Sunday, March 23, 2008

Anyone else got an idea?

2 weeks! It's been 2 weeks since I last posted.. And 6 weeks since I last ran. The two are related. To some extent there is little news to report: I am still injured and still not running.

One of the things that is so difficult about injury (I’m sure Susan will back me up on this) is that everyone has a different opinion on how to treat you or what would be beneficial for you.

My GP was the first point of call. A man who visibly did not put exercise at the heart of his life, his advice was just to “take it easy”. Whatever that meant. I did cut down on my mileage but it didn’t ease the pain. At all.

So then – in this country – you head into the land of private (ie you pay for it) healthcare. There are physios, osteopath, podiatrists and many other options available. How to choose? In my case, I asked some fellow runners and they recommended physio at the local sports injury clinic.

So I went and started to see a physio. He’s good; he’s very dedicated to getting sports people out on the road. I think his initial prescription for me – strengthening my adductors, stretching out my ITB – was based on a general treatment of knee pain in runners. When I went back last week – the third time – and I could still report no progress he suggested I remove all potential stressors of my knee out of my life for a while. So no high heels and, more importantly, no hills. Somewhat reluctantly I have stopped parking my car at the top of Steep Hill (yup)
every day and walking down to work and am, instead, parking at the bottom of said hill and thus, hopefully, avoiding some of the pressure on my knees. I am wearing mostly flat shoes. We then agreed to meet in the gym that evening so he could see me run on the treadmill. He was very surprised to see that when I run I am, in his words, knockkneed. I overpronate considerably and this causes my knees to come together when I run. When he then had me running wide-legged – I felt like I was running while riding a horse if such a thing is possible – the pain immediately diminished. When I asked him what this meant for my recovery program – ie which exercises I should focus on, he had my focusing on exercises to strengthen my glutes. When I asked for his advice on how to run in this way which was far less painful, his answer was “go slow and steady”. His idea is that I start by running in this new way for 5 minutes each day, and build it up. The problem with this suggestion is a) that I’m still suffering from knee pain and b) that it’s very hard, without guidance, to really change how you run. In addition, in the course of the past week I have slowly become conscious that some of the exercises he is making me do may be contributing to the knee pain which has, if anything, got worse since I stopped running. This may be because I’m not doing the exercises right or it may be that we have not yet completely figured out exactly what it is that is aggravating my knee pain and so have not been able to eliminate it from my life (or exercises). Since Thursday, I have, in fact, stopped doing any of the exercises that I felt were hurting me and (touch wood) my knees feel better.. This is sort of good news – no pain is good news – but I am conscious that his initial advice of strengthening my adductors probably still has validity and I’m not quite sure how to go about it without hurting myself. Another appointment is called for.

Based on this lengthy paragraph above it seems quite clear that my pain is related to how I run. So I somehow need to learn how to run better, in a way that won’t injure me. ChiRunning is an option here and as you know I’m working on this. I’m practising my various focuses and exercises in anticipation of a private training session with Chris Griffin next month.

Another way to change the way you run, however, is orthoses. Now I was quite reluctant to go and see a podiatrist. Everyone who goes to see one seems to leave with 300 pound orthoses. But frustrated by my lack of progress and doubtful about my running future (and upset by my physios repeated comments about going to see a friendly orthopaedic surgeon for arthroscopy) I decided it was worth having a try. A local podiatrist is recommended by our local running shop and my friend Sally has been helped by him so I booked in to see him last Thursday. He found all sorts of peculiar things about the way I walk and move and next Tuesday I am booked in for an afternoon’s session where he films me running on the treadmill, will make a cast of my foot and then will make me orthoses which will correct a variety of the problems he thinks I have. Do I think this will help? Well, I obviously hope so. But based on what everyone else has noted there is clearly some issue with the way I move and on the face of it is seems orthotics would change the way my feet move and would therefore change the way everything else moves. We shall see. At any rate the assessment should be valuable and useful and the orthoses are refundable, should they be no use at all. I will then go back to the physio with my issues with my exercises and see what we can come up with which doesn’t hurt me more. Pile Chris Griffin on to that in a month’s time and hopefully this three pronged approach will do some good…

I have so far not consulted an osteopath or any other practitioner – I am overwhelmed with the range of possible treatment options and not quite sure which road to go down. I think I’ve gone down the physio route long enough to be able to try something alongside it, and we will see where that gets me.

I am trying to be brave about not running – the few swimming lessons I have taken so far have vastly improved my front crawl. The time freed up by not running seems to have been seamlessly swallowed up by work and domestic life – I am very behind in commenting and podcast listening. If I haven’t been to your blog recently – I am getting to it. I promise. I miss you all enormously, and I miss the sense of running alongside you all. I really hope I’ll be back again soon..

11 comments:

Susan said...

Petra,

You seem to be on the right track! I agree that one can't seem to visit a podiatrist without a $400 pair of orthotics... but I sure do love mine! Ha. When I first got them, though, I was immediately injured -- by "overuse" -- i.e. too much running -- he said. But since then I have loved the orthotics.

I miss you, too! Big stuff happening here!

Susan

Toughnoodles said...

Don't give up. I know it's hard, I've been where you are...
I have orthotics, and they have helped. Over the years, I have also found I haven't always had to run in them--but give them a fair try because often it is what is needed to "jump start" the broken down body.
Chi running has helped me too. Hope you're on the road soon!!

IrishBlue said...

Apparently, orthotics are all the rage. I have them too, but have not worn mine for a while now. However, my foot pain is returning and I may be forced back into them.

Hang in there. Sounds like you've done your homework. You'll get this thing figured out. I know it must be so hard as much as you love running.

We miss you too!!!

MarathonChris said...

Thanks for checking in, Petra. We all miss you but completely understand!!! It must be frustrating trying to deal with the knee. Sounds like you are pursuing all the right avenues! I am also an orthodics user - they have helped out alot.

Hang in there! Check in when you can.

ShirleyPerly said...

If I were in your shoes (no pun intended), I would get the orthotics first to correct your stride and then go from there. Overpronation is a very common and fundamental problem that will probably negate any good that would come of strengthening glutes, adductors, etc. I'm actually surprised someone didn't notice you might need them before ...

Great to hear your swimming has improved!!

Revrunner said...

One of the best pieces of advice I ever got was from a sports orthopedics specialist who,after watching me run on a treadmill for just a few minutes, told me to go buy a pair of running shoes designed specifically for persons who over-pronate. I took his advice and never looked back. He also also helped me through a severe bout of bursitis in my hip that made it nearly impossible for me to even walk.

Hang in there!

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Jade Lady said...

First of all, what a hill that is!

Second, Good luck with your podiatrist. I myself prefer to go under the knife only after I've exhausted all other options. But, I agree that sometimes the process can be time-consuming.

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