Category Archives: Running

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How to Self-Treat Patellar Femoral Pain Syndrome (Runner’s Knee)

Patellar Femoral Pain Syndrome (PFPS), also known as runner’s knee, is a common running related issue.  The sooner you can manage this condition, the easier it will be to recover and eliminate future problems.  Many of my recommended exercises can be adopted as part of a cross training program to prevent PFPS.  I will address the many potential causative factors for PFPS and offer advice on how to self-treat this condition.

PFPS can be quite painful and significantly affect a person’s ability to run or move properly.  The cause of the pain is often associated with a patellar or knee cap that is tracking in the femoral groove improperly.  This can occur for many reasons, but the most common causes are:

  1. Poor quadriceps strength (particularly the inner or medial quadriceps).
  2. Poor hip abductor and/or hip external rotator strength.
  3. Improper foot biomechanics during the single leg stance phase of the gait cycle or the mid foot strike during running. The most common issue within the foot is usually overpronation (when the feet excessively roll inward and cause the knee to roll inward as well during each step). Overpronation is more common among females although males experience it as well. Women may experience overpronation due to the angle of their hips in relation to the knee. A woman’s pelvis is typically a different shape to allow for child bearing. The larger “Q-angle” associated with the hip and knee can cause increased strain on the knee.

PFPS symptoms include:

  • The pain will typically increase when going downstairs. In more severe cases, going upstairs is also very painful.
  • Pain with squats, lunges, knee extensions, or other plyometric activity.
  • Pain typically worsens with prolonged sitting. The longer you sit in one position, the worse the pain becomes.
  • Grinding, popping, and cracking are often associated symptoms.
  • Pain can be anywhere along the patella (knee cap), but it’s typically associated with anterior knee pain or medial patellar pain.

In many cases, a very thorough warm up may allow you to participate in activity.  However, the pain may worsen again later that day or the next day.  Seek help or guidance quickly when your pain worsens with activity.  For the best result, the treatment plan should be multifactorial.

How to Self-Treat PFPS:

  • Improve your quad and your hip strength. Please refer to Patellar Femoral Pain Syndrome Rehabilitation Exercises for my recommended exercise program which is designed to improve quad and hip strength. To improve your quad strength, the emphasis should be on the inner quad known as the vastus medialis oblique (VMO). Weak hip abduction and hip external (lateral) rotation muscles significantly contribute to PFPS. The purpose of the lateral and external rotators of the hip is to prevent internal rotation (rolling inward) of the hip and knee. My recommended exercise program will help to improve your strength.
  • 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 promotes healing as movement is necessary to bring in the nutrients. Use a stationary bike or the rower machine initially to get the muscles warm and the knee joint more lubricated. Then work on moving into a deep squat position multiple times as part of the warm up. You may need to hang onto a beam or a pole to take some pressure off of your knee as you move in and out of the squat.
  • Cool down. After performing your exercises, take extra time to cool down and stretch. Use either a stationary bike (at a causal/slower pace) or the rower machine. Both are reduced weight bearing exercises that promote movement and circulation to the knee as well as increasing range of motion (ROM).
  • Self-Mobilize the Tissue. Myofascial release of the quadriceps muscle is an important component in order to relieve the pain and reduce the pressure and tension through the patellar femoral tendon and joint. I tend to use the foam roller for the larger part of the quadriceps. I also use a tennis or lacrosse ball to aggressively work the tissue above the patella. You can use your hand to press the ball in and work it around the tissue. To use the weight of your leg for a more aggressive mobilization, place the ball on the ground and mobilize the tissue with your leg on top of the ball.

LacrosseBallForQuad

  • Kinesiological Taping. The purpose of the tape is to assist the patella in its tracking. I have had luck using Kinesio Tape and Mummy Tape brands. There are many other useful taping techniques which utilize different forms of tape. When treating PFPS, I recommend that you apply the tape in a medial direction across the patella approximately 30 minutes prior to exercise or activity. To utilize Mummy Tape, first measure how much of the tape you intend to use. Start from the outside of the knee cap to half way around the leg minus about an inch. Cut the strip, then round the corners on the edge of the tape. This helps the tape to not catch onto clothing. Apply the tape without extra stretch to the first half of the knee cap, then apply between a 50-75% stretch for half of the tape medially toward the inside of the leg. With the last of the tape, apply without a stretch to the inner side of the leg. (You could also utilize Spider tape or KT TAPE.) To visually learn how to apply the tape, please refer to Kinesiological Taping for Patellar Femoral Pain Syndrome. For application and removal tips, please refer to Skin Care with Taping.
  • If it hurts, don’t do it! Modify the activity or discontinue it completely. If your knee is hurting when performing a squat, then initially don’t move as deep into the exercise. This would also be true for a lunge position or step up. Modify any exercise as you need to, and don’t compromise technique to complete an exercise. Poor technique will only increase your risk of injury elsewhere.
  • Have your gait analyzed while running. Check with your local running store or a physical therapy clinic for a monthly gait analysis clinic. If you’re not a runner, but you’re experiencing pain during other forms of exercise (group aerobics or CrossFit), ask your teacher or coach to analyze your movements during an exercise session. How is your foot striking the ground? Is it rolling in (landing flat footed)? Does your knee rotate inward or stay tracking in line with the foot? Ideally, the knee tracks in line with your second toe. This is important for running as well as squats, step ups, and lunges. If your foot isn’t maintaining a good position during its mid foot strike, a new pair of shoes may be indicated specifically to control pronation. Over-the-counter orthotics can help as well. Superfeet Blue Premium Insoles are available in varying models to help support the arch and heel. They are color coded by model. I wear the blue insoles which are for moderately flat feet. These insoles are very durable. In the past, these insoles have lasted for 1,000 miles through the life cycles of two different pairs of shoes.
  • Start a supplement. Many herbs help to reduce inflammation and pain. CapraFlex is one of my favorite supplements. 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 recommend that you try it for 30 days to see if it improves your pain. Another option is 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.)

