Injury Prevention

When Pain Becomes an Injury. What Next?

By Jessica Green

Returning to running after pregnancy is hard . . . even 8 months postpartum. Pregnancy is one of many things that can seriously throw your body out of whack. Don't let life events damage your running career long term. Take control and see someone before it's too late.

If you're reading this, then chances are you enjoy running and you have a long term goal to run for the rest of your life. I share that long term goal with you, but over the last few months I've been wondering why my body feels like a 55 year old body rather than a 35 year old body.  More specifically, I was afraid to try new workout classes or do intense speed workouts for fear that sporadic aches and pains that I've been dealing with since the birth of my second daughter 8 months ago would manifest into full blown injuries.  And then it happened . . . I got injured after throwing caution to the wind and doing an intense stair workout.

After two weeks off from running, I felt new again, but deep down I knew my body wasn't whole. In reality it hasn't been whole since the birth of my first child almost 3 years ago. Despite a marathon PR 14 months after her birth, I've felt muscular imbalances and weaknesses since her arrival that didn't exist pre-pregnancy.  As time progressed, I began to wonder how these would effect me down the road. Unless I did something to address them, they would only get worse. I started worrying about how I will feel by the time I really am 55 and beyond? The answer wasn't pretty. 

The recent injury coupled with the same on again/off again aches and pains since my first childbirth led me to seek out a physical therapist this month who is as committed as I am to helping me fit the puzzle pieces of my body back together. To an outsider, I don't appear injured. I'm able to comfortably power up huge hills on the trails, complete interval workouts and enjoy long runs on the weekends. Dig a little deeper though and you will find major deficits in some areas of my legs and glutes as a result of compensation and lack of strength. As long as I don't do anything, the chances of more serious injuries and discomfort only increase down the road - and my body will feel older than it should!

The takeaway, if you find yourself with nagging aches and pains that don't necessarily stop you in your tracks, but do prevent you from engaging in certain activities or feeling 100%, then take some time to fix them! This doesn't mean you have to stop running. For me, this means making a plan with my physical therapist. I see her once a week - It's basically the same commitment as a weekly workout class.  I have had tremendous success with my physical therapists in the past for both rehabilitative work and preventative work. Good ones are worth every penny.

Don't have a physical therapist? Not all PT's are created equal. Ask around for recommendations and find one that you connect with. If you don't like the first one you go to, keep trying. You're not locked in. It took me a couple tries to find a new one after moving to Portland, OR from NYC and leaving my favorite PT behind. Yes, I miss you Erica Meloe!

I'm not necessarily thankful for my injury, but I am thankful that it inspired me to take control of my body and reminded me that the more I "enable" my imbalances and weaknesses the more I throw off my game and limit myself in the future. I'm also thankful for these two little rugrats despite the chaos they imparted on my body!

My new long term goal? To feel 35 when I'm 55, not the other way around!

 

 

The One Move Runners Need

by Meghan Reynolds

Ok, you might need more but this one move is great because it works so many muscles - your hips, glutes, hamstrings and core, with the added bonus of working your chest muscles. I like this move because it works multiple areas and is efficient.

Super Bridge Press

Begin laying on your back with a pair of 5-8 lb dumbbells in hands. Put both feet on a Bosu ball (or, use sofa cushions or stair step) and get in a bridge position. Keep your knees at 90 degrees, glutes engaged and shoulders on the ground. Lift your right leg straight up in the air as you perform a chest press. Keep you right leg straight up as you simultaneously do a bridge lift and a chest press (lift hips and straighten arms together, then lower). Repeat for 20 reps and switch sides.

 Start Position

Start Position

 Lift your hips and arms together

Lift your hips and arms together

I've been doing this move for the past week - 2 sets of 20 reps every other day and my hips and hamstrings are not as achy when I run. Do these first thing in the morning. I'll be sharing new moves every week - follow us on social media to see our recommended strength moves for runners.

Returning to the Trails After Pregnancy

By Jessica Green

It seems crazy to think back to this time last year - I had just given birth to my daughter and was in major recovery mode. At that time, all I could dream about was getting back on the trails in Forest Park, but I knew there was specific work to do before I laced up my running shoes and hit the trails hard. I knew this mainly because I am lucky enough to work with fitness professionals and therapists who taught me how to return to running the right way postpartum.

With targeted strength work, expert advice and a lot of patience, I'm running stronger and faster than I have in years. This week alone I hit the flat trails for speed, the hilly trails for a mid-distance run and am looking forward to a 20-miler this weekend which will include plenty of undulating trails. In the last month, I finally feel like I beat pregnancy!

