Hitting the brakes at Mile 21

mcstrangelove

 I've hit a roadblock that is seriously inhibiting my marathon performance and I wonder if anyone has ever encountered this. 

 

In all 8 of the marathons (stand-alone) I've run, my hips lock up in the last quarter of the race.  It's a tightening of the sides of my hips which gradually "grinds" my legs to a halt. This causes my fresh quads, hamstrings and calves to overcompensate and in the process tears them up over the last 4-5 miles until I'm forced to walk the end of the race.

 

I'm pretty sure it's not a pacing/execution issue. My vDot score is 47 and my splits during any given marathon I maintain a rock-steady 8:20 - 8:30 pace every mile of the race, until my hips lock up and my pace plummets. So I tried running two marathons much slower (9:00 pace at the LA Marathon, 9:30 in San Diego) and my hips still locked up, even though my HR was normal and the rest of my body felt completely relaxed and unfatigued.  I even tried running the Long Beach Marathon at a 10 min pace (super easy for me) and walking at every aid station and my hips still locked up.

 

I'm not so sure it's a training issue either. Whether I follow a 7-month marathon training plan or no training at all, it still happens on each race day.  I do extensive glute stretching before races. I've tried yoga, weights, all sorts of warm up exercises, aminos, gels, supplements, compression tights...but nothing works.  It's hard to diagnose because my long runs are typically < 20 miles and it only happens 20+ miles.  It never happens during cycling, btw.

 

I've consulted with two doctors and an orthopedist.  All said to "quit running" as the only solution. The only person who has come close to solving this is a trainer who thinks my glutes are the problem. Although I concentrated on glute-strengthening squats & other exercises for the entire season, the problem still came up. 

 

I'm not sure what else to do.  It makes me feel like I'm wasting my time doing countless hours of speed work each season only to see it all go down the drain in the last few miles.  I feel like my times would drastically change if I could figure out this problem.  

 

Sorry to be a downer...Thanks for any advice or suggestions!

 

Paul Hough

Mac - don't you hate docs who's advice to a running issue is to quit running? They should lose their license to practice medicine. Your problem is definitely unique. My hips get very tired from the continual exercising in one plane. I often feel that if someone tapped me on the shoulder when I'm past 20 miles that I would fall over. But my hips don't lock up. I thik the trainer is closest to a solution...some shortfall in functional strength. I would suggest adding running drills, lunges, jumping lunges, etc into your routine (slowly and carefully) to build up hip strength. I would also suggest a lot of ITB stretches and foam roller time. In the meantime,if you feel it coming on in a race, stop each mile and take a minute to stretch the hips. The time lost stretching might be a lot less than you lose from locked hips.

mcstrangelove

 Thanks for taking the time to respond, Paul.  I think one of my biggest concerns is that there's no way to tell if I've solved the problem until race day.  Every race I try something different in training and execution and once I hit mile 20 it inevitably rears its ugly head.

I'll be talking to the trainer about what happened so maybe he'll have some other stretches & roller exercises to try.  It's just heartbreaking to fall short at the end of every race, especially when the rest of my body feels great.

mgraffeo

Mac, I'd suggest asking the trainer to test your strength in the gluteus medius muscles (on the outside of the hips, responsible for stabilizing the pelvis while on one foot). I found that weak glutes combined with excessively built-up shoes (with a heel of 23mm or greater) caused a similar phenomenon for me. By strengthening the glute med muscles with exercises like clam shells and lateral walks with a band around the ankles, and moving to lower shoes that still had some pronation control (like the Asics DS Trainer), I was basically able to solve the problem for me.

YMMV, as it may be something different, but worth a shot. Hopefully, Leigh Boyle will also chime in with some questions to better isolate the problem, as she's the best!

Paul Hough

@ Mac - I don't think it is outlandish to test your legs up to 21 miles once a month (or every other month) after you've made some changes. If that means more than 2.5 hrs (it does for me!) then do it on a dirt trail or other soft surface. But at least you will be able to test various solutions without waiting for a race. Don't wait to Louisville to find out whether you have an answer.

delesh

Not sure if this has anything to do with what you are experiencing but there was an article on Trifuel recently that talked about neuromuscular fatigue. It basically states that the brain gets tired of firing the same patterns over and over and at a point it becomes sloppy or shuts down. They recommended taking short "breaks" or in effect a run/walk strategy to overcome this. Anyway, might be something to think about.

Found the link:

http://www.trifuel.com/training/triathlon-training/speed-up-your-ironman-racing-with-neuromuscular-resets

jwpicciotto

Not sure what doctors that you went to, but would strongly suggest going to a sports med person. The guy that Penny uses in Houston is one of the Race Doctors for the Houston Marathon, so he is use to dealing with pro and high level amatuer athletes. Might see if there is someone comparable in your town. These guys are use to working with pros so they know that the answer of stop participating, means ending someone's career so they take it very serious.

Leigh Boyle

hrm. the odd thing to me is that long bikes don't trigger it. if there were something going on nerve/artery....that hip angle would likely trip it up as well. so my first thought reading this is that there is something going on form wise in your stride.

what did the doctors actually do from a test perspective?? what were the exact symptoms (just pain, just tight, both, tingling, clicking, legs feel wobbly and unstable)?? I know you say that everything feels awesome, but at mile 21...it's starting to be work regardless so leading up to the hip pain, what do you notice??

Hip stuff usually comes from repetitive overuse...so typically impact is transferred there because you aren't landing/pushing off normally or because something in the foot/ankle is off on the pronation/underpronation front.

mcstrangelove

 My longest bike rides have been 50-70 miles so perhaps I'm not riding far enough to trigger it yet.

