Physio Therapist's Analysis

Week of July 16 ~ 22

Leg is gradually getting better...hope the progress continues. I went to Tokyo Physio on wednesday, their analysis is below.

I have been doing self-massage with a foam roller each day (Marty: I find that easier to use than a tennis ball), as well as abs almost every day.

Monday
AM - walk 40 mins.
PM - walk 30 mins.

Tuesday
AM - gym workout
3:00 - walk 500m, run 1k x 4. Runs were very easy, around 6:00/k.
Slight soreness in hamstring.

Wednesday
Went to Tokyo Physio, then to the track workout.
1200, 1000, 1000, 600 (cut fm 1000), 800, 400
All at about 5:00/k, so that was a big improvement. Hamstring was slightly sore. Ran them at 180 steps/min. cadence (see below).

Thursday
Rest

Friday
AM - gym workout + 3 x 1k @176 cadence and 3 min. walks. on the treadmill (raining).

Saturday
Walk 500m, run 1k x 5. Runs at approx 5:00/k, @ 176 cadence (for some reason, 176 is just what I run at, even trying to do 180. Counting every other step for 30 seconds, I always get 44 instead of 45.

Sunday
Bike ride at a fairly fast speed (although numerous slowing for obstacles first and last 25 mins.) for 1:27. Actually, did this last week also. I basically don't like bike riding, but it's a pretty good workout for the quads.

I went to Tokyo Physio (popular with expats, run by an Australian couple who are triathletes) for a "biomechanical assessment" to try to get at the root cause of my injuries.
It was very interesting (and expensive - 18,000 yen). The woman said it would be an hour and a half, but she wound up spending two hours on me (a tough case to crack?).
She spent a long time listening to all my running/injury history, then evaluated my posture and flexibility (legs, hips, back), then had me go outside and run up and down while she videoed me on an iPad. Then she made some suggestions and had me run again.
Finally, we went back inside and she showed me various recommended exercises/stretches to do. Later, she emailed me the videos and photos of how to do the exercises.
So I think it was worth it, and as I said, was very interesting.

Of particular note:

- The iPad is great for taking videos and analyzing form. It gives you a large, clear view of your running, and you can slow it down (control the speed with your finger). I would really like to do this for all the runners I know, i.e., Namban and ASIJ kids. It is SO helpful to see what you look like when you run, and rather surprising (even shocking) also.

- The video showed that I do not really midfoot strike, which was quite a surprise. I point my toe down, but right at the end of the stride it comes up (heel goes down) and then I land sort of all along the outside of the foot (heel to mid). Anyway, I do not have a nice midfoot striking stride, which I thought I did. (Photos at the end of marathons would show what looked like a heel strike, but I thought that was just because I was tired. No, I do that all the time.) Really have to work on this more.

- It also showed that I move my arms from side to side much more than I realized. She said I should keep my arms straighter, to the point of imagining that I have a long set of chopsticks under my armpits and I am holding on to them, i.e., arms moving (nearly) straight up and down.

- She also strongly recommended that I use a cadence of 180 steps per minute. I had read at some point that this is ideal and once counted my steps and was just about at 180. However, that was at a pretty fast training pace, like marathon pace (4:20/k) or faster. When I am running slower, my cadence is much less. She says I should always run at 180, which shortens my stride and thus prevents (well, mitigates against) heel striking. For the test run, she gave me her iPhone with a metronome app - great! (I now have it.) Of course, you can just count steps as you look at your watch.

- I had thought that leg length difference might be a cause of my problems, but she said that my legs are the same length.

- Her analysis:
As expected, it can be challenging to assess what would normally be your running technique when your left hamstring is still symptomatic, however I was able to identify a number of ways to improve your running efficiency and to decrease loads through the hamstrings.
Key Findings:
·         Dysfunction of the SIJ in its ability to transfer load during weight bearing.
·         Increased tone in hip flexor muscles, causing an anterior pelvic tilt - preventing effective gluteal activation and hence loading of hamstrings.
·         Reduced stability of the deep gluteal muscles - resulting in internal rotation of the hips and increased lateral pelvic tilt.
·         Decreased thoracic rotation, particularly to the left.
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(SIJ is sacroiliac joint.)  
So she gave me four exercises to do to overcome these problems. 
She also said, don't stretch much while the hamstring is sore, and don't try to strengthen it until it is healed (I had been doing strengthening exercises).
And I should run every other day, fairly easily of course, but with a 180 cadence, so it's not THAT easy. Actually, on Wednesday night at the track (after the evaluation), I was able to run at 180, at a pace of 5:00/k (had been jogging at 6:00/k). With almost no soreness. Don't want to try to run faster yet, but at least I am seeing some progress. Now with these exercises, I hope to see more.



This is the main exercise for the glutes:
Lie on your back with legs bent and arms flat against the floor.
Extend one leg out and lift the opposite arm up off the floor. Push down with the other leg to lift the hips up off the floor whilst at the same time pushing into the floor with the elbow of the opposite arm. From this position, swap sides so that the opposite arm and leg are pushing.
Do 10 each leg, 3 sets, twice a day.