Just Run Through It?

Holly's beautiful running form at the end of the Mid-Mountain Marathon

Holly’s beautiful running form at the end of the Mid-Mountain Marathon

By Emma Maaranen

It is prime time running season with runners all over the Wasatch Front training for the Wasatch 100, Mid-Mountain Trail Marathon and St. George Marathon.  At Focus Bodywork we are often asked how to decide if a pain experienced during a run is okay to run through or not.  First, pain is your body’s way of letting you know that something is not okay and needs to be investigated.  Listen to your body!  I lump running pain into two categories: pain that develops while running and pain that develops after or continues several hours after a workout.

Pain That Develops While Running

Discomfort while running is part of the game; if you run you will experience pain now and then.  There are times, however, when you need to listen to your body and call it quits. When running pain causes you to alter your gait, it is time to call it a day.  Your compensated gait is a sign that there is a problem, and to run through it in this odd gait will most likely cause more problems and/or usher the painful site into full-blown injury status.  If the pain is not altering your gait, slow down for five minutes and focus on good running technique.  At the end of five minutes check in to see how the pain has changed.  If is the pain has reduced, pick up the pace and see what happens.  If is the pain has stayed the same, try another 5-minute technique period.  If at the end of this second test period the pain has increased or your gait has altered, it is time to walk home.

Pain That Develops or Persists Several Hours Post-Workout

You need a rest day! If the pain has subsided after a day of recovery try an easy run and see how it goes.  If you do not have pain while running and it does not return a few hours after rest, you can resume training.  If not, start with some good home therapy.

Home therapy:

1.)    Day 1 – Take a rest day- a real rest day!  Don’t even go to that yoga class.  RICE (rest, ice, compress, elevate) as often as you can.  Sit in a hammock (with your legs up and iced) and catch up on some reading (If you NEED to call this day a training day I recommend reading “The New Toughness Training for Sports: Mental, Emotional and Physical Conditioning from one of the World’s Premier Sports Psychologists” by James Leohr.)

2.)    Day 2 – If your pain is still hampering you, try a regiment of OTC anti-inflammatory, such as Ibuprofen.  Initially this will mask pain symptoms, but if taken as prescribed for 5 days you will reap the anti-inflammatory benefits of the medication.  RICE.  I know you are panicking about your fitness diminishing already (it is not, this takes two weeks), so try some cross-training, such as swimming or biking.  If your cross-training sport increases any of your pain symptoms, you need to try something else.

3.)    Day 5 – If your pain has not resolved, it is time to see a professional.  A sports massage therapist (like the ones at Focus Bodywork), a physical therapist or sports medicine doctor can help you develop a plan to get back to running pain free.

Endurance sports regularly require athletes to push through discomfort.  Should you “just run through it?”  It is important to evaluate your pain keeping in mind that cutting a training day short may save you several weeks of being side-lined.

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One Of My Favorite Clients And Why

By Emma Maaranen

I work with athletes of all flavors: a stay-at-home Mom  training for her first marathon to lose baby fat and carve out some time for herself, a professional Extreme skier trying to keep his spine healthy as he drops 80-foot cliffs, and a 14-year-old US Figure Skating Team member who trains more hours in a day than I am even awake for.  I love the variety of motivations my clients have to be athletes.  I am regularly introduced to new sports (like skeleton) and constantly dive into medical journals to learn how to meet each of these clients’ novel sport and injury needs best.  Recently I have met my biggest challenge.  Her name is Micah, and we can all learn a lot from her about injury psychology, trusting the healing process and the importance of “homework” to get back to the things we love.

Micah is a runner and, through some poor footwear decisions, developed pain in her feet.  Because she was unable to continue running, she saw several specialists to diagnose her foot pain.  Many doctors, MRI’s, and cortisone injections later, she did not have a diagnosis or relief.  She was recommended to rest and hope that the problem resolved itself; it did not.  It soon became painful for her to even walk.  Months of limping soon made her hip painful.  This is the point where I started working with Micah and her medical team.  An insightful podiatrist radically changed her footwear, which  changed how her heels interacted with the ground until finally she showed signs of improvement in her feet.  However, as her feet improved, her  hips got worse.  I surmised that all the gait alteration to escape the pain in the feet required new and novel uses for her hip joints.  I released the tight and overused muscles in her hips, stimulated the muscles that were not pulling their weight, did gentle joint gliding for the hips and lower back to encourage synovial fluid production (lubrication for joints), and introduced lateral movement into Micah’s rehab work to strengthen her atrophied muscles.  I was glowing as a therapist after this first session.  Micah was in the least amount of pain that she had been in for months, and she was finally hopeful she would return to racing on the trails again.

