Friday, August 12, 2011

Finally, I see a PT

I had made an appointment to see a PT via my workplace when my calf pull episode flared up. 


Recall that I'm trying to address some structural problems that I've had for, well, my whole life, so that I can function better and hopefully for more years ;) 


I have been able to run, and run pretty well (for age 55), e.g. having run a 4:06 marathon last year at SF and then recently a 4:10 in Copenhagen. But, I am concerned that if i don't address my lifelong problems, they may create premature joint wear or other problems down the road.


What I've found is that it's not easy to get this kind of help....doctors are really good when you walk in with a broken bone or simple infection but they aren't really into debugging complex messy  bio-mechanical problems.


Recall that previously I had been referred by my normal Dr to a sports orthopedist...no PT recommendation from her...she wanted to send me to the real Dr first...  He said two things that helped a little bit:


1) Told me to wait longer after a calf pull than I was doing....I waited 5.5 weeks this time with no running, only cross training. This was a Very Good Suggestion...but I had already figured this out myself.


2) He took and X ray of my pelvis and confirmed nothing too horrible wrong but some tilt visible. Unclear why I'm so lopsided but at least I could see that I had plenty of cartilage left (so far).


He also gave me a prescription to see the 'hip guys' at my HMO..however they see nothing but people that need hip repair and resurfacing. Somehow, I think this would be a waste of time and potentially just scary. So I've giving it a pass for now...


And that's what he did...bye bye, good luck, haveaniceday 8/


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Anyway Thursday I go into see a true PT. Here's her bio:


Lang is a graduate of the University of Connecticut. She previously worked in sports medicine, outpatient orthopedics and pediatric sports medicine.

Lang has taken continuing education courses on the pelvic girdle, functional manual therapy, spine assessment and treatment, Pilates, and running/gait assessment. She was certified as a kinesiotaping practitioner in 2004. In 2010, she completed her certification of functional manual therapy with the institute of physical art and passed with honors. She is also an ART (active release technique) practitioner.

Lang enjoys traveling and the outdoors, especially running, rock climbing, hiking and beach activities. Her athletic goal is to qualify for the Boston Marathon.



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I liked that bio....she's a runner too, always a good thing.


Basically she had me walk, do some one-legged squats and showed me with my hands on her hands how my hips and pelvis were positioned  ..she showed me that my legs are actually the same length, the difference is purely 'functional'..i.e. it's all from pelvic tilt not from the legs...it's pretty badly tilted (as I kinda already knew from the X-ray, although that was taking lying down which probably hides some of it).

On my back she brought my knee toward my chest and showed (by placing my hands in the right places) on my normal leg the progression of leg, then pelvis, then spine taking up the angle. However, on my right leg the pelvis didn't do anything...I went right from leg to spine taking the angle. This is really bad for the back...lots of stress is sent there that should have been addressed in the hips.

She gave me two deep pressure stretches to do..one for the psoas muscle and another for a teeny muscle in the seam between my leg and pelvis (forgot the name)..both are completely tight as drums and effed up.

 It was amazing that with only 15 minutes of pressure she was able to change my range of motion a huge amount and make my gait seem more normal...! I will also get my massage guys to do these stretches on me.

Previously I've tried to do stretches for the hip and just felt like they were going to pop my hip apart..I never seemed to get any better. She explained it's because the pelvis is what is tight and so all my stretching was just trying to pop the hip out and not stretching the muscles that were the problem..so don't do that, instead fix the pelvis to have the proper range of motion...hips are just fine.

The tendency toward right side calf pulls  is pretty well explained by the stuff I've been doing to compensate...if I solve the pelvis flexibility problem it should be fine too.

She says I'm not getting anywhere near the strength from my right leg as I am from my left (and my left is just fine) so if I can fix this problem I will be way better off..

Confirmed that running is ok...have to build up the miles and stress gradually again but no problem running. GOOD!  (I've already run 18 miles (slowish paces only) since Saturday ;)

She also explained that "tweaky feeling in my hamstring" that seemed to not be getting better very fast is actually a problem with the nerves being stretched out (muscles can be stretched to fit wonky frame, but nerves can't) ..so it's NOT a muscle pull, (i.e. I'm not hurting the muscle by running on it) , this feeling should be addressed by improving the range of pelvis motion.

(She also said the numbness I have in the outside of my right foot when biking hard for over an hour could also be due to the same thing)

After the 45 minutes I felt like I finally found somebody that knows what they are doing and for the first time that some of the things I've lived with might actually be changeable to some degree. Not something I expected.

 I'm seeing her once a week for 8 weeks ....we shall see how it all works out !


4 comments:

  1. The PT sounds wonderful (even from her bio) and it seems like the visit was worth it in every way. It is great she was able to understand the why behind what you knew was happening. I like when that happens.

    Thank you for the comment on my blog because I didn't realize that over training could cause insomnia -- but of course it makes sense. And honestly, I didn't think I was over training but when I think about it even just adding the 10k's on top of the regular running had me at more than the recommended 10% increase in miles each week. That combined with the fact that yes, two of the three 10k's were run full out makes for a big fat DUH for me. Sometimes I'm still a bit slow at catching onto things even though I'm trying so hard to be smart and not get injured. Anyway, thank you thank you. Even if it wasn't cause for the insomnia, it certainly explains the muscle fatigue that has definitely been present this week.

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  2. Based from your marathon time, it doesn't show that you're actually experiencing some pain for as long as you can remember. You're doing a great job in spite of the problems you've been experiencing. My, my, my, you're even faster than some runners half your age!

    I'm also going thru some pain in my leg and thanks to you, I think I'm gonna pay my PT-Rehab doctor a visit.

    Keep us posted please. I hope your condition improve in no time.

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  3. First, I wish I could run your marathon times and I'm a decade and a half younger than you, so well done!
    Glad to hear that you have found someone who can give you more info than you had. Interesting "diagnosis" and I wonder if it doesn't apply to most of us runners - the tight psoas and the other muscle. I notice that in the last year I have been unable to sit as cross legged as I used to because of tightening muscles.
    So pleased that you are back running again and that you have a go ahead on that. I am also very impressed with your cross training - well done on all the swimming.

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  4. @Tricia: you are welcome....congrats on the 10k PR!

    @Nora: I didn't mean to imply I have always had pain..just kind of a messed up duck-footed gait 8) Hopefully I'll stay away from pain with the help of the PT!

    @Staci: I think some amount of tightening as a runner is ok...studies show most of the really fast runners are not that flexible..being a noodle isn't required ;)

    But having balanced muscles that aren't always locked up in spasm would be a good thing ;)

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What do you think about all this? Please leave me a comment! 8)