In Physio Focus

I have been staring at this white screen way too many times in the past month, wondering what I could write about. Last time I wrote it was all about doing more of what made me happy. And I did follow suit, however these opportunities were far and in between. There is a sort of lassitude that is slowly creeping in. The less I work out, the less I am motivated to do it, kind of -
"without running, what's the point?". I know it's silly, but I am slowly losing the passion, the fire that ignites my willpower. Without races on the horizon, without a coach, without a plan, it's easy to fall back into the couch potato routine.

Pretty sure I was about to cry. Thank God for that Larabar.

I managed to drag my sorry ass out for a swim every week, hot yoga once a week and a bike ride or two every week, mostly outdoors. However, I've only tried running once for 15 minutes, and that was rather uneventful. Another reason for this decrease in activity has been because I've started working with a new physio therapist and I was told to stay put. Everything has to be "easy" and no runs longer than 20 min for now. But I am very busy taking care of my hips and glutes. All physio work is targeted towards strengthening these areas, so I've been trying to be a good student and fit in as many exercises as he prescribed.

I went to see this guy, who was recommended to me by half a dozen people for being the best at fixing wonky knees and shredded IT bands. I could not afford going last year because I had maxed my physio budget before my IT bands decided to go on strike. But as the new year started, I made it a mission to have a gait analysis done and find out what it would take to fix my legs so I can return to running. His practice is just 5 min away from my office, so that worked out perfectly. The good news is that I run well and he had nothing to say about my gait. He said things like "natural ability", "great posture", "talent" blah blah blah. Maybe he was just trying to be nice. But anyway, then he went on giving me the not so nice picture about my strength. "You are nowhere near as strong as you should be for doing the kind of distances that you chose". Or rather, I am not strong in the places that I should be, like hips and glutes. I've heard this one before... But only now I've been given extremely specific exercises that target precisely those areas. And gosh, he has me working hard.

He said that if I were to do just sprint triathlons or run 5Ks, he would have just told me to go home and not bother, but since I made him understand that running long distances is important to me, he is committed to seeing me returning to doing what I love. And he wants to follow me throughout the entire season to make sure I keep on doing things right. Not once he tried to sway me away from doing long distances or to tell me that I am destroying my body, like many other therapists said before. He isn't Lisa Bentley's PT for nothing. I really liked the guy. He also took time to explain every single exercise and how it affected my body. He puts a lot of emphasis on doing all exercises with such focus and purpose, it's almost intimidating when you think about engaging all these muscles during a single stretch or exercise. Like the bridges below. Try doing them on your heels, tilting your pelvis, squeezing your butt and the legs to keep them close to each other. And don't forget to breathe. Ouch.

He has me on a 40% mobility, 40% stability and 20% strength routine. I don't have the video to share with you, but when I run, my knees collapse inwards and good running technique can only take me that far before knees and hips start complaining. It's all normal since I sit at least 10h a day and then I add more sitting on the bike. So now I have to get up every hour and stretch my hip flexors and IT bands. I have to do a variation of the "couch stretch", by using my desk, with a good posterior pelvic tilt and glute recruitment, at least 5-6 times a day. At home, I get to do daily bridges and work with bands, and a thousand jumps and core stuff. Here's what this week's torture session looked like:

• 10 x bridges 10 sec on/off 
• 10 x bridges with leg and arms lift 10 sec on/off 
• 5 x 5 lateral steps each direction with 2 bands 
• 12 cross leg stretch on step and opposite side lunge, each leg 
• 5 x 10 basic stance hops 
• 5 x 10 left leg runner forward stance hops 
• 5 x 10 right leg runner forward stance hops 
• 5 x 10 forward/backward hops 
• 5 x 10 forward/backward hops with open/close stance 
• 10 cross step and side lunge with bands, each direction 
• 10 x 10 sec low plank with arms on bosu ball
• 5 x 10 sec side plank with leg lift each side

Band Level Up! Twice the bands, twice the resistance.

Sweat makes perfect

Can you guess how sore I am? These exercises make me grunt and sweat with each step! But after 2 weeks of work, the PT seems to be happy with my progress, so fingers crossed that I'm on schedule for his 6-8 week prediction of seeing real improvement (aka no more pain while running).

What else can I share? Maybe a little more of that stuff that makes me happy? It may not have been all unicorns and rainbows, all the time, but sure it did the trick, at least for a while.

Warm enough to wear my new Coeur bike jersey

Riding my bike with hubbs

Channelling my inner cycling diva before falling on my face (true story)

I knew I could turn the gloom around. Now that was a beautiful day worth reminiscing. Just looking at these pictures makes me smile!! 

What else did I do that made me happy? 

First, I got my NCCP coaching certification. Yessir!! I am supposed to sound legit and shit when I talk triathlon now. Just don't forget to talk to your doctor before doing anything I say, mmmmkay? Not that I plan on giving up my day job for becoming a coach any time soon... But at least I keep my mind entertained with knowledge since I cannot keep my body busy with practice.

Second, I managed to renew my Hot Yoga pass! For cheap. And I'm not even a Goodlife member. Don't ask me how I did it, as it may, or may not have required a pig tail and the blood of a virgin.

Last but not least, I met a bunch of friends and we had dinners and fun together. Friends make everything better!! Here is Phaedra and I eating ALL THE SUSHI and chatting up a storm. I love this girl!

