Category Archives: rehab

Move That Ass

Since starting 3rd year, I’ve been living some great combination of standing, sitting and running all over the hospital in heels, clogs and on rare days sneakers. Thanks to this, my a** has been killing me since about March. Right on cue, another blogger friend sent me a great followup post about how to fix butt pain when all you do is sit. This applies to almost all of us, regardless of profession. In our culture, we sit. All the time.

Since getting his email and getting fed up with constant pain, I’ve been much more diligent about taking care of my rear. I get up when I sit for a few hours, try to use good posture when I have to stand (in the OR, on Rounds, in the ED etc) and stretch whenever appropriate, especially focusing on my hamstrings and hip flexors. It’s hard to stay on top of it but I’m much happier when I do.

How do you handle sitting all the time?

Week in Review: 4.14.14 to 4.20.14

Vacation is over. Le sigh. In a normal week, it takes forever for Friday to come. In vacation week, however, it was hear before I knew it. I accomplished 25% of what I meant to over break, failed to study for Wednesday’s test and now have a “normal” Sunday of frantically trying to get ready for the week. I did manage to get a massage this week and lots of good running.

Monday: Lifted (back and chest) at the gym then ran home. First few steps were awful and wasn’t sure the run was going to happen but things warmed up. 80 degrees out! Starting the shorts tan early…

Tuesday: Off day, prorated at 6.3 miles. Lifted arms.

Wednesday AM: 20 minute elliptical and legs.

Wednesday PM: 6.5 miles plus strides.

Thursday: 6 mile farlek. Intended to do 3 by 5 minutes at tempo effort but because the Intervale flooded, it ended up being more hodgepodge. Did sections at tempo and 4 all out hill repeats up my favorite hill. Massage in the afternoon.

Friday: 7.2 miles. Recovery run with heart rate monitor on, keeping it below 135.

Saturday: 7.66 miles. Previewed the Champlain Classic course with Will. It somehow doesn’t look as bad at bro pace…

Sunday: 12 miles. Long run with Kath, another beautiful day.

Total: 52.6 miles

Reflection: I’m starting to be more comfortable at this mileage and not waking up as sore, which is encouraging. Although my workout this week didn’t go as well (in part because I hadn’t thought it out), I was surprised to find that my interval and tempo efforts were yielding paces close to where I was before surgery. I certainly can’t do 16 mile steady state runs at that pace right now but it seems like I didn’t lose as much as thought.

For this coming week, the goal is to get two days of lifting in, two days of aquajogging extra, one workout and a PT session in. With school starting again and a new class, the goal is maintenance, not building. Mileage will stay right around 50. 2 weeks til the Classic!!

Fixing Running Form (or how I’m ridding myself of TRex arms)

Runners with perfect form are rare and perfect form does not necessarily a good runner make. There are plenty of elite runners who have form peculiarities. In recent years, runners like Ritz and most recently Mary Cain have received lots of attention for their attempts to correct form. For Ritz, it doesn’t seem to have borne out enormous benefit and he’s still struggling with injury. With Cain, it’s too soon to see if the tweaks will help. There is an increasing body of work that suggests that perfect form isn’t necessarily something to work towards; the way we run, quirks included, may be most bio-mechanically efficient for us. That being said, there are things that most runners can do to generate more power and run more efficiently.

I have good parts of my form: high stride cadence and a light, mid-foot landing. This explains my relatively low incidence of injury (my two surgeries not-withstanding, but those are from anatomical variance). I have bad parts of my form: my quick cadence means I terminate my stride early and my hamstrings don’t snap my foot back well. And then there are my t-rex/twisty arms that waste a ton of forward movement. Recovery from surgery is the perfect time to focus on my form. Since I can’t run, my choice for exercise is predominantly lifting and I’m taking advantage of that opportunity. My major focus is on building stronger hip flexors, stronger arms and back and improving hamstring flexibility. Read on for a few explanations of why and links to great articles covering common form issues.

