When I first started writing about this injury, I had an analogy in mind and wanted to explore it further. What if an aging body is like an aging city, its infrastructure gradually deteriorating with age and overuse? The deterioration might be imperceptible at first, but soon enough cracks would start appearing; once smooth surfaces would become rough and pot-holed; failures would become more common and more severe. Or what if an aging body is like an aging building? Old systems become less reliable and efficient. Materials wear out and must be replaced. The body as infrastructure. It had a certain appeal.
But I quickly became dissatisfied with the analogy.
It seemed to me that with the body, aging, while challenging, isn’t a “problem” in the sense that there’s a solution to it. It would be equally bizarre to claim that “Time” is also a problem to be solved. Nor did I believe that aging, per se, causes injuries. It would be just too easy to blame any new breakdown on age, and avoid grappling with underlying mechanisms.
No, that wouldn’t do.
In fact, I didn’t think there was anything about my recent injury experience directly related to age — related to habit, yes, but not to age. In other words, this wasn’t about deterioration, it was about imbalance.
Last fall, I read a great book called “Anatomy for Runners,” written by a practicing Strength Coach and Physical Therapist named Jay Dicharry. It’s written as a practical guide for clinicians or athletes who are trying to understand how to make bodies more resilient to the wear and tear of running. Rather than using the analogy of a crumbling city, Dicharry compares the runner’s body to a car, and points out that most runners — and especially distance runners — spend the vast majority of their time trying to improve the performance of the engine (the cardiovascular system and various energy systems) and very little time on the chassis (the system of bones, tendons, muscles, and ligaments responsible for executing the movement patterns involved in running.
“Like most kids from the Nintendo generation, I grew up playing my share of games. I liked racing games when I was a kid, and a lot of them followed a similar format. They start you off with a simple car for your first race. As you improve your skill on the racetrack, you win races and get “money” that you can use to upgrade your car. […] Spending your prize money on a bigger engine, you can hit very high speeds. […] However, you soon realize that all that horsepower leads to a crazy bucking bull in the corners. You just can’t keep it stable in the turns unless you spend some dollars on suspension and tires. The video game almost “forces” you to follow a well-rounded progression of your car because sinking all of your dollars into one category doesn’t get you what you need to win the race. […] All of that horsepower needs to be transferred through a stable chassis if you want to see the fruits of your labor.”
A stable chassis: what does that mean to a runner? It means being able to maintain postural integrity and proper alignment of multiple body joints while repeatedly absorbing forces equal to several times your body weight applied over a fraction of a second. Maintain posture and alignment and the tissues of your body have a fighting chance. Fail to maintain alignment — either through lack of strength or a lack of skill — and tissues are deformed by forces for which they aren’t prepared.
Or, more succinctly:
“Large forces applied to unstable levers is a recipe for disaster.”
As I wrote earlier, I’m not the best at seeking out help when I experience symptoms of pain or discomfort. Like many runners, I’ve learned to ignore a lot of things, and like many runners I have a tendency to hope that the things I can’t ignore will just go away. Is this because seeking help undermines my self-image as a tough and self-reliant athlete? Or is it because I’m afraid of being told that I have to change my habits or give up my favorite activities? I don’t know. But one thing that makes it more difficult for me with running-related issues is when a professional — perhaps a sports medicine practitioner — looks only at the symptoms, and doesn’t look for underlying causes.
Sam Peck, who met with me to investigate my symptoms and assess the structural weaknesses that might be playing a role in my injury, is not a doctor or medical specialist, and if my foot had been broken, I would have needed a different kind of help. But my problem was of a different kind. I wanted to know why I could run a fast quarter on Tuesday night and feel good, and then struggle to run 8:00-miles on Wednesday, seemingly doomed to repeat a frustrating cycle of good and bad runs that had been going on for months. And, of course, I wanted to know what I could do about it.
People like Sam whose background is in functional strength training seem to be focused on helping people like me identify and change the fundamental movement patterns that lead to tissue injury. Jay Dicharry and Sam both speak of running as a skill, and emphasize both (strength) exercises and education/practice to improve that skill.
Sam gave me a lot of homework. For the past week, I’ve been doing daily active release work on trigger points, stretching for muscles that have become overly tight through compensation, resistance work for tendons and muscles, and balance exercises. I won’t lie. It’s not nearly as fun as running.
But maybe the best thing I got from Sam was the conviction that this was necessary work. I came away knowing that I needed to work on my current weaknesses — the ones that are preventing my foot from healing and meanwhile making everything else on my right side unhappy. But beyond that, I became convinced that I needed to re-program old movement patterns. I don’t know if I’ll be able to do that. I also don’t expect that if I am, it will be easy or quick.
On the other hand, I’ve already tried muddling through and waiting for things to improve; it didn’t work. So unless I’m ready to blame everything on being old…
…I’d better get started on that homework.