Showing posts with label physical therapy. Show all posts
Showing posts with label physical therapy. Show all posts

5.21.2011

dorsisaywhat?

Don't let the smile fool you, we didn't get off to the best of starts.


Michael took one look at my feet and proceeded to say very, very unflattering things about them.  I tried to shield them from the criticism, but they heard and recognized, as with the cruelest of heckles, just how much truth hurts.

It was my Achilles that had brought me to Drevna Physical Therapy Associates but discovered there were outlying issues causing my pain.  Michael filled me in on planterflexion and dorsiflexion, the first being the downward movement of the foot at the ankle and the latter being its opposite.  Turns out I don't have any issues with planterflexion, but my dorsiflexion flat out sucks.


The extent to which you can bring your toes toward your shin is measured in degrees with 15 being about the max. Running as much as I do (or want to) would benefit from at dorsiflexion of at least 10-12 degrees. Let's just say I didn't come anywhere near double digits on my bum foot. And then, just for kicks, we measured the good foot which, um, isn't any better.

But being a professional, Michael agreed to give things a go.  Hence the photo that opened this bulletin documenting his attempts to manipulate my foot into a more flexible state.  He tried and tried, session after session, but even the best of physical therapists aren't magicians.  Six sessions later my dorsiflexion has improved very little.

The upside is that we worked on far more than that.

I rode the bike.


I stood shakily atop a platform on one leg and lowered my other leg to the floor.  I stretched, squatted, jumped, struck tai chi poses.  I did none of this gracefully, of course, but with utmost of conviction.

Much of what Michael asked me to do, he asked me to do perched on unstable objects like whatever this thing is:


At first, I fell and fell often.  Slowly, I progressed to weebling, wobbling but no longer falling down.  I got stronger and gained more confidence.  


Each session ended with the minor miracle that is ice and I assume it deserves a good deal of credit for my suffering no swelling during therapy.

My toes didn't draw any nearer to my shin but there were positive signs.  My balance improved dramatically.  Leg stretches that had been a struggle became doable.  What little running I was doing happened without pain.

All of which added up, eventually, to my not needing to go to therapy any longer.  This should be, and is, fantastic news, but I must admit that it's slightly bittersweet.  I came to enjoy the inching of progress from one session to the next and the teensy but unmistakable victories.  When you're healthy and fit, it can be hard even impossible to recognize improvement, but when you're down a peg steps forward are refreshingly evident.

So, Michael, you've done it.  The curse of a good therapist is that he or she ends up not being needed any longer.  Of course, I'm likely to need help again sooner than later and when I do, I know where I'm headed.


Thanks, buddy.  For real.

5.17.2011

baby steps (weeks 18 and 19)

May is here, people.

Yes, there's been plenty of rain here in Pennsylvania, but there's also been a wealth of sunshine and warm (not hot, not yet) temperatures.

I should be cranking out the miles but I'm doing my best to pull on the reigns and give my Achilles time to heal.  Or, more importantly, I'm trying to improve flexibility and leg strength to help alleviate the undue stress I'm putting on my Achilles by being weak in other places.

Thankfully, I am also managing to log miles, if not nearly as many as I'd like.  I laid low for the first week of May but have again gotten back to lifting my feet, moving my legs and loving every minute of it.

Because I'm not ready to write off summer entirely, I've been using these relatively slow miles to get used to running with water.  That might not immediately make sense and, admittedly, I don't need to be carrying water for the current efforts of 3-5 miles at a time at 7:30-10 minute mile pace.  But one of these days I'm going to feel all the way better and be ready to get back to 25K, 50K and beyond distances.  With any luck, that'll be sooner than later and is likely to coincide with the wicked humidity that visits the Mid-Atlantic each and every summer.  When that day arrives, I'd like to be tackling runs without having to condition myself to carrying the extra weight of a couple of bottles.

How's that for spotting the last drop of water in a formerly half full glass?

For now, it'll have to do.  Here's a look at May thus far:

Sunday, May 8 - So happy to be back on the Horseshoe Trail that I forgot to restart the GPS after we stopped and chatted at Eagle Rock - probably went 1.5 miles further than the photo suggests.

Tuesday, May 10 - Short loop on Penryn and White Oak roads - tentative to push in the Minimus. 

Thursday, May 12 - Out and back on the Lancaster Junction R2T - feeling the effects of the ab work from the prior day's therapy session.

Friday, May 13 - Ran the Penryn/White Oak loop in reverse on my lunch break - stronger effort.

Sunday, May 15 - Horseshoe Trail and Explorer Lodge Road (?) - Struggled a bit early with the humidity/climbing but finished feeling strong and pleased to feel the legs rebound late in the run.

4.20.2011

the higher the bounce (week 15).

The day before heading to Clinton County for the Hyner View Trail Challenge , I sprung for Chinese and was greeted with the following fortune:


Considering the questionable state of my Achilles, the demands of the Hyner course under the best of conditions and the horrendous weather report for the weekend ahead, I didn't like the sound of falling or bouncing.

