Anyone who knows me well will tell you that running is one of the most important things in my life. I treat it just like eating and sleeping, it’s something that I build into each day and without it, I’m not myself. I love the exercise, time in nature, and the stress relief that it brings me. When the day goes perfectly my way, I wake up, and within 10 minutes my dogs and I are on the trails (I sometimes have to settle for a mid day run with my current work schedule, but that’s ok too.)
I started running at a young age. My parents are both avid runners, so I grew up running a few miles with them regularly. In college, I started making plans with my mom and dad to join them in longer distance races. Pretty immediately into starting longer runs, I began a cyclical cycle consisting of getting a lower leg injury, resting for a month, rebuilding my mileage, then 4 months later injuring myself. It was obnoxious, but I was able to work through it and still see progress in my mile times each race.
When I was 23 and in graduate school I broke this cycle for the worse with a more serious injury. I was running stadiums with my husband and I injured myself jumping down from the last few steps. This injury took me completely out of running for 4 months, and took another 2 of slowly rebuilding back into a normal morning run for me (needless to say, I was likely not the most pleasant person to be around those months!). A lot of my symptoms didn’t fit the pattern of any injury that I was being treated for. In regards to sacroiliac dysfunction, I do believe that this was part of the injury, but not the whole picture. My symptoms didn’t completely fit because after a week or so of rehab I could jump, squat, and do Pilates with reciprocal motion without pain. Within a month I could run as fast as I wanted as long as the stride was short. Anytime I tried to lengthen my stride while running, I would feel radiating pain. Then, the focus switched to hamstring. My symptoms also didn’t fit a hamstring strain, as I could hamstring curl, do eccentric hamstring work, stretch my hamstrings, and I didn’t have any tenderness or pain to palpation. Hamstring rehab didn’t change my symptoms at all. It was a mystery, one of my PT’s actually did a case study on it. And for those of you PTs out there, yes, we did try nerve gliding initiated from the foot and it didn’t help, leading me to believe that these residual symptoms were not neural in nature.
After the injury and “recovery,” I would continue to feel radiating hamstring pain, sacral region pain, and pain at the bottom of my foot when I ran. Most days the symptoms were mild, other days more significant. At this time in my life I wasn’t in school anymore and had a clinic job, so I had a consistent schedule and was running in the mornings always. Being a little bit on the obsessive side about my running, especially back then, I would just run through it and it never worsened back to the initial injury, but it definitely limited my pace and the overall enjoyment of the experience.
As described in my previous blog post, I discovered my thoracic mobility impairments in yoga. I began incorporating mobility exercises into days when I didn’t take class, and one day noticed that when my upper back felt more restricted (perhaps from a longer day of sitting), that thoracic flexion recreated the symptoms I felt in my back, hamstring, and foot. The next time I felt these symptoms when running, I did some dural mobility exercises on the trail, and the symptoms ceased. Mystery solved. It was neural tension, but was coming from spinal region neural restrictions vs more distal peripheral nerves. Looking back now that I am further in my career, it seems so much more clear. When I injured myself, I was a graduate student so I was sitting a lot at a desk. I was also running in the mornings, after hours of static posture. A perfect recipe for thoracic spine and neural mobility impairments to get set off by a sacroiliac injury.
The concerning thing to me about this experience, is had I not happened to find yoga and link that dural mobilization helped resolve my symptoms, I likely would have been given all types of labels for an explanation of pain, such as disc herniation (many people have non symptomatic disc bulges, they are not necessarily the source of pain), sciatica, plantar fasciitis, hamstring tendonitis etc. I could have had unneeded injections, medications, and perhaps even surgery. This being said, I believe that dural/neural mobility is highly overlooked in treating orthopedic injuries.
Over the past 7-8 years, I have been able to run everyday without pain. Literally. I don’t usually take rest days unless my travel schedule isn’t conducive to running. I often go 90-120 days straight running and I don’t have any issues anymore at my lower leg or sacrum. This can’t 100% be attributed to improving my neural mobility, as since the injury I have also incorporated much more hip and core stability into my routine. But as far as that plateau in symptoms is concerned, this was the biggest game changer for me after that injury running stairs.
I would encourage anyone struggling with radiating pain, headaches, sacroiliac pain, spinal pain, glute region pain, or plantar fascia region to ask their health care professional if this may be related to a plateau in recovery. It’s worth an ask, as it may be a game changer for you like it was for me.
I love incorporating neural mobility exercises into my client’s routines and into my yoga classes, so much so that I have chosen to post a dural mobility sequence into one of the first four videos that I release on my platform next month. Check out our Instagram page for more previews and information, and feel free to reach out with any questions or to share your story.