Wednesday, May 15, 2013

Simply Running: I Wish

It's a simple thing. I just want to run. I only did two runs last week: 3 miles on the treadmill and 2 miles around the neighborhood. I did make a lot of phone calls. I have an MRI scheduled next Friday for my hip. Some days I feel good and pretty much balanced and then all of a sudden, I will get like these light burning pains from my toes, to the bottom of my feet, to the back of my knee (these are all only on the left side) to my adductors, to my lower back, and up my back to behind my shoulder. It may last all day and then just disappear. It can't be muscular as I am not really doing anything. I also am tight in the adductors and glutes on my left side and maybe tight in my high hamstring, too. The hip doesn't want to work right.  I have no clue what all this is, but it reminds me of the randomness of things pre hip surgery.

I have a physiatrist visit planned at the beginning of June and the possibility of seeing a new chiropractor who does dry needling, gait analysis, ART, and a functional movement screen. These may be worth a shot.

I went for my fourth weekly visit to the new chiropractors office this morning. I wanted more work on my feet which she had done the first session and had my running well that night and less work on my back. I think the spinal manipulations there may have been too much for me to handle. I like the variety of techniques she uses, but I am not sure what works and what doesn't and she is young and new to the practice and I am well, I guess, complicated..

Typical smile when running these days.
What happened to my smile?
At the end of the session, she had a question about my hip for the head chiropractor, who is well known for his work with amateur and professional athletes and a strange thing happened. The first thing he asked me was about my facial tone. I said, "What? What are you talking about?" a few times, but he caught me with his question, because I have been wondering about the left side of my face. When I look at photos, it droops down, particularly when I am running, but I wasn't sure if that is what he meant.

He did a balance test. I have been doing this at the start of every session where you stand on a foam mat and close your eyes. I always end up leaning to the right with pressure on the outside of my left foot, He did some eye tests: looking at a pencil to the upper right and then down to the lower left and made some comments to the lady who had been treating me. I did  the balance test again and was more balanced that time. Then he  had me sit down and raise a leg one at a time. I had told him about how hard it is to lift my left hip flexor so he gave me a very cool hip flexor strengthening exercise I have never seen before (see below).

He spent only about 10 busy minutes with me, but it was mind boggling. As he was giving me a doctor's name to consult with about my hip, he said I should look up something called  "pyamidal distribution of weakness".  When I got back to school, I did. He had told me not to be frightened by all the stuff I might read on the web, but I got a bit uneasy reading what I could find. It has something to do with a lesion and neuromuscular stuff and some pretty crappy illnesses. I immediately got a massive headache: whether from the eye movements we did or from seeing this new stuff. Really I just want to run, not be a basket case, but I am interested in what he might say. I will have to call and see if he can guide my treatment, instead of the lady chiropractor as he was making asides to her about what we should or shouldn't be doing and I didn't catch it. I had been planning to stop treatments before he worked with me until I found out info from the MRI.

Well, at least I may know some answers after the MRI (and if you know how much I hate MRIs then you know I am serious about getting answers) and who knows what this stuff the chiropractor was mentioning was really about?  A retorn labrum almost sounds nice now. I am hoping they only find some scarring or tendonitis or something that is simple to treat. Another hip patient looked at my recent x-rays and thought she saw slight cam on the hip and some possible pincer (but she is just someone on the internet). Those would be signs of FAI and something my surgeon does not acknowledge and I have found a few other patients of his who had similar problems to be and had to go to another surgeon after their labrum re-tore due to the FAI. FAI is an impingement that the surgeon needs to fix during surgery or it can re-tear the labrum. Let's just hope I aggravated some muscles or tendons and that some rest can fix things up.

Here is some good news about the tightness in my adductors. I have learned to avoid most stretching of my psoas and adductors as I found it aggravates things. I also found that doing glute medius exercises like the clamshell or straight leg lifts tighten things up too much in the glutes like someone hit them with a baseball bat, but I am supposed to do those, right? Fortunately, I started listening to myself and what some other hip surgery patients have said about their muscles getting aggravated by doing these so I am stopping. However, one night this week I found this page called Untying the Four Knots I had bookmarked in the past and decided to do this frog like stretches and movement for both adductors at the same time. A single leg move always throws things off. The day after doing the movements in the video, my muscles were tight, but I noticed I could lift my leg up higher. I waited a couple of days and tried them again. They don't seem to aggrevate me and I can lift my knee even higher. Of course this could also be due to some Graston work on the adductors, or due to the fact that I started taking Advil. I also notice I can lift and rotate my leg to get out of a car seat without using my hand for assistance. So maybe I have found a helpful stretch for those adductors.

Here is the video:

The new hip flexor strengthening move I was given goes like this:

Kneel with the leg knee on a cushioned mat (theirs was 2 " thick or so) with the toes pointed behind.
The left hip and knee are both at 90 degrees like in a typical hip flexor stretch.
Dorsiflex the left foot and lift the foot off the ground by bringing the knee up and down. Repeat.
Then he had me look to the right and hold my right elbow up to shoulder lever with the hand 90 degrees pointing up. Lift the left knee again. I immediately felt it target the hip flexor in a new way.

I don't know what type of movement therapy this is from, but I will give it a try.

I used to blog a lot on teaching on my Simply Teaching blog. I found this one more rewarding and haven't posted there in awhile, but I look forward to the day I can call this blog "Simply Running" because it really shouldn't be this complicated and all I want to do is run.


jdawg said...

Have you tried a pedorthist? I think they're pretty good up here, in Canada, but I don't know about in the USA. It could be something as simple as a bad foot type like varus forefoot or you may have external tibial torsion just on one leg. Check out the Gait Guys again and look at external tibial torsion.

Jim Hansen said...

I had to look up what a pedorthist is. I guess it is similar to a podiatrist. I did go to a well-known podiatrist the summer before I stopped running. I got an insert made, but he is world famous for diagnosing functional hallux limitis, so my orthotics were for that. He wasn't too interested in tibial torsion, but he did do dome good foot manipulations which worked better than the orthoitcs. I tried putting in the orthotics again last week and I just don't like them.

I do think my foot is the root of all evils. The Gait guys looked at videos of my stride that summer before surgery and said I had tibial torsion. They even highlighted it on their blog. I like what they do in diagnosing, but I never get a sense of what you are to do about things like this. I know my left foot throws everything else off right up the chain and into my hip.

Thanks for your comments.