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Part 2:  Running Through the Pandemic – Recovery from Injury

 

For the second installation of Running Through the Pandemic, I want to share my personal injury recovery from this year.

 

Tom_pelotonFirst off, injuries are no fun.  As I’ve discussed training, time trials, and social distanced running with you over the past 2 months, I realize that some of you are in the same boat as me = unable to run.

 

In normal times injuries leave us without our beloved “Runners’ High”, often time a lack of focus, sometimes weight gain, and a general ambivalence about our path forward. It feels like this is magnified 10x via our current disruptive work environment, home schooling and overall lack of socialization.

 

I began to experience chronic knee pain in January.  Unfortunately, this we not the typical tight quads and non-firing glutes.  On July 16th, I had a scope of the knee to remove some loose pieces and examination of the trochlea head.

 

Not surprisingly, my surgeon discovered evidence of all the 60,000 miles of running my knees have endured over the last 30 years.

 

My recovery has been slow.  I am near pain free walking but can’t do single leg squats which is one of the markers, my physical therapis Ky set as a prerequisite to running.

 

Frankly, this has left me unfocused in everyday tasks, less productive, generally ambivalent and somewhat rutter-less.

 

Sound familiar?

 

When I walked on at Penn State, my coach - the late, great Harry Groves, made this guarantee to me:  if you train hard – you will improve and eventually get injured.

 

Coach Groves passed in February with a tremendous legacy of instilling strong work ethic in young men and I’m often reminded of the lessons he taught.  He had a way of challenging us with lots of explicit-ridden acronyms such as “GOYFA”, where G = Get, O = Off, Y = Your and I’ll leave the F & A to your imagination.

 

With no running in the past 6 months and probably none until at least next year, I was forced to think of how I would move forward and get off my proverbial seat.  The real impetus for the start of Runcoach was that running has always been more than a sport or exercise for me.  When I’ve been stuck, running is the milieu for a path forward.

 

Almost always injuries are mitigated with physical therapy.  Often times it is not the therapy itself, but the psychosomatic benefits of doing something as opposed to nothing.  So, I continue to be religious with my PT.

 

After years of despising the bike and spin workouts, I’ve found a new, non-inflammatory love of the Peloton.  There’s just something about that leaderboard and those spunky instructors urging me along.  I’d love to follow you on Peloton and join you for a class and my user name is RuncoachTom.

Meanwhile, my former running partner, Lester (yellow lab) continues to need his exercise and at 8 years-old my knee injury is a Blessing for him.  We routinely log 15K steps/day and sometimes stretch to 20K+.

 

The combination of my PT, the Peloton, and walking Lester keeps me moving forward.  In these times, we need to find whatever we can to resiliently keep on.

 

I also am grateful for all the miles I was able to run and those still ahead.  It is funny how much one appreciates something routine after it is gone.

 

For all of you who have been on the sidelines like me either currently or historically, I encourage you to focus on what you can do today, and the potential of what tomorrow may bring.

 

As always, any movement leads to activity which becomes a path forward.

 

Coach Tom’s Top-5 List for Moving Through Injury in the Pandemic

1. Focus on your physical therapy, flexibility and strength work as there are multiple benefits
2. Draw strength from all the great coaches and motivators you’ve had along the way
3. Find a new activity that does not aggravate your injury
4. Be grateful for all the miles you’ve logged to date
5. Remain hopeful for what the future may bring



Written by Jennifer Van Allen
Updated by Hiruni Wijayaratne 

ashley perrott tri mediumOne of the most challenging parts of getting fit is staying healthy and injury free.  Dr. Ashley Perrott  is an Ironman finisher, busy mom, and family medicine physician at Novant Health Salem Family Medicine in Winston-Salem, North Carolina. (See photo, left, of Ashley with her parents and brother). Dr. Perrott is answering some of the most-common questions our users have on staying on track. 

How do you know which aches and pains you can keep exercising through, and which ones should send you running to a doctor?

 

Muscle soreness can be expected for 1-2 days after a more intense workout or more intense week of training.  This soreness should improve daily.  Recovery with rest or light workouts after an intense workout can help muscle soreness and stiffness. Try a light massage or foam rolling. 