Patellar Femoral Pain Syndrome can be very painful, but it can be easily self-treated if you handle your pain and symptoms quickly.  If you’re not experiencing relief after aggressively managing the symptoms, contact your local physical therapist for an assessment and help in managing PFPS.  The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area.

Has a specific treatment for PFPS helped you? Which treatments haven’t worked for you? Additional discussion can help others to manage this condition more effectively.  Please leave your comments below.

Don’t forget to subscribe to my e-mail list to gain immediate access to My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain for step by step exercise instructions and photos!

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!

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How to Self-Treat IT Band Syndrome

Pain in the lateral (outside) leg or knee is commonly associated with a condition known as Iliotibial Band Syndrome (ITBS).  (Iliotibial Band Syndrome is also known as IT Band Syndrome, ITB Syndrome, or IT Band Friction Syndrome.)  Pain can range from the lateral side of the leg up toward the hip area to just below the lateral side of the knee joint (where the head of the fibula bone begins).  The pain can be very debilitating to the point that running or hiking activities have to be stopped.  Even walking becomes difficult.  I will address the many potential causative factors for IT Band Syndrome and offer advice on how to self-treat this condition.

TherabandRoller

The IT Band is a very thick fibrous band of tissue that spans from the hip’s origin point at a muscle known as the Tensor fasciae latae (TFL).  The TFL transitions into the IT band and progresses down the lateral thigh and ends at the head of the fibula.  The IT Band’s primary function is to provide additional lateral support for the knee joint (particularly when standing or landing on one leg).  IT Band Syndrome is often associated with an over use injury.  It can be very painful, but it can be easily self-treated if you handle your pain and symptoms quickly.

How to Self-Treat IT Band Syndrome: 

  • Improve your mobility. Mobility issues and myofascial restrictions are highly correlated with ITBS. Tightness in the IT Band or in the deep hip internal or external rotators is a contributing factor to ITBS. The tighter the IT Band, the more likely it will rub on the femoral condyle and develop into pain. Bowlegged describes a medical condition known as a varus deformity, an inward rotation of the tibia resulting in a leg that looks like it is bowed out. It can develop due to chronic friction of the IT Band along the femoral condyle. ITBS may also occur after a total knee replacement (TKA). I recommend using a foam roller to address tightness in the quadriceps or IT Band. To learn how to use a foam roller, please refer to Foam Rolling for Rehabilitation. I also recommend a Thera-Band Standard Roller Massager, which is very firm and allows for a deep amount of pressure. You may also utilize a tennis or lacrosse ball to mobilize the Tensor fasciae latae (TFL) appropriately. The foam roller and roller massager don’t work as well because the greater trochanter of the hip (the boney part of the hip that sticks out) tends to be in the way. Stretching the IT band or the TFL is very difficult, so I tend to utilize other mobilization techniques. However, I recommend a few pelvic and hip stretches. Please refer to IT Band Syndrome Rehabilitation Exercises for my top stretches, foam rolling, and self-mobilization techniques to address IT Band related issues.
  • Strengthen your hip muscles. Weakness in the hip external rotators and the hip abductors, like the Gluteus medius and the Tensor fasciae latae (TFL), can lead to IT Band Syndrome. Strengthening of these muscle groups can help avoid future ITB issues as well as reduce your risk of developing Patellar Femoral Pain Syndrome (PFPS). Please refer to Hamstring, Hip Flexor, and Piriformis Stretches for LBP for additional hip and lower leg stretching exercises.
  • Over use injury due to downhill running? IT Band Syndrome is often associated with an over use injury. For runners, a common cause of ITBS is running downhill. Few runners actually train appropriately for a race with downhill running. Afterward, they end up with a case of ITBS. I have been guilty of improper training in the past. If you have ever run in the Robie Creek Half Marathon, then you understand the importance of downhill training. To avoid ITBS, adequately train for the downhill portion of the race. Also, vary your running routine and surfaces while training. Although ITBS is often associated with over use, always address other contributing factors as well.
  • 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. This could result in IT Band Syndrome or other hip, knee, or ankle related issues. 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.
  • Did you progress too quickly 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.
  • Have your gait analyzed while running. Gait or running abnormalities can increase your risk of developing IT Band Syndrome. Over striding tends to occur while running downhill. Scissoring occurs when your leg crosses over the midline with each step. Both over striding and scissoring are easily recognized by a professional. 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 either over striding or scissoring.
  • Don’t forget to ice. IT Band Syndrome is typically is due to a specific event. Afterward, there is usually an active inflammatory process occurring. I typically apply ice to the lateral part of the knee, but place it on your most painful location. The rule for icing is to apply ice no more than twenty minutes per hour. Don’t place the ice directly against the skin, especially if you are using a gel pack style. Individuals with poor circulation or impaired sensation should take particular care when icing. A bag of frozen peas can be a cheap alternative or you could use one of my favorite gel pack style cold packs.
  • Start a supplement. ITB Syndrome is typically associated with a specific event and an active inflammatory process typically occurs. I am a supporter of natural supplements and remedies. Many supplements include herbs which are designed to help reduce inflammation. Phenocane Natural Pain Management 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 thinner medication, please consult with your physician prior to taking Phenocane Natural Pain Management.

If you’re not experiencing relief after a week or two of aggressively managing the symptoms, contact your local physical therapist for an assessment and help in managing IT Band Syndrome.  The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area.