Okay, I think that's enough smiles and good news to redeem this post. What say you? Here I click Publish.

Trial and error

Today is a better day and I have to write about it before the feeling goes away. Nobody likes reading endless complaints, or so I think. But if you stumble on a pity party like in the previous post, every once in a while, you may feel compelled to comment, to help, to share your story, to empathize. However if you've heard the same story for more than 6 months, I suppose that it's starting to become annoying and you may even find yourself saying "shut up and do something about it already". But as I said, I have been trying and it hasn't been easy, mostly because of all the conflicting expert information that is out there. When you don't know who is wrong or right, you have to be open minded and go through trial and error. Unfortunately for you, my readers, I share (almost) everything as I document all my attempts to returning to a pain-free state of being. Every day I tell myself the same thing - wouldn't it be WONDERFUL if today my knees and hips stayed quiet? I can't wait for that day to arrive, but in the meantime, you have to bear with me as I go through the motions of experimenting with things that make sense to me in a particular moment. Only when one avenue has failed, I move onto another because there is method to my madness.

Let me give you an example: foam rolling. First and foremost, I have to admit that I am lazy. Any good reason not to roll and I'm game. For many months last year I went to see a massage therapist named Antonio. I loved Antonio - his specialty was myofascial release and he knew how to make my aches go away, even though I'd come back home with bruises all over my legs. Yet he always said that I could help myself by rolling more often. And I would always reply... sorry, not today. Eventually I ran out of money and I stopped going. Then my ITBs became more and more problematic, and the pain in the knees followed. But don't get me wrong, I am not necessarily implying that it was a cause and effect - just that I could no longer give my legs as much TLC as before and maybe, just maybe I could have delayed the knee pain if I had continued going to see Antonio regularly.

Anyway, back to foam rolling. My massage therapist would tell me to roll, my coach would tell me to roll, my husband would tell me to roll, and so would many of the people I know - but then I'd come across expert opinions such as these "Your IT band is not the enemy (but maybe your foam roller is)" or "ITB or Not ITB... That is the question" and then my brain would go into a deadlock: what to do, what to do?? It also did not help that I was sent to another massage therapist/acupuncturist and this guy told me that he didn't believe in foam rolling either, especially for ITBs. I respect and trust many of the health professionals that I see and I know that there isn't ONE solution to all issues. But there it was, another reason to NOT roll. And I believed in it 100%. I also believed that the key was in releasing the TFLs and hip flexors and stretching the glutes etc.
Alas here's where I failed because I didn't do those things either.

When I wrote the previous post, I received many pieces of advice and of course some were conflicting. I am always happy to receive suggestions, don't get me wrong, but I ended staying awake until past midnight weighing pros and cons and reading hundreds of opinions that you can find on those websites' comment sections. All articles are interesting, and all opinions carry their weight, but at the end of the day, I have to look at what I already tried and worked (or not) vs what is left to be tried even if some people are passionately against those ideas.

So here I am, holding another list of TODOs in front of me and looking forward to the process, or rather to a different outcome. Someone once said that the definition of insanity is doing the same thing over and over and expecting different results, but as I consider myself sane enough to see the difference between approaches and the value in each of them.

After the initial shock that my IT bands/hips/knees combo is still not operating pain free, I skipped my bike workout because I was scared to make things worse given that my hips were somewhat achy and the rubbing of my left knee cap was puzzling. Just to make it clear, so far I have not experienced the kind of pain I was in last year during the Ironman training months, but the same tightness, pulling and rubbing that I would feel at the beginning of every run. In the past, it would only go worse from there, hence my erring on the side of caution. However today I decided to make another attempt at running, but a little differently. I also bought a new pair of shoes which I wore during my 4km walk earlier this week. I didn't choose the pink but they were $72 so I can't complain.

I went to Cassie Campbell Recreation Center where they have a nice gym with a track and started with dynamic stretches and the usual ABCs of running warmup. Only then I went to the treadmill, where I did 1km of run/walk alternating 1 minute each at 1% incline. Nothing violent and I am not even sure that I ran 1km, but I could not feel anything "wrong" at the end so to speak, so I take it as a win.


Then I did my strength workout, followed by the famous "couch stretch" and foam rolling. Because why not. These are the tools that I'll use in this new trial because I also trust my friends and coaches who I know have been through similar experiences. If it worked for them, maybe it will work for me too. Out of this exercise, I did find a possible causal relationship between my left knee pain and tightness on the hip/leg/whatever.

Let me explain the "couch stretch" with a few images from the very useful book "Ready to Run" by Kelly Starrett.

On the right side, which didn't present any symptoms so far, I can go to step #6 and hold it for 2 min, while on the left side, I can barely get into #3, and then only hold it for 30-45sec at a time with my arms raised on a block. The difference between sides is dumbfounding, but it definitely explains why the left feels tighter than the right, and why it may affect my ITB/knee. Because it freaking IS tight.

So what if this whole mess is not an injury, but just tightness that I need to get rid of to become a "supple leopard"? One inch at a time - poke, listen, address weakness, imbalance, stiffness. There must be a way and I'm gonna find it. I have tools, I have plenty of support and I'm working on my patience every single day. Can I have a yay?