Three Alignment Exercises for Pain-Free Running and First Prolotherapy Injections

Here are three new exercises to try that work on improving your alignment for better and more pain-free joints when running. I had my first prolotherapy injections today, so I am not ready to try these yet, but once the ligaments around my si joint and hips tighten up again. I hope to get my alignment under control. These come from MaryAnn Berry and feature ideas from Posture Align Therapy.

A common myth is that running is bad for your joints because it is high impact and leads to joint wear and tear. But if you are experiencing this pain or joint wear and tear, consider that running is not the culprit.

In truth, your body is simply out of alignment, kind of like a car that needs an alignment. Your car’s tires (or your knees) wear unevenly and eventually need to be replaced or repaired. While that might work for your car, it’s not a great plan for your joints.
These three simple alignment exercises are no quick fix, but they will help get your joints into a better position before you run.

I had my first Prolotherapy injections today to my left si joint and lower back. I only felt a few injections, but my doctor used guided flouroscopy (I think) to move the needle around to hit the ligament attachments on the bone. I had a big spasm from the injection in my lower back. The injections are supposed to make me sore today, but I feel pretty good. Actually the lidocane, or numbing agents, has my hip and pelvis feeling more stable and better aligned (it could be just my positive thoughts!) I will need to go in monthly for a few months before we know if it works for me. A small percentage of people feel better after just the first set of injections. It does not immediately heal things, it inflames the area around the joint so that it can jump-start healing. As my osteopath said, "It should make it like the si joint fuse together." My hope is that strengthening the joint helps with my instability and then I can better deal with my imbalances and misalignments. The doctor does say that after all is done, I may need PRP or stem cell treatment in my hip joint.

Awesome 4 Week Postural Realignment Therapy Program: Online Videos and Instructions

These videos make up a 4 week/ 4 video postural realignment program that is found on Breaking Muscle and contributed by Maryann Berry. Maryann is someone who has fully recovered from the chronic hip pain in her twenties which put her in a wheelchair. She uses an exercise technique called Posture Alignment Therapy, These exercises remind me sometimes of Egoscue. I started this program on week one, but stopped doing it because my si joint was real sore. I got a Serola Sacroiliac Belt last week and it is feeling better, so I am ready to start the program again. There is a video for each week of the program and you can find more directions for each week's exercises here. I have been following the videos each week as Maryann makes them available online and it looks like a well-thought out program.

Lots of Ideas for Recovering My Stride

Running cross-country for Wheaton College back in the fall of 1980.

Besides the wonderful fall weather and beautiful foliage, it is also cross-country and marathon season. This is absolutely the best time of year to be a runner. Unfortunately this fall,  I do not feel like much of a runner at all. I got my new orthotics two weeks ago and at first they felt great. I thought I would get used to them slowly and on the second day did 4 miles. I felt real good and did 8 miles the next day feeling even better. I then thought, I might have a long shot at finishing the Baystate Marathon on Sunday, even with the limited training over the past month and 1/2. However, the next few days found my muscles getting stiffer and stiffer as I walked around in the orthotics trying to get my body to adapt to them. By race morning on Sunday, I found it hard to even walk comfortably to the starting line. I stood around waiting for the start and when the gun went off, I let my brain win this one over my will. I knew it was not going to be a good day to run and any running I did would not be helpful or fun at all. I ran for 3 minutes and 12 seconds and pulled out of the race.
It has not been easy sitting around for over a month and a half and not running, but I have realized that my body cannot handle it in a healthy manner anymore. Everything is out of whack and running this way just reinforces all my imbalances. But thank goodness the medical establishment is to the rescue, I think! The last doctor wanted me to set up an appointment with a physiatrist. I tried to research as much as I could, but could not find a sports related physiatrist in the local area. I finally chose one nearby, based on the qualification that he looked young and my hope is he is up on the latest sport injury rehabilitations. Getting an appointment is another matter. You have to have your records sent over to his office. After figuring out how to do that, I have to sit and wait for them to call me. I did call Friday and they still don't have my records. I have the feeling this could take a long time. Update: I got an appointment and the earliest I can go in is Nov. 30. Nothing like moving through the medical system at a breakneck speed!


