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Building A Better Bumblebee

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Re: Building A Better Bumblebee

Post  Mark B on Sat May 24, 2014 2:28 am

@ounce wrote:row machine?  (I guess box jumps are out.  What a Face )

Gaa. Another machine. We have no machines, and gym memberships are expensive, so all that's out.

@mul21 wrote:So I've been chastised twice this week, first by my PT and then by the massage therapist, for how tight my leg muscles are.  I think I may have to incorporate some sort of stretching into my routine.  She was trying to stretch my TFL and as my right leg dangled off the end of the table, I got the somewhat incredulous "You're fully relaxed?" since apparently my leg should have dropped about twice as far as it did.  Oops.  You're not the only weirdo around here!

Oh, and it's a structural issue and not functional at all.  The leg length difference has caused all the issues I've had over the last several years.  And I wear a 1/4" lift in all of my left running shoes to help.

Stretching is good. And the reaction from PTs is always hilarious. Mine was trying to manipulate my cuboid (a foot bone) and could *not* get my foot to relax enough to let her get it to move. Whenever she started the motion, my foot would reflexively tense up, no matter how hard I tried to keep it relaxed. She finally gave up.

Did my second round of heel lifts tonight. All I can say is, I am shocked at how difficult it is, and how much it hurts.

And last but certainly not least, I got the full report back from the radiologist today. The sports medicine doc read it and says she wants me to keep at the PT and refer me to a podiatrist. I'll offer up some details of the MRI tomorrow, after I've processed it a bit. There's a lot of stuff, and the one thing that's missing from this report (which had me searching up anatomical vocabulary like crazy) is an explanation of just how significant the findings are.  Neutral
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Re: Building A Better Bumblebee

Post  ounce on Sat May 24, 2014 10:13 am

Mark, I think it'd be educational for us to know just how limber, as runners, that we should really be.  Either with pictures or words.  For example, should runners be limber enough to bend at the waist and put the palms of our hands to be flat on the ground or flat on the top of our feet?  And what exactly is the benefit of being able to do that or what happens if we are not that limber?
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Re: Building A Better Bumblebee

Post  Mark B on Sat May 24, 2014 1:07 pm

@ounce wrote:Mark, I think it'd be educational for us to know just how limber, as runners, that we should really be.  Either with pictures or words.  For example, should runners be limber enough to bend at the waist and put the palms of our hands to be flat on the ground or flat on the top of our feet?  And what exactly is the benefit of being able to do that or what happens if we are not that limber?

I don't know if I'm qualified to offer great advice on stretching, especially on benchmarks -- we're all so different, and there is such a thing as being TOO flexible.. which is kind of an issue I'm dealing with at the moment.

Still, being too tight restricts the range of motion, causing muscle imbalances. In fact, muscle imbalances are often to blame for the tightness -- but opposite what one might think, it's usually the weak muscle that gets tight. So if your glute med is tight, you're better off working to strengthen it, not get it all noodly and loose.

Still, when I established a stretching routine a number of years ago, I used the stretches on this site as my basic set. It's worked pretty well.

The only other stretch I favor is what's referred to by some as a latrine squat, or as some unartfully have termed it, the "third world squat."

It's surprisingly difficult to find good sites describing it, here is one that is kind of interesting but not so athletically oritented, and this one is good at describing the squat, once you scroll down to it. The top of that last page may be NSFW.

The latrine squat works not only the glutes, but the lower leg and foot muscles, as well. It's quite relaxing, once you get used to it. And it's important to get your heel down to the floor.

Hope that helps.
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Re: Building A Better Bumblebee

Post  Mark B on Sat May 24, 2014 1:42 pm

And now on to the MRI report...

I'll spare you the intensely technical aspects of the report (it had me looking up terms just to be able to figure out what he was saying), and go straight to his impressions/conclusions.

1. Moderate tenosynovitis of the peroneus longus tendon as it passes under the cuboid immediately proximal to the base of the 5th metatarsal.

