WEEKLY SUMMARY (February 3-9): 43 miles (95% easy and 5% tempo paces)
Sunday: 6 miles at 7:20/mi.
Monday: off
Tuesday: 7 miles at 7:20/mi.
Wednesday: 2.5 E, 2 x 1 mile T @ 6:17/mi. (1 min.), 1.5 E (6 miles total)
Thursday: 4 miles at 7:26/mi.
Friday: 7 miles at 7:18/mi.
Saturday: 13 miles at 7:21/mi.
Running has not been easy this week, but I think I am indeed on the road to recovery. With the help of the physical therapist whom I saw again on Thursday this week, I'm taking the long road to recovery that involves doing gradually more difficult exercises (in addition to running) to strengthen my weak and imbalanced hip muscles in hopes that whatever recovery ensues will not be short-lived. It now seems to me that the primary injury is to my right gluteus minimus and gluteus medius, with the TFL and psoas also affected. When I got acupuncture (for the first time) on Thursday, I realized that I had been unclear about exactly where the gluteus minimus is. It's one thing to look at it on an anatomy chart, to do stretches that target it, and so on. By when the PT delivered the charge to the needle that made my right gluteus minimus contract in isolation, it seemed to be at the very center of the pain and tightness that I've felt all through this injury. The more superficial gluteus medius attaches a bit higher on the iliac crest where I've had a pretty constant, dull pain since my 18-miler on 1/19. So it's clearly in a troubled state as well. But the deeper muscle seems to be the deeper problem, and the original pain that I felt several days before that 18-miler (but didn't worry much about) was lower and deeper at what I suspect may have been the lower insertion area of the gluteus minimus. So now I'm doing glute, hip abductor, and hip flexor exercises almost daily in order to bring those muscles back to life and to strengthen them all in a balanced way so that even the weakest of them (which is apparently my right gluteus minimus) can handle the running I do. I've slowed down my easy pace marginally this week in order to accomodate the extra stress of the exercises, but only slightly because the point is to get those muscles to cope by starting with very light exercises and gradually increasing the difficulty. At the same time, I'm trying to ease back into some harder runs. I did basically half of a tempo run on Wednesday and a medium-long run on Saturday that was almost twice as far as I'd run in the previous three weeks. My hip was ok during and after the mini-tempo, with only a little uncomfortable stretching in that area during the run that immediately went away when I stopped. But after Saturday's 13-miler there was some tightness and pain right where one would expect if the gluteus minimus is the main problem. I took ibuprofen and waited until this morning (Sunday) to stretch, and it seems fine. Next week I hope to continue on this trajectory. I'll still take things one day at a time, but I'm starting to think in weekly chunks again and hope to do a full 4 x 1 mile tempo run and another medium-distance run (maybe 11-12 miles this time) during this coming week while continuing daily exercises. If I run the 10k race next Sunday, then the best idea would probably be to treat it as a tempo run. The jury is still out on whether I'll be up for the marathon or half-marathon on March 16, which is only 5 weeks away. I won't run the marathon unless I can beat my current PR of 3:12, such as it is, but I'm not sold on whether I should run it even if I think I can run faster than that. At this point it doesn't really matter and wouldn't affect the sort of training runs I do, which are just aimed at nursing me back to general distance running health. By the way, when I was talking with the PT on Thursday it emerged that I had misunderstood one thing he said that I reported in my last post. The underlying lower back issues that he had in mind were effects of bad posture and nothing else. His point was that doing all these exercises and running with perfect form won't enable me to dodge injuries like this if I spend most of my waking life standing and sitting with bad posture. So trying to avoid that is the most important thing I can do.
Sunday, February 10, 2013
Monday, February 4, 2013
WEEKLY SUMMARY (Jan. 27 - Feb. 2): 40 miles (92.5% E and 7.5% M paces)
Sunday: 6 miles at 7:23/mi. on a treadmill
Monday: 7 miles at 7:16/mi.
Tuesday: off
Wednesday: 6 miles at 7:21/mi.
Thursday: 7 miles at 7:16/mi.
