Heeding Advice Much Harder Than Giving It

Just this morning I read on one of the forums a question from an already-active new runner who was ramping up their running time.  “Can I progress more quickly through the program since I’ve been active prior to starting running?”  Of course my advice was “Sure you can.  But the risk of getting injured goes up.” 

I’ve been increasing my running time since the feet are responding so well to the ASTYM treatments and running (finally!) just feels great!  My anal-retentive brain has caused me to create for the umpteenth time a training log in Excel so I can look quantitatively at my ramp up and see how fast it is progressing.  I so badly want to put bigger numbers in some of those cells – but the equations tell me I’m risking doing TMTS (Too Much Too Soon) if I do so.

Holy smokes it’s hard to hold back…………………

Jim

Body Worlds & The Story of the Heart – Denver

[Disclaimer:  There are no images in this post.  There are links to websites with images that some people may prefer not to see.  Please be aware of this if you decide to visit any of the links I’ve included.]

Body Worlds & The Story of the Heart is currently visiting the Denver Museum of Nature and Science and when I heard it was close by I knew I “had” to go. 

Body Worlds are a set of traveling exhibitions that feature real human bodies and body parts that have been preserved.  The preservation process is called Plastination and was developed by Gunther von Hagens when he was working at the University of Heidelberg.  There is another Body Worlds exhibit occurring now in North America called Body Worlds & The Brain, in Calgary, Alberta. Canada.  There are also exhibitions in Europe and Asia.

Why did I “have” to go?  There are two components of my personality that are deeply ingrained:  I’m very interested in understanding how things work.  (I remember clearly when I was five years old asking my mom if I could take a clock apart.  I had to see what was making things move.)  I also have a highly addictive personality.  (A runner?  Addictive?  Say it isn’t so!)  Put these two things together, in a runner that can’t seem to get over some injuries and you have a guy that has spent HOURS AND HOURS on the internet looking at anatomy images, obsessing about what might be going wrong and why, reading blogs, reading papers, asking questions of my docs and PTs……..  I knew this was an opportunity I might not get again.  So with a little trepidation, I decided to go.

I wasn’t totally sure how I was going to react.  On the one hand, if I felt so inclined, I wanted to be able to stay a long time.  On the other hand, if I got in there and got creeped out, I wanted the flexibility to leave immediately.  That challenged a bit the various possibilities on when to go and how to fit it into my schedule.  It turns out my wife was leaving on a trip this weekend and I saw the perfect opportunity:  I dropped her off at the airport which gave me the rest of the day, sans commitments, to attend the exhibit – for as much or as little as I wanted.

Overall I have to say it was totally fascinating.  It was so cool to be able to actually see these structures that we talk about so much as injured runners:  The IT Band.  The various tendons from the stirrup muscles that wrap around the inside and outside edges of the foot and attach underneath.  The menisci of the knee and the ligaments that hold the knee together.  The Achilles Tendon and the big space that exists between it and the tibia/fibula.

One really neat thing they did was pose a number of the bodies in real-life activities:  Someone throwing a javelin.  A woman doing a back somersault on a balance beam.  Two hockey players involved in a collision.  One really incredible display was of two bodies:  A figure skating pair with the man holding up the woman in a one-arm fashion like we see in pairs competition.

There are a couple of other things that really struck me – and it took a while for these to develop in my brain as I went through the exhibit.  One is how very small many of these structures are.  I have this image of wide open spaces in the body – especially when it comes to the chest.  When you see the actual body you get a sense for just how crammed together everything is.    Some of the tendons of the lower leg – things that have a mental image in my mind of being not tiny but not huge – look very small and frail.  The major branches of the nervous system look like thick string.  Surgeons must have quite the difficult job.  Second, it was amazing how everything is placed in a pretty small space.  They had one display that sounds like it would have been more difficult to observe than it was:  The body was standing in a relaxed, neutral pose.  Some parts of the limbs had “cylinders” of tissue going all the way out to the skin, while other parts of the limb had significant portions of tissue removed down to the bone .  It demonstrated very very well the small space all these structures are contained in.  I tend to think of the different sub-systems  as occupying the space individually:  Skeleton.  Blood vessels.  Nervous system.  Muscular system.  Etc.  Then when you realize they’re all occupying simultaneously the small volume of space we take up it’s quite incredible.

As I entered the exhibit I became nervous on another level:  There happened to be a number of small children in front of me that were very excited, jumping around, making all kinds of noise, etc.  I wondered what the tone of the exhibit would be and whether I’d be distracted.  (I’m not against kids – nor did I think it inappropriate that they were there.  It just made me wonder what it was going to be like inside.)  Not only did they quiet down, the whole place was very quiet and very respectful.  It was like being in a library.  Any talking that was taking place was done in whispers.

