Tuesday, January 06, 2009

"...moving fast and efficiently, breathing calmly, monitoring himself so as not to get into oxygen debt as he fought gravity to the top. His sure feet knew the trail so well, every rock and root, twist and slant, that he felt he could close his eyes. But he didn't. Every path, no matter how well known, contains the unexpected."

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The path is in sight.

After many fits and starts, entire pain-free weeks followed disparagingly by short test runs that ended in calf-seizing setbacks, I finally went to the doctor. He referred me to the very knowledgeable physical therapists at Elite Sports Physical Therapy. During my first consultation my therapist, Jacon, confirmed what I had suspected, but also explained something that had remained a mystery to me. It certainly appeared to be a fairly severe calf strain. However, the reason I have been having so much trouble recovering from it is that I have been fighting against the body's natural healing process.

When the body heals a wound, scar tissue develops around the site to help promote healing. It was explained to me that it works somewhat like a cast holding the injured fibers together. The problem is that scar tissue is inflexible and doesn't necessarily align with the movement of the muscle. This means that as you try to come back from an injury you are often working against the scar tissue (especially if you are trying a little sooner than you should). Not only does this explain the occurrence of re-injury, it also explains why I was experiencing the "cramping" feeling whenever it happened. My calf muscles were basically pulling against the scar tissue that were holding the injury in place.

My rehabilitation involved some ultrasound and soft tissue work to break up and help re-shape the scar tissue along with exercises that increasingly load the muscles to both strengthen the supporting areas and help align everything with proper movement. It started with seated toe-ups against pressure from my hands, but quickly progressed to body-weight versions. Combined with this has been a number of single-leg balancing exercises performed on spongy blogs that reduce impact, but also really work all the stabilizers on the outside of the legs. The one-legged jumps were the final test and I could really feel it in the legs as well as the hips. I am going to incorporate all of these into my normal routine going forward.

So, the end result of all of this was that yesterday I got on the treadmill. I ran at an easy 10 minute-mile pace while Jacon watched my gait. He showed me a couple of stretches to help with some tightness that might be causing a slight outward rolling on the injured side. I went less than a mile, but felt ZERO tightness in my calf or pain around the inujured area. This was a first as when I did the previous tests on my own I always felt tightness at the start (foolishly convincing myself that it would go away upon warm-up). The only thing I did feel was a in my shins, but this was most likely due to the 50-mile bike ride I did on Sunday. In the end he gave me the go ahead to start running.

I did 3 miles last night at a very easy pace with my wife. No tightness. No Pain. No calf seizing up. Everything felt good. I'll probably do a couple more easy runs this week and then do about 6 or so this weekend to see how it holds together approaching the one hour mark. I'm going to keep it on the flats for now, but returning to the trails in the near term no longer seems a fantasy.

I will most likely head up Mission Peak once I feel strong enough for the hills. Being as it is so familiar to me, it has stood most clearly in my mind when I imagine being back running on the trails.

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"Kim was, as always, utterly happy while running, in accord with nature, in harmony with the universe, in touch with the truth that was in him, full of love for all creatures, even the lowliest insect."

- The Holy Man by Susan Trott

1 comment:

angie's pink fuzzy said...

that's awesome!

a friend of mine thinks the scar tissue problem is what's plaguing the back of knee/hamstring issues that i have that i can't fix. he's suggesting exercises to break up the soft tissue and help re-heal it.