Since my last session I had been really trying to focus on keeping my head in the right position rather than jutting it forward, keeping my shoulders back and my back straight (so that I resemble less of an S shape overall). However, I had been having a bit of knee pain in the days leading up to seeing John.
When I arrived at my appointment I told John about the knee pain and we went through what I had done that week that may have caused this. I did a 35 mile cycle and a long swim on Sunday – but I have been able to go on 2 cycle tours in France since my injury so it almost definitely wasn’t that – the we realised it was the wedding I had gone to on Saturday in shoes that weren’t totally flat (which are all I’m used to wearing) and standing around and dancing in them for over 10 hours.
I was so relieved that the pain could be easily pinpointed. During this session we practiced my checks for setting my body in the correct position and then practiced the order of drills/exercises to do before ‘falling’ into running (I haven’t tried running properly yet – just the preparation!). The list is as follows:
Leaning backwards as if I am standing on the edge of a cliff (weight on my heels)
rocking that weight forward onto the widest part of my feet – now in my ‘eddie the eagle’ pose
alternate knee pushes (don’t bob up and down!) keeping my core engaged and my head back even as I start to concentrate
add elbow drives to my knee pushes without starting to twist my hips
stop mid movement – with my knee cocked and my elbow back
lean my weight forward until I fall forwards taking the tiniest step possible (this is my first step of a run!)
glide off trying to remember the feeling of falling forward, keeping my head back, keeping my core engaged, not twisting my hips…there’s a lot to think about!
After going through this, John worked on the back of my neck, which has got used to years of me holding my head forward. We realised this may be one of the causes of the many headaches I get around the base of my skull/neck. After he had given me a treatment my head felt really light for the rest of the day.
At the end of my appointment we talked about my October 10k goal, and John said that he thought we should have a closer goal to work towards. We agreed on a 5k at the end of July/beginning of August.
That afternoon once I was back at work, John sent me a couch to 5k podcast programme which he recommended I start this week. He gave me some bits of advice over text – how to do the walking sections, how long to leave in between each run or other ‘bouncing’ exercise and to start on week 2.
I tried my first run/walk yesterday and am overjoyed to report that it was pain free! It consisted of 2 mins brisk walking followed by 90 seconds running for a total of 20 minutes. Before each run section I would reset (as per my list above) and fall into my 90 seconds of running. At 2 points – once on a downhill and once on an uphill – I got a small twinge in my bad knee but neither time did it persist and my knee has felt fine since (it’s now 24 hours later). I am looking forward to doing it all again tomorrow!
I was recommended a visit to John by a colleague after living with a knee injury for the past 2 years. John and I are currently working towards getting me back running which is something I have really missed since my injury. In my first 3 sessions, John has taken a really holistic approach to my injury and has identified different links and factors that haven’t been highlighted to me before, but which make a lot of sense. Now we are working on the way I sit and stand in normal life (which leaves a lot to be desired especially as my job is largely desk based) as a starting point to work towards running. I’m not having to do loads of exercises every day but rather I am trying to think about and be aware of how I’m holding myself (or try not to think too much as this seems to be the problem!) and to re-programme old habits. I have booked a 10k race in October so this is what we are working towards, fingers crossed!
I have always struggled with my knees, when I was a child I experienced pain and they felt like they twisted when I ran; that along with being an over weight child I tended to avoid exercise. When I got older I went travelling for 6 months and spent a large amount of that time wearing just flip flops and carrying a heavy bag most days as I moved around; once I returned to England I found that my knees had got considerably worse, they would click and crack when climbing stairs and cycling (it would make me feel sick hearing and feeling it), and when bending or kneeling down my knees would get stuck and I wouldn’t be able to stand back up again.
This all lead me to requesting assistance from an NHS Physio, she didn’t take a lot of time treating me, she just set me exercises to do, and based on my pain and thoughts of the exercises she changed her thoughts about my injury each week. It when from an old hamstring injury, to a flabby core, to you’re overweight and this is why you’re experiencing pain. at 13 & a half stone I wasn’t hugely overweight, but there was definite room for improvement. So after seeing no improvement in my knees and worsening pain in my hips, I felt that I was not getting any benefits from seeing this Physio and I never returned to her. After losing 3 and a half stone I felt great, but my knees had not improved, while training for my first half marathon I was experiencing pain and swelling as well as not being able to bend my knees to climb stairs after long runs – which at 28 should not be hard thing to do. While in the running shop asking about knee supports the guys in there recommended that I have a session with their in house Physio, so I thought why not. After an initial consultation I thought lets give a few sessions a go and see how I feel.
