I am putting up a few posts basically for myself as I try to figure out things I am learning about my feet. In this way I can check back and see what works and doesn't work and keep track of my thinking. Please skip over if you are not interested, but sometimes people find my stuff on the web and offer really good suggestions or are also looking for similar answers to biomechanical issues.
Last night I posted what I am learning from the Active Release doctor who I am currently working with. My left foot is a problem foot and he gave words to the strange things that my foot does that affects my stride, hip, and back.
Basically he said the left foot has an inverted heel, which causes the foot to suppinate and then I have something called functional hallux limitus which means the forefoot goes into a severe pronation because the bog toe and metatarsal do not work and contact the ground correctly. Thus I have problems.
Here is what I have found on inverted heels (besides some crazy dance step). It comes from Carson Boddicker, whose blog I have been reading for the past few months (see "My Blog List" to the left). He gives some exercises and drills (some using a wedge that I have not tried as I am relying on the therapy I am undergoing now).
Following ankle injury, a positional fault is often observed in subtalar joint position, which is locked into inversion known as rear foot or subtalar vars Rear foot vars is when the position of the foot is inverted relative to the ground in subtalar neutral.
Given the body’s remarkable ability to adapt, it can attempt to shift the position of the talus to compensate for an inverted calcaneus. In observing the rear foot, a compensated rear foot vars will appear perpendicular in subtalar neutral but averted in standing (left). Uncompensated, it will appear inverted in both ranges of motion (right).
With the subtalar joint in inversion, the foot must pronate more to clear the heel from the ground. Once clear, the foot is forced to rapidly supinate to be effective in propulsion, creating a whip-like effect, which has been implicated in Achilles’ tendonopathies. Additionally, the first ray of metatarsals becomes an inadequately stable base for propulsion (remember the joint by joint approach) and the big toe begins to lose mobility.
Finally, remember that the subtalar joint translates this rotation (pronation) to the tibia and the tibia translates rotation higher in the body. Excessive relative internal rotation of the foot, tibia, and subsequently femur can cause femoral head position changes and scarring of the deep hip rotators. This can ultimately lead to a grab bag of pain and pathology of the knee, hip, and low back.
I don't know if this is an accurate description of half of my foot's problems, but it sounds right.
Next up is an excellent descriptive video from "The Gait Guys" which descibes rearfoot varus, which I think is the same thing as an inverted heel.
Finally, I am putting up (hate to do this) some videos the chiropractor wanted of me running. It shows my stride Tuesday (after one day of ART treatment) and after an 8 mile run. It shows the weird things my left foot and leg does even at a slow jog. I would guess it looks much worse at a faster pace.
Now you can see why running is so much fun for me!
Here's a link to the stretches for my feet and ankle that the chiropractor says I should do. The first is pretty much a Z-Health Toe Pull. I now have better informed instruction on how to do it. The tops of my toes are really stiff.
Now about jammed joints and how I seem to get relief from hip problems when the joints in my feet are mobilized. Here is a video on the arthokinetic response showing how a jammed foot joint affects the glute medius muscle (the muscle that the postural restoration therapist said was one of my weakest muscles on the left side).
I also posted about Z-Health and jammed joints here, where Dr. Eric Cobb (Z-Health) demonstrates the affect of jammed joints here. Mike T. Nelson of Extreme Human Performance (blog on my list to the left) wrote about jammed joints here.
Last weeks running = 44 miles: Monday- 8 miles, Tuesday- 8 miles, Wednesday-8 miles, Thursday- 8 miles, Friday- 0 miles, Saturday-4 miles, Sunday 8 miles. At the last moment I realized that there was a race at Mine Falls Park on Saturday and so I entered the Otter Run 5K put on by 3C Race Productions. I ended up finishing in 3rd place overall in the unremarkable time of 20:16 (results). My left hip felt so much more balanced then it has the past few years running so many times on this course. It was a much better race then the one on Sunday and a better starting point for the season. I am very much looking forward to the Gate City Striders track workouts starting this week.
What can you say about another entertaining Boston Marathon race. A new course record for the men and a dramatic finish for the ladies. Lots of Striders and other friends ran super races! Robert Cheruiyot ran a super race for a new course record. The most ridiculous news report on the race suggested that he may have cheated by stepping up on the sidewalk. Oh really? No this is silly and is certainly no Rosie Ruiz move. View the video here.
