My second visit to John I was pleased to report that stiffness in my lower back after running in particular was reducing after persisting with the (slightly oddly named) neural flossing. It is even becoming quite the enjoyable stretch post running. It was good to review the other exercise I had been doing, the split squat, with John as it seemed I had been going off piste with the technique which is why it seemed to be getting too easy too quickly! That corrected, I am back to working on these in order to strengthen the muscles around my right hip in particular to stabilise the joint more and give me a better range of motion. The difficulty I find doing this exercise demonstrates that it is something that is really limiting my overall movement.
This visit focussed on releasing my vertebrae – from my neck to lower back, and allowing the nerves exiting my spine to move better. Having a very tight back means the nerves are getting ‘caught’ during movement and limiting my range of motion, particularly in my right side. With a number of loud and satisfying crunches all the way down my spine, the instant result was remarkable. My legs (and arms) moved further and more freely, which goes to show the nerves are a major source of the problem – an area that I haven’t been treated for before. It was also great to feel how a late-20-something back should feel – rather than one that felt fused from top to bottom.
In addition to the exercises, I have to improve my walking technique – lengthening my stride and allowing my legs to complete the full stride, activating the gluts on the right to stop interference from my lower back. I also need to think about my bending down technique – less bend in the back and more in the knees to prevent exacerbation in my lower back muscles.
I always had the feeling that my back and hips should be more mobile but I have never had resulting niggles of this tracked back to their origin, I now thank that initial foot pain..
Surprisingly, after four weeks of sound running advice, postural adjustments and gentle manipulation, my knee of little faith has defied all odds and become, in comparison, an irrepressible preacher. In other words, I’ve made good progress with John and no longer require ‘fixing’ in the immediate sense as before. Its now down to me to take on board what’s been discussed and advised, and maintain accordingly. That meant today’s session was really a wrap it altogether, check everything is improving sort of session.
A key focus was some renewed gait analysis to assess whether my newly-adopted mid strike running technique was as I imagine in my head, and not in fact worse than my technique before. I have been out for two hour-long, fairly pacey outdoors runs in the last week to act as the crucial ‘can I run yet?’ tests, as well as testing out the new pose. Thankfully, I (and my knee) passed with flying colours, with no aches, pains or Kelloggs crunchy-nut noises present during or the days following. I did notice that the transition between my old technique to new was an odd feeling, mainly in that, for the first 15 minutes or so, I felt very unstable and a bit wobbly – probably because I was used to the feeling of landing on something equivalent to a large bag of clouds at each heel. However, once I got going, I soon felt the difference: lighter and bouncier on the feet, taller in posture and, overall, faster! A real success in my books. Fortunately, so too was the gait analysis. A significant improvement on four weeks previous. One take-away message that John did make, with regards to the analysis, was the circles I was making with my arms and legs (discussed briefly in past posts). Like the beloved Roadrunner, I need to bring my limbs in to my body more (shortening the pivot) to ramp up the cadence, which will ultimately provide me with more speed. Consider it done.
Overall, the last four weeks have provided me with some very insightful advice and help, which will hopefully steer the outcome of my biggest athletic year away from total disaster. I am certainly a happier and more confident triathlete because of it. I will make sure to keep you all updated with my progress throughout the year’s events and the gruelling training involved. For now though, all I will say is that Operation Ironman is very much go, go, go…
My first assessment from John arose from having mentioned some soreness in my right foot occasionally. He tracked this all the way up to my hip and lower back – focussing on the nerves rather than the muscles. It seems that my consistent aches and stiffness can be related to these problem areas which was good to know – means I can focus on getting these working properly rather than trundling along with what could be seen as individual problems.
After a thorough comparison of right and left, it was very noticeable how my range of motion is much more reduced in my right hip. John tracked this up to my back – which generally always feels like that of someone 50 years older rather than in their late twenties. The little flexibility and movement in my spine causes a vicious circle – reducing hip movement, causing my back to compensate and further tightening everything. This then affects the whole leg – hence the foot pain.
