Training log - Week ending 8/25/2024

This week was 33 miles of running, 2:30 on the arc-trainer and 9 "miles" of pool-running -- training log is here.

And of course, just when I thought I'd "turned the corner" my obturator flared up again.  In this case I think the cause was a) being a bit more aggressive with the hill repeats on Friday combined with b) doing a move in Pilates on Saturday that eccentrically stresses the internal rotators.  In any event, my hip was crampy on Sunday morning, and so a planned 10-12 miles became 7 tentative miles plus a shift to the arc-trainer.  So that was annoying.  Two steps forward, one step back...

Regarding the arc-trainer: I used to be a fan of them a decade ago, but had moved away from them - mostly because I didn't have any injuries that required me to use one.  But now that I'm stuck in rehab land (and have been for several weeks) I think I'm going to use it more and limit my pool-running to once a week.  

I've got a few reasons for shifting from pool-running to arc-trainer right now:

1) I'm worried about losing my lower legs' strength and ability to handle impact - while the arc-trainer isn't high impact, it is at least weight-bearing, so it's a bit closer to the impact of land running.

2) One of the causes of my obturator issue seems to be a hypertonic (i.e., always contracted) pelvic floor, and I'm working to break that habit.  I've noticed that I have to contract my pelvic floor and keep it contracted to pool-run, so essentially pool-running forces me to do something I'm trying to practice doing less.

3) Another possible side benefit of the arc-trainer is that it may improve my stride.  One issue I have to manage when I run is that my quads always want to contract and straighten my knee.  This makes it pretty hard to not overstride - I have to focus to bring my foot under me, and as soon as I lose focus, I'm overstriding again.  

Using the arc-trainer at most inclines forces my knee to bend and my foot to land under me.  It feels very awkward, but then again, not overstriding when running feels very awkward also.  I've also noticed that my quads get very fatigued quickly when I'm on the arc-trainer because I'm using them in a different way when I bend my knee more.

My hunch is that because my tendency now is to run with little knee flexion, my quads have become stronger in that position and weaker when I bend my knees.  Which just reinforces my tendency to run with nearly straight legs and overstride.  So...if I can get the legs stronger and more comfortable in moving with a bent knee (and strengthen the quads in that position), perhaps that will improve my running stride.

Monday: 9 "miles" pool-running and streaming yoga.  Foam rolling in evening.

Tuesday: 7 miles very easy (10:02) and upper body weights/core. Foam rolling in evening.

Wednesday: 3 miles very easy (9:53) and 40 minutes on the arc-trainer, with a workout of 7x4:00 on, 1:12 off.  Followed with leg strengthwork. Foam rolling in evening.

Thursday: 6 miles very easy (9:51).  Pilates and foam rolling in the evening.

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Friday: 8 miles with 7 careful Iwo Jima hills (2:30 at a moderate effort up a 2% slope with about 3 minutes jogging recovery.  Followed with leg strengthwork.  Foam rolling at night.

Saturday: 2 miles very easy (10:02) on track, 40 minutes on arc-trainer and streaming pilates. Foam rolling in evening.

Sunday: 7 miles very easy (10:02), 70 minutes on arc-trainer, and injury prevention work.  Foam rolling in evening.

Training log - Week ending 8/18/2024

This week was 37 miles of running, 30 minutes on the arc-trainer/stairclimber, and 9 "miles" of pool-running -- training log is here.

My overall mileage (land+pool) was a lot lower than I would have liked - in large part because I'm running more and it's very hard to fit in both pool-running and running if I'm not running right by the pool.  This was balanced out by a careful return to faster running and increasing the mileage of my runs, so I was generally happy with the week.

I started testing things on Monday by trying my standard warm-up fartlek (3:00, 4x0:30, and 4x0:10).  Normally I target half-marathon effort, 5k effort, and mile effort for those segments, but this time I settled for "anything faster than easy pace" - I just wanted to test stuff out.  That felt clumsy but safe, so I did a careful hill workout on Friday.  

One frustrating thing about Parkinsons is that I forget physical skills very easily, and running fast is a different skill from running slow.  Because I've continued to run easy over the past few weeks, I remember how to run easy.  But I can tell that I've forgotten how to run fast.  Hills force one to run with good form, and so I'm doing hills for my intervals to relearn fast running mechanics.

