Posted on Wednesday, April 1, 2015

How to Safely Overreach to Advance Your Training

Overreaching is a term used to describe an acute training phase during which you temporarily increase the training volume, load, and/or intensity as part a specific training strategy to gain a specific training outcome. When properly programmed, overreaching can be an effective and important part of a training cycle. Unlike Overtraining Syndrome (OTS), overreaching is an actual training strategy to build strength and/or performance. Although it typically results in additional fatigue and soreness, you can easily recover with a few days of rest and a specific recovery plan. After resting, the desired outcome is an obvious improvement or supercompensation in that specific sport or activity.

Overreaching is an important component of high-quality training. When utilizing overreaching, please be aware of the potential to develop Overtraining Syndrome (OTS). Please refer to 12 Tips to Prevent Overtraining Syndrome for the warning signs. Overreaching is an advanced training concept and shouldn’t be utilized by novice individuals regardless of the sport or activity.

Why risk Overtraining Syndrome to incorporate overreaching into your training?

Overreaching helps your body to perform the extra steps needed to produce more results in a shorter period of time.
Overreaching helps you “shock” the body in order to improve. During a short period of time (days to weeks), you push yourself to a state of being nearly overtrained prior to backing off. This is more than the typical overload you are attempting with regular training.
Supercompensation occurs as you push yourself to the limit. Then you pull back from the brink of being overtrained as you transition into a rest and recovery phase, which is outlined in 12 Tips to Prevent Overtraining Syndrome and 10 Tips to Self-Treat Overtraining Syndrome.
Quality intermediate to advanced training plans incorporate a stair step increase in performance with 3-4 intermittent bouts of overreaching throughout a typical periodized training year. Make sure that your training plan is right for you.

6 tips on how to safely overreach to advance your training:

A planned and programmed overreaching session should last no longer than 1-2 weeks.
Increase your training, intensity, and/or volume no more than 40%. For example, if you typically run 50 miles a week, then plan on a week or two of 70 miles before your scheduled rest and recovery days. You may also choose to combine two harder variables in one training session. Combine a long run with challenging hills, a tempo session with speed work, or take a long run after performing a high intensity interval training session (HIIT).
Watch for the following warning signs of overtraining syndrome: feeling fatigued sooner during the workout; excessive fatigue or soreness; changes in appetite (larger or smaller); and a longer post workout recovery time. If you’re experiencing these symptoms, then you are into overreaching and on the verge of overtraining. Depending on how much longer in the phase you need to progress, you may need to discontinue your overreaching training plan and initiate your recovery protocol.
During the overreaching cycle, be sure to properly recover between each bout of exercise. Implement specific recovery strategies including: extra sleep; adequate nutrition and hydration; proper supplementation; and foam rolling.
Plan a 5-7 day recovery protocol. Several methods to help you to recover are outlined in outlined in 12 Tips to Prevent Overtraining Syndrome and 10 Tips to Self-Treat Overtraining Syndrome. Find more recovery tips in Muscle Cramping & Spasms – Treatment Options.
Once you complete your recovery time, continue with your training plan. Take note of where you are and how you feel in your training. If you are feeling well and are demonstrating improvement, be sure to adjust your training plan by appropriately tapering up the volume and/or intensity to match your added gain. For example, if you were squatting 200 lbs. as a part of your work sets, you may increase the weight by 5-10% for a total of 210 or 220 lbs. This would also be the case for any other exercise or running distance and/or pace.

Overreaching can be an excellent method to speed up and quickly advance in your training. Overreaching increases your risk of developing Overtraining Syndrome (OTS). It should be performed carefully and thoughtfully as part of a complete training plan. Overreaching should always be followed with an equally thought out rest and recovery protocol. During your overreaching cycle, document your training and recovery strategies so that you can refine your process. It will make your next attempt at overreaching even more effective and safe in the future.

Discover how you can continue to train hard and avoid the associated poor performance, illness, and injury that can result in lost training days and opportunity!

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In my book, Preventing and Treating Overtraining Syndrome, I show you how to recognize the risk factors and symptoms of OTS. You’ll learn how to utilize prevention strategies to help you develop a personal training strategy that will allow you to push past your limits and prior plateau points in order to reach a state of what is known as overreaching (your body’s ability to “supercompensate”). This will speed up your results, so that you can train harder and more effectively than ever before! In addition, learn how to use the foam roller (complete with photos and detailed exercise descriptions) as part of a health optimization program, recovery program, rest day or treatment modality.

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http://marathontrainingacademy.com/plantar-fasciitis

Marathon Training Academy
March 26, 2015

In this guest post for Marathon Training Academy, you will discover the risk factors for plantar fasciitis and learn how to quickly return to your running routine with these self-treatment techniques!

Posted on Monday, March 23, 2015

10 Tips to Self-Treat Overtraining Syndrome

Overtraining Syndrome (OTS) can affect any athlete in any sport or at any level. I have treated high school athletes to weekend warriors for OTS. Recently I have noticed more cases of OTS among CrossFit enthusiasts and runners of all distances. People are training harder and longer than ever before with wonderful results. At times, even the best of intentions can lead to not so desirable consequences. OTS usually starts with muscle soreness and a feeling of fatigue. Then it quickly progresses into a case of overtraining syndrome or injury. Overtraining can occur when the intensity and/or volume of exercise becomes too much for the body to properly recover from. For my tips and strategies to prevent OTS, please refer to 12 Tips to Prevent Overtraining Syndrome. In this follow up post, I will specifically address how to self-treat OTS.

Overtraining Syndrome will significantly impede your performance and frequently leads to a serious injury. In OTS, your body isn’t able to adequately handle or adapt to the high volume and intensity of exercise that you are performing. If you develop OTS, you will need to take specific steps to speed up your recovery in order to prevent injury. Depending on the duration of symptoms and the severity of the case, OTS is a serious condition which can take a long time to recover from. OTS not only affects the muscular system, but also the circulatory system, the nervous system, and the hormone regulation system. Recognizing the warning signs early and being proactive in prevention will help you to avoid OTS. If you’re already suffering, use the following tips and strategies in your recovery.