I do have ideas of what I want to try if the physiatrist does not work, unfortunately all ideas might cost some money and I have a kid in college, so I have to be quite sure about what I might do. Here are my ideas:
Resistance Stretching:
Because my left hip is still unstable and pinching tight even while even walking around and my left adductors are tight and almost painful when running, I feel I need someone who can move and manipulate muscles and joints around. Unless it is a labral tear, the muscles around my hip need a lot of loosening up. The loosest my muscles ever got was when I went to a resistance stretcher, a couple of years ago and I could do that again. One thing I might try is to go down to Boston and get worked on by the originator of resistance stretching and author of the book,The Genius of Flexibility: The Smart Way to Stretch and Strengthen Your Body, Bob Cooley (mega expensive) or one of the other trained stretchers at his clinic (expensive). This would help the tightness in my muscles, but I am not sure if it would retrain the patterns of movement that I have. My hope would be that it loosens my muscles and allows my orthotics to work with the idea that I could then more easily generate new patterns of movement without the restrictions I now seem to have.
Rolfing:
I thought when I went through the entire rolfing series a few years ago that all my problems would be solved. It was an interesting process, however it did not last long. I never felt better than after a rolfing session. I had twelve. My thinking is that the rolfing fell apart for me because my feet, because of the hallux functional limitus, kept collapsing and I reverted back to my poor movement patterns as compensation. Now that I have orthotics to correct the FHL, maybe a rolfing tune-up would help my body heal and strengthen. I met a Gate City Strider this summer who goes to a rolfer about an hour away who is also a physical therapist. I was hoping that at the last doctor's visit, I would be allowed to pursue going to this PT, but the doctor wants me to see a physiatrist instead. I also noticed that the rolfer that I went to in the past is now a trained resistance stretcher. However, interesting that sounds, she never really fixed me in the first place, so it may be good to go to someone new for a fresh set of eyes. For those that don't know, rolfing is not really massage. Massage is for your muscles, rolfing is for your fascia, the covering around all your muscles and connective tissue. The goal is to give your body "space" so that it can go back to alignment.
Retrain My Muscles
Another option is related to a book that I started reading this week called Muscular Retraining for Pain-Free Living. I really enjoy the reading as it gets technical about muscles and functioning of the body, but it is written in an easy to understand way. What I like is that it talks about a kinesthetic sense to the body and how it moves. No matter how much therapy and things I have tried, I firmly believe that my mind has its own movement map of how to move, and that what it thinks is correct is actually incorrect patterns. This book explains all this and then offers a series of exercises to reteach your body for proper movement patterns. They exercises are simple enough and they seem like a mix of Egoscue and Feldenkrais movements. The descriptions of the exercise, what they hope to achieve, and the author's notes on what you should feel are all clearly written. This is something that is missing from many books I have seen. I have started doing some of these exercises and a few of them pull and loosen my muscles in all the right ways. If I think these have an impact, I could make an appointment with the author, Craig Williamson. It would be a bit of a drive as he is in Portland, Maine, but I am at the point where I really need to find the right expert to fix things.
Gait Analysis
Recently Running Times has been putting out a series of videos called "Fixing Broken Runners." There are two videos (video one and video two) of the UVA Center for Endurance Training. I found that there is gait analysis being done at the Boston Running Center in Boston. This sounds really interesting, but I would be worried that it shows me what I already know about my stride. I am not sure of the therapy to fix things. I need more than to just be told what I need to fix.
An Athletic Physical Therapist
Finally, last night I discovered some excellent videos from a website called Athletes Treating Athletes. The website has informative videos which they call the The A-Tx-A Self Treatment System. Currently, there are 13 videos in the self-muscle masssage section. I have only had a chance to preview a few of them, but I like the teaching style, the descriptions, and the techniques that are illustrated. I have a house full of trigger-point tools like regular foam rollers, The Grid, and most recently the RumbleRoller, and all sorts of other things I have tried. I also have some DVDs put out by Trigger-Point, but these videos look like they are the most thought-out and descriptive videos to learn self-massage techniques. It also seems that the Physical Therapist. Leigh Boyle, who is putting this website and videos together works out of Plaistow, NH. That is less than an hour away. She is also an athlete and Ironman triathlete, so she would know the endurance athlete's body. I also like the fact that she is sharing her knowlege and doing an excellent job at it.
Here is the video I spent time with last night and then tried out. It relieved a lot of tension in the front of my left lower leg. I am a slow learner at figuring out how to work with trigger points, although I have been trying for years. I really like this book, Trigger Point Therapy for Low Back Pain: A Self-treatment Workbook, and have been slowly reading it. I worked my calf and soleus trigger-points for a few night a couple weeks ago, and that worked real nice. I did overdue it because I could not find them again the night before the Baystate Marathon and I think that is some of why I felt a bit off. Maybe it was time to work on other muscles like these:

