Somatics: Pain Relief Through Movement

I graduated from Physical Therapy with Leigh Boyles yesterday. I celebrated with a trip to the YMCA and a treadmill run. I wanted to run harder than I had been going and eventually ended the run at 5 miles at my fastest pace yet. It felt good. Some wobbling on the left side, but things are improving. I also had 4 trigger point injections in my left glutes on Friday. I think they have loosened things up a bit. I have been feeling tightness in my adductors at times and I also feel tight at the front of the left hip. I asked Leigh about this and she said that as the front of my hip loosens up (by pushing back as I run) the adductors should feel better.


 One thing that Leigh has been mentioning all along is that I have to retrain the way my brain works through proprioceptive work. This is something the Gait Guys have mentioned as well as Dr. Michaud in the past weeks. There was the mentioning, but finding out what to do about it is hard to do. Sure, some exercises and taping have helped me, I am running noticeably straighter, but how do you get your brain to change your whole-body movement patterns?



Last summer, right before my hip surgery, I discovered something called somatics through Martha Peterson's blog Pain Relief Through Movement and webpage. Some of her movements helped my hip in the weeks prior to my surgery when I was in Kenya. I received her DVD after I returned from Kenya and started going through it again post-surgery a while back. I have been doing the movements more frequently and then I got her newly published book Move Without Pain this month which has new exercises as well as guides to those on the DVD. It also includes a good overview of somatics.

It is a very simple to understand book to both read and use. The pictures and text structure make it easy to read and follow. While the DVD guides you through the exercises and the speed as to how to do them, the book is easier to pull out and review before doing an exercise. These are not exercises that will leave you stiff and sore like yoga or stretching can often do, but they are exercises that feel good and leave you feeling changed. I am not ready to thoroughly review the book at this time, but I do want to highlight the key ideas of somatics. You can read more here from Martha's blog.

1) Sensory Motor Amnesia- This happens when muscles are so tight that they will not relax. One thing that I found very interesting is something that Martha mentions in her book: what looks like a structural abnormality can be an issue of sensory motor function -tight muscles that won't relax. The point of somatics is that because the brain and nervous system control the muscles you have to engage the brain to unlock muscle patterns.

2) Three Reflex Patterns- In somatics there are full body reflex patterns that people us in reaction to stress. The Green Light Reflex involves an arching of constantly tight back muscles. The Red Light Reflex is another stress related posture with a rounded back due to anxiety or fear or from sitting all day hunched over a computer. The Trauma Reflex is a response to an accident or injury and involves a twist or rotation as a way to avoid injury or pain. This can lead to imbalances as your body gets stuck in this pattern.

3) Pandiculation- This is the somatic alternative to stretching. It works like a reset button. It involves making a tight contraction, followed by a slow release of the contraction to lengthen the muscle, and a complete relaxation at the end.

Somatics uses these ideas to help you rebuild your movement patterns and get rid of chronic pain. I highly recommend Martha's website, DVD (more are promised to come out soon), and her book Move Without Pain. It might just be the method to get you to get out of pain, move better, and to recover your stride.

I have emailed back and forth with Martha and she graciously offered to do a Skype session with me. I won't go into too much specifics, but will write down the things I need to remember before I forget them. It was an awesome experience to have someone so knowledgeable take a look at how I move, perform exercises, and offer me ideas to pursue.

We worked on the side-bend (one of the exercises I had found before going to Kenya that helped my sore hip and back before the labral-tear surgery). I learned some tips on doing this move, but most important, I need to slow down when doing it. Here is an tutorial for the side-bend.



We also worked on the back-lift (directions here) and then she gave me a different exercise for my tight illiopsoas that I don't recall as being in the book or on the first DVD but is found right here.

I was also told to check out this post on 3 common mistakes when doing Somatic exercises and this post on Standing Tall and Walking.

I had a valuable learning time with Martha on Skype (first time I have ever Skyped) and a thank Martha for her time, knowledge, and inspiration.

Arms up - Face Forward

A recent article Healthy Running Comes from the Arms and Head Connection over at The Natural Running Center by Jae Gruenke gives two tips to improve your running posture that counter the notion that you tuck your chin in when running and keep your hands low. Her tips are based on the Feldenkrais Method of movement. One is to keep your hands close to your chest, and bring your knuckles to the midpoint of your breastbone on the forward swing as in the photo taken at the World Cross-Country Championships.

 Her other tip is on the face forward head position.

When you run and therefore lean, you still need your eyes and inner ears upright relative to gravity so they work properly for balance and orientation, which means you have to let the distance between your chin and your throat increase in a move we have nicknamed “face forward.” What actually happens is that your skull slides forward on your atlas vertebra (this is the top vertebrae that along with the axis forms the connection to the skull) the same way it does when you kiss someone or when you hunch up at your laptop. But in running you allow this forward movement of your head to cause your whole body to fall forward, rather than just caving in your chest and hunching your shoulders, and it leads you into a beautiful, free, and easy lean.

Jae can be found over at The Balanced Runner. I have enjoyed doing Jae's cds in the past as a method to warm-up for a run or in an attempt to move better. If anyone these cues on a run, let me know how it goes.

Here is a Runners World interview with 3 time Olympian Jenn Rhines who explains her work with Jae  Gruenke and the Feldenkrais Method.

Well, you mentioned earlier in this Chat that there had been some tweaking of your running form. What exactly did you do, and what was the reason a need for that was perceived?
JR: Last year, I was running some decent workouts. I couldn't put anything together in a race and felt like I was really struggling. I felt like my body couldn't do it anymore, so I figured I'm either done or I need to figure out a way to do it differently.  I've been working with Terrence; I also worked with a woman in New York. Her name is Jae Gruenke, doing a thing called Feldenkrais Lessons – basically, teaching your body there's an easier way to do things. Things are starting to stick now. It's starting to come around.
Can you explain a little bit what Feldenkrais Lessons re?
JR: They're called awareness through movement lessons. I was actually doing them with her over Skype. To me, the easiest way to explain it is just that you're doing simple movements and teaching yourself to use different muscles and to do things a little move easily than in the patterns you've been stuck in. For somebody like me who's been running for over 20 years, I was definitely stuck in some bad habits.
One thing I've learned about is how everything interacts together. I'll get a very tight upper body and my arms with be way up high and twisting when I get tired, and now I kind of understand you can't just force yourself to drop them and have it be perfect. I understand more how everything works together.  It's probably still subtle, because I know I don't look dramatically different, but I'm not overstriding quite as much and I'm using my glutes and hamstrings more so I have a little bit higher back kick. It's better for me;  I don't look like a gazelle yet.

Attack Mode

For the last two weeks, I have been on attack mode. I am doing all I can to get myself healed up and it's been enlightening. I have had 4 doctors visits (3 different doctors) as well as 2 PT sessions. I am very hopeful that with all the advice, knowlege, and work that things will start progressing quicker.

First, I had the visit with Dr. Michaud who measured all my angles and joints and gave me somewhat of a confirmation of things that aren't right and what to do to get stronger. A few days after that I went to Dr. Dannenburg and he did manipulations on my knee-popliteus and on a cuboid bone in my foot that was causing my foot to be stuck and not work or move correctly. I also had PT work each week where I am getting graston technique done on my popliteus and surrounding muscles as well as getting taped around my knee as a proprioceptive thing to get my body and mind used to a better positioning of my knee. Today I had 4 trigger point injections into my glute medius. I will go back every two weeks for more for 2 or 3 more times.

