Injury Prevention

Shin Splints

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What is Shin Splints?

It is inflammation of the muscle attachments and interosseous membranes of the tibia (shin bone) on the front of the lower leg. The symptoms you experience is soreness along the inside of the shin, pain at the beginning of the run, gets better during the run, sore afterwards.

Causes?

There are several things that can cause shin splints. The following would/could contribute to the injury:

  1. Overtraining
  2. Overpronation of the feet
  3. Weak Tibialis Anterior (front of shin)
  4. Old shoes
  5. Running on concrete/asphalt
  6. Tight Achilles tendon

Treatment

In order to combat the pain and train properly, treating the cause of the problem is important. Ou may have to try multiple modalities until you find the culprit!

  1. Strengthening exercises for anterior lower leg muscles (see Exercises Below)
  2. Footwear to correct overpronation, better shock absorption
  3. Run on softer surfaces,
  4. An anti-inflammatory, ice
  5. Stretching of the calf muscle and Achilles Tendon

Exercises to Strengthen Those Muscles

Do these 3 sets, light weight or resistance band, for 12-15reps only; 2-3 times a week

OR

You can walk on your heels around the house for 1 minute at a time 2-3 times a week as well to strengthen the anterior tibialis muscle

Injury Prevention

RUNNING INJURIES: The Big 5

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There have been several times in the past few years (not in my 20s) that running injuries have slowed my training. I have always been on top of my shoe wear but other things can cause injury. All of the “big 5” most common running injuries are overuse injuries. The most common running injuries we see is typically the following: Achilles Tendonitis, Plantar Fasciitis, Iliotibial Band Syndrome, Shin Splints, and Patellofemoral Pain Syndrome

They can be prevented through the following:

  • Ease into increasing- Don’t increase your weekly mileage by more than 10% a week. This allows the body to adapt to new training levels.
  • Allow for rest- Your body needs time to recover. This rest phase is actually when our muscles get stronger. Not allowing for enough rest leads to continual muscle breakdown.
  • Softer is better! If you are preparing for a 5K or other race there is no substitute for outdoor running. However, constantly pounding on concrete leads to
  • increased stress on the muscles and joints and compounds the risk for chronic tissue trauma. The more you can run on the asphalt (5 times softer than
  • concrete), packed dirt, or gravel, the better. Also, throwing in a couple of treadmill runs or track workouts a week is a nice way to give your body a break from the impact.
  • Running too much uphill or downhill can lead to various overuse strains such as Achilles tendonitis (uphill) or extra stress in the knees (downhill). If you add a hill workout to your schedule make sure you ease into it and stretch your calves really well afterwards. On the week you add hills DO NOT also add mileage. In the same vein, if you add a speed workout do not also increase mileage. Make sure you are comfortably sustaining 15 miles a week before adding any “quality” workout.
  • Shoes make the runner- Have a professional do a gait analysis to make sure you are getting the right amount of support and fit for your foot type. Running shoes last between 350-450 miles depending on running style, weight, and the surfaces on which you run.

Exercise

Breathing 101: Running and Beyond

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I have recently started to train for my StrongFirst Kettlebell Certification with an instructor and I hear her constantly tell me about my “biomechanical breathing” with each exercise. I have been teaching runners for several years, all distances, and one of the early on lectures I give to them is “find a beat with your feet when you run, using your breathing pattern.” I am sure that all my students recall this lecture and running class. The basic premise of breathing should feel like the following:

  • Always Exhale on Exertion
  • Always Inhale on Relaxation

During exercise, two of the important organs of the body come into action: the heart and the lungs. The lungs bring oxygen into the body, to provide energy, and remove carbon dioxide, the waste product created when you produce energy. The heart pumps the oxygen to the muscles that are doing the exercise. When you exercise and your muscles work harder, your body uses more oxygen and produces more carbon dioxide. To offset this extra demand, your breathing has to increase from about 15 times a minute (12 liters of air) when you are resting, up to about 40–60 times a minute (100 liters of air) during exercise. Your circulation will speed up to take the oxygen to the muscles so that they can keep moving. The diaphragm is a dome-shaped muscle beneath the lungs. When you inhale, it flattens and moves downward, pressing against the abdominal organs so the lungs can expand. This gives you the best “bang for your breath” and it is called, diaphragmatic breathing. If you were to place one hand on your stomach and another on your chest. The majority of the breathing motion should be felt near the stomach, not the upper chest, during everyday life and especially during exercise.

