Jan
24
Hamstrung – The Dangers of Road Camber
Photo Credit: Fog by Flickr user 1banaan, used under a used under a Creative Commons Attribution 2.0 license. Image is included in the Predawn Runner / Running Manifesto Calendar.
Having received the diagnosis of a strained hamstring and consulted with a physical therapist to look at potential causes and come up with a recovery program, I proceeded to meet with a physical therapy assistant to execute this program. However, this assistant did more than just follow the instructions of the therapist – he performed his own more thorough evaluations, focusing on potential structural issues, and in doing so uncovered what may be one cause of the strain.
The first step in this evaluation (and at every appointment since) was to go through a range of motions – knees to chest, then feet down near buttocks, then extend legs out – during which Mike (we’ll call him that because, well, that’s his name) looked at the “lay of the legs.” His determination was that the left leg was ¼” longer than the right leg. It was his belief, based partly on my long history of running without injury and the general motions of my legs as he worked them, that this was a “mechanical” issue, not a “pathological” one. In other words, it is a temporary issue brought about by something in my form versus a genetic issue such as having a longer femur or tibia in the left leg.
Mike asked if I always ran on the left side of the road. My immediate answer was “no, of course not” – I know the dangers of doing that, of the imbalanced stresses that road camber (the slope of the road from its center down towards its shoulders) can put on a runner. But as he continued with his evaluation, I began to wonder if I in fact had been as careful as claimed. As I have moved to running more on main roads, further from my home neighborhood in a desire to chart new routes, and as winter has taken me off of the level running paths that I do rely on around my neighborhood, perhaps I had yielded to my long-imbued instinct to run against traffic – even when no traffic is present. So perhaps I have gotten sloppy, and paid the price for doing so – but the fact that a small slip in this area yielded such an injury points out there are other weaknesses in my overall running approach to address.
And, without confessing my sins, that is what we proceeded to do. Mike explained that my left pelvis appears to have rotated forward, thus creating a pull on the hamstring and the eventual strain. In addition, and unsurprisingly, he informed me that my hip flexors were not particularly flexible and my hamstrings not particularly strong, in spite of the leg curls I make a part of my regular workout routine. As with Greg, the therapist, Mike emphasized that issues in a particular area like the hamstring often point out shortcomings in the muscles and tendons around the area, as opposed with the injured muscle itself. My adductors also happened to be weak, or at least out of balance with my abductors, and I’m wondering if this is related to the fact that I am bow-legged and have to concentrate on keeping my legs spaced (through using the abductors, I imagine) to avoid kicking my ankles when I run. So the goal in therapy would be to get my hip back in alignment, come up with exercises to strengthen the hamstrings, glutes, and adductors, and stretches to improve flexibility in the quads, hip flexors, and calves. I am under strict instructions, for now, to avoid stretching the hamstrings.
At each session, Mike has started by attempting to “rock” my pelvis back into alignment; as I lay on my back, he lays a towel over my left hip to spread the force, and then proceeds to put his weight into pushing my pelvis towards my shoulder and down into the table, pushing and releasing with just a one- or two-second cycle time. We have then proceeded to stretching the quads, calves, and hip flexors through a few standing positions. Then we focus on balance exercises on a on a soft mat or balance board. The balance activities are as much for neurological gains, training you to make fine adjustments quickly on the fly, as for any pure physical gains, and are certainly the toughest for which to judge the benefits – thus, the most subject to sacrifice when time gets a bit tighter. We then proceed to leg presses, curls, and adductor exercises on their gym equipment – with a focus on slow, lightweight reps. Obviously, the stretches and strengthening exercises are not new, but it’s always helpful to focus for a while on your form and timing while doing such exercises. In one session, Mike also showed me a hamstring strengthening exercise where you sit on a stool and pull yourself across a (preferably carpeted – lightly) room using only your heels.
Coupling this work with the bridges Greg has taught me, including doing them with a ball squeezed between the knees to simultaneously work on the adductors, and the yoga he has recommended, plus the myrtl which Bob Kujawski and Jason Fitzgerald have pointed out, I have a broad repertoire of routines to target my weaknesses. Which is a good thing, since the lack of running (and, for the past 10 days, even any work on the elliptical) has provided both the time and energy to do so. Progress has come in fits and bounds. Just as it seemed the corner had been turned after a successful pain-free 1-mile walk/run on the treadmill, a 4 mile run on the roads two days later turned out to be too much, and set the recovery back. We have attempted microcurrent therapy and ultrasound, in addition to further work with the Graston technique, to try to get over the hump. The original two-week goal will not be met, and I have started to set my sights beyond the Cleveland Marathon to ease any pressure on getting back at it sooner than I’m ready.
I continue to be driven by the idea that I will come out of this a stronger runner – more durable, more flexible, and more understanding of my own limitations – and thus able to design and execute effective training plans around these limitations. It is clear that my previous approaches left me vulnerable, as this seemingly minor injury, which has come at the price of two planned marathons, has so usefully instructed. It may be a week. It may be a month. It may be more. But someday soon, there will be a new Predawn Runner, and he will be better and smarter than he was before.
In case you missed it…
I had the pleasure last week of chatting with Mike Croy (previously profiled here) on the Dirt Dawg Running Diatribe podcast, as well as sharing my top moments from over a year on dailymile in their dailymiler of the week feature.
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