Physical therapy #2

Update on the knee. It's exactly the same. My thigh is super tight. It hurst to roll it. I can run on my knee. It's 90+% for walking up and down stairs but I notice that it's not 100% And I'm using that (and work stress) as an excuse for not running.

I went to physical therapy today and they had me run on a treadmill to analyze my pronation and what's going on with my running.

Guys, I failed this test. Hard.

Good things first: My cadence is perfect. Right around 180 steps per minute.

And that's the extent of what I do right.

Pronation:
When I first started training LAST MAY, I went to a running store and they watched me run and put me in a neutral shoe.

I watched the video at Physical Therapy and I pronate. 164 degrees on my left. 172 on my right (should be 180). My ankle collapses it. It's gross. (I would like to blame the treadmill. I run stupidly on the treadmill. Also I've always felt that I wobble a bit in my first mile and my get into my stride when I'm good and warmed up after a mile or more. But excuses, excuses.)

He also says I'm a heel striker and completely lock out my knee when I run. He wants me to land on my mid foot and bend my knees more when I run.

What this means:
Last week we addressed my hip issues, so having my hips in place when I run (which my hips being in the right place has really hurt my back). So that's causing a hips down issue. (My hips are tight when I run. I understand this.)

And the pronation/ heel striking is causing an ankle up issue. So this is just bad news for my knees.

What he said to do:
Go to the running store and buy light stability shoe. This should fix the pronation. And then focus on mid foot strike and bending my knees more.

For my therapy today, he did more cupping and some muscle stem.

I honestly didn't have that great of a visit. I thought we butted heads about the shoes. He really wanted me in light stability shoes. Not moderate stability shoes. He gave me a list of shoes that would work. And told me to go to talk to the running store owner. I was trying to look up shoes on my phone and he kept insisting I talk to the store owner. I asked about trail shoes and said it didn't matter.

And I had flashbacks of the last time I bought running shoes FROM THE SAME STORE OWNER. When I was fitted. I tried on EVERY SHOE in the store. 30 pairs. I've tried some of the pairs on the list before—because they were cute. And TBH I think I've worn light stability shoes before, when I was just buying cute shoes.

And I just don't think this is a shoe issue. I've been training the same—same shoes for 1,000 miles with no issues. What changed? I went to the trampoline park. I've been slacking on my yoga.

Also, I have about 10 pairs of neutral shoes. I have backups and backups. I LIKE my Nike Pegasus. I don't like Brooks Ravenna or Ricochet. I like them better than my heavy Asics (that I also got knee issues in.) I will get inserts, but I have so much money in shoes, I'm not switching out every pair. (Currently 5 trail shoes, 2 racing flats, 5 road shoes.)

But I was good. I went to the running store right after physical therapy. And the employee said that for light stability they usually tell people to get an insert. That's the halfway point between neutral and moderate stability. So I spent $50 on an insert that I can stick in running shoes and trail shoes.

This is Hummus. She was at the running store when I went there.

Week off running: Recap

I've taken a week off running. It's the first week I've not run since February 2016 when I got really sick.

I thought it would be harder. That I'd go crazy. That I really would want to run.

Nope. I quite enjoyed the week. Saturday morning, I usually go running. That's my routine. So I thought about it the most then. Instead I rode the exercise bike for an hour and then went on a marathon of errands. (Ok, more like a 10k. I had 6 places to go.)

I enjoyed the extra time I had. I enjoyed not being so tired in the evening. And I generally felt less tired. (I've been feeling extremely run down lately.) really I needed a week to recharge.

I did four yoga classes and two stationary bike workouts. I avoided weight lifting, since that's apparently the root cause of my injury (tight quads leading to knee and shin issues). I even asked a friend to teach me about lap swimming

I think if I wanted to walk away from running, it would be easy. I could stop now. And I'm not sure that I'd really regret it.

I remember being constantly injured running in high school. I pushed my body harder and harder to go faster and that often meant shin splints or knee pain. I don't really want to go that route again, My goal for the year was to stay healthy.

I think I'll start running on Tuesday and see how it goes. If I lose fitness, so be it. I can make it up. I have no races scheduled until next April.

