New Year - New Goals: Running To Better Health

Improved health tops nearly every new year's resolution list ever made, 2019 will be no different. From this, running comes to the forefront of our ‘get in shape’ plan because of its ease (almost everyone can shuffle one foot in front of the other, not saying it is easy) and relatively low cost (a decent pair of shoes and some running gear is all you need). While this plan seems fool-proof, there is a reason 60%+ of the people we see in our clinic are runners, new and old.

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While running seems easy to do, there are many things to consider. Are you a runner? Have you ran since high school, or ever? Did you know your body type matters? Can you cover 1-2 miles and not be in misery the next day? Do you have good shoes? Do you have a partner to run with, accountability is essential for follow-through? You didn’t think about any of that, did you? While we will have more running and running-related injury articles to share with you in 2019, let’s start with some current research (Nerd-Alert).


Article 1: ‘How Do Novice Runners With Different Body Mass Indexes Begin a Self-chosen Running Regime?

Who:

  • In this study, the authors gave 914 novice runners a GPS watch and tracked them over a year to study their habits and direction of their running habits. The group was divided into 3 groups based on their BMI (Normal, Overweight, & Obese) to help determine if there were any differences and similarities in their training selection.

What They Found:

  • The first interesting finding was that in this self-guided exercise program, all categories selected similar training doses. The authors suggest that this may explain the higher injury risk among overweight and obese runners compared with normal-weight runners.

  • Normal weight runners ran faster and farther than their overweight and obese counterparts. This is anticipated as these are all novice runners, but the perceived effort was not established and could be an interesting metric to develop.

Suggestions:

  • Starting a new exercise program is exciting, but one must also be willing to understand and see that they are at a starting point. Novice runners are at high risk of injury if they start too fast, or do too much too soon. An initial dose of high volume can lead to an injury that causes you to become inactive, losing any benefits you sought to gain in the first place.

  • BMI is important to consider. Have a higher BMI does not mean you can or should not run, it means that the programming must be different. Training has to do with ‘load,’ and by that, we mean that if you are 200 lbs, it is a bit more challenging and harder on your body to run 3 miles than for someone who is 150 lbs. This changes as we continue training and adapt, but at first, we must take things slow.

  • Any activity is better than a sedentary lifestyle! Remember to take things slowly. Your body will be sore, but that is to be expected. If you have pain, or your soreness lasts longer than a few days after exercise, seek professional guidance on preparing your body and running programming.


Article 2: ‘Progression in Running Intensity of Running Volume and the Development of Specific Injuries in Recreational Runners:

Who:

  • The authors of this study followed 447 runners over a 24-week running program. Their goal was to determine the risk associated with high-intensity running plans and high-volume running plans.

  • Before the study began, they hypothesized that runners on the high-intensity program would have higher rates of Achilles tendinopathy, calf injuries, and plantar fasciitis while runners on the high-volume program would experience more runners knee, iliotibial band syndrome, and patellar tendinopathy.

What they found:

  • Over the 24-week training program, 80 runners sustained an injury. However, the authors found no difference in the risk of injuries related to training volume or intensity.

Suggestions:

  • The others suggest this discrepancy between these results and other related studies and running-related injury beliefs are related to the periodization of the running schedules, the scheduled running intensities, and the categorizations of injuries.

  • Runners or all shape, sizes, and abilities will eventually run into injury. Prevention by adhering to a solid warm-up routine, frequent attention to weaknesses and immobilities, while also modifying a training plan to one's abilities can help prevent injury.

  • When beginning a new running plan, or increasing your volume or intensity, it is suggested to do one at a time. Listen to your body and take time off as needed.

If you are taking up running again, or for the first time, and you have questions, we are here to help. Running injuries are common. You often do not have to stop running, just a rework and refocus of your training plan. Train Hard & Train Smart.

Happy & Healthy 2019!


Dr. Reheisse is a Board Certified Chiropractic Sports Physician practicing in Cottonwood Heights Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management.

New Year - New Goals: Setting & Achieving Your Goals This Year.

2018 is over! 2019 is here!

If you are like me, you love to set goals, spend hours on action plans to achieve those goals, and ponder on the impact and improvements you can make to yourself, your company, your family, your health, and everything else around you.

While you will not find a shortage of articles telling you how to set goals. Or how by February 1st, over 80% of people will have already abandoned their resolutions, lets just keep this short and to the point in hopes that you are aiming to be part of the 20% who holds on, pushes through, and progresses not just your life, but your families, and everyone you interact with.

