Friday, December 31, 2010

Kickstarting the New Year Early

I have kick-started my New Year a few days early. 2010 was not a very good year running wise, I can only hope that I can run in 2011. There are not many highlights. Probably my only achievement was winning the age group in the Moose on the Loose 10 miler which got me a RRCA state champion plaque. It was a very uncomfortable race for me as my hips were all off, but I fought back to pass a competitor to win the age group. I did hit 85 miles total in one week of running this summer and ran about 12 races in August, but by the end of the month I realized I couldn't run my hip into shape and have barely run since.

That means I have been eating a lot of bad foods, losing fitness, and not feeling motivated or able to do other exercise. I have been waiting out the medical care people to figure out my hip and stride, but patience has not helped. Every time I run a couple of miles, I feel it the next day with muscles around my hip lighting up like Times Square on New Years Eve.

This week I started doing something about it and I seeing if I can kick off the New Year and regain the ability to run, move, and feel better. So Tuesday, I started reading The 4-Hour Body. I knew I needed to change from the diet full of carbs and ice cream that I had been living on. I started cold turkey using Tim Ferris's Slow-Carb diet. Basically I am eating eggs, meat, beans, and veggies. You don't eat carbs from bread, cereal, pasta, or other sources so it is a about-face for my body. Fortunately, I am not really running so I am using this to drop some weight pretty quickly. The interesting thing about this plan is that one day a week you can eat anything you want and it doesn't even have to be healthy food. The body needs that jolt to keep up with the rapid weight loss. Here is Tim Ferris describing how to make a 3 minute breakfast. By the way I have eaten more spinach this week than in my entire life!

Also on Tuesday, I am finally getting some excellent therapy for my hip and leg. Back in November the physiatrist wanted me to try some physical therapy for my hip before considering other options. I went along with his recommendation for a therapist. The PT he sent me to was useless. I was getting basic old therapy, just moving my hip around and things like lunges. I have done this all before and the therapy wasn't changing even though I was going in twice a week. He couldn't answer any questions for me, was unwilling to listen to my observations, and if something puzzled him he just shrugged his shoulders. After three weeks I quit and asked the doctor if I could choose another therapist. I had an idea. After discovering the videos that Leigh Boyle was putting online over at Athletes Treating Athletes, I decided that she was the type of therapist who had the skills, creativity, and desire to help. I finally got my referral changed and ended up in Plaistow, NH for my first visit on Tuesday.

What an excellent choice. Leigh is a triathlete and understands the athlete's body. On Tuesday she worked for about an hour on the muscles of my left foot and leg. She is working on the weaknesses and tight muscles, and trying to straighten things out. She also uses the metal scraping tools of the Graston Technique and ART (Active Release Technique) and who know what else. My left leg was a bit straighter after one session. The next day I tried a treadmill run and went 3 miles. I felt much more balanced, but my glutes were still tightening up a bit. That afternoon the glutes got tighter and tighter and all around my hip started getting tight. That night I was up for around 2 hours trying to loosen up, and finally I got the left psoas muscle to release and it all went away. It is not going to be an easy fix.

Leigh wrote up a whole list of things that explained what was going on. Despite my abnormal structure, she thinks the calf tightens and everything else stiffens up. She thinks that my foot and lower leg is what is hurting the hip so that needs to be fixed first. I trust what she is doing and it is the hands on type of therapy that I have been searching for for years. So even if it is a drive of almost an hour each way to get there, I am happy to head out to Plaistow twice a week to get fixed.

Leigh's site is Athletes Treating Athletes. She is putting out some of the best videos I have seen for self-treatment of athletic muscular injuries. Check out the site. Look for the stretching and self-massage sections. She works out of Pinnacle Physical Therapy. I noticed a lot of articles on Dave Dunham on their bulletin board. Dave goes there for treatment and he is a master on running and getting injured.

Monday, December 27, 2010

"Unbroken" - Never Give up!

"Never give up!"
 In 1977 I graduated from the Stony Brook School on Long Island. The commencement speaker was the Rev. Billy Graham (his son Ned was a classmate). I don't remember much of Billy Graham's speech, but I do recall his final words," Never give up. Never Give up. Never. Never. Never," (although the "never"s sounded more like "nevah"). Those are great lines and through the years I have remembered them. Fortunately my struggles in life have not been too dramatic and I have only resorted to using Mr. Graham's words in situations involving athletic endurance and health.

