Friday, June 18, 2010

Two Halves do not make a Whole!

After a bit of a hiatus from training, I am back on the roads this week. I was getting good running success with the Postural Restoration therapy that ended in February, but as I continued to run (and faithfully do the exercises) things started to slowly fall apart again. I was back to a point in my training where the left side of my body and the right side of my body were doing two different things. I noticed my mileage going down from 50 a week to 40. Then it was down to 30 and then 20. Each run was taking longer to recover from as I got more and more imbalanced and as my hip hurt more and more after most runs and there was not much fun in it at all. The racing was even worse! Finally last week, I only ran twice: two 5k races. At the end of both races I was limping on my left hip. The last race was the Hollis Fast 5K. As I limped back to the awards ceremony, I had the feeling that something "more" was wrong with my hip. It hurt. I seemed to be "protecting" it more as I ran and I had such a terrible stride as I tried to run faster that it was no fun to even race. I thought to myself that "something" must be more wrong with that hip then I could figure out and I felt that the next step must be to go to a doctor and get it looked at. Maybe it was a labral tear that wouldn't let the femur fit properly in the pelvis. I did not feel like running any more as each training run was leading to a day or two of problems and I was uncomfortable running at any speed.

Before calling up a doctor, I also was thinking that no matter how hard I worked on my exercises and strength work I was just strengthening a dysfunction and not correcting it. I had already gone back to the postural restoration therapist last Monday (on my own dime), hoping to see if she could see what I was doing wrong with my exercises. I was shown the ones that should work best for me, but there were no new revelations. The only thing that was confirmed is that when I run my left stride is slower that my right. I was wondering about this and that is probably why that my legs get worse as I try to run fast. I still believe that the Postural Restoration work is very valuable for me, but until I can figure out and straighten out the root cause of my imbalances that nothing will get fixed. It does give me good strength work and can help with working on positioning and muscle balance, but it seems to help me more for basic walking and standing and I haven't got it to work yet for running (fast running in particular). That left me again frustrated at the end of the Hollis race and asking myself, "What is wrong with my body causing it to work so incorrectly."

I started thinking that before I call a doctor to check for an injured hip and socket, I might want to try one more time at seeing if there are restrictions in my hip that may be causing the failure after all the exercises I have been doing. Maybe it was time to call an ART (Active Release Technique)doctor. I was very high on ART back about 10 years ago when I first went to Boston to have treatment done. The doctor started fixed my psoas muscle that had been giving me back pains for years (due to triathlons). He got rid of the scar tissue and the results were pretty dramatic (the first thing that worked on me in over 15 years). However when I went back to see this doctor a few more times to see if he could help with my hips, he did little and seemed real disinterested in the whole process and in even helping me (I believe he no longer practices). I had wanted to try ART with someone else, but I could not find anyone local who took insurance. Maybe it was worth another shot, so I called Dr. Steve Barooby of Artful Chiropractic in Manchester. I had talked to him on the phone a few years ago, but never went in to see him (I did Rolfing instead). Dr. Barooby has lots of certifications in ART and I had heard good things about him. I gave him a call and was even more happy to find he takes insurance now. I have gone in three times this week. I told Dr. Baroody that my body was a puzzle and there had to be a way to figure it out. He has discovered some missing puzzle pieces that I have been trying to get answers on from so many other people I have seen and there is even names for these things that are wrong with my feet.

He did a lot of listening and asking questions and then he got tolooking at my feet. I have been trying to figure out why my left foot does so many strange things during my stride and I have tried all sorts of remedies on my own to figure it out and fix it. In fact, that is how I got the referral from my doctor last fall. I simply wanted to ask a PT about my foot and ankle. He asked if I have ever damaged my left foot with a severe sprain. He said my left heel was "inverted". I have asked many other therapists about this heel that seemed "out of position" before and could not get an answer. I think that what he means by inverted is that it is rotated inwards. Maybe this is why my forefoot also everts out. I don't know. He said this inverted heel causes my heel to suppinate. He also said that I have something wrong with my front toes. It is called "functional hallux limitus". Basically on the left side, the toe and its metatarsal does not work. That is why that foot rolls over onto the inside trying to connect to the ground. In other words, it pronates heavily. So, my left foot suppinates at the heel and pronates from the forefoot. It is trying to do two opposite things at once! Is that it? I have been thinking my imbalances stem from the left side of my body being different from the right and not equaling a whole. However it might simply be the back part of my left foot not playing nicely together with the front part and creating havoc on the left side of my body and messing up my running and alignment throughout my body.

Dr. Baroody has been softening up my feet by mobilizing my stuck joints as well as using ART on my heel area to work on the "fixing" of my heel. All of a sudden my running is easier again (not perfect) but I ran 8 miles on Tuesday, did the track workout on Wednesday (800, 1200, 1600, 1200, 800 first laps in 90 sec. each lap after that in 91 sec. Mike Ward started pushing the pace on the last 1200 and we did that in under 6:00 mile pace, and then I ran the last 800 in 2:52- certainly a decent workout). My hip didn't hurt at all during or after the track work, and I ran 8 miles each of the next two days. Still no hip soreness (I have been getting ART treatment on the Psoas muscle along with the foot work). So far that is good progress.

The interesting thing that I now recall is that during the two months of Postural Restoration work, the PT twice mobilized the bones in my left foot. The PR exercises helped, but it was after the mobilizations that my mileage started going up in the winter. I could get the left toe metatarsal on the ground after those mobilizations and I could run so much more easily. I think it lasted for awhile, but the joints got stuck again and that is why my running got worse and worse each week. I felt the same "working" of that first metatarsal after the mobilization work this week. When I ran yesterday, I tried to "listen" to my feet (after learning more about this "functional hallux limitus"). On both of my feet, the first metatarsals are now touching the ground as I run. However on the left foot, the big toe does not even touch the ground at all during my stride. As I run it goes "heel-first metatarsal" and that is how I push-off the ground. There is no involvement of my toes. On the right foot it is the same thing, except the big toe does touch the ground, but it doesn't exert much force. This also gives me a scary reason for my having a "pins and needle" toe joint pain on my right big toe knuckle for the past 3-4 months after my runs. That toe joint is very stiff and I notice that there is a further condition that many runners develop where that toe joint becomes rigid. Oh, No! I don't want to go there!

Anyhow that is more than anyone needs to know about my feet. I am again getting closer to figuring out my stride problems and I think this doctor has some interesting solutions. Today, I ran with Dr. Scholls insoles that Dr. Baroody advised me to try. He showed my how to cut out the area under the first metatarsal so that it "dropped" the toe joint down and "hopefully" cause it to function correctly. I didn't like the bouncy feel of the arch on the insole, and I am not used to it yet at all (basically I used it as soon as I cut up the insole), but it really shook things up in the way my stride and muscles worked today. I don't know if this will help in the end, but it is certainly worth a shot! The next few weeks should be very interesting!

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