Category Archives: Running

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Battling Athletic Overuse Pain in the Knee

There are many different types of lower extremity injuries that could affect a person throughout his or her lifetime.  Common among runners and sports enthusiast may include knee sprains, patellar tendinitis, and patellofemoral pain syndrome.

Frustrating for Patients and Providers

A knee sprain could affect one or many ligaments.  Ligaments that could be affected with a knee sprain include:  the medial collateral ligament (MCL); the lateral collateral ligament (LCL); the anterior cruciate ligament (ACL); and the posterior cruciate ligament (PCL).  A ligamentous sprain can be from either direct contact or via non-contact injury.  Meniscal injuries within the knee are also very common and can be via direct contact or non-contact.

Patellar tendon pain (often called patellar tendinitis or patellar tendinosis) occurs when the tendon connecting your knee cap (patella) to your shinbone becomes inflamed and irritated.  Patellar tendinitis is often called “jumper’s knee” because it occurs so frequently in sports like basketball and volleyball.  It also affects runners, primarily due to poor lower extremity biomechanics during running, which can lead to an overuse syndrome affecting the patellar tendon.  Continue Reading to learn about treatment options for knee pain.

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My Top 3 Most Popular Posts of 2018!

As 2018 comes to a close, more and more people are realizing the value of taking control of their health care and personal well-being.  In today’s health care environment, we all need to learn how to treat common aches and pains proactively instead of reactively.  We must get to the root of the issue instead of placing a Band-Aid over it.  We must realize that our individual health is our responsibility.  We cannot rely on others to make decisions for us.  Our present health care system in America is not designed to help you optimize your health–that is your job!   

The purpose of The Physical Therapy Advisor is to help people like you to take control of your health and to save money by learning how to safely self-treat and manage common musculoskeletal, neurological, and mobility related conditions safely and effectively.

My Top 3 Most Popular Posts of 2018:

  1. Does Kinesiological Tape Really Work? – You will learn what can you use Kinesiological tape for and how exactly it works.  You’ll discover why it’s best used in combination with other interventions (such as manual therapy based techniques and exercise).
  2. How to Use an Exercise Ball to Improve Posture and Treat Shoulder, Neck, and Back Pain – Poor posture (due to poor thoracic mobility) and poor scapular muscle strength are often major contributors to neck, shoulder, and upper back pain.  In this video post, I demonstrate how to perform I’s, T’s, and Y’s exercises on an exercise ball in order to address lower and mid trapezius and scapula muscle weakness.
  3. How to Prevent Overtraining Syndrome (OTS) – You will discover why Overtraining Syndrome (OTS) not only impedes your immediate performance, but it also substantially increases your risk of injury.  Implement these recommended prevention strategies in order to avoid OTS while keeping your training at a high level.  Also, be sure to check out my book, Preventing and Treating Overtraining Syndrome.

2018 has been an exciting year!  Thank you for supporting The Physical Therapy Advisor!  I look forward to serving you in 2019!  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.  In case you haven’t already, be sure to subscribe to my e-mail list and join our community on Facebook by liking The Physical Therapy Advisor!

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How to Self-Treat Tarsal Tunnel Syndrome

Tarsal tunnel syndrome (TTS), sometimes called jogger’s foot, is a relatively common cause of pain along the inside (medial) portion of your ankle.  TTS can be a repetitive strain injury or an entrapment (compression) type injury.

The tarsal tunnel is a fibrous tunnel that is not structurally flexible.  There is limited room for swelling inside the tunnel.  This can cause nerves and blood vessels to be “entrapped” and lead to pain and other symptoms.

TTS is often caused by repeated pressure that results in damage on the posterior tibial nerve.  Similar to carpel tunnel in the hand, the tarsal tunnel is located just below the medial malleolus (the large bump to the inside of the ankle).  Basically, the tibial nerve branches off of the sciatic nerve and travels down the inside of the leg.  It eventually runs through the tarsal tunnel, which is a narrow passageway inside your ankle that is bound by bone and soft tissue called a retinaculum.  Continue Reading

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BeastNet Podcast Recap: Ben and Ted

In this podcast interview with Mike James (host of the BeastNet Podcast) and Ted Kielley (friend and Physical Therapy client), we discuss injury rehabilitation and what you need to do practically and mindset-wise to get back to obstacle course racing events (like the Spartan).  We also discuss the importance of teaming up with medical providers who actually understand your specific sport or lifestyle and how to find medical providers that can help you along the way.  Finally, we discuss best practices in preventing injury as a person ages to insure longevity as an Obstacle Course Race (OCR) athlete and how to age well in general.  Listen to the podcast

Disclaimer:  This blog post and podcast are not meant to replace the advice of your doctor/health care provider, or speak to the condition of one particular person but rather give general advice.

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7 Tips to Quickly become Heat Acclimated for Your Race

Running and exercising in warmer weather tends to be more taxing on your body and requires more energy to remain cool.

