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

How Exercise Shapes You, Far Beyond the Gym

By

When I first started training for marathons a little over ten years ago, my coach told me something I’ve never forgotten: that I would need to learn how to be comfortable with being uncomfortable. I didn’t know it at the time, but that skill, cultivated through running, would help me as much, if not more, off the road as it would on it.

It’s not just me, and it’s not just running. Ask anyone whose day regularly includes a hard bike ride, sprints in the pool, a complex problem on the climbing wall, or a progressive powerlifting circuit, and they’ll likely tell you the same: A difficult conversation just doesn’t seem so difficult anymore. A tight deadline not so intimidating. Relationship problems not so problematic.

Maybe it’s that if you’re regularly working out, you’re simply too tired to care. But that’s probably not the case. Research shows that, if anything, physical activity boosts short-term brain function and heightens awareness. And even on days they don’t train — which rules out fatigue as a factor — those who habitually push their bodies tend to confront daily stressors with a stoic demeanor. While the traditional benefits of vigorous exercise — like prevention and treatment of diabetes, heart disease, stroke, hypertension, and osteoporosis — are well known and often reported, the most powerful benefit might be the lesson that my coach imparted to me: In a world where comfort is king, arduous physical activity provides a rare opportunity to practice suffering.

Few hone this skill better than professional endurance and adventure athletes, who make a living withstanding conditions others cannot. For my column with Outside Magazine, I’ve had the privilege of interviewing the world’s top endurance and adventure athletes on the practices underlying their success. Regardless of sport, the most resounding theme, by far, is that they’ve all learned how to embrace uncomfortable situations:

• Olympic marathoner Des Linden told me that at mile 20 of 26.2, when the inevitable suffering kicks in, through years of practice she’s learned to stay relaxed and in the moment. She repeats the mantra: “calm, calm, calm; relax, relax, relax.”

• World-champion big-wave surfer Nic Lamb says being uncomfortable, and even afraid, is a prerequisite to riding four-story waves. But he also knows it’s “the path to personal development.” He’s learned that while you can pull back, you can almost always push through. “Pushing through is courage. Pulling back is regret,” he says.

• Free-soloist Alex Honnold explains that, “The only way to deal with [pain] is practice. [I] get used to it during training so that when it happens on big climbs, it feels normal.”

• Evelyn Stevens, the women’s record holder for most miles cycled in an hour (29.81 – yes, that’s nuts), says that during her hardest training intervals, “instead of thinking I want these to be over, I try to feel and sit with the pain. Heck, I even try to embrace it.”

• Big-mountain climber Jimmy Chin, the first American to climb up — and then ski down — Mt. Everest’s South Pillar Route, told me an element of fear is there in everything he does, but he’s learned how to manage it: “It’s about sorting out perceived risk from real risk, and then being as rational as possible with what’s left.”

But you don’t need to scale massive vertical pitches or run five-minute miles to reap the benefits. Simply training for your first half marathon or CrossFit competition can also yield huge dividends that carry over into other areas of life. In the words of Kelly Starrett, one of the founding fathers of the CrossFit movement, “Anyone can benefit from cultivating a physical practice.” Science backs him up.

A study published in the British Journal of Health Psychology found that college students who went from not exercising at all to even a modest program (just two to three gym visits per week) reported a decrease in stress, smoking, alcohol and caffeine consumption, an increase in healthy eating and maintenance of household chores, and better spending and study habits. In addition to these real-life improvements, after two months of regular exercise, the students also performed better on laboratory tests of self-control. This led the researchers to speculate that exercise had a powerful impact on the students’ “capacity for self-regulation.” In laypeople’s terms, pushing through the discomfort associated with exercise — saying “yes” when their bodies and minds were telling them to say “no” — taught the students to stay cool, calm, and collected in the face of difficulty, whether that meant better managing stress, drinking less, or studying more.

For this reason, the author Charles Duhigg, in his 2012 bestseller The Power of Habit, calls exercise a “keystone habit,” or a change in one area life that brings about positive effects in other areas. Duhigg says keystone habits are powerful because “they change our sense of self and our sense of what is possible.” This explains why the charity Back on My Feet uses running to help individuals who are experiencing homelessness improve their situations. Since launching in 2009, Back on My Feet has had over 5,500 runners, 40 percent of whom have gained employment after starting to run with the group and 25 percent of whom have found permanent housing. This is also likely why it’s so common to hear about people who started training for a marathon to help them get over a divorce or even the death of a loved one.