When gearing up for 2019, set your aim high and work these 3 steps.

 

 

BE SMART

We have all heard of the ‘SMART’ acronym about goal setting.

  • Specific: Be as specific as possible with your goals, they are easier to break up and achieve if they are clearly defined.

  • Measurable: This is usually the easiest part. How will you know when you have achieved your goal? When you hit your mark. 1000 miles running - $100K in growth - 2 full weeks of vacation time with your family. Put a number to it!

  • Attainable: Don’t make your goals too easy. Set your goals just at the end of your reach. Goals that make you work and dig down deep create the best feelings of accomplishment when completed.

  • Relevant: Is this goal important to you? Does it help you become a better person? Can accomplishing this goal help and serve others?

  • Time-Based: Every goal must have a deadline, or it is just a thought, a dream, an everyday task.

Break down each goal you have set into smaller, workable, SMART pieces.

 

 

THE ONE THING

Studies have shown that we are incapable of multi-tasking! Don’t believe me, just try to do 3 things at once and see how well they are completed, if at all. The new year brings about much excitement about the possibilities and opportunities ahead, but if our focus shifts to too many things at once, it will all quickly fall apart. Start by reading ‘The One Thing’ by Gary Keller and focus all of your attention on one goal at a time. See it through to completion and then move on to the next.

 

 

10X EVERYTHING

Look at your goals. Look at the energy, time, commitment, and focus it will require, and 10 X it! In Grant Cardone’s ‘The 10X Rule’, he discusses that anything worth accomplishing will require ten times more time, energy, and resources than you initially thought. How do you attack this, with massive action.

In summary, take an hour this week, work through your goals and develop an action plan. Assure they are SMART, begin by focusing on just one, and TAKE MASSIVE ACTION!

- Happy New Year -


Dr. Reheisse is a Board Certified Chiropractic Sports Physician practicing in Cottonwood Heights Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management.

Iliotibial Band Syndrome: Treatment & Rehabiliation

What happens when stretching and strengthening are not enough to get you out of the Iliotibial Band Syndrome rut? What happens when you are like me, and you can’t get past that 5-mile threshold without the following days being painful to walk, much less get to run on back-to-back days? You seek care. You find a provider that understands running mechanics, realistic time frames and does everything possible to help you maintain some running while recovering from the injury.

Side note before we start, if you are picking up this series right now and have not read and worked through parts 1-3, do so now. The understanding you will gain will help this part be that much more helpful.

Part 1 - Anatomy & Common Symptoms

Part 2 - Running Biomechanics

Part 3 - Self-Care & Training Modifications

 

 

TIME FRAME TO RUNNING RECOVERY

Let's start by setting realistic goals. IT Band pain rarely, if ever, comes on overnight. It may seem like it was the ‘last run’ or the race that caused the pain, but if you reviewed the anatomy, mechanics, and nature of the injury, we know it was a long time coming. That alone, in addition to attempting to maintain some running through rehabilitation, means this will take longer than a couple of weeks.

Quick Lesson On Tissue Healing.

While bruising, swelling, and pain may subside, tissue damage can take weeks to months to fully remodel and heal to a fully functioning tissue that can handle the stress imposed by endurance training. The biggest mistake we see is when patients decide to quickly ramp up training and stop working as diligently on their rehab and mobility because they had a good run or two without pain. Don’t be fooled, routines matter and healing takes time.

We runners are just an impatient bunch.

With a realistic time frame in mind, care will typically range from 4-8 weeks. Holy cow you say? I think the same, but think about how long you tolerated the little ‘twinge’ at the side of your knee, how long your hip had to be tight and inefficient to cause that pain at the knee. Keep in mind, most doctors and therapists are going to try and keep you running and are talented in their craft, but just as a broken bone has to heal and remodel, so does our soft tissue; and it - just - takes - TIME.

 

 

WHAT DOES CARE LOOK LIKE?

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Soft Tissue:

As Iliotibial Band Syndrome is an overuse injury affecting the soft tissues of the hip, lateral thigh, and lateral knee, addressing the involved muscles is priority number one! As in other conditions, utilizing treatment methods that have been proven to help relieve symptoms, improve mechanics, and help you return to running faster is our aim. Clinically, therapies such as dry needling, IASTM, cupping, and active & passive myofascial releases have shown to be useful in the treatment of IT Band Syndrome.