Tenosynovitis is swelling of the sheath that wraps around the tendon. The MRI showed fluid around that tendon, which indicates this condition. If it continues, it can lead to damage to the tendon itself. This is where my foot was bothering me most, so it's not surprising something showed up there.

2. Moderate tendinosis of the peroneus longus tendon near its insertion with a small amount of adjacent edema in the soft tissues.

Tendinosis is actual damage to the tendon itself. This is a bit of a surprise, because I don't remember feeling any discomfort in that part of the foot - which is where the tendon hooks up to the base of the first metatarsal (the big toe) deep in the sole of the foot.

3. Forefoot ganglion.

This was a "Huh? What?" moment. The MRI showed a glob of something along the plantar (bottom) side of the shaft of my third metatarsal, squiggling over toward the fourth metatarsal and reaching up toward the to of the foot. He concluded that it's a ganglion cyst. That might explain the tingling I've had in that general region of my foot, since these cysts can press on nerves. Even though the MRI said there were nodules of it near the top of the foot, I can't find them - though I probably don't know what to look for.

4. Small multifocal mid and forefoot osteophytes indicative of early osteoarthritis.

Sigh. Yeah. Well. "Osteophytes" is the fancy term for bone spurs. They form when the cartilage breaks down and the bones start rubbing on each other. The biggest downside of my freaky feet is that I would be prone to this sort of thing over time. This has probably been developing my whole life. I've known it for a long time (it is, in fact, the reason I've been trying to learn how to run more gently), so I'm not surprised they found something. I just hope that "early" means there's a long, long time before it starts posing a problem.

***

So, that's it. It's heartening to know that they found injury in pretty much exactly the places that hurt, and also that they found something that might be impinging on a nerve (though I never imagined a ganglion).

Less clear to me is just how significant this is. "Moderate" could mean anything, depending on the scale they're using. (You could have a "moderate" heart attack, after all.) Hopefully, I'll eventually get some answers on this, because it'll obviously affect the time and patience required to get it healed up.  

The other aspect, of course, is trying to figure out exactly what I did to cause these injuries, and if there's anything I can do about it to prevent/delay/mitigate similar issues down the road.

One last thought: I wonder what an MRI of an average ultrarunner would say right after a race? It probably wouldn't be pretty.

Anybody else ever deal with any of these issues before? I'd love to hear about it.


Last edited by Mark B on Sat May 24, 2014 7:23 pm; edited 1 time in total
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Re: Building A Better Bumblebee

Post  Mark B on Sat May 24, 2014 4:07 pm

Okay, so here's a bit of good news.

After yesterday's two sessions of heel lifts, when every muscle fiber and joint from my knees on down screamed in pain, today's felt much easier. I was able to do a set of 30, 20 and 20 lifts before the ow-ow-ow kicked in. I know that's more a sign that my muscles are figuring out how to move than a sign of growing strength, but I'll take it. It probably also helped that I did this session on carpet rather than a hardwood floor. A tad easier on the soles of my feet.

And on we go...
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Re: Building A Better Bumblebee

Post  dot520 on Sat May 24, 2014 8:56 pm

I took a look at that squat.  Sheesh!  I believe I have tried to put my heels down onto the floor but I just tip over backwards.  I'll try it later tonight and see if I'm in the same poor state of affairs.  I'm hyperventilating thinking of all of the stretching, strengthening etc that I haven't been doing.  To my only credit, I have been rowing!

Ganglion cyst, interesting stuff.  Had one on my ring finger (first joint) about 5 years ago, dicey surgery to enable you to maintain flexibility. 

Oh, and I'm lovin' the responses that your PT is giving you.  Every time you pose a question...it's 'really?, wow?, haven't a clue.'  Poor gal! 

