Monday, January 16, 2012

A New Year, An Old Injury

With the new year, I usually begin thinking about race plans for the year and getting into a groove of training after some rest during December.  Making any definite plans is difficult as I'm not sure I'm ready to race.  I've been able to run some, but have been limited over the last few weeks by injury.

Right Hip, IT Band, and Piriformis Muscle

Progress has been excellent in my rehabilitation of hip pain that began back in mid November.  I started a stretching regimen and strengthening exercises in late December that have brought me back to pretty much one hundred percent.  Here are several things that got me real results in restoring this injury:

-- Three weeks off from running

-- Five treatments of graston, ultrasonic and electrical muscle stimulation from Bloomington Bone and Joint

-- Regular stretching of the piriformis muscle, IT band, and hip flexor and right quads

-- Regular use of a foam roller, including before and after runs.  Especially useful when I started using it to apply constant pressure before and after runs for around a minute specifically to piriformis muscle

-- Strengthening exercises target at the piriformis muscle and hip abductors.  I did lots of lying down on my left side with knees bent and then holding feet together and knees together, then extending the right knee up with feet still together and repeating.  Once this got a little easier, standing up and using a resistance band or pulley and extending the right leg forward and out to the rightmost limit was also useful.

-- I also did lots of "pillar bridges" on both sides plus front and back.  This british guy does a pretty good demonstration.

A tight IT band was also especially obvious when I did the "table top" stretch with one leg hanging entirely off the end of the table and brought the opposing leg up.  My right side was almost an inch less flexible than the left side.

Right Foot 2nd Metatarsal Head Pain / Metatarsalgia

This injury although easy to run through has proven to be the most difficult to eliminate.  I started off with a prescription anti-inflammatory (Mobic) but didn't get much progress on eliminating it even when not running.  Walking around seemed to cause as much if not more inflammation than running.

2nd Metatarsal Head

I had an MRI done to be sure I wasn't doing any damage attempting to run through this injury and thankfully nothing but inflammation was found.  So far I have found the most relief by:

-- Not wearing minimalist shoes.  For the time being the lack of cushioning in a minimalist shoe just doesn't help my foot out at all.  I would feel no pain but then just walking around in the New Balance MT110 would cause a flare up.

-- Buying a new set of cushioned shoes to run in and wear pretty much everywhere.  I ended up buying a pair of Brooks Launch from the Indiana Running Company sale table (I've had good luck with shoes based on the Brooks universal platform in the past).

Brooks Launch

-- Using an off the shelf metatarsal pad taped just behind the metatarsal heads to take pressure off of the head.

Spenco Gel "Ball of Foot" Pads

Pad Positioning

-- Wearing the toebox of my shoe a little looser and using Infinji toe socks with the 2nd toe taped to the big toe.  This should cause a wider spread between the 2nd and 3rd metatarsal and help to force proper spread positioning on landing as well as alleviate pressure from the 2nd metatarsal head.

Taped Toes

-- Here is something I tried that I'm not sure worked at all.  I attempted to alleviate pressure by cutting out old insoles and leaving a hole where 2nd metatarsal hits to lessen impact on it.  For whatever reason I don't think this made any difference.  I wore all three insoles at once which also isn't tremendously comfortable as the taller platform makes for greater instability.  I don't recommend trying this.

Failed Experiment

So after all this, I was able to run up to fifteen miles on my ailing foot but I'm not sure the injury is really healing.  At this point pain doesn't seem to be increasing, but my confidence in resuming real training or adding speed work is pretty low.  I'm hoping the next few weeks will show more recovery.