What is your form weakness? Have you ever tried to improve your form? Any major improvements in performance?

Knee Drive

“Generating hip drive is also a concern for runners with a very short, quick stride. When these “choppy stride” runners try to accelerate, they often find their speed and ability to change gears during a workout or race is limited by their cadence—since their default gait already uses a very high stride frequency, they can’t increase it any more to speed up! These kinds of runners tend to terminate their stride a bit early, giving the appearance of a quick “lifting” of the foot off the ground instead of a good drive with the knee straight and the ankle plantarflexed. Learning how to increase stride length by generating more power from the hips is a big help if you are a “choppy” runner.”

From: http://runnersconnect.net/running-injury-prevention/hip-drive-running-stride/

“Hanging from a bar, draw your feet up to the bar while bending at the waist. Build up to three sets of 10. An easier version is to bring your knees to your elbows. Use a 12-inch diameter band, or double loop a longer one. Place the band under your left foot, and put your right foot in the loop. Pull your right knee up toward your chest 10 times. Repeat 10 times and then do the other leg. In waist- or chest-deep water, perform high knees in place for 30 seconds, recovering for 30 seconds. Repeat 10 times. You will work against the pressure of the water, strengthening your hip flexors without the pounding.”

From: http://www.livestrong.com/article/108587-running-exercises-increase-knee-lift/

Arm Swing

“To help the above occur as efficiently as possible, arm swing should be initiated at and through the shoulders. Driving the elbows down as well as back can help avoid elevation of the shoulders, which in itself causes tightness and limits range of motion.

Just as bringing the knee through in swing phase needs to be a passive movement, so does the forward movement of the arm. Driving your arms up and forwards wastes energy and reduces the efficiency of the stretch reflex mechanism in the shoulders. Your hands crossing the midline of the body is a sign that you may be driving the arms forwards instead of backwards, or that you have tightness in the chest.”

From: http://runnersconnect.net/running-injury-prevention/running-biomechanics/

Keeping Fit on Crutches

From an informal poll I took on New Year’s Eve, most people view recovery from surgery as a time to veg out, catch up on TV and generally ignore exercise. For me, it’s precious weeks off from the aerobic base I’ve spent the last 36 months building. As such, I’ve been “working out” almost since surgery. Granted I’ve been limited by the instruction to not weight bear and the sheer of ice over Burlington, but I’ve made do and found some entertaining websites in the process.

First, I googled “chair workouts.” I figured that there must be people who have limited mobility that still like to workout and I’m not the first person on crutches. It turns out that they run the gamut but that YouTube is full of personal trainers with “great cardio workouts.” I’ve tried a couple of them but my two favorites are the following:

Chair Cardio by Trainer Trish (tough on already tired crutch arms)

Seated Cardio by Spark People

Ridiculous as it may sound for someone who runs 70 miles a week, I’m working through these videos every day, with a goal of adding reps of the first workout and completing the whole second workout. In concert with my crutch to and from our classroom, this comprises most of my daily workout. I’m also doing as much strength training as I can, primarily upper body and core. I figure that if I can come out of this with great arms, I’m ahead of the game.

After finding out that UVM’s handicap doors don’t work and crutching half a mile on ice tonight due to some jerk parked in the handicapped space without a permit, I googled “keeping fit on crutches” for entertainment. I learned that crutching for 10 minutes burns 50 calories and got some not-so-useful tips on “surviving crutches.” The article is right about the bag (I have a backpack for school and a lovely Vera Bradley tote for home), but misses just about everything else including what to do if an ice storm hits (tiny steps!), how to not show everyone how sweaty you are (black everything) and ways to style your hair when showering is just too damn hard (low bun, works every time).

Thankfully, I only have about another week on crutches. Next week, I see Mark and transition to my walking boot. Assuming the ice is gone by then, this will make coaching and life in general much easier. I also look forward to many boring hours on the bike and in the pool.