I saw some interesting Z-Health videos today where Dr. Eric Cobb demonstrates the Arthrokinetic Reflex. According to his thinking. a jammed joint equals weak muscles. I find the Z-Health joint mobility program interesting. It never solved my problems, but I did learn about the movements of the joints and probably just never became proficient in learning exactly how to utlilize the movements in the precise way and manner to effect the changes I needed. One problem I had with the program was that it never fully explained why things were supposed to work. These videos show a little more of the "why" about jammed joints.
This video shows how a jammed joint in the foot affects the hip flexor on the same side by weakening it. This intrigues me because I have had a weak left hip flexor along with misaligned joints in my left foot. The middle toe-pull move is supposed to fix the joint in the foot and thus strengthen the hip flexor. I can't always make it work, but last month it did work perfectly when my hip flexor was gimpy. If you scroll down this page you will see how to do a toe pull.
This video show how the limited motion of the heel in running shoes can impact the heel and create weakness in the hamstring.
This video explains active vs. passive care. The body learns and responds best when it fixes itself not when someone else does the work. Of course it only shows the passive care with joint manipulations. If you look down this page a bit, you will see the outside toe-pull that is supposed to be the self-care for for the cuboid joint.
These final two videos explain more about Z-Health.
There is supposed to be a new Z-Health video coming out next month that explains more about the science of why Z-Health works. You can find out more about Z-Health here. What I would like to see from Z-Health is the "which" and "when" videos. They have some on the "how" and will be putting out the "why". It would be most beneficial to know which exercises to do for certain conditions, so you can use the correct joint mobility routines instead of hunting on your own for the right one which may or may not work. Seeing how quickly Dr. Cobb could manipulate a joint to jam and unjam it makes you wonder how a wrong movement pattern may be jamming joints and creating havoc in your body on a daily basis just due to bad movement patterns.
Carson Boddicker has an interesting blog post on the hip flexor muscle today regarding stretching and strengthening the psoas muscle. You can find it here on his blog (also found under my blog list on the left of this page). He suggests doing moves like bridging before doing hip flexor stretching to fix dysfunctional movement patterns in the hips.
This morning I had a cortisone shot in my hip gently delivered by my physiatrist. Just a tiny pinch and I was good to go. I guess the idea is if the hip pain goes away, it could be a labral tear, as this is for diagnostic purposes. If the hip stays the same, then he has to keep looking for the problem. The interesting thing is that he watches the hip through x-rays as he puts the needle in. He showed my some freezes of the hip x-rays and he said it looks like the dye they used shows what could be a small tear on the outside of the hip joint. I could see it. We didn't talk about this, as I have a follow-up next week, but if that is a tear that needs repair it sounds good as it doesn't appear to be in the joint. It will be interesting so see the effect of the cortisone on my hip, although it shouldn't fully work for a couple of days. I may run a bit tonight on the treadmill. It feels fine walking around. I have seen reports that a cortisone shot can permanently fix the labral tear pain. It is not suppposed to fix it, but some people have been fine after the shot. Others get a few weeks pain-free. Others get many months. Sometimes it doesn't work at all. I see it as a major problem keeping me from running right now, but I really have to seek out the cause of the hip pain. I don't really think the cause is found in the hip as this is mainly the effect of my poor biomechanics.
I was scanning some pictures for my parents at the Cape this weekend and found some pictures they had taken back in about 1986 or 1987. One picture shows my lovely girlfriend Sarah, who is now my wife. This shows me with someone really pretty. The other picture shows me at the same time with something really ugly: my running stride. This is me finishing the Falmouth in the Fall Road Race (same course as the Falmouth Road Race. Ughh! There is that terrible twisting of my leg that I keep seeing in more recent photos. No wonder I am so messed up. I have been running and racing like this for years.
Beauty and
the Beast
See the left leg twists out and the knee and hip twists in. I was still into Ironman and triathlon racing and training at this time, despite a horrible left lower back pain that made it hard to sit and move comfortably just about all the time. Yet, the last three of my five Ironman distance races run in 1983-1987 were completed in 10 hours 20 minutes to 10 hours 23 minutes. You can also see the contortions that my body has to do to compensate. No wonder I have so much pain throughout my body for many years.
