Friday, October 24, 2014

Further workout and thought on sports injuries

So, to keep myself honest, here's the latest installment of my workouts (prior to the bold type is what was on my last blog):

Week 6: Last week
  1. Continue eating well, sleeping at least 8 hrs a night and rising early
  2. Move up to week 3 of the C25K and add in Burst Fit video workouts:
    • Monday (W3D1) - 2.41 miles at avg 14'16"/mi in 34:27 mins
      • Hurrican Ana... not direct hit!
      • Burst Fit:  Abs and Back Shredder 
    • Tuesday (golfing) – 7.6 miles (used push-cart for clubs!) at avg 35’32”/mi in 4.5 hours
      • Burst Fit: Shoulder & Leg shaper
    • Wednesday (W3D2) – 2.37 miles at avg 14’46”/mi in 35:05 mins
      • Burst Fit:  Chest & Arm definer
    • Thursday (walk) – 3.11 miles at 18’01”/mi in 55:55 mins
    • Friday (W3D3) – 2.27 miles at avg 14’56”/mi in 33:50 mins
    • Sat/Sun - hurricane Ana!!!  Stayed inside as it rained ALL day!

Monday morning after the storm... ready for my run!!



















Week 7: This week

  1. Changed shoes to accommodate a heel lift both feet as both Achilles tendons are getting worse pain (left worse than right).  Icing left Achilles bursa post workouts and during day.  Adding 1000mg turmeric daily to regimen for anti-inflammatory nature.  Kinesiotaping left Achilles tendon/bursa. 
  2. Stay on week 3 of the C25K due to worsening nature of Achilles pain and difficulty in doing the run portions last week:
    • Monday (W3D1) – app failed, but ran identical route as last week, so can assume at least 2.25 miles and was gone from house for 32 mins.  
      • Burst Fit: Abs & Back shredder
    • Tuesday (walk) – 3.13 miles at 17’44”/mi in 55:32 mins
    • Wednesday (W3D2) – 2.51 miles at avg 14’38”/mi in 36:44 mins
    • Thursday (walk) – 3.12 miles at 17’48”/mi in 55:36 mins
    • Friday (W3D3) – 2.36 miles at avg 14’53”/mi in 35:04 mins
So... what's up?  Achilles bursitis and tendonitis... both legs :(  

http://www.eorthopod.com/achilles-tendon-problems/topic/29
The hubby, in trying to help, sent me a great link to a runner's website talking about how some runners, once they've switched to newer or minimal footwear begin to have pain in their calves or shins due to the decrease in heel height.  I wanted to scoff at that at first, until... I sat and thought about it.  It makes sense!  One has to look at one's self to notice what's going on and I did spend about 8 weeks in combat boots (which do have a considerable heel on them compared to toe height) and the pain began while doing my last stint in uniform.  

However, I continues to run/walk in my minimalist shoes WITHOUT adding in extra achilles/calf stretches!  Oops.  You'd think a PT would know better!!  I mean, these shoes HELPED me start running and got over my propensity for shin splints!  I don't want to give them up!!  


So, what now?  Well, for the time being, if I want to keep running, I feel the need to give in and wear my "old" running shoes (the ones I bought WAY back when I wanted to run but my shins hurt too bad to do so... so I never wore them).  I love New Balance... they keep my heels and arches the most comfortable for "motion control" shoes.  So, no reason not to wear them and they actually have helped the past two days.  BUT, also must do something else!! 

So, que the roller!!!  Ta-da!!! 

I've been rolling sore muscles for a while and use the roller a LOT with my patients.  It just takes a few minutes and a slight knowledge of where the muscle knots could be related to where your pain is. I've no pain in my calves, just the area of the achilles tendon that connects the calf muscles (gastrocnemius and soleus) to the back of the heel bone (calcaneus).  BUT, one shouldn't roll the tendon as it really is inflammed... look UP.  No, not the sky... up the region of muscle to which the tendon is connected.  THAT is where to focus on the rolling.  There are a LOT of methods for rolling and the one I use involved pushing the muscle (or body part) over the roller, finding the spot that hurts when the pressure is on it (a trigger point) and putting a lot of pressure right on THAT spot - for about 45 seconds.  Then... roll around again, kinda like rolling pie crust, and find a new spot or the same one and place pressure again about 45 seconds.  Repeat this with the entire muscle region.  I've got about 4 to 6 spots that just KILL when I push on them... but they work out with the pressure.  Then I stand up and stretch the same muscle.  

from VHI handouts
WHY roll and not just stretch??  Well, kinda two reasons in this PT's head for that:
1.  self massage
2.  stretching the middle portion of the muscle.  



OK... there are a few ways to stretch... one is to extend the joint/limb to the limit and hold it there (static stretching: like the runner's stretch for the heel), 






Photo credit:  Hosmer Chiro Blog
another is to actively move the limb/joint to the end range over and over (dynamic stretching: such as hip circles and swings), 












but a great way to stretch is to put pressure on the middle portion of the object you are trying to elongate.  That's the goal... make the muscle longer - elongate the muscle fibers, right?  (excuse the hand drawn demonstration!!)




Now... WHY is there pain in that midpoint as we roll it??  That spot is called a trigger point by PTs, massage therapists, physicians, etc.  It is an area within a muscle that is overly irritable and can be felt as a knot or a taut band (kinda like a tootsie roll under the skin).  No one's really sure (there's a LOT of theories, though!) what they are or why they happen... but, one thing is sure... they HURT!!  There are also many ways to treat them, from massage to therapeutic dry needling to stretching, but the basic thing is... YOU have to find out what works best for YOUR body.  As a PT, I enjoy using all of the above as an eclectic way of treating my patients.  Some respond well to massage and stretching, other patients need the dry needling (which is VERY effective), while others need a more conservative approach beginning with modalities like ultrasound.  If you have significant trigger points, or cannot figure out how to stretch your muscles the best, get with a local PT!!  Some states no longer require a referral (however, many insurance companies do... check with yours). 

Anyhow... off I go to roll, stretch and ice some more!!  

Photo from prehabexercises.com



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