One fact I should note right off the top: I am not a doctor. I didn’t even take AP bio. The only letters after my name have to do with writing words and organizing information systems, and it turns out that alarmist googling of Runner’s World injury forums does not in fact make one a font of valid medical advice.
What I am, though, is a runner who gets injured a lot and has to dig herself out of it.
Since I started running in 2008, I’ve been making my way through a checklist of most of the standard running injuries. Plantar fasciitis? Check. Achilles tendinitis? Sure. IT band syndrome? Reporting for duty. Not-shin-splints-and-probably-not-MTSS-but-something-else-lower-leg-ish? I got your NSSAPNMTSSBSELLI right here.
So I wanted to document what I’m doing to try to get, and stay, healthy this summer. The vast majority of these exercises came to me via the PTs at the CPMC outpatient physical therapy clinic; a handful came from my best friend the internet. Obviously, at a whopping 10 days into my return to running (which has yet to include a continuous run without walk breaks), it’s a bit early to say they’re working — but I have been at this place with injuries before, where things occasionally feel tight but never hurt, and I think of it as a small hop from there to “you’re fine; stop worrying about it.”
Of course, I might someday end up saying, oh, screw it, none of this stuff worked and these other things I’ve never even heard of today were actually the magic bullets. If that happens, I’ll update this post. Pinky-swear.
When I was first in physical therapy after my IT band went bananas last summer, I was given three main “homework” exercises: single-leg squats, single-leg deadlifts, and single-leg sideways step-downs. There were a few others thrown in for me to do as I felt like it or as part of a regular core routine — most notably planks and bridges — but those three were the gold standard.
When I went back for the mysterious leg injury, I got more or less the same exercises, only now I do them barefoot. The first step of each of these exercises is to transfer my weight onto the standing leg and concentrate on “pulling up” my arch. To me, that feels like pushing the base of my big toe into the ground, spreading my toes slightly and creating a sturdy base. In all honesty, I hadn’t been doing this step until, uh, last week, and as soon as I got the correction, I noticed a difference. The bigger muscles these exercises were initially intended to work — glutes and hamstrings, mostly — are stronger now than they were last summer; the teeny tiny muscles in my feet and legs, though, still need help, and focusing on my foot position forces them to wake up.
Here’s what I currently consider my Big Four, which I do at least twice a week. A full set (2x through each exercise) takes me between 20 and 40 minutes, depending, basically, on how many times I lose my balance and fall over. I used to combine them with lifting at the gym, but now that I’m doing them barefoot, I’m sticking to my living room — which is fine, because that’s where the TV is.
- Single-leg squats. I do these two different ways: with my resting leg held up just off the ground in front of me, or with my resting leg alternately going to the front, the side, the back, and across my body behind me (e.g. crossing my right knee behind my left and reaching my right foot toward my left side when my left leg is working). I’ll either do 20 of the straight-up-and-down ones or 10 of the multi-directional ones per set.
- Single-leg deadlifts. I’ve also done these different ways, both weighted and unweighted. I always start with my working leg very slightly bent at the knee and my free leg extended behind me. In one version I hold a light weight in one hand and, as I hinge forward, aim it in three different directions: the outside of my standing leg, my ankle (e.g. straight down), and the inside of my standing leg. I always forget which hand the weight is “supposed” to be in, but according to my PT, it works with either, so I alternate. In the unweighted version, I hold onto something like a skinny PVC pipe (at PT) or my Stick (at home) with both hands and hinge straight forward, keeping the stick/pipe level and maintaining stability and control with my standing leg. I aim for 10 of the multi-directional ones (30 total, though I can typically only get through 7 or 8 rounds with good form so far) or 15-20 of the straight-up-and-down ones.
- Sideways step-downs. I hate these with a fiery passion, so I guess I need to do them. I stand with the foot of my working leg on the outside edge of a box and my free leg dangling off it to the side. I bend/squat with the working leg until the foot of the free leg just barely touches the floor, then push myself back up. I do 15 on each leg.
- Single-leg calf raises. An oldie but a goodie; I started doing the double-leg version after every run a couple of years ago. (I live on the second floor, so when I come in the door, I do 10 on the bottom stair and 10 on the top stair.) I’m now also doing a single-leg version on the same step I use for the step-downs, dropping my heel off the back and pushing up fully onto my toes. I shoot for 15 on each leg and usually want to cry by 12.
And I’m also doing a few things every day, or at least five times per week:
- Ankle inversion/eversion with a resistance band. Cris explains this well.
- Balancing on one foot. Just…balancing on one foot. I do 30 seconds with my eyes open on each foot, then 30 seconds with my eyes closed on each foot. Luckily, I watch a lot of TV, so I do this during commercial breaks, which also makes commercial breaks go a lot faster.
- Foam rolling/Stick-ing/rolling on a lacrosse ball. Like, a lot. Again, good thing I watch so much TV. I try to get my IT bands, hamstrings, quads, and calves with the roller (regular most of the time, trigger point when something feels especially in need of attention) every day. I’ll also sit with a lacrosse ball under any knots in my calves and then roll the inside of my left leg on it. I’m trying to use The Stick more, because it can be very targeted, but I’m a little wimpy with it and don’t think I apply enough pressure.
Some things that occasionally get thrown into my routine:
- Catch on a bosu ball. I stand on the squishy part of a bosu ball with both feet while someone else throws a light, soft medicine ball at me in different directions and I reach to catch it without coming off the bosu.
- Bosu steps. I stand behind a bosu ball, squishy side up. With one foot at a time, I’ll step partially onto the bosu — not fully onto the surface but just enough feel resistance — and then push back and repeat with the other foot. I’ve also done these standing to either side of the bosu to get more practice moving laterally.
- Karate kicks. I like this one cause it freaks out my cats. Standing on one leg, lift the opposite knee to waist height and then kick that leg to the front, then side, then back. I repeat 10 times or until I fall over.
- Bridges (two-legged and single-legged); planks (regular and side). Since I started going back to yoga, I don’t do these as much on their own, but sometimes if I’m already lying down I’ll throw a couple in.
And, most recently, I started doing the MYRTL routine (PDF; video) after every run. Given that it’s supposed to help with hip stability/flexibility, which I know I need, I figured it wouldn’t hurt. That was my actual logic: “I figured it wouldn’t hurt.” And that, folks, is why I’m not a doctor.