The Step-Over

In response to comments left on "Be Hip" post, I decided to post a new exercise for hip strength and stability. I had written it earlier in the year, but hadn't posted it yet. Here's the link: Step Over. Hope this helps.

Be Hip!

(c) http://www.physiotherapy.co.uk/
This weeks topic on take and run Thursday is running injuries. This guy has a problem. Check out that hip position. This is a great picture of hip drop which is a problem we see often. The left hip drop is most likely because of right Gluteus Medius weakness. The primary function of this muscle during gait and running is to help stabilize the hip when the foot is in contact with the ground. It controls stance leg hip adduction. This can lead to multiple running injuries including ITBFS, knee, groin, lateral hip & lower back pain. The best way to correct this problem is to train/strengthen this muscle the same way it functions during gait. That is with the right foot on the ground. With my left groin strain last year, we noticed that my pain would increase in cushioned running shoes which allowed more pronation. We also noted that along with that I had more right hip drop (left gluteal medius weakness). I initially worked on left single leg stance exercises while simulating where my hip should be during stance (level hips). This is done by contracting or squeezing my left buttock/ leveling the pelvis. I would hold this position for 5 to 10 seconds and would fatigue very quickly. I then progressed to higher level functional exercises but only if I could maintain this position. In my case, flexibility had very little to do with why I was having pain with running. With a different neutral running shoe and increased functional strength of my hip I was able to return to pain-free running.

Our previous post on the step down, is an example of one of the higher level exercises. We will post some more video of others. Check out this related post. Got strength?
I hope this helped to explain this common hip issue.
Be hip!

More on Running injuries

Here is a link to a good post on Universal Truths about Running Injuries. I am pleased with the praise for physical therapy! I want to expand on the comment of "best PT". It is important not to automatically assume a MD or PT who tells you not to run is a bad one. I don't believe this was the intent of the author of this linked post. As I've previously posted, rest is a very important part of training but also of rehab. We must give the body time to respond to rehab without the stress that helped to cause it originally. As a PT, I often have my running patients stop running. In our current health care system, by the time they get to me it is not in their best interest to continuing to try to run through it. Most have already tried that and it hasn't worked. One of my biggest battles is to get my runners to actually stop "testing it out". I try to get my patients back to running as fast as possible but very carefully. I follow the rule of, if I feel my symptoms walking around doing my daily activities, then I have no business trying to run. I start back at a very low level/ walking then progressing to walk /jog then to continuous running. Each phase of this must be symptom free before progression to the next phase.

Please visit our other posts on strengthening, running injuries, prevention & rest.

Ready for summer!

I don't know about everybody else out there, but I'm getting really tired of this cold & wet running weather. Here is a hopeful look forward to summer! A poem written by one of my daughters.

Summertime.
Hear the seagulls,
and halyards hitting the masts
And the laughter.
Smell the barbeque
and smores cooking on a bonfire.
And the chlorine from the pool.
See the crystal clear water in the lake as you glide past on a tube.
And fireworks exploding over the hill
and the sails puffing out in the breeze.
Taste the cold ice cream,
And hot dogs wrapped in a warm bun,
and fresh corn on the cob, dripping with butter.
Feel the warm, setting sun on your skin
and the breeze in your hair
And sand on your bare feet
And the cool, refreshing water after a long hot run.

Yeah, Baby, Yeah!

Getting a new pair of running shoes is a lot like buying a new car. The smell, the feel, the magic of something new on my feet.......ahhhh. I used to think that this strange feeling was something found only in female social circles, where a new pair of shoes was like chocolate. But then i started running.

Last week i decided to step out of my Brooks "comfort zone" and try something a little more on the wild side: The Adidas Supernova Control 10. So far, this shoe is a little piece of heaven. This shoe has just the right mix of medial support and cushion. I'm a "late-stage" pronator and at heel strike i hit very lateral, but the Supernova controls both of these things very well. I had almost conceded the fact that i would always feel some sort of ache or pain with my long runs, but this weekend I ran without even a twinge! Now the question is how long is this going to last? Maybe I'm still in the "honeymoon" phase ;) I guess we'll see, but for now this shoe is making things a lot easier for me. If you tend to need a little stability in your shoes, but don't want a big motion control shoe, i would check this one out.

Learn how to read!

This week's topic in the Runner's lounge: "Take It and Run Thurday" is Building the miles and going long!

My input this week involves learning how to read your body. As the weather finally warms up and the spring races draw nearer, most of us are adding to our training. We are either adding some miles and or introducing some quality (speed). During any change in our training which requires an increase in effort it is important to determine how our bodies are responding to this change in stress levels. We must learn to read our bodies / to be able to determine what we can ignore versus what is trouble brewing.

Here is a common scenario:

Fred ran 4-8 X's 400 in the first week and that this is the first time he has done any up tempo workouts this season. He wore the same shoes that he has been wearing all winter (250 miles) and they are showing some wear. On this workout, he felt really good and went quicker than scheduled. The next day was an easy run and he felt just a little tight. The next time he ran, his legs felt great so he pushed a little, but toward the end of the run he noticed a slight tightness or pinch in his distal Achilles. After the run, he gave it a good stretch. The next day he felt slight soreness during the day but a mile into his scheduled 10 miler it went away. At 3 miles it comes back and by the end of the run it is more of an aching pain. After he stopped, it goes away so he stretches it out some more. The next AM, Fred can barely walk as his Achilles is very sore and tight.

Where did Fred go wrong in this scenario? How could he have avoided this injury?

The biggest issue here, was his inability too read and listen to his symptoms. When he felt the tightness the first time, he should have used ice on his Achilles and avoided the aggressive stretching. But the biggest mistake was continuing to run during the long run when his symptoms got worse. I advise that when symptoms are felt during a run and they don't go away or they worsen, stop. At least slow down and shorten the work out. ICE and avoid aggressive stretching. If the symptoms had gone away and not returned, he could have finished the work out. It still would have been prudent to shorten the run and ice. If symptoms are felt during the day just walking around, it is better to not run. REST and ICE! No running until pain-free during everyday activities. Then the return to running needs to be a short and easy, followed by a rest day. This will allow Fred to evaluate how the Achilles is handling the return to running with less of a chance for re-injury.
Learn to read your body!

Other contributing factors:
Stick to the scheduled pace especially on the first quality run of the season.
Never a bad idea to break out a newer pair of shoes when doing quality runs or long runs.

I hope this is helpful!

More on overtraining & rest!

Here is a link to a great summary on overtraining! Also see the previous post on rest.