My goal 2 weeks ago was to run only a mile or two each day. I got in 7 straight days of running before my glute medius tied up after one run and things fell apart again. The good news this weel was the physiatrist wanted me to stress my glute medius before the injections this morning so I ran 10 miles on the treadmill last night. That was my longest run since August 2010 and if felt good to go that long.

So I have had work on my feet by the podiatrist, on my knees and popliteus through PT, and on my glutes through the trigger point injections. That should cover a lot of things and hopefully everything will play nice together. I have also been doing all my PT work to get my hips strong. I will say that when I run on the treadmill, my hips stay aligned and straight which is very different from how I ran before surgery. Everything from the knee up looks a lot better than before. It is just the left leg rotating out that looks bad. It had appeared to be pointing out about 40 degrees  last month, after seeing Dr. Dannenberg it improved to about 20 degrees, but if I pushed off more on the foot, it got down to about 10 degrees. That tells me I can improve on things.

Despite all that work, I have also written back and forth a bit with Martha Peterson this week and learning more about somatics. I found a few of her videos and postings online a few days before I went to Kenya this summer and some of her exercises helped keep my pain at bay during that trip. I got her DVD, but didn't start working on the movements until recently again as I was letting my hip heal from surgery. She also just published her book Move Without Pain which I have been reading and enjoying very much. Somatics deals with sensory motor training and reteaches the body how to move properly. I enjoy the movements and their effect and they don't "hurt" my body like yoga or stretching often can. I will have more to say on this at a later date, but her book and video are top notch.

Here is a new hip movement from Martha's soon to be released DVD "Pain-Free Legs and Hips" .

A story about consistency and durability

Earlier in the year I wrote about the Baker brothers from New York, Brian and Jeff, and their ongoing streak of running (now) 33 straight Falmouth Road Races. I have to congratulate Brain Baker for reaching yet another significant (and magnificent) milestone. Earlier this month on December 10th, he ran the Rehoboth Beach Seashore Marathon and just dipped under 3 hours with a time of 2:59:53. The 7 seconds under 3 hours are very important. Back on December 2 in 1979 Brian first ran a marathon faster than 3 hours when he ran the Jersey Shore Marathon in 2:56:29 . That marks a span of time of 32 years and 8 days between his first and most recent sub 3 hours marathon. Soon Brian's name will appear on  this international list for longest time spans between sub 3 hour marathons. He will be in 25th place and will be keeping fast company with a list of high quality runners, some with national and world class performances. This is the list I want to recover for and try to make some day. It may take awhile, but it is my primary racing goal, if I ever get up and running healthy again. For me it is just a far in the future dream right now, but the competition is getting stiffer to make the list. It is great to see an extremely consistent runner like Brian make this list. Congratulations and well done!

I think this shows how good it must feel to finish and beat your goal! It must have been harrowing the last few miles trying to get under the 3 hour barrier!

Craig Virgin deserves it!

Craig Virgin is one of America's greatest ever distance runners. He won the World Cross-Country Championships twice (1980-1981). He finished in 2nd place in the 1981 Boston Marathon, qualified for the Olympics 3 times in the 10,000 meters and won the 1979 Falmouth Road Race among other achievements. Earlier this month he was inducted into the National Track and Field Hall of Fame. Here is a video of the incredible finish of the 1980 World Cross-Country Championships. Even if you have seen this multiple times, it is always inspiring.



Craig Virgin certainly deserves such an honor. However, I think what he really deserves is to get himself running again. This recent article tells about the struggles he has overcome and still faces. His body has been through the wringer and he just wishes he could recover his stride enough to run a 10K again some day.

Virgin was badly injured in an auto accident in 1997 and ruptured his right quadriceps during a fall on ice a few years later. He has had 15 surgeries and the most he can run is two miles although he still continues to workout at a gym. He has also three surgeries because of a congenital kidney condition. 

"I'm no longer Craig Virgin the Olympian," he said. "I'm Craig Virgin the middle-age everyman who wants to lose 10 pounds."

and then goes on to say:

"Jimmy Connors still plays tennis. Jay Haas and Hale Irwin still play golf," he said. "Running is something you do because you love it. I still have a passion for it."

You can't take the run out of a runner and for someone who has reached such high levels in the sport of running, it must be incredibly hard to not be able to run. If anyone deserves to get their legs back and be able to recover their stride, I would put in my vote for Craig Virgin. 

 

I took this photo of Craig Virgin at the 1978 Falmouth Road Race where he placed 3rd.

So not born to run!

I had the privilege to go visit Dr. Thomas Michaud yesterday. It was actually more than a privilege as he emailed me earlier in the week inviting me in, after he saw my blog post and a question I had over at the gait guys Facebook page. He is a busy man and the earliest scheduled appointment I could previosly get was next April, so it was nice of him to offer a time to fit me in. He also wrote the book on gait related disorders called Human Locomotion, so I was an eager patient.

I think he was just as excited to delve into the mysteries of my running stride as it is quite a puzzle as I was to hear what he would say. He spent a long time measuring angles, testing muscles, and watching me run. He was giving me a running commentary of all the specifics (I couldn' t hold them all in my head) and was very much interested in what he found.

Basically, I should not be a runner! These are not muscular problems, but structural. He was able to give me a clear overview of what was going on in my body. I have heard parts of it all before, but this is the first time someone has put it all together for me. Basically, I have tibial torsion. I forget some of the numbers for what is normal, but I think he said my right foot is pointed out 10 degrees. I don't really notice this one, but my left foot is pointed out to the side at about 40 degrees! You can't fix that!

Don't let your kids sit like this or they could get tibial torsion!

Coupled with that, my left hip has femoral anteversion. That means my hip, femur and knee want to rotate inwards (hello knock-knees). So while my upper left leg rotates in,  my lower left rotates out. They both meet at the knee, which collapses down. He said that my body was doing some interesting things on its own, trying to make the whole structural mess work and these things aren't bad, my body just had to find a way to work. He also said my left hip doesn't' rotate out (well it does at about 5 degrees when most people get 60 degrees).

He said I also do have the functional hallux limitis, but actually my right foot has it more than the left. One thing that surprised him when I ran was that my left foot suppinates upon landing (trying to hold everything in line) before pronating sharply over. I wasn't correct in the last post that FHL was my main problem. In fact my orthotics are very good. They were made by Dr. Michaud's brother up in New Hampshire.

Well, there is no easy fix. He gave me some exercises to do and the reasons for doing them. Some are based on very recent research. They are nothing new, but now I know which exercises to do and why. I also bought a copy of his book, which is going to keep me busy for a long time. Flipping through, there are many references to conditions like mine.

I was thrilled with the visit and the time I got to spend with Dr, Michaud. It clarified a lot of things for me. I hope to do his exercises and my goal is to just run a little bit each day (1 mile on the treadmill/day) as I try to strengthen and reeducate my brain into doing better movement patterns. Yes, he confirmed what I had read on the Gait Guys website: the brain's mental map needs to be changed. One key exercise he wants me to do is a dyna-disc lunge. I am to hold the lunge for 3 seconds. They wiggling I will feel as my foot tries to balance and for my knee to provide stability is the way that my brain is to rewire itself.



One final thing: he said my muscles were very strong on all the testing. The popliteus was strong too. I am wondering if it is going into spasm when I have difficulty with it?