Has a specific treatment for IT Band Syndrome helped you? Which treatments haven’t worked for you?   Additional discussion can help others to manage this condition more effectively.  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!

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!

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How to Self-Treat Plantar Fasciitis

Plantar fasciitis is a very painful and potentially very debilitating condition.  It’s one of the most common causes for heel and bottom of the foot pain.  The plantar fascia is essentially a band of connective tissue (a ligament) which runs the length of your foot from your heel to your toes.  It helps to support the arch of your foot by using “windlass mechanism” to make the foot more rigid and aid in the foot’s ability to transfer force and push off when walking or running.   In the case of plantar fasciitis, the fascia on the bottom of the foot becomes swollen and irritated and may cause pain when you stand and/or walk.  It’s typically at its worst in the morning with your first several steps after sleeping.  Plantar fasciitis is also more common the older a person becomes.

Image courtesy of www.runnersgoal.com

Risk factors for developing plantar fasciitis include:

  • Excessive foot pronation. Your feet tend to roll inward as you stand, walk, and/or run.
  • Either excessively high arches or overly flat feet.
  • Spending long periods of time standing or walking.
  • Spending long periods of time on hard surfaces, such as concrete.
  • Obesity
  • Your shoes don’t fit well or the shoe is worn out.
  • You have transitioned too quickly from a more built up running shoe into a minimalistic style.
  • Poor ankle mobility, particularly excessive tightness in the Achilles tendon or calf muscles.
  • Poor foot muscle strength, particularly the foot intrinsic muscles which help to support the arch of the foot.

Plantar fasciitis typically begins as a mild discomfort which grows steadily and quickly to the point that a person may struggle to walk, stand, or run.  Plantar fasciitis may occur after a specific event.  The plantar fascia could be over stretched due to a slip.  It could occur after an overzealous training day in unfamiliar circumstances, such as running barefoot in the sand.

Fortunately, plantar fasciitis doesn’t always require formal medical treatment.  The key is to intervene quickly to identify the actual cause or causes that led to the inflammation and irritation.  The recommended treatment is the same whether or not the plantar fasciitis developed over time or due to a specific event.

How to Self-Treat Plantar Fasciitis:

  • Begin your rehabilitation. Start with these Plantar Fasciitis Rehabilitation Exercises. Complete with instructions and photos, this guide outlines how to safely self-treat your plantar fasciitis. Stretch your calves as tight Achilles tendons and calf muscles can cause excessive strain on the plantar fascia, which increases your risk of pain. Stretch your plantar fascia by performing stretches prior to standing or walking upon morning waking and after any prolonged sitting.
  • Mobilize the tissue. Depending on how aggressive you want to be, a tennis ball, lacrosse ball, or golf ball can be used to mobilize the tissue. I recommend mobilizing once or twice per day for 2-3 minutes. Then perform additional stretching of the plantar fascia and calves.
  • Use ice. My favorite technique for icing this area is to use a frozen water bottle. Roll your foot over the bottle for 3-4 minutes until your foot starts to feel numb and the pain subsides. It’s possible to frost bite your foot, so be mindful of the length of time you’re icing.
  • Strengthen your foot and ankle complex. Weakness in the foot and ankle muscles (as well as the smaller foot intrinsic muscles) can lead to excessive strain on the plantar fasciitis. I recommend initiating a complete ankle/foot strengthening protocol. Please refer to Ankle Resistance 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 reduce the risk of plantar fasciitis and is an important part of the rehabilitation. Please refer to Improving Balance by Using a Water Noodle.
  • Start a supplement. I am a supporter of natural supplements and remedies. Many supplements include herbs which are designed to help reduce inflammation. Phenocane Natural Pain Management 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 thinner medication, please consult with your physician prior to taking Phenocane Natural Pain Management.
  • Use a plantar fasciitis night splint. Although a little cumbersome and annoying, night splints can be helpful. While lying, the natural tendency is to flex the foot to point your toes (plantarflex). This position causes the plantar fascia to shorten and tighten, which explains the pain you might experience during the first few steps after sleeping or resting. The night splint helps you to heal by maintaining a neutral position which doesn’t allow the fibers to shorten.

While you’re self-treating your plantar fasciitis, you’ll likely need to modify your exercise or running program.  It’s an excellent time to focus on cross training activities.  I recommend following this protocol for two to three weeks.

If you’re not experiencing significant relief upon progressing into your exercise program, please consult a medical professional.  I recommend a physical therapist who specializes in feet or who works with athletes for the treatment of plantar fasciitis.  The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area.

Has a specific treatment for plantar fasciitis helped you? Which treatments haven’t worked for you?   Additional discussion can help others to manage this condition more effectively.  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!

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!

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Top 10 Strategies to Avoid Injury

An ounce of prevention is worth a pound of cure.  –Benjamin Franklin

As a physical therapist, I help people who have suffered from an injury through the process of rehabilitation.  Accidents will happen, but certain activities can help you to avoid and limit the chance of an injury.  Nothing will derail a perfectly designed training program like an injury.  Optimize your health and lessen your risk of injury by being proactive upfront.

Top 10 Strategies to Avoid Injury:

1.  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 promotes healing as movement is necessary to bring in the nutrients and remove any cellular waste products.  I like to use a stationary bike or the rower machine initially to get the muscles warm and the knee joint more lubricated.

2.  Cool down. After performing your exercises, take extra time to cool down and stretch.  Use either a stationary bike (at a causal/slower pace) or the rower machine.  Both are reduced weight bearing exercises that promote movement and circulation to the knee as well as provide range of motion (ROM).  The perfect time to perform static stretching is after exercising.  Work on those tight and restricted areas.  Keep moving throughout the day and avoid sitting for extended periods of time.

