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Posts Tagged ‘rehabilitation’

OK, so I’m 16 weeks post-injury.  I still have pain and effusion in my knee, and I’ve crossed off the spring races from my calendar but for the most part I’ve stopped whining and limping and feeling sorry for myself.  And today I had one of my mini-epiphanies..the kind where I suddenly have an exciting revelation about something that should have been obvious long ago…I think I’m going about this all wrong!  Basically, the problem is that I have no idea how to come back from this injury.  I did PT, I had a cortisone shot, I had ART/Graston therapy, and I saw a doctor about getting PRP injections (I haven’ t decided yet).  In other words, I’m trying things at random, hoping something will work, and expecting that eventually I’ll find the magic bullet and I’ll all of a sudden get better and be able to start running 30-35 miles a week again.  And I think this is wrong.  I need to be more methodical.  I need to train.  I need a plan.

So first I asked the Internet for a plan, but it was frustratingly silent.  The Internet has plenty of rehabilitation protocols for post meniscus surgery, and all sorts of PT protocols for knee injury that assume by 12 weeks you are all better and back to normal activities.  But nothing to tell me how to get from where I am now, able to run 5 miles, with pain but not too much, to running 14.5 miles, which was where I was before the injury.  So I’ve decided that I will use one of the half marathon training plans out there, and train myself back to running.

This will be a first for me, since I’ve never been one to train for a race, preferring instead to just run whatever I feel like and on race day just show up  and run the race. (Yes, I know, that could conceivably be contributing to my many injuries, but I can’t help it..training is annoying and takes the fun out of everything! )  So, anyway, I am leaning toward the 8-week Hal Higdon half marathon program, with an extra mile tacked on at the very end.  That will have me back to pre-injury long-run distance by the beginning of May if I have no major setbacks.  Knock wood.

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It has now been one year since I injured my AT.
I have more pain than I had a year ago.  I’m sure that I have lost cardiovascular fitness  and I am not yet back to my pre-injury running routine; the most frustrating thing being the lack of improvement over time and the constant setbacks.  I can now run 5 miles  at about a 10 minute pace without pain, but I can not do it two days back to back.  I  seem to need 2 days for the tendon to recover from each run.  I have an exercise routine that feels like it is helpful so I am sticking with it for a while longer.

Twice daily:

  • eccentric heel lifts 20 X 2 with 10 LB

Once Daily:

  • bridge marches 30,
  • rear leg extensions 15 X 2,
  • single leg squat  1- X 2,
  • isometric toe exercise 30s,
  • calf stretch 30s,
  • single leg stand eyes closed or heel-toe eyes closed 30s X 2

3 times per week: 

  • Side step with the red Theraband on the feet – down the hall and back,
  • 5 mile run @10 minute pace with orthotics OR 40 minutes elliptical OR 1 hour stationary bike
  • Kneeling hip flexor stretch 3 minutes

Once weekly:

  • pool running 20 – 30 minutes,
  • thigh, calf and foot stretches in the whirlpool,
  • hip abduction (Nautilus) 12
  • Seated Leg extensions (Nautilus) 12

I also foam roll and massage the ankle and gastroc whenever I have time.  My goal is to run a 10K race in January, a 5M in February, and a 10K in March. 

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I’ve now accomplished five weeks of no running.  Usually when I say no running, I mean, no running more than 3 miles.  But this time I really mean no running.  Zero.  I now suspect that the whole reason that needle tenotomies are effective (if they are) is that they cause you so much pain that they force you to really truly not run for eight weeks.  The tendinopathy pain is definitely worse than before the procedure, in that before the procedure I could run a couple of miles with no pain, and now I can’t run more than a couple of steps without experiencing a hot-poker-in-the-tendon feeling.  So, in a probably futile effort to maintain some sort of cardiovascular fitness and keep my legs in shape,  I’ve started aqua-jogging, aka pool running.  I don’t think I quite have the hang of it yet, though.  Basically what I do is clip on my aqua-fitness buoyancy-belt-thingy, hop into the pool and proceed to sink to the bottom while running in place.  I did this for 30 minutes today, feeling very silly, but my PT seemed to think it was a good idea, so I will keep working on my pool running form and maybe eventually I won’t sink.

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