Breathing When You Run

I teach a very simple way to find what is comfortable for you, but reminding yourself to breath. When you begin running, many times you can hear your feet make a beat (ie: Stomp, Stomp, or Stomp-Shuffle, Stomp, etc,) and then once you hear what your feet sound like when you are starting out, match your breathing pattern to that beat with your feet. For example, I do the following, right leg land-breath out shallow, left leg land – breath out shallow, right leg land – long breath in, left leg land – still breathing in….sounds complicated perhaps, but I take one breath for every two foot strikes, which is called 2:2 rhythm.

  • Synchronizing the breath to running cadence will keep the organs from putting unnecessary pressure on the diaphragm, which can impede breathing

Nose or Mouth?

There are studies that support both but what you should really do is teste it out and see what works best for you. Some people have small nasal passages, with enlarged turbinates within the nasal passage, making it difficult to breathe through the nose only. Other people have no issues breathing through the nose, so they can keep their mouth closed. My preference is to breath in my nose and out my mouth. Just make sure you are breathing out on exertion and in on relaxation.

              Quick Points

  • Breathing in through the nose can also help warm the air entering the lungs
  • If cold weather and you can’t breathe well through your nose, stick the tip of your tongue to the top of your palate and allow the air to move around the tongue to help humidify the air and reduce the ‘burn in your lungs”
  • Just BREATHE 😊
Exercise

Foam Rolling Basics

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What is a Foam Roller/Rolling?

A foam roller is cylindrical in shape, and available in various sizes and densities (ie. medium, firm), the roller is positioned between the ground and the muscles to be treated. The idea is that you literally roll the muscles over the foam-roller at an even tempo, back and forth, and work on any tightness – at your own pace and in your own time. Foam-rolling is often referred to as a form of ‘self-myofascial release therapy’. Fascia, or myofascia, is the dense, tough tissue that surrounds and covers all of your muscles and bones. Foam-rolling is a form of self-manual therapy which aims to reduce myofascial tightness.

What are the Benefits of Foam Rolling?

Foam Rolling is used by many for the following reasons that have been shown in research (keep in mind a PubMed search with leaner criteria than normal for me only gave me 40 papers, then from those I picked out about 11 to create this post)

  • Increased flexibility, including increased range-of-motion (ROM)1-4
  • Improved short-term athletic performance, when included as part of the warm-up routine5-8
  • Improved recovery post-activity, through reducing the experience of delayed-onset-of-muscular-soreness (DOMS)8-10

What is the Optimal Protocol to Maintain the Benefits?

After reviewing the current body of research, the following protocol is suggested for potentially optimal results:

  • 3-5 sets of 20-30 second repetitions
  • 3-5 times per week, performed on a consistent basis, to achieve and retain the long-term effects on flexibility.

I prefer a little less time, which is the suggestion on the video I posted with 3-5 sec, counting “1-Missippi, 2-Missippo, etc” for 5-10 repetitions just because that seems to work for me best.

Risks to Foam Rolling

              I would be doing you in justice if I did not mention the risks of foam rolling. With that said, here are the following basics to make sure you are aware of since foam rollers are intended to be used over muscles only:

  • You should never roll over a bony joint. Applying pressure here could result in hyper-extension of your joints. It’s good to get close to the attachment of the joints, but best not to go over them.
  • Avoid rolling your lower back, as it can create too much pressure on your vertebra, causing the muscles here to stiffen up to protect your lower back.
  • Don’t roll for too long. You don’t want to cause further inflammation by over doing the rolling. Follow the above-mentioned program for best results.

