First Visit: Initial Diagnosis
During my first appointment with Dr. Jess Greaux at Innersport I learned that my suspicions about the pain originating from the peroneal tendons and peroneal muscles was correct. Unfortunately, I was hoping that I had a simple tendonitis, but her initial diagnosis is that I have tendinosis. Tendinosis is defined as damage to a tendon at a cellular level. It is thought to be caused by microtears in the connective tissue in and around the tendon, leading to an increase in tendon repair cells. Explained another way, tendinosis is an accumulation over time of small-scale injuries that don't heal properly; it is a chronic injury of failed healing. She pointed out that I had a build-up of scar tissue all along the side of my right calf where it was currently experiencing tenderness and pain.
Dr. Greaux (or Dr. Jess) used Active Release Technique (ART) and the Graston Technique on the side of my right calf where the muscles and tendons were tender to the touch. She also applied Spyder Tech tape to the side of my calf. My first visit was on a Thursday, and by Sunday the pain and tenderness on the side of my calf was dramatically decreased. That Sunday I even went for a 4 mile and I had NO PAIN! This was amazing considering just prior to my visit I was experiencing pain after running a mile or less.
Second Visit: Video Analysis
While things were looking up, I still awaited finding the cause of the tendinosis. Dr. Jess had me do a running analysis during my second visit. In order to analyze my stride, Dr. Jess' assistant took a video of me running in front of the office at the beginning of my appointment. She took a video from the side and from the front/back. As I ran for the video I purposely didn't think at all about my stride so that I would demonstrate whatever bad form I have when I am not paying attention. Dr. Jess analyzed the video and we discussed what was out of alignment. I was embarrassed to find out that I was heel-striking worse than I thought I was, I wasn't taking enough steps per minute, and my feet were staying on the ground too long. One of my hips was also dropping down more than the other one. All in all, my alignment and my form need improvement.
A Metronome
After seeing the weaknesses in my running form, Dr. Jess directed me to purchase a portable digital metronome to run with. She said if counting every foot-strike I should be at 176-180 on the metronome. If I am counting one foot strike, it should be 88-90 on the metronome. She also directed me to do running exercises which I basically call "knee thrusts" where you thrust your knees forward as hard as you can, lifting your leg in a more exaggerated fashion forward. Finally, during both of my visits she gave me several different exercises to do at home, some stretching exercises and some glute strengthening exercises. Dr. Jess also told me during my second visit that until further direction from her, I am not allowed to run more than 3 miles every other day. She didn't say I had to give up on running the San Francisco Marathon, but also didn't say that I could. So the jury is still out on that issue.
Like a good student, I purchased a metronome immediately after my second appointment so that I could start running with it. I purchased the Seiko DM70B Pocket Digital Metronomee, and had it delivered within two days to my office. I ran with it on Thursday and found it was challenging at first to make sure I was taking enough steps per minute. On Saturday while at the gym I ran on the treadmill and instead of using the metronome I just counted 30 foot strikes for 10 second increments every few minutes to make sure I was taking an average of 180 steps per minute.
This week I have two appointments, Dr. Jess recommends that her patients come twice a week during the initial weeks. I will report back soon with any updates.
No comments:
Post a Comment