Adventures in Physical Therapy

On Friday, I completed my last day of physical therapy. I’m not magically cured, and I probably won’t be in running shape for a long time (if ever without surgery), but I’m getting around just fine, so we’ll call a win a win.

Let’s start with the basics: Physical therapy is where you go when you don’t want to or can’t have surgery. It’s also the place you go after surgery. All of this so you can get better.

This isn’t my first rodeo. I’ve done PT before. I had a chest injury three and a half years ago, and I finally decided to do something about my back last year.

I’ve played this game before, but each round has its own quirks, so I wanted to dive in a bit.

What stayed the same?

The biggest thing is the focus on getting to muscles you’re not used to getting. When I was dealing with the chest injury, I was trying to pull my shoulders back, so there were a lot of pulling exercises that got behind my shoulder blade in a way I wasn’t used to (I actually got nauseous the first day). And that trend continued. This time I was hitting my glutes and hips in weird ways (more on the actual exercises later).

Next, there was the assumption I’d do the exercises on my own. That lasted a full week here. The problem was (kind of) yoga (ok, the problem was me being lazy). The idea is they’re little exercises you can do on your own, and long-term, that’s what you’ll have to do.

And finally, I got a new band.

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The first time I did PT, I got a yellow band. I was SO psyched they gave me a free thing (never mind I was paying for said free thing). Eventually, I got blue and black. This time, I didn’t get a band in the beginning. I was actually let down, but I already had three at home. But on the last day, they saved me and gave me a red one. Now I just need green.

I wonder if these colors are universal?

What changed?

The big difference was the clinic itself. Before, I’d done PT on campus. The first PT group I was with had a regular clinic off campus I went to once, but they were across the street from my office on campus in a smaller setup once a week, so that was a no brainer. This is the first time I’d been in a clinic. It was interesting. There was equipment everywhere (awesome) and people too (not awesome, especially when you’re doing stupid human tricks).

The people make up the next point. In a bigger clinic, there’s a bigger staff. Even when I’m only working with one person, there are 4-5 other PTs going, usually a similar number of PTAs. We’re in a bigger room but not that much bigger. There are also the staffers who handle the clerical work. I was used to the first place where there was a PT and a PT student. That’s it. Having so many people around meant you weren’t going to lack for access to people, but it also meant there was always someone who could see if you messed up (Exhibit A: on the penultimate day, I almost ate it trying to get an exercise band off my legs. And that’s how a conversation with a PT I’ve never talked to got started). I actually worked with two PTs and two PTAs. Never knew who I would see day to day.

Frequency of visits was the other big adjustment. I went three times a week for six weeks. I was used to weekly appointments. That was a much bigger time commitment, especially when I was having to drive 15 minutes (and more when they upped the intensity and I had to start going home to shower). The plus was I was basically forced into three workouts a week. There are worse things than exercising three times a week (plus 1-2 more when I was able to get into the yoga studio).

The last difference was the exercises themselves. But let’s give that a full section.

So what were you doing?

I was doing all the things.

The one consistent thing was a warmup. It started with an exercise bike, which actually hurt my left knee the first couple of times. Then they moved me to an elliptical. I hate ellipticals (and irony dictates that was one of the main final recommendations for me to do on my own).

This was sufficient to get me warm and make me a little self-conscious about returning to work without showering. Just not self-conscious enough.

Then the real work began. The real work changed a lot.

At first, it was just weird little exercises. One where I was bending my knee like was taking a step down. This progressed to standing on an actual step. And then a slightly bigger step.

Another that was an extremely abbreviate pistol squat. As I got that down, they had me dipping lower. It doesn’t sound like much, but 25 half squats on one leg get tiring.

One where I bent forward with one leg on the ground and one rising up like I was picking up a golf ball (or a screwy-looking warrior III from yoga). The weird part is they had me progress to an easier version of this for the longest time where I didn’t reach down as far. And then they added weight the last day. That fried my hammies.

I hated it the first day, but after that my favorite activity was the BOSU ball.

The first day was the wobbles. The wobbles make you feel like you’re about to be pitched off. I never got pitched off by a horse, but I was in danger of being pitched off by a piece of plastic. After that, I was a champ. The wobbles went away, and I could own that junk.

And then they had me balance on one foot. This wasn’t as bad as the first day, but when they stick you on the round side and say stand on one foot, you don’t necessarily think, “This will end well.”

The last week, I moved to using the leg press and a machine that was like an assisted jumping machine. Google tells me it was a shuttle machine. Basically, you lie down and then jump. It’s weird.