IT Band and the Foam Roller

IT Band, or iliotibial band, is a thick tendon that runs along the outside of the thigh from the hip to the knee. Your glutes and tensor fascia latte (TFL), connect to the IT Band, and together help to move the hip and stabilize the knee. Studies have shown so far that it probably can’t be permanently deformed.  While it may be stretched in the short term this is due to its viscoelastic properties, the IT Band cannot actually permanently be lengthened with stretching.  Actual lengthening would require you to damage your IT Band to get it into a lengthened state (ie: surgical lengthening). Studies have shown 5 minutes on a foam roller or 10 minutes of daily stretching would not be able to permanent lengthening.11  The best idea is to foam roll the muscles that surround the IT band, particularly the quads, hamstrings and glutes. The IT band may be forced to compensate and pick up the slack if these muscles aren’t functioning properly. The result is an overworked and inflamed IT band—one that’s more likely to cause problems. Foam rolling the areas around the IT band helps the muscles and tendons. Studies show that you can roll of the IT Band but not for long, consider on 5-8sec, 1-3 reps, on each side only, and AFTER rolling the glutes, quads, and TFL areas.

Best Type of Foam Roller

              I do not support any 1 particular product brand (unless a brand wants to show me otherwise) but make sure of the following:

  • Foam rollers with a smaller diameter are also helpful for elderly patients who need to be closer to the ground for stability.
  • Half-round foam rollers are a good choice for an elderly person or someone with little strength or muscle tone
  • Select a 12-inch (30 cm) round roller if you intend to transport your roller often (I have a 12inch and a 36 inch- which you saw in the video)
  • A lower density foam roller is great for beginners (usually the white foam rollers)
  • A foam roller with a dimpled surface will give a deeper massage to trigger points in the muscles. This type of roller is great for parts of the body that are prone to muscle tightness, like the back and shoulders. FYI – Can be painful and he 3-5sec rule may be best to follow at first, like I teach on my videos

Precaution and Learning

              If you are not sure how to start, which roller to start with, or simply want help at first, then consult with a healthcare provider to help you in the beginning! There is nothing wrong with asking first and then trying it out. I ask all the time how to do something properly if I don’t know how to do or use something.

References:

  1. Jay, K., Sundstrup, E., Søndergaard, S. D., Behm, D., Brandt, M., Særvoll, C. A., & Andersen, L. L. (2014). Specific and cross over effects of massage for muscle soreness: randomized controlled trial. International journal of sports physical therapy, 9(1), 82-91.
  2. Cheatham SW, Kolber MJ, Cain M, Lee M. The effects of self-myofascial release using a foam roller or roller massager on joint range of motion, muscle recovery, and performance: a systematic review. Int J Sports Phys Ther. 2015 Nov;10(6):827-38.
  3. Halperin, I., Aboodarda, S. J., Button, D. C., Andersen, L. L., & Behm, D. G. (2014). Roller massager improves range of motion of plantar flexor muscles without subsequent decreases in force parameters. International journal of sports physical therapy, 9(1), 92.
  4. MacDonald, G. Z., Penney, M. D., Mullaley, M. E., Cuconato, A. L., Drake, C. D., Behm, D. G., & Button, D. C. (2013). An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force. The Journal of Strength & Conditioning Research, 27(3), 812-821.
  5. Cramer JT, Housh TJ, Weir JP, Johnson GO, Coburn JW, Beck TW (2005). The acute effects of static stretching on peak torque, mean power output, electromyography, and mechanomyography. Eur J Appl Physiol.;93(5- 6):530–9.
  6. Cramer JT, Housh TJ, Coburn JW, Beck TW, Johnson GO (2006). Acute effects of static stretching on maximal eccentric torque production in women. J Strength Cond Res.;20(2):354–8.
  7. Behm DG, Bambury A, Cahill F, Power K (2004). Effect of acute static stretching on force, balance, reaction time, and movement time. Med Sci Sports Exerc. Aug; 36(8):1397–402.
  8. Healey, K. C., Hatfield, D. L., Blanpied, P., Dorfman, L. R., & Riebe, D. (2014). The effects of myofascial release with foam rolling on performance. The Journal of Strength & Conditioning Research, 28(1), 61-68.
  9. Peacock CA, Krein DD, Silver TA, Sanders GJ, VON Carlowitz KA (2014). An Acute Bout of Self-Myofascial Release in the Form of Foam Rolling Improves Performance Testing. Int J Exerc Sci.,1;7(3):202-211.
  10. Pearcey, G.E., Bradbury-Squires, D.J., Kawamoto, J.E., Drinkwater, E.J., Behm, D.G., and Button, D.C. (2015). Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. Journal of Athletic Training, 50(1): 5-15.
  11. Hall M, Chadwick Smith J. THE EFFECTS OF AN ACUTE BOUT OF FOAM ROLLING ON HIP RANGE OF MOTION ON DIFFERENT TISSUES. Int J Sports Phys Ther. 2018;13(4):652-660.
Exercise