Joint Mobility

Manipulation is a great treatment option, especially when you look at the complexity of running mechanics. We have discussed in other conditions how one area of the body can affect another. When someone presents with IT Band Syndrome, we not only address the area of pain, the anatomy involved, but we also look at the whole chain. Assessing the movement of the foot, ankle, knee, hip, pelvis, and low back are all important in healing an Iliotibial Band issue. Restoring normal movement can be achived through manipulation of the joint. Determining which areas of the body that need this treatment comes from an exam focused on making you a better runner.

Rehabilitation & Home Care

See Article 3: Make your foam roller your best friend.

 

 

EXERCISE REHABILITATION PROGRAM

Coming back as a better, stronger, bulletproof runner.

 

 

RETURN TO RUNNING

This is the most common question asked by runners once we finish discussing the problem and how we are going to address it. While most runners have a VERY hard time taking a step back, our goal is to maintain some form of running. Rehab requires a load, and as runners, running is our ‘load.’ Over time it is the capacity of this ‘load’ that has to expand. Too rapid an increase in volume or intensity, and we are back where we started. When it comes to a return to running program after an injury, just follow the fantastic advice of the Beastie Boys…slow and low, that is the tempo!

Assumptions:

While in an active treatment plan, cut the running volume 50% and take out the hard intensity work for the time being.

What other activities can you add in to maintain your cardiovascular effort while allowing your body to heal? Biking, swimming, aqua-jogging, weight training, etc.

WEEKS 1 & 2:

Run:

  • 50% of the volume that preceded the IT Band pain.

  • Avoid down-hills & alter the terrain you run on (track, trail, road).

  • Take a break from any speed work/tempo/interval runs. Treat this time as base mileage. Our goal here is to maintain some load (running) while allowing the body to heal and adapt to care. Be Patient!

  • No back-to-back days or running. At this stage, rest time to recover between runs is the most essential part of your recovery time.

Rehab:

  • Start with our Best Running Warm-Up 1 before each of your runs these 2 weeks.

  • Foam Roll, Foam Roll, FOAM ROLL!

  • Work through the IT Band Phase 1 Rehab above. Perform these on non-running days. Slow & controlled movements are best.

Alternatives For Training:

  • Runners, it is okay to do something else every once in a while to replace and let your body rest from running. Bike, swim, zumba, pilates, yoga….

  • Take one ‘running’ day each week and get your cardio in some other way.

WEEKS 3 & 4:

Run:

  • Have you been able to get one pain-free run? If so, increase the volume of your long run by 10% over these next 2 weeks.

  • Introduce some basic ‘pick-ups’ in one of your runs. I suggest starting with 5-6, 30-second pickups over a 4-6 mile run. Easy, but it allows you to work on your turn-over, form, and increase your heart rate a little.

Rehab:

  • If you have yet to do so, start adding in bands to your warm up and to our IT Band Running Rehab Phase 1. Work on endurance with those exercises, beginning with 1x10, working up over the next 6 months to 2-3x15.

  • If you have been able to cruise through Phase 1 of your rehab exercises and have already introduced bands to each exercise, start working on Phase 2.

Alternative To Training:

  • Continue to do ‘something else’ for one of your running days. We are trying to change and reinforce good habits here for long-term injury-free running.

WEEK 5 & 6:

Run:

  • By now, we should be having a few runs each week that are pain-free with minimal soreness after. Time to progress!

  • The body responds to load, increasing the load is part of the progress. Start ramping up 10% in volume each week.

  • Ramping volume and intensity at the same time are often difficult, even for those who are not coming off an injury. Work on your volume before you drastically increase your intensity.

  • Bring hills, repeats, speed work, and tempo in gradually. See the point directly above this.

  • Lastly, time to start running back-to-back days. Let’s not get too excited here, keep it to one 2 day block each week.

Rehab:

  • If you haven’t started yet, it’s time to begin Phase 2 of our IT Band Syndrome Rehab Exercises. Same protocol as before. Perform these on non-running days.

  • Running warm-up. Work through parts 2 & 3 of our Best Running Warm-Up Series.

Alternative To Training:

  • Now that the habits are formed. Weight training, cross training for endurance, and other methods to improve your overall athleticism as a runner are vital to remaining injury-free. Keep it up!


Dr. Reheisse is a Board Certified Chiropractic Sports Physician practicing in the Greater Salt Lake City Area of Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management.