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.