10 Tips to Self-Treat Overtraining Syndrome:

Rest. One of the first and primary treatments for OTS is to rest. More rest is required the longer the overtraining has occurred. Therefore, early detection is critical. If the overtraining has only occurred for a short period of time (such as three to four weeks), then a brief three to five days of rest may be sufficient while implementing the following treatment strategies. After the rest days, slowly taper back into training at a lower training volume until recovery is complete. Typically, the intensity of training can be maintained as long as the volume is decreased. I also advise that you start an alternate day recovery cycle. Train for one day, and then take a day off. This will typically last for a few more weeks before resuming your normal training cycle. As you resume full training, it is important that the warning signs of overtraining are identified and corrected. In more severe cases, the training program may have to be interrupted for weeks or months for a full recovery.
Cross train. Opt for an alternate form of exercise to help prevent exercise withdrawal syndrome. If you are heavily participating in CrossFit or running, choose leisurely cycling and yoga as part of your cross training routine. The key is to keep both training volume and intensity low while preserving a baseline of fitness. Most of the medical studies on overtraining are geared toward single sport athletes. For triathletes and other multi-sport athletes, the recovery process may be different depending on the circumstances. If you can identify that the overtraining has occurred in only one discipline, then resting from that discipline (as well as significantly decreasing training in the other sports) may result in a full recovery. Don’t try to substitute more workouts in one sport in order to compensate for rest in another. This will only worsen the symptoms of OTS, which affects both the parasympathetic (PSN) and sympathetic nervous system (SNS). Resting from overtraining on the bicycle by swimming more will help to rest fatigued quadriceps. However, stress is stress to the cardiovascular, nervous, and hormone systems. Cross training is an important component in your recovery. Incorporate it in your typical training cycles as a method to limit your risk of injury. Cross training can make training more enjoyable as it keeps your body stimulated and ready for improvement. As you recover from OTS, the volume and intensity must be significantly reduced to allow for adequate rest and recovery.
Spot train your weak areas. In addition to cross training, use this recovery time to spot train your weak areas. Work on your mobility and balance as a prevention technique for areas that are prone to injury. If you have a history of low back pain or a prior knee injury, utilize this time to single out all those weak areas in an effort to prevent injury in the future. As you rest from your primary training routine while incorporating cross training, perform spot training as well. The Resource Guide includes a specific exercise section with rehabilitation exercises ranging from low back pain to knee pain. These .pdf files include photos and detailed descriptions to help you get started on spot training your weak areas. This is also an excellent time to work on the specific technical skills that your sport requires. It may include learning how to mentally manage your sport better.
Actively manage your aches and pains. Consider seeing a masseuse for regular body work. Another option is to use the foam roller after exercise to speed up recovery times and decrease the risk of muscle soreness or restriction. To learn how to use a foam roller for self-treatment, please refer to Foam Rolling for Rehabilitation.
Acupuncture. Incorporating acupuncture into your recovery process can be very beneficial. Acupuncture can help to address a multitude of conditions which affect the nervous, muscular, and hormonal systems. All three systems should be addressed during the recovery process. Along with many of my clients, I have experienced wonderful results with acupuncture. I highly recommend an acupuncturist who specializes in sports medicine and has experience treating athletes. During acupuncture sessions, you can take time to specifically work on intentional relaxation and meditation which has the added benefit of addressing the nervous and hormonal systems.
Seek help early. If you are experiencing chronic aches or pain or are struggling with an aspect of your training, seek help immediately. A healthy lifestyle is a lifelong pursuit. If you are injured or not enjoying an activity, you will not stay engaged or motivated in the long term. Seeking advice specifically from an experienced coach, physical therapist, or physician can be beneficial.
Decrease the stimulants. It is important to take steps to help both the nervous and hormonal system re-regulate and rejuvenate. Often with OTS, the adrenals become overtaxed and the level of cortisol (a stress hormone) is too high. Intake of stimulants, such as caffeine, tends to worsen the condition. Remember, caffeine can be found in many pre-work out supplements, running gels, soda, coffee, and tea as well as some over the counter (OTC) medications. During your recovery phase, limiting chemicals that promote stimulation to the nervous and hormonal systems (particularly in regard to cortisol and adrenal function) will speed up your recovery. Once you have recovered and are tapering back into full training, I caution you in limiting stimulants as a prevention strategy for future episodes of OTS.
Eat healthy. A healthy diet is critical to avoid injury. Your body tissue needs nutrients to be able to perform at a high level. Avoid processed food as much as possible. Limit sugary food and add more protein and healthy fat in your diet. Maintaining a diet with adequate healthy fats is essential in providing the nutrients to support all hormone function in the body as well as support the brain and nervous system. In the case of OTS, I encourage that you consume a higher fat diet to help your body’s hormonal system re-regulate. Also, adequate protein intake is necessary to support muscle health and development. For more information on protein intake, please refer to How Much Protein Do I Really Need?
Hydrate more frequently. The human body is primarily made of water, which is critical for all body functions. In the case of OTS, I highly encourage you to hydrate more frequently during recovery. Adequate water intake is critical to avoid dehydration which can negatively affect your training. Dehydrated tissues are prone to injury as they struggle to gain needed nutrients to heal and repair. Dehydrated tissues are less flexible and tend to accumulate waste products. Stay hydrated by drinking water. Try to avoid beverages that contain artificial sweeteners or chemicals with names you can’t spell or pronounce. Coconut water is a popular drink that offers vital nutrients. Also, consider a juicing cleanse with a heavy focus on the kidneys and liver to help detoxify the body.
Supplement. My most recommended supplement to help recover from injury is CapraFlex by Mt. Capra. Essentially, it combines an organic glucosamine and chondroitin supplement with other natural herbs which are designed to reduce inflammation. CapraFlex can be taken long term or intermittently. In the case of OTS, I also recommend a colostrum supplement called CapraColostrum by Mt. Capra. Colostrum is the first milk produced by female mammals after giving birth. It contains a host of immunoglobulins, anti-microbial peptides, and other growth factors. It is especially good at strengthening the intestinal lining which prevents and heals conditions associated with a leaky gut. Colostrum can also help a person more effectively exercise in hotter conditions. Over all, it can boost the immune system, assist with intestinal issues, and help the body to recover faster. Like CapraFlex, Tissue Rejuvenator by Hammer Nutrition contains glucosamine and chondroitin as well as a host of herbs, spices, and enzymes to help support tissues and limit inflammation. I recommend taking either CapraFlex OR Tissue Rejuvenator. You can take CapraColostrum independently or in conjunction with either CapraFlex or Tissue Rejuvenator. I recommend taking these supplements as a recovery strategy. I recommend initially trying a 30 day protocol. If the supplements are aiding your recovery, you may choose to continue taking them for an additional 30 days. I implement this protocol as part of a prevention strategy during times of heavy volume or high intensity training. (Please consult with your pharmacist and/or physician prior to starting any new supplementation protocol. Herbs could interact with some medications particularly if you are taking blood thinners.)