I finished off the week with my longest run in a while - 10 miles.  My hip held up very well, so I think I've turned a corner on this.  Now it's a matter of carefully increasing the load each week.

As for the hip injury - I think it might be helpful to outline exactly what it was (and what it wasn't), in case it's ever helpful to someone else.

Essentially, I had an irritated/spasming obturator muscle.  Most people have never heard of this muscle, but you do use it in running.  It's two of the "deep 6" rotator muscles - the most famous of those muscles is the piriformis.  (I say two because there's an obturator internus and an obturator externus - they get treated as one muscle for my purposes).

The obturator is lower on the hip than the piriformis - it wraps around your sit bone (ischial tuberosity) and attaches to the femur.  It stabilizes the femur in the hip socket.  It is also one of the pelvic floor muscles, which is why I was referred to a pelvic floor specialist to get it calmed down.

Obturator issues can be really confusing and hard to diagnose.  For one thing, both the obturator nerve and the sciatic nerve are adjacent to this muscle, so when it spasms it can irritate those nerves and refer pain all over the hip.  

And...because the obturator wraps around the sit bone (where the hamstring attaches) a sore obturator is very easy to confuse with high hamstring tendonitis.  Both cause pain when you flex your hip and stretch your hamstring.  There are two ways to tell the two apart.  

The first way is that the pain of a sore obturator feels horizontal and is most painful on each side of the sit bone. In contrast, high hamstring pain feels more vertical and is centered on and just below the sit bone.  

The second way is pretty easy: do a weighted hamstring curl or reverse plank or something else that contracts the hamstring without flexing at the hip.  If you are completely pain-free while contracting your hamstring against heavy resistance, then your problem is very likely not your hamstring, but another muscle in that sit bone area.  And the obturator is a solid candidate in that case.

At this point, my obturator muscle isn't damaged.  It was just spasming for a while and had several trigger points as a result.  Now that those trigger points have been addressed and it's no longer spasming, there's no real problem with the muscle.  However, my body is still sensitized to that area and hyper-reactive.  The best solution to that is exactly what I am doing - carefully re-introducing stress to the area so that it resets.

Monday: 5 miles mostly very easy (9:20) on the track with a short and careful fartlek and 30 minutes on the arc-trainer with a workout of 5x4 minutes hard with 75 seconds recovery.  Followed with leg strengthwork.  Foam rolling in evening.

Tuesday: 8 "miles" pool-running and streaming yoga. Foam rolling in evening.

Wednesday: 7 miles very easy (9:50) and upper body weights/core. Foam rolling in evening.

Thursday: 4 miles very easy (9:55) and 20 minutes of hiking, followed by upperbody weights/core. Foam rolling in the evening.

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Friday: 7 miles with 6 careful Iwo Jima hills (2:30 at a moderate effort up a 2% slope with about 3 minutes jogging recovery.  Followed with leg strengthwork.  Foam rolling at night.

Saturday: 4 miles very easy (9:50) on track and streaming pilates. (also got my first shingles vaccination). Foam rolling in evening.

Sunday: 10 miles very easy (10:02), 1 "mile" pool-running, and injury prevention work.  Foam rolling in evening.

Training log - Week ending 8/11/2024

This week was 22 miles of running, 15 minutes of rowing, 1:20 of on eliptical/arc-trainer/stairclimber, and 26 "miles" of pool-running -- training log is here.

Another week of mixing running and cross-training.   My hip felt better but still needed work, so I had a second visit with the pelvic floor specialist.  In the meantime, I kept mixing easy running with cross-training volume and some cross-training workouts - shorter intervals on Tuesday and longer intervals on Saturday.

The hip felt better after the second session - since I thought I might have been too aggressive after last Friday's appointment, this time I cross-trained on Saturday before a few cautious miles on Sunday.  My hip was sore for the first mile, and then better.

At this point, I think that the remaining pain is mostly nerve pain that needs to be worked through (several nerves, including the sciatic and obturator nerves, touch on the obturator. I tend to protect that hip, which makes it stiff, which irritates the nerve.  So I need to unwind that. 

