If you’ve caught my last post, or noticed some of our Instagram photos (@prairieprincessrunners) or tweets (@PrincessRunners), you’ll know I’ve been rehabbing a bum leg for just over 3 weeks now. Thankfully, I’m finally out of the really acute phase where we were trying to reduce inflammation and do mostly ice and rest…that was agonizing. Now, I’m working on getting back in the game, and hoping to set a new 5k PR at the end of August, and a 10k PR at the end of September. Ambitious, I know.
Anatomy of the Injury:
This injury is really a perfect storm of stuff that I have been lucky enough to experience all at once, all leading back to my lazy @#$!! It has manifested as knee pain…but there is really nothing wrong with my knee.
1) Tight IT band. Most runners have experienced this one. My IT has been particularly grouchy closest to the knee, and less so toward the hip. It took about 2 weeks, lots of ice and heat, and about 3 trips each to massage and chiro/Graston, but it has finally relaxed.
2) Exaggerated Q-angle on left side. Essentially, Q-angle refers to the angle between your thigh bone and your lower leg. This is genetic and set by your bone structure, so there’s ultimately nothing we can do to fix or eliminate the problem permanently. My Q-angle on the right is normal…my Q-angle on the left is significantly larger. That means my left leg is predisposed to overuse injuries and patellofemoral pain.
3) Issues 1+2 are creating knee pain, as kneecap is being pulled out of alignment, creating all kinds of yuckiness and pain. For the first 10 days I could barely walk, as with each step my knee was pinching and catching. I once described it as a tiny crab living inside my knee, torturing me.
4) Weak glute medius. This is affecting both sides, but more so the injured side. My glute med is proving to be epically lazy, even while doing simple things such as walking or jumping on both feet. That means my glute max, ITB, and quads are doing much more of the work, leading to the tightness and other problems above. Activation of glute med requires a lot of mental work to retrain, as much as physical work. I quite literally need to reteach myself how to walk properly, using glutes to swing/push my leg rather than lifting with quads/hip flexors.
The list is long, and I can tell you that they are exhausting, but I’m committed to getting better and preventing this from happening again. We’re looking at 3 sets of 10 reps for most of these exercises, with another 1-2 sets on the right (the unaffected side), just to keep things balanced.
– Roll out IT band and glutes before any exercise. This includes physio exercises, weight lifting, or running. Looking to warm up the tissue, release and relax it before we put it to work.
– Pilates Clam to activate glute med and be reminded of the muscles that are supposed to be working.
– Kneeling side leg raise
– Terminal extension with 10-20 second hold at extension. Meant to activate Vastus Medialis Oblique (VMO) – the bulging muscle just above your knee on the medial (inside) side of your leg that pulls up your kneecap and keeps it tracking properly.
– Lying leg lift turned in with band. Meant to isolate glute med.
– Single leg squat on box with pause at bottom of range. These go much slower than shown in the video – 4 seconds down, 4 second hold, 4 seconds back up.
– Single leg step ups.
– Single leg Romanian (straight leg) deadlift (unweighted), touching opposite hand to foot.
– Clock jumps: jump out and back to centre, in the pattern of a “clock.” Trying to achieve increasing distance. Jump to 12 o’clock and back, 2 o’clock and back, 3 o’clock and back, etc.
– Clock squat. I couldn’t find a real video of this, but it’s something that I can relate to dance training, similar to a battement fondu. In the dance version, both legs (supporting leg/leg on ground and working leg/leg in air) bend and extend at the same time. In my physio version, they do the opposite; the working leg extends as the supporting leg bends. This is do be done on an unstable surface, or on flat floor with eyes closed… As with the clock squat, this is to be done in multiple planes – working leg to 12 o’clock, 2 o’clock, 3 o’clock, etc.
– Run/Walk intervals. Run 30 seconds, walk 4:30. Emphasis on squeezing glute med as the opposite leg lifts and swings through.
– Side plank to activate the whole lateral chain.
– Plank with leg lift, holding at the top for 5 seconds.
So, as you can see, I’m in for a world of hurt, trying to retrain this lazy @#$!!
…have you done any of these exercises? What was the intention? What were the results? Leave me a note in the comments!!