Overtraining Syndrome can be dangerous and severely limit your ability to train. It also significantly increases your risk of injury. A recovery protocol should include a multifaceted approach that incorporates strategies to positively affect the muscular, nervous, and hormonal systems.

Nothing can derail your best laid training plans and goals like an injury or suffering from OTS! If you develop OTS, you will need to take specific steps to speed up your recovery in order to prevent injury and return to a normal training schedule.

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Posted on Wednesday, March 18, 2015

12 Tips to Prevent Overtraining Syndrome

If you exercise or participate in any sport, then you have likely had some experience with Overtraining Syndrome (OTS). It usually starts with extra muscle soreness and a feeling of fatigue. These symptoms can quickly morph into a serious case of overtraining syndrome. Overtraining can occur when the intensity and/or volume of exercise becomes too much for the body to properly recover from.

Although not well understood yet, research indicates two forms of OTS. One affects the sympathetic nervous system (SNS). The other primarily affects the parasympathetic nervous (PNS). Sympathetic OTS tends to affect sprint or power athletes. The resting heart rate tends to be elevated in the sympathetic form. Parasympathetic OTS tends to affect endurance athletes. In the parasympathetic form, the heart rate is even more decreased than typically found in endurance athletes.

There is no specific test for OTS. The diagnosis is usually determined when a number of factors or symptoms begin to manifest. Warning signs, ranging from mild to severe, include:

Fatigue (mild to severe)
Muscle and body achiness and soreness
A sudden drop in performance
A drop in strength
A drop in cardiovascular endurance
Insomnia or excessive sleepiness
Headache
Illness due to a drop in your immune function
Irritability and moodiness
Decreased appetite or weight loss
An increase in your resting heart rate
A decrease in your heart rate variability
A substantial drop in training capacity and/or intensity
Depression and a loss of enthusiasm for activities (such as training)

Avoid Overtraining Syndrome if you want to effectively train at a high level. It not only impedes your immediate performance, but it also substantially increases your risk of injury. Remember, recovery from a workout is a critical part in avoiding OTS. Your recovery routine should be an intentional and a multifaceted approach.

