Cottonwood Heights

Injury Prevention For Runners: Tips To Support Your Training

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.  


INTERVIEW 1:  Nutrition Tips For Runners with Dietitian Tayla Russell

INTERVIEW HIGHLIGHTS:

  • Runners and other endurance athletes are different from athletes who play soccer, football, baseball, etc., and therefore have higher specific nutritional needs that fluctuate depending on the distance and type of race.  One must is that we need more carbs during our training cycles.  Choose good carbs like grains, fresh fruit, and fresh vegetables.  
  • As runners, injuries are inevitable.  Know what foods can help during the healing cycles can speed up your recovery and get you back out on the road or trails quickly.  Great Anti-Inflammatory foods include healthy fats like avocados, nuts, and seeds, high anti-inflammatory fruits like pineapple, and spices such as ginger and turmeric.  
  • Myth:  All runners must carb load before a race?  False, while long-distance runners do need some extra for energy stores later in the race, most people just over-eat the night before a race.  So if you are waking early the next morning for a 5k or 10k race, you are better served to have a light dinner of fresh veggies, lean protein, and a small amount of carbohydrates.
  • Contact:  Tayla Russell - dietitiantayla@gmail.com - 435.553.5698 - Max Muscle Cottonwood

INTERVIEW 2:  Mental Skills Training with Nate Last, M.S. from Mental Grit Consulting

INTERVIEW HIGHLIGHTS:

  • Negative Self Talk:  Negative talk puts us in our own way on our path to our goals.  Everyone does it and it is a major contributor to not performing at our best.
  • Ideal Mindset: We have an ideal mindset, we have to practice it just like everything else we are working on.  Understand you can accomplish your goals, we can and will fail at things in the process, but use it as a building tool to strengthen your mindset.  
  • Process Before Outcome:  When training and racing, focus on the basics, focus on doing everything you can do RIGHT NOW, in the moment that will help you perform better in the future.  It is okay to think ahead and dream about the future, but don't stay there!  Bring yourself back to the process.  
  • When Injured:  Stay on track through an injury.  Believe your body is capable of healing and training again.  When you believe this, it will happen, and it will likely happen faster.  
  • Contact: Nate Last - Mental Grit Consulting - 801.368.7564

INTERVIEW 3: Strength Training For Runners with Ryan Carver, CSCS from Leverage Fitness Solutions

INTERVIEW HIGHLIGHTS:

  • Should Runners Weight Train:  YES!  Weight training can help prevent injury by building the strength of not just your muscle, but ligaments, tendons, and joints.  Weight training can also make you faster by improving your overall economy and efficiency.  
  • Increase The Weight Or Volume:  As runners, we spend most of our time doing high volume training.  So when it comes to weightlifting, increasing the weight and shift toward lower reps is ideal to obtain the most benefit.  Also, just because we run or cycle, we still need to lift with our legs, don't shy away from the squats, lunges, and deadlifts.  
  • Top Exercises For Runners: (1) Weighted Step-Ups (2) Nordic Curls - Hamstring (3) Hip-Hike (4) Shin Strength - Toes To Shin w/ Resistance (5) Stir-The-Pot Core Exercise.
  • Contact: Ryan Carver - Leverage Fitness Solutions - 385.985.3603

INTERVIEW 4: Running Shoes & Injury Prevention with Darrell Phippen from Wasatch Running Center

INTERVIEW HIGHLIGHTS

  • New Technology: All name brands have great technology, but which one is best for you and your running style and goals?  Shoes are lighter, have better and more comfortable uppers, and have more fits than ever before.  Getting a correct fit, and finding the best shoe for YOU, is almost as important as your training plan.  
  • Shoe Fitting:  Trying a shoe on is not enough to make a decision.  How does it feel with movement, walking and running?  Working with the professionals who have been trained in shoe fitting can make all the difference in finding the right shoe to help you remain injury free.  
  • How Many Shoes Do You Need:  As runners, more shoes is always better.  But when you look at the average mileage of shoes, 250-350, and how often you run, having multiple shoes has its advantages.  Our suggestion is to have a minimum of 2 shoes if you are primarily a one surface runner, 3 if you mix trails with road running.  This allows them to last longer, continually challenge your feet and allow them to adapt to a variety of surfaces, and help prevent injury.  
  • Contact: Darrell Phippen - Wasatch Running Center - 801.566.8786

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.

7 Things You Need To Know About Dry Needling

The more we study dry needling, the more we understand its benefit and expand its use in the treatment of musculoskeletal injuries.  Addressing everything from low back pain, migraines, and sports injuries; dry needling proves beneficial in the most common muscle, tendon, ligament, and joint issues seen in a physician's office.  

