Just like starting over...

Wow. I have so much to catch up on. I lost momentum. Being unable to run, I felt lost. I had no program to follow. It was difficult to get to the gym when I had so little motivation. And it was difficult to bring myself to write about it when I felt so disoriented.

But help is on the way in the form of Matt Sheehy, my physical therapist at Kaiser. I had my appointment with him this past Friday. Matt is a runner himself and his specialty is sports rehab. Not only did he examine my body, but he put me on the treadmill and observed my running form, noting 4 things I'm doing wrong which are contributing to knee problems:

1) Holding my posture straight up. Instead, I should lean forward from the ankles, like a skier. This prevents the next thing...

2) Landing on my heels. I should be landing on my midfoot. Landing on the heels is like putting on the brakes. It causes a lot of impact on the knees. Leaning forward will help me land correctly.

3) Allowing my right foot to turn outward. I already knew this was a problem. Matt says I can correct it by doing hip adduction exercises (squeezing in with the thigh) as well as simply focusing on keeping that leg straight at all times, especially when running. It feels really strange to keep it straight. He says if I am diligent, I should be able to correct it myself within a month. And after examining me, he feels that my muscles are strong enough that there should be no reason they can't hold my leg straight with practice. It's just a weird habit that has developed over time rather than an actual defect in my body.

4) Low stride rate. He counted 78 strides per minute. I should be running 85 strides per minute, taking quicker, shorter strides. This will help me land with less impact. He wants me to purchase a clip-on metronome to help me learn to run at the correct rate.

Some other things he wants me to do:

1) Read the book, ChiRunning, by Danny Dreyer, and learn to run using the form described in the book, which is based on principles of Tai Chi. This form includes the forward lean, landing on the midfoot, relaxing the lower leg and ankle and using more of the core muscles to run, and picking up the feet. Matt says that all his running patients cleared up their knee problems by adopting this running style. And he was able to demonstrate it for me himself; so as strange as it feels, I know it can be done.

2) Switch to soft Bio-foam insoles. He thinks Superfeet insoles, which I have been using, are too hard for running. And he agrees with Dr. Augé that I should be wearing well-cushioned neutral shoes rather than the heavy motion control shoes I was wearing.

3) Use a different stretch for my quads after each run that is less stressful on my knees.

4) Run 3-4 times per week, only 1-2 miles each time, focusing on improving my form rather than on speed or distance. Then, come back to him in 3 weeks for evaluation.

So, I purchased the book as soon as I left his office and have done 2 runs since then. So far, no knee pain whatsoever. The form feels very strange, but I'm actually able to run faster than I ever have before. Yesterday, I ran a 10:24 mile on the treadmill: my fastest yet. The forward lean is like a gas pedal, according to Dreyer. The more you lean, the longer your stride has to be to keep you from falling, and if you maintain your stride rate, you will go faster.

The only pain I'm having now is the soreness in the left side of my right shin. Dreyer says that shin pain is caused by overusing the lower legs and also landing on the toes and balls of the feet rather than the midfoot. I do think that I have been overcompensating for the heel strike by landing on the balls instead. My next run, I'll focus on picking up my feet and landing flat-footed.

So, new plan: I still have an opportunity to participate in the San Francisco Marathon. I found out today that they have a Progressive Marathon. You fill out a sheet showing runs you've done in the last few months adding up to 23.1 miles and then complete the final 3.1 miles in a 5K race during the SF Marathon. You can run or walk the 5K, so I can still do it even though I'm not supposed to run more than 2 miles. Then, you end up with a medal and a T-shirt. It will be nice to salvage something from my previous plan!

As far as the Nike Women's Marathon: Matt thinks I should switch to the 1/2 Marathon on October 22, which agrees with Dr. Augé's opinion. I'll see how I do in the next few weeks before I make that decision.