The ART of healing

Two weeks ago, I got off my bike after a five and one-half hour bike ride and started my brick run. It was supposed to be a 45 minute jaunt, nothing fast and furious, just your basic brick run.

A mere twenty minutes into the run, my right leg became so irritable I had to stop and walk. It was time for me to accept the fact that this leg was not getting any better–and in fact–was getting worse. Tendonitis, ITBS — whatever the heck the problem was, it was signalling its presence and stopping my run.

At that time, Lake Placid was 6 weeks away, and I wondered if I would ever be able to run without this being a chronic injury. The first two times I had these symptoms, it took about 7 weeks for the pain to subside, 7 weeks with absolutely NO RUNNING and limited biking.

I simply didn’t have that kind of time for recovery.

Yet, I had to make time. For months, I had not taken recovery seriously enough. I started training for this season in January with indications that my leg was not 100% recovered from the stress of the Vermont 50. But rather than take proper recovery at that time, I kept pushing. After all, I had to prepare for Boston, right?

Then, after Boston, despite my leg telling me it wasn’t 100%, I kept pushing. After all, there was Quassy to prepare for.

Then, after Quassy, my leg pain increased to a level that was sufficient enough to get my attention.  During that brick run two weeks ago, I felt a sharp jolt in the lower half of my IT band (iliotibial tract, see above), along the outside of my the knee and into the top right flesh of my calf (gastrocnemius muscle).

Yup, that got my attention. I did not keep pushing. I stopped and walked back to my car.

Disappointed.

Frustrated.

Afraid.

What the h – e – double hockey sticks was I going to do? I have an IRONMAN in 6 weeks!

Thoughts of extreme terror raged through my mind that weekend. I did not have 7 weeks to “take it easy.” I could see my vision of an Ironman finish somewhere in the 12 hour range fading from view.

Running was my ace card, my linch pin, my rabbit in a hat, my fox in a hole.

If I had to walk the marathon, I would be praying to make the 17 hour cut off. Seven months of training, seven months of killing myself on the CompuTrainer, seven months–wasted.

And on and on the thoughts went as I almost spiraled into a negative cycle of hopelessness.

But just moments before I lost all hope and decided to eat copious containers of ice cream, get fat and give up running and triathlon forever, I remembered two things a fellow triathlete, Francine, had shared with me: Dr. Eric Nelson and Active Release Technique (ART).

Francine had actually told me about Dr. Nelson over a year ago, after the first time I had a flare up with my leg. But, I was in denial that I had a “real” problem. I couldn’t afford to be in denial anymore.

I looked up his information online, and committed to calling first thing Monday morning. Sunday dragged on as all I could think about was whether or not I’d be able to get an appointment right away.

Monday morning finally came, and I called at 9:01 a.m. The office opened at 9 a.m., so I figured I’d give them a minute to get in the door.

A cheery woman answered the phone almost immediately: “Hello! Nelson Chiropractic and Pilates.”

Oh, I liked the way she sounded. I was starting to feel better already.

“Uh, I – I – I’m a triathlete,” I stammered, not sure what I was even asking for, not sure I was actually a triathlete. “I have a race in 6 weeks, and a friend told me that Dr. Nelson and ART might be able to help me.”

I continued quickly, worried that if I didn’t she would laugh maniacally and tell me I was royally screwed: “I’ve been diagnosed with hamstring tendonitis in the past, and I think I’m having a flare up.” (Notice the denial apparent in my “I think.”).

I waited anxiously for her response, feeling each millisecond tick away, fearful that she would say that the doctor was booked for the next year.

“Okay, we can definitely help with that!” She sang. “When would you like to come in?”

“As soon as possible,” I replied, obvious fear in my voice. Oh, please don’t be booked for weeks. Oh, please don’t be booked for weeks, I repeated in my head.

“Well, he has an opening tonight at 6:45, can you do that?”

O frabjous day! Callooh! Callay! I chortled in my joy.

“Absolutely! I didn’t think I’d be able to get in so soon. Oh, this is great news…Oh, this is wonderful…I’m so appreciative” I gushed and rambled on. No doubt she put a note in my chart about that.

I went to work that day, and all I could think about was my appointment. I don’t think I managed to make any sense, but that may be nothing new for my students.

Finally, the hour had arrived.

“Hi, Maria?” He asked, soma friendly, smiling. “C’mon back.”

Along the walls of his office were various awards (2010 Sports Chiropractor of the year), news clippings of his work at the Olympic training center in 2009, various news articles and testimonals about his excellent work.

If he’s good enough for Olympians, he’s definitely good enough for me!