I don't think I'm quitting running, but we'll see how getting back into it goes.

If it's not too hard on my my body, I have a few things I'd like to see if I could do in the next few months.

Mini goals
1) Run a 5k under 23 minutes
2) Get my mile time down to 6:30 (or 6:28 so I can match that pace chart I have)
3) Get my 10k time down to 48 minutes

Shin splints : what my chiropractor said

I went to the chiropractor for my back. And for my shin splints too. She's not an orthopedist, but I know if my hips are out of alignment it can make my knees hurt. I wanted to make sure this wasn't causing or aggravating my shin splints.

She remarked that my shins were really tight. And my quads too.

I told her my quads have been tight for three or so weeks now. (From Bodypump, I think).

I also told her my knees felt funny when I walk down stairs. (Ding, ding, ding).

Then she tested how high I could lift my legs while laying on my belly. (Same test an orthopedist did for my IT band issue years ago.) She test if my legs felt tight when she bent them a certain way. Then she tested my knees. She had me flex my knees while she poked them.

Basically, my tight quads (that I thought nothing about) have been wreaking havoc on my lower leg and knees. Because my quads are tight, so are my shins. And somehow my knees are tracking wrong due to a muscle imbalance. My outside quads are strong my my medial quad is weak, and that's causing knee issues. So she gave me some stretches for the medial quad and for my knee.

And I feel all sorts of messed up.

The good news is my shins are feeling better.  I've been resting and making sure to up my calcium. They feel almost good enough to run on. I'd like to give it a few more days. (Maybe 10 days off running? Honestly, I'm fine with losing some speed. I don't have any planned races.)

I'm not sure how I feel about my knee and running.

My knee did hurt worse after getting adjusted. I'd felt a twinges before I went in, so it was a problem waiting to happen. It felt better the next morning, so nothing to worry about.

I've taken a whole week off running and I think I'll take a few more days and then try some miles.

Week off running

Ozzy approves of naps and running less

Well, it's been a good few months of upping my miles, but I'm taking the next week off running. I've got the beginnings of shin splints so I want to see if a week off helps.

I've been worried about them for a few weeks.

I got the first pain a month ago. It was the first week I ran 30 miles—and probably too many miles on road. So I've been running more trail miles and decreasing my miles. It's not horribly painful yet, but I don't want it to get worse, so time off. I won't lose fitness in a week (I think) so I'll take the week off, and go to the doctor if necessary.

I blogged about a little bit of pain after the week I was in Florida. I had some pain after my nine mile run.

And last week, I ran 7 miles in the morning and then noticed the pain while walking around shopping afterwards. I took it so easy this week. I ran 10 miles. I scaled my miles way back. There was a little bit of pain during my five mile run, mild and at the beginning. But that's the only time it's hurt during my run. It usually hurts after my run.

Rest, Ice, Compress, Elevate. Or is that C for cat?

It's just an ache. I can take anti-inflammatories and I don't notice it at all.

I ran a race yesterday. No pain during the run. Some afterwards. It's achey. I feel like the front of my leg is bruised.

I feel like I did what I should have
• I run in new shoes from the running store (gait analysis done. I love the shoes!) So it's not worn out shoes.
• I followed the 10% rule ramping up my mileage. I was very deliberate (so hopefully not too much, too soon)

I do worry about calcium. I take a calcium supplement, but I worry about my bones since I don't eat dairy and haven't for 5 years. (I faithfully take a supplement.) I usually drink soy milk so I make but I've been extra diligent to make sure I drink a glass a day and get 100% of the calcium I need.

It could be road running? That I just need a break? Who knows?

In the mean time, I'm looking forward to a lazy week. And if it's still bad, I'll go see the doctor and see if I can use an anti gravity treadmill. At least if I miss running this summer, it's during the hottest part of the summer!

Ankle Injury: Two Years Later

Two years ago, I tore a ligament in my ankle at the trampoline park. (Facebook time hop reminded me).