Friday: 7 miles at 7:16/mi. on a treadmill
Saturday: 3 E, 3 miles progressing from 7:00 to 6:30 pace, 1 E on a treadmill (7 miles total)
This week was less bad than I feared it would be, since I ran almost every day and felt by the end of the week like I was on the road to recovery. But I probably have some ways to go before I can do harder workouts again. Monday was the first day that I started to feel like I was clawing my way back to health. My hip didn't hurt when I ran, but that whole area felt weak and tight. Since that run seemed to go relatively well, and it was my fourth day running in a row, I decided to take Tuesday off in order to consolidate whatever gains I'd made and, I imagined, to feel better still on Wednesday. Instead my hip hurt more during my run on Wednesday than it had any other time since my injury. I was close to despairing, but it dawned on me that this was evidence that tightness was a large part of my problem. I hadn't activated my muscles in any way for 48 hours, and stupidly I didn't stretch before running on Wednesday. It relieved me somewhat to think that all this was caused only by tightness somewhere. But where? So many muscles were involved, but what was the root of the problem? That same day I read an article that led me to think that tightness in my psoas was the underlying problem, since apparently that can cause secondary tightness in all the other muscles where I was feeling pain. (Apparently you often don't feel psoas tightness directly because it's such a deep muscle). So I started doing psoas stretches before and after running. Perhaps coincidentally, my next three runs went ok. On both Thursday and Friday I felt looser and felt less (but still some) direct pain along my hip bone (iliac crest). On Saturday I headed to the treadmill without a plan but thinking that I might pick up the pace a bit if I felt ok again. After three miles in the 7-teens I felt fine, so I then went to 7-flat and gradually picked it up every half mile until I got to 6:30/mi. pace and three (more) miles. That's not very fast, but I did feel it a little in my hip as my form stretched out some. The next day (Sunday) I was ok, though, and ran 6 easy miles as normal. That was about the safest possible way to test whether my hip can handle running faster right now, and it was neither encouraging nor entirely discouraging. I'm going to have to keep taking baby steps forward. Today (Monday) I finally had my appointment with a physical therapist. I found a great (but expensive) running-specific PT who put me through various strength tests and videotaped me running on a treadmill. In addition to giving me tips on running form (my feet land too far in front of my body, and my arms swing unevenly) and posture (I slouch while sitting and shift my hips forward while standing, both of which put pressure on my lower back), he discovered significant strength imbalances in my hip muscles. Something has caused certain muscles in my right hip (especially my TFL) to atrophy. After finding my right side to be significantly weaker on some strength tests, the PT started probing around and said that he could feel the difference in the size and tension of certain muscles when comparing my right and left sides. "There's just nothing there," he said of my right TFL. Well, no wonder it hurts. A puny, atrophied muscle that isn't firing correctly will get tight and hurt when dragged through activities that healthy muscles can handle. So what has caused muscles in my right hip to atrophy? The search for an answer to this question was inconclusive. The PT looked for evidence of some underlying lower back problem, but it seemed to me that he must not have found the evidence he was looking for because at that point he started talking about psoas tightness, which is common in distance runners and squares with the tightness I've been feeling well above my hip just below my rib cage (where the psoas attaches to the spine). So he gave me some exercises to do to resurrect the dead muscles in my hip and asked me to come back (and pay more) for some acupuncture that might shock them back to life. I guess I'm relieved that he didn't find any major strain, but at the same time of course I'm annoyed to learn that my muscles are weak and imbalanced. When I was a kid, my dad used to wake me up - after I'd slept through the five previous attempts to wake me up - by quickly pulling all the sheets off me. (Ok, maybe he did it only a couple times, but it worked and I remembered it). I'm going to pull the sheets off those atrophied muscles in my right hip, and I'll even pay for acupuncture if that might help. Maybe this is also what I need to jolt me into regularly doing the ("core") strength exercises that I've known for a long time that I should be doing.
Sunday: 6 miles at 7:23/mi. on a treadmill
Monday: 7 miles at 7:16/mi.
