The Kinetic Chain

First it was the SI joint; I've been managing that little bastard for over a year now and racing/training in pain despite physical therapy, stretching, strength training and the best intentions of multiple chiropractors. At least this issue was something that I could manage; it hasn't been fun, but it hasn't kept me from training or racing to the best of my abilities.

The inflammation in my right knee, however, was the breaking point. It ended my season prematurely and put me on the sidelines. Thankfully, I'm swimming and cycling again, but it's been 3+ weeks since the last time I really ran. I gave it a go yesterday but only made it 10 minutes into my run before the discomfort kicked back in and shut things down.

What I would give to run 9 or 10 miles right now...

But, there is hope. Last week, I paid a visit to my friend, professional strength coach and fellow triathlete Franco Zuccoli who thoroughly evaluated my posture, flexibility, range of motion and degree of muscular balance. In addition to a couple of other glaring issues, Franco immediately pointed out the fact that my left arch is basically completely flat and that my right arch isn't much better. He insisted that I make an appointment with orthotist Dan Bishop ASAP. As a kid, I overpronated to the point that the medial heel cups of my track spikes would actually become discolored by whatever track I was running on. Orthotics quickly cleared this issue up and allowed me to race/train pain free (I suffered from frequent bouts of achilles tendinitis as a youth runner thanks to my overpronation).

Franco's notation/recommendation was something that made a lot of sense to me and I started dwelling upon it over the weekend/early part of this week. I've always known that I overpronated, as I can actually feel my ankles rolling inward during races, especially once the fatigue sets in, but I never thought about what kind of biomechanical problems overpronation might pose. Even when I ride my ankles roll inward... In this case, overpronation would explain why I tend to start riding "duck toed" during hard efforts and why the medial heel cup on my cycling shoes makes so much contact with the crank arms that they end up looking polished.

Franco's evaluation, and his recommendations regarding our course of action on the strength training/rehab front, focused heavily upon the body's kinetic chain. I've been seeing specialist after specialist to try to "fix" this SI joint problem for over a year now, but nothing has worked. Yes, I have experienced some temporary relief here and there, but the problem has never gone away. Reason: The symptom is being treated, not the cause. Physical therapy was aimed in the right direction, but fell short in that the fundamental cause of my SI joint problem, and the knee pain that is now accompanying it, has a lot, if not everything to do with the simple equation shown above.

The short of it: The left foot in particular pronates during both running, and to a lesser degree, cycling. As a result of the overpronation, everything from the ankle up is affected biomechanically. I won't bother trying to guesstimate what the hell is going on biomechanically with my tibia/fibula, patella, femur, pelvis/SI joint and every muscle that attaches to them thanks to the overpronation, so check out this great article for a little more insight and an example of what kind of trouble overpronation can cause.

I'll tell you, it'll be a combination of euphoria and frustration if the ortotics prove to be effective. I'm dying to resume hard-core training, and will be extremely happy when I'm able to do so, but if I find out that I wasted over a year, not to mention a lot of money trying to fix a bunch of injuries that were all caused by flat arches, I'll be pretty pissed off to say the least.

Well, you live, you learn. I met with Dan today and he's very confident that the orthotics will clear my SI joint/hip flexor/knee issues up.

We shall see. I'll have them by next Wednesday. I'm optimistic at least.