With some neural flossing techniques and a satisfying crunch of the back I was off feeling a little lighter but with lots of work to do to increase the strength in my gluts, stabilise my hips and to get the nerves adjusting to leg movements a lot better…
So, my fourth session with John focused mainly on pain relief. I came with aches and pains built up after a weekend seeing the tourist sights of Barcelona. I talked through my pain which had started to radiate from my side down through my hip flexor and into the front and back of my thighs. It was starting to affect not just my ability to climb and exercise but my every day movements like walking, sitting at my desk.
John spent most of the session working on my neck and spine. I hate manipulation so when John “cracked” my neck it took me a bit by surprise but did seem to loosen things up a little. He tried the same on other parts of my spine but my body was too tense to allow it to have its full effect. For my next session John suggested bringing in a colleague for a second opinion and to try some acupuncture on the muscles in my side, which are all in spasm. I’m slightly nervous. I’ve tried a couple of needles once and found the sensation pretty strange. But it has to be better than manipulation!
John suggested that I’m almost too flexible and that it is often the case that flexible people succumb rather too easily to gravity – that might explain why I often slouch or feel the need to rest my elbow on my desk at work. “For some people it’s a head game”, John told me and I think for me that’s the case. I have to remind myself constantly to hold myself upright. Perhaps I’ll leave post-it notes at my desk, in the car, at the kitchen table as a simple reminder.
Towards the end of the session, John then gave me a few simple exercises to relieve my pain and to slowly build up the basic core strength that appears to be lacking in my left hand side. These are all really easy so can be squeezed into my hectic days.
Next week – acupuncture!
Twenty six days to go and it hasn’t escaped my attention that there is one day left for every mile I will have to run. I feel that this is somehow apt – the marathon is not only run over the 26 miles on the day, but over the many more miles run over the days and months leading up to it. This miniature mountain of time and distance (and hills) already covered is what makes my sensations heighten as the event draws nearer – I have put in so much effort to get this far that I don’t want to miss out due to injury or illness at this late point.
The exercises John has recommended have adjusted my posture to the point that the right calf is much less problematic, although this adjustment does seem to have ignited soreness in the left achilles. I am working on my gait to push right through to the toes on the trailing leg, increasing speed and reducing effort in the legs. This weekend will be my last truly long run before the marathon. As long as that goes well it will be all about keeping the legs ticking over for a few weeks and giving absolutely everything on the big day.
COUNTDOWN TO MARATHON: 56 days
I feel it is no coincidence that this Christmas I was given two books which are undoubtedly related: Hemingway’s ‘The Old Man and the Sea’, and Melville’s ‘Moby Dick’. Both describe the immense efforts of people to overcome multifarious obstacles in order to capture a monster far bigger than themselves (although I haven’t read Moby Dick yet). It may be over-dramatic, but in some way this is how the marathon has become for me.
Particularly since the calf problems, it has been a daily struggle to stay on top and build the mileage back up enough to make the marathon plausible. I put in calf-strengthening exercises daily, I now also slot in postural exercises and some ‘neural flossing‘ as recommended by John. I am careful to warm up and down thoroughly around each run. I run three times per week, unsure each time whether the calf will fail again, but monitoring and adapting my runs accordingly.
Add to this that I will not be satisfied purely with finishing the marathon, but I would like to run a reasonable time. My running is currently limited not by my fitness but by the leg, which sometimes does not allow me to run further. This is concerning given that my longest mileage since the injury is 15 miles. Still, I believe that my approach is giving me the best chance possible. It combines patience, determination, and discipline. Keep doing the exercises even though you may be bored. Keep training even though the weather may be terrible. Keep believing even though other people may not hide their doubt. There is never a guarantee of success, but you can always put in your best effort possible.
COUNTDOWN TO MARATHON: 64 days
On my second appointment with John, he once again demonstrated to me the flaws in my posture. With me standing casually, a quick profile photo showed that my pelvis and nose stuck out in front of the rest of my body. I am curving my lower spine backwards and then my neck and head are pushing too far forwards from my shoulders (see photo); as John rightly pointed out, I am a two-pillow sleeper. These extra curves in my skeletal frame mean that the nerves strung over that frame have further to travel than they should, and therefore have less give in them.
My first prescription was to sort out my posture during the many hours I use a computer (at the office and particularly when using my laptop at home, for which my posture is really pretty terrible).
In the first photo you can see the sofa is low and I am hunched over; the second I am sitting more upright, although the screen still needs to be higher!
