MobilityRx Home Strength Plans
In our office we regularly provide patients with rehab exercises to improve their strength, pain, and range of motion. A while back Dr. Chloe had the brilliant idea of taking our rehab exercise and turning them into circuits of three exercises - now called the Triplet Training System - that included everything that a patient would need in order to correct imbalances, decrease pain, and improve strength. Today we weave the Triplet Method into everything that we do, including our MobilityRx home exercise plans, and our MoveRight fitness, and yoga classes.
The 3 Key Components To A Complete Rehab Exercise Plan
We've identified the three key components for a complete rehab plan for targeting chronic problem areas. They make up the bones of our Triplet Training System. As long as your current plan consists of exercises from all three of these components, chances are you are on the right track. Make sure you current plan consists of:
Your FREE MobilityRx Back Program
We’ve created a FREE 3-day home exercise program for people who have a history of back pain. Our MobilityRx rehab exercise plans are based on the same in-house methods that we use at Mobility-Doc. All you will need is your phone, some very basic gym equipment, and 15 minutes to spare. We use TrainHeroic, a free app for both iPhone and Android users, to deliver our training programs. With TrainHeroic we can fully customize our exercise rehab plans with videos, written description, and so much more.
Please feel free to share our MobilityRx back plan with anyone that you think could benefit from it. The information is free so that we can help as many people as possible.
How To Claim Your FREE MobilityRx Back Plan
Want Something More Customized?
MDRx Custom Home PT Plan
We've helped numerous clients around the world with their movement and mobility issues. Using our video chat software we will speak face to face with you for 30min to get a feel for your issue. Then we will create a corrective strategy for you. We won't stop until we've got it perfect.
Mobility-Doc Remote Total Care
You are not average. Why should your care be?
We've had an amazing number of patients ask us if we could still help them even though they lived too far to come to us regularly. After experimenting with what we could do, and how we could do it, we came up with Mobility-Doc Remote. No longer do you have to settle for average care, or get lost in the medical mess of bouncing from specialist to specialist.
Let us be your healthcare consultants by managing your case. We can provide you with home exercise plans, direct you to the right specialists, answers your questions and calm your concerns as you get back to doing what you love, and so much more.
How It Works
We will start the month with a scheduled phone call, or video consultation. It's your choice. Expect to talk to us for approximately 30-minutes. We will find out everything about you, your case, and your goals. After that we will provide you with a detailed email summary of our conversation, and what your action plan should be. For some this might mean we are narrowing down a diagnosis and helping you to connect with the right local medical professionals. For others this might mean we then create a home exercise, or recovery, plan for you. For many of our current patients we are also monitoring, and editing, their training programs so that they can transition faster back to their regular activities.During the month we will require you to check in with us at the end of each week and provide us with a full report regarding your progress. We encourage you to send us questions throughout the week as well. We will do our best to answer immediately, but at the latest we will answer you within 24 hours.
Save Money When You Add-On
You can add a second month, or a third month, in advance to save money. You will also see options for other add-on services that might make sense with what you need. Feel free to contact us with any questions before purchasing. All we care about is providing you with the care that you need.
Add On ADetailed Corrective Exercise Program
We will work with you to create your home PT plan. It will be specific to your goals, current difficulties, and needs. We prefer touse TrainHeroic, free for you, to send you your program. That way you have video, audio, written description, and you can easily follow your program.
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Why yes they do.
I wouldn’t actually qualify what’s going on with as an injury. I call it a pre-Injury. It would definitely be going in the direction of an injury. But after 15 years of running, I’m finally learning some temperance.
So I want to detail what’s going on as a means of helping people to understand. Maybe you can relate to some of this in the past, present, or future. Regardless I want to help in some capacity. So I’ll answer some questions
You said pre injury. What is that?
I was having discomfort that passed a threshold that I was comfortable with. It shifted from tightness to pain, and it was affecting my stride and pace. I felt it when I was walking around, sitting, and standing. I decided to stop running and shift to more cross training, mobility work, sleep, and treatment. I didn’t want to insist on continuing to run until it got to the point of being unbearable and an actual injury. So I’m going with the concept of a pre-injury. I’m not letting it escalate into an injury.
What is wrong?
In essence, I have pain in the outside portion of my left foot. I can feel aching, throbbing throughout the bottom of my foot by heel and along the pinky side of my foot. I had some point tenderness at the base of the outside of my heel. (Medical translation: the cuboid, 5th metatarsal)
When did this happen?
Well, like a lot of (pre) injuries, there wasn’t a specific moment. It didn’t happen after I sprained my ankle two weeks ago. I didn’t have a specific moment. In the next two weeks my left calf had been feeling tighter, and within the last week my foot felt tighter too. I knew something was up on Friday when I was running I could “feel” my foot the whole time. I still ran, walked to work, and then went for a walk later that day, because I just thought it was pass. Then on Saturday, while I was running, it never “warmed up.” It crossed over to pain, and I ran differently. It ached the whole car ride home, and then I had pain walking barefoot.
Why did it happen?
Of course there is rarely a single cause to an injury. So I'll detail all of the contributing factors
How are you going to address it?
I still plan on trying to do Loopy Bunny trail run on June 29th. I’ll keep reassessing this plan, and I’ll continue to do numbers 1-4 above. #1 will be particularly difficult as I start feeling better. I’m writing this in part to keep myself accountable.
So the point of my sharing this is to tell you that I get it. I get the mental and physical aspects of injuries. Also, I strongly encourage you to not let yourself move into that injury phase; stay in the pre-injury phase and begin to address it. If you aren’t sure what to do, let someone help you.
Remember knowledge is power but only if you use it.
I’ll report back about what I end up doing for Loopy Bunny.
31 years of doing the same thing is enough time to become an expert at what you do, and Dr. John Sr. is no exception. At this stage in his career he is ready to help expand the services of Mobility-Doc, and start to service Mobility-Doc's Medicare patients to the fullest extent possible. It is for that reason that Medicare patients can finally find their chiropractic home at Mobility-Doc in Bethlehem, PA.