12 Tips to Prevent Overtraining Syndrome:

Keep a training diary. An exercise or training diary allows you to keep track of how you feel before, during, and after workouts. How did your body respond to training that day? How did you sleep? How was your food intake and nutrition? Also, record your heart rate response during your exercise session. Document as many variables as you can in order to look for patterns. Discover which combinations work well for you and those that have a negative effect on training. Focus on the positive and eliminate variables which cause negative effects. The diary helps you to keep track of it all. There are software programs available to assist in this as well. One such program popular with cyclists and triathletes is Training Peaks.
Monitor heart rate variability. Another potential warning factor for overtraining syndrome is heart rate variability (HRV). It is simply the variation in the time interval between heartbeats. HRV is affected by stress, hormone changes, and changes in the sympathetic or parasympathetic system. A decrease in parasympathetic activity or increased sympathetic activity will result in reduced HRV. A reduced HRV is a sign of OTS. The higher the HRV, the more capable your nervous system is able to adapt to stress. Many different apps can quickly measure HRV. Some apps are more accurate than others. The more accurate and precise the measurement, the more expensive the app. One free app that I use and recommend is Azumio’s Instant Heart Rate.
Monitor for OTS warning signs. Watch for the warning signs (listed above) and decrease your training volume if you are experiencing symptoms. Listen to your body.
Cool down. After performing your exercises, take the extra time to cool down and stretch. Choose exercises and activities that provide range of motion (ROM) to the particular area that you just trained or used. The perfect time to perform static stretching is after exercising. Work on tight and restricted areas. Keep moving throughout the day and avoid sitting for extended periods of time.
Foam rolling. The foam roller is a wonderful tool which allows you to manipulate the body’s soft tissues. This has a potential positive effect on the fascial system, the musculotendinous system, and the circulatory system. It can aid in recovery by improving blood flow and reducing myofascial restrictions. To learn how to use a foam roller for self-treatment, please refer to Foam Rolling for Rehabilitation.
Active recovery. Every day shouldn’t be an intense training day. As part of your training cycles, be sure to include time to participate in other activities to help the body to recover and rejuvenate. Participate in a yoga class, take a leisurely bike ride, or take a walk in the park.
Proper periodization. You cannot and should not train at a super high intensity all year long. Your work volume needs to be properly periodized. Well-balanced gradual increases in training are recommended. Be sure your training plan varies the training load in cycles with built in mandatory rest phases throughout the year. The plan will likely be based on when you need to peak for certain events or races. During the high workload phase, try to alternate between high intensity interval work and low intensity endurance work.
Taper up the training volume appropriately. The 10 Percent Rule is a guideline that many fitness experts use to help athletes (of all levels) avoid injury while improving performance. Many cases of OTS can be attributed to increasing the intensity, time or type of activity too quickly. The 10 Percent Rule sets a weekly limit on training increases. The guideline indicates not to increase your activity more than 10 percent per week. That includes distance, intensity, amount of weight lifted, and/or time of exercise. For example, if you are running 30 miles per week and want to increase the distance, add 3 miles during the next week for a total of 33 miles a week. If you are squatting 200 pounds and want to increase, don’t add more than 20 pounds during the next week. The 10 Percent Rule is only a guideline. In some cases, 10 percent may be too much. Instead, a 5 percent increase per week may be much more realistic.
Rest more. Your body must rest in order to grow and develop. Training every day is not the best way to improve. It can lead to injury and burn out. Take a rest day and have fun. Sleep more. Proper programming includes mini cycles with an off season as well as active rest cycles in between heavy load and heavy volume training cycles. Don’t fear rest, embrace it!
Eat healthy. Your body tissue needs nutrients to be able to perform at a high level. Avoid processed food as much as possible. Limit sugary food and add more protein and healthy fat in your diet. Maintaining a diet with adequate healthy fats is essential in providing the nutrients to support all hormone function in the body as well as support the brain and nervous system. Adequate protein intake is necessary to support muscle health and development. For more information on protein intake, please refer to How Much Protein Do I Really Need?
Stay hydrated. The human body is primarily made of water, which is critical for all body functions. Adequate water intake is critical to avoid dehydration which can negatively affect your training. Dehydrated tissues are prone to injury as they struggle to gain needed nutrients to heal and repair. Dehydrated tissues are less flexible and tend to accumulate waste products. Stay hydrated by drinking water. Try to avoid beverages that contain artificial sweeteners or chemicals with names you can’t spell or pronounce.
Supplement. I take certain supplements during times of heavy training volume or when I am in a phase of overreaching. I also take them intermittently to help prevent injury or heal from one. My most recommended supplement is CapraFlex by Mt. Capra. Essentially, it combines an organic glucosamine and chondroitin supplement with other natural herbs which are designed to reduce inflammation. CapraFlex can be taken long term or intermittently to help heal from an injury. I also recommend a colostrum supplement called CapraColostrum by Mt. Capra. Colostrum is the first milk produced by female mammals after giving birth. It contains a host of immunoglobulins, anti-microbial peptides, and other growth factors. It is especially good at strengthening the intestinal lining which prevents and heals conditions associated with a leaky gut. Colostrum can also help a person more effectively exercise in hotter conditions. Over all, it can boost the immune system, assist with intestinal issues, and help the body to recover faster. Both of these supplements can be used in heavy volume or intense training phases to help you to recover faster and avoid OTS. (If you are taking blood thinners, please consult with your physician prior to use as the herbs could interact with some medications.)

If you begin to experience any of the warning signs of OTS, be proactive about modifying your training. It is important to objectively measure your training routine and make adjustments before you become sick, overtrained or injured. Incorporate these recommended prevention strategies to help keep your training at a high level. In the follow up post, 10 Tips to Self-Treat Overtraining Syndrome, I specifically address self-treatment strategies.

If you are experiencing chronic aches or pain or are struggling with an aspect of your training, seek help immediately. Seeking advice specifically from an experienced coach, physical therapist, or physician can be beneficial.

AVAILABLE NOW ON AMAZON!

Discover how you can continue to train hard and avoid the associated poor performance, illness, and injury that can result in lost training days and opportunity!

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I am excited about presenting a Low Back Pain Seminar at CrossFit Station.

Date:	Saturday, April 11, 2015
Time:	10 a.m. – 12 p.m.
Location:	1396 E Iron Eagle Dr. Eagle, ID
Registration:	$25 Registration Fee (due by Friday, April 3)
More Info:	Contact Trina or Tony at 208.631.3410 to reserve your spot! Click CrossFit Low Back Pain Seminar for more information.

Event:	Low Back Pain Seminar

Posted on Tuesday, February 24, 2015

Why You Should Practice Tai Chi

When was the last time you saw an American elder person perform a full squat or be able to move up and down from the ground? Now ask that same question about an elder person in China or India. The answer is much different. We notice some interesting differences in how people age when we study other cultures around the world. Many societies have fewer infirmed and immobile elders than does America. Elders in many of the Mid East and Eastern cultures tend to function at a much higher level. Lifetime participation in activities, such as Tai Chi and yoga, is one reason for this difference in healthy aging.

Aging healthfully and successfully involves integrating the body, mind, and spirit. Few activities and exercises simultaneously address all three aspects of a person’s life. Tai Chi and yoga are two forms of exercise that have an effect on all three aspects.

Tai Chi, also known as Tai Chi Chuan (TCC), is a soft form of martial arts that originated in China hundreds of years ago. Its basic movements allow for full body strengthening and balance. A focus on relaxed breathing and mental attention helps to achieve balance between body, mind, and spirit. It doesn’t require special equipment–only a small space indoor or preferably outdoor to perform. Research on Tai Chi supports many wonderful medical benefits. The major outcome of regular practice is reduced frailty.

12 Reasons Why You Should Practice Tai Chi:

Increase your lower extremity and core strength.
Improve your lower body and upper body arm control.
Improve your balance and postural stability.
Improve your flexibility.
Reduce your body fat.
Reduce your number of falls.
Utilize your practice as part of a cardiovascular rehabilitation program for prevention and/or post surgically.
To produce higher peak oxygen uptake during exercise and reduce your blood pressure.
Safe and beneficial exercise if you have diseases such as rheumatoid arthritis (RA), osteoarthritis (OA), and multiple sclerosis (MS).
Benefits your immune system and aids in hormone regulation.
Improves your bone mineral density. Regular Tai Chi exercise can help to treat osteoporosis and osteopenia (the loss of bone density and associated with fractures of bones in the elderly).
Improves your mood and reduces stress, tension, depression, anger, fatigue, confusion, and anxiety.