During that first visit, he explained his philosophy about training, recovery and treatment, which can be summed as a holistic active care approach. (For more details, see his website: http://www.chiropracticrehab.com/).

Then, he asked me to do a series of various movements.

When the examination was complete, he explained, “I don’t think the problem is your hamstring. It’s your ITB, which in turn is being caused by a weakness in your gluteus medius.”  (See diagram above.)

I was relieved to hear it wasn’t my hamstring, given the long-term chronic nature of most hamstring injuries. Truth be told, I was always confused about this being a problem with my hamstring. When I first had these symptoms, I had thought it was my ITB, but the first physical therapist I went to insisted it was my hamstring, my bicep femoris to be exact. But, the pain never presented itself in my hamstring; it always hurt along my IT band, and into the outside of my right knee.

Dr. Nelson explained how the root cause of my symptoms was weak gluteal muscles, and how improper form could aggravate the problem. When you consider that this problem always presents itself after hard downhill running, it was all starting to make a lot of sense. I felt like we were finally getting to the root of the problem.

Dr. Nelson treating a patient. (Image from http://www.chiropracticrehab.com)

In the two weeks since that first visit, my treatment has been comprehensive, including ART and gratson technique to remedy the tightness and the adhesions, a focused breathing, stretching and strength training regimen, and attention to fixing my biomechanics through postural alignment. This experience has NOT been about simply getting the ART and Gratson technique and going on my way. Dr. Nelson’s approach is holistic and exceptionally educational, with the most important information relating to my biomechanics.

Simply summed up: my posture sucks.

So, during the past two weeks, I’ve worked on my posture in two key ways: 1) keeping a neutral pelvis and 2) dropping my shoulder blades down my back (without jutting out my ribs or chest).

My upper body is not exactly posture-perfect. Like most triathletes, I round my shoulders forward, which makes maintaining a neutral pelvis more difficult. And, that’s my big issue: I stick my butt out, which causes my pelvis to rotate forward, which in turn causes improper running form. My leg muscles and IT band take the brunt of the force and effort, while my gluteus medius just hangs out for the ride.

Well, freeload no more, you lazy butt! I’ve learned how to improve my posture and strength, and to recruit the powerful gluteal muscles while swimming, biking and running.

Last Wednesday, just 10 days after my first appointment, I was cleared to try a run the next day.

“Nothing crazy,” he cautioned.

“Can you define crazy because apparently I’m not very good at drawing that line,” I responded.

I awoke the next morning with one thought on my mind: Running. Despite my excitement, I began my run very tentatively. How many times have I returned to running too soon, only to feel the tell-tale pain just 10-20 minutes into the run? I warmed up thoroughly, using the stretches and strength exercises I had been given. Then, I walked for 10 minutes. Then, I ran for 70 minutes.

The pain never came.

Saturday morning arrived: time for the long ride-run brick. I had a 6 hour bike on the schedule, followed by a 40 minute run. This workout would be a key test of the leg. In the past few weeks, I almost always felt some kind of pain in my run after the long bike. Not this time.

The pain never came.

Sunday morning arrived: time for the long run. I had a 2.5 hour run on my training plan, but I was nervous to do that duration all in one shot. After consulting with Dr. Nelson, I opted to break the run into two parts, and do a recovery cycle in between runs. I ran over 15 miles across the two runs. With each run, I felt better and stronger, and was able to dip my pace below a 10 minute mile during the second run of the day.

The. Pain. Never. Came.

Since the first time I experienced this injury, I have hope that this problem won’t reoccur. I didn’t just treat the symptoms: I learned how to fix the problem.

During today’s visit with Dr. Nelson, he confirmed that the almost-crippling tightness and lumpy adhesions that had gripped my leg just two weeks ago were all but gone.

“Your IT band responded really quickly to treatment, which confirms that this was not really an injury but rather an issue related to biomechanics,” He explained.

“How does it feel to be my new favorite person?” I asked him.

7 Comments

  1. Pingback: The *other* 4 letter word: ITBS » Running A Life

  2. Pingback: Because I say so: A different perspective of injury » Running A Life

  3. I call my ART doctor my guru…I found your blog when I search for moose man/ Groton hill road….I live down the road and we climbed it yesterday and I was looking to see what other thought of it

    Good luck in placid, we are making the trek up to support some friends

  4. Ed Cohen

    Maria Two weeks ago I got up from a nap so that I could go back to SLEEP. I also take a nap after I wake up in the MORNING after a night’s sleep.. See if you can top THAT.. ONLY JOKING.

  5. Danielle

    I don’t run nearly as much as you do, but I went to Dr. Nelson about 2 weeks ago for the exact same problem. I went from not being able to run a block without pain to running 3-4 miles. 🙂

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