Interests include: setting unrealistic expectations for myself and then being disappointed with myself that I haven’t achieved an arbitrary (and always moving) standard.
Enter: agreeing to take a friend’s bib to do a 25k trail race that I haven’t trained for.
Now there is no reason to think that I would do “well.” I am not in race shape. I have been do three 4 miles runs (2 easy, 1 tempo) and one long trail run that’s about 8-10 miles with 1200’ of elevation. I didn’t even know about Red Newt’s Iron Mines 25k/50k until 10 days ago. Alas, that doesn’t stop me. But I agreed to do this race, because I knew it would be good to counter these tendencies that I have (and I know so many people share.) I knew that I could at least hike a 25k. So I agreed to do it.
I wanted to share my experience, because it’s one that so many can relate to. It’s one about unrealistic expectations, fear of failure, perfectionism, and acceptance.
I met my friends, Diana and Wanda, at a Waffle House at 4:58 AM on Saturday to head to Ringwood, NJ. The course started at the New Weis Nature Center and went throughout The Norvin Green State Forest. When we got the course map and cues, I knew that it wouldn’t exactly be intuitive in terms of finding my way. I also knew that based on the course map, there would be about three climbs with some nice downhills. At the end there would be some “baby” hills. That’s what I knew going into it. So I knew what I physically had to do (kind of), but more importantly I was preparing myself for what I mentally had to do.
Prior to the race, I kept having to challenge my tendencies that I previously described of setting unrealistic expectations for myself. Oh and that is coupled by the fact that my expectations are always a moving target. If I achieve the desired goal, then it must have been too easy. I kept reminding myself, with the help of John, that it doesn’t make sense for me to think that I would do “well” on this if I’m comparing myself to when I prepared for Naked Nick 25k in December 2018. Like I said, I haven’t trained for “racing.” I knew that I could definitely hike and run at least a bit of the 25k. So I kept reminding myself of that and challenging my narrative of unfair expectations.
I also decided to do it, because I know that I have previously been immobilized by fear of failure. A year ago, I would have never agreed to do this. But in some recent months, i’ve realized that failure is only based on how I define it. I couldn’t actually really fail in this case when I thought about worst case scenario. Worst case is that I got hurt. I feel pretty comfortable on trails, so I wasn’t too worried about that. The other worst case is a mental one: I DNFd (did not finish), because I was too tired. But even not finishing because I was too tired would give me an idea of the shape that i’m in. Then I realized that there’s so much freedom if I change my definition of failure. Throughout the week leading up to the run, I kept challenging the fears that I had, because I knew that they were a construct of anxiety and my perfectionism.
So the ruminations of unrealistic expectations and fear of failure kept resurfacing throughout the week, but they pretty much subsided by the time I got my bib. I knew that this was going to be a really cool race in terms of terrain and overlooks. And it was going to be great weather. I kind of got an idea of what to expect in terms of climbs. I knew that I was supposed to do 15.1 miles with 2800’ of elevation. I knew to follow the little pink flags in the ground. Got it. Well kinda...
My heat started at 7:45 AM, and I went out pretty easy. Within the first .5 miles the one part of the pack went off course. I should have realized that that wouldn’t bode well for the future. Within 1-1.5 miles I was lost after following a group of hikers that said they were doing the 25k course. Well, they thought they were doing the course. But then I didn’t see any pink flags for a while and new something was wrong. So add about 1-1.5 miles and I’m back on course. Immediately my perfectionism felt crippling. I was thinking “I’m not going to have an accurate gauge of how I did. This won’t properly represent the shape i’m in. I wonder how I would have done without being off course.” I just wanted to call John, but I knew what he’d say: It doesn’t matter. The real problem would have been if I stole the rest of the experience from myself. I was going to be running through the woods, climbing on boulders, and hopping from rock to rock. That’s what I love. That’s what makes me feel free.
After that point, I slipped into a meditative state. I remember certain pieces.
-I remember thinking around mile 5 that I was so happy to be out in the woods, looking at the moss, hearing the water, being able to physically do this.
-Around mile 7 I was thinking about how I need to keep hiking and focusing on using my glutes. (See, I practice what I preach to my patients.)
-Around mile 8-9 I remember thinking about how typically I would be close to finishing my long run.
-Around mile 10 I was reminded of hiking down from the second highest point of Lake Como with John (as he complained incessantly haha).
-Around mile 11 I was at the last aid station, and I had a moment of panic when I found out I still had 6.5 miles to go. But then I got excited. I knew I was going to run the furthest I ever have.
-Around mile 12 or 13 I was going to be going up to High Point. I tried to tell myself it wasn’t going to be so bad. But I remember the graph. I remember how much I just went downhill, and I knew I had to go back up. So I knew this was going to be critical. I knew that this is when I could really burn out. So as I started to climb, I remembered the sage advice of a patient: eat, drink, rest. I did just that. I knew that when it leveled out for part that I would keep walking quickly, because it was better for me to rest and let my heart rate come down.
-Around mile 14 I was speculating about how much more I had to do. I knew there were two “baby hills” left. Then I kept going up and down, and I kept thinking that that was the two. But then I kept going up and down.
-Around mile 15 I followed a group of runners ahead of me instead of following the pink flags. There was a moment of impatience; I just wanted to be done. But I knew the impatience and frustration wouldn’t have me finish faster. Then I thought of my crazy patients that run 100 miles. I would be in the infancy of my race. Then I thought that I’m going to stick with 25ks.
-Around mile something-near-the-end FINALLY I saw a volunteer, and they said 1.5 miles left.
-Around mile something-nearer-the-end I saw another volunteer that said 1 mile level when I swear I saw that other volunteer 1 mile prior.
-I began to recognize the course vaguely from the beginning. Then I got excited. I did it! I made it!!
A few (several) things I’ve learned:
So let me ask you:
What is one of the most important things you’ve learned from training or racing?? Comment below!!