Following this, we tried some little hops as if skipping, first on both legs then switching to one leg, showing that this was much worse on my right side. Similarly, when balancing on one leg, I would lean my upper body much further to the side on the right leg than when balancing on the left. It seems I am literally a lazy arse, at least on the right side, where the upper glute muscles do not want to work to keep me balanced. Prescription two was the sitting-to-standing posture exercise from the physiotherapy.co.uk website to wake these muscles up. You or I may well ask what all this has to do with my calf injury? I believe John’s answer might be that you treat the body and not the symptoms of injury, and the rest follows…there is a logic to this, and as a scientist I see that you can only test this theory by following the advice, so fingers crossed and here goes…
Who knew sitting could be so hard? Over the last week I’ve made a conscious effort to break my sofa-working habit and have been working at my table instead. I bolstered my seat, used a back support, and did my best to sit in the “right” way, but have ended up with pain and stiffness in my upper back between my shoulders! My lower back has also complained a fair bit at various times throughout the week, and I had another headache, which is possibly neck related last night. It’s hard not to feel down heartened at the moment really, especially when I have done piriformis stretches every day this week, and have tried to keep up the neural flossing. I’m trying to stay positive though.
When I saw John today I gave him an update on how things have been, then he went through and identified all the areas of stiffness and restriction, and treated them. We’ve decided that a lot of the problems I have with my back could stem from my neck. That’s almost certainly why sitting at a table hasn’t helped, because although I’m hopefully at the right height, and in the right position, I am working on a laptop, so am constantly looking down at my screen. I’ve decided to invest in a wireless keyboard, so I can raise my screen, but keep my keyboard in the right place. I’m also going to invest in some bolsters to try and make sofa working more appropriate.
Anyway John showed me some more neural flossing exercises, and explained a bit more about them. He showed me a good, gentle stretch for the back of my neck (and also commented that my neck muscles are similar to actors – in other words in common with people who talk a lot!!) and generally tried to show me how I should position my head. I am aware that I do naturally bow my head quite a lot. I often notice that when practising yoga.
So this week I intend to do the stretches John showed me, buy a wireless keyboard and try and keep doing the neural flossing. I’ve also had a look at the dynamic sitting on his website: http://www.physiotherapy.co.uk/exercises/corestability/dynamicsitting_supported.php
I’m going to really try and get this right. I’m also going to keep up my yoga and climbing, but take it easy with that, and maybe try a couple more runs.
In the 5th session of Physio my knees did not seem much improved. After examination we found a ‘niggly bit’ under my knee cap. But still is it the niggle bit a symptom or the cause?
We had a look at a simple forward step. I thought it was easy on both strides but actually my hip couldn’t stay straight. Since realising I should focus on keeping my hips and core strong in my steps I have felt new parts of my back leg muscle! Simply from walking up and down the stairs. My homework for the next fortnight is to keep working on dynamic sitting, dynamic standing, stretching my neck, split squatting and to have use my legs not my hips when walking.
At my last appointment with John, we looked at my shoulder movement. It seems that isn’t behaving either. Instead of using it relatively independently, I seem to be shifting my whole trunk forward, in an attempt to compensate for a lack of mobility there. I was beginning to wonder if anything was working properly? But, John remained conifdent that I can be fixed.
We moved into the gym, where John showed me an exercise on the rower with just one leg in the foot strap. I’m used to rowers, but I could see that there is a lot more to the technique than I had thought. John also showed me a couple more jumping, stepping and balancing exrcises. They all seemed simple, but were pretty challenging to actually execute without falling off balance.
I left the session with lots of homework. However, the next day I was heading away on a weekend city break. Of course, I completely failed to do any of the exercises over those three days. What is more, John’s theory that my problem is walking, rather than sitting correctly was found to be painfully correct. After just morning of wandering the streets of Barcelona I was in a lot of pain. The pain travelled from my side to my lower back, down my buttocks, hip flexor and both the front and back of my thighs – all on the left hand side. I was stopping to sit and relieve pain every 30 minutes. Over the weekend, the pain lessened a little as I tried to walk less, but I was not feeling postive about things. I’ve tried to pick the exercises up again now that I’m back in Bristol, but will have plenty to discuss with John at today’s appointment. Lets hope he can help…