I am fairly convinced the hip pain comes from my left foot and toe. So I really want some answers to this. I think the complications from the hip comes from using the new insoles this summer to correct the Functional Hallux Limitis. I felt better stability in my foot and immediately ran way too many miles too quickly and this may have impacted the motion in the hip bringing the pain.
What I have to consider is that the best my running has felt all year was the times a physical therapist manipulated my foot back in the winter and then again after my first visit with the Dr. Dananbergwhere he fitted me to the first insoles and again manipulated my feet and leg. Things in my foot and leg felt so much better those times when the freed up my joints. I know I have told I have tibial torsion in my left leg, but I wonder if there is something else going on instead or in addition and the picture above shows exactly what I feel 20 something years later.
If I walk forward onto my left foot and try to shift my body and weight over it, the tibia will not move straight over the top of the foot like my right leg does. I feel a stickiness or stoppage of movement over the top of the ankle where the tibia isi supposed to go. Instead it halts and finds an easier movement by sliding to the forward to the right, throwing the knee to the inside and pushing the foot to the outside and then rotating my hip to the inside too. Is this because of tibial torsion or because of jammed joints or a combination.
Seeing the photo above this weekend, almost convinced me to throw in the towel forever. This will never be fixed! But I always had a strange stride in high school and college, but not like this. I think it really got messed up when I did triathlons and adjusted my pedals so my left foot pointed out due to my leg problems and this just started the severe chain reactions that I have since had.
Then I remembered the manipulations helped me and that once I used these new insoles on my bike this summer, for the first time I had no pain biking and I much better cycling motion than I ever had without pointing my left foot out.
I went back to reading the few and limited things I have found online on twisted tibia and foot mechanics and found one runner in Sydney, Australia. This guys right foot does exactly what I think my left foot does (I have never seen how I look from behind). We are like a matching pair.
I wrote in some questions under the video last night and the folks at Sydney Sports Podiatry so nicely replied today:
This is what my left leg does. I have been running for 35+ years (50 marathons), and have been fighting the imbalances and strange stride (tibial torsion-left leg points out-knee knocks in- hip and lower back imbalances and pain) for years but can't fix things. What should the orthotics be doing? I just got a pair from one of the best podiatrist in the states (Dananberg) but he is treating "functional hallux limitis" and hasn't addressed the tibial torsion.
What are the best type of running shoes? What type of technique training? Do you let the foot do its own thing? or point it forward. Any advice would be appreciated.
Me (marathonnh)
@marathonnh You can't make it point forward without pretty advanced surgery. Also be aware of actual or functional leg length differences which may be stuffing up your back. Your hip/leg will always dictate where your foot points before strike. If orthotics and technique change aren't helping, Dr Dananberg will give you your surgical options, the most radical of which may be getting the torsion fixed. Look up Ilizarov aparatus. It's pretty dramatic and will stop you from running for a long time.
XOZTCATPREZ
Me-know way I want the Ilizarov aparatus. I get cast claustrophobia (broke leg twice and had cast removed to a softer removeable cast). I can't imagine having that thing around my leg, let alone the surgury.
Hi Marathonnh,
Dr Dananberg is well regarded here. Your hallux limitus is probably from years of overload from the increased velocity and amount of pronation because of the tib torsion. You probably have two very different orthotics already, but if your limitus is advanced, this can have dramatic consequences during propulsion.
A low profile shoe (minimal heel elvation), midfoot strike technique with high cadence can help, as there is slightly less dorsiflexion required from the joint.
XOZTCATPREZ
That is some great feedback. Thanks! I also went from my years of miniimalistic low-profile running shoes to a heavier structured running shoe this summer trying to see if that would help correct things. Maybe my intution was correct. I had also spent years transitioning from a heel-strike to a more midfoot strike. Maybe I need to work on that higher cadence when I can start running.
This video shows the compensations for a defective ankle rocker that could be the jamming feeling that I feel in my ankle.
This video shows some corrections for a defective ankle rocker.