Tuesday: off
Wednesday: 6 miles at 7:21/mi.
Thursday: 7 miles at 7:16/mi.
Friday: 7 miles at 7:16/mi. on a treadmill
Saturday: 3 E, 3 miles progressing from 7:00 to 6:30 pace, 1 E on a treadmill (7 miles total)
This week was less bad than I feared it would be, since I ran almost every day and felt by the end of the week like I was on the road to recovery. But I probably have some ways to go before I can do harder workouts again. Monday was the first day that I started to feel like I was clawing my way back to health. My hip didn't hurt when I ran, but that whole area felt weak and tight. Since that run seemed to go relatively well, and it was my fourth day running in a row, I decided to take Tuesday off in order to consolidate whatever gains I'd made and, I imagined, to feel better still on Wednesday. Instead my hip hurt more during my run on Wednesday than it had any other time since my injury. I was close to despairing, but it dawned on me that this was evidence that tightness was a large part of my problem. I hadn't activated my muscles in any way for 48 hours, and stupidly I didn't stretch before running on Wednesday. It relieved me somewhat to think that all this was caused only by tightness somewhere. But where? So many muscles were involved, but what was the root of the problem? That same day I read an article that led me to think that tightness in my psoas was the underlying problem, since apparently that can cause secondary tightness in all the other muscles where I was feeling pain. (Apparently you often don't feel psoas tightness directly because it's such a deep muscle). So I started doing psoas stretches before and after running. Perhaps coincidentally, my next three runs went ok. On both Thursday and Friday I felt looser and felt less (but still some) direct pain along my hip bone (iliac crest). On Saturday I headed to the treadmill without a plan but thinking that I might pick up the pace a bit if I felt ok again. After three miles in the 7-teens I felt fine, so I then went to 7-flat and gradually picked it up every half mile until I got to 6:30/mi. pace and three (more) miles. That's not very fast, but I did feel it a little in my hip as my form stretched out some. The next day (Sunday) I was ok, though, and ran 6 easy miles as normal. That was about the safest possible way to test whether my hip can handle running faster right now, and it was neither encouraging nor entirely discouraging. I'm going to have to keep taking baby steps forward. Today (Monday) I finally had my appointment with a physical therapist. I found a great (but expensive) running-specific PT who put me through various strength tests and videotaped me running on a treadmill. In addition to giving me tips on running form (my feet land too far in front of my body, and my arms swing unevenly) and posture (I slouch while sitting and shift my hips forward while standing, both of which put pressure on my lower back), he discovered significant strength imbalances in my hip muscles. Something has caused certain muscles in my right hip (especially my TFL) to atrophy. After finding my right side to be significantly weaker on some strength tests, the PT started probing around and said that he could feel the difference in the size and tension of certain muscles when comparing my right and left sides. "There's just nothing there," he said of my right TFL. Well, no wonder it hurts. A puny, atrophied muscle that isn't firing correctly will get tight and hurt when dragged through activities that healthy muscles can handle. So what has caused muscles in my right hip to atrophy? The search for an answer to this question was inconclusive. The PT looked for evidence of some underlying lower back problem, but it seemed to me that he must not have found the evidence he was looking for because at that point he started talking about psoas tightness, which is common in distance runners and squares with the tightness I've been feeling well above my hip just below my rib cage (where the psoas attaches to the spine). So he gave me some exercises to do to resurrect the dead muscles in my hip and asked me to come back (and pay more) for some acupuncture that might shock them back to life. I guess I'm relieved that he didn't find any major strain, but at the same time of course I'm annoyed to learn that my muscles are weak and imbalanced. When I was a kid, my dad used to wake me up - after I'd slept through the five previous attempts to wake me up - by quickly pulling all the sheets off me. (Ok, maybe he did it only a couple times, but it worked and I remembered it). I'm going to pull the sheets off those atrophied muscles in my right hip, and I'll even pay for acupuncture if that might help. Maybe this is also what I need to jolt me into regularly doing the ("core") strength exercises that I've known for a long time that I should be doing.
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