Sunday, August 21, 2011

The Plan



First, I appreciate all the feedback (and I will reply individually soonest). I really do. On and off this forum, people have been giving me hints of encouragement and all of it is taken to heart. It really is.

The Plan is as follows:

A. Dawn on Monday - try running in specialty shoe (Merrill Trail Glove) to see if pain persists in hamstring. This is a Towpath idea. Although I despise all things Towpath, I will try it.

B.11:00am on Tuesday - appt with DC-area running specialist Dr. Pribut

C. TBD - appointment with hip specialist per Beth Young

UPDATE: My two closest "injury advisers", Sarah the Stretcher and Dr. Beck the Chiro, say the following:

SARAH:
"Over the past year, you have reported pain on the right side of your lower body. At the same time, you have presented with a number of tight as well as weak/inhibited muscles. The biomechanics on your left side, while not perfect, are much better than the right.

The differences in the right and left side of your body have resulted in unusual and abnormal stresses on the muscles and tendons. Stresses so great that they resulted in two stress fractures of the pubic bones.

Last time I saw you, the muscle involvement was consistent with a Category 1 Pelvic Fault - a pelvic imbalance where one side of your pelvis (the left) rests slightly forward of the other side (the right). Because your dysfunctions are solidly established, there was no quick fix. The pelvis corrected and was fine while you were lying down, but as soon as you stood up and walked, the patterns of muscle contraction and recruitment caused the pain that had previously existed.

None of this happened overnight and cannot be corrected quickly. Your lack of flexibility is causing an imbalance of the pelvis. This imbalance has resulted in an unusual amount of stress/strain on passive tissue (tendons, ligaments, joint capsules)."

Dr. Beck:
"The process is long term with any treatment protocol. Go and see these guys and have the studies done(mri, ct,etc) and see what they come up with. The odds are we are looking at some tendon issue with some joint function issue. Get back to me with the details and we can go from there. I will try to give you my opinion on some options. Just give me a call when you put it all together and we can see if chiro and muscle work fit in your course of treatment."

11 comments:

Peter said...
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Towpath said...
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Towpath said...

Context for Towpath plan: After watching video of Jake racing, I have noticed that he has a pronounced heel strike. Since he has nothing to loose at this point, I want to see what happens when he runs in a shoe with zero heel-toe drop (meaning that there is just as much material under the heel as there is under the forefoot.)

My hope is that Jake will be able to land more on his forefoot in these shoes which in turn will hopefully reduce the impact forces causing pain in his hamstring.

I expect a detailed report Monday afternoon.

Charlie Ban said...

If you're opting for a Towpath strategy, then you must be in it to win it

JARRIN said...

He's actually now in JARRIN territory. Pribut's my guy; I claim him since I've been his loyal patient for 5 years and more importantly, he's a friend. I was actually in to see him today of all days - I've developed some pain in my anterior tibial region. It's definitely from overuse caused by a) my first over 70 mile week last week; b) running in beat trainers. Good luck at Pribut's and great to read that you're finally using good advice.

JARRIN

Towpath said...

All due respect Bobby, doctors are pretty useless when it comes to treating complex biomechanics related running injuries. I saw Pribut and numerous other docs back in '08 when I was trying to fix the chronic tightness in my hamstring. I heard that I had scar tissue, pelvic misalignment etc. Not one of these medical professionals ever thought to address the problem from the ground up, by looking at how my foot was impacting the ground. Once I started running in shoes without a raised heel, the pain all but vanished.

Granted, I lost a year to stress fractures, probably as a result of too much, too soon, but I think Jake would be throwing his money away consulting with these mainstream MDs. I think he's best served by slowly building up his mileage in zero heel-toe drop shoes and then if he has time see a PT to get stronger.

KLIM said...

Bottom line - I need to find the route of the problem and correct it. Or try to. Sarah and Dr. Beck seem to agree macro, but now I need a system in place on how to correct my weak right side. Sarah noted how my pain could now "settle" in a different spot while wearing different (types of) shoes.

Ancient Chinese secret said...

Have you try acupuncture? My brother injured his lower back and hammy when he play tennis couple years ago, but cured by acupuncture recently. Just a suggestion, hope it helps.

JARRIN said...

Petey - First thing Pribut asked to look at were my shoes. He then had me walk/run in them and without them. We went from there. I can't attest to the other docs but I stick to those that work well for me and he's been spot on every time. I too had meandered from doc to doc during my plantar problem days. I saw him for three months during which he consistently advised new orthotics with a "divot" cut out at the spot of the pain. I avoided doing so because of the cost and time waiting. Stupid. When I finally did it - pain was gone and I was running within two days. Moral: find a good doctor and stick to him.

JARRIN

Towpath said...

Stromboli,

Your doc suggested that Klim run in shoes that have an 11mm+ heel-toe drop even after Klim reported that his symptoms were significantly improved when running in zero heel toe-drop shoes. Madness! I stand by my statement that conventional medical wisdom sucks at diagnosing and treating biomechanics problems. Best to correct the form via footwear that allows for a midfoot/forefoot strike and then work with a chiro and/or PT to strengthen.

KLIM said...

I think I need to do both - strengthen/stretch my problem area(s) while running in a midfoot/forefoot strike shoe. It's madness to think running in shoes like this, for the miles we do, won't lead to a NEW injury.

That being said, for the time being I am appreciating these new types of shoes.