Running Rehab: Ankle Irritation, Lower Leg Pain, and Pronation - Part II

I resolved to rehab my ankle last week. I said I'd check in, and here I am, still not a doctor! Over the past week I've been doing 3 things:

1. Massage -
Self-massage with a small glass bottle, plus these delicious $5 (150 baht) foot-and-leg massages here in Chiang Mai, Thailand. (Sorry for even mentioning it!)
It hurts so good! I can feel my progress because my soreness is abating.

2. Stretching -
Rotating my ankles qigong style, and focusing/pushing hard on the medial portion of each roll
While sitting on a chair, keeping ankle alignment and slowly going through palmar and plantar flexion, limiting my range by my ability to hold alignment.
keeping good ankle posture through forward fold, downward dog.
Can you feel that stretch? I can, though if I overdo it, that feeling might turn into clicks instead.

3. Practicing posture -
In addition to daily focused practice "penny-pen" style, keeping posture in daily life. This has included engaging my right abductor to keep my knee over my ankle, especially while going down stairs.
I'll get more into that below.*

When combined with stretching and massage, the progression of exercises goes signaling, strengthening, movement, and integration:

1. Focused signaling: practice of "short foot posture."

This is a neurological learning process. Gains can be made through attentive repetition; attending to and trying different things, feeling the difference, correcting, and trying again. Honing the signal from the brain to the foot includes both what to flex and what not to flex; differentiating the signal to flex the arch and medial ankle from the signal to flex the toes or the ball of the foot.

2. Strengthening

Through that same focused repetition, I was strengthening my arch. While I got more specific with my movement, I noticed I became less motivated to do the work, because it was no longer a puzzle and a challenge. I've got to keep at it though! Only over the long term am I going to combat lanky tendons (I hear those don't shrink) and really refine that alignment.

3. Movement Variation

Keeping this posture, I'll ask the foot to absorb shifts in weight. I've used this very light exercise. For my hips, I already use a yoga bridge, keeping my hips aligned and shifting my weight from one ankle to the other. However, I'm noticing as I ask my ankle to load differently, my legs respond differently as well. I'll similarly do some slow squats.

4. Integrating the new posture with everyday movement

I'm already constantly working on and observing this during my daily activities, e.g. while standing, walking, jogging, climbing stairs, and riding a motorcycle. I'm learning a ton as I watch changes in my weight distribution and the angles of my ankle, knee, hip, and even shoulders. I should take it easy and not push or geek out too hard because I don't want to get burned out. (On a hike, I was being very attentive to my desired posture, and found I had made noticable change for the downhill muscle groups to adapt to on the return trip! *That's a where the abductor came in especially handy.) Overall, it's starting to form a nice habit.

Changes:
Engagement of outer calf muscle while walking, esp,. stairs.
Less external rotation of leg when lying down.
Less "clenching" and fatigue of right adductor.
While stretching ankle joint, or in forward fold, less general soreness.
While receiving massage, less soreness in the ankle and sole.
While running, a noticeable lateral shift in right foot load pattern.
Still got to keep the ball of the big toe down!

Still more changes to be seen. For the first week, this is more than I hoped for.

Further resources:
Overpronation diagnostics rant
Diagnostic trick, advice
Some badass doing something pretty intense. I'm not yet, but you can if you want.
And another badass doing some fun things.

Running Rehab: Ankle Irritation, Lower Leg Pain, and Pronation

Hey everybody: I'm no doctor and I'm not offering medical advice!!

I started running consistently for the past month or two. For the last week, after longer runs, my lower legs were in increasing discomfort! Resting didn't reset how they felt, so maybe I was building the wrong kind of tissue, and headed toward an overuse injury? Yikes! I tried a flip-flop walk. (Not on purpose; I'm not that smart.) I noted lateral rotation in my left foot, and ended up with acute irritation on a lateral ligament. Yay, feedback!

Something I started with before running regularly: Overpronation in the right foot. For years I experienced knee pain in that same leg if running or hiking, and tension in that adductor if sedentary. When I lie down, my whole right leg externally rotates, so my right foot flops to the right about 15 degrees more than my left, with a bit more plantar flexion as well.* I assumed it was part of a hip issue, but for now I'll take this as a symptom of lower leg tension often accompanying overpronation, and see if I can make headway there. Reevaluation ftw!

Short-term goal: Rehab strained lateral ligament on left foot, relieve pain and get back to a stable gait.
Actions taken:

• RICE! Rest, ice, compress, elevate
• Self-massage of sole with body weight and small glass bottle
• Self-massage of ankle with hands, elbows in sukhasana or var.
• Penny-pen exercise; press down on ball of foot, engage arch
• This exercise also helped me find that "arch" muscle group.

Long-term goal: Strengthen and stretch for healthier lower legs, and get back to running!
Actions taken:

• More self-massage!
• Uttanasana/Adhomuka svanasana focus: Soften knees, drive ball of the foot while engaging the arch (using penny-pen skill above). Keeping these layers, add flexion stretch to heels, and isometric lateral rotation to hips. So doing, I feel this stretch all through my legs, in my problem muscles, in subtle but deep ways which I hope will have a positive impact.
• This stuff feels weird in my knees, but I'll do it once in a while to check my progress.