Overall it was a fascinating, educational, and humbling exhibit.  I’m grateful not only to the people who did the work to perfect the plastination process, create the displays, and make it available in a touring exhibition, but more importantly to the individuals that felt strongly enough about this work to donate their bodies so that, even after they die, thousands could learn from them.

Jim

A Different View On Plantar Fasciitis

Maybe I’m dating myself – but have you seen the movie Sleeper by Woody Allen?  Woody Allen’s character is frozen after he dies and is brought back to life many years in the future.  The plot involves him trying to deal with all these things he doesn’t understand.  A consistent theme is that what was once thought to be harmful is now considered healthy – such as smoking. 

I’ve thought of Sleeper frequently as I’ve gone through the process of resolving my various maladies.  I once thought I could run only with orthotics.  I once thought I needed padding in my shoes to protect myself from this horrifically harmful environment in which I run.  And I thought, because of my very flat feet and overpronation, I needed shoes that were incredibly structured and that controlled the motion of my feet.  Now I’m running with no orthotics, in shoes that are so thin I can feel a pebble through the sole and, sometimes, with no shoes at all.  Who’d have thunk it.

I think I’m in the process of putting Plantar Fasciitis into this Sleeper category.  I wish I could remember where – I think it was in some YouTube video – but I saw a doctor call Plantar Fasciitis a “trash bucket” diagnosis.  He asserted that all too frequently almost any foot pain was just labeled Plantar Fasciitis.  That term may be encouraging people to pursue remedies that aren’t appropriate and, consequently, aren’t effective.

Plantar Fasciitis (strictly speaking) is an inflammation of the Plantar Fascia; hence the ‘itis’ after Fascia.  The same holds true for tendonitis – tendon inflammation.  We tend to think inflammation is bad, so the treatment for Plantar Fasciitis is focused on reducing that inflammation:  Icing, stretching, cortisone, etc.  Obviously, with all of these treatments, the goal is to reduce the inflammation in an effort to reduce the pain, and get us back to doing what we want to do.

What portions of the medical community are now thinking, however, is that the inflammation of Plantar Fasciitis goes away relatively quickly; on the order of a few weeks.  At that point the Plantar Fascia starts to degenerate.  The interesting and unfortunate part is that the pain continues.  So to a certain degree not much has significantly changed from a symptom perspective, but what is happening physiologically is very different.  This degenerative state is called Plantar Fasciosis.  Where “itis” is inflammation, “osis” is degradation.  This degradation scenario supports the stories we hear and have experienced ourselves about taking significant amounts of time off, stretching for weeks, icing for weeks, etc. and seeing no improvement.  We’re taking steps to reduce inflammation when there may not be any.

The trick, then, when dealing with Plantar Fasciosis is to rebuild the Plantar Fascia.  I’m no scientist so I can’t explain all the science, but what appears to be working for me is ASTYM.  ASTYM intentionally injures the tissue on a microscopic level to cause the body to initiate a healing response.  If the tissue is actively used while it is rebuilding the body will rebuild it the right way – in a way that enables it to be used as we want it to be used.  Graston Technique is, in my amateur opinion, a similar concept.  I feel that I’m repeating to a certain degree a point I made when I compared the more efficient running forms:  While different they have similarities and it comes down to which one sounds best to you.  Some swear by ASTYM and others by Graston.  They have their advantages and disadvantages – but I’ll leave it to others to fight that battle.

So, since the tissue is supposed to be used, and the tissues are being stressed and asked to do more, they often feel “uncomfortable” following activity.  The really difficult mental model to break is to not stop doing the activity!  The sensations being felt are a result of tissue being rebuilt – just as our arms would be sore after doing an intense weight training session.  No – those “pains” aren’t coming from inflammation.  The body is rebuilding.  There may be times where too much has been done, and “pain” really is felt.  But by and large, use it and keep using it.  Movement and stress is good.  The body will adapt.

Three weeks ago, when I started ASTYM, I could run 4 minutes out of a 30 min walk.  Today I completed my 6th and final ASTYM treatment.  The last two times I ran I ran for 12 minutes both times, and tomorrow I’ll do 13 or 14 minutes.  It really is bizarre – not having everything feel perfect but continuing to exercise.  I wonder what else in our lives we currently accept as truth will be challenged by some “radical” thinking?

Jim

P.S.:  I’m not suggesting one always “runs through the pain”.  I hope I’ve been clear that it’s important to work with a professional.  I’m relaying my experiences and what I’ve learned from my PT.  Your mileage may vary.