Guess I'm going to start with some heel lifts tomorrow morning.  The heel deal where they move the 'c' something around or try to... my right foot was very stiff and that was one of the root causes of my PF, but the left foot was fine.  It's really going to be quite the puzzle to figure out your chicken/egg situation.
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Re: Building A Better Bumblebee

Post  Mark B on Sat May 24, 2014 9:40 pm

@dot520 wrote:I took a look at that squat.  Sheesh!  I believe I have tried to put my heels down onto the floor but I just tip over backwards.  I'll try it later tonight and see if I'm in the same poor state of affairs.  I'm hyperventilating thinking of all of the stretching, strengthening etc that I haven't been doing.  To my only credit, I have been rowing!

Ganglion cyst, interesting stuff.  Had one on my ring finger (first joint) about 5 years ago, dicey surgery to enable you to maintain flexibility. 

Oh, and I'm lovin' the responses that your PT is giving you.  Every time you pose a question...it's 'really?, wow?, haven't a clue.'  Poor gal! 

Guess I'm going to start with some heel lifts tomorrow morning.  The heel deal where they move the 'c' something around or try to... my right foot was very stiff and that was one of the root causes of my PF, but the left foot was fine.  It's really going to be quite the puzzle to figure out your chicken/egg situation.

Hey, Dot! Thanks for stopping by.

Yeah, I do pity the folks who are trying to figure me out. All "freaky feet" jokes aside, I've done a little research and found that the bone structure in my feet are considered birth defects, with an incidence of about 1:1,000. So it's fairly rare but not entirely unheard of. It doesn't lead to serious problems for most people (except the higher incidence of mid foot arthritis), and some people probably go through life never knowing the difference.

When something does happen, though, it means that treatments dictated by the traditional medical playbook don't necessarily apply. My biggest challenge is reminding medical professionals of that when they automatically suggest one thing or another. ("You need arch supports!") Once they're reminded what they're dealing with, they often end up back-tracking. ("Arch supports make you run on the outside edge of your foot, making the problem worse? Uh. Hm. Uh...")

And while it's amusing to shock and amaze these folks, I have started to slightly dread once again being a part of their journey of discovery. Well, at least most of the ones I've met so far are at least willing to *take* that journey. I know that's not always the case. I should be grateful that they've been willing to listen.

Squats! I know the latrine squat can be tricky. When I develop muscles in my calves, it might get more difficult for me, as well. But for now, it's about as easy as it gets:



To be fair, I had a lot of practice in the Peace Corps in this squat, since those are the sorts of toilets they have there. Smile
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Re: Building A Better Bumblebee

Post  dot520 on Sat May 24, 2014 10:06 pm

Ha!  I just tried it and there is no way the heels can go down without toppling over onto my back.  I can only stay on the balls of my feet.  I am probably one of the most inflexible people I know. 

Yeah, I'm with you on trying not to be told pat answers to unusual situations.  It's discouraging because usually the results are lousy.  Thankfully your MRI shows some real issues...now..how to fix it.  I'm really curious what they'll say about the ganglion cyst.
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Re: Building A Better Bumblebee

Post  Mark B on Sun May 25, 2014 12:54 am

@dot520 wrote:Ha!  I just tried it and there is no way the heels can go down without toppling over onto my back.  I can only stay on the balls of my feet.  I am probably one of the most inflexible people I know. 

Yeah, I'm with you on trying not to be told pat answers to unusual situations.  It's discouraging because usually the results are lousy.  Thankfully your MRI shows some real issues...now..how to fix it.  I'm really curious what they'll say about the ganglion cyst.

I've been wondering about that myself. And doing research.

I've seen discussions of all sorts of treatments, from very conservative to... well... this:



 tongue
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Re: Building A Better Bumblebee

Post  ounce on Sun May 25, 2014 5:53 am

The 2nd and 3rd removal was unexpected.  Lots of local anesthesia or at a nerve point made this video possible.
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Re: Building A Better Bumblebee

Post  ounce on Sun May 25, 2014 10:37 am

@Mark B wrote:
@ounce wrote:Mark, I think it'd be educational for us to know just how limber, as runners, that we should really be.  Either with pictures or words.  For example, should runners be limber enough to bend at the waist and put the palms of our hands to be flat on the ground or flat on the top of our feet?  And what exactly is the benefit of being able to do that or what happens if we are not that limber?

