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7/14/10 Personal Trainer at 7AM – Building Endurance
So, this week, I met my personal trainer, Melissa, at 7AM on Wednesday morning. We immediately got to work with pushups first. This time the push-ups are on the weight bench, not the Smith Machine. I figured that would not be much different from using the Smith Machine, but I was totally wrong! It is much harder to do the push ups on the weight bench because it changes the angle of your hands and, thus, the muscles that you use. I was able to do 12, though, which is a number I am very proud of 🙂
Then, on to squats, of course. The weight for the squats this time was a 45lb barbell (no extra weight on the barbell – yet!). I have to do 18 reps and 3 sets. Yes, my butt hurts.
Then an exercise for the shoulders and a fabulous exercise for my hamstrings. Also, 18 reps on all and 3 sets 🙂
Next set – starts at Smith Machine, but this time, I start resting on my elbows and my knees. Then, I put my foot on the bar (pick one – left or right an switch for the next set) and push up. That is it. It is perhaps one of the best glute exercises ever! However, I had difficulty with my left hamstring working instead of the glute. I swore up and down that it was not sciatica, but later that night I had the familiar static-electric feeling in the hamstring/calf muslces. So, it was sciatic. However, Travis gave me another exercise, but I think I can do it on the Smith Machine too (same thing with leg bent at a 90 degree angle). Also, 18 reps. Working on Endurance!
Then onto the weight weight bench where I do one arm flies with my knees off the bench at a 90 degree angle and my opposite arm hugging my stomach. This is a very difficult move because you cannot counterbalance yourself. You must stay centered. 18 reps on each arm at 10lbs. Very challenging – especially for the left side.
BAck to the floor for some skull crushers, which work the triceps. 10lbs in each hand and you start laying down holding the weights xtended straight over your chest. Then you lower on either side of your head (not touching your ears or skull in any way – this is why it is called the skull crusher b/c if you are not careful you can crush your skull). Push back up to the ended position and then lower to where the top of your arms are on the floor and forearm is at a 90 degree angle from the upper arm. Then push up again. Very challenging. Also 10lbs. Also, 18 reps.
Finally, take a 9lb bar weight and lay on a side with under leg bent and upper leg straight. Lay bar weight on top of straight leg and hold slightly in front of hip. Lift top leg 18 reps. Feel the BURN!
Repeat 3 times.
This is not a difficult as last week as far as lifting the weight, but the 18 reps are the kicker. Melissa said that last week was to help build muscle, and this week is to work on giving that new muscle some endurance and speed. So far, I’m very sore on Day 2 after the workout. I’ll be doing the workout again tomorrow.
7/9/10 Chiropractor and Massage for my Feet Only!
Did you know that a massage therapist can spend a whole hour on just your feet? Well, I was a little skeptical, but it is true! However, before I go there, I want to talk about my adjustment last week.
I started with just the massage and no adjustment, but when I got there I was informed that if I wanted an adjustment they could squeeze me in. So, I thought about it, and I noticed that my neck hurt, my hips felt a little stiff, and the L5 felt that it could use a little movement. Ok, I’m in – I need an adjustment!
So, I go back and Dr. Larry gets some awesome pops on the neck. Then, the mid back was not so mobile. My hips were normal, my ankle was really a big movement, but my low back was not a much as I had expected.
I then decided to take this time to brag about how my multifidus muscles felt much stronger when I was doing my PT exercises. Dr. Larry then tells me that my back does, in fact, feel more “balanced” 🙂 Hooray! It’s working!
Of course, after the whole session I am really feeling flexible and awesome. Then comes the massage on my feet.
I did get a tiny bit on my right shoulder because there was this knot right over the shoulder blade….oh, nevermind.
Anyway, Lynda actually spent one whole hour on my feet. She massaged the back of the heel (I keep meaning to look up what is back there anyway), and it was amazing the kinks that were there – I mean, who knew the back of the heel had issues?
