I went to Boston for my third Active Release (ART) appointment today. I was feeling good since my run on Tuesday, but didn't run yesterday as I spent a couple of hours in a dentist's chair before celebrating 20 years of marriage!
Today the I had a quick treatment on the back of my left hip and my left adductors (I didn't tell him that this was bothering me on Monday). The ART therapy never hurts me and I don't feel a thing but it does do something. He has me check my balance doing lunges and of course my left side is awkward when I do these. He gave me a hamstring strengthening exercise. I am to lie on the floor on my back with me knees at 90 degrees and my heels resting on a bench at knee height. I am to press my heels into the chair and lift my rear off the floor. I am to do this until tired (maybe 50 times), rest a minute, then repeat. I am to do these once per day. He doesn't say anything when I mention I am working on the tibialis posterior.
Here is a video where an Active Release Technique therapist explains the process. The second technique he does for this persons sciatica is similar or the same as one of the hip movements I had done the last two appointments. I do it with straight leg and bent leg as shown.
Here the founder of ART, Dr. Leahy, talks about what ART is and its effectiveness.
This is another video dealing with sciatica and ART. At about 7 minutes into it you will see the ART Psoas release similar to the one that is done on my Psoas muscle.
Today my run was really good. I think the heel lifts are right on. I feel so much more balanced and my hips don't have to do all this work trying to be leveled and balanced. I feel better walking and running and the back of hip pain is subsiding. Today I added an extra loop to my run so I did close to 10 miles. I would do more but I am nervous that the change by using the heel lift could create a new problem from adjusting muscles. I am getting my legs to feel straighter and I could happily train at this level as I don't feel so exhausted from fighting my own body. Although not 100%, I do feel a whole lot smoother and solid as I run.
I am doing the Tibialis Posterior exercises. They are simple and feel so right for what I need to do with my knee and feet. I found another exercise to try for strengthening the tibialis posterior. The accent is from New Zealand and the person, Gary Moller, is the older brother of Olympic Marathon Bronze medalist Lorraine Moller. Here Gary writes more about correcting foot pronation. What I find interesting is that his diagram and the diagram on the Yoga site I listed the other day, both show the inward knee rotation and hip problems that I suffer from.
Showing posts with label Tibialis Posterior. Show all posts
Showing posts with label Tibialis Posterior. Show all posts
Thursday, July 10, 2008
Tuesday, July 8, 2008
The Olympic Track Trials in One Workout
I missed four days of running last week due to going to the Olympic Swimming Trails. When I came home Saturday night the heel lifts I had ordered had arrived. My left hip and left shoulder were off the whole time I was away so I was happy to try them out. I adjusted them by taking many layers off and put them in my shoe. I liked the feeling of balance. I woke up and wore them again and the tightness I had were gone. I had a very well balanced 8 mile run and felt good afterwards and the next morning.
Then I went in for a massage. It went well and I got looser. I had a very tight right ITB band and left hamstring. When I was done my hip was tight in a new way. I had lost the balance I had. Still I decided to do the 5k at night. This time I did a 4 mile warmup right to before the start of the race, but I was all off and my hip was not working. I had a horrible race and lumbered to a slow finish.
Then my hip was sore all night. I couldn't sleep and got up a few hours early. All day it was out of whack. I tried rolling the left adductor which was tight. It is hard to do but here are two clips on how to do it:
It helped ease a little tension, but not enough. I did Z-Health drills (no help), used a heating pad on my back (nothing), and although I was dressed to run I decided the hip still hurt so I decided to bike.
I got dressed for biking but then thought I'd go back to an earlier page on my blog where I had placed a web link that I intended to get to later. I decided it was later. I decided to take a closer look at the tibialus posterior tendon as explained here. This muscle can cause a flat pronated foot and knock knees. That is me!
I read it through and tried the strengthening exercises on my left side. That is the side where my knee knocks in. The exercise gave me an idea of what that muscle should be doing and the effect it should have on the functioning of the foot and knee. It lifted the arch up like the orthotics I had tried last month did artificially. I learned to push the knee out and what that felt like (actually like I felt the Z-Health knee circles should be doing-but aren't). I also felt I lot of tightness and work being done on the outside of my hip. After doing the exercises my muscles felt distracted enough that I though I'd try running, so it was back to putting on my running gear.
I tried running with some of the cues from the exercises I had done and it was tough but I was able to get a better alignment and feel. However since I only did the exercises on the left side, I found it hard to use the cues on the right side. After about 3 miles I started cuing in the right side and things were falling into place a bit. I was running and my stride was changing. I felt I was bearing the running load on the outside of the hip rather than on the inside like I normally do. I am sure I was only making minor movements toward straightening my knee-leg out. It started getting easier and flowing and I realized a good mental image would be to picture Gabe Jennings running the 1500 at the Olympic Trials. There is not a whole lot I care to emulate about Gabe Jennings and in particular his running style, but I put the image of his almost bow-legged running stride in my mind and used it to help keep my knees straight and because of that they were not buckling in.