A dear friend and amazing Pilates instructor, Frances  Darnell, once told me that it usually takes her clients about a year of hard work to feel comletely like themselves again after pregnancy. She was right in my case. She also had a lot more to say in the article that I wrote in this month's Trail Runner Magazine, "Hitting the Trails After Pregnancy." 

To all moms and moms to be, I highly recommend taking a look at the advice Frances and others offer in this article as you begin thinking about starting to run again after your pregancy. Here's a glimpse at the article if you don't have access to the magazine:

 

 

An Apple a Day . . .

By Jessica Green

"An apple a day keeps the doctor away." The same can be said for a strength move a day for runners. Each week I preach about getting out there and doing your strength work and for the last two months I've been listening. It's made a difference. My lower back no longer aches from time to time and my hamstring doesn't feel as tight. I attribute a large part of this to my commitment to some type of strength work almost every day of the week. 

What does this look like? In our training plans we often provide suggested strength routines for both core and lower body. These routines typically take 10-15 minutes to complete. That kind of time can be difficult to carve out of our busy lives day in and day out. What's important though is trying to - or at least remembering to think about strength training on a regular basis.  For myself, this means getting down on the ground and actually doing something on a daily basis. On some days, it's only one series of planks/side planks/planks, but on other days it turns into a full blown 20-minute routine. Sometimes I'm in my pj's and other times a sports bra. No matter what it feels great to know that I've done something. The biggest benefit - I stuck to my routine and didn't let another day pass without some sort of strength.

Imagine going a week or even two without running . . . not good, right? Well, the same should be felt for two weeks of no strength.  If you're looking for one move to get you through tonight, start with bridges with knee folds.  They are great for pelvis stability, glute and hamstring strength and help prevent IT band issues. 

Lie on your back with your hands at your sides and bend your legs to bring your feet flat on the ground and about a hands length away from your buttocks. Raise your hips by firing your glutes and driving your heels into the ground. Lift up until you create a straight line from your hips to the knees. Maintain this position by firing the glutes and not flexing the lumbar spine.

Once in bridge position, alternate bringing each knee up towards your chest keeping the leg bent at a 90 degree angle. As you raise and lower each leg, keep the pelvis steady and avoid rocking back and forth. Press your arms down into the ground with your palms facing down to help keep you stable. Continue alternating knee folds for 30-60 seconds. Repeat 2x.

Recovery tip - foam roll

Stretching and foam rolling are important post run activities that will help keep you running and prevent injuries.

Here's how to foam roll your quads, IT band and hamstrings:

Start in a forearm plank position and position the foam roller towards the top of your quad underneath your hip. You want to let the quad sink into the foam roller and then roll down one inch. Stop and rock left to right, then roll down one more inch and again rock left to right. Repeat this pattern all the way down to just above your kneecap.

Next, roll out your IT band. Again, start up by the hip, roll down an inch and then rock left to right. Repeat that action all the way down the outside of your leg until you are just above the kneecap.

Next, move onto your hamstrings, the muscles on the back of your leg. You want to sit so that the foam roller is directly underneath your gluteal muscles and then move the foam roller down an inch and rock left to right. Do this all the way to just above the knee crease.

Keep your legs fresh and happy as you ramp up the miles this spring. Watch the video on how to do this type of foam rolling technique: http://www.livestrong.com/video/1009743-rolling-out-thighs-prevent-lactic-buildup/

Strength Workout of the Week: Shin Splint Prevention

It seems like shin splints are in the air the last few weeks.  Perhaps it's because as the weather gets nicer people are ramping up their running.  There are a few, very simple strength exercises you can do to prevent the onset of this nagging injury often caused by overtraining, ramping up your mileage too soon, or an imbalance in strength between the shin and the calf. These exercises include the following (do them every day if you can):

1) Toe/Heel Walking: Walk the length of the room on the toes and then heels with the feet and knees pointed straight ahead of you. Then externally rotate the legs 45 degrees and walk the length of the room on your toes and then heels. Finally, internally rotate your legs 45 degrees and walk the length of the room on your toes and then heels. Walk slowly, emphasizing balance. Make sure knees are tracking the same direction as the toes.

2) Calf Raises: Stand on one foot, with other leg bent and standing knee slight bent to prevent locking. Slowly raise up on the ball of foot as high as possible and slowly return to the floor, emphasizing balance. Repeat for 2 sets of 10 repetitions on each side. Use a wall or railing for balance.

