Improving Physical Function for the Long Run
Despite her doctor's advice, Leigh Ann refused to give up on running.
Client: Leigh Ann
Personal Trainer: Casey Stutzman, owner, The Performance Locker
Location: Alpena, Michigan
Not giving in. Leigh Ann loved to run. However, after completing her first half marathon in October 2010, she began to experience knee pain. A subsequent race resulted in even more pain and swelling. Leigh Ann was benched.
In November of the same year, Leigh Ann met with personal trainer Casey Stutzman. “Leigh Ann had seen an orthopedic surgeon who advised her to stop running,” explains the Alpena, Michigan–based trainer. “He told her she was not built to run, and he strongly suggested that she stay away from any sport or activity that caused repetitive stress on her joints. Leigh Ann had no desire to stop running and was at the end of her rope. She wanted the pain to go away. She wanted to keep running, and she was open to anything that might make that happen.”
Dysfunction discovery. Stutzman believes that the presence of pain is usually the result of dysfunction somewhere else in the kinetic chain. “Don’t look at the problem,” he says. “Look around it.” To determine potential catalysts for Leigh Ann’s pain, he facilitated movement assessments such as squats, lunges, push-ups and TRX® rows. “During squats and lunges, I wanted to see what her spine, hips and ankles were doing; the pushes and pulls were to see shoulder action.”
The assessments revealed a series of issues, including a large anterior pelvic tilt, right-foot eversions during lunges and a right valgus knee during squats.
Releasing and strengthening. Stutzman first taught Leigh Ann various self-myofascial-release techniques that emphasized the calf muscles, quadriceps and tensor fasciae latae. The primary objectives were to increase ankle mobility, promote a more neutral pelvis and minimize pressure to the knee. She performed these tasks at home daily and prior to her training sessions, which incorporated the TRX Suspension Trainer® and the Rip Trainer™, among other tools.
“We did a lot of exercises—for example, standing rollouts on the Suspension Trainer—to promote good posture and a neutral spine. This kind of exercise taught Leigh Ann how to lift the front of her pelvis to keep good alignment. The Rip Trainer helped place rotary demands on the trunk even in simple moves like a standing press.”
Stutzman also insisted that Leigh Ann eliminate all running from her weekly routine until the dysfunction cleared up. A tall order—racing season was quickly approaching.
Movement freedom. “By the time summer rolled around, Leigh Ann was pain-free and back on the road,” says Stutzman. “She participated in four half marathons and was smiling at the finish of each one.” He adds that Leigh Ann also drastically reduced her training miles—from 400 in 2010 to 200 in 2011—which he believes was paramount to keeping the pain at bay.
“She finished the season pain-free and was even able to improve her average finish time from the year before. This past season (2013), Leigh Ann finished seven half marathons, two sprint triathlons, an Olympic-distance triathlon and her second Tough Mudder®. By the end of the season, she was tired but not hurt.”
Stutzman and Leigh Ann continue to train together and to spend the off-season improving movement mechanics. “We do a lot of multidirectional-type training so her year is not [filled with] repetitive linear training, and we use other modalities like boxing, rowing or jumping roping for her endurance work,” he says. “Every summer (in season) we focus on mobility and recovery. Repetitive stress leads to injury; we do everything we can to keep her recovering as quickly as possible from event to event.”
Earned progressions. “I think Leigh Ann did so well because she was invested in earning her progressions,” explains Stutzman. “Too often in fitness we want to throw people into the deep end of the pool before teaching them how to swim. Working smart, not hard, allowed Leigh Ann’s life to change for the better. Success for our clients boils down to the professional’s courage to give clients what they need, not just what they think they want.”