It was all going well until all of a sudden I felt a sharp twinge at the inside bottom of my left heel. Bam I had to quickly adjust my stride, I felt like Tyson Gay pulling a muscle. Of course he was going fast when his hamstring went and he veered all over the track trying to stop. I was going slow and veered about 5 inches as I tried to adjust my stride and stop. I walked for a few minutes and got back to running but without such an effort to adjust that foot! Fortunately the pain did not reappear.
In the end I feel like Alan Webb. Last year he was fast and set the American record in the mile. This year he looks lost and confused without the stride he used to have. Of course Alan's worst day is still 5th best in the USA. I can't get my body working correctly and it too is confusing. The 5K's I am running are pathetic and I can't move my body properly. Sooner or later I hope to hit on the right combination of strategies and recover my stride. I will continue with the heel lifts and work more on those posterior tibialis strengthening exercises.
I hope you like the pictures of Gabe, Tyson, and Alan running in the Olympic Trials, because pictures of me trying to straighten my knees out, hobbling with a pain on the bottom of my foot, or racing last night would have been really horrible to look at!
More on Tibialis Posterior Dysfunction:
"The tibialis posterior tendon is the primary dynamic stabiliser of the medial longitudinal arch,6 and its contraction results in inversion and plantar flexion of the foot and serves to elevate the medial longitudinal arch, which locks the mid-tarsal bones, making the hindfoot and midfoot rigid.7 This later action allows the gastrocnemius muscle to act with much greater efficiency during gait. Without the tibialis posterior, the other ligaments and joint capsules gradually become weak, and thus flatfoot develops. Furthermore, without the tibialis posterior the gastrocnemius is unable to act efficiently, and therefore gait and balance are seriously affected." (from here)
Here is another look at the same exercise I did today from a Yoga perspective:
It says, "If you have a tendency toward flat feet and knock-knees, use an elastic exercise band to create the resistance...Even if you don’t have flat feet, this exercise will help you learn and practice good action in the feet. The essence of the exercise is to learn how to keep the inner heel and ball of the big toe grounded while lifting the arch, and not throw all of the weight to the outer edge of the foot.
Then the article describes a "wide-legged standing forward bend" that uses the same lifting of the arches by strengthening and lengthening the tibialis posterior. It says, that this stretch "is obviously a stretch to the hamstrings, but a big part of the stiffness that holds us back from fully expressing the pose comes from tight adductors. These inner thigh muscles pull the thighbones toward each other, tightening and even locking the hip joints. And you will find that what goes hand in hand with tight adductors is the inability of the tibialis posterior to keep the arches of the feet lifted." What I find interesting is I do have that tighntess of the adductors (particularly the left side) and this is the side where I have the most trouble with the knocked-knee and fallen arch and it was the first thing I thought of treating today!
Of the many sites I visited, these two suggest a stengthening of this tendon. The other doctor related sites suggest surgery, orthotics, or arch supports. This quote from the last site suggests why this is not the best strategy, "In the orthopedic world, what is often offered as a solution for fallen arches—particularly when they cause a knock-kneed condition—is support in the form of a lift or orthotics in the shoe. The artificial arch takes over the job of the tibialis posterior—and certainly the support is appreciated over the course of a long day as our feet get tired. Yet when the tibialis posterior is not working properly, a host of postural misalignments ensue, and some of them are not rectified by arch supports. With arch supports, changes do happen in the lower leg: the arch is lifted, and the shinbone of the lower leg (i.e., the tibia) rotates out from its base at the ankle, as it should. But not much changes in the thighbone: it remains inwardly rotated and, in the case of knock knees, adducted. This means that while the shin is now rotating out, the inner thigh muscles remain tight and pull the femur in toward the midline of the body, causing a twisting and grinding in the knee. It’s not enough to shore up the arches. This simply shifts the problem up the leg to the knee, where the twisting can damage the knee ligaments and cartilage. The solution, beginning with the tibialis posterior, has to involve the whole leg."
Then I went in for a massage. It went well and I got looser. I had a very tight right ITB band and left hamstring. When I was done my hip was tight in a new way. I had lost the balance I had. Still I decided to do the 5k at night. This time I did a 4 mile warmup right to before the start of the race, but I was all off and my hip was not working. I had a horrible race and lumbered to a slow finish.
Then my hip was sore all night. I couldn't sleep and got up a few hours early. All day it was out of whack. I tried rolling the left adductor which was tight. It is hard to do but here are two clips on how to do it:
It helped ease a little tension, but not enough. I did Z-Health drills (no help), used a heating pad on my back (nothing), and although I was dressed to run I decided the hip still hurt so I decided to bike.
I got dressed for biking but then thought I'd go back to an earlier page on my blog where I had placed a web link that I intended to get to later. I decided it was later. I decided to take a closer look at the tibialus posterior tendon as explained here. This muscle can cause a flat pronated foot and knock knees. That is me!