Anterior + Lower Leg from Leigh Boyle on Vimeo.
I will be spending time studying the rest of these videos and maybe I can get a referral to get some work done someday. So even though I no longer feel like a runner anymore, when the time is right, I have some new options to explore. Choosing the right option is going to be a tough decision.
The good news is that I only have my running idiosyncricies to complain about. This blog's purpose is to share ideas as well as to track my progress and ideas for myself. It is a lot of fun, but I would guess that someone reading it might think that I complain about running injuries a lot and that there is not much else going on in my life. I feel extremely fortunate that all that I have to complain about is running. It's not really complaining, but I enjoy the curiousity of trying to solve this running problem and I don't intend to give up. Otherwise, life is great: family, friends, and work are all great and so I have the energy and desire to figure this out. I would like nothing more to again feel the enjoyment of running fast, loose, and free.
Finally, I also have to look at the obvious. At the top of this page is a picture of me running cross-country in college. At the end of my senior year my right hip got really sore and I couldn't run without pain days before my final cross-country race. Almost too late, I figured out the problem. I carried my wallet in the right hip pocket of my jeans. This was causing the problem. I kept the wallet out but it was slow coming back to normal. I ended up being in last place in the midwest regional championships race at the one mile mark. At which point, my hip started relaxing. I turned it on and passed runners throughout the race and ended up with my fastest ever 5 mile race.
The obvious thing is my sitting posture. I sit a lot and this is not good. My computer chair is a horrible chair and I end up slouching and not sitting straight nor do I balance properly. The obvious is to find a better way to sit and a better seat. Duh! I better start working on that, too!

The Egoscue Method: The Good and the Bad

I first heard of The Egoscue Method over 10 years ago when I bought "The Egoscue Method of Health Through Motion" and later "Pain Free" both by Pete Egoscue. I found the books interesting reading, but I was looking for a magic bullet and the programs seemed difficult to undertake and figure out. Upon further reading and practicing the stretches over the past year I have come to a better understanding of the program and its strengths and limitations. The Egoscue Method is basically a set of prescribed stretches that should put your body back into it's natural alignment and function. Rather than use manipulation, massage, or any other technique Egoscue strengthens the appropriate muscles which then can be used to pull your body back into alignment.

The Egoscue Method of Health Through Motion: Revolutionary Program That Lets You Rediscover the Body's Power to Rejuvenate It is dependent on your understanding of some diagrams that depict different types of body abnormalities. After you figure out your body type (if you can do this) then you follow a prescribed menu of exercises (or e-cises). The diagrams of misalignments captured my interest first because the showed rotations and imbalances that reminded me of "me". I found that you had to diagnose your own body, but this was rather difficult because I was a mix of more that one type and was not fully any of the types listed. From this point you find a list of prescribed exercises listed on one page and then you have to flip through the book to find how to do each exercise. It is a pretty ambitious book and the exercises were interesting however it didn't solve any problems for me.


The next book I bought was Pain Free: A Revolutionary Method for Stopping Chronic Pain. This book also has menus and e-cises but it is a bit more specific based on the reader's need. You can find menus for hips, or knees, or any other problem areas. I suppose this is easier to read and figure out particularly when you have just one problem area. Again nothing was resolved for me when applying this book to my posture.


Last year I noticed some the Egoscue: Pain Free Workout Series DVDs. These are generic Egoscue exercises not particularly geared to any specific problem. I find both to be good stretching routines that are worth the investment if you wish to learn more about some of the stretches and to receive good instruction. Like other Egoscue products, I find them to be a valuable resource but that they really didn't solve any problems for me.