During my first 45 minute session with John, I saw a massive improvement in my movement and reduction in pain when being stretched in different ways, I was so shocked and couldn’t believe that it was that quick at getting results. We ran through some movements to see what my body did and reacted, then we manipulated my back and cracked it a bit, then my leg and hip was in a much better place flexibility wise. John set me an exercise called Neural Flossing to help increase the movement in my legs (stretch them out), as well as dynamic sitting to support my back and core when sitting at my desk all day.
After 1 week of dynamic sitting, at first it was weird and my back would sometimes go into a spasm, however as the week went on I found I was sitting correctly without even thinking about it. I went from pain and trying to crack my back 3/4 times a day to not at all. I even think about it when I am standing still or walking, and I feel much better inside for it.
Roll on session number 2 to see what further improvements can be had!
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…
OUCH! HIP PAIN
Week two of not being able to run and after a pain-filled weekend trying to juggle a two year old who refuses to walk down the stairs, I hastily book a second appointment with John at his AAA-Physio Clinic in Bristol BS8. As I hobble (very much a left leg limp) the short distance from my office to Moti, I am aware that every step is pinching my left hip and is a struggle.
And so the debrief, I have managed to spin and row in the week since I first saw John, but the pain I’m experiencing hasn’t eased at all. In fact, if anything it’s much worse. Carrying said two-year-old halfway across the Downs to the circus certainly didn’t help.
I’ve been to the doctors (usual anti-inflammatory prescription and inconclusive x-ray) to no avail and am told it could be six weeks before I can run again…
After a brief look at the extension on my left hip (or lack of it) John sets to work on my back. I’m shocked at how painful my lower back is. Ten years post-surgery, I am somewhat used to niggling there but as John works his way around my lower spine, I feel sharp shooting pains that actually make me scream. And so, the initial diagnosis is reiterated. In my inability to stabilise my core, I’m causing myself all kinds of problems in my neck, arms and, most painfully, my hip.
BACK TO RUNNING
I think it’s going to be a slow road back to stability and running, but leaving the clinic, into the driving Bristol rain, I’m already feeling a bit stronger and if I really put my mind to it, can see how strong core (deep breath in relax into the stomach) does help ease the pain. Another challenge…and one I’m determined to win.
Top of right glute painful, John has identified that my right foot veers left just at the end of my stride, meaning my hip twists probably causing the pain. It’s only in the last month.
Question is what causes it; shoes, stance or what?
1. New tyres – popped in to Moti and the attentive chaps spent 45 mins sorting that in line with John’s instructions. Very different but comfy, hope an old foot injury in my foot isn’t aggravated as it always casts a shadow over new shoes.
2. Posture – while standing – ‘peering over cliff’, this is the one I’ve been concentrating on, feet, knees, pelvis and head, oh and chest and shoulders if a man can concentrate on more than 4 things at once! While sitting – pelvis, shoulders and head (superman eyes)
3. Running style – shorter stride landing on ball of foot not so heavily on heel, pelvis, elbows (pushing back and not too far forward), and the head, again. Needs working on at the next session.
I really should stretch more.
Been running and out on MTB, neither very good. Torn between resting and pain of getting fit again once John has worked his magic vs glute and back pain of continuing exercise.
These drills from The Running School (R) , have great potential for improving the trunk and lower limb strength and stability in a range of age groups.
I can see this style of exercise being particulary effective and engaging for teenagers. JS Physio MSc
Bristol Physio John Stephenson has been providing movement retraining courses for Health Professionals & Physiotherapists since 1999. He also works on a 1:1 basis with private clients wishing to improve their low back stability and running efficiency. Or for a more gentle introduction, ask about the Walk:BacK & Row:BacK programmes!
Book a consultation or free minute open clinic online:
Having done a long distance run in training for my Iron distance I managed to injure my foot. I have been unable to weight bear for the last 6 days.
WHAT THE PHYSIO SAID….
Interestingly instead of being due to the camber in the road it was due to a total misalignment of my left side. I have a tight ITB, and weak glut medius. This combination makes me rotate my entire pelvis, valgus knee position which results in me placing all my weight and pressure on my lateral 1-2 toes….. And injuring my self!
The plan this week is to do lots of swimming to allow my foot to heal, with core stability working on my gluts, stretch my piriformis muscle and ITB and try and run in line! Not much hey! Let’s see what happens……