Running Injury

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: Self-Care & Training Modification

As we work our way through this series, let not forget what we have learned so far.

  • Iliotibial band syndrome is a common overuse injury plaguing runners of all abilities. The most common offense is trying to increase your volume too soon while also increasing the intensity without cross-training or varying surfaces.

  • The Iliotibial band DOES NOT STRETCH! The tension we feel is caused by the muscles that support the IT band, Tensor Fascia Latae and Gluteus Maximus.

  • The stabbing pain we experiences as runners suffering from IT band syndrome is thought to be caused by the band itself shifting forward and backward as the knee flexes and extends. The research is out on that one…if we ever reach a consensus, I will let you all know!

Where are we now? Well…if you have made it this far, you are probably dealing with IT band syndrome and wondering if it will ever go away and let you get back to running the way you would like.

For this, we are going to discuss self-care. What you can do about the knee pain and tight hips at home while also mentioning a few stretches you can do at work or out on a run. Our goal is simple - Allow you to continue to train, modified while improving your IT band syndrome pain week-to-week.

What we are talking about today, where the real work takes place, the day in and day out self-care. And the big question….can you continue training?

 

 

SELF CARE PART 1 - START WITH A BETTER WARM-UP

I can not stress this enough! As you are working through an injury, maintaining some kind of load (training volume) is important, but you are better served spending time on a proper warm up, running just a few miles, then spending a good amount of time on the cool down. With just about every running injury we deal with, runners have a dismal warm-up if one at all. Most are so pressed for time, they lace up the shoes, run out the door, only to return and head straight to work. Most of us are not teenagers anymore, our bodies just can’t do this…not for long periods anyway. Start with a thorough warm-up - we will emphasize this again in our next article where we talk rehab and return to running so prepare yourself!

 

 

SELF CARE PART 2 - SELF MYOFASCIAL RELIEF

Understanding that foam rolling and stretching of the IT band itself is ineffective, where do we focus our attention? The hips…it is always the hips! But some attention at the knee can be beneficial while appropriate rest and recovery are always suggested after an acute flair-up or long run.

  • Rest & Recovery:

    • Traditional pain relievers for running related pain include ice, heat, topical creams like biofreeze, and some good old-fashioned rest. Today we have an array of tools that can aid in recovery, one we like to use frequently are compression boots from Rapid Reboot. We don’t expect everyone just to have these lying around, but they sure feel great after some dry needling, IASTM, and manipulation in the clinic.

  • Rolling & Stretching:

    • Now that we understand what anatomy we need to address, it is time to get your roll on! If we are able to continue to train, we suggest rolling and stretching 4-5 times each day. Before you lose it, these sessions are only 3-4 minutes each. If you are a frequent runner, or just starting out, here are the basics.

    • Rollers should be in your home, office, and car. You should have at least 3 lacrosse balls around, purse, cup holder in your car, in your desk, and your gym bag.

    • Roll in the morning, pre and post run, after your lunch break, when you get home, and then a good session before bed.

  • Cupping & Flossing:

    • These may not be tools accessible to all, but they help you achieve stretching in ways that are difficult to do on your own. One of my personal approaches to provide relief to the knee pain we experience with IT Band syndrome is to place a few cups (I have a few sets of these) around the lateral knee and lateral quadricep muscle, walk about for a few minutes, perform a few squats, rinse and repeat 2-3 times per week.

 

 

SELF CARE PART 3 - TRAINING MODIFICATION

Training modification is the hardest part to address. For most, the ability to continue training toward your race is almost as important as fixing the injury. While maintaining some load is ideal, there are instances where a total shut-down is necessary for a few weeks. If you are a typical runner, meaning that you are going to run through the injury, we must modify. Here are the basics. Remember that Iliotibial band syndrome is the result of too much mileage or intensity, too soon in your training plan. Not having a proper base as you head into a 20-week marathon training plan is a recipe for disaster.

  • Our first suggestion is to cut your volume by 50% and decrease your intensity for the next 2-4 weeks. Our goal is to maintain some running, but the speed work and downhill bombs need to take a backseat for a while.

  • Please, cross-train! As runners, we think that running is it, period. When we are injured, and more so when we are not so that we can prevent injury, we must cross train. If you have been battling IT band syndrome for more than a few weeks, it is time to work in some biking, swimming and weightlifting. This allows you to maintain most of your cardiovascular capacity while taking out the pounding associated with running.

  • Lastly, look at your running form. Can it be cleaned up a bit? For most of us, that is a very strong, Yes! I’m not saying to go out and get an extensive running evaluation to change the subtle nuances of your stride, most of us just are not at that level, but shortening your stride, increasing your cadence, and working on your running drills can provide a needed boost in your running efficiency.

    • Cadence should be upwards of 170-180 steps per minute.

    • Perform drills on a soft surface (track or field) 2-3 times per week.

    • More on this in the rehab portion next week.


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.