Hamstrings and Balance

Most runners have frequent and recurring hamstring problems.  It seems endemic to the sport.  And it’s debilitating – if your hamstring is talking to you, then in Bob Dylan’s words, “You Ain’t Going Nowhere.” The anatomy and biomechanics of the lower extremity is complicated.  A chart noting interrelated muscular actions in Joseph Hamill’s Biomechanical Basis of Human Movement  provides a clear picture of how each muscle, joint, and tendon plays a role in proper movement in running gait.  The three hamstring muscles (semimembranosus, biceps femoris, and semitendinosus) form the “meat” of the posterior (backside) thigh.  And attached to these three, either directly or indirectly, are about a dozen muscles attaching to the hip and knee.  If that isn’t involved enough there are the anterior (frontside) muscles that serve as antagonists to the posterior muscles.  For example, the four quadriceps flex the hip while the hamstrings extend it.  It’s a beautiful system when it works as designed! But few of us have perfect biomechanics and things happen, the most noteworthy being imbalances. These may be minor, for which we tend to compensate without notice.  But over time these imbalances build up and result in some muscles having to work harder than … Continue reading

The Precious Moment

Last week I saw an email from Ralph, a long-time running friend, briefly describing a bike accident.  He was on a less traveled road approaching the Charlotte Town Beach.  The scenery approaching Lake Champlain on this downhill stretch is beautiful.  In its infinite wisdom, the Town of Charlotte decided this was a good place for a pronounced speed bump, just on the downhill side, with the aim of slowing traffic approaching the beach parking lot.  Good idea?  Maybe.  But for Ralph it proved otherwise. Ralph’s front tire hit the bump at a slight angle, twisting the tire and sending him flying over the handlebars.  He spread eagled on the pavement, landing hard on his arm and side.  As he slid along, gathering road rash, he had a rush of thoughts and questions, foremost being “what just happened.”  In any event, the result was a fractured pelvic bone, determined later at the ER, and an arm that looked like Popeye’s.  Fortunately, four people on a bike tour happened to be there (in fact it was noticing the parked bikes as well as the vista that distracted his attention from the road) and came to the rescue.  The tour leader bandaged his … Continue reading

It’s the Hips! – Part 2

My friend Linda, to whom I have offered coaching advice, told me the other day she was having hip pain, keeping her from running. She said her physical therapist evaluated it as weak glutes, which they are working to strengthen. This led to me rereading my August 11, 2015 blog post, It’s the Hips!, which offered no substantive advice on strengthening. So this post intends to do that. First point is to define the hips. And while this may be simplistic, from a runner’s perspective let’s consider the broad definition of hips as our core. John Davis in RunnerConnect defines “core” as all of the muscles of the lower trunk and pelvis: not just the abs and back, but also hip flexors, glutes, abductors, and adductors. He states further that these hip muscle groups are particularly important because they’re involved in a range of running injuries. When you look at the descriptions on the side of machines at the gym of what muscles are targeted, there’s often a range, with some primary, some secondary. That can be useful information but the real question is whether our overall strength training routine gets at the full range of core muscles. If we … Continue reading

Surprise #6 – Habits

Shoot from the glutes; lead with the hips; run tall! This post builds on posts on August 11, 2015 – It’s the Hips! and July 29, 2015 – Running Fast! This is the 6th post related to my February fall resulting in rib surgery to plate four of eight broken ribs. The last post on this was May 7 and a lot of water over the dam since then. By now, I had hoped to report a full recovery. The reset is now for mid-August. To recap, I took 12 weeks off from running.   I was hardly inactive during this time. After several weeks of walking, I worked back into StairMaster, deep-water running, and light weights.   I’ve now been running for 10 weeks, building up slowly in speed and distance beginning with weeks of 11, 14, 19, and 18 miles in May. In June the weeks were 24, 18, 24, and 26 miles.   The first two weeks in July have been 25 and 33 miles. Wise or not, I ran three races in June: two 10Ks and a 5 Miler. Not pretty, but these were target races and a test of my fitness. Previously I had bounced back rather quickly … Continue reading

Surprise #5 – Step-by-Step

I was cleared to run beginning May 1st – just short of 12 weeks post surgery. I had been planning for this re-entry for weeks and then it was here! I have now run four days, every other day, starting at 2 miles, then 2.5, then 3, and today 3.5 for a week’s total of 11 miles. Nothing fast or fancy but running nonetheless!   And all runs included running drills. To begin, I broke the two miles into half-mile segments, with about three minutes of walking, jogging, and stretching in between. Each day I increased the long segment half a mile. So today my final run was 2 miles. I’ll continue this approach for the next couple weeks until the total distance is a single run and I am up to about six miles. Then I’ll incorporate some faster pace and easy hills. By month end I look to be up to 20 miles a week. One step at a time! So, what have I learned and how might this help others coming back from a similar layoff? First, as much alternative exercise I have done, mainly fast walking, water running, and StairMaster, it was not running. And certain muscles … Continue reading