Muscle injuries lasts longer than 1-2 days. You may notice the inability to complete a light workout or even regular activity.  Rest will generally help this pain.  Any pain that gets worse with activity should prompt the athlete to reduce speed/intensity to avoid injury.  Muscle pain or weakness that persists despite rest is a reason to see your MD.

Joint or bone pain, swelling, or redness may represent more significant injury.  Certainly a specific episode of injury (rolling ankle, falling, tripping) that causes deformity should prompt an evaluation at the MD in some fashion.  

If your joint pain feels worse with pressure on that joint (expecially if your are just resting and can feel the pain) schedule a doctor appointment immediately. 

Reoccuring pains, these are aches and pains that show up like clock work should be addressed. Shin splits, IT band stiffness, runners knee, achilles tendonitis are all chronic pain that tend to simmer down and flare up as you increase activity. It's critical to address the root cause of these pains, perform corrective exercises, and break the pain cycle for good.


Have a question about staying healthy and injury free? Contact Us. 






If you follow a Runcoach training program, chances are you have seen the term "cross training". 

So what exactly does it mean? 

Cross-training means a type of exercise that you can substitute for running. We include things like cycling, swimming, and strength training in this category. 

The purpose of cross training is to improves your aerobic fitness without the impact of running.  This is why most people consider cross-training to also be an injury prevention tactic during training. Below I will list some of my favorite cross-training exercises. I recommend taking at least one cross training day each week to prevent injuries, allow your body and mind to rejuvenate, & become a well-rounded athlete. 

cartoon-girl-on-elliptical-cross-trainer-vector-12090079_2#1-Elliptical
These are easy to find at any gym. Wipe off the handles before use and get pedaling.  Remember to maintain good posture and not place a lot of stress on your lower back. You should feel nice and tall, while moving the legs and arms in synchronization. 

Workout:
Elliptical 20 - 30 minutes total 
To challenge yourself, add in one minute of hard effort every 5 minutes. 

**Extra challenge: Set the resistance on the machine to a higher number for 30 seconds, pedal hard. Reduce the resistance for 5:00. Repeat. 




b1f9a3a5-f0ea-4ab6-a5f9-b9c8962b2444.__CR0016001200_PT0_SX800_V1___#2-Get in the Pool

The water is a great ally for us runners. If you can find a pool, maximize it for more than just a dip to freshen up. The two best methods to use the pool is to either aqua jog (pool run) or swim.  

Workout:
Aqua jog/ swim 30 - 40 minutes total. When aqua jogging it might be helpful to have a flotation belt. 
To challenge yourself, add in 2 minutes of hard effort every 8 minutes. 

**Extra challenge: Simulate a fartlek in water. After a 5-minute warmup aqua jog, or leisure swim, perform 1 minute hard/ 1 minute easy, 2 minutes hard/ 2 minutes easy in rotation 30 - 40 minutes. The "hard" and "easy" are all effort based. Whatever feels tough and relaxed to you on the given day. 


#3-Full Body Workout

Running is an extremely liner sport. This means we always move in one direction, often neglecting many muscle groups. Those neglected muscles need attention too. Especially your core. 

Workout:
15 – 20 minute full body workout. 
To challenge yourself, add in a 5 - 8lb weight. 

Checkout Coach Tom’s favorite full body workout.


Other Ideas: 
-Jump rope 
-Cross fit
-Pilates/ Yoga class
-Rowing machine
-Spin bike 
-Heavy weight lifting session
-TRX or HIIT Session












High Hamstring Tendinopathy

Written by Dena Evans April 28, 2020
hammie_croppedThis month in Ask the Practitioner, we inquired about high hamstring tendinopathy with Renee Songer, Clinical Director of Agile Physical Therapy. 

Read on to find out more about one of the most common injury problems among runners.


Coach:  What is high hamstring tendinopathy? 

RS: Tendons connect muscle to bone. Tendinopathy is a degenerative condition of the tendon structure. High hamstring tendinopathy is a degeneration of the hamstring tendon at it's insertion near the buttock region.


Coach: What are the primary symptoms of this injury?

RS: Primary symptoms include local pain at the top of the hamstring. Often these injuries can be painful to the touch, painful with stretching and painful with forceful muscle contraction.

While running you may feel the pain as you are pushing off the back foot or as the leg is swinging forward.