I was trying an arial and landed wrong. I knew something was wrong immediately. I tried to do my best not to cry. I drove myself home (I kept my sister on the phone to distract myself from the pain) and had my sister take me to an urgent care the next day. And recovery took a long time. It was the end of January (almost four months) before I was back on the trampoline (in a brace). It took forever to rehab my ligament because it was a tear, not a sprain. It looked like just a bad sprain on the original X-ray, but when my twice weekly physical therapy wasn't progressing as it should (I was in so much pain doing their exercises), I got an MRI that revealed a tear, two sprains and bone bruises. So there was even more physical therapy (I really loved physical therapy), and slowly but surely, I strengthened my ankle and didn't have to have surgery. I spent a few months being cautious so I didn't re-injur it.

I think it's amazing that the body can heal itself from this. And I don't notice it all these days. I run gnarly trails. I tumble. Ankles are great.

 I look back on think of what a different place I'm in now. I mix up my workouts more now, and only miss the trampoline a little. I still go every once in a while. Here's what I learned

10 lessons learned from spraining my ankle

1. Time heals all wounds.
It seemed like it took forever to heal my ankle, but it did. And looking back it doesn't seem like that much time. So glad to have healed.

2. Everyone wants to give you advice about how to care for your ankle.
Just smile and nod and do what the doctor tells you to.I heard about how a friend healed his ankle my sitting on it, and now it crunches, how another friend had even more swelling than me and slept upside down and heeled his ankle, how I should just go ahead and workout like normal, how after 48 hours I shouldn't ice it anymore that I should use heat, how my injury couldn't have been that bad, and so much more. It really got annoying. I try not to do this when friends get hurt. But sometimes I can't help myself. So I'll usually pop back in and tell my injured friends that I hope they heal quickly, and to do what works for their body. Everyone is different.

3. Physical therapy is the best.
If I was 5-10 years younger, I'd really consider going to physical therapy school. It's a career that makes a difference and is always going to be in demand—due to sports injury, and especially older patients needing help with mobility issues. There were a lot of white-hairs in there working out shoulders or legs. I could see myself loving a job like this, being active. But alas, it's four extra years of schools (plus science pre-requisites.) So I'll just have to cheer for physical therapists and the amazing work they do healing our bodies. They know the right exercises and stretches to get you back to where you were. And I'd trust some of them more than an M.D. (Example: My physical therapist gave me a compression sock that I desperately needed. The doctor did give this to me or tell me to get it. This made all the difference in my recovery.)

4. Voltarin Gel is awesome.
This is a pain gel that's often prescribed to arthritis patients. I got a prescription for my ankle, since my doctor was worried about my stomach taking all of those pain pills for four months. The gel is amazing. It numbs the pain away, and works fast. I've kept the extra around for aches and pains I know I'll have (wrists after gymnastics, IT band when training too hard etc.)

5. Flat shoes are the way to go.
I loved wearing sneakers to work all those months—on doctor's orders. I really appreciated how comfortable they are—when compared to heels. The one lasting difference of my ankle injury is that I live in flats now. Five-inch platforms used to be my go-to work shoes. Now, I wear the most comfortable flats I can find
• Puma makes ballet flats. I like to think they're as comfortable as Puma shoes.
• Clarks makes very comfy flats
• Some Cole Haan shoes are made with Nike Air footbeds.
Other brands: Hushpuppies, Aerosoles and probably more.
I will rock my flat shoes.

6. If you're going to sprain an ankle, sprain the left one....because not being able to drive is the worst.
I couldn't drive for at least a month after my injury. The doctor didn't want me to drive when I couldn't SLAM down the brake pedal, since I hurt my right ankle. I worked at home or got rides to work. (It is not fun to ask for rides). The worst was grocery shopping. I'm used to just picking up something on the way home from work. But I had to go with my husband—and walking around the grocery store on crutches is not fun—on his time. And he didn't like the daily requests for milk or eggs. He just wanted to go once. I can't plan what we're running out of. I can guess, but sometimes you just don't know.

7. Don't even try to get your own food while you're on crutches.
Just have someone else pickup your restaurant soda or your buffet plate. There will be a nice soul who will ask. Just let them. You can't balance your crutches, purse and a tray. It won't end well.