CoolDownStretch

3.  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.  Adequate protein intake is necessary to support muscle health and development.

4.  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.

5.  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.

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 for injury prevention or as a recovery strategy.  I recommend trying a 14-30 day protocol.  (Please consult with your pharmacist and/or physician prior to starting any new supplementation protocol.)

6.  Take cross training seriously. Performing the same activity day after day without variation can lead to overuse injuries or muscle imbalances.  You may spend a majority of your time specifically training for a particular sport or activity, but it is important to vary the training load and/or stimulus.  Not only can cross training limit your risk of injury, it makes training fun by keeping the body stimulated and ready to improve.

7.  Actively manage your aches and pains. Spot train your weak areas and work on whole body mobility and fitness.  Don’t neglect the small stuff as it will catch up with you sooner or later.  Consider seeing a masseuse for regular body work.  To learn how to use a foam roller for self-treatment, please refer to Foam Rolling for Rehabilitation.

8.  If it hurts, don’t do it! Modify the activity or discontinue it completely. Modify any exercise as you need to, and don’t compromise technique to complete an exercise.  Poor technique will only increase your risk of injury elsewhere.  Work with your coach or athletic trainer to determine if poor form and technique is causing the pain.  With instruction, you may avoid pain and injury while taking your training to the next level.

9.  Adequate rest is important. 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.  Participate in a yoga class, take a leisurely bike ride, or take a walk in the park.   If you are participating in a yearly training cycle, be sure to incorporate an off season which involves a change of pace from your regular training and some active rest.  Proper programming includes mini cycles with an off season as well as active rest cycles in between heavy load and heavy volume training cycles.

10.  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 a running coach, physical therapist, or physician can be beneficial.

Unfortunately, injuries will occur.  However, incorporating these strategies will reduce your risk of injury while likely taking your training and exercise program to the next level.  If and when an injury occurs, take it seriously and manage it quickly.

How do you avoid injury?  Which particular strategy has aided in your recovery?  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!

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.

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Q & A: Should I Exercise if I’m Sick?

Q.  I had a sinus infection this past week. I have felt really guilty about not exercising.  Should I exercise if I’m sick?  –Josh

A.  Thanks for the question, Josh, and I hope you’re feeling better! Feeling ill is never a fun experience, but it happens to all of us.  Cold and flu season starts as the weather begins to turn.  I’ll first address the reasons why we tend to experience more illnesses during this time of year, and then I’ll offer guidelines to determine if exercising while sick is the best choice for you.

Why do I tend to get sick during the winter?

  • 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 prevent illness.  Consider supplementing with vitamin D during the winter months.
  • Decreased ultraviolet radiation from the sun allows viruses and bacteria to live longer on surfaces.  Consider frequently cleaning your cell phone, 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.
  • As children head back to school and more people spend time indoors, the close quartered contact allows for easy transmission of illness.  In the U.S.A., the winter months include major holidays, which mean more shopping and gathering together.  You may be exposed to many people who are ill.  Once again, wash your hands frequently and teach your children proper hygiene.

Red haired woman blowing nose

Should I exercise if I’m sick?

A small amount of activity or exercise can actually boost the immune system, but a heavy amount can actually lower your immune system in the short run.  Follow these guidelines to determine if exercising while sick is the best choice for you:

  1. How sick are you? Determine the severity of your illness. If you have a fever or may be contagious, it’s your responsibility to not spread the illness. Stay away from others. If you have an upper respiratory illness, I recommend that you don’t perform any heavy cardiovascular exercise as you run the risk of driving the illness further down into the lungs.
  2. Listen to your body. How are you feeling? If you’re just a little under the weather, light activity might actually help you. If you’re too tired to get out of bed, listen to your body and rest. You need to support your immune system in every way you can. Don’t feel guilty about not exercising! A missed work out will not completely derail your training program. Remember, quality over quantity.
  3. Take the time to cross train. An illness is an excellent time to perform light cross training. Take a break from your regular exercise routine with active rest. Take a few walks or perform yoga at home. Focus on your problem areas. When I’m not feeling well, I concentrate on performing back strengthening exercises. Is your knee, low back, or shoulder bothering you? Now may be a good time to start a rehabilitation program. Please refer to the following posts to get started: 7 Tips to Get Rid of Knee Pain, How to Safely Self-Treat Low Back Pain, and How Should I Treat Shoulder Pain and Impingement?
  4. Don’t expose others just so you can get your work out in! If you are coughing, sneezing, or have a fever, you’re likely contagious. Please don’t spread it around! If you insist upon exercising, then exercise in your home or outside. Be mindful of others and always clean the exercise equipment at the gym after working out.
  5. Stay hydrated. Regardless of illness, it’s important to stay hydrated. Colder air can be very dry and can lead to dehydration. Prevent illness during the winter months by drinking extra fluids.

Did you know that as you get older, you tend to experience fewer colds?  Your immune system is more geared to fight the cold after many years of practice.  You can more easily recognize those who are sick and stay clear.  You make wiser choices such as frequent hand washing and less sharing of personal items and food. (Teach your children how to prevent spreading germs as well.)  Unfortunately, we can’t avoid getting sick every time.  When you are sick, use the guidelines noted above to determine if exercising is the best choice for you.  Thanks for your question, Josh!

Do you exercise if you’re sick?  Can you offer any tips on how to quickly recover from an illness? 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!

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.

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My Top 10 Anti-Aging Tips

The science of aging and how to age gracefully and successfully continues to evolve, and the results are amazing. The accepted norm for an aging adult is crumbling before our eyes! This is such a wonderful time to grow older!  Many age-related declines can be counteracted with exercise, diet, and lifestyle modifications. What are my top 10 anti-aging tips?  Let’s get started!