I don't know if I'm qualified to offer great advice on stretching, especially on benchmarks -- we're all so different, and there is such a thing as being TOO flexible.. which is kind of an issue I'm dealing with at the moment.

Still, being too tight restricts the range of motion, causing muscle imbalances. In fact, muscle imbalances are often to blame for the tightness -- but opposite what one might think, it's usually the weak muscle that gets tight. So if your glute med is tight, you're better off working to strengthen it, not get it all noodly and loose.

Still, when I established a stretching routine a number of years ago, I used the stretches on this site as my basic set. It's worked pretty well.

The only other stretch I favor is what's referred to by some as a latrine squat, or as some unartfully have termed it, the "third world squat."

It's surprisingly difficult to find good sites describing it, here is one that is kind of interesting but not so athletically oritented, and this one is good at describing the squat, once you scroll down to it. The top of that last page may be NSFW.

The latrine squat works not only the glutes, but the lower leg and foot muscles, as well. It's quite relaxing, once you get used to it. And it's important to get your heel down to the floor.

Hope that helps.
I was thinking to ask the PT person if there's a degree or measure of suitable limberness.  But I will look at the links.  Thanks, Mark.
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Re: Building A Better Bumblebee

Post  Mark B on Sun May 25, 2014 1:18 pm

@dot520 wrote:Ha!  I just tried it and there is no way the heels can go down without toppling over onto my back.  I can only stay on the balls of my feet.  I am probably one of the most inflexible people I know. 

Yeah, I'm with you on trying not to be told pat answers to unusual situations.  It's discouraging because usually the results are lousy.  Thankfully your MRI shows some real issues...now..how to fix it.  I'm really curious what they'll say about the ganglion cyst.

Don't feel bad about feeling unstable in that pose, Dot. Believe me, my fellow PCVs had some great slapstick moments as they tried to get into that pose -- and then poo or pee. It took a while, but we limbered up. Very Happy

This stretch makes sense to me in a sort of evolutionary biological way. Way back when, our distant ancestors probably didn't have a set routine of stretches before they went out and ran and walked all day. They just did it, right?

Or did they? Every single human being ever born until the seated commode was invented had no choice but to do this squat to defecate (and pee, for the gals), which means that every human being did this regular deep stretch of just about every muscle from the belly button on down every single day.

If there's a perfect natural stretch for the human form, this is it.


Last edited by Mark B on Sun May 25, 2014 1:20 pm; edited 2 times in total
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Re: Building A Better Bumblebee

Post  mul21 on Sun May 25, 2014 1:19 pm

Well, I hope that's the grossest thing I see all day.  Yuck.  Now I have to show it to the GF and gross her out.   Twisted Evil
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Re: Building A Better Bumblebee

Post  Mike MacLellan on Sun May 25, 2014 1:22 pm

Mark, that video.   pale   Shocked
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Re: Building A Better Bumblebee

Post  Mark B on Sun May 25, 2014 1:26 pm

@ounce wrote:The 2nd and 3rd removal was unexpected.  Lots of local anesthesia or at a nerve point made this video possible.

Oh, it'd have to. I read that podiatrists tend to use nerve blocks for that sort of work. That second an third removal caught me off guard, too. It's amazing how much stuff was in there.

Luckily, mine is MUCH smaller.

@ounce wrote:I was thinking to ask the PT person if there's a degree or measure of suitable limberness.  But I will look at the links.  Thanks, Mark.

There probably is an optimum range of flexibility, though it's pretty clear that I'm on the "too flexible" end of the spectrum. It's entirely possible that I shouldn't stretch as much as I do, though my PT wasn't quite ready to go that far.

