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

Ways to cope in the midst of uncertain times

LIVING WITH HEART & HOPE-“It is often in the darkest skies that we see the brightest stars.” — Richard Evans

The world as we know it has undergone quite a lot of change and it can be challenging to navigate the stress that often accompanies uncertain times. During this month that’s so focused on love, we want to focus on the most impact-full thing you can do to diffuse stress and keep hope alive: self-care.

Here’s the paradox—when you’re stressed, it makes sense that taking care of yourself falls to the bottom of your to-do list; after all, there are so many other people and priorities that are more important, right? Well, no. Self-care is actually MOST important to help buffer you against the health-eroding effects of stress and it’s also a way to keep what’s going on around you in perspective. You can only change yourself and how you show up in the world—and you can only do that when you are healthy and nourished. So avoid the temptation to brush it aside.

To that end, here are three ideas for how you can remain grounded and cared for during the month of February and beyond.

Find community

In stressful times, it’s even more important to reach out to your community—to become engaged with other people, and build human connections. This can be as simple as finding time to spend with friends or family. Kids, in particular, are fantastic supporters of living in the moment and building connections. (Try obsessing about politics around a two-year-old—they will not let you!)

Simplify

Our smartphones have our go-to for staying connected, but spending all of your waking hours glued to a screen is bad for your soul. Balance out the need to stay informed with some simple time-outs:

  • Go for a walk in nature.
  • Make time for exercise—sweaty exertion is GREAT for clearing the head and harmlessly channeling any feelings of anger or frustration.
  • Read a book: Nothing can help you gain perspective like reading about how others have overcome obstacles.
  • Take care of your basic physical health: practice good sleep hygiene, eat well by focusing on whole foods, and remember to stop and breathe when you’re feeling overwhelmed.

Simplifying is not an excuse to tune out. It’s a necessary step to keep yourself from burning out and lapsing into apathy.

Give Back

The best cure for an anxious, blue mood? Giving back to those who are truly less fortunate.

It’s tempting to hide away and remain overwhelmed. But using your skills to give back is not only beneficial to the world—but also beneficial to your well-being! Giving back to others is a great way to feel proud, motivated, and strong. It allows you to really define, prioritize, and fight for your values: What’s most important to you? What good can you do in the world? How can your skills help others? Start thinking of small steps you can take to help others:

  • Can you volunteer some time to help a local charity?
  • Can you mentor someone in need?
  • Can you forego that daily Starbucks run and commit to a small donation to a non-profit?

Seemingly tiny acts add up mightily if you can start a real habit.

To your good health,

Karen

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Snowboarding Ankle Injuries

By Dev K. Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Snowboarders tend to get more ankle injuries than skiers, and skiers tend to get more knee injuries than snowboarders
  • The “snowboarder’s fracture” is unique to ankle injuries in snowboarding
  • A fracture of the “lateral process of the talus” is sometimes missed on regular x-rays and it’s sometimes necessary to use specialized imaging to make a proper diagnosis
  • When treated early and properly this fracture will typically allow full return of sports participation but a missed diagnosis can result in significant problems

In this post I’m going to discuss a particular type of broken bone seen in snowboarding snowboardoften referred to as “the snowboarder’s fracture.” This particular fracture occurs in one of the ankle bones called “the talus”. A fracture in the lateral process of the talus is called the snowboarder’s fracture.

Patterns of injury are a bit different in snowboarding compared to skiing. Skiers tend to get more knee injuries than ankle injuries, and snowboarders tend to get more ankle injuries than knee injuries. One proposed reason for this difference is due to the less rigid boots used in snowboarding, which provide minimal protection to the ankle joint.

Most ankle injuries in snowboarding affect the lead leg. And about half of all ankle injuries in snowboarding are fractures. The “snowboarder’s fracture” occurs because of sudden upward movement of the foot, combined with the foot turning inwards. This injury typically occurs when landing from a jump. Pain is present on the outer side of the foot and ankle, and is often associated with swelling, bruising and significant tenderness to touch. Unfortunately, this injury is often missed, because regular X-rays don’t always show the fracture very well. If I’m suspicious for a snowboarder’s fracture and the x-rays look normal, I’ll often order a CAT scan as this can be a much more accurate way to diagnose this fracture.

