combining a new, minor physical ailment with a major emotional response to the possibility of not being able to participate in the race. The treatment, therefore, must be aimed at getting the mind to understand that, whatever the physical pain is, that it won’t interfere with race day and it’s something to be overcome. This isn’t to say that some people don’t break down and have major injuries, or minor injuries at the wrong time. More often than not, however, injuries will happen in the weeks leading up to the taper period, during the highest volume of training and intensity, and not during the taper itself.

The two most common foot ailments I see that fall into the category of acute taperitis are number 1: plantar heel bursitis that mimics acute plantar fasciitis or a calcaneal stress fracture, and number 2: forefoot pain that mimics a metatarsal stress fracture. When treating each of these possible ailments, the unique factor is that despite feeling a lot of pain in either the heel or the metatarsal area, the pain isn’t consistent. It may feel as though the foot is broken one minute, and normal the next minute. Associated signs and symptoms of injury such as swelling, bruising or consistently feeling pain are not usually present. During the physical exam, the pain is often relieved by finding a triggerpoint(s) elsewhere in the foot and/or ankle. Treatments aimed here typically relieve the pain completely, even if just for a few days. In these situations, it’s important to realize that the problem is NOT serious and should not jeopardize race day.

Believing in your ability to perform is crucial as this condition truly is a case of mind over matter. The pain is real, but the pain is also amplified many times over out of fear that all of the hard work and effort you just put in for the past months is all for naught. Pain shouldn’t be ignored, because sometimes injuries do happen. However, if you can get the pain to disappear by treating an associated trigger and all signs point to a diagnosis of Acute taperitis, then understand that come race day, the body will respond to the best of its ability, and put forward the performance you earned through training.

Author Dr. Neil Feldman

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