That said, hard and fast rules are tricky due the wide variability of the human form. And there is not even a consensus that we should stretch at all. So, it's probably another one of those n=1 sorts of situations.

@mul21 wrote:Well, I hope that's the grossest thing I see all day.  Yuck.  Now I have to show it to the GF and gross her out.   Twisted Evil

Glad I could get you in trouble with your GF, Jim. Smile
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Re: Building A Better Bumblebee

Post  Mark B on Sun May 25, 2014 1:27 pm

@Mike MacLellan wrote:Mark, that video.   pale   Shocked

Heh. Could you imagine what the patient said when the doc showed HIM the video?  affraid
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Re: Building A Better Bumblebee

Post  Mark B on Sun May 25, 2014 6:02 pm

Gosh, I hope I didn't scare everybody away...

Well, you needn't worry about more gory videos, because it's time to talk shoes!

As most of you know, I get in to the Nike Company Store in Beaverton because of my work as a dynamic and lab tester for them. We hadn't been in a while, but Alec has worn the heels of his shoes to the nub, so it was time to get him a new pair. I was looking forward to seeing the new Flyknit version of the Free 4.0, which I tested and is about the sweetest of all the Flyknit shoes out there. Except, alas, they hadn't arrived yet. Drat.

But what they did have was both types of Nike's new and pretty well-regarded trail shoes, the Zoom Wildhorse and Zoom Terra Kiger. Alita and I tried both of them on, and both felt good. We settled on the Terra Kiger, which has a Zoom air module in both the heel and the forefoot. The Wildhorse has the air module only in the back, and it felt unbalanced fore and aft. The Terra Kiger felt more solid. Both have a 4 mm drop, more than my Altras, but really a very small amount.

Here's how they look:


(The duck approves.)

And the sole is colorful, but I'm sure a bit of dirt will tone them down nicely.



I'm not sure how well they'd handle slick mud, but for general trail use -- and probably some road use, they look pretty good.

So to the obvious question: Mr. Minimalist-Barefoot-ZeroDrop-NatureBoy is playing around with Nike Air products? Yes. I've clearly got some damaged tissue on the sole of my right foot, so it seems logical to offer a bit more protection for it at least until things heal up. If they end up working well for me and even replace the Altras someday, well, it wouldn't be the first time that sort of thing happened.

Oh yes, one other thing I saw at the store y'all might like:



A poster-sized version of an iconic Nike ad from back in the day. Smile

Oh, I almost forgot! Yes, we did get Alec shoes, too. He settled on the Flyknit Lunar2. Hope they hold up until he outgrows them.


Last edited by Mark B on Sun May 25, 2014 8:16 pm; edited 1 time in total
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Re: Building A Better Bumblebee

Post  Mark B on Sun May 25, 2014 7:13 pm

Rehab Run/Walk: 2 miles

Weather: Overcast, warm, a bit muggy. 69 degrees, 55% humidity and climbing. Gear: Nike Terra Kigers, shorts, T.

Alita and I went out today for my first run in a month. It was done under the strict guidelines given to me by my PT - walk 0.1 miles, jog 0.1 miles, repeat 10 times. That works out to two miles. The goal/hope/prayer is for no pain/soreness during or after the workout.

It went well, though I can feel the new muscles I've been building, and my coordination is off. Wearing different shoes may have made it trickier, but I wanted to see how they felt on. (Quite good for trail shoes on pavement -- better than anything I've ever tried before -- though I can tell they'd be far better on dirt.)

This was a good workout for Alita, too. She's getting ready to do the Portland-to-Coast walk this summer, and the extra aerobic boost of intermittent jogging will help her get her legs and lungs back.

After the run, I can feel my right peroneal muscle has been exercised, but it's not sore. Hoping it stays that way.

I'll need to wait two days before I can do this again. Then, if that goes well, I can go up to the next level and do 0.1 mile walking, 0.2 mile jogging, for a maximum of two miles. If anything gets sore, everything stays on a holding pattern.