SeniorRunner

  1. Improve your growth hormone production – Strength training (focusing particularly on large muscle groups with appropriately heavy loads) has been proven to improve growth hormone levels.  High intensity training (HIT) performed once or twice per week may also help to increase growth hormone levels.  A proper diet is also the key to improving hormone levels by including adequate protein and fat levels while avoiding excess sugar.  An adequate amount of sleep also plays a major role in growth hormone production.
  2. Regulate your insulin production – Strength and endurance training have a positive effect on your body’s ability to regulate insulin levels.  Strength and cardiovascular training are a critical part of a maintenance program for diabetes. To maintain an even energy level throughout the day, a stable insulin level is critical.  Diabetes prevention is important in order to avoid cardiovascular disease and dementia.
  3. Maintain your strength – Although all muscle fibers show some decline as you age, the fast twitch (Type II) fibers show the most decline.  Again, strength training is a critical component to maintaining and growing additional Type II muscle fibers.  The stronger you are, the more resistant to injury you are.  Also, strengthening of the core area (the abdominals and back extensors) helps to manage low back pain.
  4. Keep your heart healthy – Decreased stroke volume, cardiac output, and a decreasing maximal heart rate are all age associated declines.  These declines affect your ability to perform maximum efforts.  Strength training (particularly incorporating large muscle groups such as performing squats and HIT) can insure the heart remains strong by maximizing its ability to pump blood.  HIT appears to be one of the best methods available to slow the progression of a decreased maximal heart rate.  Strength and endurance training cause the heart muscle to hypertrophy.  The heart is capable of growing stronger just like any other muscle.
  5. Perform high intensity training (HIT) – As you age, your VO2 max can decline.  VO2 max is the maximal amount of oxygen you can uptake during exercise or activity.  HIT has been proven to increase a person’s VO2 max, so incorporating all types of HIT is important.  Activities could include CrossFit, running intervals, or hill repeats.  Perform your cardio in short bursts (ranging from 30-60 seconds at a time) followed by a one to two minute recovery.  The 30-60 seconds should be at a high intensity, meaning your rate of perceived exertion (RPE) is high.  You should be breathing heavy.  If you are overweight or have arthritis, HIT may be performed while using a stationary bicycle or in the pool.  You can also walk uphill at a quick pace, then stop and rest.
  6. Use a foam roller – As a person ages, the body tends to become stiffer as it loses elastin.  This negatively affects a person’s range of motion (ROM).  It also makes the muscle and tendon fibers more likely to tear if overstretched.  I recommend that everyone participate in a flexibility program.  (The older you are, the more important this becomes.)  Mobility and flexibility become more difficult if you aren’t purposefully working on it.  Yoga is an excellent choice as well as utilizing the foam roller.  Using a foam roller can help keep tissues pliable.  Regular use may also beneficial as it helps improve arterial stiffness and can improve arterial and vascular function.  To learn how to use a foam roller, please refer to Does Foam Rolling Help or Hurt Your Performance?
  7. Manage your weight – Excessive body weight causes abnormal wear and tear on your body (particularly in the knees and feet).  It also places additional strain on your cardiovascular system and increases your risk of diabetes—thus increasing your risk of stroke, heart disease, and dementia.  As we age, our metabolism begins to slow.  Maintain a diet rich in protein (particularly plant based protein as well as healthy fats such as olive oil or avocados) while avoiding processed foods and excessive carbohydrate intake.  A strength training and high intensity training (HIT) program can help you to maintain a suitable weight by insuring your metabolism stays elevated and your hormone levels remain balanced.
  8. Stimulate mitochondrial growth – Mitochondria are known as the power plant for your cells and are responsible for much of the energy production in cells.  Endurance exercise stimulates mitochondrial growth.  Keep moving!  Also, foam rolling can help to promote more blood flow to the muscle tissues by bringing in much needed nutrients while removing wastes to help promote cell health.
  9. Stay active and cross train – As a person ages, the nervous system can slow and the muscular system can also decline.  Balance and mobility can suffer.  The best way to combat this decline is to continue to move.  Move in various ways and cross train.  Participate in activities like yoga and tai chi to gain the balance and motor control as well as strength and cardiovascular training.  Eating adequate amounts of healthy fats also helps to support nerve function and avoid excessive carbohydrate (sugar) intake.
  10. Drink more water – 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 be a common problem for older adults.  Water intake supports proper brain, muscle, and hormone function as well as lubrication of the joints and skin appearance.  Skip the fancy drinks with ingredients that you can’t pronounce and drink more water!  Your body will thank you.

Many medical conditions can make aging gracefully more challenging, but don’t let it deter you from trying! Engaging in an exercise program may even help you to manage your medical condition.  A lifestyle that includes a well-rounded exercise program and healthy diet can push you to the next level as you optimize your health.  It is never too late to start living a healthy lifestyle!

If you are over age 50 or have never exercised before, I recommend that you take a Physical Activity Readiness Questionnaire (PAR-Q). The PAR-Q has been designed to identify the small number of adults for whom physical activity may be inappropriate or those who should have medical advice prior to initiating in physical activity.

With a proper exercise and nutrition program, we can strive to age gracefully and successfully and continue to enjoy our favorite activities well into our senior years. For inspiration regarding the aging process, I recommend reading Ken Dychtwald’s Age Power: How the 21st Century Will Be Ruled by the New Old.

What does it mean to YOU to age gracefully and successfully? Whether or not you’re still running or CrossFitting into your senior years, I’d love to hear your thoughts on aging.  Please submit your comments below.

