by Stefanie Mueller in Stories, image by lululemon athletica

Yoga and Pilates: The Road to the splits conquers Patellar mal-tracking

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When a case of Patellar mal-tracking rendered me almost immobile and stole the flexibility I had taken for granted all my life, I was completely caught off guard. I hadn’t injured my knees, fallen over or twisted anything in any way, shape or form.

Visits to the Osteopath revealed inflamed kneecaps, unsurprisingly, excessively tight muscles and a significant imbalance between my quads and my VMOs. Treatments prescribed by the Osteopath were initially quite helpful but ultimately Yoga and Pilates classes gave me back the flexibility I had been used to, the ability to move freely again and a better understanding of the muscle network connecting throughout our bodies. It turns out a knee problem could ultimately link to poor pelvic posture or even a weakness in the abs.

So what had happened? Why, all of a sudden, did my knees start playing up? Well, to be perfectly honest I am still not entirely sure. It’s a bit of a mystery, but I can only guess that a sudden change in exercise caused my muscles to react very extreme. The weird thing is that I was always reluctant to call it an injury. As far as I was concerned I had not injured myself…but something had definitely gone wrong.

Things unfolded last year in the spring of 2011 when I injured my shoulder. Initially after the injury I could barely pick up a glass, so needless to say that any jerking movements were out of the question, and that included running.

Since I began running in 2006, at the time mainly to get fit, the sport has become an increasingly important part of my life. Getting out for a run after a day at the office helps clear my head and get perspective on things. For me it has never been about running a marathon or a specific distance, but about pushing my own limits and getting healthy, while having that time to myself. By 2011 I couldn’t imagine my life without running, I was training regularly trying to add a little distance, shave off a little time and I had taken part in a couple of 5km and 10km charity runs.

But, what does a shoulder injury have to do with running or a misaligned patellar, I hear you asking? And how did it turn a Yoga and Pilates snob into a ‘believer’? I had tried Yoga once before, a decade ago, and have to admit that the class had entertained me for all the wrong reasons. I became a giggling wreck!

Just to clarify, I am well aware (now) that Yoga and Pilates are not the same, even if they cover some similar exercises, but the focus of the exercises varies from class to class. Furthermore, since there are several types of Yoga, in this article I will be referring to Hatha Yoga.

But I digress. When I injured my shoulder I worried about getting out of shape. Over the previous year I had been training a lot with plenty of hill – running, plus the first 10km race under my belt. I was probably at my fittest to date and I did not intend to lose that. So, how to keep fit? Well if I couldn’t run I could still walk, and tucking my arm in tightly I even managed to keep my shoulder still. And I went walking, as fast as I could, almost every day after work for several kilometres. However, since I was ‘only’ walking, not running, I became increasingly lazy when it came to stretching and it is probably worth mentioning that I had been an avid stretcher. I have always been reasonably flexible and found that I could improve the ‘bendiness’ by stretching properly after an exercise session.

Within three weeks my right kneecap had started ‘clicking’ or ‘popping’ now and then. A long weekend in the Yorkshire dales made it even worse and the following week I decided to get some advice from an Osteopath, as the standard quad stretches did not seem to work. After some extensive assessment and a rather painful massage of my quad, VMO, ITB and calf, I was sent home with exercises to do daily, the suggestion to self-massage my leg (Have you ever tried that? It’s hard work) and a new appointment for the next week.

By then I had over compensated on my left leg to such an extent that it had started to come out in sympathy!

I was at a point now where everything had become so tight and my kneecaps inflamed, that I could barely bent my knees, let alone cycle, walk properly or even get down the stairs as usual. Everything that would require my thigh muscles to tense up was almost impossible, as it pushed my kneecaps too tightly onto my thighbones. It was surprisingly painful.

Over the next couple of months I regularly saw the Osteopath and followed the prescribed exercise and massage instructions diligently. While things were improving slowly, by mid-summer stairs were still an issue, as was walking for any more than 10 minutes, and running as well as squatting or kneeling were entirely out of the question. I had gained some of my mobility back and was able to cycle again, but the clicking kneecaps continued, so did the visits to the Osteopath, and I had to stretch after every bike-ride or walk, as my muscles would tense up quickly if I did not.