There is a bestselling book out now, that epitomizes these words of Rev. Billy Graham. It is the remarkable life story of Louie Zamperini told in Laura Hillenbrand's book, Unbroken: A World War II Story of Survival, Resilience, and Redemption. Louie grew up a juvenile delinquent in California. In high school he became a runner and turned his future around. He set the high school mile record and ended up at the 1936 United States Olympic Trials as a teenager. He earned a berth on the team to Berlin by finishing the 5000 meter track race in blistering heat tied with world record holder Don Lash. In Berlin he made it to the finals and in a remarkable final lap made up tons of ground to pass many runners and finish eighth. His final last lap of 56 seconds caught the attention of Adolf Hitler who asked for a private meeting.

This book isn't really about Louie Zamperini's running career, although a case could be made that Louie was on the fast track to possibly becoming the world's first sub 4 minute miler. The mile was his race, and that final 56 second lap was 3-4 seconds faster than the world's best milers were running in the final laps of their mile races. Louie did go on to set a collegiate mile record that stood for 15 years.

World War Two was looming and Louie joined the United States Air Force where he became a bombardier. After flying numerous missions his plane went down due to mechanical failure and he survived 47 days at sea in a small life raft with one other man (the record prior to this for life raft survival was 21 days). He was rescued by the Japanese Navy and sent to prisoner of war camps were he was subjected to unbelievable cruelty. Meanwhile he was considered dead back in the USA. One particular guard, "The Bird", tried to break Louie with constant pummeling and hatred. It was remarkable for Louie to continually face such outrageous treatment, hunger, and conditions to survive.

He did, however and returned to the United States as a war hero. He thought he could go on with his life, but his demons caught up with him and nightmares of "The Bird" sent his life into a downward spiral. A speech by a young Billy Graham helped bring Louie to his senses where he learned to find peace, forgive his captors, and bring his life back in order.

This was a wonderful read that was masterfully written by Laura Hillenbrand, who  also wrote Seabiscuit: An American Legend. It was the first book I read on my new Kindle,I found the Kindle experience to be a great way to read a book and I was engrossed in the text for the past two days. This is a must read book and I must say I now have a much better idea of what Billy Graham meant when he said, "Never give up. Never give up. Never. Never. Never." He could have just told us the story of his friend Louie Zamperini. Maybe he did. I just can't remember.
Here is a 4-part series on the Life on Louie Zamperini (maybe you saw this years ago on CBS during Nagano Winter Olympics).

 Great video of the 1936 Olympic Trials 5000m finish.

 Beware the loud white noise ending this clip.

Beware! While the volume of this video is on the soft side, the is FULL VOLUME WHITE NOISE at 9:26 that could blow your speakers.

 Includes CBS interview with "The Bird"

Book Trailer for Unbroken

Fox New Report: Portrait of an American Hero

 Laura Hillenbrand's website for Unbroken
2002 Running Times article "The Meaning of Endurance: Olympian Louie Zamperini's Story
January 2011 Runner's World article "Life according to Louie"

November 2010 Wall Street Journal article on Louie Zamperini and author Laura Hillenbrand, who is a prisoner herself in her won way due to Chronic Fatigue Syndrome: The Defiant Ones


Here is a recent photo of Louis meeting with Billy Graham in June 2011


Saturday, December 18, 2010

You know what, I want to get back and compete!

I like a guy who doesn't give up, and the American record holder in the marathon in just one of those guys who doesn't quit. There is a very good article on the "Races Like a Girl" blog on what is currently happening with Khalid Khannouchi. He still dreams of recovering from injuries and running fast times.
"You know what, I want to get back and compete!"
I have no clue what it is like to run at the level that Khalid Khannouchi  competed at, but I can feel his pain about being injured and just wanting to get back to running and racing. It would be great to see him tearing up the roads again.

Here is a letter I wrote that got published in Sports Illustrated back in 2002 after the magazine failed to acknowledge Khalid Khannouci's world and American record being set at the London Marathon in the same week that an article lamented that Alberto Salazar was the last great American marathoner.