Then, she worked on the top of the feet: the band that holds your ankle together (that’s a doozie); the posterior tibial tendon (all the way up the tibia) – it did a really nice release; the muslces on the outside (anterior) of the tibia; and, finally, the underside of the foot. Wow! That underside of my left foot was all kinds of messed up. That sucker was painful, but when she finished I had excellent range of motion and mobility in general.
Yes, folks, one whole hour on the feet (ok, maybe minus 10 mins on the shoulder). I highly recommend having an hour long foot massage. I highly recommend Lynda. However, you will have to wait until she has finished her bike ride across the entire state of Ohio.
7/14/10 Physical Therapist – “You are a lot stronger!”
Today I had a Physical Therapy appointment with Travis, and when he did the test for strength on the gluteus medius, I was able to resist quite successfully! This is a far cry from how I did on the test in February. Then, he and I got to talking about how it would have been great if we had had actual measurements in February rather than just pictures.
So, we decided to do the measurements today since I am not done, yet. There is more work to be done and more success to be had 🙂
Travis drew a line on the inside of my foot just above the arch, and he explains it below:
“The test where I drew a line on the inside of your foot is called the Feiss Line and with it I check the degree at which your navicular [the bone basically at the top of your arch] changed from a non-weightbearing to a weightbearing position. Â Ideally the navicular should stay very close to this line and if it falls closer to the floor it indicates varying degrees of flat feet. Â The distance on your R [right] foot was unchanged and on the left it was 5 mm (virtually unchanged).”
Right Feiss Line
Left Feiss Line
Woohoo! Did you read that?! My left foot arch was virtually unchanged! I’ll bet that in February it would have been quite different. I cannot help but smile at this 🙂
Next, I had to lay down with my feet hanging off the table so Travis could find subtalar neutral on my feet. He then drew a line on the heel of my foot. This is called measuring the “degree of eversion”, and he explains this below:
“Then I also measured the degree of eversion noted at your subtalar joint while weighbearing and it looked great. Â There was a minimal amount of eversion noted on the left foot and essentially none on the right foot.”
Right Eversion
Left Eversion
OMG – Are you reading what I’m reading? He just said that my right foot is basically “normal” when I am standing! I am standing in a virtually subtalar neutral stance on the right foot, which is as good as it gets. The left is only off by a tiny amount (2 degrees or something).
Now, this does not take into account when I am running, which still has some falling of the arches. So, more work to be done with strengthening the foot. However, standing still with almost normal stance is AWESOME!!
So, today he gave me 6 exercises with the caveat that I may stop the other exercises unless I have symptoms that the exercises correct. Hooray! Less exercises! Oh, wait, these new exercises are not easy….
First, I isolate the gluteus maximus by laying on my stomach and bending one leg at a 90 degree angle at the knee (where else would it bend at a 90 degree angle – duh!). Then, I lift the leg using the glute 10 times for 3 sets.
Next, I do what he calls the “stork”. I stand on one leg leaning against a workout ball. Then, I do one-legged squats (essentially) keeping my hips aligned (not letting one fall). It is harder than it sounds.
Then, he told me that I would be doing a side plank, and I told him that would be too easy. So, he told me to balance my arm on a Bosuâ„¢, then do the side plank. Once in a side plank, I lift up the top leg for 10 reps and 3 sessions. Yeah, that’ll teach me to talk smack.
Another exercise is an oldie, but goodie. I stand on a step on one foot with that foot angled in. I then lift to standing on the toe and lower to slightly below the top of the step and repeat for 10-15 with 3 sets.
Finally, I balance on a very squishy circle with my eyes open for 30 seconds. Try this at home – it is harder than it sounds. When that becomes easy, I close my eyes and when that is easy I close my eyes and then tilt my head. I’m going to look really hot in the gym when I start tilting my head 🙂
Anyway, a very awesome visit, and I hope to document even more cool changes!
