So… back to square one. Kind of.
I started running in 2009, and I knew that it would be an uphill battle for me. With funny joints (knees that can dislocate), high arched feet, and calf muscle atrophy, you could say that I started running with an inbuilt biomechanical series of challenges. I had a lot of troubles in 2009, with my knees feeling the stress and my legs taking a long time to adapt to a Couch to 5k programme. So in late 2009 I started working with Coach T on leg strength and stability, to aid my running and to help me to accomplish my goal of running the 10k portion of an Olympic distance triathlon.
The year was great – we had a lot of success. My legs grew stronger, but I just felt like no matter what I was doing, I wasn’t getting faster. I felt like something was limiting me.
So we filmed my running, and I consulted with Gita, the research physiotherapist I had been working with at the Institute of Neurology.
On a cold December morning we took a set of videos for Gita to review, to help her to understand my running, and to enable her to put it in context with CMT.
What do you see when you look at this video?
I received a lot of comments when I first posted this in December.
My friend Joy, a USAT triathlon coach with CMT, suggested that I take a look at Chi Running. I happen to have the book, which I purchased in 2009, but I haven’t felt like I was ready to work through the principles yet. I have felt like something more fundamental is happening with my biomechanics and running that I need to address first.
Jeff Kline, with whom I have chatter on Twitter for over two years now, commented previously on my photos and how I have an arm twist across my body. I think the video shows this too. But what was the root cause?
And another person on Twitter sent me a series of observations – almost a laundry list of commentary on the video. To give you a flavour: you overstride on the right, you swing your left arm forward which makes your right knee come forward, you aren’t falling forward but you are pushing yourself forward, you have a left heel strike and a forced right forefoot strike, you sit back in the run which puts your centre of gravity behind you, you run like a lot of runners do, you may be locked into the belief that you have to push yourself forward with your legs… And after 15 messages, finally a “well done though, you are looking great” – yep, sometimes posting things can invite A LOT of commentary! And, clearly running form and helping others is something that a lot of people are interested in!
I have to admit, when it comes to helping my running, there are very few people I would trust for advice. I look to my physiotherapist Gita, who understands both running as well as my nerve disease. And I look to Coach T, with whom I have been working for 18 months to improve my overall health, fitness and triathlon performance.
Gita took a look at the video, and instantly suggested a high level rehabilitation protocol, designed specifically to address the compensations that I have developed due to CMT.
You see, what Gita saw and no one else spotted, due to her training and work with CMT patients, was a gait compensation where I use my hip flexors to propel myself, rather than a push from my feet and calves.
According to research (see “Hip Flexor Fatigue Limits Walking in Charcot Marie Tooth Disease” by Ramdharry, Day, Reilly and Marsden), the hip flexors compensate in gait when distal muscles are weakened (which occurs in CMT). The study also showed that if calf strength could be increased, this could have synergy and improve overall endurance (less fatigue) of the hip flexors.
Other research (see “Foot drop and plantar flexion failure determined different gait strategies in Charcot Marie Tooth patients” by Don, Serrao, Vinci, Ranavolo et al) also details how CMT patients compensate for muscle weakness in the lower leg by using knee and hip compensations. These compensations lead to less efficient gaits, and quicker fatigue.
So in short, research and the view of an expert have me back to the beginning, building my push phase of running and working to strengthen muscles and undo the compensations I make (using my hip flexors rather than my calves and quads for running). I am on a protocol of calf raises, jumps, step ups and similar – all designed to build run specific gait strength and form.
So, me and running. The story continues. I trust my coach and physiotherapist. I appreciate all of the advice, book recommendations, emails, messages, suggestions, and support – it keeps me going. And I think that at the end of the day, it is just going to take time, work, and patience to hopefully transform my running into a form and speed that I can be proud of…
I am truly impressed by all of your running. I completely understand the frustrations associated with it. Keep up all your hard work and it will pay off.
Thank you for sharing this. Good luck with the rehab.It sounds like you have very good people to advise you. Finding those people I’m pretty sure is the key. Putting yourself through the work is somehow easier if you have confidence in the people advising you.
I don’t face anything like the same challenges you do. It isn’t the same thing at all but I went through an intensive period of rehab (calf raises, jumps etc plus balance specific stuff) after a series of injuries to my right foot almost 6 years ago. Going back to square one to undo compensations, “fix” injury related problems and learning more or less to walk again and then run again was tough mentally and physically. All in all I was out of running for 18 months and I would say it took me another 2 years to regain fitness and then move on from there. It makes me appreciate being able to run now more than I ever did.
Thanks Erica. I think so much of what I am doing is about avoiding injury too. If I can fix the compensations, I can keep myself going, stronger and for longer (more years as well as more distance, when I get happy with how things are going). It is neat to hear how you did the same thing, and how it has made you a stronger runner. I hope I can say the same too, someday.
Donna, I really appreciate the information on your website and am inspired by your determination and hard work. I am not a runner, but love walking and hiking and am trying to see the problems my CMT has caused in my walking gait, and looking for solutions to correct it.
Hi Barb, thanks so much for reading. CMT can be behind so many issues, I have spent almost 2 years now trying to understand and address them, sometimes it feels like progress is elusive! I am glad you are finding the site beneficial, and I plan to post some more videos of the therapy and approaches we are doing over the course of this year. Let me know if there are any specific questions you would be interested in me writing about!
Hi, Thanks for sharing your inspirational running and story. I have CMT and my brothers do also. I don’t know which type, I never had any test done yet. I used to run in highschool Phys Ed. class with the rest of them. I don’t do it by myself anymore. I’m trying to stay more active. I do weights and bike riding at the local gym. I have special shoes. My brother just talked to me about running and said he’s having trouble doing it anymore because of ankle limitations and problems. Keep up the good work. I hope one day I’ll get more fit myself and maybe try something more like running as you do.
– Curtis
You are an inspiration, thanks for sharing.