No wonder why Chinese doctors utilize Tai Chi to treat hypertension, stress, depression, mental strain, chronic indigestion, insomnia, and arthritis!

Tai Chi offers a wonderful method to maintain your mobility and health as you age. With people living longer, the focus should be on health span versus life span. Older adults participating in Tai Chi exercise report a sense of improved well-being, increased alertness, relaxation, an improved mental outlook, and greater confidence.

I strongly recommend finding a local Tai Chi class to participate in with a group. Active engagement in your community is a critical part of successful aging as well maintaining meaningful relationships with others. If you are unable to locate a group or Tai Chi instructor, then utilize the free resources available on YouTube. Daily Tai Chi, a free instructional video, will teach you how to perform the basic Tai Chi movements. Tai Chi for Beginners discusses the origins of Tai Chi and offers a sample lesson.

America is heading into a generational change as the baby boomers move into their elder years. For a more thorough discussion on successful aging, please refer to How to Age Successfully. For an excellent read on America’s aging population and how it will re-shape our expectations, check out Ken Dychtwald’s Age Power: How the 21st Century Will Be Ruled by the New Old.

Do you participate in Tai Chi? What benefits have you experienced? Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Posted on Wednesday, February 11, 2015

Why You Should Walk, Not Run

Although controversial and disappointing for some, running isn’t appropriate for everyone. As a physical therapist and runner, I understand why some people cannot and should not take up running as a form of exercise. Not all bodies are built to run. An existing injury may make it unsafe to run on a regular basis. If you can’t run, don’t worry about it! Many other forms of exercise without repeated impact can help us to keep fit. Walking is a wonderful method of exercise. Out of all the possible movements we can perform, we’re best at walking! Walking daily can reduce stress, improve circulation and hormone regulation as well as benefit your overall well-being.

There are many wonderful methods to stay fit and improve your cardiovascular system, but running may not be the best choice for you if you have any of the following conditions:

Certain Forms of Arthritis – There are 171 different kinds of arthritis. Although causes and presentations vary, the most common form is osteoarthritis (OA). You can still run if you have OA, but you may choose not to if you are symptomatic (experiencing pain). Running would be ill-advised for those with other types of arthritis such as gout or rheumatoid arthritis (RA). The risk of joint injury during repetitive impact based activity (like running) is too high. For more information specifically on RA, please refer to Q & A: Exercises Beneficial in Managing Rheumatoid Arthritis.
Joint Replacement – As America’s population continues to age, total joint replacement has become an increasingly more popular method to treat pain and arthritis in joints. The procedures continue to improve and evolve. Although you may be capable of running after a total joint replacement, I don’t recommend it. Running on a total joint replacement, particularly in the knee or ankle, increases the likelihood that the replacement will wear out and/or fail prematurely. If you have had a total joint replacement, I recommend a less impactful method of cardiovascular exercise.
Morbid Obesity – Running can be an excellent form of exercise and a wonderful method to help one reach his/her desired weight. However, running may not be the safest choice initially if you are morbidly obese. Morbid obesity is defined as a Body Mass Index (BMI) greater than 40 or having more than 100 lbs. of body weight. Running with excessive body weight increases your risk of injury and permanent damage to joints throughout the body. Initially, pursue non-impact activities. As your weight decreases, you may choose to participate in a running program.
Recent Medical Procedures or Injury – The inability to run can be temporary. Often after a medical procedure, physicians will advise not to run or participate in overly strenuous exercise during recovery. The list of possible conditions is long, so refer to your physician and physical therapist regarding when to avoid activity. Once you have sufficiently healed, you can taper back into your prior level of activity or even progress into a new activity. Your physician or physical therapist can offer advice on how to safely resume your activities.
Severe Osteoporosis – Osteoporosis is the weakening of the bones. Running is not contraindicated for all forms of osteoporosis, but it is for severe cases. In mild cases, the repeated impact during running can be beneficial to bone formation if the mileage or time spent on your legs isn’t excessive. In severe cases, running increases your risk of fractures. Initially, the best course of treatment, besides dietary modification, would be weight bearing activities such as weight training and walking.

The key is to rule out possible issues which may make running unsafe. Being well informed initially allows you to tailor an exercise program which can be safe and effective in maximizing your particular goals and needs. For a more thorough discussion on the safety of running, please refer to Is Running Safe? In most cases, running is safe with proper training and a strong focus on technique.

What are the benefits of walking?

Improves circulation and blood flow to the entire body.
Releases stress reducing hormones.
Releases hormones that can control blood sugar levels for up to 24 hours.
Burns calories.
Helps to prevent constipation.
Walking in a fasted state can help your body to learn how to utilize fat more efficiently as an energy source.
We are naturally good at walking. Do it daily!
It is a weight bearing activity that can be beneficial in reducing osteoporosis.
Keeps the spine healthy. The walking motion is vital to nutrient exchange in the spinal discs.

Choose walking as an intentional exercise, and add it to your daily activities as part of a healthy lifestyle. To increase the amount of calories burned during a walk, you may need to make a few changes to your morning or evening stroll. Don’t walk at your preferred speed. The trick is to make your body inefficient by walking slower, faster, uphill, downhill, or at varying speeds. Perform a high intensity workout by walking uphill briskly or using the Fartlek method.

Nordic walking, which utilizes walking poles that can help to stabilize you if your balance is poor, is also very popular. The use of walking poles can reduce stress from your back and lower extremity joints, increase your body strength, and burn more calories than traditional walking!

Do you prefer to walk or run? What might be holding you back from participating in an exercise program? I encourage you to get started now by walking. You may be surprised how quickly you see results! Please leave your comments below.

