Saturday, 30 May 2020

Let's see how the running goes....

My new running shoes! 

When I first tore my meniscus back in December 2016 I initially had a very successful return to running. I did lots of rehab right from the start, and in late spring 2017 I began a couch to 5km plan that combined varied running with cross training, taking care to listen to my body rather than follow the plan rigidly, with the pleasing result that I ran my fastest ever 5km and carried on progressing to 10km. Then a rather over enthusiastic physiotherapist session caused my meniscus to tear again, and this time I couldn't rehab it (it's likely there was an underlying issue with the meniscus before the physio session, so it probably would have torn at some point anyway; it turned out later that I have discoid shaped meniscus that tear easily). I ended up having surgery in 2018 to repair and trim two tears, but it continued to be easily aggravated with the knee frequently swelling up and after an attempt to return to running in 2019 didn't go well I decided to knock it on the head and focus on improving the underlying function of the leg in the context of the whole of me. I have really missed my running but the most important exercise for me is long walks so I concentrated on this instead. I am no longer climbing as it's too much temptation to put torque through the knee, which I was warned off doing by the surgeon.

So, lots of somatic style exercises and JEMS exercises to restore the natural movement I had lost through chronic injury. I also tend to overly focus on my knee - understandably - which amplifies negative sensation leading to tension and anxiety. I am now aiming to widen my focus away from how the knee is feeling.

Endless squats and lunges with increasingly heavy weights have strengthened up my legs but there is still muscle wasting on the vastus medialis (partly because the knee has often had some swelling present) so I am including other functional movement exercises. I noticed that I lose optimal movement when I am moving down steep ground so I need to practice vertical hip release and incorporate this into my exercises. I need to improve my one leg dips on the injured side and I continue to work on foot sensitivity and propriocetion. I introduced exercises to encourage the return of spring and bounce to absorb forces and be energy efficient.

Last week I went for a tentative short run, a standard walk 30 seconds, run one minute for ten minutes. It went ok, no problems 24 or 48 hours later so I ordered some new shoes online (on the sale, hurrah!) from a favourite outdoor shop that I want to support whilst it is closed to visitors during the lockdown. New shoes felt important as my current ones have been shaped by my gait since surgery and so have negative connotations for me; they are also wearing out. Of course I went for a run the morning they arrived: a short, gentle 3km where I walked the steepest bits (I need to acclimatise my Achilles tendon on the uphills and get better control for the downhills before I run them), and slowed down or walked for 30 seconds to a minute when I got very breathless. I visualised the helium balloon supporting my central longitudinal axis, and kept my stride short. It felt great! Now lets see how it feels 24 hours later, then 48 hours....

I did notice that I wasn't rotating freely with my trunk so as well as thigh slides and greyhounds (an exercise I haven't posted about yet) I will be doing a couple of simple Muscle Energy Technique stretches as follows (please be responsible for your own comfort and safety when doing these, don't force the stretch):

Lie on your side on the floor or your bed. Keep your bottom leg straight and bend your top leg so the knee comes towards your chest but is still able to rest comfortably on the surface - you can use a pillow to support it, especially if you have irritable hamstring tendons. Position your bottom arm straight out in front of you so it is at right angles to your torso and let your top shoulder roll back, taking the top arm and your upper back with it. Now really stretch out that bottom arm and hold for ten seconds before taking a deep breath and relaxing. As you breath out see if you can let your shoulders and back roll back a little more; relax and breath easily in this new position. Now press your top knee gently into the surface it is resting on and sustain for ten seconds before relaxing and again letting your back roll back as far as it can do comfortably. Relax in this position for thirty seconds, then roll back and bring yourself slowly back up. Repeat on your other side.

Half moon stretch, one that I like to do pretty much anywhere - against a wall, lamp post, tree.... I began to describe this but really, it is easier for you to google how to do it as it is a yoga pose. It's often shown with no support but I like to lean my hands against something so I can really relax. Stand sideways on to the structure you are going to lean against, make sure it will take your weight. Your chest and pelvis must face straight forward through the whole exercise, at right angles to the support. In my experience if people aren't feeling the stretch it is because they are turning their chest and pelvis inwards. I always hold the stretch for at least 45 seconds on each side. I find it a very relaxing stretch that restores the sensation of connection through the body whilst also releasing tension.  

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