Learning to Run

Physical therapy, that was the answer. Rest, orthotics, swimming, stationary cycling, wearing a sock that pulled my toes toward my ankle while I slept, acupuncture and consultation with an orthopedic specialist didn't work. Physical therapy has been very effective. The other methods have their strenths, and I would suggest that anyone with an injury pursue any of these methods to see what's effective. Cycling and to a lesser extent swimming helped maintain a floor of running fitness. Acupuncture brought the most immediate relief, but didn't sustain. My podiatrist and orthopedic specialist recommended physical therapy, so their suggestion proved correct.

My first visit was not unlike those with other medical professionals. I described my symptoms, which the practitioner found puzzling, and then I was given a hypothesis. In my case my physical therapist Imee said the muscles in my legs were too tight and she observed that when I walked my foot didn't rest on my heel as much as with most people. She suggested that I focus on landing on my heel, advice that I have not followed, at least consciously. I figure I know how to walk.

A lot of research indicates that stretching brings no health or performance benefits, although there is not a consensus on the topic. I followed the practice of avoiding stretching for more than five years, and felt that soreness and tightness in my legs indicated that I was working hard and getting fit. Assuming that tight muscles equaled strong muscles, I only stretched after really lng runs when I made time for it, or before some races.

Other than changing my walking gait, I strictly follow everything Imie says. I'm a very good patient, and motivated to get better. She prescribed some stretching exercises at first and said that I should not expect to run for five weeks. My second visit she massaged the back of my right knee. She was looking for the source of my pain, and she found more pain than I could by myself. This ordeal feels like nails in the soft tissue below the knee. The shoots of pain caused me to break out in sweat, a response that she still triggers whenever she tells me to lie on my stomach.

On my second visit Imee prescribed strength training, including leg lifts and clamshells, both while lying on my side, and leg presses and hamstring curls at the gym. My third visit was an epiphany. Imee observed me running on a treadmill. It was my first run in several weeks, and I really enjoyed it. More importantly, I ran two miles with no pain. Imee discovered that I was not following through on my right leg. I was speeding through the right side, almost like running on a crutch. She also noted that I seemed stiff as opposed to fluid, and that my back kick was abbreviated on both legs.

The session went so well that she said I could run five miles at a time. She said I should focus on her observations. Even better she said that I could skip my next semiweekly sessions with her. That week I ran three five-mile sessions 100% pain free. The next week was three six milers.

I reported back to Imee at my next visit. It was amazing to not expect pain while running. I do have some residual sensations of injury in the knee, so I know I have to ease back into my routine. Imee said my plan to increase mileage about three miles a week seems reasonable, but to back off if it hurts. She gave me another break from visits, and I'll see her the week after next. That will give me a respite from breaking into a cold sweat.

I have to give credit to my colleague Anne Selting for suggesting Physiotherapy Associates, where I get my treatment. They are very close to the office, which eliminates the biggest obstacle to my frequent visits for therapy.