Monday, September 26, 2011

Achilles' Ankle and Lee Saxby

As part of their sponsorship of the NYC Barefoot Run Weekend, VivoBarefoot offered injured runners a chance to have a training session with Lee Saxby, who leads the VivoBarefoot running education program, and trained as a Pose coach with Nicholas Romanov.  I've heard excellent things about Lee's training sessions, so I entered the lottery for a session.

Much to my surprise, since I never win anything, I won.

I had the chance to speak to him prior to the session, and it was quite amusing, since the last time I'd spoken to him (at the VivoBarefoot store in NYC), I'd told him that I think coaches are unnecessary if the "Born to Run" hypothesis is true.  He was curious why I wanted a coaching session with him.

I wanted Lee to give me an independent assessment of what's going on with my weak leg.  To that end, I tried to tell Lee as little as possible of what was going on with my bad leg.  Armed with an uncooperative patient, he gamely started off with a video assessment of my barefoot running form.

What's the worst he could say, I wondered?  "Your form is horrible: give up on running", was one of the possibilities I imagined...

Happily, he told me I had pretty decent form.  He noted that I leaned back a touch, and videoed me again standing in a pose that I thought was proper running form, and showed me the contrast between that and how I actually run.  That was an interesting datum, one that I will work on.  But he complemented me on my foot strike.  A compliment only a barefoot-style runner could appreciate.

Then he videoed me running in my Merrell Trail Gloves.  Form was indeed different, and sloppier in those, which was hardly a surprise to either of us.  As we'd agreed the night before, adding anything to your foot is going to alter the way you run, and the less you add the better your form should remain.

And he didn't notice any difference in my running form between my two legs, which was a good thing, I suppose.  I've put a lot of effort into getting them to work in the same way, and I've made a lot of progress. I still notice differences, but it seems I've ironed out the gross inefficiencies.

Next he addressed the issues with the bad foot.

 Lee asked me to do what he referred to as a hunter-gatherer squat, but which I refer to as a potty squat.  It's also known as the Asian squat.  This is a movement that most modern Americans can't do easily or correctly, but it's a basic movement pattern that we all ought to be able to do.  He noted that, no surprise, my mobility in my right ankle was worse than my left.  Next he had me lie on my back with my feet in the air, so he could, basically, yank my foot away from my body to help stretch out the ankle.  Then he bent my toes down to look at where the "knuckles" in my feet were.  Bingo!

His conclusion was that I've got Morton's Foot*, but only in the "bad" foot.  The good foot has adapted.  Morton's Foot is essentially a high arch condition where the first metatarsal head is pulled behind the second metatarsal head.  This is something that should correct itself with continued barefoot running, and he explained that he had Morton's Foot, and was able to correct it.  This explains my observation that for most of my life, my "bad" foot has been the longer foot, but now the good one is.  The arch has come down in the good foot, lengthening the foot, and allowing the first met. head to be equal to the second, as it should be.

Then he described to me the various issues one would experience with Morton's Foot: 

  • Over-Supination in foot-strike; check, had that, resolved (after some blistering) though barefoot running instead of Vibrams, allowing for more feed back.
  • Ilio-tibial Band Syndrome: check, got that, during this race.  Too much cushion under the weak leg.
  • Sore Metatarsal-Cuboid Joint: check, got that; that was my first running injury, during the Brooklyn Half Marathon.

To that list I'd add Runner's Knee, (Patello-Femoral Syndrome), which was in the strong leg from compensating for the weak leg when running down hill.  I've also developed a clicking in the first meta-tarsal-cuboid joint.  I'll often wake up with that joint locked, and only a deep potty squat will free it up, often with a large pop like a cracked knuckle.

The stretch he suggested to help improve the ankle mobility was a variation of the potty squat: I should squat down while holding on to something ahead of me, so I don't fall over backward, and bounce gently up and down while on the balls of my feet.  This is supposed to help stretch out the tendons in the foot, and keep them loose enough for proper movement.  He also recommended barefoot jump rope, to dial in the proper landing pattern.  And, of course, continued barefoot running.

One other important ability Lee mentioned was being able to do exercise 3 in this post: to isolate the Flexor Hallucis Brevis. Lee got this from Jay Dicharry, who wrote that post.**  Lee is able to stretch his big toe far away from his second toe, an capability I refer to as monkey-toe.  Even another barefoot runner we spoke to who has run a few marathons couldn't do that trick. 

Along with isolating the FHB is pressing down on the ground with the big toe when running.  This trick made a big difference to me in the latter stages of the 8-mile barefoot run I did this weekend.  When the weak foot started getting sloppy round about mile 7 (my longest previous barefoot run was 6 miles), I made a point of pressing down, and it helped correct the foot.  It also gave me a whole range of exciting new sore muscles in my weak leg.

I ran a total of 11.5 miles on two days after working with Lee, and his suggestions definitely made a difference to my running, an immediate difference.

Back to the question of "barefoot running coaches" that I discussed with Lee when I first met him: I still don't think they're necessary.  As Peter Larson said during our time with Merrell, if people were raised wearing well-designed shoes, no form coaching would be necessary.  Children naturally run with perfect barefoot-style form, they don't need to be taught.  This is perfectly consistent with the "Born to Run" hypothesis, and good evidence that's it's true.  Even an adult with no legacy injuries or bad movement patterns should be able to transition injury-free, if he takes his time.

