Unilateral Butt Syndrome

This time of year, the road to Spokane from where I live (just a little east of Seattle) is moderately nerve-wracking; you have to take one of three passes (North via the 2, South via the 410, or the standard I-90) and two are typically closed (the north and south). The 90 itself has a history of landslides and closures, and since my PT appointment was at 11am in Spokane this meant I needed to leave the house around 4am and cross the pass at night. (Actually it meant I needed to leave at 6am, but I didn’t realize the South pass was closed and so drove all the way down to South Auburn before I figured that out and had to double-back).

Once you get past the pass, though, it’s eerily beautiful in these cold winter months, with snow on the ground and overcast skies. I pulled over to take a picture on the way back, both to capture the light and also to stretch the legs; otherwise five hours in the car is a bit much, even for those of us who enjoy driving.

The question you may have that I haven’t yet answered is why I was going to a physical therapy appointment in Spokane in the first place. I live in the Seattle area, surely there are good physical therapists here? Yes, of course there are. But the very best physical therapist I have ever had (who managed to get me off of regular knee injections and back into running in my 40’s) moved to Spokane and so for things like orthotics and gait analysis and exercises I go see her. (It’s Kit Vogel at Tailwind Physical Therapy, if you’re interested– she also does bike fittings.)  Yes, I will take a day off work and drive 600 miles roundtrip to keep myself active. Quite apart from all this Kit is a wonderful person and fun to hang out with.

My knee, sensing an expert appointment was at hand, decided to go out three days before my planned appointment. It was my first outdoor run in months (not including the Disney Half) and I was sore post run — and then the next day — and then really sore the next day. So off to Kit I went.

After marking on my legs (with green washable marker) and measuring my gait in slow-mo and reviewing my shoes and my orthotics, she pronounced my problem: Unilateral Butt Syndrome. In short, my right cheek has been doing all the work for both cheeks (when running and working out), and so my left cheek is lazy. Therefore over time my knee has had to take up the slack for my left leg when running, and as my orthotics and shoes wore out (I use Hokas but because it’s for knee cushioning they don’t last more than about 6 months with regular use) my ankles and feet stopped doing their part and sent the work up to my left knee.  The left knee will only put up with so much of that bullshit before it screams and so here I am, with a busted knee. Apparently UBS is a real thing, as I was explaining it to a friend at the gym and one of the trainers chimed in with, “Oh yeah, I have that!”.

I now have new orthotics on the way and new shoes, and a new set of exercises I’m doing probably less often than I should but probably more often than Kit thinks I am; and kinesio tape on the knee. That the exercises are awkward (see pic) and difficult is not unexpected. It’s also hard to tell how quickly I will recover. I’ve stopped running for now and am walking (on the treadmill at incline, outside with my best friend) to keep moving. I’ve figured out (finally) that I will not be able to continue running without the routine of floor exercises to keep my butt from being lazy and shifting all the work to one cheek; this is not a case of “ok the pain is gone now I don’t have to do clams anymore”.

If you suspect you have UBS, talk to your PT, and I’m happy to share info on the exercises I have to do. Mostly it’s clams (for the glutes), bridges, push me/pull you (as seen above), hamstring work, and balance work. It’s not particularly fun and for those of us who are impatient and just want to go do the run or walk or whatever it’s an extra series of steps. Considering that impatience got me here, though,  I shouldn’t let it keep me here.

Side note: if you find yourself alone in the car for five hours each way, the Rich Roll podcast is particularly good. Thanks to my brother and Havi Zavi for the recommendation.