If you got this far, I commend you. This is basically my thoughts for myself (or therapy) so I can check back, but I hope this certainly helps someone else with similar conditions. There may be only a few of us built like this and running, and so there is little information for runners with tibial torsion. As my 10 year old daughter said to me today, "Dad, you should have become a doctor because you like to find out everything you can about the body." Well, I just can't conceive of giving up. I hope to beat this thing one way or another.
Thinking about manipulations, since I basically stopped running in September, I have had all sorts of pains up my left side (toe, ankle, hip, back) that seem to originate under the left outside ankle bone. Something feels "caught" and it travels up and down my body to various joints. The left lower leg also gets very tight. I wouldn't know how to adjust the foot, but if this is what remedies things and keeps me running , I need to find someone who can every few weeks or when needed. I certainly had better foot placements after the adjustments this year. One adjustment Dr. Dananburg did was to my upper tibia (Dr. Bigelow also did something like this at times for me). You can see it here (actually he says it is for the popliteus and it keeps the tibia from externally rotating) hmmm!:
I tried this move with my trigger point Quadballer Roller
two nights ago (putting it behind my knee and pushing it together against the tibia) and got a little movement or pop and my left foot, ankle, and lower leg and they have felt the best they have in about a week (no constrictions).
Here are some blog entries and articles that I have found interesting as I attempt to learn more about joint mobility. Unfortunately I haven't found much on Z-Health from the running community. The Z-Health website does say this :
"As for endurance athletes, we recently helped a world-class middle distance runner shave nearly a full minute off her 5k time in two weeks of training. (We had her doing only 1 exercise 3x’s a day so it qualifies for the 3 minute rule!) She subsequently made the US World Cross-Country team and placed very highly in international competition."
I do wish a name was mentioned and that there was follow-up.
My information about Z-Health first came from reading about kettlebells. So it is another group of athletes that may be leading the way and maybe runners will pick up on this soon. Scott Sonnon's "Circular Strength Training" comes from the martial arts.
Here is an interesting post by Sara Cheatham on taking responsibility for your your own pain and healing. One of the strangest moments in my life was the time we were in the hospital awaiting the birth (well, I was doing the waiting) of one of our children. I had a bunch or medical type books with me as I was researching some Physical Therapy techniques or something and the nurse saw what I was reading and asked, " Oh are you a doctor?" My wife still laughs at that one! I have always been looking for ways to figure things out myself. Never do I want to take the "instant gratification" of surgery to try to fix something when other alternatives can be explored. Here she writes about Kettlebells and Z-Health. Exploring kettlebells this past fall is what led me to looking into Z-Health.
Mike T. Nelson has a blog that I have been reading a bit. I was particularly intrigued by this article about foam rollers and why they may not be the best therapy. He has had another post on "jammed joints " and how Z-Health can help remove the "neurological brakes" that inhibit mobility and performance.
Here is another introductory article from "Kinetic Edge" which explains joint mobility and in particular how Z-Health works with the central nervous system. There are three pages but that may be difficult to notice at first (and music so be ready to turn down your speakers if you need to).
But my left leg still is all the wrong angles. It is depressing to keep seeing this! Even my face in the photo show me concentrating on form and not doing a good job of it!
This looks like it is going to be a year of PW's (Personal Worsts) with my running. I ran my first road race of the year (not counting the 5k trail races) at the Bill Luti 5 miler in Concord, NH. It is not my of my favorite races to begin with as there is a hill after 5 miles and it is run on the wrong side (left) of the road for me. Last year I had a lousy race and ran 32:07. My hips were very much off that race and I ran my one and only race in a pair of Newton running shoes. I figured I could do better this year. I felt energetic even though I ran some good mileage running up to this years race. I even took Friday off from running.
The day was very hot. I went out slower than normal in this race (about 6:10) and went up the hill OK but then the wheels fell off. I was hot. My legs were going in different directions. My hips weren't working correctly. I struggled all the way in watching runner after runner pass me. I finished in a 5 mile PW of 34:28. I was disgusted!
