Tuesday, March 20, 2012

An Epiphany of Sorts

Alternate Post Titles:
1. Why Trail Running is Bad for Me
2. It's All in My Head

Solid progress since my last post, which was highlighted by a 3-mile, nearly pain-free run today. My range of motion and flexibility have dramatically improved. Additionally, the pain in my left knee is no longer nearly as acute when running. The mandate is still "run to the point of pain," but that point is less painful—more of a tug than a stab. Still, my longest run until today was 2.5 miles, but most have been 1.5 miles. Yes, its frustrating, but I am seeing progress. Today was an affirmation of that.

In my last visit to Jamie, he worked a lot on my right hip flexor and back. And, yes, for those of you scoring at home, the pain is in my left knee. He did do some focused work on the adhesion in my left leg, but based on how tight my entire body is he wanted to focus on, essentially, lengthen me. Since there's no way I can accurately explain how all the pieces are affecting each other, I can say that it's clear that "it's all connected."

With that in mind, I set off on my run this morning not thinking about my leg, but about my back. I wanted to stay long. Stay tall. And, in this process, I started thinking about my head. I realized that everything was titled forward.

Look at these pictures:

In both of those photos, note how rounded my shoulders are and how far forward my head is. I believe that position is causing strain on my back, pelvis and leg. "It's all connected." In short, my posture sucks. Granted, my everyday posture isn't the best (although I'm sitting up very straight while typing this), and it translates into and is exaggerated in my running posture. So, today on my run I really focused on keeping my head up and "running tall." I think it made a huge difference. And, I think with practice, it will make an even bigger difference moving forward. It did feel a bit odd, but that's just because I'm not used to it. I'm used to trail running and having to look down (to save my weak ankles—"It's all connected.). All that looking down has lead to bad posture, tightness and a jacked up knee.

Now, I know it's not that simple, and Lookout Mountain was the tipping point. I asked Jamie about that, and he said that that's exactly the case. All these small issues have existed, but putting them through 50 miles brought them over the edge. Now, each of them has gotten bad enough that they've each taken on a life of their own. But, we're addressing each one. More importantly, all this work has made me realize that I need to work on my mechanics. I need to "run tall." And, it's affirmed the notion that I'll be better off in the long run. Jamie feels that at this point, aside from the acute IT issue, we're really doing work that will set me up long term. I'm a big fan of that.

Admittedly, my knee has been sore this evening, but that's not a surprise. I'm not ready to start running for real yet, but I can feel myself inching closer. Almost time to put the training schedule into the planner for that goal race in the fall.

Friday, March 9, 2012

Two Months

More silence on the blog as I cross the two month mark with no real running to speak of. So, what exactly is going on? Not an easy answer. The simplest way to put it is: "My knee hurts because my entire left leg is stuck together." But, that doesn't tell the full story.

I wrapped up my five sessions with Julia, and she came to the conclusion that there was nothing else she could do for me. That's one of the things that I really like about Julia: she's realistic about what massage can do. And, in my case, it was only so much. She did a fantastic job of stripping away the top layers of nastiness, but she couldn't get my left leg to release. The knee pain persisted. She referred me to Jamie Raymond, a sports chiropractor that many of my friends had seen in the past. Admittedly, I was a bit skeptical as the one and only time I'd seen a chiropractor previously was a terrible experience. (It was near the end of our Appalachian Trail journey, and he didn't help a bit.) However, I knew that I needed to see a doctor, and he was the logical choice.

My first appointment with Jamie was eye opening. He had a great deal of praise for Julia's work as overall I didn't seem too bad. We spent an hour with evaluation and a lot of popping, cracking and twisting. Needless to say, it was unpleasant, but my entire body felt a lot better afterward. Maybe there's something to this. (He even popped a "frozen" rib that I thought I was shoulder pain that I'd been dealing with for about 10 years. He spent 20 seconds on it, and it hasn't hurt since.) Jamie asked me a ton of questions, and keyed in on two areas: my glute and my ankle. His diagnosis was that my knee hurt because my glute wasn't firing properly, essentially causing the knee to overwork. The cause of the glute problem was my weak left ankle, which I had forgotten mostly about aside from rolling it three miles into the 50 mile race at Lookout Mountain. After that appointment, I looked back through my training logs and remembered that I rolled it badly in August, re-rolled it two and a half weeks later, and hobbled along for much of September. After a series of tests, it was clear that the left ankle was very weak. But, by the end of the appointment, he'd managed to work my glute so it was indeed firing properly. He gave me a series of exercises and sent me on my way, confident that he'd have me up and running after 2 or 3 visits. Additionally, since I'd been able to walk around pain-free for about a week, he asked me to do a couple test runs to see how my knee would respond. Instructions were "to run to the point of pain." That was a month ago.

Fast forward to today. Essentially, nothing has changed. My runs have been limited to 1.5 miles. (I did push one run to 3 miles, but that was clearly a mistake. My knee was extremely painful for the rest of that day and most of the next. Runners are good at pushing through pain.) Each time I head out to run, I'm fairly certain, I'll be back inside 12 minutes later. That's been the pattern. However, with each visit—4 total now—Jamie has found something new. First off, the top of my IT-band will simply not release. It's stuck. He's been completely wailing on it: "Hold on tight to the table here. Now relax." Ummm...right. Please ignore the cold sweats. Secondly, my hamstring is stuck to my IT-band just above my knee. Adhesion is the medical term. I have adhesion out the kazoo. (Not a medical term.) Third, my aforementioned ankle weakness, which is creating an unstable platform. And, last but not least, my popliteus muscle, which I didn't even know existed, is completely jacked up. (Not a medical term.) It's a stabilizing muscle at the top of the calf/behind the knee, and mine is completely overworked. With the other issues in my leg, it's no longer preventing my knee from rotating inward, hence the stress on the IT-band at the knee. The discovery of the popliteus issue (great movie title!) arose from how I feel on each run. I'll feel 100% fine for about a mile, then I'll start to feel tightness behind my knee. Not pain, just tightness. Soon after, my IT-band will begin to hurt. That progression has been consistent in all my runs. However, I can say that on both my runs this week, the pain in my knee was less stabbing. So, I have that going for me...which is nice.

Where does this leave me? Today, at my appointment with Jamie, I was prepared to have the "what else can we do?" talk with him, but he actually brought it up first. He admitted that there is a lot more going on than he initially realized. He also decided that I should see him twice a week, rather than once, to aggressively try to break up the adhesion in my leg. Today, for instance, he scraped my IT-band. Yes, scraped. Picture using a spatula to clean out a dirty pan. That was my leg. Needless to say, it was unpleasant. However, I can handle 15 minutes of unpleasant, if it'll break things up. I have a series of stretches that I'm doing, and I'm going to stick with my test runs. Running is the only thing that will give us a gauge of progress. Yes, running for 12 minutes is mentally scarring—it takes me longer to get dressed—but I have to do it. (Last week, I only ran once because I was...let's say, despondent.) I'm confident that Jamie is going to help heal this injury, but I know it's going to take time. Hopefully, my patience can outlast the adhesion.

Unfortunately, there's no answer to the obvious question: what's next? More treatment. More stretching. More foam rolling. More exercises. Being injured is brutal. Today, he asked me about biking. I laughed. I told him, "I don't run to be fit or healthy. I run to run." I have zero interest in the bike or the pool or the anything else. Only one drug for me, thank you. I have been really good about my core exercises, though. I wouldn't say I'm starting to like them, but I am starting to hate them less. That's positive. But, again, it's really all about doing the things I can to get healthy and waiting.

Oh, one more thing...I've already chosen my goal race for the fall.