Marathon Man
It was nice to revisit
Alberto Salazar (CATCHING UP WITH, April 22). However, the article begins, " Alberto Salazar has no desire to be known as the last great American marathoner, but that's exactly what he is." Well, in case you didn't notice—and it looks that way—an American set a world record in the London Marathon on April 14. Khalid Khannouchi broke his own mark in a long-anticipated, epic race against two of the greatest distance runners ever, Ethiopia's Haile Gebrselassie and Kenya's Paul Tergat. The often overlooked Khannouchi is an American citizen who was born and raised in Morocco, but this does not make him any less an American. Just ask Alberto Salazar, who was born in Cuba. The greatest marathoner in the world today is an American! JIM HANSEN, Nashua, N.H.

I had Khalid sign it before the Falmouth Road Race one year. He was sitting next to Alberto Salazar and I thought it would be funny to have him sign it too, but I didn't think that would be  respectful of me.

Here is the Mark Beech article in Sports Illustrated that I was responding too. It is the only time in my life I wrote a letter to a magazine and I was very shocked to see it got published.

My letter was later quoted in a Running Times article in January of  2003: Foreign Born Americans: The Diverse Face of Team USA By Jonathan Beverly, Roger Robinson.

I cannot believe that  there is no video to be found online of Khalid Khannouchi setting one of his marathon world records.

Sunday, November 21, 2010

30 Year Ago: Running and Racing in 1980

I recently dug up an old sheet of paper with my summer mileage for the 1980 cross-country season at Wheaton College. I was never that talented of a runner, but 1980 turned out to be one of my better and more interesting running years. I ran some personal bests that year that were very pedestrian by collegiate running standards, but it was the best I could do.The sheet shows that in 12 weeks of summer training, I accumulated exactly 1000 miles of running.My goal over the summer was to do more mileage than anyone else on the team and hopefully make the varsity squad for my last year of college cross-country.

Here are some highlights of an average, but determined runner in 1980 that saw me race distances from 1500 meters to the marathon, plus a 50 mile run on the track. I basically wasn't needed on the track team in college, OK I stunk and we had plenty of guys much faster, but I did race a few meets here and there and practiced with the track team often.

1979 ended with me running my second marathon on Nov. 25 right after the cross-country season was over. This was the Philadelphia Marathon and I ran 3:03:57. After the race immediately  took a train to NYC, then a bus to Worcester, Ma., where I met some friends and we then drove 20 hours straight packed into a car to get back to college. Somehow I unwound myself to run the cross-country teams 24 hour relay on December 7- 8. We went 250 miles and then stopped earlier than 24 hours as too many guys were injured and couldn't run anymore. I said, "Never again!" to doing one of those. I like my sleep too much!

March 22-I ran a 1500m in 4:27 and a 5000m in 17:07.
April 13 I ran the Aurora Marathon in 2:54:38 (my 3rd marathon and my first under 3 hours. I had not run a training run longer than 11 miles since running the Philadelphia Marathon back in November-although I did run 30 miles in one mile intervals on Dec. as part of that 24 hour relay). My time in the Aurora Marathon is very important to me now. If I can get my hip and stride fixed, my number one running goal is to run another sub 3 hour marathon. If I do, I will get on this list of Longest Time Spans Between First and Last Sub 3 hour Marathons. The longer it takes me to go sub 3 hours, the higher up the list I go.

May 8- I ran a 1500m in 4:17 and an hour or so later ran a 5000m in 16:02. It was a beautiful night at a North Central College all comers meet. The 5000m was won in 13:50 something by teammate Danny Henderson. Olympian Steve Lacy and other top level runners werealso in the race. The closest I got was when I was lapped by the lead pack, but I got to watch the sprint finish from across the track.  Earlier that night an errant hammer throw went flying over a screen and hit a guy in the head. He died later that week.
May 17 Gil Dodds Marathon in Wheaton, Illinois. I ran 2:50:07 just missing the qualifying standard for Boston. I lost some seconds running into a parked car with about a mile to go and running too far around the  track before heading up the football field with just about 75 yards to go. It was a disappointing race to miss a qualifying spot by seconds, but I was the first Wheaton College runner to finish. 1980 was the only year the race was held. A lot of it was run on a gravel "prairie path".

Heading to the finish. I thought it would be one lap around the track.

Nope, you had to cut up the infield to finish. It was my second 11th place marathon finish in a row.