I was very overwhelmed after the appointment. I finally found a doctor who could look at the whole picture, explain it to me (although I forgot so much), and be excited to work with my at the same time. I think he found my mechanics very interesting. Unfortunately, as I left, I had to come to the conclusion that there are some things I just can't fix! You can't fix twisted bones that rotate the wrong way. It left me a bit sad that there is no quick and magic fix. I will do what I can to see if I can run how I would like run, but I am stuck with the body that I have. My body did work somewhat decently years ago when I was younger, so I need to reverse a few of the compensations and take things slowly.

I read somewhere this weekend some saying that goes something like this. " Do what you should and not what you can." I am going to take things slowly and see if the exercises work. That is what I should do. I have to get rid of the "can" part. I can run 8 miles, but I probably shouldn't at this point until I get things under better control. That will be hard for me as I like to push things, but it is time to do what I should.


And sadly, biking is not and was not the best thing for to do with a tibial torsion and the femoral anteversion. He confirmed that that is what probably really messed up my hip, although in the 1980s when I did triathlons it was my back that felt the pain. He said that the glutes have a mass five times greater than the back muscles which take over the work when my hip isn't working right (or jammed in the joint) and that is why it could not handle the stress. It is also why I have to keep working on my glutes, particulary the glute medius.

1987 Cape Cod Endurance Triathlon: It looks like I was trying to keep the foot straight, but the hip then was jammed. This was my fifth and final Ironman distance triathlon.

Dr. Michaud did say that when running and biking I should keep the knees straight ahead and let the foot do its own thing off to the side.

The popliteus muscle and functional hallux limitus

This is just a quick post for myself before I go for a new and welcome appointment tomorrow. I think I have clarified a lot of my thinking lately and I want to see how right I am. The really really good news is that in the last post I wrote about a doctor who I was told I should go see. I got an appointment, but he is so busy that my appointment wasn't going to be until the end of April. Well he found my blog post and emailed me to offer me an appointment this Saturday as he was going to be in the office doing paper work. Well, isn't that the greatest? I also had a running friend email me as he has been a patient and he also says that he is the best and definitely who I should see! I can only say that I am very fortunate to find a doctor who is very eager to fix problems and to make time to see a new patient. That is quite exciting. The rest of this is more boring stuff, and mostly for my reference, but you never know who may read this and offer some insight or get some ideas to help figure out their own biomechanical problems!
So my hip has been fixed and an MRI ruled out a back or nerve problem so what is up? And what is the etiology, or cause, of my messed up mechanics and problems running. I am going to write what I now think and I then want to compare it to what the doctor says tomorrow, but most important for me is what to do about it all and I think I have found the right doctor to do that!

Last week (after a month of feeling my left lower leg was pointing out more to the side and creating instability on my whole left side) I did some massage on the back of the knee and upper calf. It started feeling better and lining up better. I asked my PT about this and she said it is the popliteus muscle and that muscle can rotate the lower leg out. She then did Graston and deep tissue massage on this and the surrounding muscles. My leg felt better than it had in over a month. I also noticed, however, that when I stand or walk, my big toe really doesn't touch the ground and when I walk or run that left foot awkwardly shifts from from the outside to the inside rotating my foot and lower leg out to the side to try to get that toe on the ground. I also noticed that I have no foot tripod on my left foot (I was aware of this before) as when I  pronate forward the 1st MTP joint gives way and collapses without supporting my foot. The joint and toe is there, but it is almost like it is cut-off and doesn't do what is supposed to do and just gives way.There is a name for this phenonena and it is called functional hallux limitis and I do have orthotics for this, but they seem not to work correctly anymore. So I took out the orthotics ( a cutout under the 1st MTP joint is supposed to preload the joint so this doesn't happen) and instead put a wedge under the big toe which is supposed to do the same thing for the toe joint but in a slightly different way. It is called a cluffy wedge and I bought a set before I got the orthotics made, but I never really used them as I had orthotics. I used them and had a great 8 mile run on Saturday (my only run of the week) and my foot felt much better (of course I got sore muscles from going so far with a change in what I had inserted in my shoe and using a regular insole instead of an orthotic).

So I think that my big toe is the source of my problem.s With functional hallux limitis the big toe joint doesn't work and the foot can't propel itself over the toe, so it finds an new way to do this through pronation. Over time the pronation then forced my foot to point out and that created havoc with my knee (the poplietius muscle). This created the inward rotation at my hip which caused the hip not to work correctly which led to the back pain on the left side for the past 25+ year and the labral tear in the hip. In other words I think the problems start in my toe. Now the question is can we finally fix it and retrain my muscles to work properly. I will be most interested to see what the doctor says tomorrow.

I was also supposed to see the podiatrist who is renowned for his work with functional hallux limitis and made my orthotics this week. I somehow got lost and missed the appointment, which is too bad, because I was looking forward to his thoughts and to get the manipulations on my feet. I have an appointment next week if I need it.

This is my podiatrist showing one of his manipulations for the popliteus:



soft tissue treatment of the popliteus



more on the popliteus and its role as a knee rotator- also ways to strengthen the popliteus



how the cluffy wedge works



My current orthotic works like this with a first ray cutout:



Here is my PT showing a big toe mobilization that I have started doing:




Here is a TRX guy showing some toe joint manipulations:



Here is his explanations for the big toe joint and if I am right explains a lot of the compensations my body has created over the years:

Often overlooked, the big toe is not a big joint (metatarsophalangeal joint) but vital for performance and non dysfunctional movements. Mobility is key in locomotion and reciprocal patterns with the feet like the lunges in all planes of motion. Compensations will happen when motion can't occur in this part, which can give other dysfunctions higher up in the chain, muscle or joints or both. Proper gait pattern requires ability to flex the knee to 40 degrees, the dorsiflex the ankle at minimum of 20 degrees, and to be able to extend the first MTP joint to a minimum of 65 degrees (Oatis, 2004). The inability to extend the first MTP joint due to joint degeneration, structural change, or general restriction is commonly known as hallux limitus and is often seen in running athletes who wear traditional running shoes (not all but many of them). This range of motion is very important in the grand scheme of the "Windlass Mechanism" , which is a passive loading mechanism that occurs as the calcaneus clears the ground in late stance and the weight transfers over the heads of the metatarsals. Combined, these motions load the plantar fascia and intrinsics of the foot that help to transform the foot into a stable lever off of which to push (Fuller, 2000). As demonstrated by Carlson, there seems to be an incremental, linear relationship between hallux dorsiflexion and increased tensile strength of the plantar fascia (Carlson, 2000). As you know, the plantar fascia and Medial Longitudinal Arch are capable of producing a great deal of elastic return in running, so imagine the detrimental effects when this mechanism cannot function well. Those with reduced hallux extension and pronated feet often have diminished effects of this mechanism and ultimately less efficient (Dananberg, 1986). When the big toe does not extend well during late stance, plantar flexion torque decreases and occurs in a delayed fashion (Hall, 2004), knee flexion increases (potentially as a result of tension from the distal end as the calcaneus raises early), and hip extension decreases. To compenstate, there must be an increased drive of the hip flexors to advance the leg. When the foot is fixed upon the ground, this contraction creates potential for lumbar rotation and lateral flexion can occur stressing the intervetebral disks and potentially leading to low back pain and dysfunction (Kapandji, 1974). Add to that the possibility of the body compensating with an anterior tilt to facilitate hip flexion and you have a gamut of issues that sounds a lot like the makings of Janda's lower crossed syndrome with excessively toned hip flexors, inadequate gluteal strength, and possibly an increased full body anterior tilt placing the plantar flexors under excessive load. It is very common in the running world. Additionally, the early knee joint flexion and limited extension of the hips can beget a loss of transverse plane stability possibly as a result of ineffective use of the "screw home mechanism" at the tibiofemoral joint and ineffective activation of the hip extensors. Put all of the above together and you have a recipe for increased forces at the PFJ, shearing across the iliotibial band, potentially increased contact pressures at the anterior hip capsule, excessive activation of the deep hip rotators forcing the hip into a hyperextended position causing decreased sacral rotation during gait, low back pain, and SIJ instability. Clearly, limited hallux extension/flexion/abduction is not something to be ignored.

