Sunday, May 31, 2009

Running With No Pain and Straighter Hips

I was not able to run from Monday until Saturday. My back on the left side was in spasms again. It was a repeat of what happened in March. My mid back on the left side was really sore and would not work. It was hard to move, turn over, or bend so I did not run. I do think I know what is going on, however.

I have had back spasms like this four times now that I can remember and that offers a big clue. The first time was about 10 years ago. I was running the Cape Cod Marathon and for the previous 2 months I was adjusting to orthotics. It seemed that as I used them I needed more and more of a lift in the right shoe. I was up to over 1/2 inches of lift when I started the race. I had some tension in my right back (with the lift) and I just braced that side with my muscles as I ran. It worked for 16 miles but as I went to get a drink at a water stop, I relaxed, and the whole right side went into a horrible spasm. I grabbed onto a tree and it took about 5 minutes to just get onto the ground. The race was over.

A couple of years ago I was getting ready to run the Boston Marathon. I had gone through 11 sessions (one more than normal) of Rolfing the previous summer, but my hips were again out of alignment. I went to a different rolfer about 10 days before the marathon for a tune-up. He did a different type of rolfing, Rossiter, where you are stepped on to apply a lot of pressure and then you move your leg or arm to release the tightness. I took as my pressure as I could and it was very painful and powerful. I also had some back movements or adjustments done that were supposed to help my imbalances. I felt great when done. Running was fantastic, but on the second run, I felt something in my left side, and by that evening I was going through the same back spasms I had this week. I could not run because of my back and my first run was the Boston Marathon where I figured I would run a few hundred yards and be the first to drop out. It was a nice day. I made it to 9 miles before I had to stop and wait for hours for a bus to pick me up and deliver me to the finish line.

Then I had the same problem in March and again this week. I can now see a link between all of them (even when the first was on the other side). I believe it keeps happening when I get my hips level and in balance. My hips do fine, but my back muscles are not used to the shift in balance and they react with the spasms.

I think that is a reasonable explanation for the spasms and they happen when I am too aggressive in making changes. Earlier I have mentioned DVDs I have received on something called The Malalignment Syndrome. I had bought the two DVDs and was using some of the muscle energy techniques back in March and again last week, along with some new stretches and movements based on the book from an ebook called Run With No Pain. When I got my hips into a better balance, it seems that the upper back hasn't been able to handle the redistribution of loads and I get the spasms. I talked with my chiropractor and he said this is a reasonable explanation.

While my back was in disarray again this week, I received the textbook on Malalignment Syndrome from Amazon (the most expensive book I have ever bought) because I needed to read further, even though this stuff can be way over my head. I am starting to make some sense out of it and I am getting a new education and insight into what possibly could be my imbalance issues. First of all, the book contends there are 3 typical Malalgnments of the pelvis, rotational (posterior and anterior), inflare and outflare, and upslip and downslip. I think I have two of these. I was working on the posterior rotation of my right hip (confirmed by my chiropractor), and after reading more of the book, I think I should work on the left inflare and right outflare of my hips first. When this gets resolved (according to my reading) the posterior tilt often clears up. Of note, Dr. Wolf Shamberger contends that a majority of children become misaligned at some point. I know I have been misaligned since before I started running. In Junior High I failed the scoliosis test and was sent to Boston Children's Hospital for many visits where they tracked my "short leg" and even wanted to do surgery at one point (they did the surgery on my brother).

The past 20+ years, I have lamented the fact that my left leg rotates in and no one can fix it. I am looking at that in a new light, however. Maybe there is nothing wrong with my left leg. Maybe it is the hip that rotates in (inflare) on the left side and rotates out (outflare) on the right side. This makes a lot of sense (because the left hip is rotated in- the femur then is rotated to the right and forward- and I get the "stuck" feeling in my hip as well as that awful stride) and it seems to be backed up by the fact that when I do the Muscle Energy Technique movements, my hips feel straighther, the knee and left femur doesn't rotate in, and my left leg straightens up and starts pointing forward instead of out to the side.

I am working on keeping the movements simple and easy realizing that all havoc could break loose again if I push the exercises. I was able to run pretty well the last two days and while things were not perfect, I can tell my body is readjusting. I notice many positive changes in my stride and balance, however I think I need to be patient and allow everything to adjust and change without going for long runs everyday things start feeling good.