Posted on Wednesday, January 28, 2015

7 Tips to Prevent Illness & Seasonal Affective Disorder (SAD)

During the winter months, most people experience more illness, fatigue, and a lack of energy. Seasonal Affective Disorder (SAD) is one particular condition that worsens in the winter months. A lack of sunlight causes decreased serotonin and melatonin levels in the body as well as a reduction in vitamin D. Lower levels can lead to symptoms of depression and fatigue. People also tend to become ill more frequently in the winter months due to the following:

Decreased sun exposure as there are fewer daylight hours. With less sun exposure, the body isn’t able to produce the same amount of vitamin D as it did during the summer months. Vitamin D is a powerful antioxidant that helps to prevent illness. Consider supplementing with vitamin D during the winter months or during periods of heavy training.
Decreased ultraviolet radiation from the sun allows viruses and bacteria to live longer on surfaces. Consider frequently cleaning your cell phone, the coffee pot handle, keyboards, door knobs, and remote controls to avoid exposure. Wash your hands frequently and teach your children proper hygiene.
Dry conditions lead to dried out mucous membranes. The colder temperatures tend to be the driest times during the year. Drier conditions can lead to dried out mucous membranes which exposes and damages them. Then the mucous membranes can’t optimally function as a physical barrier to virus or bacteria exposure. Consider using a humidifier in your home during the winter months.

7 Tips to Prevent Illness & Seasonal Affective Disorder:

1. Increase light exposure to increase energy and to boost your immune system. SAD tends to peak in the months of January and February. To prevent SAD, increase your natural light exposure or use an artificial wide-spectrum light source such as a Lightphoria Energy Light Lamp. It provides a natural glow that mimics real sunlight. (Be cautious if you have sensitive skin or a history of bipolar disorder.)

2. Exercise regularly. Exercise (when not excessive) improves your mood and your immune system response. Regular activity also helps to regulate hormone levels which can lead to improved energy levels and endurance.

3. Do not eat anything that comes in a package. Most packaged foods are devoid of the needed micronutrients. Your body tissue needs nutrients to be able to optimally perform and fight illness. Avoid processed food as much as possible. Limit sugary food and add more protein and healthy fat in your diet. Maintaining a diet with adequate healthy fats is essential in providing the nutrients to support all hormone function in the body as well as support the brain and nervous system. Adequate protein intake is necessary to support muscle health and development.

4. Eat fruit and vegetables. Choose a variety of dark greens, reds, and oranges. Eating high quality fruit and vegetables provides your body with needed vitamins and minerals as well important micronutrients, phytochemical, and antioxidants. The benefits of consuming fruit and vegetables include: helping you to maintain your health; boosting your immune system; improving your energy levels; and insuring internal body processes to function appropriately.

5. Stay hydrated. The human body is primarily made of water, which is critical for all body functions. Adequate water intake is critical for a healthy immune system and to avoid dehydration. Stay hydrated by drinking water. Try to avoid beverages that contain artificial sweeteners or chemicals with names that you can’t spell or pronounce.

6. Sleep more. Adequate amounts of sleep boost the immune system as well as your metabolism. Your body must rest in order to grow, develop, and fight illness. Most people are not getting adequate sleep and rest. Sleep is critical to maintaining your growth hormone and testosterone production as well as stabilizing your metabolism. Rest more!

7. Wash your hands. Practicing proper hygiene is critical to avoiding illness. We touch our faces on an average of 5,500 times a day! Viruses and bacteria are easily transmitted by touching our eyes, nose, and mouth with our hands. The most effective methods to avoid illness include proper hand washing and avoiding those who are ill.

Regular activity and exercise can actually boost your immune system, but a heavy amount can actually lower it in the short run. If you are starting to feel ill, exercise may or may not be the right choice for you. Please refer to Q & A: Should I Exercise if I’m Sick?

To prevent SAD, spend time outside every day or begin using an artificial light source. Eat a well-balanced diet and exercise daily. You may also consider supplementing with vitamin D, vitamin C, and B-vitamins to increase your energy level and to boost the immune system. Stay involved with your friendships and regular activities. If you feel depressed, fatigued, and irritable the same time each year, consult your physician for recommendations for lifestyle changes and treatment.

Have you experienced symptoms of SAD this winter? What are your top tips for staying well? Please share your comments below.

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Disclaimer: The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice. No health care provider/patient relationship is formed. The use of information on this blog or materials linked from this blog is at your own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Do not disregard, or delay in obtaining, medical advice for any medical condition you may have. Please seek the assistance of your health care professionals for any such conditions.

Posted on Wednesday, January 21, 2015

How to Self-Treat Shin Splints

If you have ever experienced shin splints (anterior compartment syndrome), you know how excruciatingly painful it can be. You may struggle to run or walk. The pain can linger for weeks and months–taking the fun out of running and exercise. In the previous post, I discussed How to Prevent Shin Splints. Now I will provide simple treatment options to quickly help aid in your recovery. Shin splints can typically be easily self-treated if you don’t have a more serious medical condition, such as a stress fracture, causing the pain.

How to Self-Treat Shin Splints:

