Back to No Running

I wrote to Linzay Logan, the woman who blogged about her injury on competitor.com. As it was exactly like mine, I asked her if she had continued to run a bit while she rehabbed. This is her answer:

I'm so sorry to hear about your injury! They are the worst! It does sound like you have a similar injury to mine: hamstring torn almost off the pelvic bone, but still hanging on by a thread. In my experience I had do no running at all and just do the PT/strength training. I felt like running, even for a few minutes, would pull on my hamstring and reverse all the progress I had done. Instead I biked, did the elliptical and went to PT twice a week for almost three months. I credit my recovery from the strength training I did at PT and not running at all. It's really tough to give up running for a little while, but it's worth it—I continued to run short amounts once a week or so for a few months because I wanted to run, but I really think it was hindering my recovery and I could have cut down my recovery time by months if I had stopped running earlier. 


I agree with her: I think the running I am doing is not doing me any good training-wise, and is probably aggravating the injury. In fact, I had been leaning in this direction even before I heard from her, and didn't run yesterday, doing a bike ride instead.


So I won't run for about a month and then I'll see how things are.


By the way, I got into the lottery for the Kobe marathon in November, but decided not to enter as I won't have time to train. I am entered in a half at the end of September, but I either won't run or will just cruise it for the fun of it, if my hamstring is healed..


So my long-term goal is now Boston 2013.

A Little Running, Interesting Blog Post

Week of July 23 ~ 29

Did a little running this week, but not much. 5 x 1k with walks in between on Monday, 4x on Wednesday and about 7x in the beach town of Kamakura on Saturday. Doing my best to run at 180 steps per minute, and in fact ran Mon and Wed holding the iPhone (metronome app), so managed to do so. I also tried to focus on proper midfoot striking, causing my calf to get a bit sore on Wednesday, thus proving that I had not been doing it properly before.

Also went to the gym on Tuesday and Friday, and of course am doing my physio exercises every day. Went to the physio again on Wednesday, and she gave me 3 new exercises to do, so I hope they work!

Read a very interesting blog post on competitor.com (Staff blog by Linzay Logan - Lessons Learned from a Running Injury). Interesting because the injury she describes is EXACTLY what happened to me. Pain in glutes - kept running - pain in hamstring - kept running - thought it might be piriformis or bursitis - ran a few races - pain finally got so bad had to stop. Well, she had an MRI and found out that she had torn her hamstring - but not all at once, little by little. I'm positive that this is exactly what happened to me. Read the article - it has some good advice.
The good thing is, she's running again! This too, shall pass.

Good running to you all.

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.
-----------------

(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.

A Little Bit of Running

Week of July 2 ~ 8 — No running.

Week of July 9 ~ 15

Monday — 3k
Wednesday —4k
Friday — 5k
Sunday —8k

Monday and Wednesday were: run 400, walk 400.
Friday and Sunday were: run 1k, walk 500
All at very easy pace, just a jog, really.

Not pain-free — some soreness, but not bad pain. Sometimes the pain is in the hamstring, sometimes higher, which is strange.
Also doing various exercises and stretches.
So maybe there is light at the end of the tunnel.

Hamstring Still Painful

Ran a bit...a tiny bit...on Monday, Tuesday, Wednesday and Friday, with the hamstring getting more painful each time, so decided that "active rehabilitation" at least in the form of running, is not what is called for. Also had some massage, acupuncture and PT, which feel nice, but the effectiveness is questionable. I think I just have to rest until there is no more pain, however long that may take.
My preferred treatment now is heat (to bring blood to the area) and compression. Patience is called for.

If you or anyone you know has actually cured a badly strained hamstring, please let me know what they did.

Cheers....

Bursitis!

Week of June 18 ~ 24

Still no running, as soreness persists, but is lessening.

I found this and it describes my smyptoms exactly, so I guess this is it.

A common spot for bursitis is on the side of the hip. Here a large tendon passes over the bony bump on the side of the hip. The bony bump is called the greater trochanter. Inflammation in the bursa between the tendon and the greater trochanter is calledtrochanteric bursitis. This problem is common in older individuals. It may also occur in younger patients who are extremely active in exercises such as walking, running, or biking.

Friction can build in the bursa during walking if the long tendon on the side of the thigh is tight. It is unclear what causes this tightening of the tendon. The gluteus maximus attaches to this long tendon. As you walk, the gluteus maximus pulls this tendon over the greater trochanter with each step. When the tendon is tight, it rubs against the bursa. The rubbing causes friction to build in the bursa, leading to irritation and inflammation. Friction can also start if the outer hip muscle (gluteus medius) is weak, if one leg is longer than the other, or if you run on banked (slanted) surfaces. … This thickening, constant irritation, and inflammation may result in the condition becoming chronic, or long lasting.

The first symptom of trochanteric bursitis is usually pain. The pain can be felt in the area of the hip right over the bump that forms the greater trochanter. Eventually the pain may radiate down the outside of the thigh. As the problem progresses, the symptoms produce a limp when walking and stiffness in the hip joint. Eventually, the pain will also be present at rest and may even cause a problem with sleeping.

This is exactly where I have had pain for the last 6 months - sore to the touch - so I guess that qualifies as chronic. And I do have it at rest, in fact, it gets worse when I sit down.

I thought it was weird that that spot is ALWAYS sore to the touch, so I guess that is why.

I sent this to a fellow club member with leg/hip problems, and he said Yes, this is what I have had for 15 years (!!). He controls it with stretching, specifically, with the stretch known as Pigeon in yoga, where you put the affected leg in front of you at a 90-degree angle and extend the other one in back of you. I can't do 90, so I do about 45 and lean forward until I feel the stretch. You can also bend the back leg to make it easier to do.

Sometimes he stops while he is running and stretches for a while.

He says if he stops running he can walk with no discomfort, but it never heals completely - comes back when he starts running again. (Maybe if you stopped for 4-6 months it would go away, but that is an experiment I am not willing to try - as long as it is manageable.)

So I am stretching a lot, and since I have not run for a month, I plan to start tomorrow with very easy and short runs. Let's see what happens.

Still No Running So Here's an Aussie Music Video

Hamstring still sore, so no running yet. It is improving, but I plan to be super-cautious and not run until I am sure, no doubly sure, that it is healed.

Now for all you Aussie blokes, do you remember this? Most people, at least Americans, think it is a Johnny Cash song. Some know that it was done before him (and better) by Hank Snow. But the original version was by Lucky Starr.

Here is the Hank Snow version.