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Tag Archives: UCSF RunFit
Happy Summer! It was a weird week in the Bay Area that started off very warm until the Summer Soltice; then it seemed like Fall arrived – at least for a few days.
Not much changed last week. I continue to mix up my workouts with strength training and cardio. I was only to get to one yoga class, but I ran the most miles than I have in the past 6 weeks. Here’s how the week went down:
Yoga was actually listed on my schedule but I got a 2-hour Thai Massage which essentially is passive yoga. I expected my IT Band and Piriformis to be my only trouble spots during the massage. Turns out, I had a lot more than anticipated and it turned out to be another mind-numblingly, painful massage. I accidentally kicked the therapist in the face too – unintended but that’s what he gets for inflicting so much pain.
I figured since I’d only be out for 4 miles that I didn’t need to carry water with me. I should have; it was a warm one. Since I’m still having numbness in my foot, my instructions were to run 1-mile, then walk for a minute to ease the pressure. It was relatively minimal during this run but I felt my Piriformis for the first time while running. So I came home and did a lot of rolling. My PT is having me roll against the wall vs sitting on the ground. I prefer it and find it more effective for me.
Lunch Time: Vinyasa Yoga Class
Made it to the weekly Vinyasa Yoga class that’s held at my office. It’s the one class I made it to last week. My instructor had me attempt a handstand, which I have always failed to do. This time was no different. I just do not like inversions.
PM: 1-hr Strength Training
Since it was the Summer Solstice, I met Trainer Dave out at Seal Point for an outdoor evening workout. I did a TRX Circuit, then ran 1 hill sprint. I had forgotten my compression knee brace and didn’t feel comfortable running without it so I just did the one sprint to experiment. It felt good and it’s something that I want to do more of, but I definitely still need to use the brace.
AM: 1-hr Spin Class
PM: 4-mile Run
Just as hot as it was on Tuesday, it was Fall-like weather on Thursday. I learned my lesson from Tuesday and brought my small handheld water bottle with me. I had some foot numbness in the very beginning of the running and then nothing until the last half mile when it was pretty “thick.” I am supposed to stop and walk when I feel *any* numbness but I was in a good rhythm and was almost done so I didn’t. :/
AM: RunFit Visit #3
I had my 3rd visit at the RunFit Clinic. You can read about my first 2 visits here. During this visit we reviewed the past week and then the PT had me go through a series of the PT exercises she had assigned. I’ve been doing them at least once, often twice, a day. She liked the effort so she gave me 5 more exercises to incorporate.
Then she did the Graston-like therapy on my IT Band.
PM: 50-min Stair Climber
That evening (yes, on a Friday night), I went to the gym and did a 50-min Stair Climber workout. I felt great, but when I came home, I noticed this:
Apparently the morning’s Grastone-like therapy session was the most intensive of the 3 I’ve had so far. At the end of the session the PT had told me that my leg was quite hot and I should ice it and not foam roll it for 4 days, but I did not expect this huge bruise to appear. You can’t tell in the photo, but it was just bright, bright red. It scared me, but everyone who I sent it to that evening reassured me that I’d live. Since then it’s turned to a dull black and purple.
Not a good one. I started later than I would have liked which meant it was warmer. I felt tired and had achiness in my knee. I hadn’t felt it *while* running in a while which disappointed me. I’m going to chalk it up to still being tender from the PT session. I had a lot more foot numbness as well which meant I was forced to walk more than the instructed 1-mile. I tried not to be stubborn or egotistical reminding myself that it would be best in the long run.
Rest Day. I had a late Saturday night and was super tired today so I am switching my schedule and doing today’s workout on tomorrow’s Rest Day. At least I hope I do…
Not the most ideal week, but it’s the most I’ve run in 6 weeks so…progress. I think this photo is a good expression of how I’m feeling right now.
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!
A couple of weeks ago, fifteen months after my initial visit to UCSF’s (University of California – San Francisco) RunSafe clinic, I went back for a Performance Evaluation.
The Performance Evaluation was comprised of:
1. A Body Composition Analysis
2. Lactate Threshold Testing
3. VO2 Max Testing
4. A private consultation with an Exercise Physiologist
I was so nervous going into the appointment because I wasn’t sure what to expect. I knew that both tests were designed to have me reach max level of exertion. As if that wasn’t enough to make me feel jittery, the tests were also conducted on a treadmill which I *never* run on. In addition, one of the reminder emails said, “Please be well hydrated and ready for a strenuous bout of exercise.” Umm, I wondered just how strenuous this workout was going to be…
When I arrived, I met the physiologist who was conducting my session, as well as the other person who was assisting with the testing. Unlike the RunSafe Clinic where 4 people were evaluated at once, this time I was the only person being evaluated, so it was just the 3 of us in the clinic that morning.