Ice. Although shin splints can occur insidiously, they are often associated with a specific event. An active inflammatory process typically occurs. Apply the ice to the anterior tibialis muscle (the muscle right next to the shinbone). The rule for icing is to apply ice no more than twenty minutes per hour. Do not place the ice directly against the skin, especially if you are using a cold pack. A bag of frozen peas can be a cheap alternative. Individuals with poor circulation or impaired sensation should take particular care when icing.
Rest. If you are experiencing an episode of shin splints, then you will need to rest. Avoid running (particularly downhill). At the very least, taper your training intensity and avoid exercises that place undue stress on the shins, particularly the anterior tibialis muscle. Utilize this time to incorporate cross training activities, such as yoga, to improve flexibility as shin splints can be linked to poor mobility.
Consider changing your shoes. Your shoes may be worn out and may be the cause of the pain. If you wear a shoe that helps to limit overpronation, remember that the inner cushion and structure of the shoe can wear out before its outer appearance. If this occurs, the shoe can no longer adequately control inappropriate foot and heel movements such as overpronation. This can lead to shin splints as well as IT band syndrome or other hip, knee, or ankle related issues. Shoes only last 350-500 miles. If you are nearing those miles, then it may be time to change.
Add an orthotic. Additional foot control is often needed to normalize gait mechanics. Many running stores sell an over-the-counter orthotic such as Superfeet Blue Premium Insoles. The blue tends to fit most feet, but a variety of options are available for customization. In my experience, these insoles can last 1,000 to 1,500 miles easily. If the over-the-counter options aren’t helping you, please see a physical therapist or podiatrist for custom orthotics. Seek assistance from a professional who is a runner and has experience with treating other runners.
Warm up prior to exercise. I recommend that you increase your normal warm up time by at least 10 minutes in order to increase blood flow to the area. This allows for better mobility and also prepares the tissues for exercise. Consider using a self-massage tool to roll up and down the anterior tibialis as part of your warm up. My favorite self-massage tools for this area include the Thera-Band Standard Roller Massager and The Stick Self Roller Massager. I also recommend using the massager on your calf muscles. Perform calf stretches, but be mindful that prolonged static stretching before exercise may worsen performance.
Cool down. After performing your exercises, take extra time to cool down and stretch. Focus on calf stretching as well as general lower extremity mobility stretches. Use the same self-massage tools as you did during your warm up. If you are prone to developing shin splints, I highly recommend regular massage and mobilization of the anterior tibialis muscle, as well as the calves. Tightness in the calves and Achilles tendon are a risk factor for developing shin splints. Be sure to emphasize stretching your calves. Hold each of the following stretches for at least 30 seconds, 3 times on each leg, 2-3 times a day. (These stretches shouldn’t cause more than a mild increase in pain or discomfort.)

Self-mobilize the tissue. Be sure to mobilize the tissue of the anterior tibialis. For this particular area, you may want to use one of the self-massage tools referenced above. You could also use a tennis or lacrosse ball to aggressively work out the tissue along the shin. Remember that mobility issues and myofascial restrictions in the lower legs are highly correlated with the development of shin splints. Use the foam roller to address any lower leg tightness or restrictions. I tend to use the foam roller for the larger parts of the leg including the thigh, back of the leg, calves, and buttock muscles. To learn how to use a foam roller, please refer to Foam Rolling for Rehabilitation.
Work on the stabilizing muscles of your hips and ankles. As part of a comprehensive rehabilitation protocol, I almost always have clients work on keeping the muscles of the pelvis, hips, and ankles strong. This will help to maintain normal gait mechanics during exercise and running. Not only will this help to prevent shin splints, it will likely help to prevent developing other orthopaedic issues such as plantar fasciitis and hip or knee pain. Please refer to Ankle Resistance Exercises and How to Safely Self-Treat Low Back Pain for my recommended hip and lumbar stabilization strengthening exercises.
Work on your balance. Poor balance is often associated with muscle weakness in the foot and ankle as well as the knee and hip musculature. Weakness and balance deficits can lead to poor foot mechanics, which can lead to excessive strain. I always include balance work as part of my recommended rehabilitation protocol. Please refer to Improving Balance by Using a Water Noodle, How Do I Improve Balance? (Part I), and How Do I Improve Balance? (Part II).
Kinesiological taping. The purpose of the tape is to assist the anterior tibialis muscle with its contraction and to possibly help with swelling and nutrient exchange by assisting the lymphatic system. I have had luck using the KT TAPE and Mummy Tape brands. When treating shin splints, I recommend following these step by step instructions for Kinesiological Taping for Shin Splints. For application and removal tips, please refer to Skin Care with Taping.
Use a compression sleeve or stocking. This condition is often associated with swelling and inflammation in the anterior compartment of the lower leg near the shinbone (tibia). The compression sleeve/socking can help to limit the amount of swelling and promote blood flow back out of the lower leg. This insures better nutrient exchange, waste removal, and can limit the swelling. I particularly recommend wearing a pair while you are in the rehabilitation phase or tapering back into full activity. There are many different styles of compression socks and sleeves, but I prefer Vitalsox Graduated Compression Socks. If you prefer a sock style, then I recommend choosing a pair that is at least knee high.
Start a supplement. Many herbs help to reduce inflammation and pain. One of my favorites is called Phenocane Natural Pain Management. It combines the following: Curcumin, an herb that reduces pain and inflammation; boswellia, a natural COX2 inhibitor that also reduces pain and inflammation; DLPA, an amino acid that helps to increase and uphold serotonin levels in the brain; and nattokinase, an enzyme that assists with blood clotting and reduces pain and inflammation. (If you are taking blood thinners, please consult with your physician prior to use as the herbs could interact with some medications.)
Ask for help. If you’re still experiencing pain after implementing these self-treatment strategies, then it may be time to seek additional help. Your medical physician can help to determine if your pain is associated with a stress fracture. He/she could also prescribe stronger anti-inflammatory medication if necessary. The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area. In most states, you can seek physical therapy advice without a medical doctor’s referral (although it may be a good idea to seek your physician’s opinion as well).

Have you ever experienced shin splints? If so, which treatment techniques have you found to be the most effective? Please leave your comments below.

Looking for that exercise or book I mentioned in a post? Forgot the name of a product or supplement that you’re interested in? It’s all listed in the new Resource Guide. Check it out today!

Posted on Wednesday, January 14, 2015

How to Prevent Shin Splints

The term shin splints, also known as an anterior compartment syndrome, refers to pain along the shinbone (tibia), the large bone in the front of your lower leg. Shin splints can be excruciatingly painful to the point that you may struggle to walk or run. Worse yet, the pain can linger for weeks to months, but it may not be severe enough to prevent you from exercising. However, it will take the fun out of exercising and running. I will address the common causes for shin splints and share my top tips to prevent shin splints. I provide treatment options in How to Self-Treat Shin Splints.