My legs actually felt quite good and the right Achilles seemed to have quieted down during a low mileage week and with the aid of diligent icing and heating.  I'd managed a fairly demanding (though not long) run in the rain on Tuesday, clambering up and down Mole Hill in the closest mimic of Hyner I could find within easy striking distance.  Steering clear of my most stripped down footwear, I stuck with my relatively burly Montrail Mountain Masochists.


I sometimes forget how much I genuinely like these shoes and I definitely appreciated the extra support during this forced taper.  Eking out sub-10 minute miles on Mole Hill with recovering legs left me hopeful for Hyner.

Chris and I pulled up in front of the start/finish around 9:00 PM on Friday night and found few inhabitants.  The National Weather Service had issued a wind advisory for much of Pennsylvania and heavy rains were projected for Saturday morning and afternoon.  Temperatures hovered just above 50 degrees Fahrenheit but threatened to plummet.  We spent little time considering putting up a tent and agreed that Chris's minivan had ample room for both of us to sleep comfortably.  Listening throughout the night to the van bracing against the increasing gusts, I felt thankful to be "indoors" and wondered what sunrise would bring.

We awoke an hour-and-a-half before the 8:30 AM start to find participants starting to assemble.  Twelve-hundred runners and hikers had signed up for the 16-mile event but we wondered how many would show with the forecasted conditions.  The start was pushed back nearly a half hour due to overnight winds that had toppled one of the support tents.  It was apparent that many who had signed up stayed away when we saw volunteers with fistfuls of unclaimed race bibs.

Knowing that we had little more than a mile before the course settled into climbing single track, Chris and I inched up in the pack.  The maneuver paid off as we left the road behind with no more than 40 or 50 runners ahead of us, all of whom were holding a steady pace.

The first climb up Humble Hill came upon us almost immediately and I was thrilled to find that I felt strong.  I wasn't strong enough to run much of the climb (few were), but strong enough to maintain forward progress on the ridiculously steep pitch.

Just over 3 miles into the race, we'd climbed 1200 feet and reached the first top out at Hyner View, a popular launching point for hang gliders.  The wind was whipping and I was shocked to see my mother, stepfather, aunt and uncle waiting with Lily and Piper.  I knew they'd planned to attend the event but thought the weather would keep them away.  My initial excitement was immediately tempered by the realization that Lily was visibly shaking in the cold.  I spent several minutes with the kids before continuing on my way.  Chris had trucked right through the top out and was long gone.  I wouldn't see him again until we were both done racing for the day.

I was feeling some stiffness in the Achilles but nothing too concerning. Overall I felt solid.  The next 3 miles consisted mostly of downhill running which saved my lungs but had me second guessing my footing.  An extended section of side hill running found the trail basically disintegrating underfoot,  putting undue strain on my outside leg (which just so happened to be my already strained right leg).

 "Nothing too concerning" suddenly seemed a premature determination.

The upside was that this section included frequent creek crossings that allowed me to continuously dunk my right foot and enjoy the on-the-fly icing.  I hoped that this might keep any swelling at bay.

The climb out of Reickert Hollow seemed gradual in comparison to Humble Hill and I hit the 9 mile aid station surprised to learn that the first two major climbs were now behind me.  Though I now knew I was going to be hurting at the end of the day, I was pleased to know I was past halfway both in terms of mileage and required climbing.  I couldn't remember the description of the next section but was initially relieved to see that it was downhill.

That relief vanished quickly as I found myself tiptoeing between the rocks that littered the next mile of trail.  I was getting caught from behind with regularity and kept an eye out for places to step out of the way to let fresher runners pass by.  Despite the raw weather, I could feel heat emanating from my right shoe and wondered if my Achilles was going to hold up.

At Cleveland Hollow, just ahead of the final climb, we passed by two volunteers in pick-up trucks and I considered hitching a ride back to the start.  I was already past 10 miles, however, and expected I could claw my way up the S.O.B. and hobble through the last 4 miles if it came to that.

A mile later my day was done.  My toes stopped responding and I'd progressed to actually feeling pain with every step.  Jesse had sent me an e-mail on Friday with a warning about attempting the race if things weren't in working order.  The words "you'll be out the entire summer" were rattling around in my head and I worried that I'd already accomplished that setback.

Disappointed, I began creeping back the way I'd came, struggling at this point to put weight on my non-responding right leg.  I eventually got back down to the Hollow and commandeered the ride I'd skipped over in the first place.  I was on the way back to the start with my first DNF.      


Chris ran incredibly well and was still looking fresh at the finish.  He was good company and I was in relatively good spirits considering my wounded pride and my swollen leg.  I'd get to see Chris the next day too as he was the attending physician in the emergency room on Sunday morning.

X-rays were negative and I was further relieved to find that I didn't appear to have any tears.  Chris did confirm, however, that my tendinitis was very much for real.  At least in the short term, per my new physical therapist, here's what my workouts will look like:


So there's my "hard fall".

Nearing a full four months into the year, I'm heading in the wrong direction.  The first two of my "goal" races resulted in one missed event due to scheduling conflicts and a did not finish.  I can't even think about the races I'd planned to run later in the year when I'm not even able to log short runs without repercussions.

Here's hoping for one hell of a bounce.