Robin was skeptical. She called a few times to the clinic and asked questions. She had medical questions as well as financial questions. She was a friend of the clinic, and the literature on MVPT’s website/blog had intrigued her. She has a very long history of lower back pain and was told she should never run. She wondered if we could help. As her evaluation unfolded, we learned she had a fusion in her lower back about 4 months prior. She went to a traditional PT to recover from the surgery, and her PT instructed her that jumping and running were too risky for this back. Robin wanted to run again, and she wouldn’t take NO for an answer. Good for her.
Evaluation: Female, mid 30’s. Long time active athlete and registered nurse. Multiple year history of lower back pain, including fusion. She also had left knee pain and left ankle pain. Robin was told these issues had nothing to do with her back or recovery from surgery. Her range of movement was poor and her back/hip stability was even more limited. Poor is how we document it as we were starting very low. So poor, in fact, that she also had loss of urine - big sign her trunk muscles are not properly sequencing stability actions. She was determined to work. She wasn’t going to listen to the fear tactics or legal recommendation she got from traditional medicine. She simply asked “do you think I will be able to run?” My response was, and still is, that if you have the range of motion, strength, landing mechanics, and running mechanics to pull it off, then YES. That proposition would be A LOT for her to overcome. We agreed to work and see. Honestly, many people want to run but are not willing to put in the work. There are no hocus pocus short cut treatments. Robin needed to be able to handle the load of running. She had to be willing to work. And she was.
Intervention: Create joint mobilization of her lumbar and hips to get her closer to normal range of motion. We gave Robin a progression of “mechanical” stretches to systematically build in more movement. Not muscle stretching but joint movement. Her range of motion would not be normal with the fusion, but we could strive for the most possible. Next, attention was placed on her stability. She had to recover the basic functions of how our foundation muscles or our “core” even fire. Once they fired correctly, we began to load them. Her back and her hip stability greatly improved in the matter of a month. At around the 4-6 week period we began to introduce some loading. Robin was significantly sore for 2-3 days after squatting with a 15 pound kettle bell. That is how low level the entire body was and how this body could not tolerate the ground reaction force of running. Her knee pain and ankle pain were directly related to poor stepping biomechanics and poor hip/lumbar stability. They diminished by the 4-6 week mark simply by giving her back and hip control. Within weeks she was squatting with a bar plus weight with excellent mechanics, able to tolerate lunges and other higher level strengthening. Squatting is necessary for our skeleton. Poor squatting mechanics or improperly weighted squats are how squats get a bad name. We began to jump. Robin then had to learn how dynamic stability is different than static stability. She had to move with the same stability. After a week or so of jumping and learning a soft landing strategy, she was itching to run. She developed normal ROM, advanced hip and lumbar stability, sound landing and jumping mechanics, and now she was ready to run.
Robin’s first “run” was 1 min on/1 min off X 3. She was pooped and a little muscular sore for a few days. She continued to develop even more advanced body strength while we built in more and more running volume. Her running volume increased to 15 min without a break after about 3 months of training. There were no reckless decisions made. Every progression was earned, and she was ready to move to the next stage. She progressed her running stepwise. She was in the gym 3-4 days a week and out running 3-4 days a week. Robin trained her connective tissue to handle the force of running. She developed the strength and stability to run with efficient landing strategy.
So should she run? YES! Is her back issue something to watch? YES! Having an issue did not make her disabled. She worked to become ABLE to handle force. Could her skeleton handle running 3 months ago? Who knows but most likely not. We, at Maximum Velocity, are so proud of her work and attention to detail. She changed completely how she moves her body and what she thinks her body is capable of doing. So much so, she has prepared herself quite well for the Las Vegas ½ Marathon. Robin built her mileage up safe and sound. She put in the work to stay strong, and she developed the biomechanics to run pain free at that distance. GOOD LUCK ROBIN!!
The best part? In 3 months she came for 11 visits. She is in the middle of getting her visits reimbursed by her insurance company. There are alternatives! Robin’s story is not new to us, we have hundreds of people with similar stories! There is someone who understands that running is part of our soul. That cannot be overlooked. It is a part of us. If you’ve been injured or sidelined and want to get back to running, don’t try to do it on your own. Let the professionals at MVPT educate you on how to develop an independent approach to running. A gait evaluation can identify any problems coming down the pipe for healthy runners, as well as, improve running performance. If you are injured, a running evaluation will education you on the “table” impairments to work on (ROM/Strength etc), and we will give you running homework. Resting usually isn’t the ideal way to treat a running problem. Can you get more efficient on the couch? How much strength do you develop on the couch? Let us help! Visit maxvelocityPT.com or call 702-932-2900 to schedule an appointment today!