Most running experts suggest performance impairments of between 1.6% and 3% in marathon times for every 10 degrees above 55 degrees Fahrenheit.  The exact ideal temperature (approximately 45-55 degrees Fahrenheit) is debatable and based also on humidity.

When you’re not acclimatized to running in heat, it takes even more effort to keep your running pace.  This increases your risk of muscle cramping, bonking (hitting the wall), and/or being unable to maintain your goal pace (which leads to a longer finishing time).  Continue Reading

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How to Avoid Overtraining as a Long Distance Runner

http://marathontrainingacademy.com/how-to-avoid-overtraining-as-a-long-distance-runner

Marathon Training Academy

May 30, 2018

In this podcast interview with Angie Spencer (RN and Certified Running Coach) and Trevor Spencer (co-host of the Marathon Training Academy Podcast), we discuss Overtraining Syndrome (OTS) and how it differs from an overuse injury, the top mistakes we see runners make in regards to training and recovery, and answer questions from runners.

In this episode, we speak with Dr. Ben Shatto about overtraining, which is a leading cause of injury and burnout in long distance runners.  Listen to the podcast

Disclaimer:  This blog post and podcast are not meant to replace the advice of your doctor/health care provider, or speak to the condition of one particular person but rather give general advice.

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Tips for Avoiding Injury and Overtraining Syndrome (OTS)

Injury is often associated with Overtraining Syndrome (OTS) or a direct result of it.  Overtraining can occur when the intensity and/or volume of exercise becomes too much for the body to properly recover from.  Many common training injuries are directly associated with OTS.  It’s always best to prevent OTS rather than attempt to recover from it.  OTS usually starts with muscle soreness and a feeling of fatigue.  Then it quickly progresses into a case of Overtraining Syndrome or injury.

Warning signs 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
  • Illness due to a drop in your immune function
  • Irritability and moodiness
  • Depression and a loss of enthusiasm for activities (such as training)

Proper recovery is critical to avoiding injury and OTS.  Every recovery protocol should include a multifaceted approach that incorporates strategies to positively affect the muscular, nervous, and hormonal systems.  This includes proper nutrition, getting adequate sleep, cross training, and implementing self-care modalities (such as mobility band use and foam roller use).

Focus on your Recovery Nutrition

Your body’s ability to train harder and recover faster is not just about the exercises performed.  It should also be centered on the fuel you put in your body.  Your body cannot perform optimally, recover adequately or heal from injury properly without adequate nutrition.

The majority of your diet should be from real food.  My personal belief is that food which is minimally processed, organic and/or home grown is likely to have a higher nutrient load and will therefore be healthier for you.  Your body simply cannot heal and recover quickly or adequately when substandard fuel “food” is consumed.

I am a believer in supplements although you must choose wisely.  Your dietary belief system, genetics, and the type of exercise and/or activity (such as running) that you mainly participate in will determine which supplements may work best for you.

When choosing supplements, I tend to gravitate toward supplements that can enhance performance, improve recovery, stabilize blood sugar, and reduce systemic inflammation.  The ultimate goal with supplements is to aid your body in improving health and/or performance.  Try to choose the most natural products as possible and experiment to see what works best for you.  Look for supplements that don’t contain extra fillers, sweeteners or additives.

Get Adequate Sleep

On average, we need six to eight hours of sleep each day.  The harder you train, the more rest you need to insure proper recovery.  As you approach a state of overtraining, sleep quality tends to decline.  Consider napping daily.  Many of the country’s top collegiate athletic centers are adding special napping or quiet rooms to their large training centers as more and more trainers realize sleep is critical for recovery.

Hard and prolonged training can deplete one’s body of much needed minerals and macro nutrients.  Most of us are deficient in the amount of magnesium we consume on a regular basis.  Magnesium is a critical nutrient that not only helps to reduce muscle soreness, but also helps you to get a better night of rest.  I choose to take a magnesium supplement nightly before bed.  Mag Glycinate in its oral form is the most highly absorbable.  Otherwise, eat foods, such as spinach, artichokes, and dates, which are higher in magnesium.

Cross Training

Regardless of your sport or athletic endeavor of choice, cross training is an important component in preventing injury and promoting recovery.  Implement cross training in your typical training cycles as a method to limit your risk of injury.  Cross training can also make your training more enjoyable as it keeps your body stimulated and ready for improvement.

Cross training can also be the perfect 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.

Actively Manage your Aches and Pains 

Be proactive when you start to feel those aches and pains creep up by initiating a self-treatment protocol right away.  It’s always easier to prevent an injury from occurring rather than treating one.

Use a foam roller after exercise in order to speed up your recovery time and decrease the risk of muscle soreness or restriction.  Learn how to self-mobilize by using treatment techniques including mobility bands and cupping.  Don’t underestimate the value of a stretching session or practicing yoga.  You may also consider seeing a masseuse for regular body work.

Overtraining Syndrome can be dangerous and severely limit your ability to train.  It also significantly increases your risk of injury.  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.

AVAILABLE NOW ON AMAZON!

