Wednesday, August 14, 2013

Breaking down, getting healthy, and getting stronger

Runners are, by and large, the most brutally honest people I know. From work-a-day hobbyjoggers like me to professional athletes, delusions of a better, faster, more capable self simply cannot survive the rigors of real life training and racing. At the end of the day you are what the clock says you are and if you don't like it then it is up do you to do something about it. But don't complain about it because nobody wants to hear your whining. Period. When you get dropped from the group on a hilly long run there is no way to sugar coat it. On that course, on that day, among that group of runners, that's who you are. Your PRs are your identity so you better work hard for them, make them count, and, above all, be proud of them. For the most part this type of honesty is very healthy and I truly believe it has made me better at almost everything I do in life.

This is not to say we are not capable of lying to ourselves like everyone else--it's just that we carefully pick our spots. We lie when it is the only way to keep moving forward, because at the end of the day moving forward is all we have--no matter what successes or failures we have in life or no matter what the universe throws at us, putting one foot in front of the other is the one thing we can always control. Just. Keep. Pushing.

So we lie to keep on moving forward. "Fast is easy." "I can still do this." "I'm not tired." "Your doing grate!" And my personal favorite: "It's not an injury."

But when brutal honesty and relentless forward motion collide it creates a sharknado of cognitive dissonance.
The NWS has issued a sharknado warning.
For more than a decade there were two things that I knew for sure--these two basic truths were the bedrock of my entire running worldview:
  1. Injuries are never random and are always due to a failure in training by the athlete.
  2. I don't get injured because I am way smarter than everyone else.
I still believe the first statement. Coming to grips with the fallacy of the second statement has, over the past 6 months, been a less than comfortable but necessary journey of personal growth.

Hi, my name is Mike and I am an injured runner.

But I am on the mend--physically and mentally--and I believe I can still be better than I have ever been. This is the story of how I figured it out, and how I'm fixing it.

I have had a left hamstring injury since at least January and probably since as far back as November of last year--I remember vividly how badly it hurt after the Great Stew Chase 15k in early February and how I could barely take a step the next day when I went out for a little shakeout jog. A month later, by Stu's 30k, it was worse and a little jog the Monday after that brought tears to my eyes. I managed my way through the next few weeks and somehow ran a 1:19:50 half marathon at New Bedford on March 17th but by then there was no denying it--I was broken. I had planned to use my training for that half as a nice base build for a Spring of doing hard workouts in hopes of busting a sub 17 5k but instead I had to take a couple of weeks of very easy jogging.

During this time, I started toying with the idea of jumping into the Vermont City Marathon (hey, I'm injured so I think I'll run a marathon!) I thought I might like to have a Boston Qualifier in my pocket for 2014 and easy mileage didn't seem to bother me much. Then Boston happened, and I made up my mind for sure I wanted to run in 2014 and so that was that. I managed to run an okay marathon in Vermont, then got sick, then after taking some time off being sick started running again and my hamstring was no better--it was worse.

I decided to figure it out. I had already been doing a lot of reading and a lot of it focused on hips and glutes as the primary culprit--I had started doing lunges and bridges to try and strengthen my glutes and increase my hip mobility but I wasn't clear on why that was important. Still it seemed to help a little. I kept stretching and rolling my hamstrings too, which basically made no difference. It turns out I was on the right track, just not really zeroing in on the root cause.

Then in late June or early July I picked up a copy of Anatomy for Runners by Jay Dicharry and everything changed.
Are you a runner? Then read this book.
I have been reluctant to become too evangelical about a book that I only read 6 weeks ago but the thing is after reading it, my whole world suddenly makes sense. Jay Dicharry understands runners and why they get injured as well as what to do to not get injured. He mixes the anatomy and physiology with practical and real world exercises and self-assessments that make you go "oh of course!" Near the end there is a chapter on self-assessments and another (appropriately called "Putting Humpty Dumpty Back Together Again") on corrective exercises. I can't summarize the book in this space and do it justice so I'll just suggest that if you're a runner and you want to recover from an injury, or avoid future injuries, you should read it.

The biggest issue for me--and a lot of other people it turns out--is that I have tight hip flexors from sitting too much. Over time this has caused me to become a quad-dominant runner, my glutes became too weak to maintain the position of my pelvis above my femur, and when I fatigued my pelvis would roll forward on my hips. This caused me to arch my back and my center of mass to move forward which caused me to over stride in front of my body to keep from falling on my face. Basically I was running in what Dicharry calls the toilet bowl of doom.
Here I am in the toilet bowl of doom in 2010
I think the combination of rolling my pelvis forward and over striding in front of my center of mass was what put too much strain on my upper hamstring and led to upper hamstring tendonitis. But at the end of the day the exact diagnosis is unimportant--that was one of a dozen things that could have (or should have) gone wrong the way I was headed, and treating the specific injury would have done very little good.

