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running injuries

Learning Good Running Posture After Years of Being a Heel Striker

2012 Half Marathon Photo by Crystal O'Hara

2012 Half Marathon Photo by Crystal O’Hara

When I finished the 2013 Rock ‘n’ Roll Half Marathon, I had excruciating pain in both shins and feet. I was pretty sure I had multiple stress fractures from shin splints and plantar fasciitis. My coach suggested I do some work on my running form before my next race to prevent these injuries from recurring. I thought he meant I should take a half-day interactive running seminar. I had no idea that I needed 10 weeks of physical therapy.

My physical therapist, Eric, filmed me running on the treadmill, from behind and from the side, with and without shoes. He showed me the footage in slow motion which clearly showed that I had a heel striking problem and that my hips were uneven when I took a step with my left foot. I had no kick on the back side of my stride, and I was barely picking up my feet, (which explains why I frequently trip on cracks in the sidewalk).

My physical therapy regimen included stretching, exercises to strengthen my legs, and ASTYM to break up the scar tissue in my lower legs. We also did exercises on proper running posture. It feels kinda dorky to practice going through the motions of running without actually running.

Once we got the scar tissue mostly broken up, I got to practice running with the new form. Eric started me on the Alter-G treadmill – it’s a treadmill with a built-in air bubble. I love this thing. It’s a great device for practicing new running form because you tell it how much of your weight you want to run on. He started me on 60% of my body weight and each session increased it by 10%.  It gave me a chance to practice running on my toes without pounding on my joints.

The best part of running on the Alter-G treadmill was I was literally zipped into the air bubble so I couldn’t fall down when I tripped – and I tripped a lot. When we switched me the regular treadmill, I was petrified of tripping over my feet and falling – which thankfully didn’t happen.

After a few weeks of treadmill running, Eric finally cleared me to run in the real world again – just for a few miles. Eric told me to alternate between using the old running form and the new running form – one minute stretches of each – which I thought was weird until I started to run. Holy crap it hurt to run with the new form. I don’t think I’d really used my calves to run long distance before. Switching between the old form and new form gave those muscles a chance to rest a bit.

I worked up to running 3 miles every other day. I started giving equal time to the old form and new form and I’m slowly increasing the amount of time on the new form and decreasing how long I run on the old form. The new form is way more effective and doesn’t put as much pressure on my joints.

Eric's been Taping my Arch - It definitely Helps with the Pain

Eric’s been Taping my Arch Too – It Definitely Helps with the Pain

Eric’s re-checked my posture both visually and by videotaping me again and tweaked my new form a few times. He said I needed to kick more with my hamstrings on the back side of each stride. It feels like I’m trying to kick myself in the butt with each step, but I’m sure it looks normal to anyone watching. When my arch started hurting, he told me to stop pointing my feet when I run. I’m not used to picking my feet up and I think they’re reaching for the ground a bit, plus I was a gymnast for 17 years so pointing my toes is natural. Relaxing my foot is helping give me more of a mid-foot strike, and decreasing the pain in my arch. And thank goodness for that because Eric’s been massaging the crap out of it, which is excruciatingly painful. When he works on it, I grip the pillow and utter “Jesus Christ” and “Fuck” through clenched teeth.

It’s so weird and mentally taxing to run – thinking about relaxing my foot on the front end and kicking my butt on the back side. I expect it will take years for my new running form to feel normal. It still hurts to run with the old form and new form but that will get better with time. I’m curious to see what this will do for my race time. My half marathon PR is 1:52 and that was with bad form and pain in both feet and shins. I’d love to see how much I improve with proper running posture.

Treating my Shin Splints and Plantar Fasciitis with ASTYM and Dry Needling

I ran the Rock ‘n’ Roll Arizona Half Marathon every year from 2010 to 2013, and every time I did the race, I seemed to have more problems with shin splints and foot pain than the previous race – and yes, I follow a really good half marathon training program by Hal Higdon. My legs hurt so much during the 2013 race, I was pretty sure I ran the race with three stress fractures in my tibias (two in my left, one in my right).

After the 2013 half marathon I rested my legs for months, but I was in pain within weeks of trying to run again. I decided to suck it up and get professional help. I started with an informal evaluation at one of Runner’s Den’s weekly injury clinics. I described my pain to the doctor and he immediately referred me to Endurance Rehab for ASTYM®. And then he warned me – ASTYM hurts.

I didn’t think much of it at the time. I used to be a gymnast. How bad could it be?

The next day, I called to make an appointment at Endurance Rehab and relayed the injury clinic doctor’s recommendation that I receive ASTYM and she warned me – You know it’s going to hurt a lot, right?

Ok now I started to worry a little bit if the receptionist was warning me. I did some research on YouTube to get an idea of what I was in for.

A few days later I met with my physical therapist, Eric, who did a full athletic history and evaluation. He said my shin pain was due to the fact that I had a lot of scar tissue my legs, which is why they didn’t get better with rest alone. His plan of action: break up the scar tissue with ASTYM, strengthen my leg muscles, and train me on a better running posture to prevent recurrence.

My calves after a session of ASTYM - early in the process

My Legs after ASTYM – Early in the Process

My ASTYM included both anterior tibialis muscles (front outside lower leg), my left posterior tibialis (front inside lower leg), both calves, and the bottoms of both feet. The video above must have been done on a person who didn’t have any injuries because Holy Fucking Shit ASTYM hurts! The first time Eric did ASTYM on me, it hurt so much I was shaking by the time he was halfway through. (He said I was the first person he’s seen have that reaction.) I never shook again, but it is not uncommon for me to cringe, grunt, scream, swear, and pound the table during ASTYM. I’ve pulled my foot away a few times, and each time Eric patiently holds out his hand until I give it back.

And did I mention the bruising? We’re all glad I did this during winter because if I wore a dress or shorts outside, everyone would wonder who’s beating me.

The good news is the pain gets better and the bruising decreases over time as the scar tissue breaks up. When he works on me, Eric uses ASTYM and manually massages my tibialis muscles. His hands are bright red from the pressure he’s putting on my muscles and except for a few small areas on my plantar fascia and my post tibialis, I’m pretty comfortable compared to when he first worked on me.

Dry Needling - 20 Needles in my Post Tibialis

Dry Needling – 20 Needles in my Post Tibialis

We also did some dry needling in my post tibialis during physical therapy. Dry needling uses the same gauge needles as acupuncture but they go all the way into the muscles. It’s based on the premise that the needles cause micro-trauma where they’re inserted which stimulates the healing process. There are people on both sides of whether dry needling is an effective treatment or only placebo. I don’t care. It seemed to help me.

It felt really intense when the needles were in my leg, especially when they were going in. I had an urge to point and flex my foot after the needles were in but I figured that would hurt a lot so I opted to do it with my non-needled foot instead.

I’m happy to share that my legs are on the mend and I’m starting to run again. I’ll write another post soon about the process of learning to run with a completely different running form.