No HR data this time -- I went strapless.
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Re: Building A Better Bumblebee

Post  mul21 on Mon May 26, 2014 10:15 am

I picked up a pair of the Wild Horses a couple months ago.  They feel really good but I haven't really had a chance to wear them since I don't get to actual trails much.  Here's a picture:

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Re: Building A Better Bumblebee

Post  Mark B on Mon May 26, 2014 1:24 pm

@mul21 wrote:I picked up a pair of the Wild Horses a couple months ago.  They feel really good but I haven't really had a chance to wear them since I don't get to actual trails much.  Here's a picture:


Yup! Nice.

I tried those on, too. The shoes are pretty similar. I liked the Wildhorse a little less than the Terra Kigers because they had the "ZOOM" air module only in the heel unit, which meant you went from a little more cushy in the rear to fairly firm in the front. It made the shoe feel less stable to me. The Kigers have the air module in the front and back and, while I'm not a huge fan of air, it felt like a more neutral platform. (I wonder how a version without any air module would feel.)

But that's just my picky-picky perception. Both seem to be good shoes, and I hope you get a chance to let your horses run free this summer. Smile
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Re: Building A Better Bumblebee

Post  Michele "1L" Keane on Mon May 26, 2014 2:34 pm

Well, they had the Flyknit Nike Frees at the Nike Women's Half in DC.  A friend of mine got a pair, but not to run in - she likes to workout in them, but they aren't enough for her to run in (she's a bigger girl).
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Re: Building A Better Bumblebee

Post  Mark B on Mon May 26, 2014 2:46 pm

Michele \"1L" Keane wrote:Well, they had the Flyknit Nike Frees at the Nike Women's Half in DC.  A friend of mine got a pair, but not to run in - she likes to workout in them, but they aren't enough for her to run in (she's a bigger girl).

That makes sense. They don't always get the newest models in instantly at the employee/company store, and when they do, they go fast. It was a little disappointing, but that's the trade-off for the discount. We can go back again some other time and see if they're in. Besides, it gave us an excuse to try out the new trail shoes. Smile

No ill effects from the walk/jog yesterday. And I'm up to three sets of 30, twice daily, on the dual heel raises. Oof!
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Re: Building A Better Bumblebee

Post  Nick Morris on Tue May 27, 2014 11:12 am

Mark - Now those are my kind of shoes, bright and flashy. I think they will definitely help the bumble bee get better!!!
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Re: Building A Better Bumblebee

Post  Mark B on Tue May 27, 2014 4:10 pm

@Nick Morris wrote:Mark - Now those are my kind of shoes, bright and flashy.  I think they will definitely help the bumble bee get better!!!

Let's hope so! I think I need to preserve them for the trail, because the tread probably wouldn't hold up for too many miles on asphalt and concrete.

Up to 40-30-30 on my dual heel lifts now. I tried shifting my weight to one foot while I was fully extended and my heel may have come crashing down at a slightly slower speed than before. Single-leg heel lifts are going to take a while, I think.
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Re: Building A Better Bumblebee

Post  Nick Morris on Tue May 27, 2014 4:35 pm

@Mark B wrote:
@Nick Morris wrote:Mark - Now those are my kind of shoes, bright and flashy.  I think they will definitely help the bumble bee get better!!!

Let's hope so! I think I need to preserve them for the trail, because the tread probably wouldn't hold up for too many miles on asphalt and concrete.

Up to 40-30-30 on my dual heel lifts now. I tried shifting my weight to one foot while I was fully extended and my heel may have come crashing down at a slightly slower speed than before. Single-leg heel lifts are going to take a while, I think.

Yeah, the lugs on those shoes do not look like they would last that long on asphalt. I had found a hybrid trail shoe from New Balance this past winter that seem to hold up better on asphalt, but are still good on the trail. I really only us them for trail or snow, though.

Just keep at your exercises and before you know it you will be doing them with ease!
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Re: Building A Better Bumblebee

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