Book review: "Anatomy for Runners: Unlocking Your Athletic Potential for Health, Speed, and Injury Prevention"

Last week I read this book:

It's one of those books that probably every runner should read.  It explains how and why people get injured and gives you self-assessment tests to highlight some potentially weak areas and how to fix them.

A few highlights from the book and take-home lessons:

• I was surprised that he was generally positive on "barefoot/minimalist" shoes.  I had stopped wearing my Vibrams, afraid that it was going to cause injury, and the opposite is likely true.   I've started wearing them again and really working on my foot strength.
• The author suggested that sometimes 100% rest does more harm than good when injured.   This is in line with my experiences but there is actually scientific evidence that reduced workouts when injured is better than full rest.  
• Attempting to race 3 times in 4 days on low mileage is probably what caused my original groin injury, which set off the cascade of other issues.   I taxed my body way more than I was ready to do, and I broke down.   Yep.
• I have what the author calls "Toilet Bowl of Doom" running posture - way tight hip flexors, quad dominant, and excess flex in the lower back.   Note:  Do not google "Toilet Bowl of Doom" and certainly don't watch any videos with that name.   
• The amount of time it takes to affect change with stretching is really, really long.  You have to keep at it before real changes are seen.
• Single-leg balance is as important as strength.

Things I've started to do:

• Stretch my hip flexors for 3 minutes every evening.
• Work on my foot strength, including my big toe strength.
• I balance on one foot at various points during the day, and in the evening, I get on a balance disc.
• Continue the hip and core work.
• More barefoot running and walking.  Ditch the orthotics and shoes with heels.

The self-assessment and exercise chapters are short and sweet - if you really have been injured, especially with a recurring injury, there is no replacement for a professional opinion.  But the rest of the book helps put physical therapy in context and explain why it's so important to have a well-rounded physical ability before racing and taxing the body with running.  Worth the read!

Getting to the core of the matter

Tonight's workout:
2.5 miles run/walk
2x 30sec planks
2x 20sec side planks
2x 1min hip bridge
2x 20 rep clamshells

The most common strength deficiency (and the one that tends to result in injuries) is in the posterior chain and hips... my guess because we all do a lot of sitting.   Plopping down on your ass all day isn't really good for anyone... and even if you are active for 2 hours a day but then sit for the remainder, you're still sitting way too much.  Sitting also disengages your stomach muscles, slumping and slouching over our computers, which means our abs are the other weak point for most.

Runners and cyclists have the added issue of constantly moving in the forward direction (as opposed to a soccer player, whose movements include lateral and such), making the sagittal plane the strongest, and frontal and rotational ones weaker.

My suggestion typically for anyone looking to stay injury free - focus your crosstraining efforts on buiding glute and hip strength, including side-to-side movements, and working your core muscles as a unit.

There are any number of good hip workouts available on line, some specific for runners like this video.

I have become a big proponent of non-isolation moves for core work (sit ups, I'm looking at you).  The core (and specifically I mean back, abs, hips, glutes) works most effectively when all parts are humming along together.   And so you should train your core so that it's engaging and firing on all cylinders.  Asking one part to work while the rest are asleep, to me, seems like a recipe for muscle and strength imbalances.  

In simple terms, if you think about what the core does, the best exercises are then those that challenge the core to work hard/harder at that job.   The set of core muscles support the spine through normal movements - a plank works effectively because you're basically using gravity to add a force, making it more difficult for the core to keep the spine in a neutral, supported position.    If planks are too easy for you, add in difficulty by either reducing the number of contacts with the floor (raise a leg) or movement (like this).

Other good core exercises, with links to instructions/videos:
Pallof press  (engages the core to withstand a force wanting it to rotate)
Stir the Pot (a plank - with an unstable surface AND movement, incredibly difficult)
Bird Dog

Next up, why you should use a standing desk.  :)

First workout back

Yesterday I got beat up had a massage.  I felt much, much better this morning, enough that I went out after work for 2.5 miles of run/walk.  Over the last 6 weeks, I have not done any runs over 3 miles....  I have physical therapy tomorrow and I'd really like to be able to add in some mileage again (maybe next week?).  My goal 10K is this weekend, needless to say I will not be racing!