Don’t forget subscribe to my e-mail newsletter! You will receive each week’s blog post sent directly to your e-mail making it even easier and more convenient!  To thank you for subscribing, you will automatically gain access to my FREE resource, My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain.

If you have a question that you would like featured in an upcoming blog post, please e-mail contact@thephysicaltherapyadvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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Is Running Safe?

Is physical activity, like running, safe?  Most of the time, the answer is YES!  The key is to rule out possible issues (especially as you age) which may make physical activity unsafe.  More potential issues need to be screened the older you are and based on how healthy of a lifestyle you may have.  Being well informed initially allows you to tailor an exercise program which can be safe and effective in maximizing your particular goals and needs.

How to Start?

I recommend that you take a Physical Activity Readiness Questionnaire (PAR-Q).  The PAR-Q has been designed to identify the small number of adults for whom physical activity may be inappropriate or those who should have medical advice prior to initiating in physical activity.

The American College of Sports Medicine (ACSM) also offers information and a similar version of the Par-Q with clear guidelines on when a person should or should not see a physician before starting an exercise program. (When To See a Physician Before Exercising)

Assuming that you have been cleared for physical activity, let’s specifically discuss running.  Let’s attempt to get one myth off the table first.  Running is bad for the knees.  This can be true and false.  Let’s dive deeper.  Running can be “hard” on the knees in certain circumstances:

  1. If you have significant degeneration of your knees, such as severe osteoarthritis (loss of the cushion between the knee bones known as the meniscus).
  2. You are morbidly obese.
  3. You have some sort of bone disease, such as osteochondritis dissecans, where you experience cracking in the articular cartilage of the bone and loss of blood flow (causing the bone to die, which is known as avascular necrosis).
  4. If you have had a prior knee injury such as a meniscus injury or surgical repair of the meniscus; micro fractures repair of the knee cartilage; or a total joint replacement in the lower extremity such as the knee, hip, or ankle.

It is possible that running may not be the best activity choice for you, but with proper training and a strong focus on technique, it is still possible.

Research indicates that running for the typical person will not cause excessive wear and tear or injury to the knee.  If injury is already present, then running could possibly worsen it.  It is true that running can lead to aches and pains, including conditions such as patellar femoral knee syndrome (runner’s knee).  It is also true that sitting like a couch potato can also lead to knee arthritis and cardiovascular disease as well as a list of other medical conditions.

A vast majority of running related injuries can be easily avoided through proper training, proper running form, proper footwear, and proper recovery.  Running is an excellent form of exercise and a wonderful stress reliever.

TamarackRaceStart

The key to a successful lifelong running program includes:

  • Proper Training – Find the right balance of volume and intensity for you. Each one of us is capable of some running. The key is to discover the right amount for you to remain healthy and engaged in the activity.
  • Proper Running Form – There are many different running styles and form. Some focus on a mid-foot strike while others, a heel strike. Some prefer a run/walk protocol or a power walking protocol. You may also be interested learning more about the Chi Running Technique (http://idahoezrunning.com/freedemo/). The key is to find a coach who can help you find the right technique for your particular body style and goals.
  • Proper Equipment and Footwear – Your feet and knees absorb a bulk of the force as you run. Ensuring that you have adequate footwear is imperative. I highly recommend visiting your local running store for a gait evaluation. These professionals will properly fit you into a real running shoe. (The quality of a shoe from a big box store will be poor in comparison.) Your shoes should be changed every 300-500 miles depending on the style of the shoe and how much wear and tear accumulated.
  • Cross Train – As big of a fan as I am of running, it shouldn’t be your sole form of exercise. It is an excellent form of cardiovascular exercise, but it doesn’t address strength training. Strength training is an important component to a healthy lifestyle. I cross train by performing CrossFit and through weight training multiple times per week.
  • Vary Your Running – Don’t run on the same surface each time, and don’t run the same speed every time. Your body loves variety, and you will, too!

Running is well worth the effort and the risk of a potential orthopaedic related issue in order to avoid the risk of cardiovascular disease, diabetes, heart disease, cancer, obesity, and osteoporosis.  Seek the advice of a physical therapist or fitness coach to help you train and recover properly.  If a problem occurs, you will be armed with tips and strategies to deal with it before it becomes a major issue.  Happy running!

Join our growing community on Facebook by liking The Physical Therapy Advisor!  If you have a question that you would like featured in an upcoming blog post, please e-mail contact@thephysicaltherapyadvisor.com.

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5 Ways to Improve Range-Of-Motion (ROM)

Most of us think stretching is stretching is stretching.  Who likes it?  Why do we need it?  Yes, some days I’m personally still in that camp!  Stretching is actually more nuanced than that.  The real question is: why are you stretching in the first place?

There are potentially different reasons to stretch.  One reason is to decrease pain.  Stretching an ailing muscle or muscle spasm can activate internal stretch receptors in the muscle tendon unit, which helps the muscle to relax.  It can also change the blood flow to the area or affect the input on the nerve–all resulting in some pain relief.

We instinctually want to stretch.  Consider yawning.  Our outward arm motions during a yawn are nothing more than primitive stretch reflexes.  Babies begin stretching in utero!  We continue to voluntarily stretch for the rest of our lives (or in the case of a yawn, involuntary).  Animals (dogs, cats, horses, and even birds) also stretch daily.

Stretching releases positive endorphins and neurotransmitters in the brain which helps us to feel better.  Depending on the location of the stretch and the intensity, it can cause relaxation or alertness.

Stretching is used to improve range-of-motion (ROM) of a joint, but why?  The most common reason is that the joint ROM is limited and is somehow affecting performance of a desired activity.