But, there are lots of people like me.  I was able to get to good form, but still have legacy issues from my shod days.  As Lee likes to say, he fixes broken runners.  And he's got a lot of experience doing it, a lot more than I do.  Which was why my time with him was valuable.  Hopefully some of the things he showed me, while building on my own deductions, will speed up my transition time.  Lee said it took him five years to fix his own Morton's Foot.  I'm impatient, I'd like to do it faster.  And I feel no need to re-invent the wheel to do it.

Transient aches and pains while transitioning are normal, but they shouldn't prevent you from running, or last more than a run or two.  If you start getting aches and pains that do prevent you from running, or consistenly bother you for days, getting some advice is a good idea, and Lee is very good at what he does.  I was quite impressed by how accurately he described all the the injuries I've already had, without telling him them beforehand.

And my running definitely felt better afterward.

* Lee explained that Morton's Foot is different from Morton's Toe (which is usually used interchangeably with Morton's Foot).  Morton's Toe, or Greek Toe, is a longer second toe than first.  Morton's Foot is when the arch is too high, basically, pulling the first metatarsal back into the first.  Greek Toe is something you're born with.  Morton's Foot is correctable.

** The post implies that you should wait until you can do those three exercises before starting barefoot-style running. I think that's overly cautious. Happily I had the opportunity to discuss this with Jay last weekend. He thinks that a person who can do those three exercises should be able to transition to barefoot-style running without injury. I think that's 100% correct. I'm pretty much the perfect example, as I couldn't do any of those exercises in my weak leg, even after several years of barefoot-style running. But barefoot-style running is a benefit all it's own, and I've resolved other running injuries. So don't wait until you can do those exercises, but get on them while you're running.

P.S. Jay Dicharry has a video out on foot self-evaluation for barefoot-style runners.

10 comments:

  1. So, glad you got the chance to do this. Lucky you. I would LOVE to work with Lee Saxby.

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  2. Thanks for this post. I was curious to see what the outcome would be. I like your ** note at the end, sums up what the actual message of those exercises is for those who are running barefoot, but are still "crippled" (i.e. can't do any or all of those exercises).
    I find that the potty squat is a great indicator for me as well for how much improvement I am making. Still working on my right ankle, but it gets better every week (if only slightly).

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  3. You're welcome, Doug.

    Even before meeting Lee, I had been using the potty squat to help fix the ankle, a trick I got from Barefoot Ted.

    It's a slow process, but I've also been seeing steady improvement.

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  4. Tuck...I've noticed I have morton's foot too and this has especially been highlighted recently by a callus under my 2nd met. I've been running and racing quite a bit and had the 2nd met. callus a couple times off and on in the last 2 years, but am really curious of how and what kind of form issues I need to look at to prevent it. I'm running mostly on trails in Trail Gloves/Sonic Gloves and run on roads mostly in VFF Bikilas with the occasional easy run in racing flats or the Minimus Road. Have you dealt with the callus issue or heard what others do to prevent it?

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  5. @David: I've not had the second met. callous myself. What happens to that spot when you run barefoot?

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  6. When I run barefoot it seems to not be bothered as much nor does it seem bad on technical trail. The worst its felt recently is running on the road in sonic gloves as part of a long run that was mostly trail. Thought maybe it was from not loading 1st met enough, but might be a different issue?

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  7. I think you might be right about not loading the 1st met. enough. It's easy enough to try it, although it does feel a bit odd at first.

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  8. I am a barefoot-style newbie searcher and just came across your blog. I enjoy the technical and analytical material on it. That is why I feel I can pass this next on to you without working too hard.

    Regarding your weak, bad leg ('Bad leg! Bad leg!'), I believe the solution lies in Ian Jackson's Breathplay method, specifically the basic aspct of it he calls 'Switch-Side Breathing'. Jackson is an extreme-event coach.

    In a word, Jackson explains that all effort including a footstrike (or punch or hammer strike) is stronger, more effective i.e. easier on the outbreath (try it! 'ki-ai!'), and secondly that if the breathing pattern is typically timed to an even cadence (1-2, 1-2-3-4, 1-2-3-4/1-2 etc.), the movement that takes place on the inbreaths and outbreaths will always fall on the same sides.

    If your situation matches one he descibes in his book, you are probably habitually breathing out on your left strike and in on your right. Your musculature (calf circumference) is probably higher or actually stronger on your right to compensate for the greater brute force you are requiring it to do, and if you are injured it will be on the right too as a result of the imbalance and overuse. I could have the sides wrong but that is what I think before my second cup of coffee.

    Jackson includes several practice patterns and physical and mental visualizations to keep the odd (as opposed to even) patterns going. These ensure that your outbreaths will alternate between right and left footfalls (Out-In, out is always longer: 2-1, 3-2, 4-1, 4-3, 5-1, 5-4). You can see that as your oxygen requirement increases in the course of a run you would constantly be calibrating the patterns, which is also a good and accurate way to pace yourself.

    There is more, including greater oxygenation because of turbo-charging your circulation, but that is probably the simple solution for the leg thing.

    The Morton's Toe information is fascinating.

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  9. Tuck, we've spoken on the Barefoot Ted forum and coincidentally I now came across this post of yours. It is obvious to me now that I have the exact same issue as you do/did. This post is a couple of years old now. So in retrospect, what exercises and methods has proven most fruitful to date?

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  10. Peter, I don't have time to answer your question right at the moment (it's not a short answer!).

    I'll try to get to it ASAP, and I'll post a notification to BFT's group.

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