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.

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!

CLICK TO LEARN MORE

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What is Overreaching?

Overreaching is a training strategy used to build strength and/or performance.  It describes an acute training phase where you temporarily increase the training volume, load and/or intensity as part of a specific training strategy to gain a specific training outcome.  Overreaching can be an effective and important part of a training cycle when properly programed.  It typically results in additional fatigue and soreness.  Upon recovery, the desired outcome is an obvious improvement or “supercompensation” in that specific sport or activity.

When used appropriately, overreaching is an important component of high-quality training although there is the potential of developing Overtraining Syndrome (OTS).  Overreaching is an advanced training concept and should not be utilized by novice individuals regardless of the sport or activity overreaching is occurring in.

Why risk Overtraining Syndrome (OTS) 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 to “shock” the body in order to get results by shortening the time (days to weeks) in which you push yourself to a state of being nearly overtrained before backing off.  This is more than the typical overload you are attempting with regular training.
  • Supercompensation occurs as you push yourself right up to your limit.  This allows you to surpass prior limits for short periods of time.  It may help you advance your training to a higher level.
  • 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.

Tips to help you safely overreach:

Do not attempt if you are a novice.  Overreaching is an advanced technique for intermediate to advanced individuals.

  • A planned and programmed overreaching session should last no longer than 1-2 weeks.
  • Increase your training and/or intensity and/or volume tactically and strategically, but not more than 40%.
  • Watch for symptoms of Overtraining Syndrome.  Symptoms may include becoming fatigued sooner during the workout or experiencing excessive fatigue or soreness.  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, extra care and planning should be taken so you can work hard at recovery between each bout of exercise.  Specific recovery strategies are outlined in my book, Preventing and Treating Overtraining Syndrome.
  • Once your recovery time is over, continue with your training plan.  Take note of where you are and how you feel in your training.  If you are feeling good and are demonstrating improvement, adjust your training plan by appropriately tapering up the volume and/or intensity to match your added gains.  This is how supercompensation can help your training and performance reach new levels.

Overreaching can be an excellent method to speed up and more quickly advance in your training.  However, there is the risk of overdoing and developing Overtraining Syndrome (OTS).  Overreaching 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.

Discover how to best utilize overreaching as a powerful training strategy so that you can continue to train hard and avoid the associated poor performance, illness, and injury that can result in lost training days and opportunity!

AVAILABLE NOW ON AMAZON!

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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How to Self-Treat Overtraining Syndrome (OTS)

Overtraining Syndrome (OTS) can affect any athlete in any sport or at any level from high level CrossFit athletes to high school cross country runners as well as professional athletes, weekend warriors, and weekend race enthusiasts.  People of all ages are training harder and longer than ever before with wonderful results!

However, sometimes 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 How to Prevent Overtraining Syndrome (OTS).

Overtraining Syndrome will significantly impede your performance, and it 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 and return to a normal training schedule.

Depending on the duration of symptoms and the severity of the case, OTS is a serious condition which can typically take from weeks to months to recover from.  OTS not only affects the muscular system, but also the circulatory system, the nervous system, and the hormone regulation system.  Use the following tips and strategies in your recovery.

How to Self-Treat Overtraining Syndrome (OTS):

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), a brief three to five days of rest may be sufficient while implementing the following treatment strategies.  After the rest days, one must slowly taper back into training at a lower training volume until recovery is complete.

Cross train

Opt for an alternate form of exercise (like Tai Chi) to help prevent exercise withdrawal syndrome.  However, 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).

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.  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.

Eat healthy

A healthy diet is critical to avoid injury.  Your body tissue needs nutrients to be able to perform at a high level.  In many cases 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.

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.

Supplement

Appropriate supplementation can be a highly effective method to get back to training more quickly by insuring your body has the nutrients it needs to properly and quickly recover.

Overtraining syndrome can be dangerous and will 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.

AVAILABLE NOW ON AMAZON!

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.

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!

BUY NOW

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How to Prevent Overtraining Syndrome (OTS)

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. OTS can ruin your ability to effectively train, compete or even exercise for weeks, months and in some extreme cases, even years.

Although not well understood yet, research indicates there are 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.

To effectively train at a high level one must avoid Overtraining Syndrome.  It not only impedes your immediate performance, but it also substantially increases your risk of injury.  Injury is one of the most common reason people do not meet their training and exercise goals. To train at a high level, you must put as much emphasis on your recovery protocol as your actual training plan.  Your recovery routine should be an intentional and a multifaceted approach.

How to Prevent Overtraining Syndrome (OTS):

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 reduced HRV is a sign of OTS.  The higher the HRV, the more capable your nervous system is able to adapt to stress.

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.

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.

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.

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

Appropriate supplementation can be a highly effective method to help prevent OTS.  The use of proper supplementation can help your body get the nutrients it needs to support the healing and recovery process.  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.

If you begin to experience any symptoms 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.  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.

AVAILABLE NOW ON AMAZON!

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.

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!

BUY NOW