Jay Johnston's General Strength Progression

Coach Jay Johnston has 5 videos online which detail his general strength progression for runners. They originally appeared in Running Times magazine. Jay says, "The General Strength progression below is the content that I most frequently forward when answering questions on how to improve your running." You can find his post with all 5 videos here. The Colorado mountains in the background are just magnificent. Here is the first routine




These directions are pretty simple and I wish I knew and practiced this stuff years ago. The short routines that Jay presents are certainly worth the effiort and he suggests doing them post run. I have worked through the first routine a couple of times now. His lunge matrix is another valuable routine that I hope to be able to start again soon with my hip. Jay recommends doing these before running or any other work.




Coach Jay also put together two DVDs in his Building a Better Runner series. I did a little bit of proofreading work for Jay on them, so I hope you don't find any spelling or grammar mistakes if you watch them! Here I reviewed the DVD a bit. I found that the DVD had tons of good information, but knowing what to do and sorting through the DVD to figure it out was too much for me. If you want to work on your building yourself up using Jay's methods, the general strength progression posted above is an excellent way to start. He has posted a lot of other worthy stuff online. I would recommend the DVDs to a coach, a trainer, or to an athlete how wants to dig a bit deeper into building up their body for running so that they can keep injuries at bay and fun faster.

Detective Work

I had planned on chickening out on the Thanksgiving morning Great Gobbler 5k in Nashua, but woke up and decided to endure it as I haven't raced a full race since last years Great Gobbler ( I did do a leg in the Mill Cities Relay last December and did the first loop of a snowshoe race -2.5 miles last January).  It didn't go well, but it went as expected. I set an all-time personal worst over the 5k distance. I was huffing and puffing, but my stride was way off and was very discouraging to realize how far out of shape I now am. The only good thing was that I looked at all the results printed from previous editions of the race on the side of the shed and realized I have raced in all editions of this race.  It is now my only annual racing streak left. Listing the results show a huge decline in recent years in my times. I hope it goes on the upswing starting next year as I don't like running like a turkey!

Great Gobbler race results:
2003 19:59 16th originally called a Nashua High School Alumni race.
2004 19:38 15th
2005 19:19  7th  (Awesome snowstorm during the race!)
2006 18:16  13th
2007 18:09  18th
2008  20:10 28th
2009 20:46 31st
2010 22:00 77th  (off the fumes of summer training)
2011 24:45 170th (Ouch- even got passed by a guy dresses as a turkey!)

Last week I only ran twice: this race and 8 miles on Saturday. My body isn't working right, so I don't feel like running.

I know something is off with my body and I am still working on figuring it out. The last few days have been helpful. I had an MRI for my lower back about 10 days ago. Yesterday, I went for the result. I was expecting to hear something about my disks and nerve problems. I was stunned when I was told my back looks really good. I have had left lower back problems since the mid 1980s so this was a weird result. It is good news to have a good back, but what next?

The following is more to clarify my current thinking and keeping it for future reference, so don't bother to read if you have even gotten this far. I tell my students that they should enjoy solving math problems as it is like detective work and they are going to be solving problems all their lives. I feel like I have spent half a life trying to solve the problem of my back and hip. So it is back to asking questions and looking for answers.

I was absolutely floored that my back looked fine and I realised that I forgot to ask more probing questions about the MRI results. They did sign me up for another appointment with another doctor for the week before Christmas. This is another physiatrist at The Spine Center in Newton-Wellesley. This doctor will be looking more a musculoskeletal problems. I was told they made look to do things like trigger-point injections if they find a problem. I would guess they they might find a problem in the piriformis area.

I had a couple of valuable internet interactions over the weekend that were very pertinent and thought provoking. The limiting factor in my running now is my left foot/ankle "tibial torsion" or rotation outwards. The Gait Guys commented on this in 2010 for me- although their response was on their previous website and is now gone. My foot seems to be stuck and angling out more, the left side of my knee is also "stuck" and has a twisty feel to it, and because of this my femur doesn't feel right in my hip (where I was operated on), and my lower back gets tight. I have been stuck in this position for over a month now and nothing I do gets me out of it.  The Gait Guys had a post last week on an external rotation in the foot. I couldn't answer on their blog, but I did have a Facebook conversation with them on this post. It was an interesting post as the externally rotated foot was seen as a "brain issue" where the brain maps out what is the best position in space for a body part to work in it's perceived "best position".

It is quite possible and reasonable to assume that a motor pattern is a natural mechanism for joint and multi-joint protection. Consciously trying to alter a motor pattern is likely to drive an improper pattern or one that is deemed unstable by the brain.


Scenario: client has right foot spun externally into the frontal plane by 15 degrees more than the opposite side.

In this scenario, this could be the reason why merely attempting to turn inwards a right foot that has drifted its way in time outwards does not hold even though it is clearly a deviation from symmetry. It is likely the fact that the brain, in such a scenario, has calculated that there is not sufficient stability in a more neutral symmetrical foot progression angle and thus has found the necessary stability in a more turned out position. As we have always said, subconsciously turning the foot outwards helps to cheat into the frontal plane, likely because that plane is less stable with a neutral foot and with the foot “kickstand” turned out, stability is achieved. Thus, engaging the foot better in that plane gives the brain and body the perceived and actual stability that it feels it needs to more naturally provide joint or multi-joint stability. (read more)

So I wanted to know "what to do about this"... and I was told firstly that,

"The labral tear does not surprise us and the "wanting to turn the foot out more" is most likely a compensation to avoid internal rotation of the hip and impinging on a labrum that isn't there. The fix depends on the etiology: does it start at the foot or is it from above down?"

Ahh, the question I have been asking for years! Their suggestion for me was to visit Tom Michaud who is a chiropractor in Newton and who has worked on many runners including those of international stature. It seems Tom Michaud just published a new and well-received book this year called Human Locomotion.

In the course of a year, more than 1.9 million runners will fracture at least one bone and approximately 50% will suffer some form of overuse injury that prevents them from running. Despite the widespread prevalence of gait-related injuries, the majority of health care practitioners continue to rely on outdated and ineffective treatment protocols emphasizing passive interventions, such as anti-inflammatory medications and rest.

If you start here and forward ahead to pages 8-9, that is a picture that pretty much looks like how my left leg works. The book is $100 and is written for doctors, so it is not something I would buy, but the parts online sure look interesting as it addresses abnormal gaits and even has a section on labral tears. Do I think this guy could look at the whole picture of what my body is doing? I sure do. So I called to set up an appointment. His office is just down the road from the Newton-Wellesley Hospital where I had my hip surgery and where I am going now to their Spine Center. I got a call into his office yesterday. He doesn't take my insurance, which stinks, but still I wanted an appointment. Seems he is a busy guy. I got the first available appointment. It is for April 19, 2012. Well. that is a bit of a wait!