The answer was in increasing my hip extension mobility, strengthening my core and rewiring neuro-muscular system to run with correct posture. I had to rebuild my chassis.

So what am I actually doing differently now? It's really just a few basic things.

  • I think about and pay attention to correct posture all the time now, especially when I'm running.
  • Several times a day I stand on one foot, 30 seconds each foot.
  • I stretch my hip flexors for 3 minutes each after every run.
  • I walk around barefoot whenever possible, even more than I used to.
  • I've replaced all the drills I was doing with just 2 things: heel lifts and backward running.
  • When I do strides, I try to crunch my abs a tiny bit to try and bring my pelvis and my shoulders toward each other--this helps me maintain a perfectly straight back even while striding really hard.
  • I don't stretch my hamstrings at all anymore (but I still roll them a couple times a week).
  • I do a series of core and stability exercises--including a lot of glute max stuff--that take about 30 minutes, 3 x per week. Mostly it's specific bridges, lunges, squats, some stability ball stuff and some pushups and knee drives. I took a bunch of the exercises from the Humpty Dumpty chapter that I thought I needed most and that I could practically do in the space I had and with the equipment I had. After about 7 weeks, I plan to pare the list of exercises down a bit and not do all of them every session and get it down to maybe 15 minutes a session, 2 to 3 times a week for maintenance.
I honestly think the biggest and most immediate difference has been from simply thinking about posture. Until I read this book I have to admit I never actually knew what good posture was or what it was supposed to feel like. And so I couldn't have corrected it if I tried. After doing some really simple exercises and just teaching myself what good posture is, I can now feel it instinctively.

It took a lot of concentration at first to stay in good posture and keep my pelvis neutral throughout even an easy 6 mile run, but in just a few weeks it has become almost hard wired to where I don't have to think about it much at all. Very rarely now, I'll still catch myself arching my back and/or tilting my pelvis and I'll have to concentrate for a few seconds to get myself back to neutral--but those instances are becoming fewer and farther in between.

My hamstring pain is basically gone. I can still feel it every now and then the day after a long run or if I accidentally over stride for a bit but I would not really call it pain anymore as much of just an awareness of an area that used to be kind of tender. It went away so quickly that I'm sure the exercises had little to nothing to do with it and that it was almost entirely from just running with better posture--the exercises are just helping me to maintain posture and make good posture instinctive and natural.

At first my glutes were really fatigued from the combination of all the exercises I was doing and from actually having to do their job when I was running. But after just a few weeks that's gone and they have actually become a strength--I don't fatigue as quickly when running hills.

The biggest epiphany was only a week or two after finishing the book when I went out for a 12-mile run on a Sunday by myself. I had been doing the exercises and drills and giving myself something to work on in every run up until that point. That day I decided to just run and not really work on anything--no specific pace, no strides or drills. Just a run with good posture. For the first time in 6 months I made it through a run of that length without hamstring pain. When I stopped for water after about 11 miles and had to restart again I was amazed that there was no pain or stiffness. I had a pretty good idea I was on the right track at that point and it really helped my whole attitude. Since then I've gotten stronger, my hamstring has become less and less noticeable, and I've progressed to some big, hilly long runs that felt pretty good.

I've noticed that when I run with good posture, I carry my hands a little lower--it feels like I used to run when I was in highschool. I also don't get sore anywhere and I have basically no muscle knots or adhesions. I still roll my hamstrings and calfs and do a bunch of self massage, it's just that now I never find anything. Granted, I haven't really done any hard workouts other than a few long runs on hilly courses, but I still used to always have some kind of knot somewhere and now I have nothing.

Right now I plan to finish out the initial 7-week core-stability plan that I wrote out and then re-asses and develop a real, longer term training plan. I may add it some weight training in the fall but I am still undecided on that. I will definitely keep in the habit of doing some core and stability work at least 2x per week forever for maintenance. I'll still run a few races but I am putting all time goals on the back burner for now until I'm 100% healed and able to put in a real training cycle--I am excited to really be able to train with a fully healthy chassis and see what I can do. Get healthy, then get stronger.

A couple of months ago I felt like this injury cycle was the beginning of the end for me. Now I feel like I am in control again and that I can accomplish anything I set my mind to.

Boston 2014 is the next race I really care about. Everything between now and then is just part of the process. Anything is possible and I am ready. It is going to be epic.