Another study, this one published in the European Journal of Applied Physiology, evaluated how exercise changes our physiological response to stress. Researchers at the Karlsruhe Institute of Technology, in Germany, divided students into two groups at the beginning of the semester and instructed half to run twice a week for 20 weeks. At the end of the 20 weeks, which coincided with a particularly stressful time for the students — exams — the researchers had the students wear heart-rate monitors to measure their heart-rate variability, which is a common indicator of physiological stress (the more variability, the less stress). As you might guess by now, the students who were enrolled in the running program showed significantly greater heart-rate variability. Their bodies literally were not as stressed during exams: They were more comfortable during a generally uncomfortable time.

What’s remarkable and encouraging about these studies is that the subjects weren’t exercising at heroic intensities or volumes. They were simply doing something that was physically challenging for them – going from no exercise to some exercise; one need not be an elite athlete or fitness nerd to reap the bulletproofing benefits of exercise.

Why does any of this matter? For one, articles that claim prioritizing big fitness goals is a waste of time (exhibit A: “Don’t Run a Marathon) are downright wrong. But far more important than internet banter, perhaps a broader reframing of exercise is in order. Exercise isn’t just about helping out your health down the road, and it’s certainly not just about vanity. What you do in the gym (or on the roads, in the ocean, etc.) makes you a better, higher-performing person outside of it. The truth, cliché as it may sound, is this: When you develop physical fitness, you’re developing life fitness, too.

Brad Stulberg is a columnist for Outside Magazine, where he writes about health and the science of human performance. Follow him on Twitter @Bstulberg.

Endurance Athlete Back in Action After Hip Surgery

By Matt Aaronson

I had never been physically active prior to 2010. In fact, at one point I weighed morematt-aaronson than 200 pounds. But with three kids at home, I needed to make some serious changes in my lifestyle and get healthy for myself and my family.

So I started to run for fitness. I was fortunate and began losing a lot of weight. And as I lost weight, I became a faster runner. I signed up for some races and noticed that I was commonly in the top 10 or even in the top three. I got into triathlons to try something different and realized my results were excellent. I even qualified for the World Championships in 2011, in my first half Ironman.

I ran my first marathon in 2013 in under three hours, during which I qualified for the Boston Marathon. However, while I was training for the Boston Marathon my hip started really bothering me. I thought I would be fine if I just ran a little bit less. Initially for my training I was up to 60 miles a week. But once I injured my hip, I went back down to less than 30 miles a week, even in the mid-20s per week. But the pain still got worse and worse.

After seeing a couple doctors without any improvement or definitive diagnosis, I knew I needed to elevate the level of care. So I went to see a sports medicine doctor at Rush’s orthopedics program. The doctor reviewed my prior MRIs and results from the last eight months of battling through physical therapy and other exams, reports and treatments. He ordered an MRI arthrogram to get to a diagnosis of hip impingement.

He then referred me to a consultation with a surgeon, Dr. Shane Nho, to consider surgery as a treatment option given that nothing else had worked.


‘A REALLY BIG DECISION’matt-aaronson-event.jpg

For me, deciding to have surgery was a really big decision because it made me nervous. I did a lot of research to ensure two things: Did I truly need surgery? And, was Rush’s orthopedics department, where I’d been referred for surgery, the right place to go?

I made sure to consult a variety of different medical professionals, not just surgeons, to make sure that surgery was the right option. I saw seven specialists in all. And one thing I found out through all of those consultations is that the doctors at Rush had steered me in the right direction in terms of a diagnosis and course of action.

The other thing was I met with a number of different surgeons who did this particular procedure and got a feel for how they differed. Through that process I really got a sense that Dr. Nho at Rush would be the best option for me. Dr. Nho was highly recommended by my physical therapist as well as other doctors who were friends of mine who knew him. In addition, Dr. Nho does a high volume of minimally invasive hip arthroscopy procedures, and that made a big difference for me. A lot of the other hip surgeons I met with also operate on knees and shoulders, but Dr. Nho is focused only on hips.

It made me comfortable and gave me confidence that my surgeon was so specialized that he’d probably already seen any complex issues that might arise.

EFFECTIVE SURGERY AND RECOVERY

Dr. Nho performed my hip arthroscopy in December 2015. The level of care and responsiveness during the recovery process was amazing. There were a number of times when I sent an email to Dr. Nho or one of his physician assistants, and they responded almost immediately.

In the course of my research, I learned that Dr. Nho’s rehab protocol is very precise and quite conservative relative to the other surgeons I consulted. He is in close communication with the physical therapist to ensure it is being followed and is effective.

And it was effective! I didn’t start running until about five months after the surgery. And when I started running, I was running for one minute at a time and walking for four minutes. However, within six weeks I was able to run a 5K race in just over 19 minutes, only about a minute slower than before I got injured.