Summer training started June 2
Weekly mileage:
1) 98 miles
2) 74 miles
3) 107 miles
4) 100 miles
5) 71 miles
6) 92 miles
7) 53 miles
8) 92 miles
9) 90 miles
10) 55 miles
11) 73 miles  Ran the Falmouth Road Race in 39:58
12) 92 miles

I did make the varsity team for Wheaton College:
November 1- At the conference meet I secretly decided to try to have a "breakthrough" race. I went out with the lead pack and hit the first mile at under 5 minute pace. I tried to stay with the lead pack of North Central runners and other top runners as long as I could. It was going good until someone put concrete in my shoes and I waddled home in 27:55.The coach was mad! I was trying to go sub 26 minutes. You'll never know what you can do, if you don't try! I tried. I couldn't! !I then developed a sore right hip-later diagnosed as wallet in the back pocket of too tight jeans pain. I wasn't sure if I could run my final collegiate race.
November 15-My hip still hurt but I used a lot of Atomic Balm on it. Hit the first mile of the NCAA Div. 3 Midwest Regional race and found myself in dead last place. I can't imagine how slow that first mile really was. Fortunately my hip loosened up and I decided not to let my last cross-country race end this way. I took off and started passing people by the score and had a blast! I ended up running  26:52.

The end of cross-country running.
 November 23 I ran the Cape Cod Marathon. I finished in 2:51:57. It was not run in Falmouth in those days, but rather on the desolate and windy Otis Air Force Base. I was hacking away the whole race with a terrible cold and cough. Every cough seemed to send me backwards a bit. There was a lot of pack running and that time only netted me 44th place overall.

Here is a picture of race winner James Murphy finishing the 1980 Cape Cod Marathon.

Dec. 5 The Wheaton College Cross-country team was doing another 24 hour relay. After running the previous year, I said never again. I decided to start at the same time as the relay runners and run 50 miles around the track instead. I did have a plan to walk a lap at regular intervals as I was seeing what it would feel like to be an ultra-marathoner, not to go fast. It took me 8 hours 41 minutes and 43 seconds. I don't recall if I ate anything or what I did for nutrition. The highlight was that somewhere around 40 miles, someone dragged a stereo system out onto the track and played Bruce Springsteen's album "Born to Run". The second best thing is that I walked home and went to bed that night. I came back the next morning to cheer on the still running relay runners.

The day after running 50 miles and getting a good night sleep.The 5 guys on both the top and bottom rows were the 24 hour relay runners.They look the part, too!

The loneliness of a 24 hour relay. Jon Orewiler handing off to Coach Jim Whitnah.
Final victory lap for the relay runners. Mark Faris and Dave Whitnah can be seen sleep-running.

In 1980, Bill  Rodger's won his fourth Boston Marathon and Jacqueline Gareau was the female winner after Rose Ruiz tried to steal the win. 

Here is a great old clip off someone's home movie camera showing the Boston Marathon in 1980. You can see Bill Rodgers and other top runners racing by the camera. Interestingly enough you can even see Rose Ruiz (yellow shirt-45 seconds) after she sneaked onto the course. At the end of the video you can see the 1979 NCAA Cross-Country Championships that Alberto Salazar won. You can also see teammate Danny Henderson finishing in 10th place (just days after winning the NCAA Div. 3 XC Championships-blue shirt-orange shorts-orange hat). Then he did that 24 hour relay with us weeks after this race!

Here is another clip. At 1:28 you can see Jacqueline Gareau and the 2nd place female Patti Lyons Catalano. Notice the police horses on the course. In 1981 Patti would slam right into the backside of one of the horses during the marathon.

Bill Rodgers also won his fourth New York City Marathon in 1980. Greta Waitz was the female champion.

Tony Sandoval won the USA Olympic Trials Marathon (to nowhere). Part of the course was in Canada. Women were still not allowed to run the marathon distance in the Olympics.

Craig Virgin won his first of two World Cross-Country Championships with an outstanding finish. You have to see this, if you have never seen it before.

The USA did not participate in the  Moscow Olympics, but Seb Coe defeated teammate Steve Ovett after losing to him in the 800 meters.

 Miruts Yifter won the 5000 meters and the 10000 meters.

There was lots of running and track on television in 1980.

Tuesday, November 16, 2010


Labels: I have a few new ones.