I read it through and tried the strengthening exercises on my left side. That is the side where my knee knocks in. The exercise gave me an idea of what that muscle should be doing and the effect it should have on the functioning of the foot and knee. It lifted the arch up like the orthotics I had tried last month did artificially. I learned to push the knee out and what that felt like (actually like I felt the Z-Health knee circles should be doing-but aren't). I also felt I lot of tightness and work being done on the outside of my hip. After doing the exercises my muscles felt distracted enough that I though I'd try running, so it was back to putting on my running gear.
I tried running with some of the cues from the exercises I had done and it was tough but I was able to get a better alignment and feel. However since I only did the exercises on the left side, I found it hard to use the cues on the right side. After about 3 miles I started cuing in the right side and things were falling into place a bit. I was running and my stride was changing. I felt I was bearing the running load on the outside of the hip rather than on the inside like I normally do. I am sure I was only making minor movements toward straightening my knee-leg out. It started getting easier and flowing and I realized a good mental image would be to picture Gabe Jennings running the 1500 at the Olympic Trials. There is not a whole lot I care to emulate about Gabe Jennings and in particular his running style, but I put the image of his almost bow-legged running stride in my mind and used it to help keep my knees straight and because of that they were not buckling in.
It was all going well until all of a sudden I felt a sharp twinge at the inside bottom of my left heel. Bam I had to quickly adjust my stride, I felt like Tyson Gay pulling a muscle. Of course he was going fast when his hamstring went and he veered all over the track trying to stop. I was going slow and veered about 5 inches as I tried to adjust my stride and stop. I walked for a few minutes and got back to running but without such an effort to adjust that foot! Fortunately the pain did not reappear.
In the end I feel like Alan Webb. Last year he was fast and set the American record in the mile. This year he looks lost and confused without the stride he used to have. Of course Alan's worst day is still 5th best in the USA. I can't get my body working correctly and it too is confusing. The 5K's I am running are pathetic and I can't move my body properly. Sooner or later I hope to hit on the right combination of strategies and recover my stride. I will continue with the heel lifts and work more on those posterior tibialis strengthening exercises.
I hope you like the pictures of Gabe, Tyson, and Alan running in the Olympic Trials, because pictures of me trying to straighten my knees out, hobbling with a pain on the bottom of my foot, or racing last night would have been really horrible to look at!
More on Tibialis Posterior Dysfunction:
"The tibialis posterior tendon is the primary dynamic stabiliser of the medial longitudinal arch,6 and its contraction results in inversion and plantar flexion of the foot and serves to elevate the medial longitudinal arch, which locks the mid-tarsal bones, making the hindfoot and midfoot rigid.7 This later action allows the gastrocnemius muscle to act with much greater efficiency during gait. Without the tibialis posterior, the other ligaments and joint capsules gradually become weak, and thus flatfoot develops. Furthermore, without the tibialis posterior the gastrocnemius is unable to act efficiently, and therefore gait and balance are seriously affected." (from here)
Here is another look at the same exercise I did today from a Yoga perspective:
It says, "If you have a tendency toward flat feet and knock-knees, use an elastic exercise band to create the resistance...Even if you don’t have flat feet, this exercise will help you learn and practice good action in the feet. The essence of the exercise is to learn how to keep the inner heel and ball of the big toe grounded while lifting the arch, and not throw all of the weight to the outer edge of the foot.
Then the article describes a "wide-legged standing forward bend" that uses the same lifting of the arches by strengthening and lengthening the tibialis posterior. It says, that this stretch "is obviously a stretch to the hamstrings, but a big part of the stiffness that holds us back from fully expressing the pose comes from tight adductors. These inner thigh muscles pull the thighbones toward each other, tightening and even locking the hip joints. And you will find that what goes hand in hand with tight adductors is the inability of the tibialis posterior to keep the arches of the feet lifted." What I find interesting is I do have that tighntess of the adductors (particularly the left side) and this is the side where I have the most trouble with the knocked-knee and fallen arch and it was the first thing I thought of treating today!
Of the many sites I visited, these two suggest a stengthening of this tendon. The other doctor related sites suggest surgery, orthotics, or arch supports. This quote from the last site suggests why this is not the best strategy, "In the orthopedic world, what is often offered as a solution for fallen arches—particularly when they cause a knock-kneed condition—is support in the form of a lift or orthotics in the shoe. The artificial arch takes over the job of the tibialis posterior—and certainly the support is appreciated over the course of a long day as our feet get tired. Yet when the tibialis posterior is not working properly, a host of postural misalignments ensue, and some of them are not rectified by arch supports. With arch supports, changes do happen in the lower leg: the arch is lifted, and the shinbone of the lower leg (i.e., the tibia) rotates out from its base at the ankle, as it should. But not much changes in the thighbone: it remains inwardly rotated and, in the case of knock knees, adducted. This means that while the shin is now rotating out, the inner thigh muscles remain tight and pull the femur in toward the midline of the body, causing a twisting and grinding in the knee. It’s not enough to shore up the arches. This simply shifts the problem up the leg to the knee, where the twisting can damage the knee ligaments and cartilage. The solution, beginning with the tibialis posterior, has to involve the whole leg."
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