Earlier this year I went to the UCSF Human Performance Center for a Vo2Max and Lactate Threshold testing. The Exercise Physiologist that I worked with was so kind and knowledgeable that I peppered her for weeks after my visit with running questions. When I started to experience shin splints and feeling like my feet "slapped the ground" when I ran, she suggested that I visit their RunFit Clinic. Unlike their RunSafe clinic that I had been through a couple of years ago, RunFit was a one-on-one consultation with a physical therapist who would work with you on your running form. I had read countless articles and watched endless YouTube videos on "proper" running form. In my head I understood the concepts but never quite knew how to implement them. RunFit sounded like just the thing I was looking for to help me. I contacted them to schedule an appointment back in March, but due to other scheduling conflicts, didn't have my first visit until a week and a half ago.
I envisioned my appointment going something like the PT watches me run on a treadmill, gives me a couple of pointers on what to do/what not to do, and that's it. It was not like that at all.
I had my first visit on June 8th. My therapist started the appointment by asking me questions about my running history, fitness background and typical workout schedule. Then she shared her own background with me of being a lifelong distance runner who'd run several marathons and also experienced various injuries herself. It made me feel like I was going to be working with someone who could relate to the things I'd experienced. I immediately felt comfortable with her and knew that I was in the right place.
First she had me do various exercises so she could assess my strength, flexibility and mobility. Some of these exercises were calf raises, single leg squats and resistance to her pushing down on my leg. I had to do A LOT of these exercises because she wanted to see how my body responded when the muscles started to fatigue.
Some of her findings were news to me, but most of them I'd heard before:
• My body is lastic. I'm not sure if this was a good or bad thing, but she said that I am more prone to such things hyper-extended knees.
• I am well-balanced in the Fitness Triangle of cardio, strength and flexibility.
• My muscles are strong and my body is flexible, but the timing of how my muscles engage and interact with each other is off. What does this mean? - When I started to fatigue during the exercises my hips and knees would start to collapse. - When this happens I don't have a lot of pelvic stability - I draw power from my hamstrings and not my stability muscles (glutes and hips)
She said it makes sense that I developed an IT Band injury because the IT Band is connected to the stability muscles and when they become overtaxed the pain will travel down the IT Band to the knee.
Although rest will relieve the pain and eventually I'd be able to run again, it's important to actually correct the problem so it doesn't keep recurring, and that's done through Strength Training. She gave me 5 exercises to do to strengthen these stability muscles. I was confused because they are the same exercises that I had already been doing, so she had me show her how I was doing them. Turns out I wasn't engaging the muscles that needed to be strengthened. She showed me the muscles that needed to be targeted, and how I can tell if I'm engaging them properly. Turns out, I needed to shorten the range of motion.
Lastly, she treated my IT Band and Knee with a technique that is similar to Graston. She put some type of gel on my leg and used a flat, round-edge tool to scrape out the adhesions. Without having to tell her, she zoned in on the precise areas that I'd been feeling pain. The treatment itself was painful;t left me sore but feeling better.
My second RunFit visit was a week later on June 15th.
As a side note, when I walked into the UCSF building that morning the very first person I saw was Ronnie Lott of the 49ers! I am a HUGE Niner fan and could not have been more excited to see him! Turns out, Harris Barton (also a former 49er) was hosting a charity breakfast there that featured Joe Montana, Jim Plunkett, Steve Young, Tom Brady and Aaron Rodgers. All those Superbowl MVP's were in the same building I was in! Unfortunately security was tight so I only saw Ronnie - but that was plenty enough!
My therapist started off Visit #2 by reviewing how the past week had gone. I am doing the 5 exercises she gave me religiously - 30 reps of each, 2 sets in the AM and 2 sets in the PM. I was convinced that the exercises were already working because my IT Band/Knee pain was significantly reduced.
Unfortunately I had developed another symptom. I'd started to feel numbness in my foot (on the same side as the bad IT Band) while running. The conversation eventually led to Piriformis Syndrome. I knew the 2 had to be related because when I foam rolled, and when I held the Pidgeon pose in Yoga, my foot would go numb again. I shared with her the details of my prior experience with Piriformis Syndrome. She said all the pieces were starting to fit together. She suggested using a foam roller and tennis ball while standing against the wall vs. on the ground. The pressure would be less intense and more effective -- and it really is.
Next she had me run on the treadmill while she videotaped and analyzed my gait and form. Then we reviewed the footage:
• My knees don't collapse while running.
• I am landing on soft knees with my feet under me.
• My cadence is 45 on each leg at 30 sec = 180 per minute which is right in line of where it should be.
• My left foot kicks higher than the right. It needs to be to be balanced out.
• My left leg seems to be working so much harder - doing so much pulling. I'm using more force on the left side; the sound of my steps isn't even symmetrical.
• My feet turn slightly outward which is okay, (its only bad if it turns inward), but it's not even. It also needs to also be balanced out.
• My hips do collapse on opposite sides meaning when I step with one leg, the opposite hip collapses. This means that there is extra pull on my IT Band. Its evidence that I really need to stick to doing the prescribe exercises to stabilize the pelvis and strengthen the gluteals and core.
Like the first visit, she did the Graston-like treatment on my IT Band. It wasn't as inflamed or tender as the previous week and overall felt much better. She also did some ART-like treatment on my Piriformis. As she did this my foot started to go numb again pretty much confirming that the 2 are indeed related.
I'll be going back for a couple more visits. She said that right now the exercises are building a mind-body connection and it takes 8-10 weeks to see change in the muscle. She also said that if I continue to do the exercises, my body will be different by end of July (just in time for SFM 2nd Half). I have nothing to lose by sticking with this routine.
I'm still running, albeit minimally, but miles are still miles. When I start to feel my foot go numb, I just have to take a walk break and then start up again. The one thing I'm told not to do is run through it. It's teaching me how to be more mindful. In the meantime, I'm really enjoying all the cross-training activities. It's helping me to maintain my endurance and build up lost strength. I'm in a good place, not somber and depressed about this nagging injury. I'm still able to run, and I'm happy that I'm getting fixed.
I'm so glad that I visited the RunFit clinic and feel so thankful to have such a valuable resource available to me. It's been a worthwhile investment!