Anyhow I saw John V. of Kickbike fame (moderator of the KickbikeUSA Yahoo Group) at the Concord race. Not feeling pleasant after that race- the heel lift that had seemed to help my stride- didn't appear to be working the same way anymore. My hip was tightening up again and my left leg was all messed up. I decided to ride my kickbike in the afternoon and even found that hard to do. My legs didn't seem to be moving correctly. Strangely enough I seem to get more push off my left leg, but as I paid attention to what my feet were doing on the ground I noticed my right foot seem to track straight off the ground (as the footbed of my kickbike rolled forward past the leg on the ground). My left foot contacted the ground and the leg and foot rolled like this ). The leg doesn't track straight but curves in and then back out as it rolls over my foot. The kickbike ride wasn't smooth at but it felt good to get out and exercise some frustrations out.
Yesterday and today my hips and leg refuse to work right. They are back to the right hip angling in and the left leg rotating out. I am very uncomfortable. I saw a question on the Runners World forums about a rotated tibia and chimed in a question about stuck or rotated joints. A physical therapist, Damien Howell, wrote back after reading a what I wrote and looking at my running pictures at this blog. It is not a diagnosis but just some ideas (or a possibility) based on the limited information he saw. But he wrote:
"marathonnh this is a very interesting series of stillphotos. Your long history and the still photos do suggest the possibility that either the pelvic bone (acetabulum) has an odd shape; the femoral alignment having excessive femoral internal torsion; excessive tibiial external torsion; or a combination of the above mal-alignments.
I believe a CT scan would be required to definitively rule in or rule out anti-version of the hip, excessive femoral internal torsion, or excessive tibial external torsion. A CT scan could also quantify the degree of torsion. An Orthopedic Surgeon could order and interpret a CT scan of both lower extremities, and transverse plane measurements should be compared to the uninvolved side.
The fact that you have had a remarkable career in competitive running, and if you have permanent bony mal-alignment from childhood, you are an example of the remarkable ability of the humans to compensate and accommodate for short comings in order to achieve remarkable successes.
I found the description at your blog site remarkably insightful and analytical "If I position my left knee pointing forward, the left ankle points correctly, but the foot rotates or splays to the left and tilts up on the inside. If I place my left foot straight on the ground, the left knee is rotated to the inside. If I try to force that knee straight the inside of the foot rotates up. I can't even get that knee into proper alignment with whatever force I use. I still can't tell if it is a knee rotation, or a foot or hip problem. It just won't line up".
You should recognize that Orthopedic Surgeons order this kind of a CT scan measurement in order to plan surgery, the surgery involves breaking the bone rotating the bone and fixing the parts together. It is a extensive procedure and for some one who is functioning as well as you are the Surgeon is likely to think you are a bit odd for requesting such a diagnostic image test.
Good luck
Damien Howell MS, PT, OCS www.damienhowellpt.com"
It is not pleasant to think that the only way to resolve my issues would be to cut my femur apart and then put it back together. Of course, I could never do that- but it does point to the real possibility that what I am really dealing with it a faulty skeletal problem and whatever I try I can never fix that!
I had a PT tell me before that it may be hip problem that I was born with before. I remember her telling me, "Jim, You are someone who is so made for running, but you are also someone who is not so made for running." She was a young PT that couldn't figure out a problem in that left hip. It was so jammed I couldn't run. The PT work and exercises she tried didn't help. She enlisted all the other PT's in the office to look and talk about the problem (some had helped me in other years). No one could figure out why my hip (or where the femur inserts into the hip) was jammed up. She kept researching and found a hip capsule stretch (sort of a figure 4 stretch) that moved the hip into a new position and I all of a sudden I could run again. I went back to that PT place last year but that therapist was no longer there.
So I am back to dealing with the same issues all over again and maybe it will never be resolved. Everything I try works for awhile and then it stops working. Maybe it is a skeletal problem that will never ever be fixed!
It all sounds so very good and if I was a involved with sports medicine ( I really wish I was) this is how I would market and run a clinic (if I had the answers!). It just looks like it may be very expensive and the nearest person may be a couple of hours away. I will look into some more to see if it could be a possibility and if I could at least "know" what my biomechanical problems are.
Anyhow being in Kickbike mode I started putting up some YouTube videos of portions of an introductory tape to Kickbikes I got when I first purchased my kickbike. Here is what is up so far! Enjoy! Maybe someone will get motivated to try a Kickbike!