A quick test is a Reverse Plank (see picture). Pain or weakness compared to your non-injured leg indicates possible problems with hamstring tendon.

Supine_plank_startSupine_Plank


Coach: What are some tips for addressing these symptoms or preventing their onset?
RS: If you see bruising in the hamstring it is best to get in to see your physical therapist or physician to assess the severity of the damage.

If you feel pain in this area acutely, it is often best to rest and ice for the first 24 hours. If pain allows, gently stretch the area and working on a foam roll or massage can help. Slowly return to activity over the next week avoiding activities that cause pain. If pain persists beyond a week see your physical therapist or physician to assess the problem.

This type of injury can also start with a gradual onset as a localized buttock ache, first noticed after a workout and with sitting on harder surfaces.

To prevent high hamstring tendonopathy make sure your glute muscles are strong through a full range of motion. Often we tend to avoid the last 20 degrees of hip extension (straightening) with exercise but we need it to be strong for running. Bowing, single leg bridge, and single leg curtsy squats are excellent exercises to maintain adequate glute strength for running.

Curtsy Video Version I

Curtsy Video Version II


IT Band Syndrome

Written by Coach Tom McGlynn March 07, 2020
it_bandHow to treat the IT band - 

What is IT Band Syndrome?
The Iliotibial Band, or IT Band, is a dense band of connective tissue that originates in the hip (iliacus), runs down the outside of the leg and inserts just below the knee.  Every time you bend your knee the IT Band crosses over a bony protrusion at the outside of your knee.  If the band becomes tight it starts to snap more aggressively over this bone and it can then get irritated and inflamed.  When this happens you have IT Band Syndrome.

Common signals or symptoms:
- The most common symptom is pain at the outside of the knee.  
- Tightness at the outside of the hip.
- Soreness in the lateral (outside) quad muscle.
- Swelling around the knee

Prevention Tips:
There are a number of things a runner can do to prevent IT Band Syndrome.  
The easiest thing to do is use a foam roller, "the stick" or some other form of self massage.  This is probably the most effective thing you can do to keep the IT Band loose.  There are also various IT Band stretches but many people have a hard time getting into a position where they actually feel an effective IT Band stretch.
Other causes:
  • -Lazy stretching routine 
  • -Pushing too hard -- run too far or for too long
  • -Lack of rest between workouts
  • -Worn-out sneakers
  • -Steep downhill runs
  • -Running only on one side of the road (Roads slope toward the curb, which tilt your hips and IT band)
Treatment:

The most effective treatment is rest.
If your knee is swollen, ice, compress and elevate.
If you can find a pool, you can swim to maintain aerobic conditioning.
Get a massage on your quads, hips, and hamstrings 
Foam roll 2-3 times per day
Perform IT band, glute stretngth exercises


Video demonstrating Hamstring Bridge (also works glutes)
Video demonstrating Single Leg Squat
Video demonstrating Glute Stretch



PlantarLet's talk about Plantar Fasciitis

What is Plantar Fasciitis?

Most often felt in the heel,  over 50% of Americans will experience this pain during their lifetime.
Plantar fasciitis (PF) is a condition caused by drastic or sudden increases in mileage, poor foot structure, and inappropriate running shoes, which can overload the plantar fascia (the connective tissue that runs from your heel to the base of your toes), resulting in heel pain.


Self Identify PF:
- Sharp stab or deep ache in the heel
- Pain on the bottom of the foot in the arch
- Worst in the mornings. First few steps out of bed are excrucating
-  Pain experienced during "push off" while running


Common causes of plantar fasciitis:

PF occurs due to a variety of reasons: overuse of improper, non-supportive shoes, over-training in sports, lack of flexibility, weight gain, too much standing. 


Plantar Fasciitis Treatment:

As with any pain ice and rest is the first step. Fill a bucket of water and add ice to it. Stick your foot in. Another option is to freeze a plastic bottle of water and roll your foot with it.
Other options:
- Use a lacrosse ball or golf ball to massage your foot. Gently roll over the pain spots.
- Use an Arch support
- Update your shoes 

If pain is present for more than three weeks, see a medical professional about the problem. Treatment options such as orthotics, foot taping, cortisone injections, night splints, and anti-inflammatories can help.