I updated after one week. Check my progress.

* "Fifteen degrees?? Big deal!" you might say. I don't have clinical hip dysplasia. For those that do, may God's love and a great PT be with you.

Disclaimer: Everyone is different. I have a weird situation. (Don't we all!) My hips sit at different angles, my left leg is longer than my right. This is probably exactly like your body... but we still might have a lot in common. Bipedalism, for example!

Body say!

You don't need your teachers anymore.  They've been telling you how to make yourself feel good with postures.  It's a gift, to know this, but it's yours now.  It's felt better since you've felt more safe, more able to open up, more intent on healing and taking good care of yourself.

Your spine is a luminous, incredibly complex and irreplaceable piece of equipment, enmeshed perfectly in the delicious form of flesh you call your body, having grown together like a tree around a fencepost.  Your muscles all configure in the best way they can for all the things you often do.  Your joints, too, have graciously allowed you the range of motion needed in all your regular tasks, big and small.

Yoga is your tool now, your way to express and commune with me, your body.  You have been letting the thoughts "having to" or "ought to" make me feel terrible.  You can use yoga to conquer those, too, when you do it as you and I please, when we please, as long as we please.

What you really need is some creative license.  Some time to yourself, however often you seek it, to put yourself into the place you want to be.  Let it out, sink into it, find an old wisdom new again.  Use the breath and the sensation find that place in my mind, smooth as Jiffy and sweet as Smucker's.  Yoga is a tool for moderating your mood.  Like chocolate.  Like music.  Like marijuana.  Like Yogi New Yorker said; "Everyone there was doing it to get fit.  I was doing it to get high." 

Get high.

Power Plug

Ah, my spine.  It is inside my body, connecting it to my brain, and it's the one thing that has so much value to me, besides my brain.  I haven't taken loving care of it.  This luminous, incredibly complex and utterly irreplaceable piece of equipment, encased perfectly inside the delicious form of flesh I call my body, having grown together like a tree around a fencepost.  I have inhabited it for so long, appreciating it so little, and even taking out on it my rage at feeling so trapped inside it.  But it really is beautiful.  Even though I've put it through so much, and done so little work on it since I got it.  The bare minimum to feel okay.  Oh, my lovely self, the core of me.  Let's go play together, eh?  Just you and me, spine!

Death and Resurrection

It's been six months.  Finally, my practice is mine again.  Whew!  That was close, almost started out by selling my soul.  That would've been a debacle!

How did I lose it, that presence of mind, that fluid interaction with my body and spirit?  Like most injuries, all it took was pushing a little too hard, the wrong way and in the wrong direction. 

Yoga was for my physical and mental health.  My body didn't feel my car crash anymore, but only the joy of strength and flexibility.  My mind wasn't trapped in dark twisting tunnels, but dwelt in expanses made of breath and movement.  I took personal pride of moments of wanting to step out of a pose, and not, in immense joy in holding that pose until a traumatic event of bygone years comes rippling through me into the supple sweetness of relief.

One more pose, one more breath!  The dance, gymnastics, massage, meditation, psychology, martial arts, all came together to ask yoga to tie them all into a game they could play together.  These disciplines informed one another, and their joy was multiplied in me.  A way for me to play with myself.  Call it masturbation, or navel gazing.  Call it a waste of time, but it was who I was.

Then it became an identity point.  Yogi.  All those women at the studio telling me, "Your poses are so perfect, you should really be a teacher!"  My friends telling me, "You're so dedicated to get up so early and go every day!  I could never do that."  I was not internally motivated toward teaching.  I fell into it a few times with friends, or when a teacher didn't show up.  I wanted to offer my joy to those I cared about.  No evangelism here!  But I needed a career.

The direction.  Yoga Teacher.   That was my way forward.  I became attached to an outcome, and that outcome had to do with who I was.  I remember thinking that I was driven toward being a particular way, only to find that I was actually geared toward being perceived a certain way.  What I desired was to be perceived as worthy of teaching someone yoga.  I didn't desire to share knowledge.  I desired status; polarized relationships where I am idealized.

Ah-WOO-gah, ah-WOO-gah!  Turn this ship around!

A teacher is necessarily one part of a relationship.  Without a student, there is no teacher.  Where was my student?  Why, within me, of course!  And how was I teaching that student?  Aggressively.  All the negative self-talk in the world cannot a yogi make.  No amount of force or fear can lead to true knowledge and growth.  It took all the joy out of my practice and infused it with frustration and shame.

After my teacher training tuition was paid for, I rolled around on my mat, looked at the impressions of my feet and hands.  Thought.  Cried.  For months.  Why was it gone?  Why can't I do this?  Why can't I think about my body the same way anymore?  I worried about how I would fit in at the school.  I worried about my ability to keep up.  I thought about how I would explain a pose to someone else, in my own words.  I cowered from these thoughts.  I'm not good enough.  I'm not a teacher.  I'm not even a yogi.