Last Monday I had a cortisone shot. It was supposed to be a diagnostic tool and I guess it was.
The shot was great. I didn't feel a thing just a small needle  pinch. Nothing hurt or got sore afterward either. That night I ran 1 mile on the treadmill. The next morning, I woke up and ran another mile. Everything was OK, so I ran 3 miles that night. I was still fine so I looked forward to the next day. I ran 8 miles. Everything around the hip felt loose (no muscle problems) and at the same time the hip joint felt firm and tight. I had no problems on the run or after the run. The next morning I could lift my leg up without the stiffness that I usually would have. I liked the feeling. I ran 8 miles again the next day with the same result. This was unusual. Nothing was making my hip sore. I didn't want to overdue it so I took a day off and Saturday ran again. My left foot was rotated a bit to the outside and my stride wasn't the best, but I decided to "test" things. About a mile into the run, I felt "something" in the muscle of my right back side-lower ribs. It was like a muscle "let go". I have had this a couple times in the past and I end up having muscle spasms or a back pinching for a week or two after. I kept running, but I wasn't as loose as before. I felt things deteriorating and my left glutes were having a problem. After 30 minutes of running, I had to stop. The back hip "glute medius" or "piriformis" had tightened right up and was in something like a spasm. It was cold and I was in shorts. I had to walk for an hour to get home. It hurt to lift my left leg and swing it forward as well as put it on the ground each step of the way. This felt like a  muscular pain, but I also noticed a tightness or rubbing in the hip joint. If it wasn't so cold, I would have just sat on the ground because it hurt to walk. That was the last I have run. My lower right ribs still have a stiff spasmy spot and my glutes have been sore since the run. The cortisone was great while it lasted, unfortunately it didn't last long.

Today, I saw the physiastrist again. He looked at everything again and thinks it is not so much tibial torsion, but femoral anteversion. He thinks it is the hips that make the leg do what it does. Labels! He said that it looks like the cortisone wore off. I think it is still a bit of being out of balance. I have felt like a truck has hit me since Saturday's run. I think that my body was running smoother and then  muscles reacted to a new pattern to protect itself-even though nothing hurt. I have had the upper back go off like that before, and it was usually after I had some body work done to relieve tightness in the hips.

The physiatrist wants me to get a gait analysis done to see exactly what my body is doing with the tibial torsion and femoral anteversion. I am not sure if insurance will cover this. He thinks my body has done a remarkable job compensating through the years to keep me running and doesn't want to alter that much. He is also sending me to a physical therapist to work on stretching my left internal hip rotators and adductors, and to strengthen my left hips external rotators and abductors. He made an extra label on my referral slip: "high level runner". Well, I have never been called that before, but I like it. At least he is not treating me like a joke. I do feel that way when I see the other people who are in all sort of pain and distress in his office.  I can't really complain about my problems, but I like the challenge of figuring this all out.

What is femoral anteversion? 

Femoral anteversion is an inward twisting of the thigh bone, also known as the femur (the bone that is located between the hip and the knee). The physiatrist thinks that this is causing an impingement in my hip due to the rotation and that is the source of my pain. The twisting of the femur means my left glutes get weak and stretched and that is why it is sore. He showed me where he thinks the small labral tear is, but isn't sure if this is the real problem. Anyhow, he wants to treat things conservatively with therapy before he looks into more aggressive  things like surgery. The surgery to fix a femoral anteversion is usually only performed on children. He doesn't think it has is performed on athletes to keep them running. It seems to involve breaking the bone and having it grow back again. I don't think I want to be the first or next runner to have this type of surgery!

Anyhow right now I am back to being a low-level non-runner. The cortisone was great the few days it lasted. That was the longest string of days without pain of many in years! I was really enjoying the added hip mobility and the feeling of what a normal leg would feel like.

Here is a very cool web site  I found to learn about muscles. You click on a muscle and the animations show you the origin, insertion, and actions of the muscle. It is called Get Body Smart.

Monday, November 8, 2010

Cortisone Shots and Ankle Rockers

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.
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.


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.

I also went back to checking out what the Gait Guys had to say. They were the first to give me a name for the tibial torsion. This is from their podcasts and pretty much descibes what my left leg does: Podcast #7: All about the Glutes (and nothing butt).

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).

Wednesday, November 3, 2010

A Trip to the Physiatrist

I had my first appointment with a physiatrist scheduled for the end of the month, but I got a call yesterday that there was an opening so today I had my first visit. When I arrived, I really wondered what I was doing there, It is a pain clinic and the people coming and going looked like they were in bad shape and I was just sauntering into the joint. Then I had to fill out all sorts of forms, a lot of them dealing with drugs and pain medicines. It was a longish appointment (over an hour with the doctor) to go over my history. He had already viewed my records. I liked the physiatrist, he was young and seemed  interested and puzzled. He listened and didn't jump to conclusions like he was a know-it-all and thought about each tidbit I presented him with. So things were off to a good start.