25k Race Recap
Wow. So I did it! Saturday, I ran the Naked Nick 25k at Blue Marsh Lake, and it was a pretty much ideal first race experience: It was in the 40s; the rain held off for us; I was surrounded by a great group of runners. I’ll go into full details of the race and my thoughts after, but I wanted to first start with talking about my pre-race thoughts.
Pre-race thoughts and feelings
I first consider my capacity. I felt pretty comfortable with the thought of running this race as described on the website consisting of a 25k (or 15.5 miles) with rolling hills and total elevation gain of about 1500’. While my training wasn’t ideal, I felt comfortable with my ability to do that. So that helped to ease my nerves. More on that later.
Then I was thinking about 18 year old pre-race Chloe to present day Chloe. Chloe at 18-21 was crippled by pre-race anxiety. I would feel this desire to escape. I would dread a race. I would fear the pain of running hard and pushing myself. I would fear the potential for dissatisfaction (spoiler alert: I was always dissatisfied). I would avoid thoughts about it for a few days leading up to it, and then on race day, the thoughts of the race would consume me. However, Chloe at 31 can look at those fears more gently, with more clarity, and more distance. I had some of the same feelings to a milder degree. Yes, I had the thought of “umm, why did I sign up for this?” I was aware of the fact that I would have to be in some level of discomfort in order to push myself how I knew I wanted to push, and I knew that I might be dissatisfied in the end.
But those thoughts didn’t have the same intensity. They came in my mind; I saw them and acknowledged them; and then I let them go. They’re just thoughts. They’re the words that I choose to say. Now that’s not to say that I blindly subscribe to this whole mind over matter sort of thing. That isn’t broadly applicable. What is applicable is that there is always the potential for dissatisfaction or failure, but what we work toward is diminishing the odds of that. I diminished those odds by training. So what is the point in fixating on the small odds of failing and sabotaging myself mentally? I approached those pre-race anxieties with gentleness. They’re there. But I don’t need to engage with them. They won’t make me more prepared. That allowed for space between those thoughts and what I really needed to focus on. That gave me clarity. That carried me through during the race as well. Well. For the most part.
Even on the day of the race, I felt a calmness. That was, in part, attributed to the yoga I was practicing that week. My PrePose Method partner, Carrie, helped me with some breath work on Friday, focusing on getting full expansion of the rib cage, front to back and side to side. I paired that with the muscular stability that you can find with breathing. This ended up helping me tremendously during the race to not only keep me calm but focused and strong.
I’ll break up the race into thirds, because they were very different experiences.
First 5 miles of the race
It was a bit surreal when I got to Blue Marsh, because I was picturing this moment since I decided to start training in early September. That morning I could feel the adrenalin. I was quiet and very focused. I couldn’t help but think back to college running Chloe again, and I was so appreciative of that fact that I wasn’t in that same headspace. I felt ready.
As the race director said that we had 45 seconds until the start, it kind of hit me: “oh wow. I’m doing this.” Then my nerves really set in. The start was down hill; there were tons of people; Christmas music was playing; my adrenalin was flowing strong throughout my entire body. I quickly became aware of 3 facts:
So let me address these.
These three thoughts consumed my first 4-5 miles. I looked at my watch every .75 miles. There was a lot of anticipatory stress and distraction: people passing me, uphills, downhills, mileage. Then I realized that I need to lean into this and accept it. People will pass me. There will be uphills. There will be downhills (that with eventually become uphills). There are still more miles to go.
After that point, everything became a bit lighter. I ran my pace. I reminded myself that I have only been training for 3 months. I enjoyed the scenery. I surprised myself with running up some of these uphills. I didn’t fixate on the fact that somehow I stopped my watch and then had to restart a new workout. I embraced my pounding heart rate and the relaxation. I breathed into my chest, front to back and side to side.
I can’t really offer any more details, except for the fact that there was brutal hill that I ran up around mile 7 or 8, and I was so pleased to have been able to run it. For the most part, those miles were very meditative.
I could feel the urgency of wanting to finish when I passed the last aid station and Ryan told me that I had 3.8 miles to go. “Ok, that’s less than when I run to the office and back.” That’s my typical weekday run where I run from to home to our office and back. “I can do this.” I kept thinking about the last two hills. There was one going up a road and then one right before the finish. I was aware of the fact that I was just holding onto my pace. I was not finishing any faster. I was not getting excited. My legs ached. When I got to 15.5 miles on my watch, I was...sad? I just wanted to be done by the point. I kind of (read: most definitely) fell apart that last mile. Those two hills were brutal. I told myself that I wouldn’t walk during this 25k, and well, technically I didn’t, because I walked parts of those last two hills in that last mile. I was so close, yet so far away. Then I heard my mom’s voice as I crested the one steep portion of the last hill. Then I saw my husband, John, and everything felt ok. I was so relieved. I crossed the finish line, and I knew that I did what I had intended. I trained, I pushed myself, I enjoyed it.
I was so satisfied with myself. Well, full disclosure: the first thing I said to John was that I had to walk 25-50’ on the last two hills. I wasn’t completely satisfied with my performance immediately. But once I got that out, I settled into contentment and satisfaction.
I was able to run 16.5ish miles in 2:52:49. That’s about 10:30 pace. That’s on about 2200’ of elevation through muddy conditions. That’s on 14 weeks of training. That’s on aches and pains. That’s on an overly ambitious first 5 miles. That’s on my anxieties and nerves. So I’m satisfied.
I feel satisfied with that race, but of course, there is room for improvement. I realized a few aspects of my training that I want to change:
The last and most important thing that I want to say is thank you. Thank you to people like Lisa, Diana, Sue, Wanda, Lea, Ryan, Joy, Cheryl, and many others that I am forgetting for inspiring me and supporting me. I think about my running friends and patients on my runs, and they’re an infinite source of inspiration and motivation. I am forever thankful for them.
One more thank you goes to John. He treated me when I needed it. He listened to me as I spoke about all of my anxieties. He was the person I looked for at the finish line. I couldn’t ask for a more supportive partner.