8. One-legged workouts are totally doable.
Take a pain pill and work out. I did a lot of one-legged TRX. I got my arms and abs really strong during this period. And I learned a lot about body awareness while adjusting the workouts while compensating for not being able to use an ankle. (Also, lots of wall squats). But it's good to change workouts up.

9. How to sit still.
I am so bad at sitting still. I'm twitchy and constantly moving. But when I sprained my ankle, I had to sit still. It would hurt to get up and I needed to keep my foot elevated. Also, the pets really liked it when I sat still. They'd all come gather around me. I got better at sitting still, because I had to. I'm still twitchy and like to get up every few minutes but if I need to sit still for an hour—it's more doable now than it used to be.

10. Ankles are important.
I learned just how much I use my ankle. I couldn't sit on my foot, walk up stairs, run, jump, drive and do so many things. I rode a lot of stationary bikes and did a lot of rowing machine workouts and wall squats. I also did a lot of toe raises to strengthen my ankle. But I won't take my ankles for granted now. And I do make sure to stretch my ankles a lot more now.

Running hiatus

This year I decided I was going to run more. Since I got a member to the university gym in January, I've run faithfully once a week or more. I finally got my 5k time under 25 minutes. I was planning on adding more miles and runs during the week. But my knee has other plans.

It's been painful for about a week now. I tried doing some stretches for when my left knee hurt last year, but I'm not sure it's helping. Thursday I tried to go running and I got about 7 minutes in before I started feeling awful stabbing pains in my knee. I tried to push through it. If I ran softly it didn't seem to hurt, but I gave up. I couldn't. The pain was still there. So I count Thursday as my off day.

I went to Pure Barre yesterday and my knee was the worst it's been. If I bend my knee and put weight on it, it hurt.

I need to see a physical therapist. But to do that I have to see a sports medicine doctor, which would take few days for an appointment, and then another week to see the physical therapist, and I want my knee to be back to normal in 2 weeks.

There's a girl in Pure Barre who told me she worked as a physical therapist. I went up to her after class and asked her about my knee. I'm sure she hates when people do that. I hate asking, but it's easier than waiting 2 weeks for an appointment.

She was so nice and helpful. So much more so than I expected. It made my day.

She thought it was my IT band and that I needed to stretch it. She showed me some stretches and indeed it did feel tight. She might be right. And saves me a bunch of time.

I went home and stretched and iced. And this morning I didn't run. So I broke my run once a week rule. (I did try to run Thursday). So sorry goals, I need to get my knee better.

Battle wounds

I'm calling this the week of the injury. Nothing serious. Just lots of scrapes and bruises.

Monday, I bruised the back of my knee at trapeze class. It always bruises my knee. It's the candlestick pose. It just hurts.

Tuesday, I wore shorts to TRX and we climbed the rope. I got some nice rope burn on my knee (it since scabbed over) and a rashy burn on my lower leg that will be quicker to heal. The rope is scratchy and when you wrap your leg, it just tears the skin off. I tried just climbing down and unwrapped my feet completely and was about 10 feet up in the air and was really worried I would fall. I was tired and my arms could fail. I didn't fall, but I kept wrapping after that. A rope burn is better than falling from 10 feet.

Wednesday, I went to get an allergy shot and the nurse really stuck me with the needle. It hasn't hurt that bad in a while. It really hurt and lasted forever. My arm swelled up like a bee stung me and the muscle was sore because she jammed it so hard. And sure enough,  I got a black bruise the size of a fingertip from the shot. My right arm was stiff going into tumbling class and later.

I suppose I should be symmetrical because at tumbling that night I got a nasty blue bruise on the inside of my wrist. I don't know how. I think it happened halfway through class. Maybe from a handstand. Maybe I hit it on something? I don't know. It doesn't hurt, but it does worry me.

Thursday, I decided I'd had enough and didn't go to the gym.

Exercising while tired/ Rolling my ankle (again!)

I can't tell if it's swollen. Maybe?

There's this fine line between pushing through fatigue for a better workout to working out tired and getting hurt. I don't know where this line is. I try to listen to my body and sometimes I know and sometimes I don't.

