Sunday, March 22, 2015

Training and PT Thoughts - 3/2 - 3/22

Well, I am back at it.  I have my plan and am working toward my races for the year.  It is officially on.  It is going to be a long cycle with my first race in it coming up at the end of May with the Ultimate Direction Dirty 30.  I have my plan all laid out through September and have already been doing a great job in increasing my mileage responsibly.

But, after running the Moab Red Hot 55K on February 14th, I ended up taking a couple weeks of some downtime.  This wasn't the initial plan, but I had some body issues that popped up several days after the race that needed to be addressed.  So, I wanted to talk about what has happened and what I am doing about it.

First off, I did not take any time off during the winter months.  This was a first for me.  I have always taken some solid time off/down in the winter months.  I always keep running, but never the mileage that I accrued this year.  But, I was fit and feeling good and wanted to be sure I kept it up to springboard into this season.  Mission accomplished.  But, in return, I needed to do some stuff to ensure I could keep that training going without any repercussions.  And I did nothing.

Due to training over the winter months and not working on my strength, I have had an issue creep in from overuse.  What it appears is that it is Piriformis Syndrome.  I started feeling it about a week or so before the Moab race.  Driving out to Moab really caused it to become irritated as does sitting for any length of time really,  I use a standing desk at work and that really helps, but mostly I need to strengthen the glute and hip muscles so I can help release the piriformis and, in turn, release the sciatic nerve from impingement.  To do that, I have been incorporating a routine that helps build my hips and glutes.  This specific routine looks at helping IT Band issues, but, if you look at all the exercises, they mimic the same ones you need for piriformis syndrome.  So, I have begun to incorporate this routine into my schedule, and am doing this every other night before bed.

I use these items to help with the below exercises:

Exercise Band


Lacrosse Ball


Foam Roller



Lateral Leg Raises: lie on your right side with a theraband around your ankles.  Lift your left leg to about 45 degrees in a controlled manner, then lower.  I do 30 reps per side.

Clam Shells: lie on your right side with your knees together and a theraband around your lower thighs.  Your thighs should be about 45 degrees from your body and your knees bent at 90 degrees.  Open your legs like a clam shell but don’t move your pelvis – the motion should not rock your torso or pelvic girdle.  Keep it slow and controlled.  I do 30 reps on each leg.

Hip Thrusts: lie on your back with your weight on your upper back your feet.  Your legs will be bent at the knee.  Lift one leg so your weight is all on one leg and your back.  Lower your butt almost to the ground and thrust upward by activating your glutes.  This exercise is great for glute strength and hip stability.  I do 25 reps on each leg.

Side-Steps / Shuffle: with a theraband around your ankles and knees slightly bent, take ten steps laterally.  The band should be tight enough so it provides constant resistance during all steps.  Still facing the same direction, take another 10 steps back to your starting position.  That is one set.  I like to do 5 sets.  This exercise will look like a slow-motion version of a basketball “defense” drill.

Pistol Squats: These are simply one-legged squats.  The key to a successful pistol squat is to not lean forward, keep the motion slow and controlled, and make sure your knee does not collapse inward.  10 per side.

Hip Hikes: Stand on your right foot.  With your pelvis in a neutral position, drop the left side so it is several inches below the right side of your pelvic bone.  Activate your right hip muscle and lift your left side back to its neutral position.  I do 20 reps per side.

Iron Cross: This dynamic stretch will help you feel loose after the previous strength exercises. Lie on your back with your arms out to your sides and swing your right leg over your torso and up to your left hand. Repeat with your left leg and do 20 reps in total.

Now, I have also been dealing with plantar fasciitis/heel spurs since July of last year and have learned to run through it.  I have done lots of PT around this injury with massage, ice, heat, stretching, but none of it seems to work.  It will flare up and then subside.  It hasn't been really bad until just recently again and I am focusing on what may be causing it rather than just the symptoms.  

In speaking with the massage therapist as well as the chiropractor, they both see that my right leg is shorter than my left.  This is known to be a major cause of plantar fasciitis.  But why is my leg shorter?  It appears that my QT muscle has been doing most of the work and not my multifidus.  The QT is one that is use for stability, but should not be doing the work for the back.  Rather, the multifidus should be doing the work.  Thus, my QT muscle has gotten too big from taking the load, which has weakened my multifidus muscle and shortened the QT causing the chain reaction down my body to my foot.  Wow!  Crazy, eh?  Here is a diagram so you can see what I mean about those muscles:


We also believe this is part of what is causing my hips to be tight and contributing to my piriformis issue.  So...the head bone really is connected to the neck bone and so on down the line.  Important stuff to pay attention to.  So, in order to combat that and get my muscles to do the work they were designed to do, I have incorporated the following into the same routine at night.  This, hopefully, will help alleviate the real cause of my issues and help alleviate the symptoms.

I use these items for the routine:

55cm Exercise Ball


Spiky Foot Massager


Foot Strengthener



I do the following in the routine:

Back Extensions:  I use the 55cm exercise ball and lay on it face down with it in my belly.  I put my feet against the wall and keep my head up while I raise my body up a bit to work the multifidus muscle.  I do a total of 30 reps and do 2-3 sets.  You definitely feel this in your back.  The key here is to make sure you don't raise your body too high.  No higher than parallel to the floor.  It looks something like this but don't come up quite has high:


Foot Strengthener:  This one is easy, but really seems to help so far.  I do 30 reps per foot and, depending on how it feels, I will do 2-4 sets.



Massage:  Finally, I use the spiky massage ball to really get in on my fascia on the underside of my foot.  I roll it along my arch and really dig it into where the fascia connects on the underside and inside of my heel.  This hurts, but should break up the fascia which is what I need.

After I do this , I spend some time doing a yoga stretching routine, which is the same one I use after all my runs, and then go into using the roller and Lacrosse ball to target the piriformis as well as my hamstrings down through my calves and into my feet.

So, that is it in a nutshell.  I have been doing this now for a couple weeks.  It does seem to be working, though, since I am running 50+ miles/week now and it is only going to increase, I think it will take some time.  The piriformis issue really seems to be getting better with the exercises.  The plantar/heel spurs have good days and bad days.  I am just going to keep at it.  I will keep updating my results in case anyone is interested.

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