At the time I had already signed up to a rowing course for that July, but the rate my recovery was going at, it was very unlikely I would be able to take part…how was I going to get into a tiny slim rowing boat if I couldn’t squat or kneel and was only able to sit on the floor by ‘dropping’ the last few inches? I decided to cancel.

I hadn’t run in about 4 months by this point and personally this was taking quite a toll. While the lack of exercise depleted me of my usual energy it also made me impatient, easily annoyed, frustrated and generally discontent. It had been such a long time that I was finding it hard to imagine myself out running again anytime soon.

Having scoured the internet for information, I had not found anything particularly useful. There is a lot online about patellar mal-tracking, covering everything from symptoms and anatomical descriptions to stretching and surgery, but no explanation on what may have brought it on so suddenly or what to do about it other than stretch.

August approached and there was a Hatha Yoga course starting in my building at work…Thinking of the stereotype, ‘people who do Yoga tend to be quite flexible’, I decided to go and see if I could take part.

The course was approximately 8 weeks and a complete eye opener!

When it started I had been seeing the Osteopath and following his advice for three months, and I continued to do so throughout the course, but the improvements I saw from week to week with the Yoga exercises was inspiring.

It was slow, included relaxation and allowed me to do the exercises to my own ability which improved from week to week. When the course finished in October, I was able to walk normally, but still needed to stretch, and had started practising on the cross-trainer and rowing machine at the gym. I still couldn’t quite squat or kneel, though my attempts were improving, and all my stretching sessions included Yoga postures now.

A basic movement sequence like the ‘Sun Salutation’ which incorporates muscle groups throughout the body, helped improve my flexibility with every try. At the same time the exercises slowly started building up my leg muscles again, which had lost significant strength in the previous months.

And not least of all, the classes provided a feeling of reasonable contentment for the first time in months. Being used to ‘aerobic’ sports, I am still surprised by the impact an ‘anaerobic’ session can have and its ability to make you feel calm and relaxed, yet still exercised.

My next experiment was a Pilates course, hoping it would offer a similar balance to Yoga between movement, stretching and relaxation. It turned out to be a little more active with exercises centred on core strengthening, posture awareness and flexibility. However, the exercises are still individually adaptable to one’s own ability, usually being split into several levels, such as the “preparation”, a “mid-level” or a “full version”. Attendees are free to decide which version they feel most comfortable with, and the interesting thing is that changes within one’s ability from week to week, serve as a really good indication on ‘problem’ areas, such as stiff backs, tight muscle groups or similar.

Another 8 weeks after starting the Pilates course and coming up to Christmas 2011 I went to my last appointment at the Osteopath. In the meantime I had started to do short bouts on the gym’s treadmill, continued on the cross-trainer and rowing machine and included a 30mins session mixing Yoga, Pilates and general stretching at the end. Somewhere around this time I also finally managed a squat!

In January of this year I went on my first outdoor run! I am now back to running about three times a week, I have returned to a Legs, Bums, Tums class at the gym and guess what, I signed up for that rowing course again this summer.

I am still doing the Pilates classes and I have no intention to stop! I enjoy noticing how my flexibility improves from week to week. Additionally I have gained an increased awareness of my posture and how to improve it, which has also transcended into my running. I am much more aware of hunched shoulders, running ‘tall’ as well as my footfall and leg extension now. My muscles still get tight, and at times my knees still get a little aggravated, but I am now in a position to deal with it and relish mostly pain-free runs.

And you know what else, a couple of weeks ago I managed to do my first ever splits!
It was uncomfortable and tough, and I haven’t managed it fully again since, but I am sure I will again soon.

The moral of the story… well I guess there are several. For me there are three things I have learned from this.

One; I am one very lucky girl. Having gotten only a very short glimpse into a world where I am not free to move as I please, I am even more grateful for my health and ability to do anything I want.

Two; don’t take injury lightly, or any other condition. Now more than ever do I believe the mantra “Listen to your body”. Take a break, get the necessary rest and get things sorted before resuming training, thus hopefully preventing anything more serious.

Three; if it comes to health vs. fitness, health should always win out. Granted a two-week or even month-long break, may set you back a bit, cause you to lose a little tone and gain a little flab, but a forced break lasting 6 months or more, will not only set you back a couple of minutes or miles but return you to naught.

Oh, and last but not least, keep supple…and do not discount the benefits of Yoga and Pilates, they provide an effective low-impact balance to the rhythmical pounding of your trainers on the track.

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