Ready to run

I had a realization this morning on my 45 min PF rehab run that I’m ready to get back running.

Even though I’ve not been able to run the last 6-8 weeks I’ve been busy ellipticalling, swimming, biking and working on my core.  Up until this morning’s realization this training has had one purpose: to keep me from flipping/freaking out at the fact that I’M NOT RUNNING.

Another tactic that’s helped me keep my head up was still thinking I was training for a marathon.  When the injury first hit in late August I moved my marathon from Hartford in Mid October to Philly in mid November thinking I’d be able to beat this PF thing and have at least 6 weeks of solid training for Philly.  So I signed up for Philly, paid the $125 even though there was no refund policy.

Philly now being less than 7 weeks away isn’t going to happen and I’m 100% ok with that.  Was that $125 a waste?  I don’t think so because I remember being so psyched for Philly and it helped me focus and stay on track.

Anyways I am ready to run, all the hard work (not really hard work because compared to the meaty marathon training I’d be doing if I was healthy it’s a breeze) had another purpose, my body is ready for these all important runs.  Will that mean I can ramp up my mileage faster, probably not, but I’m positive that in every other department of my body except my foot I’ll be ready.

Tim (Blogger Sub)

Perfection

So my diet perfection goal on my Monday Motivation blog is just so unrealistic, un-attainable and non-productive, I know that.  But for some reason the quest for perfection has helped me hold it together this week and to me that makes the ridiculousness of the goal so special, so productive.

I haven’t cheated all week.  And I have been tested as early as day two.  It’s especially hard having two young kids who eat lots of yummy treats that scream to me “come on Tim try a little corner or my delicious brownieness.”  And last night was my first serious test as my Sister came to visit from NYC which she rarely does.  I bought wine for dinner and felt like I’d be too much of a dork not to have a glass so I had resigned myself to have one.  But when the time came to pour I held back, not worth it.

Staying perfect allowed me to feel like I was training even though I hadn’t run a single mile this week.  I tackled this plantar thing head on with my head on straight and laser like focus.  Would I have had the same focus if I had been eating desserts and fatty foods all week, probably not.

And I’m still achieving this week, like doing my first palms down pull up, go me!  Sure cranking out a 3×3 mile tempo run would feel a ton better (and aren’t the cool down miles after killing a workout the best miles) but I’m grateful for any positive experience during this setback.

Starving myself to stay in my calorie limit and being good all week has not been easy, but I feel great, probably have shed a few junk pounds I seem to gain when I eat poorly, am in the right frame of mind to deal with the Plantar and will be ready to train when I’m back on the roads.  Thank you perfection.

PF update:  I’ve been to Brian at On-Track three times this week where he’s not so gently massaged (if I wasn’t watching him I’d swear Brian was using an ice pick) my PF and had me stretch it out.  Monday I had to close my eyes and try to be somewhere else in my mind as the pain was unbearable.  But by Wednesday the pain was 50% less and even better this morning.

And consulting with coach Jess Cover I’ve held off on running and won’t run until I can’t feel it at all when I walk.  The recovery is going so well that I’ll probably be able to go for a test run next week.  Best of all On Track is getting an Alter-G treadmill next week and I might take my first run on it!

I’ve pushed back my fall marathon from Hartford (10-13) to Cape Cod (10-28) to now Philly(11-18).  I want to be patient with my PF, not rush through this (thanks for the feedback Bob on not pushing too hard) but give myself enough time to have a solid marathon training cycle.

Can’t even walk

Hi I’m Tim, I’m stepping in to blog for Sarah for a few months.  I met Sarah this year at a GMAA team race where I finished 3 seconds behind her (net time) at the New Bedford Half Marathon in March.  Going into the Vermont City Marathon we had a friendly match to see who’d beat who and Sarah won again, by 13 seconds.  And even at a fun 5K this summer at the Clarance DeMar, Sarah beat me again by 9 seconds.  So we kinda got a little rivalry going.  Sarah owned me in 2012 but I’m determined to beat her at least once in 2013.  So when I read that she was stepping away from her blog for a while I sent her an email asking if I could sub in with the hope that maybe I could steal some Mojo for 2013.  So here I am.