He moved my leg around and like the last orthopaedist didn't believe I had a labral tear because nothing was painful. That would be good news if I don't need surgury. From my x-rays he said my hip was in pretty good condition (just mild arthritis). He said this could be because of all my running, strangely enough my body has found it own way to move without damaging itself. He recognized the tibial torsion in my left shin and said I also had femoral antiversion (internal rotation) in my left hip. I was born that way and I guess you can't change either of those without breaking bones in surgury so that they grow back a different way (no thanks!). He said it is very rare for someone to continue running with these "defects". The average-normal-thinking person would have found something different to do with their time. But, he also doesn't think that running has to be a bad thing. I agree on one level, despite this new hip pain that I got in the summer, once I stopped running in September all my musclulo-skeletal imbalances actually feel worse throughout the day and night. Running usually removes a lot of this tension and pain for me.

He thinks the internal rotation of my hip has led to an impingement, not an FAI impingement that begets a labral tear, but a ligament or muscular impingment. The adductors are too tight to compensate and the abductors are too weak because the are not working. He is going to work with me to see what we can do.
First off, he wants x-rays of my knees to see if there is something going on in my left knee. I have avoided knee pains for much of my life, but when my leg and hip is out of balance and rotating wrong, I do get a tightness in my knee.

He also wants to try a cortizone shot in the hip. I guess I am supposed to not want it to work. If it clears things up for a while then it could mean a labral tear. But I wasn't clear on all that he said this would be about. That will be Monday morning.

He also said it would be very interesting to get a gait analysis done. I don't know if my insurance would cover some of this. What I did appreciate is that he went to a school with another doctor who specializes in running gaits  and he is going to call her and ask her about what to look for and to look into with my stride.

I am glad I got in there earlier to get the ball rolling. I am not sure what treatment or therapy I might get as I have already done most things that we talked about, but hopefully the doctor can stick with me and things a bit more to at least get me up and going again.

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.

Monday, November 1, 2010

The Perfect Stride

Here is a wonderful article on Alberto Salazar working to change the running form of Dathan Ritzenhein. Alberto sure is a tinkerer. The article goes through the running history of Salazar as well as his awful mechanics (including his Falmouth Road Race near-death collapse in 1978 and the famous Boston Marathon "Duel in the Sun" back in 1982) and then tells about what things Alberto has been doing to perfect Dathan's running form. The article comes from the New Yorker and is called The Perfect Stride. It was written by Jennifer Kahn.

Here is the video that accompanies the article to explain a bit more of the contrasting forms of Dathan Ritzenhein and Kenenisa Bekele. You will even learn a new form technique that Alberto calls "nipple to nipple" running.

Dathan was on fire last year after a few months of work by Salazar (setting a then American Record in the 5000 meters and then claiming a bronze medal at the World Half-marathon Championships) but has been limited by injuries this year. Sunday's New York City Marathon will be the testing ground to see how well Salazar's tinkering has worked for Dathan.

Here is the awesome video of his then 5000 meters record.

Sunday, October 31, 2010

A Conversation with Fitness Expert Jonathan Ross

This week I had the privilege of having a phone conversation with  fitness trainer Jonathan Ross. Jonathon is a multiple award winning fitness trainer who most recently won the 2010 IDEA Personal Trainer of the Year. He has a blog for Discovery Health called The Everyday Fitness Blog and is the author of the just released book Abs Revealed.

If you are curious how I got to talk to Jonathan, it came about in a very serendipitous way. I happened to be on Facebook a couple of Sundays ago, when a post came up from the people at TRX Suspension Training Systems. It mentioned that the first three people who correctly answered three questions would win some TRX swag. It was a trivia contest celebrating the book release of Jonathan Ross's "Abs Revealed". It also mentioned that one of the first three respondents would win a phone conversation with Jonathan Ross. I ended up being the second person to answer the questions (you had to be quick) and later was notified that I won the phone conversation too.

I immediately ordered the book so I would have it before the phone call and checked out some of Jonathan's videos online. I have and love my TRX suspension trainer, but I am very much a beginner at using it despite having 4 of the TRX DVDs. The TRX Pendulum was the first I found and it is a really good one.