Personal Trainer and Super Sets! 7/7/10
On Wednesday of last week, Melissa gave me the beginnings of my first super set, which is when you lift heavy weights quickly with multiple exercises in a row (I think). It is definitely a “big girl” exercise as I was exhausted and sore afterward and the next day.
I was extremely pleased with what I was able to accomplish because I was doing a squat with a press starting at the middle of the up movement with a 12KG (approx. 26 lbs.) kettle bell. I squatted with 26 lbs! That might not sound like a lot, but just five weeks ago I was having a hard time squatting without any weights. Now I not only squat, I press!
I am also down to the second rung on the Smith Machine for my assisted pushups.
I feel stronger, and I think I look stronger. I am still having a hard time riding my bike up the 8th Ave hill, but that will come.
I am also continuing my physical therapy exercises for the back and foot. Total it takes about 45 minutes to get through all of them. Thus, I do them approx every other day.
Whew! Still more to do! More success to be had 🙂
7/4/10 Waterskiing on Lake Ouachita in Arkansas
Posted by admin in Reflections on July 15th, 2010
Well, I traveled to the truly exotic location of Lake Ouachita in Arkansas for the 4th this year, and boy was it fantastic! For those of you who do not know me very well, I am a terrible water skier. I rarely get up on the skis and almost always eat tons of lake water. However, this year, I was able to ski until I was ready to drop!!! It was phenomenal 🙂
However, while skiing, I noticed that my left leg was getting tired. So, I decided to give the left leg a rest and just transfer the bulk of the work to the right leg. When I did that, I noticed that my brother-in-law began scrambling around the boat like a mad man. I thought to myself, “What is he doing?” Then, he came up with a camera. Now, we had been skiing for two days, and everyone had been photographed while skiing. So, I couldn’t figure out why he had decided that I needed a photo at that particular moment. I also decided that I was ready to quit skiing because my right leg was getting tired of doing most of the work. So, I signaled to go down, and I dropped, which was awesome because I’m usually wiping out in some truly epic fashion.
When I got into the boat, my brother-in-law was animatedly telling me how freaky my legs were because I looked completely bowlegged. Apparently, my left knee had gone in toward the right knee at a grotesque angle. I was so excited by this discovery that I asked him if he had gotten a picture, but he couldn’t figure my camera out. Thus, no picture 🙁
However, I decided to ski again the next day so that I could get a look at my left leg. Sure enough, once I was up and skiing, my left knee decided to bend in toward the right leg in a truly freakish angle. I worked to get it straightened out by pushing harder with my big toe on the left foot. This worked! However, as soon as I stopped looking, it went right back toward the right leg again.
I have been water skiing several times before this, and I have never had this particular problem. My theory is that I am definitely using the posterior tibialis tendon in ways that I have never used it before. Thus, it is still adjusting to the extra responsibility – even in water skiing!
Although it was just skiing to everyone else, it was another affirmation to me that I am on the right track with my training! Go me!!! 🙂
Physical Therapist 6/29/10 – MORE PICTURES :-) and an EDIT
This last week has been another bummer. On Friday, I spent the day in the kitchen making tomato sauce (Picture 20lbs of tomatoes, and you’re on the right track.) and baking a Yay-You-Finished-Your-First-Marathon cake for my husband. By the time he got home, my left posterior tibial tendon was crying out for mercy.
Today, at my physical therapy appointment, Travis started me back at what certainly does feel like square one. 🙁
This is just part of the process. I know that my foot is improving because it is USING the posterior tibial tendon, but the tendon is not strong enough (even with all the work I’ve put into getting it stronger), yet.
The Story of Muscle: [Edit – I stand corrected :-)]
Travis Orth, my physical therpist, had a few corrections on my story of muscle.