Oh. And one last thing. I signed up for the North Face Endurance Series 13.1 trail race in New York on May 5th. More blog posts to come...
Monday, November 19th: run
Distance: 4.06 mi
Pre-run: foam roll calves, seated forward fold stretch then with calf stretch, supine piriformis stretch, ½ virasana, supine hamstring stretch
Post-run: calf stretch off of ledge, lunge stretch on step
I knew that this week was going to be a little different again, because we were leaving for Russia on Thursday. I had planned to run on Monday, Tuesday, and Thursday. Then when I was in Russia, I was just going to walk and enjoy the time with my family. This run was pretty standard. Nothing really to report.
Tuesday, November 20th: run
Distance: 4.02 mi
Pre-run: foam roll calves, seated forward fold stretch then with calf stretch, supine piriformis stretch, ½ virasana, supine hamstring stretch
Post-run: calf stretch off of ledge, lunge stretch on step
Again, this run was pretty standard. However, what I tried to do was take the guess work out of the mobility part, and I just did the same thing that I did the previous day. I am happy to report that with more consistency with mobility work that I haven’t been having as much tibia/calf pain on the right side as I was over the past 4 weeks or so.
That run finished in a pretty normal way. I went to work, and I hadn’t had a chance to eat anything. My stomach started feeling a little off in the late morning and I became exhausted. I slept for about 1.5 hours in the middle of the afternoon between my lunchtime and afternoon patients. Then treated one more patient and decided that I had to go home. I was having body aches, the chills, and just felt utterly exhausted. I went home and slept for from 5:30 PM on Tuesday until 6 AM on Wednesday. I woke up still feeling not quite 100% but was well enough to go to work.
So the reason I’m telling you this is that, again, I was panicking about my long run on Thursday. HOW COULD THIS BE HAPPENING AGAIN??? You know, I’m trying to be cool like “oh plans need to be flexible; let me appreciate my plan as existing along a spectrum,” but this was beginning to feel like some sort of conspiracy. And, yet, again, the worry set in with the slew of questions regarding my preparedness for the race in just a few weeks. But I reminded myself, yet, again, that regardless I am physically capable of finishing a 25k, even if it’s slower than I would have wanted and even if I have to walk. So I acknowledged those worries but then tried to just let them go. Investing more worry into a situation will not change the outcome. The only thing I could do at that point was keep resting, and see what happened.
Wednesday, November 21st: lift
Seated on chair DB curl to overhead press 4x10: 15#
Prone Lat sweep with barbell 4x10 + ring rows 4x10: 15k bar
Renegade row w DB 4x10+ incline push up 4x10: 15#+tumble track
By the end of the day, I was feeling pretty good. So when I finished with my last patient, I did day 2 of the upper body lifting plan that John made me. I find that I do better with consistency when I have a semblance of a plan. In order to get back into it, I had John make a simple plan for me. I really like these supersets, because you get a lot of volume in a short period of time. You can see that a lot of these are complementary movements, using the same muscle groups, which allows for more volume. This was short and sweet and perfect for the end of the day.
Thursday, November 22nd: run
Location: South Mountain Emmaus
Pre-run: foam roll calves, quads, ITB, seated forward fold, fire log stretch, ½ virasana
Post-run: standing forward fold, standing forward fold with calf stretch, calf stretch, ½ kneeling hip flexor stretch
Wow. Wow. Wow. I really surprised myself. I think that I really internalized my advice to myself on Tuesday regarding letting go of worry. For me, it typically just ends up becoming a self-fulfilling prophecy. I build up the obstacles so high in my head that there is no way to overcome them. The physical obstacle was lower, and since there wasn’t a mental one, then it was that much easier to follow through with the plan.
I was a bit concerned about how I’d feel, because I didn’t eat on Tuesday and ate 1 meal on Wednesday. I also barely drank any water. So I knew that I would just have to take it mile by mile to see how I felt. I could definitely feel like I didn’t have any power going up any incline, but I was able to keep a steady pace.
This was a huge mental success for me. I haven’t continuously run 12 miles or more in about 7 years. I have hiked/run more than that, but I haven’t run completely, start to finish. To be able to do this made me feel so good. The aspect of the mental success was that mentally, I was very calm the whole run. Typically when I’m going to be running longer, there is this moderate level of anxiety prior to doing it in anticipation. That happened on a very low level this time. I settled into a meditative state pretty early. I actually felt the same level of ease that I did just on Sunday.
I felt totally convinced that I will be able to perform moderately well on Dec 15th, barring any other issues (which, let’s be honest, keep popping up, so I’m not ruling it out!)
Friday, November 23rd-Sunday November 25th
We flew out to Moscow, Russia on Thursday night to see my brother, Reilly, who lives there. He and his wife, Yana, just had their first baby and my first niece/nephew. Her name is Maya, and she is just precious. I am still amazed by the fact that you can instantly love someone when you meet them. I can still feel her in my arms, her belly on my chest, her baby scent that I totally understand why people love, her soft hair and skin, and her wide eyes. So I spent Friday, Saturday, and Sunday just loving on her at Yana’s parents’ house in Kolchugino, Russia, which is about 2.5 hours outside of Moscow. We cooked; we went for walks around town; I went to the banya (Russian bath); we took turns holding Maya; I took a profuse amount of pictures. I didn’t plan to run, and I’m so happy I didn’t.
Things I learned this week:
Monday, November 12th: run
Distance: 4.07 miles
Pre-run: foam roll calves, ITB, quads
Post-run: stretch calves, hip flexors, quads
Recovery: Marc Pro Plus, theragun
I think that recentering myself was really helpful, because I made sure to take the time that I needed before and after a run to recover. When I got to work, I also used the theragun and used the Marc Pro Plus in my calf. I had little pain in my calf while running, so I wanted to make sure that I kept feeling progressively better.