And then the core stuff. I hate the core stuff.

The core stuff was just 5-second planks for 20 rounds and then a side plank variation that consisted of me moving my leg forward and backward. That sound you heard was my glute/hip area experiencing post-traumatic stress. Eventually core got upped to doing side plank raise (or dying mermaid, as the PTA called it). That was brutal. Then another one that was a plank where I just touched alternating shoulders with alternating hands.

And finally, there was running. The last 4 weeks involved some running. Remember how I wouldn’t shower? That stopped the second they put me on the treadmill. One day, I was sweating so bad, I had to ask for a towel. I got a towel every day after that. And water.

Ultimately, I was in PT so I could run. My day-to-day life was returning to normal, but I want to be able to run (bet you never thought I’d say that with this blog title).

This is when the knee pain started to return. I wasn’t used to running, and my body couldn’t take it at first.

It wasn’t just my knee. My feet and ankles were also unappreciative of the endeavor. The first day was in cross-trainers. That was the last day for the cross-trainers. I moved to running shoes after that. Slowly (oh so slowly), the running got better and knee pain dissipated but didn’t fully go away. The way I put it to the PT was if I was running a race, I’d keep going, but if I was just on a run, I would stop. This never really got upped in the four weeks; I just got mildly better about the little they gave me.

They also gave me an extended warmup routine that will make me look like a goober if I ever do it in public.

But what about yoga and PT?

I’m glad you (didn’t actually) ask. Yoga will make you look like a champ at PT.

For real, do yoga, and then go to PT. They have you do planks and weird little exercises. If you know both, then you know I’m talking about both. The best was the BOSU ball. Aside from the first-day wobbles, I could keep pretty still, enough so to get attention from people working there who weren’t actually working with me.

That will be the extent I brag about being a PT champ.

All in all

I’d call it a 65-70% win. I’m not running yet and probably won’t for quite a while, but I got a lot of good exercises I can do on my own, and my range of motion and flexibility got a lot better over the period of PT.

Hopefully I can maintain where I’m at and maybe make a little progress as I move out of state, but you’ll just have to stay tuned.

Let’s Talk About Recovery

As I slowly return to the world of the normal, I’ve been giving a lot of thought to maintenance. I try to do a lot for maintenance. Take away my knee, and I’m trying to do even more.

Why do we do recovery? 1) It feels good. 2) It (might) help. I say might because some of these aren’t necessarily proven to work so much as make you feel better, which then might help. The science of recovery is weird.

This episode of The Runner’s World Show actually delves into a business in Chicago (The Edge Athlete Lounge) that focuses on recovery. It’s like a regular gym, but they add in a heavy emphasis on recovery at $125 a month lowest cost (we won’t go into how this inherently caters to the wealthy who already have more access to recovery sources than middle-to-low-income folks).

But me? I can’t afford that. Ok, I might be able to afford that, but I’m not paying and I don’t live in Chicago.

I have to make other arrangements.

So I foam roll – This takes an astonishingly short amount of time, it’s the only thing that lets me function the day after a hard workout, and I just don’t do it often enough. But when I do? Oof. It’s magic.

I stretch – This may be the most consistent thing I keep getting recommended. In a bygone age, I could stand on 45-pound bumper plates and touch the ground. Now, I can barely touch my toes, and that’s an improvement. Between my back, knee, and chest, I’m supposed to stretch out pretty everything from head to toe. I need to start getting compulsive about stretching. As it is, my muscles, especially my legs, are loaded springs.

I yoga (uncomfortable stretching plus some strength) – This doesn’t have the same magic for recovery as a foam roller, but it’s the most important thing I do to remain functional long-term. You can only imagine the betrayal I felt when not only was my knee keeping me away from yoga but there’s a chance that yoga did me in. I couldn’t stay away. For my day-to-day life, this is the best thing I can do, so even if I’m limited, I’m going to find a way.

And I sleep – This one’s my favorite. I like my 8 hours at night. I’d like 9 even better. I like my naps. I like to eat breakfast, and then go right back to sleep for another hour or so. I like to curl up in my blankets in the winter in a quilted cocoon. I like to throw an exercise mat on the ground and get my afternoon nap. And why do I like sleep? Because my body craves it. That’s when I recover. No stress, no activity. Just sleep. Just rest. And you know what? I think I’ll sleep again tonight. I’ll probably sleep again tomorrow. Something to look forward to.

What do you do for recovery?

