As I’ve dealt with chronic shin splints for more than a couple years, I’ve probably read about every possible solution. The first solution that finally helped was going to a chiropractor. It was a very slow and gradual improvement, but I finally reached a point where my shins didn’t throb the day after every run. The pain was reduced enough that I felt confident enough to commit to marathon training. I did still have some shin issues during training, but the pain was not as bad as it had been in the past. Still, I wondered if there was a way to completely shake the problem. As I kept searching for a solution, I was always a bit curious about active release techniques (ART). I read that ART can help deal with scar tissue that builds up as a result of overuse, and I couldn’t help but wonder if that was part of my problem. I kept wondering if I should give it a try but didn’t actually pursue it.
Six weeks after running my first marathon, I was pretty frustrated that IT band/knee pain kept me from running more than a mile at a time. Rest was not fixing anything so it was time for me to figure out the next step. I considered physical therapy, going to an orthopedic doctor, etc., but I was still curious about ART. I liked the idea that it is supposed to help loosen tight areas to allow a full range of motion. Typically, ART is practiced by chiropractors, but not the one that I’ve been going to. That meant going through the complicated process of figuring out how to find a doctor. I always hate trying to find a new doctor. Without a recommendation from someone, I feel like I never really know if I’m picking the right person.
As I began my search for someone who practices ART, I spent quite a while trying to find someone close to home. I found that my choices were pretty limited. In a way, that was a good thing since having less people to consider made the decision process easier. Activerelease.com lists nearby providers and I found three doctors within 13-15 miles from home. I read through their websites and debated who might be best. I found myself leaning towards The Active Fix in Berkley because Dr. Eric Baraszu is a runner, has worked with triathletes, and the site mentioned using ART to deal with things like shin splints and knee problems. When Matt and I looked at the Facebook page, we saw that a runner friend had liked them. We asked her opinion and she had great things to say, so at least I finally had a recommendation from someone. I knew that insurance wouldn’t cover it and it was going to be pricey, but I wanted to give it a shot.
I called Dr. Barazsu to get more info and liked what I heard. For one thing, it was nice that I actually got to speak to him. I asked if he likes to have people start out by coming three times a week, which I’ve found to be kind of typical for many chiropractors. He doesn’t push that, which was another bonus. I set up an appointment and went for my first visit on December 4th.
My first ART visit was somewhere between 60-75 minutes, including paperwork, an exam, and my first treatment. The exam involved things like doing squats, balancing on each foot, rotating my body to each side, etc. I laid on the table as we started with the active release, beginning with the easy stuff and saving the painful stuff for later. He’d apply pressure to certain spots and have me do things like stretch my leg out and to the side as far as I could, or start with my leg straight and bend back as far as I could. Some things were difficult because I was stretching more than I was used to and I really felt the burn from the stretch. Other things were difficult because the pressure he applied could get painful in spots. When he applied pressure to my knee, that hurt as expected. My left adductor hurt a bit too. It seemed like as he felt around, he kept finding new spots. I wasn’t even aware that most of the spots were an issue until I felt the pain! I was surprised that my knee wasn’t the most painful spot. He did something where he bent the three smallest toes on my left foot and I was in agony. I am not very educated about all of the muscles, but I believe he told me it was triggering the extensor and peroneus in my lower leg, as seen here (from NY Times):
In a way, I viewed the pain as a good thing. I figured if it hurt, he was probably finding an area that needs work. As I knew going in, although the knee is where I feel pain while running, I probably have a bunch of problem areas. Limited motion in other areas could be causing the knee/IT band problems.
I expected to feel sore the next day and I was a bit, but probably not as much as I expected. A couple spots were a little sore, my knee was tender to the touch, but the psoas was the worst. That’s a muscle I didn’t know anything about before going in. I felt a little bit like I’d been punched in the side and the pain had faded for a day or two. Overall, it really wasn’t bad. He told me to go ahead and run to see how it went.
I ran the day after my first visit and didn’t know what to expect. I was hopeful that I’d see some improvement, but at the same time I was skeptical because I’d only had one treatment session. I got on the treadmill and was thrilled to make it 2.5 miles. That was double what I had done earlier in the week and the longest I’ve been able to go post-marathon. Maybe I’m on the right track by trying ART? I ran a few days later and made it to 2.1 miles. I went for my second ART treatment the next week, and I was really thrilled when I made it to 3.75 miles the following day!
I’ve been in for ART four times now over the last few weeks and I like how it’s been going. The sessions are around half an hour long. I’ve gotten used to “normal” chiropractic adjustments being pretty quick. It seems like there are usually a bunch of people waiting to be adjusted, you see the doctor for maybe five minutes, then you’re done. I understand that adjustments may not take longer than that, but the half hour ART sessions make me feel like I’m getting more for my money at least. Working on the soft tissue takes longer. I like that Dr. Barazsu didn’t pressure me to come in several times a week. I was very overwhelmed when I first went to a chiropractor because I felt like I was being told that I had to come three times a week for several months, it was going to cost a lot, and they wanted a decision and huge payment right then and there. Dr. Baraszu monitors progress as we go, and he hopes to see improvement in three to five visits. I definitely made some progress right from the beginning!
I’ve been using the treadmill because I don’t want to worry about my IT band stiffening up from the cold, uneven footing with snow, and most of all, because I never really know how far I might make it before the pain starts. Typically, when I start to feel my knee, I need to stop within a minute or two because the pain kicks in pretty quickly. I don’t want to be stuck outside half a mile away and have to walk it in. I’m tired of the treadmill but I’m trying to tough it out for now. My last few runs have hovered around three miles or so, always ending with the same pain on the outside of my knee. I’ve been hoping to make it longer, but I’m also thankful that I’m beyond a mile now. I’ve tried keeping it slow and easy, and I’ve tried speeding up to as fast as an 8:00 pace. I don’t think the speed makes any difference in how soon the pain kicks in.
I’m going to continue with ART and I’m hopeful that it will help. In the meantime, 10 miles per week has been my peak mileage lately. It’s not where I want to be, but what can I do? I’m swimming, biking, and doing more strength training at least. I’m curious to see how things go as I continue on with treatment.