Thursday, September 13, 2012

Sitting on the Bench

I have decided to stop running and exercising for now (what a horrid opening sentence). The great thing about the sport of running, when I was a kid, was that you never had to sit on the bench. You always got to train and race, unlike in other sports where you had to sit out and watch others play. I am not a bench sitter or at least I never aspired to be one. I like to be "in the game" and putting in my best effort. I am, however, a bench sitter for the time being.

Now that I have retired, here are the results of my last two weeks of running before I pulled the plug.  Two weeks ago I got 22 miles of running in along with 28 miles of cycling, 8 miles of kickbiking, and an hour of mountain biking. Last week I did 16 miles of running, 8 miles of kickbiking, and 8 miles of cycling. My muscles are just not working right, I am extremely fatigued after each run, and I am just tired of my body not working right and my muscles tightening up and leaving me feeling uncomfortable just about all the time. I have tried to push things, but it doesn't want to work right. My last 8 mile run was my fastest run post-surgery by about a minute, but I had to lie down exhausted the rest of the evening and it took 24 hours for the fatigue to lift and then I still had muscles all around my left hip, back, and leg tightened up for a couple of days.

I have tried various shoe inserts: 3 different kinds over the last month and I am now wearing my orthotics that I stopped wearing in April. At least they are comfortable, even if they don't seem to work correctly with my feet like they should.

This week I have done nothing, not even cycling and I am still tired. I have been sifting through options the past month trying to figure out what to do as I need some type of therapy.

I saw my surgeon last week for the follow-up to the cortisone shot I had one month ago. The shot seems to have taken out the inflammation that was tightening up my hip joint previously. My hip looks great from the surgery. He did mention something I never heard before, that my femur has a flatter head and doesn't sit in my hip properly, but I always had that it seems. Otherwise, he had nothing to offer in advice, beyond stretching the hip flexors. He did say the adductor tightness could be an impingement of the synovial, but he didn't explain that or say what could be done about it. I did ask if the hip tightens again, what might I do. He said I could get a cortisone shot once or twice a year. I did not think that was true.I though it was 2-3 times per joint. I do hope the tightness never comes back.

That leaves me with four potential choices to mull over. All seem worthwhile, but I can barely afford one choice and I want to make the best decision about what to do, as I am convinced rest will fix nothing either.

I could go back to my podiatrist and get my feet adjusted again and see if he can modify my orthotics. My left big toe and MTP joint really wants something built up underneath it to work well and give me stability (or at least that is what they seem to be telling me). I used the Posture Control Insoles for a couple of weeks and my left foot somewhat likes the wedge under that area, but I found my right foot doesn't like the wedge at all and something about the hard rubber material of these seems to really beat up the bottom of my feet. I went back to my orthotics and for the past week have put some material under the toe area to build it up and I walk better like this (I haven't tried running). The downside of this is it costs money (my podiatrist doesn't take insurance) and I am not sure that he would like or listen to me telling him what I might like done to the orthotics to change them. He is a top notch podiatrist, but sometimes doctors only see what they want to see and after a few minutes they have you "all figured out" and I think he needs more time to "really see" what is wrong with me. He has never asked to see me run in the orthotics (or without them), which upon reflection is something he should have done. I can't afford to pay close to $100 for a 10 minute visit and the possibility that he doesn't fully listen to me again.

I also have been debating whether to go back and get some rolfing done. The drawback is that this costs big money too (I have two kids in college and money is very tight). I think the last time I went in the spring, it was beneficial and even helped pull my left everted foot back to a better position for a while. Unfortunately, rolfing never seems to help me permanently. I like it, but at this point I can''t keep going back, like I wish I could.

I also would like to try Somatics with an instructor, but it needs repeated visits at about the same cost as rolfing. I can't afford to pay for something that just might not work. I like the idea of somatics and the theory of muscles tightening up and needed to release, but I sense that it is a gentle movement therapy, and I can't just picture something gentle unwinding and turning my muscles back on. I need more faith on this one, before I invest some money into it.