Tuesday, November 13th: yoga, ski erg and run
3 sun salutations A
Standing forward fold 3x5 breaths
Triangle 2x5 breaths
Lunge 2x5 breaths
wide leg forward fold 3x5 breaths
Wide leg lunge 3x5 breaths
Up dog 2x5 breaths
Headstand 1x20 breaths
Wheel with hands against wall 2x5 breaths
Wheel with ands on ground 2x5 breaths
Workout: ski erg + run
Ski erg: 5x2 min, 1 min rest with stretching during rest periods
Location: Bethlehem, running home
Distance: 2.08 miles
Pre-run: half kneeling hip flexor stretch, fire log stretch, seated piriformis stretch
Post-run: calf stretch, down dog, foam roll calves, quads
It was pouring in the morning, so I practiced yoga. I have been noticing that when I’m running that it feels like I can’t fully inhale. So I focused on taking long and complete inhales and exhales while practicing. I was thinking about it, and your breathing mechanics are like any other mechanics. You want to maximize your mechanics so you don't have to work so hard. Your ribs and intercostals can get tight like your hips can. When your ribs/intercostals are tight, you can’t breathe as efficiently; when your hips are tight, you can’t extend your hip as efficiently. Then you just end up exerting a lot of effort than necessary. I need to get back to doing more back bending, because that always made me feel the most expansive in my chest. I think that this would positively impact my running as well.
I also did some ski erg repeats before leaving work as my warm up. I ran home nice and easy. As I was running, I was trying to focus on fully inhaling and exhaling, and for that reason, I just kept it easy. I still feel like I’m not fully utilizing my breath, but I think that will improve with time. Then I took some time to stretch afterward. I’m trying to make sure I stay consistent with that.
Wednesday, November 14th: run
Distance: 4.04 miles
Pre-run: foam roll calves, quads, piriformis stretch, firelog stretch, supine hamstring stretch, supine calf stretch x45 sec each
Post-run: stretch calves, hip flexors x45 sec
When I start work at 7 am, I need to be very calculated with how I spend my time in the morning if I’m going to run. I typically wake up around 5 am, and theoretically, this should leave me plenty of time to foam roll and stretch beforehand. But then I start doing more immediate (not) tasks like unloading the dishwasher. Clearly, as I write this, this doesn’t make sense, yet I find myself doing little tasks at home instead of taking more time to foam roll and stretch.
I was thinking about how it has been difficult for me to foam roll and stretch more, particularly since I know that my right hip and foot have been really tight, causing excessive stress in my calf and tibia. I think that it would probably help to narrow down my options by creating a very clear plan of 3-4 things that I’m going to do before and after. More on that later.
Thursday, November 15th: lift
Front squat 5x5 35k
Cossack squats 4x7 without weight
I walked home in the 7” of snow. Does that count?
Pre Workout: foam roll glutes, quads, ITB, calves, half kneeling hip flexor stretch, brettzel 2.0, butterfly stretch
Post workout: foam roll quads, ITB, glutes, calves, butterfly, pigeon, low lunge stretch
I’m back to lifting! Well kinda. I kept it really simple today by just doing some front squats and Cossack squats. Front squats are really interesting for me, because they challenge my hip flexibility in a way that typically indicates how well I’m moving in general. I was saying earlier that my right hip has been tight, and that’s definitely true while front squatting. It actually feels painful, because I’m experiencing some impingement. So while I was warm up, I would alternate between foam rolling and stretching and then retesting what squatting felt like.
For me, if I focus on external rotation, abduction, and hip extension stretch that typically helps to alleviate this pain, particularly external rotation and hip extension. So I will do something like this: foam roll glute, do piriformis stretch, then retest front squat. Then stretch again and retest. If there is still more improvement, then I keep focusing on that area. If not, I move onto something else. Then I foam roll quad and do half kneeling hip flexor stretch, and then retest squatting. And I follow the same idea. I actually felt pretty good. I still kept the volume and weight low, because my body just isn’t used to it.
Friday, November 16th: hike in the snow
Location: south mountain Lehigh
Distance: 3.25 mi
Post-run: hamstring stretch, firelog stretch, supine piriformis stretch
This was my first time at the trails by Lehigh’s mountaintop campus. I went with my friend, Jaime, on a snowy hike. By that point in the afternoon, it was warming up, but there was still the majority of the snow on the ground. Fortunately, I had her gators as we hiked through the trails. I can appreciate when people say that the Lehigh trails are harder to follow than the ones at south mountain. I have a general sense of some of them now, and I’m looking forward to running on them at some point.
Originally, I planned to do about 6-8 today and then 10-12 on saturday, and I quickly realized that I’d have to reevaluate. A hike with some elevation was enjoyable and reminded me that hiking was the reason that trail running even become a thought in my mind. I think it’s so easy for me, and many others, to align themselves more closely with the more “effortful” task or pursuit. It feels “better” or is “superior.” I have become more and more aware of this scale that I assess everything off of. So for me, if I have experienced the “better,” “superior”, and more “effortful” option, then I only want to do that. The physical block of the snow was helpful for me to remember this point. However, it didn’t stop the anxieties of Saturday…
Saturday, November 17th: run in the snow, lift
Location: south mountain Emmaus
Distance: 8.01 mi
Pre-run: foam roll quads, calves, brettzel 2.0 stretch, ½ virasana stretch
Post-run: foam roll quads, glutes, calves, ITB, supine knee to chest stretch, supine hip ER stretch, firelog stretch x3, seated calf stretch
Seated on floor DB press 4x10 15#
Bent row DB 4x10 25#
Bent reverse fly 4x10 8#
I enjoyed my hike on Friday. However, my anxieties surrounding this run began to mount on Friday when I realized that the trails wouldn’t be clear by the time that I went on Saturday. So many thoughts and considerations continually circulated in my head: I don’t think I’ll be able to get my long run in. I didn’t run on Friday. I need to do 10-12. If I do run, it will be so tiring and take so long. It won’t truly represent my abilities in terms of pace. Maybe I’ll run on the tow path instead. Maybe I’ll run on Sunday instead. Maybe I’ll just hike at south mountain. Maybe I’ll run a little there and go to the gym to row. Maybe I’ll go to the tow path and then row. Then the questions about the future: will I be able to get in enough long runs? Will I be prepared for Dec 15th? Will I disappoint myself? What is my goal? Then more thoughts regarding those questions. But you get the idea. So many thoughts. So much energy.
