A personal story, by Dr. Sara Van Dyke, DC
I ran the first race of my 2019 season with a completely numb left foot. I remembered standing on the starting line, my mind going anywhere but my foot, distracting myself from worrying about that fact that I was about to race an 800m with a foot that could not feel the track. It was April 2019, the Bryan Clay Invitational. I had just come back from winter injuries and had started doing track workouts a few weeks prior. So when I started getting some numbness into my foot the week of my first race, I decided to ignore it, because I had FINALLY made it back into track workouts and it was RACE WEEK. No time for injuries! I toed the line and ran a pretty good race through the finish, trying not to think about my foot the whole time; but I slipped up and thought about it a few times, it was hard to completely ignore.
So many questions swirled in my mind during the next few weeks. Can I run on this? Is running making it worse? What is going on with me? Can it be fixed? How do I fix it? What does this mean for me, long term? Thankfully, I had been in Chiropractic school nearly 3 years at this point so I had some ideas about answers to those questions, but just in case, I needed to enlist some help. Self-treatment, even if you are a doctor (or a doctor-to-be, in my case), is not good. And my symptoms had been changing; I was starting to get some feelings of extreme hamstring tightness and some discomfort in my gluteals. So thankfully, I reached out to my fellow intern Nathan and Dr. Sebastian Gonzales for some help.
I had a lumbar radiculopathy; meaning that one of the nerves that exit the spinal cord in my low back and then continue to innervate my lower extremity was injured. While this may seem scary, with the right identification and management, one may continue their active lifestyle and even learn to manage their own symptoms.
It seems I was doing several things to drive my own symptoms. First, my lifting technique needed some fixing. We discovered that I have a lateral drift when doing back squats, which was linked with my symptoms. When diving deeper into the lateral drift, we realized that it was actually linked to some patterns I developed after injuring my right knee. My compensatory patterns were helping to unevenly load my left side, which continued to drive my symptoms. I was also having a problem at the end range of deadlifts-the easy solution to this was to deadlift off a block so I did not even have to deal with the end range. I also was sitting in positions that emphasized the closing off of the nerve where it exits the spinal cord (an area called the intervertebral foramina). So that would need to change.
Initial treatment in the beginning included exercises to off load my lumbar discs, which were discovered to be one of the causes of my neurological symptoms. I also did opener exercises to give my nerves more space and allow them to decompress. All of these exercises were ones I could do on my own if I was symptomatic, to get instant pain relief. The power of being able to relieve my own pain, without having to go into the office for it, was AMAZING. It meant I could get down and do them on the track and get rid of my symptoms if I was feeling them before a workout, or god forbid, a race (spoiler: I did). The openers and the disc off-loading exercises had to be progressed eventually, and unfortunately that day came on race day. More on that in a second-but first; let me talk about my glutes.
One of the things I had been noticing for a year before I began this track season was that for some reason, my left glute did not seem to be working. Sounds ludicrous, doesn’t it? Of course my glutes were working, I was running, right? Well, there was definitely a part of my left side that never felt like it was working when I would do glute-specific exercises, and I even felt like the skin over that area of the glute had decreased sensation. Me and my classmate Lane, who writes my weight training and is also a good (student) clinician, had been frustrated for a year by my left glute! We tried so many things to get it on and working. This ended up also being part of my treatment. I seemed to be loading my left side more than my right, but not even loading the right parts!! So frustrating! When Dr. Gonzales started playing around with my movements, he also noticed something seemed off with my left glute. So he loaded it. And guess what?! I actually felt the glute for the first time in a year AND when I got up, my symptoms in my leg and foot were reduced. So we had successfully off-loaded my irritated nerve.
We had many of the pieces, we just had to put them together and progress them within the framework of my season. I ended up taking 2 months off racing mid-season due to my school schedule, and when I resumed racing in July, it was with the star-studded Sunset Tour, with a lineup that had me feeling like a pufferfish among sharks-in other words, I felt mildly out of place. To make things even more interesting, my symptoms were back that day in a big way. I hadn’t experienced any symptoms in the past couple weeks and now, on this big day, of all days, they were back. Thankfully, we realized it was time to progress my nerve exercises to some nerve sliding exercises and I was able to find relief a few hours before my race, and turn my exercises into something that could easily be performed on the track before my warm-up (which I did religiously, in a secluded corner of the stadium). And the good news is that I remembered that pufferfish and sharks both swim, just as I and America’s best runners all run. The other good news was that I ran 5 races in the next 3 weeks, shattering 4 different event PRs, had a blast, and beat some seriously good competition-all while running and managing a neurological injury.
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