Body Composition Analysis
The Body Composition Analysis consisted of getting my weight, height, and body fat measurements. I have a Tanita scale at home and it turned out that my data was exactly the same as I had measured that morning. At least I know my scale is accurate – not sure if that’s a good thing. :/
Lactate Threshold Testing
The next step in the evaluation was a Lactate Threshold Test. A Lactate Threshold Test measures the maximum effort you can maintain before lactic acid enters your blood stream. You can Google the term for more detailed, scientific background on it, but basically it’s a test that tells you what level of exertion your body is capable of handling.
Prior to the appointment I was told that I could bring an iPod with my own music to be played while the test was being administered. I thought that was really cool; unfortunately, I brought my iPod shuffle, which couldn’t be played over the sound system. So instead they put on Pandora and let me pick out a station.
First I had to put on a heart monitor, and then they pricked my finger to get my first blood sample. Next I got on the treadmill, starting at a walking pace. The assistant had an RPE (Rate of Perceived Exertion) chart and I had to rate my RPE at every stage. Each stage was about 2-minutes long and at the end of 2-minutes I got off the treadmill, gave another blood sample and gave my RPE rating. This went on for about 8 stages, with the pace increasing by .5 each time, until I reached an RPE of 20; i.e., max exertion.
I was told that my finger would be pricked a maximum of 2 times but apparently I am not a good bleeder because they had to prick my finger after every stage. By the 4th time they had to move on to another finger. As bad as that sounds, it wasn’t too awful. It hurt more trying to squeeze the blood out.
VO2 Max Testing
After the Lactate Threshold Testing I took about a 15-20 minute break where they gave me water to hydrate and a towel to wipe my sweat. I watched them set-up for the VO2 Max test still not completely sure what to expect. Turns out, it’s exactly like doing a Resting Metabolic Rate (RMR) test, just running on a treadmill.
What that means is you put on a headset that attaches a breathing tube to a computer. The breathing tube goes into your mouth complete so you can *only* breathe into it. Even your nose is clipped shut.
I got back on the treadmill and they started me at a slow, steady pace. But instead of increasing the pace every 2-min, for this test, they increased the incline by 1% every 2-min until I reached max RPE. I didn’t have to get off the TM for a blood sample, but I did have to rate my RPE. Since I couldn’t speak with the breathing tube in my mouth, I had to give hand signals – thumbs up/down – to rate my RPE and to give the okay that I was ready for the incline to increase.
I get claustrophobic quite easily so this test was difficult for me. I held on for as long as I could, going from a 1% incline to a 7% incline, then I had to stop because I felt like I couldn’t breathe. If I could have taken a breath of fresh air or a sip of water I could have gone on for longer, but since I couldn’t I had reached my max RPE.
The physiologist took some time to review my test results then sat down with me to go over her preliminary findings.
• My body composition was in the normal range so there wasn’t anything to be concerned about there.
• My lactate threshold was about a 10-min/mile pace. This is the pace that I should be able to maintain for 26.2 miles.
• As for the VO2 Max, I didn’t quite hit max, but I did hit VO2 Peak and based upon the trends leading up to VO2 Peak they were able to determine my VO2 Max, which was in the mid-40’s, which was also normal.
The recommendations made were:
• To train at paces under 10 min/miles.
• Do lots of fartlek, speed, and interval work.
• About a week after the evaluation they also sent me a more detailed report that included what my training zones are based upon my HR and RPE’s.
Although I have already been training at the recommended paces and doing speed-type of workouts, I actually laughed out loud when I heard “you should be able to maintain a 10-min/mile pace for 26.2 miles.”
A certain someone had been telling me this for months and to be quite honest, I didn’t believe it. But now here is science telling me that this is what my body is capable of right now — and I’m not even in marathon training mode at the moment.
I’ve definitely been pondering that data from this evaluation, and it is not lost on me that perhaps this experience is directly tied to the race that I had on Sunday. Either way, I think this was a beneficial process for me to go through and I hope to have the opportunity to do so again.