The Psoas

My Psoas...I talk about it on my blog, unfortunately, ever increasingly. Maybe because I am CONSTANTLY reminded that I have this muscle. I wish I didn't think about this muscle on such a continual basis. But currently I am getting pain, right about where that arrow that says "psoas" is posted, it kinda feels like someone stabbed you in the stomach or that you have indigestion. But since I think about this muscle, and seemingly blog about it, and talk to my PT about it...the Psoas is just another topic that spins around and around in my head. I will have no qualms about telling anyone perfectly randomly that I have this hip injury. In fact...I tend to tell people in a more 'matter of fact' kind of way.

So when I'm chatting with one of my co-workers about my training for a HIM this summer and I say "Oh yea, but my psoas is giving me trouble". He sorta stares at me inquisitively. I...matter-of-factly...point to my belly button and say "PSOAS'...he laughs when he realizes what I'm attempting to say.

Now YOU...my dear reader... say: MY PSO-AS...

It sorta sounds like: my- so'-as' OR my-sore-a__

I suddenly realize that my coworker thinks I'm talking about my posterior...I, being slightly embarrassed at this point (although, after crossfit and stupid power snatches and weighted lunges, that comment really wasn't too far off) and thinking the comment to be also rather hysterical, bust into a fit of laughter. It must be understood though, I live in 'Cubeville' at work...and when I get a good laughing fit...I-AM-LOUD. As... in hear me 5 rows over, kind of belly laugher, loud. Ahhh...a distinctive laugh...people have commented that they knew I was coming before they saw me due to it.

So me and my PSOAS still aren't in agreements with one another. And basically every action illicit a spasm. It's real fun right now. I've decided to ignore it...i'm not quite doubled over in pain. I'm just not having a good time either. One day it will go away...i hope.

Running Gait

My PT is amazing. I am NOT a fan of having an injury. I am NOT a fan of going to the PT...but this little injury actually is not the worst thing in the world. Weird to say that.

I went to this PT last month for some ART (Active Release Technique). Now, I thought the man had healing powers because for a few weeks I didn't have any hip pain. It did feel like at ate a rock as my Psoas muscle was still spasming but no hip pain. But last week I realized with a mere 4 mile run...I was not healed and I should go see The Healer PT.

So today he had me run around while he videotapes me. Watching yourself running around on a video tape...all I could think was "I look like that". Anyway, we go analyze the videotape. AHHHHHHH essentially data analysis. LOVE.IT.

The other thing about The Healer PT, is that he is a great teacher. That is one thing I need from a doctor when I go see one. I need someone who will explain what is going on. I almost chose a path of medicine in my life and I still have a small nagging fascination with it all.

So we look at me running around, looking all silly. Conclusions:

-I'm a heal striker. Although he says, that actually isn't the worst thing in the world. If biomechanically you heal strike efficiently enough...basically strike with your body above your foot...you aren't too bad off. You can 'change' your gait...but there is some difficulties and potential pitfalls to doing such...and we all can't be Kenyans. For the moment, I want work with my God given gait and first make it as efficient as possible with my biomechanics and then see if it is really necessary to become a 'forefoot' striker. We talked at length about this.

-I overstride a wee little bit. And I have a short stride length and high cadence.

-I 'cross over' my midline while running, mainly with my right foot (the one that is having hip issues and is the tightest). This will cause adductor issues...which is partly contributing to my tight hips

-My left leg is doing beautifully. Power, push off, good stuff. We can still see effects of that hip flexor being tight, but it looks reasonably good.

-Now my poor right leg. Loss in range of motion. Losing my push off. Since I am not fully extending in my stride due to that tight hip flexor, I am compensating by arching my back (quite a bit), swinging my torso, using my arms, and rolling internally with that adductor. The hip injury doesn't help the situation, but since I've had all KINDS of IT band issues over the past few years...it is increasingly becoming obvious that I have some 'issues' in that leg.