What to do when you're on the DL

I've had a lot of experience at this.  :)  I know everyone is different, but this what keeps me mostly sane.

1.  Get organized.   Use the downtime to go through old race tees and toss ones that you no longer wear - donate the rest or send them off to become a t-shirt quilt.   Take inventory of your exercise gear and organize it so when you're back, you won't have to go hunting for stuff.

2. Read.   Training plans, forums, books, anything that will keep your mind on getting back out there.  Even better if you connect with people who went through a similar injury, so you can commiserate/get advice.

3. Create a plan.  When you get the OK from the doctor to resume normal activity, what are you going to do?   What's your ramp up schedule?  How and when will you fit in your PT, if that's to be included?  Sometimes I go as far as to make up my first month back plan, day by day.

4. Volunteer.   Races are always looking for people to help out on race-day, and it's a great way to give back to the events you normally participate in.

5.  Stay positive.  This one is self-explanatory!

Defining frustration

Athletic endeavors are framed by goals.  Goal races or events, goal times, goal distances, even goal weight loss and so on.  Your mind sets these targets and then you ask your body to go with the flow when you execute the plan to accomplish those goals.   When you accomplish something you set out to do, there is no greater feeling.

This process gets interrupted when the body can't or won't do what you're wanting it to do.   And because your body doesn't have any real way of communicating outside of a pain response, you're sort of left with this internal guessing game.  You know what's hurting but not why.   The usual way athletes approach a pain response is to rest or ice or start taking an anti-inflammatory, or some combination of that, until you can no longer tolerate the break in training and then you go see a doctor.

Regardless of the treatment or the prognosis, dealing with a body in pain is frustrating.  Let's get with the program, body!    The frustration mounts because you know with every missed workout, you are not doing what you need to do to hit your goals.  You want to do it, you have the drive to do it, but you can't.  And when you aren't hitting your goals, you start doubting the desire to hit your goals.  What's the point?  It's hard to see the target when you keep running into a forest of obstacles.

I'm at that stage now.  Debating what I want to do since I will likely have to forego all my goals I set for this year.  What's the point?  Where am I going?   Having been down this road many times, I know there will be a point where I can get back on a training plan.  For my sake, let it be sooner rather than later!  (And yes, I had to miss my triathlon this weekend.)

I really like my couch

I really like my couch, which is a good thing seeing as how I have spent the last 5 hours lying on it.

Admittedly, I do have bouts of serious laziness, but my couch is getting a visit today mostly because I managed to tweak my back kayaking.    Introduce me to a sport and I can likely do it well enough to not totally suck.  I will also manage to injure something in the process.  I am the victim of being both athletically gifted and orthopedically challenged.

Most of my time oscillates between feeling satisfied and accomplished after a great workout and cursing the world for my seemingly bad luck.   Well, maybe not bad luck, but bad genes.   Somehow I'm sure it's all my parents' fault, anyway.

Today's rehab plan was ibuprofen, tramadol, rest and ice.     The thing with low back pain is to try to cut it off before it gets worse.  Sometimes this means going for a walk and then stretching and icing.  Sometimes it means rest.  Sometimes it means a day or two on muscle relaxers.  Sometimes a combination of everything possible to try to relieve the pain. 

It is counter-intuitive to some, but staying active is the best thing you can do for your back.  (The very close second best thing is to stop with the bad posture!  Your mother was right.)  I had to take a few weeks off because of a hip/groin injury and it doesn't surprise me now that I'm having back issues.  Anytime I have longish periods of rest (and/or laziness), my back will act up.    There are other things that trigger back pain, like a lot of bending over, awkwardly lifting heavy things, etc, but sometimes doing nothing is the worst of all.

Tomorrow's plan is to at least get out for a walk and if I'm really feeling better (fingers crossed!) a short run. I have a 3.5 mile run- 12 mile bike- 1.3 mile kayak triathlon that I would really like to do this weekend.   I'm staying hopeful.