The Run With No Pain ebook I mentioned earlier is a small ebook produced by Ben Greenfield. Some of the exercises are based on his reading of The Malalignment Syndrome. The ebook is short (he has doubled the pages with new information from the 5 pages that I got when I first bought the ebook). However it has links to videos of the exercises and the demonstration and exercises he has put together are well worth the expense if you think that you have a posterior or anterior tilt of your pelvis. The exercises are not geared for the inflare/outflare or upslip/downslip conditions. The exercises work each side in a different way. I think it is a well put together program, but I am going to concentrate on my inflare/outflare first although I use a few of these exercises as they just feel good and right.


Scotty "PHAT" Graham said...

I no doctor but if I were and you came to me and said; "every time I train or run a marathon my back goes into spasm", I'd say "Don't run marathons Jim".

I know it must be frustrating for you. Keep the faith and I'm sure you'll get it figured out.

Hey are you going to be running Hollis 5K?

Jim Hansen said...

Hi Scott,
Yes, I am running the race, will I see you there?
If I listened to the many doctors who told me that I should not run at all, I would have stopped over 20 years ago.

Scotty "PHAT" Graham said...


Way to go at Hollis!! You ran a super fast race. Don't listen to the doctors!!!

The guy who won the 50 - 54 age cat. is a good friend of mine. He's super fast and you weren't to far behind him. WAY TO GO!!

Jim Hansen said...

The downhill makes the time sound better than the actual effort. You must be talking about Kevin. I "know" he is very fast. There is no hope of catching him. I got to talk with him some at the race.

Anonymous said...

Hi Jim,

I just discovered your blog and I know you posted this long time ago but I'm wondering how you're going. I also have alignment problems and I love to run nothing like a marathon but you around 10 kms is lovely but I have had a continual succession of different injuries.

I have the two DVD's you mention and I'm also struggling to read The Malalignment Syndrome which is hard. I also have Ben Greenfield's book which as you say is aimed at rotational alignment. I know I have a right inflare and left outflare and maybe that's all I can confirm so far although I feel sure I have the whole syndrome possibly from other symptoms and also it says that is the most common presentation however my partner did the tests on me and says my legs were the same in the sitting lying test etc. Anyway I have just started to try to correct the inflare/outflare but it doesn't correct fully, just improves but it is still out. It's back the same by bedtime. I'm also causing myself a bit of an issue with pain in the glute on the right side and tingly knee etc on that side maybe from the corrections.

I'm checking twice a day. Would love to know how successful you've been.


Jim Hansen said...

Hi Lauren,
There is something to these books and techniques but I could never fully figure them out on my own. I think I ran for so many year through all sorts of imbalances that fixing one thing set something else off.

That is not to say that they won't work for somebody else. I finally had to stop running in September this year.

The rest did nothing for me. I was thinking I would need surgery for a labral tear in the hip or something else. I got more bad PT that did nothing, but then I saw some online videos for foam rolling and stretching that were new to me. When I realised the PT that made them was an hour away I got my doctor to refer me there. I have gone in for therapy 5 times now. Saturday I did 3 miles outside and Sunday 3 more without the muscle pain of the past 6 months and more.

She is all hands on, working the muscles of my foot, leg, and hip. She says that there were so many tight bands. We'll see how it goes long term, but it is a promising start. I don't know if it will change structure of my body- doctor said femoral anteversion-maybe another name for inflare, but it seems to be loosening up my hip which just wasn't working.

In the end, it seems to come down to having the right therapist and they are hard to find.

The other things I am learning is how the toes, foot, and calf have a big effect on what the hip does. If there is disfunction there-you will find it also in the hips.

This is the website for the self-massage and stretching (great tutorials) , but we are not even doing this with my PT time. It is just the hands on work on tight muscles.

Time will only tell if this finally straightens things out so I can run long again.

Good luck-running should not be so hard!

Anonymous said...

Jim, thanks for taking the time to discuss. I also was up for surgery for a labral tear in my right hip but after 6 weeks not running I went back to the physio and he said it was all fixed. Then I got shin splints in the left leg. I have just changed to a midfoot strike to try to help this and am running okay for a short way but I just have this feeling if I don't fix what's wrong it will all blow up again when I increase the workload.

I know I pronate awfully on the right side but when I got orthotics, probably when my pelvis was out of alignment, they almost crippled me. Its a bit of a mystery to me but could be so many things or a combination.

Will take a look at the website - thanks for that. Thanks for the advice. ;-)


Jim Hansen said...

I will agree with you that orthotics can seem to make things worse. I got the same result when I got mine. I thought they would make me better, but the rest of my body wasn't ready for the changes due to imbalances.