He again does his thing where I stretch and he basically pinches my muscles. I can't quite explain it...aside from it hurts. PT always hurts...that basically is guaranteed. He then tests my gluteus medius muscle by having me lie on my side and put the top leg up in the air and tells me to push against the force of him pushing down on my leg. We test the left leg (healthy leg) first. The verdict: Very strong leg. I roll over to have the other leg tested. He pushes down...I cannot resist him pushing on my leg. AT.ALL. Oye vey! He tried to 'comfort me' by telling me he sees all sorts of muscle imbalances with the pro triathletes that come in.

So...I'm excited that I may be sorting out this running gait of mine and I HIGHLY suggest that anyone who is having continued injuries should have their gait analyzed. It is SO helpful.

I speak science...how about you?

Well..maybe that last post seemed like I was out to try to 'prove' my theory on trigger points. And while in a way I was, I think I merely proved that I like the scientific method in most every part of my life. If I'm not sure about something...i do a little experiment. I found Nitsirk's comment about placebo effects right up my alley. And the truth of my experiment is that all it *really* proves is my own personal insanity on the fact I do an experiment on most things in my life. I knew Nitsirk speaks scientist...so I thought she might enjoy my experiment.

At the end of any experiment in science everyone still has the choice to believe or not believe the results. The number of times i've read scientific papers and thought "that's a lot of hooey"...there are too many to count. Anywho...I was merely posting my 'results' from my experiments. Anyone is welcome to still believe its a placebo effect or a lot of hooey...i'm cool with that...that's how experiments go. But if you are a believer from my experience...buy the book. Its a good 20 dollars spent.

That being said...I made a new friend today. His name is ART. ART stands for Active Release Technique. It's sorta like PT mixed with trigger point therapy mixed with massage therapy mixed with stretching. It sorta hurts...sorta like PT makes you wonder why you are paying someone to voluntarily inflict so much pain on you. But the most amazing part about it was the change in my range in motion.

The guy doing the ART on me, checked my hip flexors, double checked to make sure it was a muscle injury and not an injury in the joint, looked at my range of motion and then went to work. It was a weird experience in one way because he's having me stretch while he's pushing on different points on my hip and Psoas. I'm mainly thinking "owch...this sorta sucks"...but dealing with it anyway because that's how PT can be. And then its over.

I'm thinking "what exactly did you do?"

He has me do some stretching again...this this time my range of motion in my hip has increased by about a foot. I'm pretty awestruck at this point, mainly because I'm thinking...what did you just do? At the beginning of all this I wasn't able to pull my leg very far back (during the point of the stride where I am pushing off and my leg is behind me) due to my hip flexors which would translate into loss of power in a stride. But by the end of the visit, I had gained back a lot of my range of motion and my pain had diminished some. CRAZY.

I'm sure I'll be conducting an experiment with this, because that's how I roll.

The Trigger Point Therapy Workbook

Athlete?

Ever been injured?

Ever have a small nagging pain that sorta hurts but you don't want to see a doctor about?

YOU HAVE GOT TO BUY THIS BOOK: The Trigger Point Therapy Workbook. Yes this post will be a shamless plug for this book but you have to understand where I am coming from.

So back in early '06 when 'Zilla was training for her first marathon, a friend of her's had referred her to this book. She gushed...i sorta nodded...she claimed it was better than sliced bread...i nodded again...i picked it up at Barns and Noble and read a bit in the store...I put it down...i thought about it some more...and then I thought about my non-existant bank account (as I was in graduate school at this time)...I thought "yea...i'm sure it is sorta a good book, but *how* good"?? I shrugged it off.

You see, I'd been down the trigger point alley (or so I thought). I'd been through two rounds of PT wherebye they dug into every sort of trigger point associated with an IT band. I 'got' it. Some overuse = some knots. That's all it is...getting those knots out. I grind my teeth LIKE A CHAMP...so i'm familiar with 'referred pain' from these so called 'trigger points'. When I get an ear ache like someone hit me with a baseball bat, I know what muscles to go after. And the pain will eventually subside.