As more practitioners utilize this technique, it is important to know the basics about dry needling, what to expect from treatment, and what conditions can benefit from this therapy.  Below are seven important items to understand when seeking treatment.  

1. WHAT IS DRY NEEDLING?

Dry needling is a skilled technique performed by trained Chiropractic Physicians and Physical Therapists aimed at managing neuromusculoskeletal injuries and pain while addressing movement dysfunction.  Dry Needling utilizes a thin filiform needle to penetrate the skin, fascia, and muscles to address adhesions, trigger points, and connective tissue.  This speeds healing and relieves pain by decreasing muscle hypertonicity, increasing joint range of motion, and correcting movement dysfunction through releasing a trigger point adhesion.

2. DRY NEEDLING IS NOT ACUPUNCTURE. 

Acupuncture is an ancient traditional Chinese technique that utilizes the knowledge of meridians.  This focus allows an acupuncturist to work on a person's inner balance, energy, qi, and one's life-force.  Work up and exam includes physical, tongue, and pulse examination.  Traditional acupuncture has been widely studied and practiced for thousands of years.

Dry needling relies on the practitioners expanded knowledge of skeletal and neuroanatomy.  This knowledge allows one to identify damaged and sensitive tissues, taut bands, and trigger points as well as injured and overused tissues.  Dry needle practitioners utilize an extensive examination that includes movement analysis, orthopedic evaluation, and a neurological workup that includes myotomal and dermatomal testing.

3.  WHAT IS A TRIGGER POINT?

A trigger point is a spot of muscle/fascia that is hypersensitive, painful when compressed, composed of a taut muscular/fascial bands that restrict oxygenated blood flow, and can refer pain and tenderness while causing motor dysfunction.  According to a recent article in Current Pain and Headache Reports, muscle overtraining or direct trauma to the muscle can lead to the development of trigger points. Trigger points may develop during occupational, recreational or sports activities when muscle use exceeds the muscles capacity to handle stress, disturbing normal recovery.  Dry needling differs from other types of therapy because it focuses on stimulating these trigger points and releasing the tension in order to alleviate pain.

4. WHAT IS A TWITCH RESPONSE

The twitch response is a localized, reflexive response of a dysfunctional area of muscle to palpation, or in our case, a dry needle.  When needling a trigger point, this is one of our goals as it leads to a rapid release of a taut muscle band, decreasing tightness and sensitivity of the surrounding area.  A tight muscle or one with a trigger point will feel an achy discomfort with an occasional twitching or cramping sensation. This twitch response returns the muscle to a normal state by releasing inflammatory chemicals from the trigger point and restoring blood flow to the area.  According to a recent study in the Journal of Orthopaedic & Sports Physical Therapy, The twitch may be a sign that the treatment will be successful.  A local twitch response is a spinal cord reflex that creates an involuntary contraction that can be triggered by a snapping palpitation or penetration with a needle.  When the patient has an involuntary twitch response, that suggests that the needle has hit the right spot.

5. IS DRY NEEDLING THERAPY PAINFUL? 

Dry Needling utilizes a thin filiform needle to penetrate skin, fascia and muscles to address adhesions, trigger points and connective tissue to speed healing and relieve pain.  Often, patients will experience a mild, dull ache during treatment and up to 24 hours post treatment.  Some discomfort is experienced during the rapid ‘twitch response’ but this discomfort is minimal and last only a few seconds.   It is normal to have mild to moderate muscle soreness after dry needling treatment.  Drinking lots of water, stretching, moving your body and heating the sore muscles can reduce the duration of the soreness.  Side effects include mild muscle soreness and bruising in some patients.

6. CONDITIONS COMMON TREATED WITH DRY NEEDLING. 

  • Headaches
  • Neck Pain
  • Low Back Pain
  • Knee Pain (Osteoarthritis)
  • Shoulder Dysfunction (adhesive capsulitis, impingement, rotator cuff strain)
  • Tennis & Thrower's Elbow
  • Carpal Tunnel Syndrome
  • Hip Pain
  • IT Band Syndrome
  • Patellofemoral Pain Syndrome (Runner's Knee)
  • Medial Tibial Stress Syndrome (Shin Splints)
  • Achilles Tendinopathy
  • Plantar Fasciitis
  • Ankle Sprains
  • Muscle Strains

7.  WHAT DOES CURRENT LITERATURE SAY & WHO CAN BENEFIT?

Dry Needling is an extremely effective treatment for acute and chronic pain, decreased flexibility, joint dysfunction, and recovery from physical activity and competition.  Patients who undergo dry needling therapy experience less pain quickly, with most finding relief after their first treatment. According to reports published by the Journal of Orthopaedic & Sports Physical Therapy, patient function is restored much more quickly when dry needling is incorporated as part of the care plan.

