Sunday, August 14, 2011

Running for Healing (Foot Adaptability)

Just when I thought I'd be able to step up the running and really lose some weight - it's all gone pear shaped! The foot pain is persisting and has dragged me back down to a bare minimum of effort - plus I've started eating too much again so I'm going physically pear shaped too. I'm also having a bit of a rest from cycling due to feeling that I'd been overtraining a bit and getting much too grumpy along with it. Today - a full week after the La Bourgui the legs felt back to normal for the first time. It was depressing however to miss a race yesterday in glorious sunshine - but it felt more like withdrawal from some form of addiction!

Peronius Insertion Tendinitis
The foot injury appears to be "peronius insertion tendinitis" - that is the bony bump on the outside edge of the foot near the middle hurts if I step on it. (Isn't life so much easier without jargon?) It seemed to be sparked off by cycling - not running - though the running has now become an issue. Standard advice is to use anti inflamatories, rest, ice, orthotics (especially a wedge under the outside edge of the foot) and to immobilise the foot. There should be no barefoot walking.

Adaptation - over 100 muscles - per foot! (Can you name one?)
Going by feel alone I had done the opposite of those recommendations on the bike -  wedged the shoe so that there was more support on the inside edge - and it worked beyond expectations. For walking though, at first I thought the experts might be right because walking barefoot was painful and obviously not a good idea - or so it appeared. I'd tried running in soggy cushioned running shoes and it worked but this didn't seem to really address the issue. The cushioned shoes seemed to mask the issue instead. It occurred to me however that the foot has 26 bones, 33 joints and over 100 muscles - it must be pretty adaptable. 1/4 of all the bones in the body are in the feet. Perhaps trying to adapt the foot temporarily would be a better idea instead of locking it up in a concrete block and trying to forget about it as usual. This is the approach that I already take in skiing when I get people to lose their footbeds and learn how to use the feet - to make shapes with them and to feel how this then affects the leg muscles and posture - and also the feedback and function of the ski.

Walk This Way!
First experiment was to walk on the inside edge of the foot and this worked straight away. I could do this by extending the ball of the foot downwards and increasing the main arch of the foot - thus eliminating the need to stand on the outside edge of the foot and pronate inwards. This is something I use a lot in skiing to permit pressure on the ball of the foot without flexing the ankle and it resembles the "toe down" sensation in cycling that also strengthens the foot and transmits power more effectively. In skiing I sometimes stand on the outside edge of the foot too - but the inside edge of the ski! Walking should be simpler that and of course it is - so I was able to adapt and walk painlessly. Is it possible to remember to walk this way though even for a short while?

Consciousness
What I've realised after 25 years of teaching sport is that people do what they learn to do - and that instinctive natural responses are seldom appropriate. Sometimes the instinctive natural response is really bad - just throw someone who can't swim into a pool and watch the natural response - or stick them untrained in a boxing ring or on skis - all contexts which require learning.

For me "consciousness" is really simple. It's nothing more than a feedback loop that allows us to re-program unconscious behaviour. Most animals aren't very good at that but humans can be. (not all humans!) We can consciously re-program behaviour so that the new patterns or coordination are the new automatic unconscious response. I've been doing that for many years myself in very highly skilled sports (and violin playing - not so skilled!) so altering how to walk temporarily shouldn't be a big issue. The real issue is just realising that it should be done - when everywhere people are trying to stuff you into shoes, orthotics and plaster casts and de-responsibilising you (if there is such a word.)

Risking the Barefoot Run
Yesterday I decided to properly test out this theory of "foot adaptability" by seeing if I could run with the foot functioning so as to protect itself. To ensure the clearest possible feedback I decided to run properly barefoot on tarmac. (Also potentially the greatest risk.)

I ended up running 3km in the Vibram Five Fingers and then 3km  barefoot - about 30 mins altogether - all slowly and concentrating on form. I tried barefoot first but the foot hurt and switching to VFFs the discomfort disappeared. Once warmed up and focussed on good mechanics I went back to barefoot and it was fine after a minute or two to adapt.
I'd decided that if at any point there was a sharp pain I'd stop immediately. As expected the pain was more evident fully barefoot on the road - but what this did was give me clearer feedback and obliged me to correct the mechanics even better. I found that the natural "protective" response to pain in the foot is to actually land slightly more on the outside edge (where the injury is) - perhaps to generate more cushioning effect though greater pronation. This isn't felt clearly with the VFFs so I couldn't spot it until going barefoot. Another tendency I spotted was to bring the foot too far forwards - also some sort of protective measure (perhaps to avoid committing pressure to the foot) - and for this to cause the foot to land mid-sole  - exactly, once again, on the point that is hurting! I consciously stopped "over protecting", made sure that my foot landed underneath me so as to land properly on the forefoot and then everything was fine at a low speed. I used ice on returning home and next morning my foot actually felt better than before the run (no ibuprofen). Not planning on doing too much of this but if I can manage once or twice a week at the moment then perhaps this approach will be OK.
It's amusing that "sensible" advice is to not even walk barefoot and to immobilise the foot or to at least use orthotics in a shoe. If that was right I should be in a mess after yesterday but I'm not.

Skiing Therapy
The idea to oppose apparently sensible advice really comes from something that I have learned from ski teaching over the years. Most injuries involving joints, muscles, backs (sciatica) etc. can actually be helped by skiing despite doctors advising people not to ski. The docs would be correct if the people skied with a "normal" understanding of the activity - but with an accurate set of insights and perceptions as to how it really works skiing becomes incredibly safe and literally therapeutic for the body. Using accurate feedback and good mechanics everything is worked in an intelligent manner. This allows the body to protect itself and to heal - through good posture, getting reflexes to work for instead of against you, working with physics instead of against it and applying many counter-intuitive rules. Barefoot running is exactly the same in this respect. Skiing makes us work to find the appropriate set of natural actions to use in a modern context. Barefoot running makes us work to become aware of a natural set of rules to use in a natural context - the work being necessary to overcome a lifetime of being forced into the modern context of shoes.

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