Injury Update & Return to Yoga

When we last left our hero, he had found indications of bipartite patella or kneecap fracture and was anxiously awaiting the results of his MRI.

Setting: Mississippi in the late teens. Our protagonist is sitting on his couch in a knee brace and typing on a computer. The air conditioner is running because of course it is. Light indie music plays in the background.

Scene:

The MRI came back with no real bad issues. There was some fluid, but nothing was out of place beyond what the X-Rays’ already showed. The recommendation was surgery (both options didn’t sound pleasant, even for surgery). I of course chickened out and asked to try physical therapy first. Low risk but low probability of success. But no knife. Doc OK’d it, so I got sent to their PT staff to get a knee brace and then set up my PT appointment in my own town.

Here’s the thing about the knee brace: He didn’t tell me why I needed it when I was pretty much ok moving around. I ended up asking the PT and didn’t get that clear of an answer. Basically it sounds like if I’m walking around on uneven ground (i.e., hiking) I should wear it. I’m not hiking.

But I have the knee brace, and I had my first PT appointment today. It was fun. Got some normal stretches and then a couple of weird exercises, and then they zapped my leg for 15 minutes. I got to do some light reading. All good.

Then I got to the realness: Could I start doing yoga again? The doc was hesitant. He wanted me to ease into it. I wanted no such thing. I did a round of the warm-up for Ashtanga and survived. That was the hard part, so I thought asking couldn’t hurt.

And the PT gave me the ok.

As long as I didn’t do anything stupid, I was allowed to do it. Benefit outweighed the risk to him. Awesome dude. Also awesome that he was OK with me not wearing the knee brace as a default since I was already on the mend.

And how long did I wait to go to yoga? Almost 10 hours.

I’ve been going half insane the past few weeks. I couldn’t even do planks in the early stage because me knee was hurting that much.

I went to my Ashtanga class prepared to behave and make accommodations. It wasn’t easy, and because I couldn’t really do anything while my knee was hurting, even my upper body was not really in the game. There were some minor twinges, and my yoga teacher watched me like a hawk to make sure I was OK, but everything was all good. I had to sit out a couple of things, but I was able to do something most of the time.

And tomorrow’s going to be rough. Ashtanga is Sanskrit for “this is gonna hurt” (it’s a stupid joke I’ve been making for over a year, but I still love it; related, I made the joke originally in this post from the first time I did the class. It usually shows up on the first page of the Google search when you look for thank you note for yoga teacher. It’s kept a steady flow of traffic to the blog from people sincerely looking to write their yoga teacher a thank you note while I was being snarkily sincere about appreciating an all-over soreness from the workout. I should add a postscript apologizing to the people looking for real advice).

I also have to contend with the weird leg exercises that got muscles I objectively knew were there but rarely feel activated. That’s going to cause some odd soreness, but it’s finally looking up for our hero.

Q and His Treacherous Knee

Or Q and His Knee Jerk Reaction

Or Q and Why Does My Knee Hurt?

This was my weekend a week ago:

Nothing like unexplained knee pain to liven up the weekend #thuglife #thisis30

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And this was me less than a week ago:

My new significant other doesn't cook me dinner but it does keep my knee from hurting (at least for a few minutes). Happy V Day

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There’s a theme here. I’m a week and half into unexplained knee pain. I know what’s happening (tendonitis), but I don’t know why (unless we accept that my knee is an a-hole argument).

I spent a week on steroids and that seemed to help, but then I tweaked it on day 5 of steroids, and three days later, I’m back in the kind of pain I was in before starting the steroids.

With a couple of other things, I’m now two and half weeks removed from my last run, which was just a light jaunt to shake out the post-10K creaks.

My goal was a 10K every other month, and it’s already in jeopardy, and not the cool Ken Jennings kind.

If I go after the race I’m targeting, I’m looking at basically 5 weeks to go from 0 to 10K.

That’s probably not going to happen.

This is going to be an interesting year.

-Q

#ihaterunning

Recapping the Super Awesome Month of Meditation

That is a wrap on the super awesome month of #meditation. #superawesomeyearofme

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I’d say the month of meditation flew by, but all the month’s fly by at this point.

I’d also say I learned lessons along the way, but I almost think the point of meditation is to not learn lessons. I think it might simply be that the point is to be there, no more, no less.

Today in yoga, which at its core is meditation, I went into a different matra than usual.

When I’m engaging in mindfulness meditation, first choice is to focus on my breath. Simply notice it.

My second choice is to narrate. In. Out. Helps keep me focused.