I realized that this is exactly what I was talking last week. My plan needs to exist along a spectrum. I may have planned to do 10-12, but 8 was sufficient for the conditions. Running on snowy trails was challenging in a way that my watch couldn’t measure. AND THAT’S OK (I kept telling myself). I will be able to get in about 2 more long runs, and I’m hoping that’s ok. If not, I’ll learn. This was a great learning experience for me.
This speaks to the next part about being a bit more gentle on myself. Life happens. Weather happens. Weekend events/commitments happen. Injuries and aches happen. I’m learning to be a bit more adaptable to those.
Surprisingly, I ran 8 miles. It was laborious, and I didn’t quite settle into the run at all. But I was pleased that I exceeded my expectations.
Sunday, November 18th: hike
In my effort to recenter myself to my original intentions for doing this trail race, I wanted to get back to hiking. I wanted to choose the less “effortful” activity. My body didn’t need another run. It needed to settle. I find that hiking for several hours does just that. Also, with hiking I prefer going with other people; whereas, for running, I prefer going myself. It was just what I needed to catch up with one of my very best friends, who I haven’t seen much, particularly since I started running.
It was a cold day with the trails still mostly snow covered. For that reason, it was quiet. It felt like we had the mountain to ourselves. I was realizing how hiking gives you a different perspective than running. With running, you may be able to see more overall in your run, but hiking allows for a bit more depth, since you’re moving more slowly. I took that time to enjoy the trails of Pulpit and pinnacle that I know so well. I could appreciate how fall is most certainly on its way out, and I compared it to the hot summer days with the fullness of the greenery. And I am looking forward to winter. I’m looking forward to the quiet and stillness. After that hike, I felt the quiet and stillness mentally in a different way than I do when I run. I am thankful for that and know that hiking has to be a regular part of my exercise for a given week.
Things I learned this week:
Week 6, 7, 8, 9
Well since i’m nearly a month behind on these posts, I figured that I might as well do a bit of a recap of the last 4 weeks. I’ll be recapping weeks 6-9. And really, it’s not even worth writing separate posts for these weeks. From mid October to the end of last week, I was pretty much living the definition of insanity; that is: doing the same thing repeatedly and expecting a different result. So what happened was that I pretty much only ran and neglected everything else: mobility, yoga, strength training, breathing, sleeping, eating to properly fuel myself, resting. I kept doing it, because I like running. I like how I feel during and after. I’m also compulsive. If I like to do something, I just want to do more of that. So I kept doing that. You know how this story ends.
I want to detail what I learned most over these last few weeks. I hope that these resonate with other people and can help in some way.
2. You should think of a plan as existing along a spectrum.
I guess one way to make your training more ideal is to accept a different premise. I am beginning to expect that my training (and other things in life) can exist on a spectrum. When Ithink about what I would have told myself if I were my own patient. I would have told myself to first concern myself with just implementing in regular running into my schedule. It has been many years since I’ve run consistently. And the other part is making sure that I’m doing the recovery work necessary for upholding that volume. When I was running consistently I was in college and graduate school. I had responsibilities, but I didn’t work 60 hours per week, interacting with patients, helping to run a business, growing a new idea (PrePose Method) and doing all of those other adult tasks (that I’m still reconciling as being a part of my life). And so many people have more responsibilities than me, so I think that we all need to think about having a plan that is flexible.
I was talking to my friend today about this idea of a minimal effective dose or minimum viable product. The way I think of it is that on one end of the spectrum there might be the most ideal version or dare I say “perfection”. On the other end is the minimal effective dose. The way I had been looking at it is that if I’m not on the perfection end, then I’m just failing. But I’ve been trying to look at it in terms of this minimal effective dose. I’m still able to run 4x/week. Part of the minimal effective dose is also recovering well. More on that next.
3. Doing more doesn’t make you feel better.
When I feel particularly stressed and when I feel like my schedule is so busy, my activity level mimics that. I just want to expend energy. I already am doing so much in a day, so I just want to keep that momentum going. I don't want to stop and get on my mat to practice yoga. I don't have to breathe fully into my chest to make my rib cage expand. I just want to sweat, my heart to pound, and to do something effortful. Clearly, you can see the issue with this.
What if the something effortful is putting in the effort to recover more effectively? I need to foam roll and stretch more. I need to practice yoga and pair my breath to movement. I need to sleep. I need to eat in a way that aids my recovery. (I resist the urge to apply morality to food choices.)
Eventually I know that I need to do more strength training. First, I need to reprioritize the recovery work, and I know that I should do more strength training. I want to just keep running. But running more doesn’t always help with running. In “doing more” I only chose running. I needed to be recovering more and doing more strength training.
4. Take care of your nagging pains
I recognize the absurdity of this. I AM A PHYSICAL THERAPIST. My husband or father in law can treat me. I tell people not to ignore their injuries. I have all of this equipment at my disposal. But honestly, when I’m at work, I do work and treat patients. So then when I get home at 8 pm, I make dinner and talk with John. I don’t ask him to treat me. I don’t foam roll and stretch after dinner. I don’t allocate enough time post run to stretch. I don’t allocate the time to practice yoga. These are all choices. I’m choosing to not take care of my pain.
It started in my right hip. My right hip has always been my tighter and weaker side. Then my foot started getting tight and through my calf. Now I have pretty significant point tenderness along the inside of my shin. I know better. I literally spend 70% of my day treating this pattern.
So I spent 4 weeks “managing it”, read: run through the pain and wait for it to kind of warm up and then do nothing to take care of it. But now, I’m at a point where I need to take care of it. These next 4 weeks prior to the race, I will reorient myself to recovering and taking care of my pain.