I started a list of the 10 best things I have tried this year in order to recover my stride. It was one of my worst years of running ever, but by the end I am finding my body is working better and I am feeling much looser and freer as I run than I have in a very long time. For once I don't live day to day wondering what is going to hurt or be out of alignment. Instead I am feeling better, in control, and on a postivie upswing with my running and feeling so much better and pain free thoughout each day. My first 5 picks can be found here:
My number 6 pick for recovering your stride is the book "Brain Training for Runners" by Matt Fitzgerald. I like books that present new and different ideas towards improving your running and this in not a retread of the same old ideas. More than half the book is training plans and I have no need for these as of now, but the rest of the book (about 200 out of over 500 pages) is very interesting. I especially like the proprioceptive clues. These are cues that you can use to concentrate on in order to improve your stride. I also like his core conditioning exercises, his dynamic flexibility exercises (what you should be doing before a run instead of static stretching exercises), and the anti-sitting exercises.
You can also find more of the dynamic mobility exercises on Eric Cressey's Magnificent Mobility DVD. Matt Fitzgerald wrote another book with Eric Cressey called Maximum Strength. It is more about weight training than running but it has some good drills and warm up exercises in the book. For such a cheap price, there is a lot of interesting information in the Brain Training book.
Number 7: Self-Adjusting Techniques:
Number 7 on my list is actually two different self-help approaches to help solve alignment problems. I link the two together because both are things I could only find through use of the Internet. They both involve "thinkers" or "tinkerers" trying to solve problems with the function of body and do so in a new or different way. They both are also self-help methods. Both of these methods I have used to bring some relief to a "stuck" sacrum. Both of the methods also utilize movement of your body to fix it.
The first method I discovered was The Dorn Method. It is likened to a gentle model of chiropractic or osteopathy. I have had two runners thank me for directing them to the Dorn Method website and they have found the exercises helpful. I have not used The Dorn Method much since I made these posts because they were not the "full" answer for my alignment problems. Some of the hip exercises have been helpful in loosening up my hip and I have also used the knee and ankle alignment exercises. However now my body is in my better shape then it was when first I made these posts. I think it is a tool I could use in the future to help if things start falling apart again although it didn't magically fix things for me.
The other method came from the Self-Adjusting Technique website. I found the video for releasing the sacrum on youtube and used it after a 1/2 marathon that I ran with my sacrum stuck.
Immediately after doing the release it felt loose and free again. I have found that I shouldn't do this release when it is not stuck, but the two times it was jammed it seemed to help tremendously. Meanwhile it has not been stuck like that for a while now so I am happy. There are all sorts of other releases in the e-book but I have not really tried them as things are going pretty well these days. I did find the e-book easy to read and understand, I just don't want to mess around with my body when other things are working well for me.
I won a T-Roller massage tool at my first race of the year. I have a couple of The Stick massage tools and have used them heavily for years. The T-Roller is small like my Travel Stick but it actually is easier to get deep into a muscle than with my original Stick (which lacks much flexibility). The reason it gets a deeper massage is that it has rollers of different widths and this allows you to target a tight tissue or trigger point more effectively. I use my T-Roller (as well as The Stick too) often when I awake and my muscles are feeling tight. It is the best tool I have for relaxing and getting back to sleep.
Number 9 on my list it the only thing on my list that I was using last year, but it was at the end of the year so I include it here. I knew last year that I would have to try something new and different to help the hip and alignment problems that were plaguing me. I decided to look into kettlebells. They can be used for strength training but they also work the whole body out in a very fun movement orientated workout. Not only that but they get the heart pumping pretty quickly. I really enjoy swinging the kettlebells. I learned the techniques on my own through books and videos. When I use them I feel so much better particularly through the back and shoulders. I did find however, when my hips were off that the exercises were not that good for me because it would pull on my hips and back and I was practicing bad movement patterns.
Kettlebells have been the best strength training device I have ever owned. They are also the most fun. I can just barely do them indoors as when I do snatches the kettlebell swings up about an inch below the ceiling. If you are tall you better have a high ceiling. This winter I hope to get back into them more as I cut back some on the running. What is nice is that workouts do not need to take a long time. I also pick up the kettlebell at various times throughout the day and do a few swings or snatches and it always feels good.