Stretching is also used as a preventative measure.  For example, if ROM is limited asymmetrically (unequally) in the hamstrings, then it could lead to a pelvic torsion and low back pain.  Another example is a shoulder which has limited ROM, yet a person continues to reach up overhead or perform an overhead weight lifting technique.  If the individual doesn’t have adequate ROM to perform the lift, then either he or she will perform the lift incorrectly (risking injury).  The body will be forced to compensate somewhere for the lack of shoulder mobility (again, likely leading to injury).

As a physical therapist, I work weekly with people who have injuries from compensating for lack of ROM and mobility in the body.  This problem is prevalent due to current American culture.  We spend most of our day either sitting (driving, working on the computer, watching TV) or hunched over while sitting or standing (washing dishes, picking up children, general slouching).  As a society on average, we don’t move or stretch enough to live healthfully.  A joint must go through its full ROM on a daily basis to remain healthy.  Without the full ROM, a nutrient rich and internally lubricating fluid known as synovial fluid cannot properly circulate and coat the joint surface.  Over time, this will lead to stiffness, dysfunction, and joint deterioration such as arthritis.

One potential issue to address is that all stretching methods aren’t created equal and certainly aren’t appropriate in every circumstance.  The research indicates that stretching, when done improperly or at the wrong time, can either help or inhibit performance.

Let’s review five different methods of stretching or improving ROM:

Static Stretching – Static stretching is basically holding a tissue in an elongated form.  This can be performed across one joint or multiple joints, depending on the muscle or tissue being stretched.  The minimum length of time should be 30 seconds to around 60 seconds at a mild to moderate discomfort.  If you want to maximize results, then the stretch should be held for a longer duration of at least five minutes.  Typically, this is not practical for most people.  Static stretching before your athletic performance causes loss of performance.  If the goal is to gain ROM, then static stretching should be performed, but only after the activity or at a separate time.

Dynamic Stretching – This is a more active type of stretching where you are moving in and out of your available range of motion.  This can be progressed into ballistic stretching, which is taking a joint actively and usually quickly, through its available ROM and into a near end range stretch without exceeding the physiologic maximum ROM for the joint or muscle/tendon tissue.  As a warm up, dynamic and ballistic stretching can improve performance and joint ROM.  If the goal is to prepare for an activity, then a dynamic warm up should be performed.  Ballistic stretching is not indicated for novice athletes or beginning stretching.  It is definitely not indicated when recovering from injury.

Myofascial Release with Foam Rolling – Research is limited presently, but it indicates that foam rolling can help improve joint ROM without the deleterious effects of static stretching.  It can be performed prior to athletic performance and not provide a negative effect.  Clinically and personally, I find foam rolling to be an effective method in improving ROM.  Foam rolling should be a frequent post-workout activity, and at times, it would be indicated as a pre-workout activity.  It is also a fantastic way to release stress and tension, and it may improve recovery times.  (Please refer to a recent post, Does Foam Rolling Help or Hurt Your Performance?)

Proprioceptive Neuromuscular Facilitation (PNF) – PNF stretching is a very quick and effective method of utilizing the body’s neurologic stretch receptors within the muscle and tendon units to assist in producing increased ROM.  There are many different types of PNF stretches and exercises.  The most basic and easiest to utilize individually is a technique known as Hold/Relax.  Move the extremity and joint to a point of feeling a mild stretch, and then lightly resist any further stretch for approximately 10 seconds.  After 10 seconds, progress further into the stretch and hold for approximately 30 seconds.  I tend to work in sets of three to four when performing this technique.  It is also important to remember that it should never result in pain, only a stretching sensation.

Neuromobilization or Neural Gliding – This is probably the least understood of all methods to improve ROM.  There are many factors to consider regarding neural mobility.  First, the nerves are covered in a protective sheath which is meant to be very flexible.  Unfortunately, when the sheath is irritated or damaged, it tends to lose its flexibility.  This typically leads to neural pain.  Sciatic nerve pain from a bulging disc is an example of when this may occur.  Trying to directly stretch a nerve is a bad idea as it usually makes it worse.  Specific neural gliding and mobilization techniques have been developed to assist with improving ROM and pain.  As a physical therapist, I use clinical signs to help guide my treatment diagnosis, which ultimately can help guide the treatment for the client.  If you are experiencing neural tightness and pain, please seek medical advice to insure you are getting proper care.  There are times when neural tension can be present without pain or other symptoms.  It may be caused by poor spinal alignment, poor posture, or other medical illnesses.

The science of stretching is as diverse as the reasons why you may want or need to stretch.  Stretching is critical to maintaining flexibility.  Flexibility is a critical component to a healthy and optimally functioning body.  Although flexibility and stretching are often overlooked, they are truly critical to optimize health, prevent injury, and maximize performance.  Stretching should never be done to the point of causing pain.  It is possible to cause injury by over aggressively stretching.  The best results are usually through consistency and a mild to moderate stretching sensation.

Please email contact@thephysicaltherapyadvisor.com if you have a question that you would like featured in an upcoming blog post.

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Does Foam Rolling Help or Hurt Your Performance?

Let’s set the stage.  Imagine that you have been training hard for weeks.  Your muscles are sore, and your body is achy.  You are definitely pushing into your overreaching phase and fast approaching over-training.  Then your overly helpful friend and neighbor mentions, “Hey, I just got this foam roller—it’s great!  My buddy says it helps him run faster, jump higher, and he never hurts.  You need one!”

Is foam rolling another gimmick or does it really help?  All of the local gyms and sporting goods stores have them.  Should you use one?