The next morning I received a panicked phone call from her mother.  Micah was worse, much worse! I reviewed the therapy I had done with her and was completely confused; at worst she should have had no change in her pain but be a little touch sensitive in the muscles I released.  We talked further and I learned that Micah felt so fantastic after my work that she promptly ripped around in the foothills with her friends that evening.  She believed that since she felt good she could go back to doing everything she did before, right away. Even though I explained to her during our session that she would feel better, a slow and methodical return to activity was essential.  This often is ignored by clients as the thrill of experiencing some improvement is seductive.  There are muscles to strengthen and movement habits to change that will take time and practice, plus some tissue healing that will take about six weeks to complete.  We set up an immediate follow-up session.

During our second session I spent considerable time with Micah teaching her the strength and movement exercises necessary to properly restore her hip biomechanics, showing her which tight muscles could benefit from self-massage, and some stretches to promote a full range of motion.  After our session I believed Micah understood the process to get her hips healthy again and a realistic time-line for returning to sport.

A few days later I received another call from Micah’s mom.  This time, Mom was laughing!  Mom shared with me that I must have gotten through to Micah as she was going out of her way to show her the exercises she was doing, and was doing them almost every chance she got.  Relieved, I saw Micah again to further therapy.  This time Micah had to show off.  She spun in circles demonstrating the lateral movement exercises I had asked her to practice; she did a forward fold placing her head between her legs to open up her hips, then went over to a piñon tree and pressed her hip into a knobby branch she obviously had pruned so she could do some self-therapy.  I was amazed;  Micah is a horse!

Micah Getting Therapy

It has been a bumpy road, but Micah is back to racing around the trails with the heard.  Even though Micah is a horse, her healing process from a frustrating injury is the same as yours and mine.  Injuries can be tricky to diagnose.  It often takes a few visits to various health care providers to figure out how to get an injury healed, and often there are multiple factors contributing to the pain. Often it takes a team of “experts” to come up with a plan.  When finally we see some improvement, it is difficult not to overdo it and set ourselves back.  Patience!  Being an active participant by doing your “homework” and becoming educated about your injury and healing process is essential.

Me, Teaching Micah Her “Homework”

Micah is my first equine therapy client, and it has provided an incredible learning experience for me.  I am available for other equine sessions; call Focus Bodywork if you would like to know more about my credentials, what is involved in a session and rates.

The Slippery Slope to Becoming a Dope

By Emma Maaranen

I don’t think I engaged in as many conversations about Lance Armstrong when he was topping podiums daily at the grand tours of Europe as I have been the past few months regarding Lance’s illegal doping scandal.  Serious cyclists argue about the edge gained and strategies employed with doping on cycling teams, parents ponder the safety of their athlete children in professional sports, even my Grandfather debated the role of politics and economics in the celebrated athlete falling from grace, but beneath each persons rants is a little voice inside cautioning us that if we had been in Lance’s shoes we may have befallen the same fate.

Me, trying not to be passed at the finish line of a race.

I am a competitive athlete.  I systematically train for races, I have a nutritional strategy to maximize my fueling for efforts, and I spend hours reading and discussing the nuances of my sport, mountain biking.  I know that I must suck down a gel twenty minutes before the start of a race to ensure I don’t bonk at the 40 minute mark.  I know I must carefully warm-up my adductors (inner thigh muscles) to prevent cramping.  I spend extra time training technical descents at speed because they are my weakness and visualize my success on these before I go to sleep.  I am not afraid to put in the time to train and try out new things to improve my athletic success, even if they are a bit strange.  This year I read an article about a molecule found in beets that would increase vasodialation (allowing more nutrients to reach muscles faster) if consumed pre-effort and actually tried it on a training ride just to see if it might give me more sprinting power.  If it worked, the effect was negated by having to slow down for vegetal burps.  I decided to stick with the pre-race gel.  However silly as my personal guinea-pig experiments may be, I wonder if this is a healthy scientific quandary into my athletic potential or if this is the first step into logic that can lead one to think using illegal substances for sport is ok?

