The Case of Elvan Abeylegesse
Turkish athlete, European and World Champion, Olympic medalist, and current European record holder in the 10,000 meters
The conditioning coach of the Turkish national running team, Nikola Borić, asked me to review the X-ray images of his athlete Elvan, who had hit her left knee two weeks earlier while stepping out of a car. Since then, she had visibly altered her running movement, and as a result, her performance had worsened. She increasingly complained of pain in her right leg and on the right side of her pelvis. The coach also wrote that he had the impression that during running, her left leg was lagging behind. They also sent me a photograph, and from her body posture it was clear that she was leaning to the right; her spine was excessively curved, her torso tight, which caused her to sway while running, likely leading to stress fractures—fatigue-induced microfractures—in her right leg. (The X-rays showed cracks on her right femur, which, according to a radiologist from Istanbul, were the result of running, and I myself saw how excessively she was straining her right leg—over a 42 km run, such micro-injuries are bound to occur.)
I suggested that she come to me for therapy as soon as possible to balance her torso and correct the improper biomechanics. But an important marathon in Denmark was ahead, and Elvan did not want to miss it. We agreed to meet at the airport in Copenhagen the day after the race. Elvan placed very poorly, and the doctors advised her to stop training for a while. When I assessed her posture myself, we decided she would come to my practice for four days of active clinical somatic therapy.
Upon arrival, Elvan showed me the latest scans of her right hip. There was evidence of fluid accumulation under the attachment of the right quadriceps and hematomas along the right femur.
Condition upon arrival in Brežice, April 3, 2014 at 12:00 p.m.
I decided to start with the most obvious problem—the overly curved spine. During active therapy, she felt the tension in the muscles of her back and the backs of her legs. Elvan was quiet; I sensed her fear of the future, but at the same time her hope that the therapy would help her. At first, she was somewhat puzzled by my method of work, and it seemed to me that she did not see any real logic in it. But after the therapy, she felt comfortable, tired, and much more relaxed. She immediately noticed a change in her step and lighter walking. Later that day, after she had rested in her hotel room, I performed another therapy session.
Condition after the first therapy at 1:00 p.m.
Second therapy, at 4:30 p.m.
Upon arrival, she already looked more relaxed, and her face no longer showed worry. She said she noticed a change in the sensation of her back muscles and that she was eagerly anticipating the next therapies. We began working on the left side of the torso so she could feel the tightness resulting from the left knee injury. Through consciously introducing slow, regular movements, she became aware of deficiencies in controlling the left side of her torso and the left side of her pelvis. By the end of the session, she felt the left side of her body as larger and more relaxed; it seemed easier to move, and she had a clearer sense of what she could do with it. She also noticed that the pressure on her feet had become more balanced.
Condition after the second therapy at 6:00 p.m.
Third therapy, April 4, at 10:00 a.m.
The next day we worked on changing the sensory-motor function of the abdominal and chest muscles. With words and touch, I guided her on how to relax the front part of the torso. I also noticed that the front part of her neck was tight, so we released that as well.
After the therapy, she went for a long walk. When she returned, she told me she felt lighter while walking, with a longer stride and a much better sense of movement in her legs and pelvis. She felt taller, more upright, and lighter. Later that day, we practiced walking forward and backward to further increase her awareness of walking movements. She said she felt excellent, optimistic, and happy.
Condition after the third therapy, at 11:30 a.m.
Fourth therapy, April 5, at 9:00 a.m.
On the third day, we began active clinical somatic therapy on the right side of the torso, with special emphasis on the right shoulder and right arm. I had noticed that Elvan used her right arm differently than her left while walking, and she also perceived them differently. This difference was the result of many years of dominant use of the left arm and the altered function of the right arm—its movements and control—which had led to chronic pain in her left leg and poorer results. Doctors and physiotherapists had tried to resolve this by changing and correcting the structure—with massages, physiotherapy, surgeries and collagen injections, painkillers, and other methods. The success was unsatisfactory because the treatment never addressed the root cause, unlike the therapy, which dealt directly with sensory-motor amnesia.
Condition after the fourth therapy at 10:30 a.m.
Fifth therapy, at 2:30 p.m.
In the afternoon, we continued improving awareness of the back and especially the left gluteus, where she felt much stronger control than on the right, but with a weaker sense of control overall. With improved control, she noticed a change in the mobility of her left leg. Then we practiced foot rotation; through movements of the knees and feet, she further integrated the movement of the torso and pelvis. This was extremely necessary, as years of excessive strain on the body had caused her to feel and control her running technique and posture less and less.
Condition after the fifth therapy at 4:00 p.m.
Sixth therapy, April 6 at 8:10 a.m.
The sixth therapy on the fourth day started late, as Elvan had overslept. According to her coach, this had never happened in all her years of training. Elvan said she had not slept so deeply and peacefully in a long time. She also shared that she went for a light run in the evening and no longer felt the pain and discomfort that had been a constant in her running for many years. She was happy, satisfied, and full of ideas and goals for the future. It was clear that her fear of the future was being replaced by energy, the desire to win, and the conviction that she was not “done” yet. The more she felt herself, the more she understood the ability of the mind to correct functional errors—it only needed to be shown the way. During the therapies, she was learning how to control her thoughts, the lower part of her body, and her breathing, with special focus on controlling the abdomen, which was her weak point. By the end of the therapy, her breathing was deeper and fuller.
Condition after the sixth therapy at 10:00 a.m.
Seventh therapy at 2:00 p.m.
In the afternoon, we repeated all the exercises she had learned. This way, she will be able to perform them more easily on her own and deepen her awareness of how the body functions, which will help her achieve top results.
Final condition on April 6 at 4:00 p.m.
By comparing the images, even a layperson can notice changes in body posture. A change in body function (posture) leads to changes in structure, and with that, the restoration of light and efficient movement.
BEFORE/AFTER 7 THERAPIES