This weekend I saw another interesting video on the piriformis. I guess since I don't have a back or nerve problem, according to my MRI, that this video is even more important, as I still have an extremely tight or knotted piriformis that can be aggravated by running. I left this comment on the site, because the doctor talks about a link between the piriformis and a foot turning out (hey,  my two problems):

I enjoyed the video and have a question. You said this about the piriformis: “Piriformis – this muscle extends from under the front side of the sacrum and attaches to the greater trochanter in the upper leg. The major action is to laterally rotate the hip as well as turn the foot out.” I am a long time competitive runner and my left foot turns out so it is not pointing the same direction as the knee. Could this be related to the pirifomis? I do have a lot of problems on the left side including a pain in the butt post runs, I had arthroscopic surgery to repair a torn labrum in the hip this summer, but the foot twisting out is always there (sometimes worse than others). I am curious about the pirifrmis’ effect on this or does the twist create the pain in the butt?

 

Dr. Gangemi wrote this in reply:

Hi Jim, yes I’d say that is exactly what is happening to you. The left foot would be the tight piriformis (could be your psoas too), with the right side being inhibited (“weak”). The twist is really not what is causing the pain, but the piriformis being too tight is causing both the pain and the lateral rotation – that puts a significant amount of stress on your labrum, hence your surgery.

It is interesting learning about the connection between the piriformis and my left foot as well as the resultant labral tear, But I really don't' want to wait until April to see Dr. Michaud or even the end of the month to have an initial visit at The Spine Center. Will they address the piriformis? Is there where I could get a trigger point injection? Will it help my misaligned left side?

On the way back from the hospital, it suddenly occurred to me what to do short term. Today, I set up an appointment with Dr. Dannanburg, the podiatrist who gave me shoe inserts and later orthotics for my functional hallux limitis in my 1st MPT joints. When I first got the inserts in the summer of 2010, my foot felt great, within a week I was doing a 65 mile week, which I soon bumped up to 85 miles. My leg had a new alignment. However, while I continued to run, my left hip got worse and worse till I had a full blown labral tear in less than two months and I couldn't run at all. My feeling is that my foot and leg were tracking better and my left leg couldn't compensate and "hide from" the torn labrum (which it had been doing for years).

I was thinking about my orthotics post surgery, my leg turn-out and misalignment is getting worse. Then I remembered that it just wasn't orthotics or inserts that Dr. Dannenburg gave me. He adjusted bones in my foot and ankles as well as my fibula. So I think I might need him to adjust my bones again, as several bones in my ankle, foot, and where the fibula joins the knee feel stuck or trapped. He doesn't take my insurance either, but he is a podiatrist who is known throughout the world for his work, so I set up an appointment and will see what he says and does next week. Hopefully, he can get me up and running again with his manipulations.

So it is all about problem solving. I can't tell if there is an end in sight, but I will keep trying to figure out how to get my body out the door and running pain-free again. Never give up!

Awesome story about getting your legs back!

Well this is an incredible story. It seems a Paralympic cyclist may represent her country in the Olympics after a bike crash miraculously gave her back the use of her legs.

 Monique van der Vorst was paralysed from the waist down and had been confined to a wheelchair for 13 years.

She won two silver medals at the Paralympics by powering a bike with her hands but last year she was knocked off her bike in a crash.

 

What could have led to a serious injury actually did the opposite. Van der Vorst started to feel her feet tingle and within months she was able to walk.

Her recovery was so rapid that she started competing on a regular bicycle - then progressed to a point that has seen her earn one of just 11 places in a top women’s professional cycling team.

Van der Vorst is hoping her form escalates to such a level that she will be able to compete at the 2016 Olympics.

So in one year she has gone from an expectation of competing in the 2012 Paralympics to signing with the Dutch Rabobank's women's cycling team and dreaming about potentially competing in the 2016 Olympics. This is the best story I have ever heard of an athlete recovering his or her stride!

After an accident in 2010 my body started to change and after a long/ hard rehab period I am back on my own feet again! For me a new competition has started now, I don’t know were or when it is gone finish but I will succeed and I will run!

Monique van der Vorst



 

Here is a quick interview where she explains how it felt after the accident.

Dathan Ritzenhein on warming up before a run

I only ran 3 days this week: Friday, Saturday, and Sunday and did 8 miles each run as it was just perfect running weather all weekend. That is 24 miles for the week and the first time I have done 8 miles three days in a row post surgery. I also had an MRI Thursday night for my lower back. It will be interesting to see what the doctor finds. Saturday's run was dicey as I had become a bit lazy about my hip stretches and had not been warming up prior to my runs. Today I warmed up first with my stretches and loosened up a lot more. I also pushed today's run the whole way and took almost another 2 minutes off my best time for the course post surgery, however the time I posted would have been an "easy run" time prior to last year. I guess it is a good reminder to make sure that you warm up prior to your run. Here is a video of Dathan Ritzenhein demonstrating how he warms up his muscles and improves the efficiency of his running form using dynamic flexibility movements and form drills. This is not what I do or am capable of doing, but it is always interesting to see what an elite runner can do.

New York Times Article: Hip Procedure Grows Popular Despite Doubt

There is an interesting article by Gina Kolata in today's New York Times: Hip Procedure Grows Popular Despite Doubt.

It is one of the most popular operations in sports medicine. It comes in various forms, all with the same name: Hip impingement or bone shaving surgery. World-renowned athletes have had the operation — the Yankees’ third baseman Alex Rodriguez had it about two years ago and the sprinter Tyson Gay had it last summer.

Hip arthroscopic surgery is a relatively recent procedure and the doctor's skills and knowledge keeps growing in this field. This summer I had hip arthroscopic surgery for a torn labrum and I was convinced the surgeon would find a hip impingement (cam or pincer) of some sort that contributed to my years of running problems, aches, and imbalances. I choose a prominent surgeon, but one who I later discovered does not treat bone impingements (at least that is what I have heard a few times on the internet). Maybe, my surgeon was a good choice for this very reason. My recovery from surgery was swift and my hip feels solid and is pain free. According to the article some sports medicine researchers are beginning to question if shaving the bone when fixing labral tears is really helpful.

One of the concerns that I had pre-surgery was what the surgeon would find and fix as well as what the recovery would be. There are untold stories of botched surgeries on the internet that would seriously trouble any candidate. As I continue to read forum posts online, so many people still struggle with pain post hip surgery and most of them have had the more invasive bone shaving of hip impingements. This is the group that today's article addresses. I have also read numerous stories of great recoveries from this surgery, where athletes are back up and pain free as they continue to pursue their favorite sport including running. As some of the comments on this article mention, as well as comments on other boards, if the surgery helps you become pain free than it is more than worth it to have it done, even if the long-lasting effects are still unknown or being debated I would recommend getting the best surgeon that you can if you are facing such a surgery. I wish the article had quoted a surgeon like the one I had who will fix the labral tears and other impingements ( I had a synovial  tissue impingement that was debrided during the surgery), but who do not believe in bone impingements as being part of the problem in hips with labral tears. My torn labrum surgery was more than worth it, even though I am just getting running again, it feels good to have a working and pain free hip.