“So, I think you got the story of muscle close, but not quite right. Â I probably was not as clear as I could have been so here is another explanation. Â With strengthening, if you are actively completing exercises for the first 2 weeks there will not actually be an increase in muscle size, but you may experience a gain in strength. Â This gain in strength is attributed to increased muscle fiber recruitment (of muscle fibers that you already have) from your brain to that muscle group. Â It takes approximately 4 weeks to verify the increase in muscle cross-sectional area, so any strength increases prior to this point are likely attributed to improvements in neuromotor recruitment. Â This is all somewhat flexible and there is likely some actual muscle growth prior to the 4 weeks, but they are the numbers and guidelines that I like to follow. Â So with your feet, there are likely increases in muscle size, that is why you see such a dramatic difference in foot position. Â If you were simply recruiting more muscle fibers of the muscle that you already had I don’t think you would see these changes. Â Furthermore the changes are likely due to increased resting tension on the tendon, tibialis posterior, that is pulling up the arch of your foot and preventing collapse of the foot. Â This increased resting tension is from actual increased muscle size, so congrats you did it! Â However, as you have noted, there are still gains that can be made and the muscles can get even larger and stronger.
A lot of the information that I have provided is from the Shirley Sahrmann book titled “Diagnosis and Treatment of Movement Impairment Syndromes”, and she cites the article:
Moritani H, Devries HA: Neural factors versus hypertrophy in the time course of muscle strength gain. Â Am J Phys Med 58: 115, 1979.”
Travis wrote the above quote in an email after reading the blog. I thought I would share it with all of you fine folks so that you are not misguided by my not as educated guesses on muscles 🙂
——Back to the original post—-
All of this muscle building got me wondering just how my feet may or may not have changed. So, now for the pictures!
Before 2.27.10
After 6/29/10
LOOK!!! I think I can tell that my left ankle is not caving as bad! Yahoo!!!
Before 2.27.10
After 6/29/10
Are those the same feet and ankles? No wonder my posterior tibial tendon is sore. Look at all the work it has been doing! My left ankle is noticeably straighter in this picture. I cannot tell you how very good it feels to have some part of my hard work pay off 🙂
Before 2/27/10
After 6/29/10
After careful scrutiny of these two pictures I have several things of note.
1. I really need to keep the perspectives and lighting the same.
2. In the Before picture the left foot looks like a fan, but in the After picture, it is beginning to look more like a foot. i.e. the left foot getting thicker and straighter from the heel to the toe. 🙂
3. I think I see some muscles that weren’t there on the outside of the left foot!!! Yay!!!
Overall, I am really liking what I see after a mere four months! That is all! And that is a lot. I am looking at a very long time frame. The goal will come. It just might take another year.
Video!!!
Posted by admin in Training (running, cycling, etc.), Try This! on June 25th, 2010
At long last, I am going to share those videos that I have been promising.
Video #1 – Me Running from the side in late May 2010. You will see 5 seconds in my super stiff running shoes and 5 seconds in my Vibram Five Fingers (TM).
Of note: First, I run like an old lady, meaning that I have a very short and inefficient stride. This indicates that I have tight hip flexors, which has been backed up by both my PT and my Chiropractor.
Second, in my running shoes, my stride is really short, while in my barefoot shoes I extend my back leg a little more.
I find this video very eye-opening. No wonder I run a slow mile!!! I am completely wasting energy and holding myself back with my stride.
Video #2 – Me Walking heel view late May 2010. The only video I have from the heel view is of me walking/running in my running shoes.
Erin Walking Posterior May 2010
Of note: First 5 seconds are walking where the problems of the left foot arch falling are not evident. Second 5 seconds are running where several issues are quite evident. First, my left arch does fall, which means many bad alignment issues further up my leg. Plus, the major pressure is on the posterior tibial tendon to keep that arch up. Last, my right foot is turned slightly out, which causes a torque in the right knee, which I have evidence of my body feeling in that my right knee is the one that had “patellular tendonitis” (i.e. your knee hurts, therefore you have an -itis). Someday I will figure out how to get a video of me in my barefoot shoes up here, which really shows the left foot caving in.
