I am back!
Sorry to have been delinquent updating my posts, however I have been dealing with an issue that, now that it has been resolved, has re-ignited my passion for running and sharing what I’ve learned with other runners and readers.
On June 26th I had back surgery for spinal stenosis, which is calcium build up within the spinal column, causing “short-circuiting” of the neural network that control my glutes and quads. Let’s start at the beginning of this latest running reprogramming saga.
Last winter I took a hiatus from triathlon training to train for the Carlsbad 5000 road race the end of March. After years of primarily endurance training aimed at being able to run efficiently off the bike after hours of swimming and cycling, my “speed” was more a figure of speech than a reality. 5K time trials in December/January established that 9 minutes miles were now the 6 minute miles of my earlier years. By early February, I had shaved most of a minute/mile off my 5K TT performances, primarily from training with a weight vest on my trusty scooter to improve hip and leg strength in the same range of motion as running while achieving greater intensity than I could running alone. Along about early March, I noticed that my TT times had gotten slower primarily due to a loss of climbing ability on the rolling course which mimicked the terrain of the Carlsbad race. Time to go see Mike.
Michael Cerami is fellow triathlete and sports chiropractor who has successfully treated my occasional bouts of sciatica in the past. He had me lie down on the table and extend each leg in a number of positions in which he would tell me to resist him. To my surprise, there were several positions with each leg for which I could not resist his pressure at all. His analysis was that I probably had stenosis between L3/L4 that were keeping my quads and glutes from fully firing. He also noted that while he could provide temporary relief, I might want to get an MRI to validate his analysis. Then came Jen.
During our next Tuesday morning group run, I mentioned my issue to Jennifer Ruff with whom I have run for years. Her comment was, “Why don’t you go see Ron (her husband), he has a spine clinic.” Duh! So I got an appointment with Ron, who after a similar physical examination and analysis as Mike’s set me up for an MRI. A couple days later we reviewed the results. Even to my untrained eye the narrowing of the conduit (my term) through which the nerves go was obvious, as was the inflammation of those nerves as they exited the spinal column. When I asked why I had not been experiencing any significant pain, just loss of leg strength, he said it was because I had been aware of the change so early on and that, if left untreated, the pain would follow. He then submitted my case to the 6 members of The Orthopedic Surgery Hospital spine panel whose consensus was that surgery would result in a very high probability of regained leg strength and function.
In the meantime, Ron recommended an epidural to relieve the inflammation of the nerves. The afternoon after getting the shot I bent down to pick up something from the floor and realized that I was more flexible than before the shot. Here is the history of my TT performances on the flat 4+ mile (never really measured it) course with respect of various treatments:
04/19 – 42:14 Run in Blades – spring weather – pre-chiro- treatment.
Dr. Cerami suggests getting MRI, which confirmed his diagnosis. My case was sent to Spine Clinic Panel, which recommended surgery. Scheduled for 6/26.
05/01 – 40:19 Run in Blades – similar weather – post-chiro-treatment.
05/10 – 2:00 Duathlon – 5K run/20K bike/20K run Lake Mead – Second 5K slightly faster than first.Thank you Dr. Cerami.
05/16 – 38:16 Run in Blades – similar weather – post-epidural treatment.
06/07 – 38:05 Run in Blades – similar weather – post-chiro treatment.
06/14 – 37:38 Run in Blades – similar weather – post-chiro teatement.
06/18 – 36:42 Run in Blades – similar weather – day after Advanced Muscle Integration Technique treatment administered in Dr. Cerami’s office to “turn right glute” back on (more on this treatment option in blog to follow).
Note: From the first through the last TT, HRs started at around 120>140 for first 10 minutes or so; increased to the 150s near half way; and finished at 165+ for each time trial. I ran at nearly constant 90 strides/180 steps throughout each TT. Since stride frequency was constant, faster times must be related to longer strides and/or shorter contact times – the last of which was a primary focus, especially in last 1/3d of each TT. Conventional training theory to explain these improvements comes up short. There was not enough time between each TT for a training effect in the traditional sense. My degradation in performance and key to regaining form was an “electrical” problem.
Prior to surgery, I met with Dr. Robert Berry who would perform the procedure. He also tested my leg strength and reviewed the MRI with me. He suggested that while most patients remain at the hospital for a day or two after surgery, that he felt I could be scheduled as an outpatient because of my high level of fitness. When asked about rehab requirements, he said that most patients severely reduce physical activity for several weeks before starting more rigorous physical therapy. However, he also noted that he rarely had patients my age who were as fit as I was. When asked what I should be careful of he cited “bending, twisting, and compressing” the back which will take about 6 weeks to heal. I had the surgery and returned to see Dr. Berry for a post-op evaluation.
When he walked in to see me, he said, “I bet you are chomping at the bit to get back to exercising and are here to find out when you can get started.” “Not exactly,” I answered. “The first thing I want you to do is retest me for leg strength and function, please.” After retesting, he looked at me inquisitively and remarked, “This is a miracle. You have full function in both legs. What have you been doing?”
“Not bending, twisting, or compressing my back – but a lot of other activity,” was my response. The whole time I was preparing to run Carlsbad, my partner Susan and I were hiking in the mountains above Park City, Utah, to get ready for 6 days of hiking from hut to hut in the Dolomite Mountains of northern Italy in September. Every weekend found us on the often icy trails above Park City. As the weather warmed our hikes got more frequent, longer, and more challenging. By the time I had surgery, 10+ milers were common and frequent. Because I was aware of the back issue, I hiked with trekking poles, which were longer than what most hikers use. Borrowing from my experiences Nordic cross country skiing, I chose to use longer poles that reached my armpits and could be used to not only reduce impact on down hills, but also contribute to propulsion on the uphills.
The day after surgery, I Nordic hiked for a half hour with absolutely no discomfort. The next day, Susan and I hit the trail for about 5 miles in the mountains, again with no discomfort of any kind. Then I added one-legged, un-weighted squats several times a day and un-weighted scooter workouts twice a week for the next two weeks until the meeting with Dr. Berry. With his astonished approval I have continued these activities and after 6 weeks am back to running better than before the surgery. In fact, I have yet to really test where my upper limits of performance might be. So stay tuned as I continue to reprogram my neural muscular networks for enhanced elite running technique.
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