3) Toe Taps while Seated: In a sitting position lower and raise the left foot with the heel on the ground as high and as quickly as possible for 60 seconds. Repeat on the right side. Start by doing this on each side once and build up to 2-3 times on each side.

4) Side-to-side Weight Shift on Toes: Stand on toes and ball of the feet, shift weight from the inside of the feet, near the big toe, to the outside of the feet, near the small toe. Rock from the inside to the outside of the feet slowly and under control, emphasizing balance (that is one repetition). Repeat for 2 sets of 20 repetitions.

If you are prone to shin splints, warm up with 5 minutes of walking and then do this routine before every run - it WILL make a difference. 

 * If you are currently suffering from shin splints, stop running for a few days to a week, ice the front of your shins and avoid hills once you return to running (pain free). Do not try to run through shin splints. This will only make them worse.  

Move of the Week - Bicycle Crunches

As running coaches who promote long term, injury-free running, strength work is always a part of our recommended weekly routine for every runner out there. Incorporating strength doesn't come naturally to a lot of runners and often feels overwhelming. So, where to start? Start with just one move a week and build from there. Hot Bird Running has you covered with our Strength Move of the Week!

Move of the Week: Bicycle Crunches
Why we love these? Get back to the basics - nothing fancy - with bicycle crunches. This simple move stengthens the oblique muscles necessary in maintaining a stable upright position during your runs. As you do these make sure your lower back stays pressed to the ground.  Start out slowly going through a bicycle pedal motion altnerately touching your elbows to the opposite knee as you twist back and forth.  Concentrate on control, not speed.  Perform for 30-60 seconds. Repeat 2-3 times.  

 

Strength Move of the Week - Walkouts

As running coaches who promote long term, injury-free running, strength work is always a part of our recommended weekly routine for every runner out there. Incorporating strength doesn't come naturally to a lot of runners and often feels overwhelming. So, where to start? Start with just one move a week and build from there. Hot Bird Running has you covered with our Strength Move of the Week!

Move of the Week: Walkouts
Why we love these? Walkouts stengthen hamstrings, shoulders, abdominals, lower back and promote hip stablity in runners. Strong shoulders, core and stable hips are all things every runner needs to ward off injury and improve speed! As you do these focus on keeping your hips stable and using your core to push yourself back to the start position - NO rocking back and forth! If you have trouble get back to standing without rocking, don't go down and far. Also, if you can't touch the ground without bending your knees, then bend your knees at the beginning to get your hands to the ground and then straighten them as you walk your hands out.

 

Strength Move of the Week - Single Leg Deadlifts

As running coaches who promote long term, injury-free running, strength work is always a part of our recommended weekly routine for every runner out there. Incorporating strength doesn't come naturally to a lot of runners and often feels overwhelming. So, where to start? Start with just one move a week and build from there. Hot Bird Running has you covered with our strength move of the week!

Move of the Week: Single Leg Deadlifts
Why we love these? This movement strengthens your hips, engages your hamstrings and gets the glutes firing - all of which are needed for stabilizing the body while running. Plus, balancing on one leg reduces the strength imbalance between your left and right sides. Bonus - this also feels like a great stretch at the end of your runs.

 

Repeat 8-15 times on one side. Switch legs and repeat.  

Interview with a Physical Therapist

Erica Meloe is a physical therapist and the co-founder and Director of Velocity Physiotherapy in New York CIty. She is an innovative physical therapist who combines her knowledge of orthopedic and neurological assessment and applies this model to treating pain in all areas of the body. She calls herself the "non-traditional", "traditional" physical therapist and gets results when others therapists do not. Erica believes in treating the whole patient, not just the body part in question.

Why do you like working with runners?
I really enjoy working with runners because they are a highly motivated group of individuals. They understand what needs to get done to put themselves back into the "game". I would say that the more experienced the runner is, the level of understanding with regards to rest and cross training is higher and more of a priority. However, no matter what level of running, their passion for the sport is incredible! Runners are a focussed group and "in touch" with how they feel when they run. It's this body sense, that makes them interesting and fun to work with!