5. You need to be gentle on your body and mind.
This encompasses 1-4. As I was physically breaking down, I was tearing myself down psychologically. I created this narrative of inadequacy because there was a disconnect between my body and mind. My mind created a plan, and then I was upset that my body wasn’t following through with the “perfect plan”. My mind tried to combat that by just trying to “do more.” In the meantime, my body was falling apart. Then I just kept perpetuating this cycle. So I’m trying to synchronize myself. I’ll do that by:
My biggest hope for sharing this is that it helps someone else. You can look at me and say that I should be better equipped, because I am a clinician who regularly helps people with their training similar to what I’m doing. But clearly that doesn’t mean that I don’t struggle with the same exact things that I’m sharing with you. It’s not like I’m exempt from these same patterns. In addressing any of these issues, it’s, of course, first a matter of acknowledging it, and then it’s a matter of having a plan to address them. So this is my acknowledgement, and next week, I’ll have more details about my plan.
Oh, and here is all of training for the last 4 weeks :)
Monday, October 8th: run
Purpose: easy run
Warm up: foam roll calves 2 min
Workout: 4 mile run
Immediate post run cool down: calf stretch off of ledge 3x30 sec, lunge stretch 3x30 sec
Cool down: nothing. Yeah…
Distance: 4.07 miles
I total fell off. I just ran. Then I went to work.
Tuesday, October 9th: Mobility work
Purpose: recover from Monday
Foam roll 2 min: calves, quads
Graston to my calves
Stretch calves 2 min each
People ask john and me if we treat each other. We rarely do. But when we do, it’s one of two things: 1. My asking John to treat me, knowing that I have 10 minutes or 2. My sneakily treating John even though he regularly declines my offers. I have said it before, but it is totally different to be treated than to foam roll and stretch by yourself. That’s exactly why I have a lot of people who come 1x/week for wellness/maintenance.
I am beginning to get used to running 4 days per week. I definitely have been noticing that my calves are taking more of the brunt than what they do on trails. Running on roads is less forgiving for any type of running asymmetries. Like many of my patients, my right hip is tighter and my glute max and glute med are weaker. Because of that, I rely heavily on my calf for propulsion. I can feel that it is harder for me to extend my hip on the right side, which makes it more difficult to use my glute to propel me forward. So I use my calves a lot, which makes them tight. This is exactly why I have been doing a lot of calf stretching. But even more importantly, I need to focus on the source of the issue. I need to focus more of my hip flexibility and then hip strength to address the underlying problem that causes me to over use my calf. Now, of course, I know this in theory, but practicing it is another thing.
Thursday, October 11th: Mobility Work
Purpose: recover from the 4 days a week of running
Foam rolling: quads, glute
Stretching: fire log stretch, seated hamstring stretch
Use of normatec
So clearly, I really needed to do more. I was thinking about lifting, but this week kind of fell apart. I was getting stressed about the fact that I was going to be away for the weekend, which prevented me from doing the majority of my training. Well it prevented me in theory. I didn’t plan for it. Also, I’m used to being done with work around 7/7:30 PM, but this week I had been done around 8/8:30. That totally changes it for me. When I know that I have to wake up at 5 am for my 7:00/7:30 AM patient, I start feeling like time is rushing by me. So I paired it down this week.
Again, if I have learned nothing else this training cycle is that I would benefit greatly from some mental flexibility. This week I was very critical of myself saying that I wasn’t dedicated enough and didn’t plan well enough. Then that creates a whole series of thoughts about how I will perform, which is completely speculative at this point. Then it’s 15 minutes later, and I’m still going in all sorts of directions mentally. It’s totally not worth it. You don't have any answers. So I tried to tell myself that this week will be more of a deload, because I knew I would be traveling this weekend and next.
You know how I said that this is about mental flexibility? Well I am learning a lot of lessons. I could tell early on that my run wasn’t exactly accurate. I ran at south mountain again, and I was noticing that the typical points of 3, 4, 5 miles seemed off. So I decided to run the same exact course that I did on Friday. It was off by 0.84 miles! I had a series 1 Apple Watch, and I know it isn’t the most accurate. It was also a cloudy, windy, rainy day, so I don’t know if that had something to do with it. That was definitely messing with me. And you know what is totally crazy? I felt less satisfied with that run, because it didn’t read it accurately. I actually felt slighted by my watch. That also made me think that my Friday’s run maybe wasn’t accurate. Now the Apple Watch was the enemy. I would point out that absurdity to my patients, and I know rationally, it doesn’t compute. So I was able to let it go after talking about it to John and revisiting it another 3-4 times. Also I was consoled by the fact that my new watch was going to be delivered in the next week or so.
I was at a wedding on Saturday night, wearing heels. I also stayed up until 1 AM. YES! 1 AM. I am typically someone who is asleep by 9:30 PM, but I was having so much fun catching up with my family. I am so glad I did. But when I stay up that late, it doesn’t matter how much sleep I get, I still feel tired. I wanted to do a little shake out run to feel a bit more awake and less stiff. It was slow and easy. I felt better...for the meantime at least.
Things I learned this week: it’s ok to adjust your plan. Some of what I’m doing now is figuring out what sorts of things I can plan for and what things I need to just roll with. We’ll see how that goes.
Monday, October 1st: run
I decided that this week, I wanted to increase my total volume for the week. Last week I decided to reduce the amount of hiking and climbing given the course I’ll be racing on. I also decided that a few more miles on tired legs will be good.
I had been becoming a bit snobby with only wanting to run on trails, but this day reminded me that I like running 4-7 miles on roads. There is something very convenient about being able to put on my shoes and run from my door. It is also more accessible to run at 5:15 AM than going to a trail. So I enjoyed this. It also helped me to address the “Do Nothing Monday” that I was falling into.
