Sunday, November 28, 2010

Poor biomechanicals

This past October 19th, I was running along, continuing to prepare for World 100k by doing a planned warm-up into track interval session. I didn’t trip or fall or slip or slide, yet I did walk off the track that afternoon with very heavy sore legs and an idea I had somehow tweaked my left hamstring.

In a former post I spoke of the mystery of it and disappointment of withdrawing from participating with Team USA. In the meantime I have sought assistance in determining what happened and how to get better from Dr. Ryan Woods, DC and Greg Blais PT of Mountain Physical Therapy in Asheville.  I have thus far avoided having an MRI as it has been my experience, that unless I have had an obvious mechanism of injury (falling on rocks to micro fracture my kneecap) that an MRI doesn’t seem to serve ready answers. An MRI may yet be in my future, yet I have some things to work on first.

Greg working with me on posture at Mountain Physical Therapy
I first saw Dr Woods about a week after the above incident. He did some Graston on my ITB and hamstring and determined through muscle testing that my left glute was not engaging and my SI joint, for lack of better description wasn’t happy. Instead of getting better, I got worse. When I asked her, Anne Lundblad recommended the fine folks at Mountain Physical Therapy in Asheville. Though 2.5 hours is a long way to go for an appointment, I trust Anne’s recommendations, and have been really pleased so far.

A summary of what I have learned:
1. Left glute max and medius not engaging. To pick up the slack, hamstrings and hip flexors are overworked.
2. I have terrible pelvic tilt and control-caused by muscle groups not doing their proper jobs. This leads to big time ITB issues.

Though I’d dealt with ITB issues on and off since June, I wasn’t overly concerned. As for the rest of it, it seems my body was doing an excellent job compensating and the last “straw” was a track interval!
Me being goofy demonstrating good form. Notice stable pelvis.
Still being goofy showing loss of control with balance leg.Notice how outside of leg creates stress on knee and ITB!

I am now doing all sorts of posture/balance exercises to strengthen and retrain muscles to do their jobs. I am not land running yet. Pool running, swimming (breast stroke, not freestyle as the flutter kick invokes hamstring discomfort), elliptical and cycling and trail hiking with poles are my fitness choices right now. I am having some results with the exercises and finally can start to tell I am gaining more glute strength and pelvic control.

This was on the white board in the PT's office on the day of my 2nd appointment
I hope to ward off something like this from happening again by rethinking my training. This past year, reading for Worlds, I ran 6-7 days a week most weeks and 75% more road and pavement and “speed” than ever before. In the past, with trail running as a focus I think I had a stronger core and was more agile all around. I don’t have a real plan-yet clearly something needs to be different!

I’ll continue to share as I progress and learn things!


Sophie Speidel said...


It sounds like you have a great group of PTs down there and that they have found the problem. Back in 2004 when i had a bad case of ITBS, my PT here in CVille taught me all the core/balance/strengthening exercises I needed in order to stay healthy and out of his office, and I am happy to report they worked like a charm---no ITBS or related injuries since then! I am hoping the same holds true for you. I am a 2-3x weekly devotee to all the core and hip/glute strengthening exercises I learned back then, and so far so good. Good luck and keep us posted!

Pam said...

Annette- I was so sorry to hear that you were injured and not running at Worlds. I hope all the PT pays off and you are able to heal up. Take care and happy birthday!

Rick Gray said...

Back to the basics sounds like a wonderful plan. It certainly sounds like you have been able to find the root of the problem, so continued progress is going to continue. By the way, I love the goofy look. Glad to see that your wonderful personality is still very intact. Look forward to seeing you soon.

Sara said...

Just coming off some very similar underlying problems, with prescribed therapies making running better than ever.

It sounds like you're in excellent hands with your therapists. That's so important - I wasted a ton of time with an incomplete diagnosis (focused on the hamstring only), but it started coming around quite quickly once I went to someone who saw the full picture.