If you could tell a runner one piece of advice, what would it be?
Prevention. Do not always wait to seek out a physical therapist until you are in pain. Engage a physical therapist ahead of time for a preventative musculoskeletal screen to determine if there exists any dysfunction in your body that may predispose you to an injury. Poor running mechanics in addition to ineffectual training methods can pose a significant injury risk. A physical therapist can formulate an individualized program that can address these dysfunctions and make your running a much more pleasurable activity. Furthermore, they can introduce you to some alternative techniques such as focussed breathing when you run that will also help make your running more efficient. Depending on the state you live in, you can access a physical therapist without a doctor's referral for a limited period of time.

What is your go-to fitness activity and why? 
I enjoy running, Ashtanga Yoga, hiking and tennis because the majority of those activities get me outdoors. I love being outside! But if I can't do that, I will get on the elliptical.

What is your favorite post workout meal?
I don't have a specific meal after a workout, but I do drink lots of water. The only thing I would recommend is to keep it light.

Base Training - Muscle Stability

A major part of staying injury free and hitting your target or goal race times is muscle stability. Your muscles need to work together, harmoniously, to properly turn over and keep you going for 20+ miles. Thus, you need strong, stable muscles and not just in your legs. We are talking core and upper body as well. A strong core will help you pick up your knees, which translates into faster times (think turnover, how many times your feet hit the ground) and a strong upper body will help keep you upright and keep those arms pumping.

Below we highlight a few exercises that we recommend to stabilize your muscles and prepare for more strength work and longer miles.  Do 30-60 seconds of each exercise, 2x. Click on each exercise to see a brief video and explanation.

  1. Bridge with Single Leg Raise
  2. Plank - Side Plank Series
  3. Opposite Arm/Leg Extension
  4. Single Leg Deadlift
  5. Single Leg Calf Raise
  6. Squat to Leg Extension
  7. Donkey Kicks
  8. Glute Press Up

How to Foam Roll your Quads

We love using our Trigger Point Grid foam roller after a long run to loosen up our quads and reduce soreness. Use your body weight to add more pressure or get a little arm workout in and hold yourself up to reduce the pressure on the roller.

Start at your hips, where the quads attach. Roll down 1-2 inches and then slowly move your body and leg left to right. Roll down another inch and repeat. Stop just below the knee cap (about 1 inch above). Rocking the body from left to right helps break up any knots that form while exercising.

Foam rolling helps lengthen your muscles and restore them. Foam rolling is safe for a pre-workout as well if you are tight.

 

How to Foam Roll Your IT Band

Do you have knee pain when you run? The iliotibial band, commonly known as the IT Band, is a tendonous and fascial band that originates on the hipbone, travels down the outside of the leg and attaches to the top of the lower leg bone (the tibia). Fascia is a connective tissue that surrounds muscles, bones, and joints, and provides support and protection. Think of fascia as shrink-wrap for your muscles! Once the shrink-wrap becomes tight, it tends to stay tight.

This tightness causes pain in the hip and knee area for runners. Usually, poor biomechanics or muscle imbalances contribute to IT pain. When the IT band shortens, the fascial band pulls the knee cap out of alignment, leading to inflammation in the joint and pain when bending the knee. This injury, known as IT band syndrome or runner's knee, is more common in women than men, most likely due to the wider female pelvis.

The good news? There are lots of ways to lessen IT band syndrome and ward off future problems: regular stretching, foam rolling (or self myofacial release), massage and icing. Massage promotes blood flow to the affected area and helps to minimize scar tissue formation. Treat yourself to a professional massage every once and while, but you can also do it yourself with a foam roller or massage stick anytime.

To help avoid knee pain and IT band injury, keep this thick band of fascia flexible, especially when you increase intensity and/or weekly mileage. Below is one of our favorite at-home ways to keep our IT bands healthy. We recommend that also you foam roll other major muscles groups invovled in running (we will highlight them throughout the month).

How to foam roll your IT Band:

Instructions: Lie on your side with the foam roller perpendicular to your body and below your hip. Bring the top leg in front of you and use it as leverage. Place your hands on the other side of the foam roller. Slowly begin to roll the foam roller down your leg, stopping just above the knee cap. As the roller moves down your leg, stop every 1-2 inches and rock your hips forward and backwards over the foam roller to release tension. Be gentle and breathe!

Shin Splint Prevention

Shin splints are unfortunately a common injury for new runners. It occurs when athletes run too much after a period of not running or if there are imbalances in the body. There are ways to prevent shin splints from occuring as you begin to ramp up your running. We've created a Shin Splint Prevention series that will help strengthen your muscles and keep you running longer and farther!

Perfrom this routine 2-3 times a week at the beginning of your workout for prevention. 

Happy Running!
-The Hot Birds