After I ran that 5K I was so encouraged with my recovery process that I decided to signMORGif-180x150-link up for a half Ironman, which was about nine months out from surgery. I trained a lot less than typical for a half Ironman because I wanted to ensure no risk to the surgery recovery. But I was able to complete it in just over four and a half hours, which was within a few minutes of my personal best time.

People in the running and triathlon community who know me always ask me for recommendations when they are injured. They know I have seen many doctors for injuries over the years. I recommend the orthopedics department at Rush without hesitation.

9 Ways to Prevent & Ease Muscle Soreness While Running

This morning my alarm clock went off at exactly 7 a.m., and a long run was on schedule. But as soon as I was out of bed, ouch, every step hurts. It’s then that I realized that my lower back, glutes, and hamstrings had another plan. In fact, I was so sore that I couldn’t walk straight. Of course, I know why this happened. Yesterday I completed a series of exercises that pushed me to the breaking point. I performed 25 reps of barbell back squats and 30 deadlifts at 80 percent of my One-Rep Max. But still, I thought I’d feel OK by now. So, guess what happened next?

Then the internal debate started. And started asking myself all sorts of questions… Should I skip on my run today? Should I hit the snooze button? Or should I go run instead in spite of the soreness and pain? After a few minutes of back and forth I made up my mind and decided to go run. That’s the right decision to make. And thank God, I knew what to do next. I grabbed my foam roller, and after a few dynamic stretches, a strong cup of Joe, I was set and ready to go. Of course, I still have some residue soreness, but, all things considered, the payoffs of getting my butt out the door for my long run far exceeds some minor and temporary discomfort.

9 Ways to Prevent & Ease Muscle Soreness While Running

Today I’m going to share with you a bunch of practical tips to help deal with the pain. So are you excited? Then here we go… But first things first, what is muscle soreness? How in the world happens? And what’s causing it?

Muscle Soreness demystified

The most popular theory is that muscle soreness occurs as a result of muscle damage, caused by microtrauma in the form of teeny tiny tears in your muscles. It’s Common: Muscle soreness is pretty common among runners of all fitness levels and training backgrounds. Nevertheless, beginner runners or those coming back to running after a long layoff report more muscle soreness episodes than those who keep a regular training program.

There are mainly two types of exercise-related soreness.

The first being the immediate or acute soreness—the muscle soreness you feel during and/or shortly after a run. The second type, the more common, is what’s known as Delayed Onset Muscle Soreness, or DOMS in the fitness circles. In most cases, muscle soreness is mild, emerging after a hard run—think long runs and gut-busting sprint and/or hill reps, and lasting no longer than a couple of days. At other times, this soreness does not emerge until after two or three days following a workout. The thing is, when the soreness is intense (or crippling at times), it’s almost always a case of DOMS.

Dealing With Post-Run Muscle Soreness

Unfortunately, according to the current scientific theory, there are no fool-proof ways for speeding up the recovery of muscle soreness. (Of course, there is one fool-proof way to avoid soreness altogether, which is to give up running altogether. And I guess that you don’t want to do that) With that said, here are a few helpful training tips and recovery guidelines that are worth trying to get your body primed for the next run.

1. Start Slow

It goes without saying, but if you are a beginner, or returning to running after a long break, slow and gradual is the way to go. For starters, if you are a complete running newbie, then start with the walk/run method. Once you can run for  30 to 40 minutes straight without much trouble, then start adding speed work in small increments. Use the 10 percent rule. Increase your running mileage by no more than 10 percent from one week to the next.

2. Eat Right Away

Immediately following a run, your body has roughly one to two hours to most efficiently absorb the food you consume. That’s why if you skip post-run nutrition, then you might not have enough energy for your next session, and you’ll fall short on the protein you need for muscle recovery, all of which can compromise your fitness routine. As a result, make sure to eat something immediately following a hard workout. For the best results, aim for 3 or 4 to 1 ratio of carbs to protein.

Easier said than done, but it’s worth trying out different ratios and foods until you find what works the best for you. In my experience, the best way to refuel following a hard run—especially if you are pressed for time and/or don’t have the stomach for solid food—is to consume liquid nutrition. And by far, my favorite is chocolate milk or a banana based smoothie. Other options include yogurt, banana with peanut butter, or orange juice with two hard boiled eggs and whole toast. If you have the stomach and the time, then go for brown rice with chicken, a bowl of quinoa, an omelet with an avocado.

3. Consume Protein

I hate to sound like a broken record, but when it comes to avoiding muscle soreness, protein is key. Proper protein intake is not only key for building muscles but it has also been shown to reduce post-workout muscle damage, according to study.