When I thought about trigger points, I thought:

"I 'get it'. Referred pain = trigger point".

I rationalized that there was an underlying 'issue' going on. The ITBS... was over use and I'm sure sucky biomechanics. The TMJ, I have some sorry teeth that decided that they didn't want to be the same height on either side of my mouth, which resulted in teeth not in the same plane...which results in me grinding my teeth. Fun.

THOSE trigger point related issues made sense in my little brain. But last week when I went to see the doctor about my hip injury and he said that I may have some trigger points that were related to the fall I had a couple of weeks ago. I'm going to be honest, I didn't buy it. There was no physical over use wear, like with the ITBS and the TMJ that aggravated some muscles so I would end up with a trigger point. It didn't make sense to me that by falling I could get a trigger point.

(It was like the hippie-granola 'sports massage therapist' telling me that the reason that my hip hurts is because I'm not 'united' with my body. She believed that my hip pain was due to the fact that I am currently going through lots of big changes in my life. (new job, new city, new life).)

BUT...just because I didn't really believe the doctor when he told me that I may have aggrevated a trigger point when I fell and hence the hip pain, didn't mean I wasn't going to take his advice. He is a MD and a PT after all. And just because someone can call me doctor, doesn't mean I know anything about anything. (it just means I know a lot about a tiny tiny subject that no one really cares about, including me...but I digress). I'm a good patient, just because I am skeptical (i'm a scientist...would you expect anything less?), doesn't mean I won't go and DO what is prescribed.

So i pick up the book and look up 'hip flexor pain'. The book describes what may have brought on the pain, as IF the person who wrote the book somehow witness my accident a few weeks ago. So that immediately got my attention.

And I'm reading about hip flexor referred pain and it tells me to look for a trigger point next to my belly button on the side my hip hurts. And what do you know? Sore spot that upon rubbing the knot out, my hip starts to feel better. But the next day...it's not perfect. So yesterday as I dove further into the book looking up "hip pain", i see other areas of trigger points I should work on. And I go 'looking' for said trigger points (all on my stomach, so i'm hugely skeptical about this at this point...as it is not on my hip),and today....... NO PAIN!!!!!!!!!!!!!!!!!!

I haven't run in over a week and have only done spin classes, yet the next day after spin class my hip would still be a little cranky. But NOT TODAY. After finding all the trigger points associated with the hip...I am in NO PAIN!!!!!!!! Not even a twinge.

Referred pain is so weird.

I think every athlete needs to own this book.

Update

So wednesday I got in to see a sports medical doctor. Granted I had to plead "urgent care"...but the way I was feeling on Wednesday morning after the run I had on tuesday I was verging on "urgent care". The sucky thing about this hip flexor issue is that when it hurts...I can barely sit up in bed.


So I went to the doctor...and the verdict: apparently when I fell last month I triggered some sort of spasm in one of my hip flexor muscles that was already crazy tight. I had started with tight hip muscles and the fall has caused some spasming that may have lead to a pulled muscle in my Psoas and Illiacus and is contributed to some increase in 'clicking' in the hip. (which hurts) Since we are getting into Dec and my good health insurance that would let me see some of the PTs i'd like to will kick in a few weeks...i'm going to wait it out. I've made an appointment to get some ART (active release therapy)...i will do more yoga like it is going out of style...look into some acupuncture, try to get a couple of massages in this month and use the book the doctor prescribed on Trigger Point Therapy. We all need more self inflicted pain right? owch.

The doctor said I didn't have to stop running unless I was getting pain while I was running...which I usually wasn't or it was at the end of the run. My plan is to dial it back to more like 3 miles x 3 times a week and skip the group running. The 5 miles on each of the runs I've been on in the past few weeks have taken too long to recoup from. So until I can get this strain/tight muscle under control, i'm just running enough so my body won't forget how.

Hopefully we can sort this out asap...its freaking me out a little since I just signed up for a HIM...i know I have time...but the doctor did say that soft tissue injuries can be hard to recover from. AKkkkk