Treatment of the snowboarder’s fracture depends on how big and how displaced the broken fragment is. For a small fracture that is in normal alignment, we can treat these without surgery. This typically means about 4 to 6 weeks of having the foot and ankle in a cast and no weight bearing on the leg. Large and displaced fractures are typically treated with surgery—the fragment is moved back into its normal position and screws are inserted to hold it in place. Recovery after surgery also includes a period of non-weight-bearing, followed by gradual restoration of motion, strength, and function of the ankle joint.

ssd.bannerOutcomes of snowboarder’s fractures are typically good if the injury is diagnosed early and appropriately treated.

Most athletes are able to get back to normal physical activity within 4 to 6 months. However, significant problems can result if this fracture is missed and appropriate treatment is delayed. These include non-healed bony fragments causing pain and poor function, as well as early arthritis of the joint, which can significantly limit movement of the foot. When a snowboarder presents with acute pain on the outer side of the foot or ankle after an injury on the slopes, it’s very important to see a skilled physician for a proper exam and appropriate diagnostic imaging to avoid missing this injury.

March is National Athletic Training Month

YOUR PROTECTION IS OUR PRIORITY

March is National Athletic Training Month (NATM). NATM is a great time to talk about the profession of Athletic Training. Throughout the month of March, all across the country, communities will be exposed to what it involves to be an Athletic Trainer. Certified Athletic Trainers are healthcare professionals, and there are approximately 50,000 collaborating with physicians to provide care to physically active people.

Services provided by Athletic Trainers encompass prevention, emergency care, clinical diagnosis, therapeutic intervention and rehabilitation of injuries. You can find Athletic Trainers in a variety of settings from, professional and collegiate sports, secondary and intermediate schools, hospitals and rehab clinics, to physician offices. Athletic Training is recognized by the American Medical Association (AMA) as a health care profession.

About NATA

The National Athletic Trainers’ Association (NATA) is the professional membershipnatm association for certified athletic trainers and others who support the athletic training profession. Founded in 1950, the NATA has grown to more than 43,000 members worldwide today. The majority of certified athletic trainers choose to be members of NATA to support their profession and to receive a broad array of membership benefits. By joining forces as a group, NATA members can accomplish more for the athletic training profession than they can individually. The NATA national office currently has more than 40 full-time staff members who work to support NATA’s mission.

Vision

Athletic trainers will be globally recognized as vital practitioners in the delivery and advancement of health care. Through passionate provision of unique services, athletic trainers will be an integral part of the inter-professional health care team.

Mission

The mission of the National Athletic Trainers’ Association is to represent, engage and foster the continued growth and development of the athletic training profession and athletic trainers as unique health care providers.

For more information on Athletic Training go to https://www.nata.org/

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4 Best Exercises You Can Do For Strong Bones

Warrior II

If you want to stay healthy as you get older, you already know that exercise is key. And when it comes to bone health, this is particularly true. However, what you may not realize is that sticking strictly to low-impact workouts isn’t helping your bone strength, says Vijay Jotwani, MD, a primary care sports medicine physician at Houston Methodist hospital in Texas.”The key for bone health exercises is that they must be weight-bearing,” says Jotwani. “Weight-bearing exercises stimulate osteoblasts, the bone cells that are responsible for bone growth.” So, while activities such as swimming and cycling are excellent aerobic exercises, they are less beneficial for bone health than, say, walking, running, or Zumba, because they don’t involve weight-bearing moves, Jotwani explains.
Holly Perkins, a Los Angeles-based personal trainer agrees, stressing the importance of mixing in some higher-impact exercises for the health of your bones. “Most of my clients still believe impact is bad, but that’s just not true,” says Perkins. “However, if you don’t want to run or have an injury that prevents you from playing tennis or jumping rope, there are plenty of other options,” she says.
Here are the 5 best exercises you can do for the health of your bones, plus alternatives that might work better based on your age, injuries, or other factors.