My third choice is gentle reminders that I’m right here and to let things mentally pass, and I’ll attend to them later.

That’s all well and good, but in yoga, the people in the room cause me problems. I don’t do well in crowds, generally, and this was one of those days.

I had to escape without being able to actually escape. I found a new mantra.

Warning, this is a little bit weird/depressing/scary/nihilistic.

I was repeating variations of this isn’t real. Mostly this isn’t real. But I had some they’re not real, I’m not real, I’m not here thrown in.

Of course, I know this is real (to the extent that anyone can actually know they’re real and here; there’s some computer simulation believers out there, so you can always wrap your head around that if you’d like). But it helped. People lead to me thinking about interactions with people, which isn’t helpful when you’re trying to jump back to chaturanga. Pretending they weren’t real if I had to be around them helped. They were no longer people to me, which kind of helped.

And so it goes.


Turning to the future, I’m trying to get my mileage up. I’ve just recently acquired a shin issue that I’m hoping doesn’t turn into shin splints, but I’m not optimistic. I’m trying to up my calcium intake to help if the bone’s taking damage, and I’m going to avoid running until the ache is gone. Not a good sign, but not a real problem yet.

If it’s just a few days of delay, then I’m still on track for getting in another 5K before the year closes out and (possibly) chasing a new goal for the upcoming year: run six 10Ks.

Ugh.

I’m tired thinking about that already.

The plan to prep for the 10Ks immediately follows the end of my Zombies, Run! 5K app cycle. The full app has a 10K prep process, so I’ll just hop back into that (and get caught up on those shenanigans in Abel). Much like the year of the 5K and my foray into a 10K this year, the goal is to finish without completely embarrassing myself, so I don’t expect to run a full 10K. I do expect to try.

That effort will probably result in alternating months, starting in February, to give me time to get up to speed and then time to recover between races. Getting a 5K every month was rough enough, so 10Ks in the southern heat doesn’t bode well.

But we try.

Whenever I think of these goals I set, I can’t help but think how arbitrary they must sound to other people. But at the same time, life is people arbitrarily attaching meaning to things. People getting emotionally attached to inanimate objects, so I can set weird goals every year (plus, I’m completely over dietary goals; I think I might have caused more problems than I solved this year).

Halfway Through Meditation Month & Running Update

We have a two-parter, folks. First up, we’ll go through the month so far in meditation. Then we’ll close with an update on where I’m at with my running.

Meditation: It’s Hard

S0 far, I’m 11 for 14. One day I just stayed up reading. Another I decided to socialize. And the third? I have no idea.

There are some recipes for my success that I’m picking up.

No. 1: Timing

I can’t meditate any old time. Well, I could; I just won’t.

That’s an important thing to realize. It means I know that I need to meditate around 8 p.m. That’s when my body is down enough to sit still but also awake enough to not just fall asleep.

I’ve tried meditating during the day, but it just doesn’t fly. I can’t make my post-lunch brain meditate, and my pre-lunch time is when I’m most productive, so interrupting with meditation meant to help me be more productive seems counterproductive to my productivity.

No. 2: Location, Location, Location

Can’t do it anytime. Can’t do it anywhere.

I need to be sitting. This causes problems. Remember the whole back pain thing? Yeah, that makes sitting still with good posture for 10 minutes a bit difficult. Basically, I can’t do it without something to lean back against. Even sitting in a straight-backed chair doesn’t really work. I need something that I can put my weight against or I’ll start bending forward eventually.

My options for meditating get messed with because of that. Most advice says to be seated. I have really one spot I can do this: sitting in my futon when it’s folded up (and not when it’s flat for sleeping).

I’ve gone a couple of rounds on the floor leaning against my bed, and that’s ok if I’m ok. But if I’m not feeling it, I have to then lie down on the ground, which borders on sleeping.

My comfy meditation spot is now a Walmart futon. Classy.

No. 3: My brain likes to think

I already knew this, but it’s hard to ignore when you’re in a month of meditation. Today’s stray thoughts in session included me considering romantic options (including making some situations up), thinking about how to ask a subreddit about meditation advice, and work. There was more, but there’s a point where you don’t need to know what I’m thinking about.

Basically, my brain likes to cycle through a collection of information when I’m not actively monitoring it, which leads to

No. 4: Have to focus on something

The idea of mindfulness meditation is that you focus on your breath. When a stray thought comes in, you acknowledge it, and then you let it move on by coming back to your breath.

Easy, right?

Nope.