This is one of the videos from the "Abs Revealed" book, which is the first book to include exercises for the TRX Suspension Trainer. Jonathan got in email contact with me and we set up a time for the call. He also wanted to know if I had a couple of questions in mind to send his way. Being a long time distance runner with all sorts of functional and biomechanical issues, I quickly gave him an overview and sent him a link to my blog. I looked forward to the phone call, but wasn't sure how it would go. Would he be a trainer who was anti-running (particularly for someone like me with so many issues) or would he just go through the motions during the call to fulfill his obligations? I would have been pleased just to have him answer a couple of questions from his book.

I was pleasantly surprised when he got on the phone and was very complimentary on my willingness to pursue my own fitness goals despite my issues and on how much I had done on my own. He had actually read my blog to find out about my issues and how to best answer my questions and give me the best advice possible. Without seeing me in person, he thought it would be hard to see all that was going on in my body, but he did put together a few exercises beforehand that he thought would help me out to get back to running which is the activity I love to do. Jonathan began describing and explaining three exercises in particular. I found his explanations clear and I was able to visualize exactly what he was saying, even though two of the exercises were unlike anything I have encountered before, and I have done a lot of research and reading on all sorts of exercises. I was writing notes like crazy as he talked as I realized that I was hearing some real creative and applicable advice. The exercises were designed to address some of my asymmetries and imbalance issues and I immediately saw the rationale and thinking behind each exercise. The time went by quickly, but it seemed like I was on the phone for hours, because Jonathan gave me so much detailed information. My brain was popping by the end and I was very tired from just all the great things I was hearing and trying to capture. Let me just say, Jonathan Ross it a true professional. He gave me more that 100% of his time and his advice was creative (not some rehash of the same old movements) and sensible. He was also extremely motivational and complimentary and made me believe again that I was on the right track and doing the right things in trying to get my body to behave again. If you go to Jonathan Ross's AionFitness website, you will see that Aion comes from the Greek word meaning age and eternity. He explains:

I believe that fitness is a life long pursuit of living to your maximum physical potential. I will teach you to enjoy movement and physical activity, and to use your body like it was meant to be used.

Fitness is about being able to do the activities you enjoy without feeling your body complaining to you or limiting you in any way.

Aion Fitness = Fitness for a Lifetime!

That is exactly what I want out of my fitness and running and I thank Jonathan for a super phone conversation full of great advice that fulfills my goals and helps me on my way to moving and running correctly again. Thanks also to the TRX folks for putting on the contest and giving me this opportuning to learn a little bit more of how to enjoy adn maximize my own fitness.

So what did Jonathan teach me? The first move was something simple called "toe raises". This is pertinent because I have hip problems and hip problems are often tied together with feet problems and I have those too. I am also adjusting to new orthotics due to a toe problem called Functional Hallux Limitis. My current hip problems that have put a stop to my running are probably due a lot to jumping into to using new insoles to correct the problem this summer. Within a couple weeks of using them, I had bumped my mileage up to an 85 mile week (including 52 miles in 3 straight days). I was correcting one problem, but starting a new one! The toe raises also help with balance and help to keep my arch from collapsing. The point is to sit or stand flat-footed (and barefoot)and lift up either the big toe or the four other toes. It sounds easy, but I found I couldn't even figure out how to lift up the big toes on their own. Try it, is it easy for you? I am slowly getting some control over the big toe, but it is hard to lift up and even get some toe awareness going. This is a great little exercise I can do anywhere.

The second is an exercise I am familiar with, but I am familiar with so many exercises it is hard to know which are the good ones to do for my own conditions and which are not that important. Because I run and move with the left side shifted ahead of my right side, Jonathan thought this would be good for me. Basically, you sit tall with a ball between your knees, hold your arms across your chest and rotate left to right for a set before rotating to the opposite side. This exercise works the obliques and I think is another easy and essential exercise to do, particularly when I even find it hard to turn around to look behind me when I run.

The third exercise is really great. Why didn't I think of this one? I think it will help my sore adductors as well as my wayward left leg with its instability. It is a standing internal and external rotation for each leg. You do it by standing facing forward on one leg and rotate the other leg across the body in front and moving around it  like the hand of a clockback toe-tapping the ground for balance as you go. If you stand on an "+" marked on the ground you can see your improvement as you go.