Running… or squat jumps

Squat jumps

Bone cells respond to impact by forming bone, says Joanne Halbrecht, MD, an orthopedic surgeon trained in sports medicine. That’s why running is often cited as a great, bone-building exercise: Every time your heel strikes the ground, it creates an impact on your bones that prompts more bone growth. Not a fan of jogging? Walking has a similar effect, though to a lesser degree, which is why Perkins recommends adding a few squat jumps to your next walking workout.

“On your next 30-minute walk, stop and do 10 squat jumps when you’re 5 to 10 minutes in,” says Perkins. “You’ll get the same benefits of running without actually running.” To do a squat jump, place your feet shoulder distance apart and drop down into a quarter of a squat. Then jump up as high as you can, land, re-set, and repeat. “You can do this as aggressively or gently as you like,” says Perkins. “It’s the landing that gives you the impact, which provides the bone-building benefit.”

High intensity interval training… or jumping jacks

Jumping jacks

Research shows that incorporating high-intensity resistance exercises followed by periods of brief rest can positively impact bone health, says Barry Sears, MD, a physician and president of the Inflammation Research Foundation. “This style of training puts stress on the bone and releases growth hormone from the pituitary gland, which stimulates bone synthesis,” he says. Now, this doesn’t mean you have to sign up for that boot camp class at the gym or hit a WOD at your local CrossFit, says Perkins. “Simply doing 20 jumping jacks, three times a day, can go a long way toward boosting your bone health,” she says. Do 20 in the morning, 20 after lunch, and then 20 before dinner, or do all 60 as three sets of 20 jumping jacks with just a little rest in between.

Weight training… or simply doing a dead lift

Deadlift
Getting into a regular strength training routine at least twice a week is something most doctors agree is a good move for healthy bones. “Resistance training has been shown to be necessary for preventing bone loss and maintaining strong bones, says Emilia Ravski, DO, a sports medicine physician with Hoag Orthopedic Institute in Southern California. Falling short of your twice-weekly weight-room goal? Simply incorporate one move—the dead lift—into your exercise routine twice a week, says Perkins.
“The dead lift incorporates nearly every muscle in your entire body, making it good for fitness and strength overall, and also a great stimulus for testosterone production, which is good for bone health,” says Perkins. Start with your feet shoulder-width apart and hold a barbell with your hands placed wider than your knees. Stand with a long, tall spine (which automatically makes you engage your core), then bend your knees, reach your hips back, and slowly lower the barbell down to your mid shins, keeping it close to your legs as you do. Pause here, then focus your energy into your heels and pull yourself upward. Start with 3 sets of 12 reps, and use a heavy enough weight that the last two reps of each set are very challenging.
Yoga… or simply practicing Warrior 2
Warrior II

The ancient practice of yoga has been linked to many health benefits, and bone health is certainly one of them. One small-yet-groundbreaking study found that yoga increased bone density in practitioners’ spine and hips; another bigger, more recent study produced similar findings. While making it to your favorite yoga class two or three times a week is ideal, Perkins says you can also simply incorporate Warrior 2 into your exercise routine. (Looking for more ways to live a happy, healthy life?

To do Warrior 2 Pose, stand with your feet about four feet apart with your right toes facing the wall in front of you and your left foot turned to about a 45-degree angle away from the back wall. Bend your right knee deeply, so your right thigh is parallel to the ground; as you do this, keep your back leg and glutes firm. Raise your arms up so they’re parallel to the ground and turn your head to gaze over your right fingertips. Stay here for 30 seconds to 1 minute, then switch sides. “In this pose, you’re dropping into such a low position in your front leg that your pelvis, legs, and core are getting a big workout,” says Perkins. “When done properly, Warrior 2 is an intense strength- and bone-building exercise.”

MEGHAN RABBITT for prevention.com