Update:
This new book from the author of The Entrepreneurial Patient blog is a must read book for anyone with hip problems and is thinking about about arthroscopic hip surgery or has had arthroscopic hip surgery for a labral tear or FAI.

Happiness is an 8 mile run

Well Charlie Brown, there are lots of things that bring happiness, but if you would ever lace up some running shoes you might just find that a good run makes you feel...happy!

This was not the best week for running. I got in a mile at the YMCA on Monday in between work on the stationary bikes. There are 9 laps to a mile and you have to dodge around walkers, joggers, and the occasional kids who is just bouncing in and out all over the track. The tight corners aren't the best for my hip, but I like that I am a bit more agressive with pace. I got it in at 6:55, but I was huffing and puffing like I was going about a minute faster as I aim so out of shape.

Thursday I got in 2 miles on my treadmill, but the next day I was feeling it. I don't think the treadmill gives me enough variety and after every treadmill run I get a bit achy in my joints the next day. It looked like it was going to be another rough week.

I have one new goal and that is not to run when I feel "off" and I was feeling "off" all week. After PT on Wednesday, when I was told what I think is muscle pain could be a pinched nerve coming from a disc problem, I decided to look that up a bit. I found a few articles pointing to McKenzie exercises that look easy enough. Here is a PDF of simple McKenzie exercises. I tried these and they seemed interesting and they made sense as the Sphinx and Cobra are a similar move to what I have been doing with the Foundations Founder and they are much easier. I also found this video that demonstrates a different take on them.



These are easy enough, but I found after doing them that my back and left leg felt a lot better. Sunday, I decided to give running a shot again as it was such a nice day. For whatever the reason, I felt looser than I have post surgery and a lot more balanced. I did my 8 miler and I felt pretty good and I even felt at times that I was floating down the road. I did not get post run tightness and it was my fastest 8 miler post-surgery by 1 1/.2 minutes and on my last two 8 milers I have dropped my time by 3 minutes without even trying. I really enjoyed the run and it left me feeling very happy! It is good to see some progress for a change and my week and outlook suddenly became much better and brighter.
Thursday, I go in for an MRI of my lower back to see if I do have a nerve and disc problem. I wouldn't doubt it and now that I read about the discs and nerves it makes sense from some of the stufff I have experienced over the past years. I know I sometimes feel a twist in the lower spine, and the pains down my leg come and go mysteriously. I would have hoped the labral tear surgery would have fixed me up good, but I created a bit more problems for myself, it seems, over the years.


Here is Dr. Eric Goodman and a co-author of Foundations talking about getting out of chronic pain and that pain is a product of poor movement patterns. He says that learning where the breakdown is, whether a herniation or bulging disk, is a road map towards learning how to change movement patterns, often brought about through sitting. He says a key movement to learn is the hip-hinge. I wish I was aware of this stuff when I jumped into triathlons in the 1980s as I am convinced that is when I started killing my hip and back. I even recall that near the end of that first summer of triathlons that I couldn’t really bend to make my bed as my lower back would hurt too much - and the was the first signal that things weren't going right. I should have learned the hip-hinge at that time. Because my left foot everts out, I locked my left pedal into that toed-out position, which still caused some pain as I kept changing the right-left orientation of my saddle trying to get comfortable. My hip then was jammed further up the chain and due to the angles it did not work right. Did I start developing the labral tear at that time? Because my hip did not rotate properly, the rotation came from my left lower back and I was in constant pain by year 2 of my triathlon racing and that pain stayed with me for the next 25+ years. I am trying to learn, what I didn’t know then, and that is how to move properly. I get worried that sometimes I have done too much damage, but then I get a nice 8 mile run in and it is pure happiness.
 

Dr. Eric Goodman - TedxAmericanRiviera 2011

And here I am doing the 112 mile bike leg of my fourth Cape Cod Endurance Triathlon (full Ironman) in 1986. I could barely sit or stand without pain at this point during a normal day when not exercising, but I knew of no way to stop the pain and insantiy except by quitting the sport.  I didn't and I did one final year. I guess movement is something that brings me happiness, if it didn't, I would have stopped trying to fix things years ago, quit, and become a couch potato, but that is something that I have not enjoyed doing this past year.

Note my race nutrition for the Ironman distance triathlon: a baggie attatched to the handlebars filled with jelly beans!

Keeping up with Ryan Hall

This is in a subway station in New York City. People are trying to keep up with Ryan Hall for 60 feet. This is his pace for a full marathon. Even Ryan had a hard time keeping up in street clothes. I think it is a neat way to make people aware of how fast the elites do run.

I am a runner

American distance runner, Adam Goucher wrote a blog post today saying he is retiring from competitive running. He has had a great run: Footlocker champion way back in 1993, NCAA cross country champion way in 1998, US 5000 Olympic trials champion in the year 2000, 6th place in the short course race at the IAFF Worlds Cross-Country Championships in 2006 among other championship races. Adam's NCAA cross-country championship race was highlighted in the book Running with the Buffaloes. He has also cowritten a recently released book Running the Edge: Discover the Secrets to Better Running and a Better Life. On the Run the Edge blogpost about his retirement, I liked the opening quote from his book:

“I am not somebody who just likes to run. I am a runner. This is the difference between a pastime and a passion. I like to play golf, but I am not a golfer. I like to cook, but I am not a chef. I don’t just like to run. I am a runner. It is a passion. It is part of who I am and is woven into the fabric of my personality, character, and psyche.” – Adam Goucher from “Running the Edge”

Yes, I am a runner, too and that quote sums it up for many of us who enjoy the sport for more than just the physical exercise!


That is what has made the last year without running real difficult: not being able to run and compte for the first time in almost 40 years. I can't wait to be fully up and running some day, but it is not going as easily as I would have hoped post-surgery. Improvements are hard to come by, as I feel the same as I did one month ago.

Last weeks total mileage = 20 miles:
Thursday: 8 miles
Saturday: 8 miles
Sunday:4 miles

Some days the running feels good and I feel like I am getting right back into it. Other days, I get a pinching pain in my inner thigh and along with it tight shin muscles and discomfort that goes under my knee, around my ankle, under my arch, and into my big toe. I am always thinking it is muscular, but today I learned from my PT that it is probably a pinched nerve of some type in my lower back that radiates all down the nerve. I guess I better call to get that MRI of my lower back that I have been putting off. The back doctor told me that if the MRI shows something then maybe I would get a cortizone shot. I had figured this may be a temporary thing like the diagnostic cortizone shot I had in my hip to confirm the labral tear earlier this year. I was now told that the cortizone shot could be a more long-term solution to a pinched nerve. Today, at PT I got some heavy ART treatment of hamstrings, adductors, hip, and lower back. I think my skin is still glowing with redness, although the PT doing the ART seemed even more sore because his thumb was pressing so hard it was hurting him. This should relieve some of the nerve issues, but if needed it looks like cortizone may help.

Rod Dixon, the NYC Marathon, and the Helmet Cam

Rod Dixon ran to one of the most spectacular marathon finishes ever in the 1983 New York City Marathon. I recall watching on television and cheering on the ever gutsy Geoff Smith as the figure of Rod Dixon loomed in the distance running the tangents and them powered on ahead to create an exhilarating victory for Dixon and a devastating loss for Geoff Smith. It also created one of the most iconic finish line photos.