Then last week, I remembered a therapy someone recommended to me again last spring called MAT or Muscle Activation Technique. I think a had a massage therapist use some of this technique many years ago and it seemed effective on just that limited scale. I have visited the MAT website, like I have many times over the years, and it still is frustratingly dated as it was years ago. I ordered the "new" CD and got it yesterday. The CD is just as dated and looks and works like the website (which is not good). It seems like it could be (or styled to be) 15 years old or at least put together on 15 year old version of a software (shockwave flash). It is not easy to use: it wouldn't work in a portable DVD player or in the player hooked up to our television. It would only work on my computer, but that means I have to read about a move and go to another room to try it out. Navigation is difficult (after every exercise you have to go back to the beginnning), the few movies are postage stamp size, and you have to scroll to read through information. There is no audio. Moves are shown using computer animations, rather than with real people. However, the information looks interesting, thorough,  and precise. I did the first test and tried the fix and I felt one of my chronically tight muscles actually working in a new way. The muscles are also labeled so you know exactly which muscle you are activating. I went through all 20 tests and most of the exercises and my hips felt re-energized for a change, so I think there is something to this. Most of the movements are movements similar to Somatics or any other movement program, but by precisely targeting a muscle with a movement that ends with a 5 second resistance that you push against seems to target a muscle in a way that hopefully "activates" a "turned off muscle". I guess you are paying for information and not glitz with this cd, but if the movements work, that is all that matters. If you like a scientific and technical approach to a movement therapy this may interest you. If you like soothing and calming music with an instructor demonstrating moves, then this is definitely not a CD for you.

I am thinking about visiting an MAT practitioner and am waiting to hear back from one.There are three in Massachusetts. Again, it is expensive (at least for me) and you need repeated visits, but if I can learn how to turn on my muscles to untighten them, then this might be a therapy just made for me, particularly when I feel like I am compensating for non-working muscles by using nearby muscles to help me move and run. There has to be a way to bring back a smoothness and ease to my walking and running stride. I don't want my favorite position to be lying down or sitting down, when I would rather be outside moving, playing, and running. Hopefully, I can get a few sessions in and learn to target the right muscles to see if MAT might be the therapy to get me off the bench. I feel I have to choose only one thing to try over the next few months and I want to to be something that works. I can't afford another failure.

I do not intend to run or do much of anything else till I get out of these bad movement patterns or at least start feeling normal again. I just had some blood test done for my fatigue, too, so I am waiting for those results. For the past few months I have been taking a good dose of Vitamin D (4000 iu/day), some vitamins, joint medicine for joint mobility, and even Magnesium Oil for muscular tightness but to no noticeable effect. I hate sitting on the bench, but it seems to be the smart thing to do, as I hate the way my body is working now and the way it responds to any movement or exercise.


Triple F said...

First . . . as you know I had the same surgery you had . . . just a little after you. I want you to read my last blog post! Yea . . . I proud of finally reaching my biggest running goal. But read what happened in the middle of the event! I was getting the same 'tightness' you describe. But now it has gone! It may return . . . we'll see. But for now it's GONE!!

Second . . . could you be over-thinking all this? Seems to me you are so focused on form and such. Maybe . . . just run. Don't try to change or adjust anything. Just run.

Third . . . I'm having to walk WAY more than I like. But I can walk and it doesn't seem to affect my hip quite as much. Just take what you can get . . . that's my advice!

But don't sit on the bench . . . unless you just have to!

All this from a runner who is nowhere near as talented as you. I suggest you ignore everything I say!! :-)

Frank Lilley

Jim Hansen said...

That is quite remarkable, 100 miles! Way to go. I enjoyed reading your account and seeing your blog. So... I have to go 100 miles and it will fix my joint?

I can understand your advice and have had PTs and the podiatrist tell me not to overthink things, but then they send me on my way without getting to fixing the obvious issues.

I am not really thinking of form in the classic sense, but just trying to get my left leg to work correctly. The foot everting out throws off everything and then the hip pays the price from the legs not moving straight. I have tried not paying attention to what the foot does, but I can feel the forces and twists go up into the hip and it throws my pelvis off and my lower back off, too.

Walking is actually worse than running as it is more uncomfortable and I feel one hip working completely different than the other. Being cleated into a bike pedal seems to give my body the least amount of stress.

I think I just keep reinforcing bad patterns. I am waiting to hear from a MAT person, but the exercises from the cd have started waking up the hips a bit. I haven't run or biked in a week and today was the first day I moved somewhat normally without the usual weakness or discomfort and I am talking just getting out of my chair when I am teaching and moving across the room. My whole body is off and weak on the left side. A year and 1/2 ago, before my surgery, I did 10,000 kettlebell swings in one month most of it with a 50 pound bell. I picked up the same kettlebell last weekend and could only do 18 swings before my lower left back got weak and it felt ready to spasm out. I tried again later and only could get to 10 safely. That sort of tells me that I have some weaknesses that need to be addressed as that is why I keep breaking down.
I need to sort that out before I keeping stressing my system trying to run distance like I want to. Once I fix things or feel better, I will be jumping off that bench.
I have even had thoughts of doing some ultramarathons if I ever get this all sorted out again. Maybe not 100 miles, though! That is something quite amazing, even without the hip surgery.
Congrats again! and thanks for sharing as it lets me know what can be possible!