Tuesday, October 2nd: yoga and mobility work
Purpose: feel better
Childs pose x3 x5 breaths
Down dog x3 x5 breaths
Headstand x3 x 20 breaths
Mobility work: later in the day
Foam roll quads/ITB then ½ kneeling hip flexor stretch then with side stretch
Foam roll glutes then pigeon stretch on table
Foam roll calves then calf stretch off of ledge
Graston: John grastoned my calves
This made me feel so good. Early in the morning I just did some simple things to behind to move. I began by activating my shoulders/shoulder blades and pairing that with my breath. Then I focused on that as I went through more challenging poses. Between each set I took about a 20 sec break, while still focusing on my breath.
Later in the day I knew I needed to do something to focus on the muscles that have been accumulating fatigue now that I’m 4 week into my training. I paired foam rolling with an immediate stretch to the same muscle group following. I typically had done all of the foam rolling first, and then I would stretch. I like this pairing of foam roll to stretch for each muscle group. I’ll keep playing around with it.
Also John grastoned my calves which was really helpful. I stretched following that as well. I always say to my patients that while I love the effectiveness of foam rolling and stretch when done correctly, but it is just different to have someone treat you. I’ve tried grastoning myself and it isn’t the same in that I can’t be in the same position. It’s just like when I treat someone’s hip; I can’t put myself in the same positions.
For those that are curious, John and I don’t treat each other much. We treat patients for about 55 hours a week, give or take 5 hours. Then we have documentation and other Mobility Doc, PrePose, and Lehigh Valley Barbell work, so we don’t really want to treat anyone else. Despite that he treats me more than I treat him, because I ask. I offer to treat John, but he doesn’t want to be bothered with getting treated. Sometimes I leave him no choice, and I treat him. And the reason why we take the time to treat each other on occasion is because it really just is more effective. So there’s my plug for manual therapy. Let’s move on.
Wednesday, October 3rd: run
Thursday, October 4th: yoga and strength training
Purpose: longer duration stretching particularly for hamstrings
Sequence: hold poses for 10-15 breaths
Surya Namaskar A x3 with 5 breaths in up dog (sun salutation A)
Surya Namaskar B x3 with 5 breaths in up dog (sun salutation b)
Padangushthasana (forward fold)
Padangushthasana with toes elevated
Pasarita padottasana 1 and 3 (wide leg straddle)
I was feeling a bit run down from the week, so I decided to practice at home, where I could take everything really easy.
Purpose: level change, posterior chain, shoulder/upper back strengthening
Warm up: Headstand 2x20 breaths, ape walk, assisted squats side weight shift, modified pigeon
Workout: FS 5x5 40k alternating with ring rows 5x8
Good evenings 4x10 25k
Single arm DB row 4x10 35#
Supinated rows 3x10 20k
Cool down: nothing, went home
I felt really good prioritizing this workout, becuase I did after work. I finished with patients around 6:30, so I took 45 minutes to do this workout. I moved quickly between sets. I added in Good evenings per Isa’s recommendation. He is our head coach and programmer at Lehigh valley Barbell. He knows a ton about strength training for endurance athletes. So I have been consulting with him. I instantly knew that I’d be sore when I did these. I tried to keep my lumbar spine in a neutral position, because I tend to excessively extend my lumbar spine with any type of hip hinging activity. I needed to correct myself with each repetition. All 40.
Friday, October 5th: run
South mountain quickly becoming my favorite place to run. I leave work around 12ish after I’m done warming up. Then I can decompress from the week by running on the trails.I was sore from doing the strength training workout on Thursday evening, particularly from the good evenings. I felt pretty good, and I think the foam rolling and stretching was my saving grace. I felt my hamstrings from the good evenings and my quads from the front squats with each step going up a hill.
The good thing about being sore or knowing that you’ll be tired/flat is that you’re more incline to prioritize recovery work. I felt so good doing the immediate post run cool down and the full cool down. Note to self.
Saturday, October 6th: run
I think the only reason I felt as good as I did was because of my good cool down the day before. There are only about 16 hours between my two longest runs of the week, which I think is good for me in terms of running on fatigued legs. I was less sore from doing the strength training workout on Thursday.
But let me just talk about something that bothers me much more than it should. I have the first generation Apple Watch. The touch screen is finicky with ending a workout. Typically I need to press it a million times before it actually ends. Well. Not today. Even though I ran that other .02 miles, it wasn’t recorded, so it didn’t actually say 11 miles. So you say, “but Chloe, you ran 11 miles. That doesn’t matter.” Yeah, I know. I know it shouldn’t. It bothers me when something isn’t represented the way it is supposed to be represented. That is a great outlook when you’re talking about things that actually matter. But I blindly apply this stance to any condition. Yeah, I’m a work in progress. Maybe I need more short stopped runs. Eh...
Sunday, October 7th: yoga and strength
Purpose: long duration practice to stretch, breathe, and recover
Sequence: held each pose for 5 breaths, unless specified
Surya Namaskar A x3 with 5 breaths in up dog (sun salutation A)
Surya Namaskar B x3 with 5 breaths in up dog (sun salutation B)
Padangushthasana (forward fold)
Padangushthasana with toes elevated
Trikonasana (triangle) x2
Parsvakonasana (Side angle) x2
½ kneeling hip flexor with posterior rotation of pelvis
Lunge with knee flexed, posterior rotation of pelvis
Lunge with knee extended, posterior rotation of pelvis
Ustrasana (camel) x3 10 breaths
Paschimottanasana (seated forward fold)
Then with block under one ankle
Reverse bridge x3
Fire log, each side
Supta virasana 10 breaths
Couch stretch 10 breaths
Sirsasana (headstand) 20 breaths
Urdhva dhanurasana (wheel) x3
Sarvangasana (shoulder stand) alternating with halasana (plow) x3 x10 breaths
This long duration yoga practice at least once a week is key for me. It sets me up for a really good week. I focus a lot on hip extension (hip flexors/quads), thoracic extension and shoulder flexion, because these are the areas that get tied down for me.
Things that went well this week:
The Mobility-Doc Blog
Drs. Chloe Costigan and John Giacalone are both physical medicine specialists, former competitive athletes, and strength and conditioning coaches.