Yep. I’m running. I can’t believe I’m saying this – but I’m running. If you’ve been here before you know I haven’t been talking about running much recently. One motivation for this blog has been to chronicle the move out of orthotics and into minimalist running, however my reports were getting really long-in-the-tooth. I’ve had this lingering heel pain that just would not go away. It most definitely has not been Plantar Fasciitis – that scourge I dealt with for so long. I’m not exactly sure I know what has and is causing it. I believe it is a combination of really bad hip function along with exceedingly tight and weak calves. As I’ve worked those elements the pain has been reduced. It’s not totally gone, but it happens less frequently, with less intensity, and when I get it the recovery time is becoming shorter and shorter.
I’m quite hesitant to write and publish this post. I’m fearful of claiming victory and then having another setback. So I think I need to do some karmic inoculation here. While I’ve obviously seen some huge improvements (over the last three weeks I’ve steadily increased my running and the systems have responded well) I must acknowledge I’m nowhere near a 25+ mpw volume. Lots could still go wrong. I still have bouts of heel pain and I have to treat it gingerly when that happens. But as I said, it’s bouncing back quickly and, I think most importantly, when I’ve increased my running time the foot has stepped up to the task.
This journey started about four years ago. I felt a niggle in my hip. I remember very distinctly thinking that getting over this might not be very easy. I’d had my share of running injuries and this pain wasn’t fitting into the traditional categories. “Might not be very easy” turned out to be prophetic, in a massive understatement sort of way. Resolving that pain has lead to a huge amount of learning, stressing, studying, reading, writing, and poring over articles and anatomy images on the internet. Four years to get cured? Sounds a little crazy, doesn’t it? Yes it does. There were a number of wrong turns, setbacks, etc. Let me tell you: Backpacking is definitely not good for people having foot problems. Two backpacking trips – while a blast while I was on them – wreaked havoc on my feet that took many months to figure out and get over. Bone bruises. Nerve irritations. Etc. All these things added to the time it has taken to get through this stuff.
Before I summarize what I think the keys were to getting better I think it’s most important to acknowledge some folks – quite a significant number of folks. Whether they realize it or not – these folks (and others that I’ve surely missed – apologies in advance) have played a significant role in me overcoming my problems. The famous saying says “It takes a village”. Well – that applies to helping people get through injuries. I participate in three villages. Two of them are virtual – internet running forums. One of them is physical – the local Drs. and medical professionals I actually see. At the Runner’s World Injuries and Barefooting forums hats off to: slowitdown, Suezee, mmrocker13, MeganZe, abbaroodle, KLL0320, John 8:13, SF/John, agelrunner, Barefoot Burt, Last Place Jason, and Packerjohn. At active.com: JamesJohnson, DamienHowell, lenzlaw, marykb, rbird, and a host of others. You may not realize you’ve helped, but you have. By answering my questions as well as responding to other posts you’ve shared information that I’ve learned from. Jeremy Huffman helped me re-engineer my running form and adopt The Pose Method of running. Ozzie Gontang, internet running legend, was very giving of his knowledge and time. From the third and final village: the local medical community: Dr. Stephen Yemm and Dr. Thomas Hecker. Dr. Yemm for his true interest in getting to the root of the problem. Dr. Hecker for approaching podiatry from such a practical perspective it’s highly refreshing. They’ve both provided valuable guidance and insight into the various issues I’ve been dealing with.
The Gold Star award – the “king of the villagers” so to speak – the one that has provided consistently the most insight and interest into my situation - goes to Brad Ott – Physical Therapist extraordinaire. Brad has been extraordinary in working with me. He has been open-minded, curious and very willing to take the time to share his knowledge. His ability to look at the body as an interwoven system is remarkable. I can unequivocally say: If you need a Physical Therapist – Brad and his team at Rebound Sports & Physical Therapy (Loveland and Ft. Collins, CO) are the folks to see. .
So, one might ask: What was the deal? What in the world was going on that required this amount of time to return to the activity of choice? What has been learned?
First – the context. I’ve been running about 15 years. I have really flat feet. Consequently, I figured I needed orthotics. I can’t even remember why I got them. But get them I did and for many years I ran in completely rigid 3/4 length orthotics. In 2007 or 2008 (I’ve lost track) some injuries started. In an effort to get those addressed I started down a path that has resulted in re-engineering certain parts of my body as well as my running form.
The primary items I had to address:
- My hips. They were a wreck. Weak. Poor control. Out of alignment.
- My feet and calves. Weak. Really weak. Not used to having demands put on them given they were in this “wall-to-wall carpeting” environment of supportive shoes and orthotics. My chronically weak foot (left) was noticably “less buff” than my good foot. And talk about tight calves: Holy smokes.
- My balance. Horribly out of practice and low on the skill rating. How critical is balance to running? Well – when you run – you are never on two feet at the same time.
- My running form. Classically bad: Long strides. Low cadence. Heel striking.
The critical learnings (in this amateur’s opinion) are these:
- The Foot Was Meant To Move. A high percentage of the time orthotics aren’t needed. We need to give the foot a chance to move. Doing so makes them stronger – and reduces the probability of injury.
- The Hips Are The Foundation. We think of foundations as being underneath something. In the case of the legs, the hips are the foundation and they’re on top. If you have weak hips then the femur rolls in, which puts pressure on the knee, which then puts pressure on the foot.
- Stretching Is Not A Cure-All. “I’ve got this pain. I’ll rest and stretch for a couple of weeks. That should take care of it.” That plan might help in some cases, but not all – not by a long shot.
- It’s About Neuromuscular Control In Addition To Strength. It’s one thing for a muscle to be strong, it’s another for your brain and nervous system to control it well. Sometimes getting better involves training the neuromuscular system to control efficiently the muscle.
- Changing Your Running May Be Warranted And Can Be Done. Some say one shouldn’t change from their natural form. I say “bunk”. “You shouldn’t change from your natural golf form.” “Jump in the pool and swim however you like. Don’t worry about technique.” Preposterous, in my opinion.
- Changing Your Running Form Is A Lot Harder Than It Looks. It’s amazing how you think you’re doing what you need to – but then find out the camera doesn’t lie.
- What Appears To Be A Universal Truth May Turn Out To Be False. Orthotics are necessary. Padded shoes are required to protect us from this bad environment. Pronation is bad. In my opinion all of these “universal truths” are in the process of being debunked.
- The Person Who Cares The Most About You Getting Better Is You. You can learn more about what is happening medically with your situation than you might realize. Look at anatomy pictures. Understand how things work. Ask questions in the forums. Push your medical professionals for information. If you don’t get answers that satisfy you (which is different than understanding things to the level that they do) go get another opinion. Sometimes you need lots of people to describe their view of the elephant before you can see the elephant for what it really is.
For all you folks out there that are injured and wonder if you’ll run again: Don’t give up. Keep pushing. Keep trying to understand. Many times in this process I wondered if I would ever run again. A number of times I concluded I wouldn’t, however deep down inside I think I knew I’d ultimately resolve the problems. I didn’t know if it would take one, three or seven years, but I figured I’d resolve them. Chances are, with enough patience and perseverance, you will resolve your issues, too.