Join us as we follow Jeremy LaMothe, HSS Fellow and first time marathon runner, through his training for the ING New York City Marathon. This is the second installment of a series documenting his journey. Read the first installment here.
As someone who works in the medical profession, I have a compulsion to disclose any potential conflicts of interest. For the record, I have no financial/personal/other conflicts of interest or relationship with the Sports Rehabilitation and Performance Center at HSS where I just had my Running Analysis. I say that because it was really good. I feel better now.
I’m three weeks into marathon training and just had an assessment by Physical Therapist Mike Silverman. The goals of the session were to assess/critique how I run and to educate me how to avoid injury and just be all around better. The session started with a brief history where questions were targeted at my previous levels of activity, injuries and current training program. My training program has me running 5-6 days per week with a variety of different goals each day; one of the weekly goals being a long run that gets extended by 10% each week. I was told that it’s a lot for a novice runner like myself who was running 2-3 times per week prior to marathon training. The risk: overtraining and subsequent injury. My risk can be muted by decreasing how much I run, subtle adjustments in my running form, or by running 4 times per week and cross training 1-2 times.
Assessing my form started with a lower extremity range of motion and posture assessment, as well as a brief strength assessment. The verdict: I have tight hamstrings and calves, and weak hip abductors. The danger of this combo is that my pelvis could tilt (i.e., swagger) when I run and get tired. This could place abnormal strain on various parts, predisposing me to injury. Mike was equipped to assess this with a treadmill and real-time recordings which was very cool. I hopped on the treadmill and jogged at a leisurely pace while Mike recorded my strides from the front, back and sides which was very revealing. I learned that for a novice runner, my strides were reasonable. However, my weak abductors were causing me to tilt my pelvis causing a kinetic chain breakdown. Sounds ominous. Also, I tend to bounce a little when I run (my friend who called me a Kangaroo while running can attest to this). The vertical displacement of my center of mass was around 11mm, the optimal being 6-7 mm. More vertical displacement = wasted energy and greater potential for injury. I could definitely be more efficient and have some stuff to work on. Mike then gave me a prescription of stretches, strengthening, and gait recommendations. This is something to stride towards in the future.
Well, the future started the next day when I did my long run for the week (16 miles). I practiced my new form, and played around with some different cadences. I learned that optimal cycles/min is approximately 180 and I was around 160. It was kind of fun to fine-tune things. I felt more efficient, but given that it was a long run, I was sore the next day and was happy it was a scheduled day off. I pushed the envelope with some sprints the following day, and I quickly learned that I was too ambitious too fast. Precocious would be a good description. My left hamstrings seized up and I couldn’t walk for a while. I missed the next day of running and it was arguably the hardest day of my training so far. I have a hard time taking days off. I need to remind myself that this is a marathon, not a sprint. I need to heed Mike’s advice and run maybe one day less and cross train one day more, and realize that days off are not wasted time.
I am not afraid of much; however I am afraid of failure and having low standards. Together, these seem incompatible with taking a day off. I need to keep reminding myself that days off represent time well spent and can facilitate recovery, which is crucial to helping me go longer and faster. In the meantime, the days are helping me nurse my pride and pulled left hamstrings, which helps distract me from my sore tibias and plantar fasciitis. I think I need to rewire my brain, or “smear my homunculus” as a friend calls it, to realize that some pain is good pain. I just need to figure out the balance between good and evil pain, and I need to do this quickly.
Jeremy LaMothe is an orthopedic surgeon from Calgary, Canada who moved to New York City in July 2012 to pursue two years of Academic Training at the Hospital for Special Surgery. In his first year, he completed a Trauma Fellowship, and he is currently a Fellow with the Foot and Ankle Service. Jeremy started running more when moving to New York as a way to see the city from the pavement, and is training for his first marathon in November 2013. Other than running and cycling around the city, Jeremy’s wife, who is a classically trained chef, has helped him acquire a special interest and taste for the culinary arts.