Chronic upper-quarter (neck/upper back/shoulder) headaches and spinal movement dysfunction have all been associated with myofascial pain syndrome (trigger points).  Kietrys et. al. published a meta-analysis on the effectiveness of dry needling on this syndrome.  Based on their research and findings, they recommend dry needling as an effective option for treatment of upper quarter myofascial pain syndrome.  They found that pain measures decreased for most patients immediately after treatment and at the four week follow-up meeting.  - Effectiveness of Dry Needling for Upper-Quadrant Myofascial Pain: A Systematic Review and Meta-analysis. http://www.jospt.org/doi/pdf/10.2519/jospt.2013.4668.   

A 2015 study looking at ankle sprain rehabilitation found that adding trigger point dry needling, of the lateral lower leg peroneus muscle, to a rehabilitation plan of proprioceptive/strength exercise the four weeks following an acute lateral ankle sprain, had greater improvements in function and pain than the controlled group of just exercise.  - Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial.  http://dx.doi.org/10.1155/2015/790209

It is normal to take several dry needling therapy sessions before the muscle is fully functional again. This is because trigger points are located under deep layers of muscles, so it typically takes several sessions for the changes to take full effect. But patients will usually notice the difference right after each treatment.

Break Up the Endurance Training With Some Strength!

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!

Let’s address these, shall we?

STRENGTH TRAINING SAFETY

As with every sport, there is a calculated risk of injury when strength training.  What will surprise some is that it is often much lower than the risk associated with training for an endurance sport.  This can depend on whether you are single sport athlete (running only!) or have taken to the range that triathlon offers.  

More can be read about sports specialization HERE from Dr. Greg Schiable. While this article is focused on sports specialization in children, the same can be shown for adult athletes who only participate, practice, and focus on one sport….an explanation why overuse injury rates are lower in triathletes compared to strict runners.  

This morning, I read a great post from Chris Beardsley (CLICK FOR FULL ARTICLE)  discussing the relative safety of strength training, especially when compared to endurance sports.  This article launched me into, again, thinking about strength training for endurance athletes, and puts another feather in the cap of it being a great cross option to break up the often monotonous droning on that running provides.

We can show that single sport athletes are more prone to overuse injuries and burnout, as well as demonstrate the benefits strength training gives to endurance, injury prevention and movement efficiency.

An interesting point made...Beardsley writes,

In comparison to the overall rate of injury in strength sports of between 0.24 – 5.5 injuries per 1,000 hours of training, the rate of injury during long-distance running is around 2.5 – 12.1 injuries per 1,000 hours and the rate during triathlon is around 1.4 – 5.4 injuries per 1,000 hours training.

He goes on to state that many studies put running injuries on the higher side of the stated rate.  

 

GETTING SWOLE

Let’s talk about getting bulky, to the point where you start to lose speed and endurance because you are just too massive to run efficiently.  It used to be that this conversation was primarily had with female athletes, but more and more we find male runners of the same belief.  In short, this is non-sense! Why is that you ask?

GENETICS: 

As a younger male, I spend countless hours, day after day, month after month, for a number of years, trying to pack on muscle and reach the elusive 200 lb mark.  It was a stage in my life….enjoyable and very educational… I have since returned to my love of endurance training, but strength training remains a big part of what keeps me fit, injury free, and happy.  

ENERGY & FOCUS:

I never made it to that 200 lbs mark.  Mainly because I could not eat, sleep, and breath lifting weights and energy intake.  To go from a slim and trim 155 to 200 is a feat which requires a lifestyle shift and not much time for anything else.  As runners, we simply can not consume enough, or slow down enough to really pack on muscle.  To make that shift, one would have to take all the time invested in putting in the miles...almost completely stop...and replace it with lifting weights...Not going to happen!  Stop worrying about getting bulky and think of what a 10-20% increase in strength could do for you during those last miles of a long run or how you can conserve energy by moving more efficiently.

 

BUT GYMS ARE SCARY

Many endurance athletes just don’t know what to do when they end up in a gym.  Fortunately, popular running sites and magazines have jumped aboard the strength train (locomotive type), and there are countless exercises and routines available if one simply does a Google search.  

My personal advice is to first master your body weight, which allows you to more comfortably perform exercise at home or on a track after a run.  Begin with push-ups, pull-ups, squats, lunge variations and jumps.  Once you reach a point where sets of 10, 20 or even 50 feel ‘easy’, it may be time to add in some weighted movements like kettlebell swings (my #2), deadlifts (my #1), and overhead press and pull variations.  

 

If you feel like you have been in a rut this summer or have had more than your share of injuries lately, maybe it is time to try something new?  Change up the routine a little...it is likely that you will enjoy the change and be surprised by the outcome.