Walking the BAA 5K

I had decided a month ago to enter today’s BAA 5K. I had a number and it’s part of the Boston Marathon weekend celebration. It was nine weeks after rib surgery and I was not yet cleared to run. So I was prepared to walk it. I aimed for 45 minutes, a 14:20 pace. I had been mostly water running and StairMastering to maintain some aerobic fitness. A bit of walking – but no more than three miles at a crack. So two weeks before the race I went for a brisk six-mile walk. Averaged 14:53 and found the last mile really taxing. A 45-minute 5K was looking ominous. Then the week before the 5K I upped the tempo for 4 miles to a 14:00 pace. I started thinking 43 minutes might be in the cards. Two days later, I walked 5 miles with two one-mile intervals of 12:47 and 13:17, for the first time throwing in some light jogging along with walking.   Now I was thinking sub 40:00! Then two days before the race, I did two more mile splits with more jogging at 11:59 and 11:46. I was being cautious but testing the ribs. None of it hurt … Continue reading

Surprise #4 – Learnings

Recovering from an injury and/or surgery tests one’s patience. As runners, we’re eager to get back to running. We also tend to think we’re tougher and more resilient than most. And that our recovery should be way ahead of the curve. We count the days, maybe weeks, but certainly not months. At least this has been my mindset. The truth is we don’t know and can’t know how things will progress. Assuming we listen, our bodies tell us the real story as it plays out. It was eight weeks ago today I broke my ribs. It seems closer when I walk down the stairs and see the dent in the wall my suitcase made as the other side drove through my ribs.   I started PT after five weeks and of course felt what they gave me was elementary – I kept asking for harder exercises. After all, I’m a tough, resilient runner! But I learned they knew their stuff. I go weekly and each time they add new exercises I do daily. These often leave me a bit sore, which actually feels good. The symptoms have moderated considerably. The ambient pain is largely gone, though I trigger a reaction when … Continue reading

Surprise #3 – Turning the Corner

Overall, the recovery from surgery has seemed quite incremental. Little steps here and here. But during course of the past 32 days, there have been some key checkpoints: (1) getting off pain meds, (2) incorporating water running and StairMaster in addition to walking, and (3) sleeping through the night. It hasn’t been all-or-nothing with the pain meds, which to be clear were narcotics only during the first 10 days. Since then it’s been Tylenol and Advil. Lately after a full workout I may feel stiff and sore and it helps to take a couple pills. But during the normal workday, nothing is necessary. I’ve never been a pill popper and being free from it is, in a word, freeing. I started StairMaster a week ago and water running a few days later. I’m now up to 40 minutes for each, with small increases in time and intensity each time. I was very timid getting into the water the first time, concerned the belt would put pressure on the ribs and the arm movement jostle things. So I cinch the belt up above the ribs under my armpits and do abbreviated arm swings. Just walking was becoming boring and I knew … Continue reading

Surprise #2 – The Prognosis

I saw my surgeon, Dr. Dasilva, yesterday for a surgery follow-up, 19 days after the surgery and three weeks after the fall. He looked at new X-rays with me and noted “It’s all looking good!” A welcomed comment for sure.   The four plated ribs were perfectly aligned with the unplated ones tagging along. Exactly as it’s supposed to be! This was of course the news I wanted to hear. In spite of lingering low level pain, and sleeping difficulties, I was moving in the right direction. And my hopes rose that I would be able to start running in another two or three weeks. Right? Wrong! Dr. Dasilva proceeded to explain how the healing process works: it takes six weeks for basic bonding of the bones and then another two months for things to solidify. I could then expect to gain full strength six months post surgery. His advice was to see him in three months and not run before that. This was not what I wanted to hear! I actually flashed back to the fall, remembering how clear it was in that excruciating moment that it would be a while before I would run again. And so it was … Continue reading

Surprise #1 – The Fall

One misstep and down the stairs I went, landing on a suitcase I was carrying. Breaking eight ribs, four in two places with displacement. With the wind knocked out, I yelled for help. Neighbors came to my aid and called 911. First an EMT arrived then an ambulance, taking me to the ER at Brigham and Women’s in Boston. It was all a painful blur. After several hours in the ER, I was moved to the ICU, due my age and the severity of injuries. The next day, the head thoracic surgeon stopped by to discuss the options. He explained how X-rays showed roughly 15% of my lung capacity was lost due to the collapsed ribs, technically called flail chest. Suffice it to say, as a runner, this caught my attention! He described a fairly new surgical procedure, developed only in the past ten years, called “plating.”    This procedure is offered only in situations where ribs will not heal on their own, due to multiple breaks and/or displacement.   Prior to the development of plating, one had to remain in the hospital on a respirator relying on mechanical ventilation for several weeks to inflate the lungs; in hopes the ribs would … Continue reading