And this morning I couldn’t walk.  The past two weeks I’ve been teased with a mild pain in my Plantar on my right foot and this morning it was on fire.  It’s humbling to have to put all my effort not to fall over and create a racket as I limped around the house in the early morning, trying not to wake my wife and kids.  Even after the PF has warmed and stretched a bit I can’t walk without pain in every step, which is not good.

But as bummed as I am, given that I’m 9 weeks out from the Hartford marathon, I see these painful steps as my first steps in my new journey with running.  What will happen I can’t predict, but I plan on being optimistic, listening and finding expert help to get me through this and come out stronger.

Cherish your runs everyone, do you realize how lucky you are!!!

Keeping the Wheels on the Bus

I’m thisclose to injury, which is excellent timing because I’m also thisclose to VCM. Last Thursday, I headed out for a run and found myself in excruciating pain in my left calf and foot that rivaled pre-surgery pain. I tried to run through the weekend, but found that things only got worse so I canceled my scheduled 20 and hoped for the best. On Monday, however, it was clear that I couldn’t run through whatever this is.

So now I’m in rescue mode. I took Tuesday and Wednesday off, I have a massage scheduled for today and I’m wearing compression socks around the clock. I’ll attempt a short run tonight to see how things feel (assuming I’m not bruised from my massage) and then try to get back on track for a decent weekend of running.

The only saving grace of this is that I’m surrounded by training partners who are smarter than me and excellent at tough love. They remind me almost hourly that I have to be healthy on the start line in a couple of weeks, not healthy this weekend. They remind me that this is the end of 24 weeks of training.

Here’s hoping my rescue plan works out…

For Claire and Neal

A couple of people who are just shortly post-op have reached out lately to ask about recovery. To be honest, I’ve blocked out most of the misery that went with post-op, so I had to go back to entries from that time and my running log. Here’s what my first two months of running post-surgery looked like:

Looks pathetic now, but I remember being so excited the first day I ran one consecutive mile. It really is all about perspective.

Sheeee’s Back

My apologies for being absent over the past couple weeks (and missing some great picture milestones), but I’ve been busy…running!  At just about 8 weeks post-op (last week), I started doing some gradual running on the treadmill.  We started with 3 minute intervals with two minutes of rest (about a mile of running total) and worked up to yesterday, where I did 4 minute intervals with a minute rest for 2 whole miles of running. Wahooooo!

The only pain I’m having is in the first running interval, where it feels like the worst calf cramp known to man.  Last week, it happened much earlier.  Yesterday, it was right at 4 minutes when it started.  A simple stretch (dropping it off the edge of the treadmill) relieved it and by the end of the run, I dare say I felt warmed up!  The loss of fitness piece is far more disheartening.  I notice it less so with running, but was breathing hard on the elliptical. 

Still working on focusing on strength.  One of my goals as I begin to base-build again (I cannot believe I have to do this again, by the way) is to continue to focus on core and hip strength, as well as upper body strength to help with my arm swing (and therefore knee drive).  It is very hard, as miles rise, to fit in strength and flexibility.  However, I want to be one of the athletes who successfully returns from CECS surgery, not one who has to return to the OR.

By the end of the month, my PT team (whom I love) and I are hoping for 30 minutes non-stop of running.  By our estimate, slow building will have me back to full fitness in about 4 months.  All told, this is a 6 month break from competition.  I’m framing it as an extended recovery period, where all the little niggles and aches of any long-distance runner have a chance to truly heal.  In addition, this recovery period has forced me to slow down, to think about what running means to me.  Running has always been a part of my fitness plan, but it hasn’t always been a positive force in my life.  Being forced to stop helps me to see just how much running does for me in terms of mood and opportunity for self-reflection, nevermind a great butt in jeans.