No tests were done by the docs other than visual inspections and squeezing various points in my legs to look for sore spots...which didn't amount to anything, unless they'd been out on the course with me around the 20 mile mark

The race routine goes like this:  I start to feel very slight tightness in my hips after mile 15 or so (no pain). It is completely tolerable, but it signals to me that things are going downhill. The tightness increases and causes me to push harder with my quads/hamstrings. Over the next few miles, my hips start to "lock up" (kind of like a rusty metal hinge) and the tightness turns to pain. This, in turn, spreads to the rest of my legs (mostly my quads).

Every time I retire a pair of running shoes I check the tread and my strike is dead center, mostly on the ball of my foot (virtually no heel strike). I've had a couple of coaches observe my stride/cadence and nothing unusual has ever come up.

The only marathon when this issue wasn't as pronounced was one of my early ones.  During that training I did lots of mileage. Long runs of 24-26 miles and 2 runs of 30 miles (being a newbie I thought that running farther than the marathon distance would make the race easier). Granted my pace was pretty slow, but I didn't have much of an issue with my hips. Since then, I've been told repeatedly not to run LSD over 18 miles.  Maybe that's part of the problem?  Should I be doing much longer LSD runs (24+ miles)?

I also run in Brooks Adrenaline shoes and am looking at getting a racing flat with less support since that could be part of the problem as well.

Thanks for everybody's advice!

 

mgraffeo

Mac, not to imprint my problems on you, but I would have described the same thing, and was also running in Brooks (Adrenaline and then the precursor to the Ravenna which I don't remember the name of now). While doing hip PT for a bunch of stuff, I inadvertently wore the Ravenna to one session, and was out of commission for an entire weekend. You may not need to go all the way down to flats (especially if you need some support for mild overrpronation), but lower-heeled shoes such as the DS trainer, the mizuno wave elixir, the Zoot TT, and the k-Swiss k-Ruuz could be worth trying. I use the shoe facts at running warehouse.com to compare heel height and drop from heel to ball.

jamison.gaddy

You sound pretty well educated and to have tried almost everything except allowing your body to rest. It would not be unreasonable return to your Ortho Dr. (or another) and request an AP Pelvis (x-ray) to be performed.

You probably are experiencing some fatigue in you glutes (stabilizers) which may strain your adductors causing additional stress to your pelvis (inferior or superior pelvic rami) possibly causing a stress fracture. If this is the case you can stengthen as much as you want, but your body needs to heal. Most of my patients are not triathletes; however, they suddenly increase their activity level and later complain of similar hip pain once they become fatigued.

If you train to reach your physical limitations daily you'll eventually find them. Your body is trying to tell you to slow down. You may continue train but if you experience the pain I would call it a day. Stress fractures are essentially like any other fracture and require 4-6 weeks to heal. Better to rest now and be prepared for your "A" race.

As they say in the Army, "Drink water, change your socks, and take motrin."

Leigh Boyle

I think the right shoes and running form are going to be the answer for you. Have you ever had a video analysis to see what the back half of the stride looks like (push off/hip extension, etc). So many of us shorten our stride the longer we are out there and the impact is that we jam the hips up. Shoe selection can help here if the reason for that shortening is calf/ankle related, but...if it's just that you have a short stride/quick cadence and are pulling the legs through, that alone won't cut it.

Time to get some help locally- sports PT or specialist who can make sure your shoe set up is spot on and then do form analysis.

mcstrangelove

@Mike - thanks for the shoe suggestions. I've looked at the DS Trainer and may end up trying a pair (or one of the others). When I picked back up running 7 years ago, I couldn't run more than a mile without CRAZY knee pain (like nails being driven into the bone!). Found out quickly that a pair of 10 year old sneakers wasn't the way to go. I tried Saucony which improved the situation exponentially. Then moved to Brooks which completely eliminated any and all knee pain (a miracle, at the time). I've been reluctant to switch shoes because of all this, but might indeed take the leap.

@Jamison - haven't had any X-rays, but I'm hoping that since the pain only comes up after 3+ hours of running that it's muscle/movement related as opposed to a stress fracture. But I'm not counting it out. I've only have this pain 3 total days out of the past 6 years of running. I don't start training again until Dec, and won't be doing any long distance (12+ miles) for several months. Hopefully that will help.

@Leigh - I've had a track coach and a few triathlon camp coaches watch my stride and nothing's ever come up. But like I said, they're not seeing me after 20 miles. I've always been leery of doing analysis work because I subconsciously "perfect" my stride (or stroke if I'm swimming) when a coach is watching and am able to hide any bad habits. I literally think a coach would have to secretly video tape me when I'm out on my own and don't know anyone's around to get an accurate representation of my running...LOL! I'm not sure who else can analyze my form, but I'll definitely try to find somebody. And have them make suggestions for shoes before I buy a new pair.

Thanks again for all the advice!

mgraffeo

Mac, just one other point. If you have shoes that 'overcorrect' for pronation, that can possibly lead to some overuse of stabilizing muscles. The end result would be that your run form looks 'perfect' to your run coach, but your stabilizers are working too hard to keep the perfect form, and it breaks down at some point.

One way to test it is to go to a run store where they videotape your foot strike on a treadmill, and try out a bunch of shoes of progressively less pronation support, until you find the shoes that control your pronation with the minimal amount of control. I know that if I ran in motion control shoes today, I'd be a wreck for a week!