Even when I get back to my breath, my brain’s capable of thinking about breathing and thinking about Star Wars, etc.

The easiest way for me to overcome this situation has been to narrate my breathing, so that I’m thinking  “In” as I breathe in and “Out” when I breathe out.

When I’m on my game, there’s not narration, just focus.

Either way, afterward, I always feel better for having slowed down my brain for a few minutes. Hopefully I can survive the month and keep up a more regular habit moving forward, but we’ll see.

Running Update

Slowly getting back up to speed

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I’m plugging right along to at least be able to survive my first 5K in a few months. It’s been rough going, but only one nagging injury has popped up, so I’ve only missed one scheduled run so far. I’ll go into recovery right before the race, but return to the Zombies, Run! 5K app to finish my training so that I’m not an uneducated apprentice like Luke who inadvertently leads to Kylo Ren and his shenanigans.

After that, I’m not sure if I’ll return to my 25-minute goal or if I’ll chase another 10K. I might just keep cycling through the 5K app and increasing my running each time just to see how I do. Right now, I’m pushing pretty even with my first round with the app, though I’m purposefully pampering myself. It would be interesting to see how I’d do if I wasn’t starting from basically scratch every time I began the program. But that’s a tomorrow problem… Or a November problem, anyway.

I’ve got a 5K on the docket, so the next time you hear from me, it’ll probably be after I’ve gassed myself running beyond my meager means.

Until then, party people.

-Q

Recap of My Week – Struggles of Walking and Running Free

This was the week of lessons.

I learned that walking can come about easily enough under certain circumstances. I also learned that walking can be a pain in the ass when you’re swamped and work what is essentially a desk job.

I also learned that maybe I should run as fast as I want like maybe I knew I should all along.

But before we run we have to walk. More specifically, we have to walk 10,000 steps ever day.

Or try.

I’ve had two blips. The first was last Saturday after running on Friday and yogaing (sure that’s a word) on Saturday and then not wanting to move the rest of the day. Weather was also a contributor, so that was my first missed day.

And then yesterday, I was just blowing and going all day. Unfortunately, all the going was mentally, not physically. I was at 5,000 as work was ending, and I decided it wasn’t really worth it to put in close to an hour of walking so late in the day.

Despite the blips, I’m still averaging 10k steps a day, so at least I know I’m doing ok even if I don’t always hit my goal. 2 misses out of 15 isn’t that bad.

Work is the wild card. When I have a good day at work in terms of managing my time, 10K steps is downright easy. Wednesday, I was about 1,800 shy before I went for my post-work run, and then vaulted past my goal. When I have a bad day, there’s not much I can do. I depend on a morning walk to the office, mid-morning mental refresher, walk to wherever my lunch is, mid-afternoon mental refresher, and the walk from the office. Generally, that gets me close. Yesterday, I got I didn’t get the refreshers, and I wasn’t even close as work was ending.

So while weekends are harder to hit 10K, they’re harder to lose on overall because I don’t have time constraints. No one shows Saturday morning cartoons any more, so I don’t really have anything better to do.

We learned about walking, so let’s learn about running too.

During the past year, I tried to slow down in an effort to be able to run longer.

It was a complete failure.

I kept running the same distance over the same time no matter how I ran. And I was honestly starting to wonder if I was hurting myself by slowing down. My first foot injury came from two slow runs back to back. After trying to run slower in August, I had an issue flare up.

It just felt like I was running more efficiently when going faster. It felt smoother. Like a gazelle. Like a 190-pound (now 185), bearded gazelle. I always assumed it was a product of only doing short distances as a kid.

In the back of my head, it just seemed better. I mostly wanted to increase my ability to run distances so I could resume running faster.

And then I found this:  http://www.runnersworld.com/injury-prevention-recovery/running-faster-could-prevent-knee-strain?cid=soc_runnersworld_TWITTER_Runner%E2%80%99s%20World__Injuries

The summary is that heel strikers (which I most definitely am), put more stress on their knees when they run slower because they have to take more steps to cover the same distance, causing runner’s knee (which I deal with, if I was properly diagnosed). Faster runners put more strain on hamstrings and achilles (neither of which have been problem children of mine).

And that was all I needed. I’m tired of running a way I don’t like so that maybe I can run farther without stopping. I can’t. I tried. And I got hurt along the way. So I’m going back to running the way I like to run. When that doesn’t work, then I’ll try something new, but I’m not running slow just to cave to peer pressure (sure, we’ll pretend it was peer pressure).

-Q

#ihaterunning