Thoughts On:
Training, Rehabilitation, & Best Care Practices
After three exhilarating weeks of discussing Runner’s Knee, we have covered the anatomy, mechanism of injury, hip and ankle mobility, training modifications when injured, and self-care options. This week, we culminate with what happens when self-care is not enough, when you need to seek help, and what that looks like.
Over the last two weeks, we have discussed the ins and outs of what Patellofemoral Pain Syndrome is, the anatomy involved, how adjacent joints (hip and ankle) can lead to maltracking issues, and why runner’s are specifically susceptible to this common overuse injury. You can read Part 1 & Part 2 here.
Now it’s time to talk self-treatment and training modification. Our goal is to maintain training (load) if possible when you find Runner’s Knee settling in, but more times than not, rest and self-care is needed while also modifying our training volume and intensity until symptoms recede.
In part 1 of our runner’s knee series, we discussed the specific anatomy involved, how and why we experience pain over/in the front of the knee, and most importantly, how running, and specifically downhill running, can hasten your onset of patellofemoral pain syndrome. ->Read Part 1 Here <-
Today, in part 2, we are going to move away from the knee and look at the friendly joints above and below. As we know, and you will soon find out, the hip and the ankle are in control of the knee and more times than not, pain at the knee is caused by faulty mechanics, immobility, or strength and stability deficiencies at either or both of these joints. Read on!
If you have been running for any period of time, then you have most likely had a run in with, or are currently battling, Patellofemoral Pain Syndrome (PFPS), or Runner’s Knee as is better known in the endurance community. PFPS is one of the most common causes of knee pain in runners but is also one of the most challenging conditions as the specific cause can be elusive. Furthering the challenge, Runner’s Knee itself has been used as a blanket diagnosis when runners present with any kind of knee pain, especially to clinicians unfamiliar with runners and running mechanics.
Our goal through this series is to help runners of all abilities better understand their knee pain, its cause, and how to self-treat and prevent future occurrences. Additionally, as a provider based in Utah, we are the land of abundance when it comes to downhill races. This causes a sharp increase in PFPS cases that come through our office during the fall marathon season.
As runners, we really only have 2 goals...
Run faster/farther than we ever have before.
Remain injury free.
For the last 4 years, it has been our goal at Revive Sport & Spine to be the leading sports chiropractic clinic serving the greater Salt Lake City area when it comes to running-related injuries and prevention. Having aimed for the same goals mentioned above through my own running the last 20+ years, there are few endurance sport related injuries that I have not encountered either personally or clinically.
While we field questions about running form, injury prevention, running shoes, pre-race meals, training plans, strength training, etc., some questions are better answered by those who work in that arena day in and day out.
Over that last few months, we were able to sit down with a few local specialists in sports nutrition, mental skills training, strength training, and running shoes. Our goal was to find out how each component can aid runners with injury prevention.
Runners in Utah and all over the country have expereinced that stabbing knee pain, during and after a run, that seems to come out of no where, leaving you sidelined and unsure what caused it or how to deal with it. Iliotibial Band Syndrome, or ITBS, is one of the most common injuries experienced by new and veteran runners alike. We discuss some of the basics and a few simple tools to help deal with it.
If you are like SOME runners, you prepare for your run by completing two quick stretches. First, you bend over and touch your toes. Next, you stand up, grab your foot from behind, and pull it toward your butt.
If you are like MOST runners, you don't even do that! In place of a long-winded stance on why you should be doing this and how research shows that warming-up before exercise not only prevents injury but improves performance. We are going to cover the bases of a great running warm-up through our Bands, Balance, & Bounce Running Warm-Up Routine.
If you are among the estimated 50% of all athletes who experience recurrent low back pain, don’t stress, there are exercises that can help…and a couple you should probably avoid.
Our ‘core’ is the link between our upper and lower bodies, and mastery of control here is the secret to improved strength, running efficiency, faster speed, and overall health and athleticism. In regards to back pain, our core needs to be solid to not only support a stable spine but provide for proper biomechanics when running, throwing, squatting, swimming, and even just walking.
As I near my 2 year mark in clinical practice, you start to realize trends. Sometimes these trends solidify what we already know, align greatly with what we are already practicing, and allow us to continue down the beaten path. However, there are things we begin to see as key indicators on how an injury occurred, things that are so simple, they often get overlooked in a treatment plan. Today I want to briefly discuss an item that falls under both of these categories.
Hip range of motion (ROM) is often taken for granted, until that time comes where one side is severely restricted and we are unable get up off the floor without the use of our hand, or the assistance from another. As I have progressed clinically, hip ROM started as just something to jot down in a patients notes, but has quickly become one of the first areas I look to and address for nearly all of the low back pain** and lower extremity complaint (acute and overuse) patients that come into our clinic.
The problem we see is that the restriction is never symmetrical, causing compensatory patterns that quickly lead to injuries and confused patients. While getting you out of pain is our job, our goal is education and prevention. Below are some great stretches and mobility movements that are not only easy to perform, but effective is restoring symmetrical movement. Enjoy.
Endurance athletes, especially runners, tend to shy away from strength training due to what I would consider a misunderstanding of what it can provide. After working with hundreds, probably thousands by now, of runners and triathletes over the last few years, I find very few have a regular strength plan. Some are afraid of getting hurt, some do not know how to effectively strength train, and some still have the ridiculous notion that if they lift weights they will get so bulky, the can no longer run!