Shin splints are typically caused by inflammation in the lower leg anterior muscles known as the anterior tibialis muscle. This is the primary muscle needed to lift your foot. Shin splints are often considered an over use injury. Unfortunately, shin splints are relatively common in runners and dancers.

As a physical therapist, I commonly treat acute cases of shin splints that occur when an individual suddenly increases his/her training volume by largely increasing the distance he/she is running. This condition may also occur when an individual isn’t appropriately trained for downhill running. Running downhill causes the anterior tibialis muscle to work very hard in an eccentric manner (meaning that the muscle is lengthening). This can very easily overwork a poorly trained muscle and may cause pain and inflammation.

Common Causes of Shin Splints include:

Flat feet, which cause overpronation while running.
Poorly fitting or worn out shoes.
Tightness in the calf muscle or Achilles tendon.
Weak ankle muscles (particularly the anterior tibialis). Shin splints are also associated with weakness in the other muscles of the ankle and foot.
Weakness in the hip, pelvic, and/or core muscles can lead to faulty gait mechanics, which causes shin splints or possibly other knee and lower extremity injuries.
A change in running surfaces. This is most evident when transitioning from a softer running surface, such as dirt, to a concrete running track.
Stress fractures in the shin (tibial bone). Also, stress fractures in the foot can cause alterations in running form which may lead to shin splints.
Training overload. The muscles of the anterior shin (the anterior tibialis) are performing training intensities and volumes that they are incapable of doing. This causes inflammation, swelling, and pain.

How to Prevent Shin Splints:

Check your shoes. Your shoes may be worn out and may be the cause of the pain. If you wear a shoe that helps to limit overpronation, remember that the inner cushion and structure of the shoe can wear out before its outer appearance. If this occurs, the shoe can no longer adequately control inappropriate foot and heel movements such as overpronation. Shoes typically only last 350-500 miles. If you are nearing those miles, then it may be time to change. If you’re unsure if your shoes are performing correctly, visit your local running shoe store. The trained staff can inspect your shoes for wear and tear. They may ask you to walk or run in order to watch your gait to fit you in the appropriate shoe. Another option to help control overpronation is an over-the-counter orthotic such as Superfeet Blue Premium Insoles. The blue tends to fit most feet, but a variety of options are available for customization. In my experience, these insoles can last 1,000 to 1,500 miles easily. If the over-the-counter options aren’t helping you, please see a physical therapist or podiatrist for custom orthotics.
Progress slowly into a minimalistic shoe. If you are used to a standard built up shoe, progressing into a minimalistic shoe may be more difficult and take more time. Unless you are a child or teenager, expect a safe transition to take at least three months. Don’t transition during a period of intense sports. I highly recommend waiting until the off season as progressing slowly is always a better choice.
If you change running surfaces, progress slowly. If you are used to running on softer surfaces, such as dirt or a running track, progress carefully and slowly when you run on a harder surface like concrete. Over all, softer running surfaces are better for your body.
Have your gait analyzed while running. Gait or running abnormalities can increase your risk of developing shin splints. Over striding tends to occur while running downhill. Check with your local running store or a physical therapy clinic for a monthly gait analysis clinic. If you’re unable to obtain a gait analysis, ask your spouse or a friend to video record you (from behind) while you’re running. Then watch the recording to see if you notice over striding or any abnormalities.
Warm up prior to exercise. I recommend that you increase your normal warm up time by at least 10 minutes in order to increase blood flow to the area. This allows for better mobility and also prepares the tissues for exercise. Consider using a self-massage tool to roll up and down the anterior tibialis as part of your warm up. My favorite self-massage tools for this area include the Thera-Band Standard Roller Massager and The Stick Self Roller Massager.
Cool down. After performing your exercises, take extra time to cool down and stretch. Focus on calf stretching as well as general lower extremity mobility stretches. Use the same self-massage tools as you did during your warm up. If you are prone to developing shin splints, I highly recommend regular massage and mobilization of the anterior tibialis muscle.
Improve your mobility. Mobility issues and myofascial restrictions in the lower legs are highly correlated with the development of shin splints. Use the foam roller to address any lower leg tightness or restrictions. To learn how to use a foam roller, please refer to Foam Rolling for Rehabilitation.
Strengthen the stabilizing muscles of your hips and ankles. Strengthening the muscles of your hips and ankles will help to maintain normal gait mechanics during exercise and running. Not only will this help to prevent shin splints, it will likely help to prevent developing other orthopaedic issues such as plantar fasciitis and hip or knee pain. Please refer to Ankle Resistance Exercises and How to Safely Self-Treat Low Back Pain for my recommended hip and lumbar stabilization strengthening exercises.
Improve your balance. Poor balance is often associated with muscle weakness in the foot and ankle as well as the knee and hip musculature. Weakness and balance deficits can lead to poor foot mechanics, which can lead to excessive strain on the plantar fascia. Improving your balance can help to reduce the risk of shin splints and is an important part of the rehabilitation. Please refer to Improving Balance by Using a Water Noodle, How Do I Improve Balance? (Part I), and How Do I Improve Balance? (Part II).
Train for running downhill. Running downhill forces the anterior tibialis muscle to work much harder than it would otherwise. Running downhill causes the anterior tibialis to perform more eccentric (when the muscle gets longer) loading and repetition. This can overload the muscle, particularly when running downhill very fast. Although running downhill may not be as aerobically taxing as running uphill, it’s actually physically much harder on your body.
If you experience pain, seek help early. Don’t ignore those little aches and pains that can develop as you exercise and train. They may be early warning signs of a developing problem. If you experience pain in your shins, start implementing my recommended treatment protocol. If the pain persists or continues to progress, please seek assistance from your medical physician or a physical therapist. The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area.

Have you ever experienced shin splints? If so, how do you prevent them from re-occurring? Please share the treatments that have been the most effective for you by leaving your comment below.

Looking for that exercise or book I mentioned in a post? Forgot the name of a product or supplement that you’re interested in? It’s all listed in the new Resource Guide. Check it out today!