Monday: 9 "miles" pool-running and upper body weights/core.  Foam rolling in evening.

Tuesday: 6 miles very easy on gentle hills (9:41) and 5 "miles" of pool-running, including a workout of 8x3:00hard with 60 seconds of recovery, followed with leg strengthwork. Massage in evening.

Wednesday: 4 miles very easy on track (9:28) and 6 "miles" of pool-running. Foam rolling in evening.

Thursday: 8 miles very easy on the track (9:35), followed by upperbody weights/core. Foam rolling in the evening.

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Friday: 15 minutes of rowing intervals.  Foam rolling at night.

Saturday: 1 hour on the arc-trainer, including a workout of 4x7:00 hard with 3:00 recovery.  Followed with 20 minutes easy on elliptical and 10 minutes easy on stair-climber (to mix up the stresses on the legs).   Later, did upper body weights/core and foam rolling.

Sunday: 4 miles very easy (9:51) and 6 "miles" pool-running.  Foam rolling in evening.

Training log - Week ending 8/4/2024

This week was 30 miles of running, 20 minutes of rowing, 1:20 of hiking, and 31 "miles" of pool-running -- training log is here.

I ended up seeing three professionals about my right hip this week - a physical therapist on Tuesday, a neuro PT on Wednesday, and an orthopedist on Thursday. The two PTs both agreed that my hip was actually a pelvic floor issue - specifically the obturator muscle(s) (there's two of them - internus and externus).  The orthopedist spent about 30 seconds moving my hip around before diagnosing high hamstring tendonitis.  I decided to go with the PTs over the ortho, especially since I can perform hamstring curls and reverse planks without pain.

I was referred to a third PT - a pelvic floor specialist - and I saw her on Friday.  She spent about 90 minutes working on my obturator, and confirmed it was knotted up and almost certainly the cause of my hip pain, along with the neighboring ileococcygeus (first time I'd heard of that one).  The obturator nerve goes through the obturator muscle, which explains why the pain was moving all around my hip.

After my 90 minutes was up, the pelvic floor PT instructed me to 1) do a specific adductor stretch three times a day, and 2) keep running and try to "push it a little."  It wouldn't be pain free immediately (though it already felt a bit better) but hopefully it would clear up completely in the next week (if not, I go back for another session).

So..I gently bumped up my mileage this weekend, and also shifted from the track back to asphalt trails and sidewalks.  It's still sore but seems better, so I'm crossing fingers for the next few days.

Separately, I kept up with pool-running intervals to get my heartrate up some.  The pool-running intervals also work my legs very hard - my legs are consistently very shaky when I exit the pool after a workout.  I also did some rowing because it's good for my posterior chain and added in some walking on trails to do some work on dynamic balance and keep my lower legs and feet working.

Hopefully I'll be able to bump my mileage up more soon and reduce some of this cross-training - running is my most time-efficient activity, and so finding the time for all this walking/rowing stuff has been a challenge.

Monday: 9 "miles" pool-running and upper body weights/core.  Foam rolling in evening.

Tuesday: 4 miles very easy on track (9:08) and 4 "miles" of pool-running, including a workout of 4 sets of 5x(30 seconds very hard/30 seconds recovery) with an extra 60 seconds of recovery after each set.  Foam rolling in evening.

Wednesday: 6 miles very easy on track (9:32) and 20 minutes of rowing, followed with leg strengthwork.  Foam rolling in evening.

Thursday: 25 minutes of walking on trails and 8 "miles" of pool-running in the morning, with 8x3:00 hard with 1:00 recovery. Streaming pilates and foam rolling in the evening.

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Friday: 6 miles very easy on track (9:33) and 6 "miles" of pool-running.  Foam rolling in evening.

Saturday: 6 miles very easy on track and sidewalks (9:30) and 4 "miles" pool-running, including a workout of 6x3:00 hard with 1:00 recovery. Followed with streaming Pilates. Foam rolling in evening.

Sunday: 8 miles very easy (10:04), an hour of walking on trails, and leg strengthwork.  Foam rolling in evening.