Monday, June 28, 2021

Focusing on Form

I've now been running for 3 weeks after taking 8 weeks off for my Osteitis Pubis and torn adductor. As I said in my last post, I am using the run-walk approach to gradually get back into my normal routine. So far my longest run has been 5 x (9 minutes running, 90 seconds walking). That adds up to 45 minutes of running total.

I'm probably at a point where I can start to get rid of the walk breaks but I like them because 1) it's crazy hot and humid and I need my heart rate to come down and 2) I'm 100% focused on my form and stride and I need a mental break from that. It's also good to check in to make sure everything is feeling good and nothing is hurting. I would hate to finish a run and realize I made the injury worse but didn't get that feedback immediately.

I went to the doctor last week and she was pleasantly surprised at how quickly I was recovering. She gave me and exam and tested my strength as was impressed that I had made such progress. It wasn't a guarantee that this adductor tendon would heal on its own, but thankfully it's most of the way there and I won't need surgery or any other kind of procedures. Just the dry needling which I stopped about a month ago.

A note to subscribers
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Issues with my running form
Back to the topic of this blog. Fixing my stride will not only prevent this injury from coming back, but it will make me a stronger and more efficient runner. 

I have always been a "shuffle runner". I wouldn't pick my feet very high off the ground and drive forward with the knee. My stride was short, partially due to limited range of motion in my ankle. In order to offset
Drills before running
this and still run fast (like a 5:52 mile) I adapted by having a very high cadence. Most runs would average 200 steps per minute and speed work would sometimes average 210. My feet would stay super close to the ground and move very quickly. Like shuffling!

Another form issue was that when I landed on my left foot, my right hip would drop down, making the pelvis unstable and uneven. This is a common issue with runners and can lead to injuries. It indicates instability and lack of glute activation. I also had this issue on the other side, but it was not nearly as pronounced. It makes sense that I tore the left adductor because I wasn't activating the left glute when I landing -- the right hip was dropping.

I have known about this hip drop issue for over a year now and have been working on it with my strength training coach. I have strong glutes! The problem is that my body doesn't naturally tap into that strength when running. It prefers to use the adductors. If I were able to access that power, I would be a more efficient (faster) runner and be protected from re-injuring my pubic bone.

Changing movement patterns
Working with my Osteitis Pubis specialist in Australia, live video feedback or mirror feedback has been essential. The focus is on doing all the PT exercises 100% correctly. It's not about doing them to get strong (although some of them build strength). It's about teaching my body to have a stable pelvis when put under different types of stress. There are literally over 100 exercises. I am not exaggerating. When I say "literally" I don't mean it like a millennial. I mean literally over 100 exercises. It would be overwhelming to do them every day, so the point is to progress through them one step at a time adding more stress and complexity while keeping a stable center of gravity and a pelvis that is controlled.

There is a huge focus on deadlifts, bird dogs, downward dogs, and side planks. There are many variations of each that challenge pelvic stability in different ways. Being able to see myself on video or in the mirror has enabled me to ensure I am doing the movements correctly, which ultimately translate to running. 

Greg has been recording videos of my running so that I can analyze my stride afterwards. He records some of them in slow motion so I can really see where I need to pick the legs up higher or keep the pelvis more stable. Drills have also been important in reinforcing the correct movement patterns, provided that I am doing the drills correctly. 

Here is what my hip drop looked like last summer:



Here is what it looked like yesterday:




And here is a back view, which is much more noticeable, taken last summer:



This was taken on Saturday - notice the difference:



My knees still come together, but that's just my anatomy. When my feet are pointed straight ahead, my knees go in. When my knees are straight ahead, my feet turn outwards. My PT said that was fine and you can't fix your anatomy! The important thing here is that the line of the top of my shorts is straight across rather than slanted down, like in the green shorts from the previous photo.

What I think about
As I said earlier, I need the walk breaks because focusing so much on my form is mentally exhausting. There are only so many mental cues you can give yourself at a time. Here are a few of them:
  • Feel the glutes working
  • Engage the core to keep stable
  • Keep the spine elongated
  • Shoulder blades down
  • Lean forward from the ankles
  • Drive forward with the knee
  • Use gravity to fall forward
  • Most of the weight in the forefoot
  • Stable foot "tripod" when landing
  • Remember deadlift form
I hope this way of running becomes automatic. I honestly have trouble running slowly when I do this. It's easier to open up the stride when you are running fast. This normally wouldn't be a problem but I don't have the cardio fitness to support the faster paces, and it's crazy hot and humid! My heart rate has been averaging in the 170s for the run segments because I am out of shape and it's hot. My paces range from 8:10-8:30 once I get going. That used to be my easy pace but it's not my easy pace right now, and it's definitely not my easy pace in the heat. So hopefully I will get the hang of it and be able to run in the 9:00's so I won't be dying in the heat. 

I'm on track with my plan to build a base in July and start marathon training in August for Richmond!



9 comments:

  1. Good info about the hip drop. I do the same thing! Since I've been seeing PT for my SIJ dysfunction, I'm working on my gluteus medius--even tho my glutes are strong, my glute meds aren't firing. Interesting, right? Thanks for sharing your recovery and I wish you the best!

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    1. Hi Wendy! It sounds like your issue is similar to Osteitis Pubis which many people get from SIJ dysfunction. Being able to stabilize the pelvis, release the pelvic floor and safely move it is super important. It's good you are working on it in PT!

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  2. Wow! Those pictures really show the difference that all of your work is making. Way to go!

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  3. I just have to say that your speedy recovery is no coincidence. You put the work in and you have the results. I know there are so many injury situations out there where people get hurt==>stop running==>get hurt==>stop running and it's a heartbreaking cycle to be in.

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  4. Great report and work you doing...your at the Core of the problem and improving that running form your answer!

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  5. I'm ALSO going to PT right now for a hip injury- although it's different than yours (mine is an FAI) I'm also working on strengthening the glute medius. I haven't started running again yet (soon, fingers crossed) but I'll take lots of videos to check my form. Thanks for the info!

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  6. 'When I say "literally" I don't mean it like a millennial.' I literally ;) LOL'd for this one. Misusing literally is one of my biggest pet peeves. It's what's lead to you having to explain what you mean when you say literally - it's totally removed the functionality of that word!

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  7. Never even knew there was a way to subscribe to be notified when you make a blog post. All these years I'd would just check out the page and see if you had posted something. This will make it a lot easier for periods you go quiet or just being reminded my awesome running pal has something to say!!

    BTW, Greg is fucking awesome for being such a support in getting you back and also allowing you to show us thru photos what was going wrong. You never know who else it may help whether they comment on here or just view it. About to read the next one where, hmm I have something to share about that day too that was just FANTASTIC

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