These videos brought to you courtesy of many long hours of working with the video editor by my Physical Therapist, Travis Orth.
I also want to say that iMovie made it possible for the clips to be short and provided the ability to play cool songs rather than the foot slapping soundtrack the videos came with 🙂
Personal Trainer – Wonderful and Creative 6/3/10
So, after all that Physical Therapy/Chiropractor/Massage day, I found out no flexion, meaning very few of my old workout moves could be done. For example, no sit-ups, no dead lifts, no twisting movements (for good measure) and no lunges (also for good measure). What was I going to do for a workout?
I let Melissa, my personal trainer, know of these restrictions in advance so that she could have ample time to figure things out. Well, she was quite ready, and she told me that she has clients who have back problems all the time. So, no biggie!
Plus, despite the restrictions, this was no easy workout! She said that without lunges, that pretty much leaves squats, but it is not a problem because there are tons of those 😉
Well, good.
I can also do plank, which she took advantage of by adding the side plank. Whew, I tell you, it is really a workout, now.
I am starting to really feel stronger in every day life, and I can see the changes in my body. Finally!
Now, to get all this cleared up so I can run!
Physical Therapist, Chiropractor and Massage Therapist – Oh My! 6/2/10
So, the trifecta hits in one day! I must say that I truly do have some of the BEST doctors here in Seattle working for me and my high maintenance body.
This morning I went to Travis Orth, my awesome physical therapist, to report on my exercises. Lo and behold it is NOT my piriformis muscles because all that piriformis work did not do a whole lot. He said that he really thought it was my back, which was fortunate because I had a chiropractor appointment this evening. So, I have a whole new set of exercises to work on the multifidus muscles, which function to move the spine as a whole.
Fun Fact: according to Dr. Larry, my chiropractor, the multifidus muscles are unique in that each section works independently of the other sections both up and down the spine as well as the left and right. This means that the right lower multifidus can fire independently of the upper or left multifidus. Cool, huh!
Back to Travis, since it is my back, I am no longer allowed to do any exercises with flexion (meaning bending over). So, the dead lifts are out; the balancing bends, out; lunges, out (for good measure; biking, out (sitting in flexion); etc. However, I can walk (on treadmill or outside) and use the elliptical machine.I also have to sit in the neutral spine position at all times.
Fun Fact: To find neutral spine, lay on your back with your feet on the floor and knees bent. First lift your lower back in as high of an arch as possible. Then, press your lower back down as much as possible. Neutral spine is the position in between these two positions. Thanks, Travis!
So, I then head over to Dr. Larry’s office where he says that he thought he was my back all along 🙂 Anyway, the L5 adjustment was just the same as my lower back adjustment, but more focused on the specific vertebrae. I also requested a set up on the shoulder, which did the trick, and he pulled my left hip and ankle to pop them both. It was a fantastic adjustment day.
I then head into my massage therapist, Linda this week (“Where’s my jello?”). So, I’m explaining the sciatic and how it’s not piriformis, etc. Somehow I tell her my hip flexor (the ilopsoas) is really tight on my right side. She says that it is connected to the L5 vertebrae, and that she has to go in from the front to get to it since it is a deep muscle. Wow!!! I had never had anything like that done. Plus, if the hip flexor is pulling the vertebrae to the right, then no wonder it is the left sciatic nerve with issues.
This is getting better and better! I’m feeling like we’re about to figure some major stuff out.
Well, this massage was simply wonderful and very needed. I had knots in my right and especially my left quadriceps and my left hamstring was really, really sensitive. Linda said that my IT bands felt way better because they were moving rather than just stuck together! Yay!!! That is awesome because I have been working on them for a very long time, and, finally, I have confirmation of progress! Yippee!!!