The attachment was so strong I couldn't see the conflict.  It was just a morass of dread.  A fog.  I lost faith in my practice and in my future.  I lost my muscle, my flexibility and my steady control.  It was when I felt my shoulders start to turn inward, and my hips begin to freeze, that I decided.  No.  It would go no further.  I could feel the despair's toll, feel the self-talk draining my hope and charisma.  This is my body, and I only get one.  This is my mind, and it is how I experience myself.  This is my fear, and I am watching it take me down.

Every time I even looked at my yoga mat I heard pieces of me, buried deep, they warned me, No!  You will fail!  You aren't worthy!  Insisting, You will be crushed later by your efforts now!  Everything will be in vain.  They told me, in my father's voice, in my past lovers' voices, in old friends' voices, You aren't good enough!  And in a panicked child's voice, which was my own voice, I heard, Run and hide!  It's not safe here!

I had listened to those voices for so long, asking them, How do I become acceptable to you?  How do you want me to be?  How can I be safe?  I bargained with them to protect that scared little girl.  To keep her feeling safe.  I had believed that those expectations were important.  Not to live a good life, but in order to be safe.  What was important now was my health, my body and mind.  Myself.

I wandered away from many practices, and cried hard while pushing through others.  The voices continued, bubbling up from murky depths to tell me how worthless I was.  I once heard my father, revoking his love, and knew he wasn't here, that this was me, doing this to myself.  I sobbed, knowing that I had been abusing myself this way for decades.

Then there was only the child left, softly asking for assurance.  Softly wanting to know, Where are we going? Why are we doing this?  Why did she want to know?  So that if we met someone, we could tell them?  And then they might not hurt us.  Girl, we grew up!  People don't care where you're going if you're an adult, and they won't hurt you if you can't explain why you're doing something.  Really?  So like, I can do what I want now?  Well, then!  I choose to play!

I don't need to have a plan.  I trust myself enough to follow my desires.  Trust that the lessons to learn and the help I need will be there sure as breathing.  I know now that the main point of yoga for me is my enjoyment, and that that in itself is a good enough reason to do anything.  In this game of life, I'm not keeping score, I'm not playing to win.  I'm playing to play.

Self-Mastery

I've read piles of American 'get-what-you-want' books talking about "self-mastery."  I now know those books are on how to better meet your own expectations, to appease your ego.  To identify and seek your desires.  Desire is a holy path; it is in obtaining the object of desire and finding it dissatisfying, that you may begin to turn within.

My desire was to be happy.  For years I trailed after and questioned individuals I thought had it figured out.  I pursued them, far from bliss, to their most private dreams and darkest moments, until I was able to see how empty their pretending had made them.  Convinced I needed a role model to become who I wanted to be, the experience was demoralizing.

There are many caves dedicated to the Buddha throughout Asia, many hand-hewn, with statues well over a thousand years old.  Many Thai Buddhist temples are built near caves, and maintain shrines within.  My luck once found me inside one of these caves, and so I found, inside me, one of these caves.  Allegorically speaking.

Having wandered the wat grounds and found the entrance, I took off my shoes and ducked in.  I am immediately surrounded by wet black rock jutting at unexpected angles.  Brimfull buckets echo the sound of steadily dripping water.  The barefoot climb up and down slick stone steps is laid with towels for sure footing.  Having entered a shrine chamber and taking seat on a mat, I found myself open-hearted and face-to-face with a triad of Buddha statues in luminous candlelight.

I looked into the faces of these statues in turn, taking in the subtle nuances of their expressions.  One is still and strong, wide awake.  Another has a calm and open smile.  The last with closed eyes, enjoying samadhi, or some such lovely state.  My imagination, or maybe my mirror neurons, took wing and carried me there.  I realized only afterward I was entirely engaged for an unknown period of time in my own enjoyment of... what?

This was not shaktipat, not a flash of enlightenment.  Just the realization that self-mastery is not in having conscious control or mastery over my thoughts and actions, but in the ego surrendering to my true self.  Whether it is inherent, imagined, or demonstrated, there is a place in my mind where dwells a part of my self which I can turn to as a master, to teach me everything I wish to learn.

Yoga for Sleepyheads

There are lots of poses you can do with minimal effort before (or whether or not) you get out of bed!  Maybe you're depressed, maybe you had a late night, or maybe you're sore from yesterday.  Strike a deal to stay in bed (just five more minutes?) while getting in touch with your body and breath.  Here are some baby steps, before your feet even touch the floor!

On your back, there are plenty of choices, aside from savasana.  Here are my absolute favorites:

• Supta baddha konasana!  Soles of the feet together, shoulders down and back to expand the ribcage.  Open your hips the relaxing way, with gravity and breath.  You can bunch your blankie under your knees if you're not comfortable flat on the bed.