These are all great exercises that Jonathan picked out for my specific needs. I think they are really great and I am thrilled that he took the time to tailor the phone call to my needs. He also gave me some tips for using my orthotics, for using my TRX (do one legged exercises for the lower body) and a progression of very slow lunges where I am to work on the weight shifting from one leg to the other and back. This is all good stuff and I can see why Jonathan Ross is such an award winning trainer. He treats you with respect, is positive and affirming in his comments, and is creative in his approach to problem solving. I was not given cookie-cutter exercises, but the exercises were individualized to meet my needs.

His new book is called Abs Revealed and we didn't even talk about that. I am still reading through the book but it has solid advice on food and nutrition as well as a progression of exercises utilizing a variety of exercise tools like the TRX as well as Bosu and stability balls. Each exercise has positioning and technique explanations as well as performance tips. It is very readable and has color photographs on its big glossy pages. My advice is to get yourself a TRX Suspension Trainer. It is such a great tool for runners that is full of possibilities and if you want a good book on using the TRX to strengthen your core, this is definitely it. I have to get my running under control and then I can really work on getting some killer six-pack abs!!

In this video Jonathan Ross answers some questions about abs training and his book.

Saturday, October 30, 2010

Exactly the Same Week after Week

30 years ago Nov. 1980 when it was much easier to run!

This weeks running; Sunday 4 miles on the treadmill, Tuesday 1 mile on the treadmill, Saturday 8 miles

Nothing worth reporting on the running front but wanted to bookmark today's run for future reference. I woke up feeling great and balanced today with no muscle or joint pains. I knew my left adductors were tight still, but wanted to try a run just to see where things were at, knowing that I will probably be sore for a few days afterwards. This run went just like the 8 milers I did a couple weeks ago and the 8 milers a couple weeks before that. I think that all the times that I have been able to complete an 8 miler the past two months that they have all progressed basically the same. So there is a pattern to follow if a doctor can figure it out.

To clarify and remember what happens with my hip I am writing it down here. First of all, I started each run feeling great. I don't seem to have the inflammation and tightness around my hips and quads that I had all summer when I was training and racing through it. As I ran down the road, and after the first few steps of remembering the process of running, I felt great. I had a pretty good even stride and I felt strong. This is the way I would like to feel. After about 1/2 mile, I could feel a tightness in the adductor, that stingy cord inside the leg that up into the pelvis. The tightness would spread first in front of the cord about an inch forward and then in back of that cord into the back of the glutes. It would feel really iffy running this way and each run I would think of returning home so as to not injure things more, but what the heck, its not getting better anyhow. After about 3 miles, the left hip would be unbalanced a bit, but things would feel a bit looser. I would focus on running loose and balanced and things would then be pretty good. Today, the stride felt really nice and much more balanced then during the summer. If I could just run with a stride like this without the pain, things would be the best they have been in years. I could keep a pretty good training pace as I ran down the road, but if I tried to go faster things would tighten up.

Then with about 2 miles to go, my hip starts to lose some stability. I can't get it loose again and I can't keep my pelvis balanced. Things would start tightening up on the front outside of the hip where the femur joins the pelvis and to the back outside as well. Today, I figured out what it happening to the hip to throw things off. This is when the femur goes back to being pulled  tight to the inside. It feels like the tight adductor or other muscle right in there starts tightening and strongly pulls the top of the femur over to the inside where it feels a bit jammed into the front inside of the hip socket which then throws off my mechanics and my stride. That is when my lower back and  the outside of the gluteals start tightening up and the hip feels jammed in place and I don't feel like running. I had to stop just a 1/4  mile my from my house 2 weeks ago as it tightened up too much to run. I made it home this time, but couldn't have run much further.

Unfortunately, I didn't get an appointment for the doctor (the physiatrist) until next month on November 30. I really wish they got me through the MRI. I'd really like to know if it is a labral tear, a sports hernia (athletic pubalgia), or some other strange injury that I can't figure out, but isn't that the doctor's job? I don't think it would be a stress fracture at this point as it has been over 2 months now.

Anyhow, it is a big tease when I can run those middle miles feeling about 80% balanced and pretty strong for the lack of recent training. I can't wait to get this fixed. It is in moments like those that I know I can beat this thing!

Sunday, October 24, 2010

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.
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!