There are a few books on kettlebells but the best way to learn is through a DVD. You can go to Dragon Door, the website of Pavel Tsatsouline to learn more about Russian Kettlebells. The best videos I have found have been the videos for the women. Pavel's videos show you how to do some of the lifts, but the women's videos take you through some routines that you can follow along with. The best is "The Kettlebell Goddess Workout". It has a variety of routines for specific body areas and includes some joint mobility work and stretches.
Kettlebells: The Iron Core Way Volumes One and Two are also good. Both take you through full body routines and explain how to use the kettlebell properly.
A kettlebell can be expensive (especially the shipping!). You need to read up on them and get the right size (which will be less weight than you think). I ordered my 35 pounder through Muscle Driver. The handle is thick but I think that is to help with your grip strength. I have two lighter weight kettlebells that I picked up at a Target store. They are good for light intensity exercise (or when learning). In summary I find kettlebells very appealing and a fun way to work with weights. But it is not just a weight workout as you are working on balance and form.
Number 10: Relearning Good Posture
Number 10 on my list would be a book I haven't even finished reading yet. It is the book "8 Steps to a Pain Free Back" by Esther Gokhale. I find the book to be visually interesting, eloquently written, and a fascinating look at the way posture has changed in the past 80 years. It shows how toddlers, some modern cultures, and people in earlier times held their bodies and moved differently. It also explores why these changes happened. Then it has a way to bring us back into better posture. I tried a bit of the positions and found them interesting but have yet to have the time necessary to devote to this book while I am still making other changes. The book trains you how to sit, walk, move, and even sleep better and to do it without the pain of an incorrect posture. The pictures of people throughout the world and in art works just make the book something worthwhile and thought provoking to read.
Well those are my ten favorite things I have tried this year in order to recover my stride. I have bought and tried and used plenty of other things: some were helpful and some were a waste of my time and money. There are no orthotic or foot insert devices mentioned. There are no sessions with chiropractors, active release therapists, massage therapists, rolfers, physical therapist, or anyone else (except Janet the resistance stretcher). Not that these aren't good things to try or that they work is not important, but after using all of these people in the past I still could not fix the problems with my hips and alignment issues without going back for more visits. I have not gone in for an adjustment or even a massage since the summer and I am feeling more in control of knowing what to do and how to do it if I want to continue to be a healthy and competitive runner.
Every athlete and person responds differently to every different therapy. We are all an experiment of one. These seem to be strategies that work for me. They may be just as helpful to others. I also look forward to making more progress so that I can run freely into my 50's and feel as good as I did when I was much younger. I may even find more interesting and workable solutions to keeping healthy and running strong.
I am also open to learning new things. I would like to know what works for others and what else might be worthwhile to look into. Or what your experience has been if you have tried any of these suggestions.
I am very much looking forward to the next year, particularly if I can maintain and improve on the positive results I have been having for the past couple of months.
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.
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!
Matt Metzgar has a blog called "Musings on Big Ideas, Health, and Other Topics." He has visited this blog before and sent me an e-mail of a book that he has been reading and blogging about. The book is called "8 Steps to a Pain Free Back" and was written by Esther Gokhale. I looked at what Matt wrote on his blog and checked out the official site for the book and also the reviews on Amazon.com . I also watched a video that Matt had on his site. The video is long so I didn't know if I would watch it all but I sat through the whole thing and tried some of her exercises. It was definitely worth my time to view this video and learn where her ideas come from and how people can simply implement them. Here is the video:
The book has wonderful reviews and seems to be not just a book about back problems and posture, but a book that looks at the way that Americans have changed the ideal posture to something that is less than ideal. The posture that is emphasized today is not correct according to this book. Esther has studied other countries, cultures, and civilizations from the past to the present and noticed that many Americans no longer how to stand, sit, and move correctly. Young children, some people in other cultures, and our own ancestors move or moved in a different way than most of us do today. She reteaches us how to stand, move, and to achieve a pain-free posture. Since her methods apply to movements like running, I think this book will be interesting to read.
I like when someone goes against the grain of popular wisdom to figure out how to solve a problem and then teach a new approach in a completely different way then all the "experts" offer. Bob Cooley did this with resistance stretching and this author seems to have her own method to teach us how to be pain free. I ordered a copy of the book and look forward to reading it. You can download a chapter of the book at her site too.