Up until last year, Egoscue had a message board. I visited every once in a while to learn more and ask questions. One thing that kept being repeated was to visit a clinic to get the right exercises and to make sure I was doing things right. I signed up for a session with a therapist at a traveling clinic. I told the therapist during a phone conversation prior to the visit that I had a couple of simple questions I wanted answered. I was assured that he would have the skill to answer my question. I basically wanted to know if I had a structural issue with the bones in my foot, knee, or hip and if the way they moved or didn't move could really be "healed" using Egoscue. I realize they are out to sell something so of course "Egoscue" should be able to fix anything, however I wished an honest assessment. Could I possibly I have a bone or joint problem that no matter how wrong I got me muscles, they would never be able to pull things right if the bones got in the way?

The visit to the traveling clinic was expensive! They young therapist was nice and he seemed to know the Egoscue protocol. He went through a logical set of steps while watching my posture walking back and forth across the room and bending. Then he set up a series of e-cises and watched me perform them. I was performing them correctly just like in the book and video so I did not learn much. What was unnerving however was our beginning conversation when he asked about me and then told me why he got into Egoscue. His friend ran the clinic and it seemed to be a good way to earn a living with the degree he had. I guess that is all fine, but I really would have appreciated meeting with someone who had "been there" and dealt with pain and imbalance issues themselves not someone who was out to earn a buck! He really couldn't answer my question except to insist that given time (and I can assume-plenty of clinic visits) that eventually things would work for me. I could tell he had no clue as to why my leg is stuck in the positions it is in with the ankle everting the foot out and the knee knocking in. If I try to straighten my knee and foot the foot is in a horrible and useless pronation.

I went home enthusiastic about trying the program. I did my e-cises every day (sometimes twice) for the little over an hour that was necessary. I felt muscles strengthening a bit but no release or fixing of my mechanical problems. I carried on for over a month and even did the "free" set of new exercises that was provided (after a phone consultation with the therapist). I was not happy that this was going to fix anything unless I was willing to commit tons of money to attend more visits with the therapist.

I decided not to go back for more exercises but continued doing the e-cises and making menus of my own to try. A lot of effort was wasted as it had no real effect on the positioning of my bones and joints and the way my leg moved. I also grew discouraged as the Egoscue website discontinued their message board. I had enjoyed reading about the success of other patients and the asking of questions but for some reason that could no longer be accomplished. One thing I did learn from the message board is that for many people the process takes lots of time (years in some cases) and is a long-term process that needs to be continued each day. I had to believe there is a better and more affordable way out their to recover my stride. Doing the exercises is also very time-consuming.

On the message board Pete Egoscue was sometimes called a "genius" by his followers. I would gather that having him work on you and observe your gait and patterns would be a very worthwhile opportunity. I am sure he would be able to do the pinpointing of specific problems and finding the right exercises to get my posture returned to normal pretty quickly. The fee for the clinic that I paid should have earned me some time with the man himself. However, having a "trained" therapist follow a script and protocol soesn't seem like the wisest use of my money. I think the method has tremendous merits but it almost seems marketed as a way to earn money from some well heeled clientele. I am just not that person!

I do think his books are a worthy read and I would certainly encourage anyone struggling with an injury or going in for surgery on the hip, knee, or other problem area to read his books and give his method a try first before going under the knife. It does seem that plenty of people achieve success with this method. The videos are a worthwhile and well-thought out stretching routine too! I would avoid the clinics unless you have time and money to spare. I have even recommended the books and program to my mother-in-law.


I have  found two other resource books that describe and outline programs and exercises similar to the Egoscue program. One is a take-off by a former Egoscue person and is similarly called The Pain-Free Program: A Proven Method to Relieve Back, Neck, Shoulder, and Joint Pain. The other has plenty of exercises written in menu forms for common alignment problems and is called Posture Alignment. It is probably the simplest and easiest of the books to follow and implement. Many of the exercises are the same or similar to Egoscue which makes it easy to create your own menus. They are all good additions to your sport library and just may help you recover your stride.