Here is a video of that race.


Rod Dixon also contributed to one of the most bizarre occurrences at the New York City Marathon. Two years later in 1985 again at the New York City Marathon he showed up in the middle of the race running behind the leaders with a helmet cam strapped to a hockey helmet on his head. Here is an article about the helmet cam from 1985.

I think the helmet cam in races is an idea that never really caught on. Now, I guess there is a thing called a GoPro HD Helmet HERO Camera that athletes like skiers, skateboarders, surfers, and others strap to themselves or to their equipment to record stunning photos and videos. There is even a youtube channel just for these videos. Here is a video of a guy using one in this years Hawaii Ironman Triathlon.

This is a picture that I took of Rod Dixon after he won the 1980 Falmouth Road Race (talking with Joan Benoit Samuelson). I did not use a helmet cam to take the picture. In the 25th running of the Falmouth Road Race in 1997, I was running next to Frank Shorter right after the 5 mile mark (29 minutes flat) when we heard an accented voice call out behind us and Rod Dixon caught up. After awhile the two former champions both went ahead of me, but I really wish I had a photo of that moment when I was running with two former champions.

Release the piriformis and stop jamming your hips

As I am recovering from the hip labral tear surgery, I am still learning new and useful things about the way the body works and correcting poor movement patterns. The book Foundation: Redefine Your Core, Conquer Back Pain, and Move with Confidenceis quite a revelation. I had been doing the basic workouts in the book for only two days and I have already noticed some positive things. As I mentioned on the previous post, I had only done 7 miles of running in the previous 2 1/2 weeks with no run over 2 miles. My body was basically saying, "Don't run like this!" so I didn't.

Yesterday, I woke up feeling aligned and moving well again, and so off I went for a run: an 8 miler and it was the best I have felt post surgery. Here is an explanation of probably the most important of the "Foundation" exercises. It is called the "Founder".



Notice how you press the hips back and where he locates the hinge point. This and the other exercises have already started their work. On the run, my piriformis did not hurt, something it has done on my longer runs, whether during the run or post run. I also noticed my hips are much looser and not jammed tight, as well as I was getting a nice rotation in the hips. These are new experiences for me! Of course, today I am sore, but for a change most of it is muscle soreness in the quads, like you get post Boston Marathon, so maybe I was using them more.

Today, I found these other videos which demonstrate the same lessons on using the hips and freeing the piriformis. They say things in a clear way. If you are having piriformis pain and tightness, maybe it is because you are "squeezing your glutes" and if you hips aren't working right, it is because squeezing the glutes might be jamming your hips. These videos are by Dr. Evan Osar at http://www.fitnesseducationseminars.com/free-videos. There are a lot of interesting videos here worth exploring.

This one shows proper femur postition during exercise and why you shouldn't squeeze your glutes.



In this one Dr. Evan Osar demonstrates  a squat exercise to create more motion and decrease tightness in the hips. This exercise incorporates proper core function during the exercise.



Dr. Evan Osar demonstrates exercises to begin working the piriformis for strength, endurance and stabilization.



Dr. Evan Osar demonstrates exercises for tight piriformis muscl


 Dr. Evan Osar demonstrates exercises to begin working piriformis for strength, endurance and stabilization.



Oh and after 2 days of working on this, I went to my PT session (after the 8 mile run). I was doing squats on a Bosu Ball with an exercise band around my knees to push out against. I was told I was doing excellent squats! I also showed the "Foundations" book to the PT and she said it looked excellent. She liked the exercises and how well the exercises were explained. She said it looked like the book that the FMS (Functional Movement Screen) people should have written.

Losing Power

Saturday night we had a snowstorm that knocked down trees and leafy branches and the power went out. After three nights in the dark, we finally got power and heat this afternoon. Unfortunately, that didn't help my running. Total miles 2 weeks ago = 4 miles. Total one week ago = 2 miles. This week = nothing so far. There are two reasons for this: one,  I feel really tired and two, while my hip feels good and strong I do feel really imbalanced. So I went to the doctor about feeling tired and they did some tests and I was extremely low on vitamin D. They have me doing 50,000 iu once per week for 8 weeks to see if I can get the levels up. I did write about Vitamin D a while back (here and here)and was doing 2,000 iu a day for awhile, but I stopped doing that last winter when I wasn't running. If you are feeling tired, get your vitamin D levels checked.

While my hip feels fine. I was not sure running on it was the best as my muscles just don't feel in balance. I have no problem with that as I had been running for years with imbalances and didn't expect it to change overnight. Knowing what to do about it, is a problem. The PT works on my hip muscles, but the more I do of the exersises the more others things feel off. I had my 3 month checkup last week with the hip surgeon's office. The PA didn't have much to offer as she said that they look at the joint and not the whole body. So she referred me to the Spine Center at the hospital. I went yesterday and the doctor moved my leg around a little, asked a few questions, and ordered an MRI for my lower back. He said he doesn't do the legs, so if he finds nothing on the MRI he'll send me somewhere else. I wish I could find a doctor that actually looks at the whole picture and not just one specific spot on the body!

I think they need to look at my ankle and my knee as something is making my foot evert out to the side again. Some days it seems pretty straight and others days it doesn't. The doctor yesterday did remark to me, "You know your foot is twisting out!" At PT we are working on that some, so I have a lot of question for tomorrow's visit.

Anyhow, when the power was off I did some reading. I read a biography on Mickey Mantle: The Last Boy: Mickey Mantle and the End of America's Childhood. He was quite a heroic figure playing through some tough injuries, but he was also quite a cad. The treatment for athletic injuries back in his day was pretty rough. I also found a book at Barnes and Noble called Foundation: Redefine Your Core, Conquer Back Pain, and Move with Confidence while I was charging my electronics and using their wifi. I had seen the book advertised before, but it had a forward by Lance Armstrong and I don't always trust what Lance signs up to support plus I thought with the word "core" it might just be another "abs" book. This one is very different and the exercises are targeted to the posterior muscles. They were new to me and the program is simplistic enough that I will give it a shot for awhile.

This video gives a peak into the type of exercises. I will write more after I try the program out. I like how it says it addresses muscular imbalances.

Iron War: Dave Scott, Mark Allen, and the Greatest Race Ever Run

 The 1980's was the decade of the triathlon (at least in my mind). The modern sport of triathlon had its beginnings in San Diego, California in 1974, and eventually the first Hawaii Ironman triathlon was held in 1978 with 15 participants. In 1979 a Sports Illustrated article drew some attention to this strange endurance race which was followed by ABC starting to televise the race in 1980 with Dave Scott achieving his first of six victories. I recall watching the race while at college and wondering whether a runner (my pick) or a cyclist (my roommate's pick) would be the victor. Little did we know that a new type of athlete was being born at this race; a triathlete. It wasn't until 1982 that triathlons really captured the imaginations of athletes and people around the world as Julie Moss painfully stumbled and crawled towards the finish line just at the same time that she was passed by a fresh looking Kathleen McCarthy for the win.