This May at the Grand Fondo New York several amateur riders tested positive for EPO and HGH.  These were not twenty year old semi-pro riders on the cusp of being asked onto team Rabobank, these were fifty-something Cat. 2 or lower riders in recreational cycling clubs!  They may take their sport seriously, but they can not think they will “go pro” or get some serious monetary payout for their performances. These athletes simply got caught up in trying to be the best cyclist they could be.  By their accounts, dabbling with performance enhancing drugs started in an effort to keep up on the club rides as they aged.  But the gains in speed, endurance and recovery soon put them at the lead of the pack.  This new found role was exhilarating, enough not to want to let it go.  Soon they were adding more drugs into the mix, altering doses scientifically to match training and race day needs, even lying to doctors about medical conditions to get prescriptions for banned substances.  If you stopped, would your training partners become suspicious since your performance would drop? Who would ever think to drug test a recreational cyclist? But a podium finish in this case did warrant a sample collection and the gig was up.

In a candid account by one of the dopers, it becomes clear that the motivation to start performance enhancing drugs came from a desire to maintain a competitive level that was harder and harder to maintain with age, career and family obligations, not to cheat into victory.  But once you have success, how willing are you to do what it takes to have more?

It is obvious that using performance enhancing drugs is bad.  The side effects range from increased body hair growth and tender breasts to stroke and cardiac arrest.  Being caught will ostracize you from your sporting community and may hit your bank account. But is the seduction of glory so strong that these possibilities seem minor? As an amateur, bragging rights to my friends will not be enough to tempt me, plus I’m so terrified of unknown side effects of pharmaceuticals that I avoid OTC’s.  Still, I wonder if the possibility of success on the world stage along with pressure from a professional team would tip the scales?  For Lance it seems it was.  I take this as a cautionary tale, it is a slippery slope to become a dope!

Olympic Fever Possibilities

By Emma Maaranen

I am an athlete.  I am on go-go mode 95% of the time.  I hate sitting still.  But, for two weeks this summer, I couldn’t leave the sofa.  I didn’t have time for laundry or groceries, let alone distance training!  I had… Olympic Fever.  And I was not alone.  During the Olympics it seems like everyone is addicted to watching the TV feed: weekend warriors, spectators, and soccer moms.  Even kids are into the Olympics.  A five-year-old from my neighborhood nearly knocked me down while sprinting the length of the sidewalk yelling. “Usain Bolt coming through!”

I love sports, I love being an athlete.  I’ve even been known to play a team sport here and there, but I do not regularly follow sports on TV.  The Olympics, however, mesmerize me.  Like every girl growing up in the ‘80s, I wanted to be Mary Lou Retton and get a perfect 10, I was shocked when Tanya Harding made the desire to win a criminal act, and I noticed being an athlete might be risky with Greg Louganis’s infamous platform dive.    It is the combination of these things that makes the Olympics special to all of us.  Every single athlete there is AMAZING – yes, every single one of them!  On top of overcoming political turmoil, discrimination, financial obstacles, and homesickness, many of these athletes have overcome physical assaults that should keep them from being on the world stage doing their sport.  Did you see the swimmer who is missing a leg, the runner on two prosthetic legs, and the 47-year-old woman gymnast competing for her third country and sixth summer games?

Oscar Pistorius inspiring all of us!

No doubt Olympic athletes are great.  Heck, they may be mutants!  But they have a secret.  They know that our bodies are capable of unfathomable feats of repair and resilience.  They know that the mind, when put to task, can create things previously unknown.  They are not confined by what is expected or what has happened in the past.  These individuals ask, “What is possible?”  With this belief there is no reason to expect you can’t return from injury completely.  In fact, you should believe you will actually be better than before.  Jared Campbell, who returned to ultra-running after an Orthopedist told him that he never would, has a great outlook on injuries. “Injury is an opportunity for my body to adapt to the activities I love.”  With an attitude like that it’s no surprise that Jared is one of the most successful Ultra Marathoners out there for the past 10 years!

Now that my TV is collecting dust again, I am going to be an Olympic athlete in my heart and just see what is possible.