The reason? This happens by stimulating protein synthesis, which is one of the most basic biological processes by which amino acids are linearly arranged to allow individual cells to build specific proteins. Also, the increased blood amino acids level serves as a sort of biomechanical signal that instructs the muscles not to turn to protein as an alternative fuel source. In other words, consuming enough proteins provides the muscles with the key building blocks needed to repair and rebuild damaged tissue.

4. Compress it

There is strong evidence that wearing compression attire can reduce post-workout soreness, and speed up recovery afterward. According to a study published in the British Journal of Sports Medicine, opting for compression garments while and after working out can reduce muscle soreness. Another research published in the Journal of Strength and Conditioning, found that marathoners who wear compression socks in the 48 hours following a race reported a faster recovery rate than those who didn’t.

Why? According to theory, technical compression fabric helps reduce soreness by supporting muscle groups, reducing muscle micro-tearing in the process. Not only that, but research also shows that compression can increase circulation. As a result, if you are chronically sore after a run, then try wearing compression tights, compression shorts, and compression socks, and see if this helps you alleviate some of the pain.

5. Foam Roll

One of my favorite methods for alleviating post-run muscle soreness is foam rolling. In fact, the long, cylinder-like tool has saved my ass on so many occasions. So, what is foam rolling and how can it help? Foam rolling is a form of self-myofascial release that uses laser focused massage to help release tight and sore spots. According to theory, this might help ward off scarring of the connective tissues, known as fascia, between your muscles, preventing all sorts of pain and injury in the process.

Also, foam rolling increases blood flow to your worked-up muscles through applied pressure—vital for speeding up recovery. Therefore, use the foam roller at least a couple of times a week, especially after a hard run or right before if you have any serious symptoms. You can do this right after running, or just before a workout as a part of your dynamic warm-up.

6. Drink Coffee

If you are a fan of coffee, then this is going to be good news. Not only that research shows that caffeine has a positive impact on training and endurance, drinking the stuff can also alleviate post-workout soreness. According to research conducted at the University of Georgia, taking caffeine, a dose that’s roughly the equivalent of two cups of coffee, can help reduce muscle soreness following a hard training session.

Why is that? According to the scientists, coffee can reduce soreness because it blocks adenosine by binding its receptors sites. Wait? What is adenosine? Well, it’s a vital biochemical for energy transfer that’s released by your body, mainly by the central nervous receptors that is heavily involved in pain processing, With that said, drinking a gallon of the stuff won’t make you sore-proof. In fact, research suggests that too much coffee might cause muscle spasms and some serious stomach issues while exercising. So be careful.

7. Use the Ice

Another helpful thing you can do to alleviate post run soreness is to take a cool bath following a hard session.

Why? Well, according to theory, ice therapy can minimize the inflammation response. What is the inflammation response you might ask? In essence, that’s your body’s natural attempt to heal itself after an injury, fight off infections and repair damaged tissue. But it also works like a cast, typically causing the affected area to swell and become stiff, immobilizing it until it fully heals. As a result, take the time to sit in a cold tub for 15 to 20 minute after a hard workout. If a cold shower is not an option, then place an ice pack on troubled and hot areas that feel strained or overworked.

8. Use Topical Ointments

If all proves futile, then you might consider using a topical ointment to alleviate the pain.

How do they work? These ointments contain an ingredient that is numbing and cooling to the muscles. And they work by inducing a cooling and pain-relieving sensation, boosting blood flow, and improving circulation. Therefore, feel free to run these ointments into your typical sore and troubled spots after and up to a couple of days after a hard run. Or until the soreness wanes.

Some of the best popular remedies you can find in the market or online, include Ben-Gay, Arnica Rub, Tiger Balm, Traumeel, and magnesium oil. Just don’t get me wrong here. Topical ointments are no magical cure… The truth is, these ointments DO NOT eliminate soreness.

9. Don’t Stop

I know -I knooooow…The last thing you’d want to do if you are sore is…more exercise. Just don’t call me crazy yet. There is a method behind this madness. The best thing you can do, according to science, is to keep moving. Of course, running might seem like a bad joke when your leg muscles are in a world of hurt. Nonetheless, research confirms that light activity increases blood flow and speeds up the body’s ability to eliminate the chemicals and toxic waste linked with muscle soreness.

Of course, this does not mean that you should go and repeat the same gut-busting hill workout or long trail run you just did yesterday. That’s a big mistake. And doing so will only spell disaster on your performance and health. Instead, what I mean by active recovery is all about performing light, easy exercise. This will boost blood flow to the sore muscles without putting too much pressure on them. Some of the best examples of active recovery include a long walk, a bike ride, yoga, or even performing a light weight training session.

By   for runnersblueprint.com

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.