I watched that race on ABC Wide World of Sport and then watched it again when it was rebroadcast (due to so many people talking about the incredible finish) in complete awe. I told myself I would have to try this new sport and I became one among thousands of others that had a new goal to pursue. Triathlons suddenly started to take off! As soon as I heard about an Ironman distance triathlon taking place on Cape Cod in September 1983 I was in, even though I had no bike or swim background. I did three triathlons on Cape Cod during the summer of 1983. My first was a local sprint triathlon held on my hometown of Falmouth on Cape Cod with less than 100 track club participants taking part, the second was the United States Triathlon Series race held at Old Silver Beach in Falmouth. Julie Moss showed up to MC a workshop on triathlons the day before the race that had over 900 participants (all in one swim wave on a stormy day). The third was the Cape Cod Endurance Triathlon where I swam and biked further than I had ever done in practice to complete an Ironman distance race. I competed in triathlons throughout New England for 5 more years ending each season with my favorite, Cape Cod Endurance Triathlon.

It was exciting to participate and to be somewhat of a pioneer in such a new sport. New athletic heroes turned up, including the "big four" of triathlons. Dave Scott, Scott Tinley, Scott Molina, and Mark Allen. Both Tinley and Molina would venture to the Cape Cod Endurance Triathlon and win it in the 3rd and 4th editions. Dave Scott showed up one year to race at the Bay State Triathlon in Medford, Mass. I came out of the bike transition to find myself running directly behind the awkward stride of Dave Scott himself. I held on for about 1/4 mile before I let him go. He was a lap ahead of me anyway! Other than those appearances I had to catch the big four on televised triathlons or on the pages of new magazines like Triathlon and Triathlete. These guys were aerobic and endurance animals of a completely different nature than the runners and marathoners I was used to. They had strengths and skills that were beyond the world class runners, so that while they may have been very good at each sport individually, they became great when combining sports together.

Magazines and television shows didn't always tell you all of what made them tick. This is why it is nice to finally read a book that delves into the biggest two of these stars: Mark Allen and Dave Scott. Iron War: Dave Scott, Mark Allen, and the Greatest Race Ever Runis a book that looks at these two athletes and their physical and inner struggles as they race in the epic 1989 Hawaii Ironman Triathlon, a race where Mark Allen finally defeats the 6 time winner Dave Scott in a side by side dual to the final minutes. I enjoyed the read as I recognized the names of the triathletes and races from the 1980s when I was following everything that I could about the sport. There was a familiar feel to the book as I was revisiting past events that I began to recall and in fact since many of the the author's retelling came from the pages of magazines I have read or the televised shows that I watched it should sound familiar. The retelling of the 1989 race is augmented with stories of prior events in the lives of Dave Scott and Mark Allen and because of this the book and author have come under fire from these two men themselves. They are not happy with the book at all and together wrote a letter and  have filed a lawsuit against the author and publisher.

We’re writing this because we believe that the soon­‐to-­be-published book from VeloPress, entitled  “Iron War,” inaccurately  and  inappropriately  portrays  us. As  an example, in the advance copy sent to the media for review, the author stated, “In  a sober, clinical sense of the term, Dave and Mark are both somewhat psychologically unbalanced.” We have never been diagnosed as “psychologically unbalanced” by any medical or mental health professional.

 And there’s a lot more where that came from—too much more for us to simply look the other way. Indeed, “Iron War” author Matt Fitzgerald has written an endless stream of inaccurate and defamatory assertions about our lives, our thoughts, our motivations and what drove us to such a high level of athletic excellence in what he spitefully and negatively describes as “the showdown that left one battling his inner demons to emerge victorious and one devastated on the pavement and unable to forgive his loss.”

In respect to the author, the book, and the two athletes to whom it is about, it leaves one to question whether to read the book or not. I decided to read it. My observations is the Matt Fitzgerald is a fan of the sport, the Ironman, and these two athletes. In reading the book I got a sense of the respect he had for their achievements. As the author, I guess he took some liberties, because he quotes conversations and small details, like the songs on the radio the morning of the race or actual quoted conversations, that I am sure are not accurate, but help propel the "story" that he is trying to tell. I think that is what all authors do, as long as they remain true to the story.  He also makes a case that both had some type of "psychological imbalance" (as noted above quote from the letter) that drove each man to his athletic greatness. Without coming out and actually saying it, except for one mention of the word, he hints that Dave Scott might be bipolar. He also talks about the relationship that Mark Allen had with his father. It sounds like the father was pretty much absent in Mark's life until he achieved his fame, and that Mark was on a type of "spiritual" search throughout his life that culminated with Mark looking into shamanism due to events and "visions" leading up to the race in 1989. With the recent revelations that Frank Shorter made about his abusive father, it was hard to tell from the book exactly what the extent of Mark Allen's relationship with his father was and what difficulties they shared, but it does add a bit of mystery and uncomfortableness with the remarks made in the book.

If you read the book for the excitement of the race and for the background information about triathlon's beginnings and first heroes, I think the book is a purely enjoyable read. I believe that Matt Fitzgerald was reaching for writing a book that might rival the popularity and excitement levels of Chris McDonald's "Born to Run". He, like the author in "Born to Run", even added chapters that related to the science behind the pain and the brains that make athletes achieve great things like these two men. As for the athletes being "psychologically imbalanced" I think that may apply to many if not most great endurance athletes. As for Dave Scott and Mark Allen, these are not really new definitions of their character or inner demons.  I decided to take out all my old VHS tapes of the Ironman races and other triathlons from the 1980s and 1990's after reading this book. While watching my copy of the 1987 Nice Triathlon a segment mentioned Dave's "down period" in the previous winter when he gave up on competing and training due to being in a funk. It also mentioned Mark Allen's forays into spiritualism and shamanism which marked his spiritual search and while not mentioned in the book, it would certainly denote a need and search in Mark Allen to find a mentor, guide, or fatherly figure to help him bring clarity and meaning in his life in replacement of his own father. So Matt Fitzgerald is not saying anything new or revealing. He is just organizing a book around a race and the personalities of these two men to sort out their "greatness" among lesser athletes.

I found it to be a worthwhile read and it has me revisiting my days and races in the 1980s when being a triathlete was full of excitement, physicality, coupled with a spirit of adventure and testing of my own bodies strength and resources. Fans of the sport should find as much inspiration when reading the book. I am not sure how much the book will do for those who know nothing about these two athletes (can that really be so?). Mark Allen, Dave Scott, and the early triathletes should not be forgotten. These were the days when the sport was full of a kind of wonder and bravado that is missing from the modern day triathletes, who to me seem overly scientific, clinical, and spend-happy. Who cares about getting online coaches, data from meters and computers, as well as bicycles, gear, and entry fees that cost exorbitant amounts of money? Just get out there and train all that you can, have fun,  and see where your body can take you. That was the spirit of the 1980s! A better book is waiting to be written. Maybe Mark Allen and Dave Scott can add some input, but I would like to know about what drove all the stars as well as the common athletes to suddenly pursue a sport with so much passion. It must be noted that "cross-training" wasn't even a word on the mouths of athletes until triathletes started and people decided to be more that one-sport athletes.

One further note. I stopped competing in triathlons in 1987. I got married in 1988 and no longer had the time to train plus my body had completely fallen apart due to back pains that I guess are related to the hip surgery that I finally had this summer due to a torn labrum. I trace all my pains and problems over the past 20+ years to my faulty cleat and bike positioning. Post surgery I feel better on the bike than I did in all five years of triathloning.  In 1990 my son Andrew was born. The day after his birth I watched the Ironman broadcast of this 1989 race at the hospital and held my newborn son on my lap watching his first television show. I was hoping that my interest in the sport might rub off on him at an early age. Last year he completed his first triathlon just for fun! I guess it worked.