Surprisingly, the actual research on foam roller use to improve performance has been minimal.  The foam roller is traditionally used as a method of self-massage or self myofascial release.  By using the foam roller, it is thought that the fascial system can be changed and manipulated.  Hopefully, improving either performance or recovery by affecting how the neuromusculoskeletal system functions.

The standard definition of fascia is soft and sometimes fibrous connective tissue system that penetrates and surrounds muscles, bones, organs, nerves, blood vessels and other structures and extends from head to toe, from front to back, and from surface to deep in an uninterrupted, three-dimensional web binding some tissues together while allowing others to slide smoothly over each other, though all layers are connected there are distinct layers with differing function (LeMoon, 2008, and http://en.wikipedia.org/wiki/Fascia).

Research indicates the following regarding the use of the foam roll for performance:

  • Foam rolling likely has a positive effect on arterial stiffness and can improve arterial and vascular function while also positively affecting joint range-of-motion (ROM).
  • The change in arterial and vascular function may in part be why foam rolling (after training) seems to have a positive effect in reducing muscle soreness.
  • Foam rolling may promote more blood flow to the area, which allows the body to eliminate waste more efficiently while providing much needed nutrients to aid in recovery.
  • Improved recovery is important if you plan to participate in multiple events over multiple days such as a relay or weekend tournament.
  • Improved recovery may also allow for more intense and frequent training while (hopefully) reducing injury.
  • It may aid training during certain cycles when the intensity or volume may be higher or during an overreaching phase of training. Overreaching is typically a very short and deliberate phase in your training when you have a spike in training volume for a week or two followed by a return to baseline or below which can lead to improvements in performance. Care must be taken though because overreaching can easily turn into over-training.
  • Foam rolling also appears to have a beneficial effect on ROM, and more importantly, it can help improve ROM without negatively affecting performance. In contrast, static stretching can impede performance.

As a physical therapist, I highly recommend using the foam roller for athletic performance because:

  • It appears to help improve joint ROM and doesn’t impede performance.
  • It can likely help with recovery, either by reducing soreness or reducing post work out tightness. By promoting improved blood flow, it allows for improved nutrient delivery which can improve recovery times.
  • Improving recovery may allow for more intense or frequent training sessions or prepare you for multiple events with little rest.
  • Alleviating soreness prior to activity can have a psychological boost, which shouldn’t be overlooked as an important outcome.

How should I use the foam roller?

  • I typically recommend one to three minutes of body weight rolling (if it is tolerated) per extremity, and the same for the thoracic, low back, and buttock area.
  • A good rule of thumb is to roll out an area that is tender and sore, or recently worked, until it no longer feels tight and sore.
  • Again approximately one to three minutes per area although this may vary based on your size. Increased time will be needed the more developed your muscles are.
  • Foam rolling is generally not advised for anyone on blood thinning medications or with blood clotting disorders.

What has been your experience with using the foam roller? Is it worth the effort? Can you notice any specific improvements in performance? Please share your comments or questions!

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5 Lessons Learned from Running Robie Creek

Robie Creek is billed as the toughest half marathon in the northwest, 8.5 miles and up 4.6 miles down.  This year the weather was beautiful, but hot!  Temperatures approached 80 degrees.  This was my first time running this particular race and utilizing a high intensity interval training (HIIT) and low running mileage to train for a distance effect.  Racing Robie Creek taught me this:

  1. High intensity interval training (HIIT) combined with low running mileage can be a successful way to training for a very intense half marathon. (See my TrainingPlan PDF.)
  2. CrossFit as a form of high intensity training (HIT) is a good way to train your legs to handle a very fast and steep decent. When running downhill, your leg muscles work more in an eccentric or lengthening fashion versus the typical concentric or shorting fashion. This results in more tissue micro tearing and muscle soreness when running downhill and injuries more frequently. CrossFit training prepared my legs to handle the strenuous downhill section.
  3. Warm temperatures are great for fans and tough on participants. With an April event, most of my training was in cool weather, but the race was in much warmer weather. This was hard on me and other participants as there were many runners who were taken off the course with heat exhaustion. Of all the race factors, the temperature was the most problematic for me. I would highly advise at least a two week acclimatization period if you’re going from cool to warm weather. Next year, I will spend at least two weeks with daily sauna exposure prior to running. I will likely over dress during outdoor sunny training days to get my body used to higher temperatures.
  4. Train for the mid pack. In larger races or in races where there is not time corrals to help insure similar running paces, I would recommend training for this variable. Constantly changing your running pace faster or slower is more tiring than just running your preferred pace. This was the case for almost the entire race (and particularly the first five miles). One easy and effective running style to train for this variable is called the Fartlek. Fartlek is Swedish for “speed play”. It involves taking your normal forty to sixty minute run (after warm up) and intermittently changing pace from jogging (at different speeds) to sprinting. This can be performed in a structured form or randomly in true Fartlek style. One method is to pick objects in front of you and vary your running speed as you approach them. This is a critical training method if you want to improve your race time, and I should have incorporated Fartlek in my training to help prepare for Robie Creek.
  5. You need to know how you feel in what you wear BEFORE the race. You don’t want to have chaffing on your thighs for many miles even if you look good wearing new clothes. Try out everything you plan on wearing and have a backup plan for any potential problems. (Lansinoh works great as a soothing salve for all those chaffed areas.)

IMG_1106_SmallRobie Creek is a nicely organized and challenging run.  The scenery is beautiful, and course terrain makes it a unique race.  I would highly recommend this race for anyone looking for a new challenge in the half marathon distance.

Robie Creek was a great race and a fantastic teacher.  I will be sure to incorporate more of these lessons learned when training for future races.  I also plan on experimenting more with high intensity training as a means to prepare for other events.

I would love to hear about the lessons and experiences you have learned either at Robie Creek or other races!