When I tore a ligament in October, I was doing a second hour of working out. I was trying something new and crazy and I was tired. Really tired and not paying attention. Looking back, I shouldn't have done that second hour.

Last night, I did an hour of circuit training and then was really tired at the beginning of cardio, my second class. I had no energy. I had a stitch in my abs. I just wanted to go home. But I was at the gym. And I felt like I was more tired than I should be.

We were playing four square and I was running over to another square and I rolled my ankle. It twisted too much to the side and my foot rolled under. I fell. I knew the feeling.

"Are you okay," a friend asks.

"I'm out," I said and stood up, leaving them with three people for a four-person game. "I think I rolled it," I said and hobbled off the trampoline. My ankle is tingling. Not a good sign. It's not a stabbing pain, but it lets me know something is wrong.

I have one of those ankles that occasionally rolls. Especially if I'm wearing too high heels. It will roll out of place. I'll be off kilter for a few steps and that's it. But this roll was somewhere between that roll and October's sprain.

I walk around the gym testing my ankle. I can walk. It's stiff, but not impossible. I elevate my ankle and ice it for about 10 minutes. I'm too anxious to sit still much longer. It doesn't hurt like last time, but there is pain and it's not in my head. I do some of the ankle stretches from last time. None of them hurt. Fingers crossed it's not bad.

I was tired and not paying attention to body position. And I was just thinking about how I haven't been doing my physical therapy. I should do more toe raises and keep meaning to run once a week or so.

But I really was tired. I didn't realize it until afterwards.  I usually workout 5-7 hours a week with two days off. But this week:

Sunday: 90 minutes of acro yoga.
Monday: 60 minutes circuits, 60 minutes cardio.
Tuesday: 90 minutes climbing
Wednesday: 60 minutes cardio, 90 minutes tumbling
Thursday: 60 minutes circuits + another class.

Adding acro yoga  into my mix is something I need to start considering and then adding that one cardio class made more of an impact that I realized. I'd already done 8.5 hours before I started the class.

This morning I woke up and the ankle was not purple and puffy. It's a little stiff and sore. Flexing it and moving it to the right are both a tad tender.  It tried to roll again when I was walking the dog in flip-flops. I need to be wearing shoes.

I am wearing a compression sock, icing it, keeping it elevated, doing my stretches and hoping that in the next week it's back to normal.

If not, there's always spin class, abs and wall sits.

Just a flesh wound

Tonight at tumbling I bled all over one of the rainbow tumbling mats. It was awesome.

I was working on a bridge kick-over on the rainbow mats. They're pretty primary colors.

The instructor walks over to me. I'm probably doing something wrong.

Her eyes get wide and her voice is a little more emphatic than her normal super excited tone.

"Are you bleeding!?" she asks me.

I blink. I don't think I'm bleeding. I'm certainly not hurt. I'm fine.

And then I wonder if I am bleeding. OMG. What did I do?

There is indeed blood on the yellow part of the rainbow mat.

"Am I bleeding?" I ask. 

She inspects me.

Do I have a compound fracture? Is there bone sticking out somewhere? What is wrong with me?

"I think it's a mole," she finally decides. "At first I thought it was a bug bite, but it's a mole. Maybe it got rubbed on one of the mats."

"I can't see it," I apologize. Really not knowing what's going on with my back.

I think of what could have caused it. Maybe when I was working on gymnastics presses and tumbled back on to one of the mats. Really, I don't feel hurt. 

And before I know it, I've turned around and the coach has applied a band-aid to my back. Like I was a good obedient, kindergartner. Except, I'm a 31-year-old woman. But it works for me, because it would be super difficult to bandage a spot I can't even see.

Tumbling class continued mostly without incident, though one guy did accidentally kick the instructor when we was working on a back tuck. Oops Job hazard. (I think I kicked the other instructor a few weeks ago. Sorry H)

The bandage fell off when I was working on my front tuck. Thankfully, it stuck to the bottom of my foot. 

Next time I will wear a shirt that covers that pesky mole. No more skinny racer-backs for me. Or I will bring a T-shirt. And show less of my massive muscles.