So thanks for the tip, Matt! I am always open to suggestions about what might work for me and what others find works for them.
After getting stretched by a resistance trainer on Saturday my running has felt really good. I was feeling light and free as I ran (not perfect) but a lot better than I have been all year. I ran 10 miles on Saturday, 10 more on Sunday and was feeling very good at the end of both runs, Monday I had limited time and managed to speed through an 8 miler, but Tuesday I had appointments all day and did not run. That night I had a little tightness in my hip and because I couldn't sleep I kept getting up to stretch. I think I pulled too hard or did too much but I had a lousy sleep and woke up in the morning with a tightness in my left sacrum or sacroilliac joint. Anyhow it is the same spot that often gets "stuck" and it has been doing this for years. It is the same spot where I kept pressing on my back to get a "crack" back in the 1980's when I was doing triathlons. It got me to the point where I had to do this every 15-20 minutes to feel good and of course messed things up for years! Anyhow it was stuck again all day Wednesday and I wondered if this is where the resistance stretching work would start falling apart.
I had a track workout at night so I did both resistance stretching DVDs before riding my bike to the track. The hip was still sore and tight but the workout went fine and was one of my best of the year. The workout was 8 X 800 meters at 5k pace. I did them all between 2:51 and 2:56 except for the first one in 3:01 and the 7th in 3:04. We had a good group and I hope my teammates don't mind but I like leading the pace in workouts at least until some of the guys would go by me on the 2nd laps and then I would have to work hard to hang on. I feel better and more determined in the front. The 7th one was started haphazardly so I decided not to lead to see if I would do better. Of course I drifted off the back and never caught up so I returned to my front running ways on the last one. I have to go with what works!
Even though my hip was off a bit my muscles were much looser and I was told my stride looked better than it had previously. After that hard track workout I didn't know what would happen today. I did the back exercises last night on the video above and by the end of the video the hip and back tightness was leaving my body. Today it is about 90% better as there is just a little niggle in the hip. I ran 8 miles today with no muscle soreness from the track workout at all. My legs were again loose and free. The hamstrings are really feeling much smoother and my legs seem to extend more as I run. The quads still have tightnesses, but I don't stretch them enough yet. The left one is still tight from where I had that "snap" last week. I still don't know exactly what happened except I really pushed the stretch to an extreme and I think some nerves must have rioted against the stretch. I am being gentle with the stretches to that area.
I am really pleased with how the resistance stretching is turning things around for me and giving me back control over my body. I notice that my legs are straightening out and rotating around the joints in ways that they were too tight to do before. My left femur does not feel jammed into my pelvis and so my hip rotates and works so much more easily. Sometimes I feel like a normal runner and not someone lumbering around trying to push my body in any way in can in order to move through a workout. My hips seem more even now and and although my right and left side do not yet work in symmetry they are a whole lot closer to that ideal than they have been.
Remarkably I also noticed something when I rode my bike yesterday and today. I have never been able to be comfortable sitting on a bike saddle. It has seemed for years that my left hip is pulled in tighter to the saddle than the right one and so I am aways shifting trying to get comfortable on a saddle because of the tighness and the fact that that hip doesn't drop down through the pedal stroke. I was sitting in the saddle so much better on these two rides. The only other time I have felt like that was when I rode my bike a few times in the midst of going through rolfing a couple of years ago. When I sit like this without the tight hip, my left leg is able to press down on the peddle with strong force. When I usually ride a bike (and this goes back to my triathlon days- I would angle my left foot out and leave that peddle loose to try to feel comfortable. I would also keep changing the nose position of the saddle right and left an awful lot-often a couple times a ride trying to get positioned correctly). So maybe these stretches are starting to change the tightnesses and imbalances that have bothered me for years. I hope this positive progression keeps up because I am thrilled to be able to move and run much more easily than I have in a long time.
two nights ago (putting it behind my knee and pushing it together against the tibia) and got a little movement or pop and my left foot, ankle, and lower leg and they have felt the best they have in about a week (no constrictions). 
. I also watched a video that Matt had on his site. The video is long so I didn't know if I would watch it all but I sat through the whole thing and tried some of her exercises. It was definitely worth my time to view this video and learn where her ideas come from and how people can simply implement them. Here is the video: