5 Ways to Stop Knee Pain in Runners

By Ryan Domeyer PT, DPT, CMPT for Athletico

Between 20 to 93 percent of runners suffer from knee pain, making it the most common lower extremity injury.  When knee pain occurs, one of the treatment options is physical therapy. Physical therapists are trained to examine, diagnose and treat knee pain to help patients return to the activities they love.

The majority of knee pain associated with running is not caused by direct trauma butknee-pain rather improper loading. Running requires the ability to absorb the weight of the body when the runner’s foot hits the ground in order to propel the runner forward. Although it might not seem like it, running is actually a complicated skill that most people do not actively practice prior to their recreational run. Knee pain can start during a run, but most commonly is experienced after running longer distances. Research shows the more miles you run the higher risk of sustaining a knee injury. The most common causes of knee pain in runners are iliotibial (IT) band syndrome, chondromalacia patella (runners knee) and patellar tendon pain.

It is common for runners to treat their knee pain with rest and ice and hope it goes away on its own. Although rest can help during the initial stages of knee pain, there are many ways that runners can take load off their knees and prevent future injuries, including the five listed below:

  1. Improve Hip Flexor and Quadriceps Mobility

Americans spend on average 13 hours per day sitting.1 Sitting for long periods of time during school, work or watching TV causes the front of the hip to shorten, which leads to tightness in the hip flexor and quadricep muscles. Stretching or foam rolling are the most efficient ways to improve hip flexor and quadriceps mobility to lessen knee pain. For more information on stretching and foam rolling, read:

Stretching: It’s All in the Hips Part 3

Foam Rolling: 3 Ways to Roll Away Muscle Tension

  1. Improve Hip Strength

Another adverse effect of sitting during the day is the inefficient use of our gluteal muscles. The gluteal muscles are the largest muscles in the body and when trained properly, can lessen the load on the knee. The easiest way to improve strength of the gluteal muscles is with bodyweight exercises including bridges, planks, side planks, bird dogs and hip abduction raises.

  1. Improve Balance

As previously mentioned, running requires the ability to land on one leg repeatedly to propel the body forward. The knee is the middle connection between the ground and the body. A loss in balance can lead to poor force absorption from the ground with each step taken during running.

To test balance, try standing on one leg without using your arms for 30 seconds. If this is difficult, balance can be improved by practicing. To take this balance exercise a step further, try balancing on one leg without holding onto anything with your eyes closed. If balance continues to be a problem, consider scheduling a complimentary injury screening at your nearest Athletico Physical Therapy.

  1. Improve Core Position and Stability

Another way to improve muscle imbalances is to improve core strength and the ability to run with a neutral spine. To do this, begin your run on the right track with a neutral neck aligned over your shoulders, neutral low back without a large backward curve and feet straight forward. Awareness of your low back and core position is important at the start of a run, as it becomes more difficult to maintain as fatigue sets in.

  1. Increase Number of Steps

Running technique is the most significant way to decrease the load on the knee to prevent or improve an injury. A simple way to improve technique is by increasing the number of steps taken. Although it may seem counterintuitive to take more steps, this will prevent a poor foot strike position and set the body in a good position to fall forwardathletico300x250 rather than absorb the force.

If you need help with running technique, request a video gait analysis at Athletico, which provides real-time audio and visual feedback on your running style. This will enable your physical therapist to provide feedback that not only helps improve efficiency, but also helps to prevent injuries.

Click to Schedule a Complimentary Injury Screen

Dry Needling: Targeted Treatment for Pain Reduction

Image result for dry needling

All patients with any kind of pain problem will benefit from dry needling. This innovative pain treatment can be used to treat a variety of diagnoses including:

  • Headaches / Migraines
  • Neck pain
  • Lateral and medial Epicondylitis (Tennis Elbow)
  • Shoulder impingement syndrome
  • Low back pain
  • ITB syndrome
  • Piriformis syndrome
  • Sciatica
  • Greater trochanteric bursitis
  • Hamstring strain
  • Groin strain
  • Ankle sprain Plantar Fasciitis
  • Carpal Tunnel
  • Osteoarthritis
  • Fibromyalgia

Dry needling is a skilled intervention that uses a thin filiform needle to penetrate the skinathletico300x250 and release underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments.  Dry needling (DN) is a technique used to treat dysfunctions in skeletal muscle, fascia, and connective tissue, and, diminish persistent peripheral nociceptive input, and reduce or restore impairments of body structure and function leading to improved activity and participation.

5 Exercise Tips For the New Year

By Donald Smith for Athletico

Many people decide that the start of the New Year is a good time to get in shape. They know that exercise helps them feel better mentally and physically, while also improving their strength, flexibility and endurance. What many don’t think about, however, is that exercise can hurt too.

Most people try to do too much when they decide to start exercising again. Oftentimeswoman-man-treadmill-running-300x200
they remember what they used to be able to do when they were younger and resolve to do it again. They might join the gym or an exercise class, and do an hour long workout that leaves them sore the next day. They might then lay off for a week before trying it again with the same results. It doesn’t take long before they give up on exercise – again. But this cycle can be broken!

Here’s a new way to start and stay active.

  1. Talk with your physician about starting an exercise program.

This is especially important if you are on medications, have a disease or condition that may be impacted by increased activity, or have not been physically active for months or years.

  1. Start slowly and build momentum.

One of the best ways to start is with just five minutes of exercise the first day and add awoman-work-out-plank-300x200 minute each day. In a month you’ll be doing more than 30 minutes a day. What’s more, research has shown that the 30 minutes doesn’t have to be continuous to be beneficial. You can do five minutes in the morning, 15 minutes at lunch, and 10 minutes in the evening. If you’re watching television, try getting up and walking around, or climbing a few stairs, during commercials.

  1. Build endurance with aerobic activity.

Aerobic activities build your endurance. The word Aerobic means that you’re exercising while giving your muscles enough oxygen for the work they’re doing. You’ll get sore when you exercise your muscles without enough oxygen. Walking, bicycling and dancing are a few aerobic exercises worth trying. Walking is a good starting exercise, as it is usually the easiest, safest and cheapest type of aerobic activity.

The best way to know if you’re doing aerobic exercise is by keeping your heart rate inwoman-fitness-on-ladder-300x200 your target heart range. To figure out your target heart range, take 220 minus you age. Then take that number and multiply it by 65 percent and 85 percent.

For example: A 50 year-old would be 220 – 50 = 170; 170 X .65 = 110 and 170 X .85 = 144. So, to be aerobic that 50 year-old needs to keep their heart rate between 110 and 144 when exercising.

If all this seems too complicated, remember to slow down exercise if you’re breathing heavily and speed up if you’re not breathing deeply.

  1. Try strength training. 

You typically won’t get as sore if you do strength training after aerobic exercise. If you strengthen using low weight and high reps you will likely stay in the aerobic heart range. Start with a weight you can do for 20 reps without stopping. Increase as able each session until you can do 40 reps at that rate. Then, change to the next higher weight and go back to 20 reps and work up to 40 again.

  1. Reduce the chance of injury with stretching.

There is less chance of injury with proper stretching. Remember stretching should never hurt!  Here’s an easy way to stretch:

Step 1 –  Move gently into a position where you feel tight, but don’t push it.

Step 2 – Take a deep breath in through your nose.

Step 3 – Let the breath out through your lips in a silent whistle, and the muscles you’re stretching will relax.

Repeat Steps 1 – 3 four times.

If you feel unusual aches and pains after exercising, make sure to schedule a complimentary injury screening at your nearest Athletico location.


Maintaining Your Winter Running Routine

By Kristin Dryden for Athletico

It is possible to maintain your outdoor running routine in the winter, but you must always keep safety top of mind.

Although running outside in the winter can be intimidating due to conditions like ice, snow and cold, you can keep your running mileage up if you have the right gear and follow some practical cold-weather safety tips. Read below for guidance on how to stay warm when battling some of the year’s coldest temperatures.

  1. Wear Layers

When dressing for the cold, it is important to dress in layers and to remember that youwinter-running will still feel cold when you first go outside. Once you start running, your body will perceive the outdoor temperature at about 20 degrees warmer than it actually is! This means that if you are warm when you first go outside you are likely overdressed and could end up overheating.

When it comes to layering clothes, keep in mind that your first layer should always be a wicking layer. This fabric will help to keep sweat off your body, while maintaining your core temperature without overheating. On top of this layer you can wear another top, as well as a windbreaker to give you extra protection against the harsh winter winds.

  1. Cover Your Head, Hands and Feet

In addition to wearing layers on your body, it is important to wear the appropriate attire on your head, hands and feet.

For starters, keep your head warm with a good running hat that is form fitting and keeps your ears protected. It is also a good idea to have running-specific gloves. This type of glove has a wicking fabric on the inside to prevent excessive sweat from accumulating on the hands, which may lead to frostbite.

Lastly, it is important to note that even though you can wear normal running shoes in the winter, you may want to purchase shoe cover accessories to combat snowy sidewalks. A couple of brands worth checking out for these types of accessories include Pearl Izumi and Yaktrax. These shoe covers can help you maintain stability on the slushy ground while still letting you run with your normal stride.

  1. Know the “Feels Like” Temperature

Before you go out for your winter run, make sure you know all factors. One key thing to keep in mind is the wind chill. While the air temperature may say one thing, the wind could make it feel colder. Don’t push yourself and know your limits! In general, it is a good idea to exercise indoors if the wind chill is zero or below to avoid conditions like hypothermia or frostbite.

  1. Play it Safe

If the meteorologist is saying to stay inside, it is a good idea to listen. When the temperatures dip, it is best to play it safe and exercise indoors.

Running All Year Longathletico300x250

By following these winter running tips, you can maintain your running routine all year long. As always, if you experience any aches and pains after exercising, make sure to schedule a complimentary injury screening at your nearest Athletico location.

Tips for Keeping Your Feet Dancing Through the Holidays

By  Kelli Barton for Athletico

The Nutcracker is the most iconic holiday ballet performed by ballet schools and professional companies around the world.

Between December 10th and December 30th, the Joffrey Ballet Chicago will perform The Nutcracker 27 times. That’s an average of 1.2 shows per day! For optimal performance, it is crucial that dancers are proactive in preventing injuries from occurring and correctly manage injuries when they do occur. Foot and ankle injuries represent 34-62 percent of all injuries reported by dancers. Female ballet dancers are especially vulnerable to these injuries because of the increased demand put on the foot and ankle when dancing en pointe.

To help prevent dancing injuries from happening, consider the following tips:

Overuse Injuries
Overuse injuries are aches and pains that occur due to the repetitive nature of danceballet-dancing movements and lack of adequate rest. Examples of overuse injuries are stress fractures and tendinitis. Fortunately, the risk for these injuries can be decreased through appropriate rest, adequate warm up and nutrition.


Getting Appropriate Rest

Fatigue has been cited as a common reason for injuries in dancers as overall injury rates vary from 0.8 to 2.9 injuries per 1,000 hours of dance training. When fatigued, decreased trunk control and faulty lower extremity alignment results in increased demand on joints and ligaments to provide stability. While you may not be able to alter the amount of time you spend dancing, you can control what you do during time outside the studio. For example, active rest is preferred over complete rest, including gentle movements, stretching, as well as strengthening and stabilizing muscle groups. This helps avoid excessive stiffness throughout the body.

It is also important to note that fatigue-related injuries have been reported to increase when psychological stressors such as work or school conflicts are present. Since performances may induce additional stress, it is important to find strategies to appropriately rest your brain in addition to your body to stay healthy during this time.

Warming Up

An appropriate warm-up primes the body for optimal performance. Morrin et al found that a combination of static and dynamic stretching provided a significant change in hamstring flexibility as well as superior balance and vertical jump values in comparison to a static-only or dynamic-only warm up.

Static stretching involves holding a specific position for a period of time whereas dynamic stretching has an aerobic approach in which the body part is repetitively moved through its available range of motion. Examples of dynamic stretching include leg swings, alternating kick-to-buttocks and scissor jumps.

Good Nutrition

Low energy availability occurs when a dancer is not consuming enough food for the amount of energy expended during physical activity. Therefore, a dancer will need to eat more as the volume of dance participation increases.

Signs of low energy availability include fatigue, difficulty concentrating and loss of menstrual cycle. Consistently low energy availability can cause sub-optimal bone mineral density and place the dancer at increased risk for stress fractures. High caffeine intake, noted as greater than two cups of coffee per day, can also contribute to low bone mass density. For specific nutrition recommendations, please seek attention from a nutritionist in order to develop a plan based on your individual needs.

Acute Injuries

Acute injuries occur when a bone, ligament, tendon or muscle is extended past its capability or excessive force is placed onto a region of the body. Examples of acute injuries are ligament sprain and muscle strain.

When an acute injury occurs, the body releases chemicals to create an inflammatory response around the damaged structure. The inflammation assists with promoting new cell growth, defending the body against harmful substances, and disposing of damaged tissue. However, this process results in swelling, redness, warmth, pain and loss of function at the area of injury. The following steps should be taken after an acute injury:


P: Protection

Relocate to a safe space away from additional danger such as fellow dancers continuing to perform and provide support to the region of injury.

R: Rest

Avoid painful movements with involved body part as continual stress may increase injury and delay healing.

I: Ice

Apply ice to the injured area for 20 minutes every 2 hours for the initial 2-3 days. Ice will decrease blood flow to the area, slow conduction of painful nerve impulses, decrease abnormal accumulation of fluid, and lower temperature.

C: Compression

Utilize an elastic compression bandage to wrap the area. If you experience sensation of pins/needles, numbness or change in skin color, the bandage is too tight. Start away from the heart using a figure 8 pattern with a gradual decrease in tightness as you pass the site of injury. Avoid gaps in bandage that expose skin as swelling will accumulate here.

E: Elevation

Raise the injury area above the heart to increase return of blood and therefore remove waste products away from the area.

D: Diagnosis

All acute injuries should be evaluated by a health-care professional for advice regarding appropriate next steps, especially if not resolved with “PRICE” or unable to bear weight. Choosing a health-care professional who has a specialty working with performing artists will be helpful to allow for a gradual, safe return to dance.

Basic First Aid for the Foot

Although blisters, cramping, split skin and bruising will not likely take you out of a performance, they can be a source of discomfort when participating in a higher volume of dancing.

Blister Blisters are caused by a combination of friction and moisture at bony prominences of the feet. It may be a sign that shoes should be re-sized as the structure of the foot can change over time. Petroleum jelly or tape placed on more vulnerable spots can decrease friction. In addition, using less absorbent material for tights or pointe shoe padding can decrease moisture. Blisters will heal independently and should avoid being popped due to risk for infection. If a blister does pop, it is important to cover with an antibiotic ointment and bandage that will stay secured in shoes.

Cramps A muscle cramp is a strong, painful tightening of a muscle that occurs involuntarily.  Another name that is commonly used to describe a cramp is a “Charley horse.” To avoid cramping, stay hydrated and perform an adequate warm up as well as cool down. Stretching the cramped muscle can assist with relieving symptoms faster.

Split Skin Split skin often occurs in the area of a callous, particularly on the ball of the foot. Prevent skin from splitting by using a fat-based balm such as coconut oil over areas of tough, dry skin. If a skin split does occur, be sure to keep the area clean to decrease risk for infection. There are some over-the-counter products that help to seal the split skin together to promote healing.athletico300x250

Bruising The best prevention for bruising is to wear padding and control descents to the floor during choreography. Avoid heating pads or warming topical creams, as this will bring more blood to the bruised region and delay healing.

By following the above recommendations, you are now ready to tackle the Nutcracker season injury free! If you experience an injury, please contact your physician or set up a screen with a performing arts physical therapist at a conveni ent Athletico Physical Therapy location.

Schedule a Complimentary Injury Screen