The Art of Indoor Cycling

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There is more to indoor cycling than just jumping on the bike and pedaling. It is a fantastic workout! I can take a class through a great leg workout, which includes those glutes, as well as a cardio workout. However, there are several things to consider prior to just jumping on the bike!

Posture and Proper Set-up Prior to Starting a Ride

Align your upper body properly to start with on the bike. Your spine should be straight, not rounded or slumped (make sure your handlebars are high enough so you don’t feel neck or back strain). Your shoulders should be relaxed and down (meaning: they should not be at your ears). Keep a slight bend in your elbows as you ride and keep your elbows in line with your wrists and your knees (no chicken-winging allowed). If you are good at angles, then aim for about 15 degrees of elbow bend. Try not to bend your wrists too much, to avoid placing unnecessary strain on them, and don’t grip the handlebars too tightly.

The placement of your bottom should be proper as well. This will help that soreness you may experience at the first couple of classes. Place your butt on the widest part of the saddle. Hinge forward at the hips and engage your abdominal muscles as you reach for the handlebars. Your knees should be aligned with your hips and your feet, whether you’re riding in a seated or in a standing position; if they flare out to the side, your seat position may need to be adjusted. If your butt is uncomfortable or sore after your workout, your positioning may be incorrect. Ask your instructor for some assistance before class if you are having issues. If you feel pain in the back of your knee, then you may need to lower the seat. If you feel pain the front of your knee, then consider raising the seat. The knee should have a 5-degree bend when the leg is fully extended down.

During Your Ride

Keep your weight on the pedals. That means stabilizing your weight in your hips so that your knees stay over the center of the pedals. Don’t lean on the handlebars when you’re seated or standing; off-loading your weight this way cheats you of some of the benefits you’d get from maintaining an upright posture and it places excessive stress on the wrists and forearms. (When you’re in a standing position, you should feel the nose of the saddle brushing against the back of your upper thighs.) Also, avoid using hand position three while riding in the saddle—a taboo move! If your instructor does it, then let them, but I wouldn’t do it!

Keep your feet flat. It’s a mistake to point your toes as you pedal because this engages the wrong muscles. Instead, press through each pedal stroke with a flat foot, driving from the ball of your foot, to reduce pressure on your knees and strain on your quads. Similarly, pull up from your knees and toes on the upstroke. This will engage the hamstrings and glutes for a nice leg workout. It is more efficient way to use your muscles too.

Hold your head up. If you let your head flop or fall forward as you ride, you’ll set yourself up for neck strain—and partially impair the flow of blood and oxygen to your head, which can cause lightheadedness or dizziness. Keeping your head in line with your neck and spine helps ensure proper breathing and a steady flow of oxygen to your brain, which can help you feel good and maximize your performance. An indoor cycling class is hard enough without increasing your chances of feeling winded unnecessarily.  And I can’t stress enough – lose grip on the handle bars…..of you are sore in the forearms, upper body the next day, chances are you gripped the handle bars too tight.

After You Ride

Make sure to keep spinning the legs for 1-2 minutes to slow down the heart rate properly. If you wear biking shoes, be sure to unclip them while standing, so you don’t put unnecessary pressure on your hips and knees. Then take 4-6 minutes (I make my class do a full song) to stretch the upper and lower body. Give your major muscle groups a good stretch after class.