Also, she worked on the left and right ankles. Well, that left ankle hurt me and apparently her as well because it was so tight. Then, she moved to the really weird iliopsoas muscles. She basically pushed down through the hip bone to the back where she just kind of pushed on the hip flexor. My left side was super easy, but my right side (the tight one) was incredibly painful.
I also asked Dr. Larry if I needed to sleep a certain way, and he said no. Just sleeping on different sides is good enough, and my husband confirmed that I am definitely sleeping on multiple sides with the fact that I always end up with the covers on my side or wrapped around me as proof. Dr. Larry also said that if my hip flexor was tight he would do some activation on it next time.
So, in summary, no running and no exercises with flexion until I have had a chance to further strengthen my back and get the sciatic inflammation down. Still a work in progress….
Physical Therapy Visit 5/26/10
It really does take a Village!
Today, I went into Travis after having an increase in the “pulling” sensation in my left hamstring and sometimes my upper calf muscle. I showed him where my problem was, and he said that he did not think it was my hamstring. After several tests, he hypothesized that the sciatic nerve is being irritated by the piriformis muscle (this is a muscle that wraps around your hip bone from the tail bone to the top of the femur or big leg bone).
HA! Once again the symptom is not really anywhere near the problem! The idea is that the sciatic nerve runs under the piriformis. Thus, when the piriformis is tight (mine is), then it places pressure on the sciatic. Pressure on the sciatic equals irritation further down the leg.
So, if this sciatic nerve hypothesis is correct, then it explains why glute exercises irritate it. When I work out my glutes, then I am definitely tightening the piriformis muscle, thereby irritating the sciatic – VOILA! My hamstring feels like it’s “pulling” or doing all the work.
Wow, if this is correct, I am going to advertise for real for my physical therapist!
The exercises:
I am to do a slumped stretch where I slump over as much as possible with my hands completely limp and resting on the chair behind me while I lift my leg just enough to stretch but not irritate the sciatic nerve.
Then, a “press-up” where I lay on my stomach and press up with my arms. This is to help relieve any pressure that might be coming from misalignment in my back (I’ll get back to that as I am now going to call my chiropractor to consult him).
Next, a bridge to specifically use my lower back.
Finally, a stretch for the piriformis.
Oh, I’m also supposed to foam roll the piriformis when I foam roll the IT Band.
So, I have a plan. I have a new diagnosis that is much more plausible. However, this is still a hypothesis.
As for how my chiropractor fits in: Travis said that when folks have sciatic nerve problems a lot of time it starts when the vertebrae put pressure on a disc. So, there could be a possibility of my having a disc out of place or something, but my symptoms are so mild that it is probably not that severe. I am going to call Dr. Larry tomorrow to talk about it.
Anyway, several things fell into place if the sciatic nerve and the piriformis are to blame. First, I have not had problems with the sciatic in a very long time – maybe a year, and that includes all the running I did at the start of this project. The one thing that is true for that point in time is that I was getting a back adjustment and an hour-long therapeutic massage every two weeks. It has been over 5 weeks since my last massage, and I had not had an adjustment in 4 weeks when I saw Dr. Larry last Friday.
Put that all together and my piriformis has had the chance to really get tight, and my back could have gotten all kinds of out of whack. Plus, when you are not getting regular adjustments, your body tends to not hold them as well. I know all this seems to point to the fact that once you start chiropracti you never stop.
Well, I don’t think it’s like fast food where you become addicted, I think it is something that your body actually needs on a regular basis. I also think that everyone should get a massage at least once per month. With our sedentary lifestyles, our bodies do not get the constant movement that they were made to do. So, they get all “stove up” or tight and run down. The chiropracti puts everything back into alignment, while the massage relaxes the muscles and helps the body to hold the correct postion, especially when supplemented further by strengthening and exercise.
However, I must bid you good bye as it is time for me to ice my butt. Have a great evening!