USI Human Performance Lab: Fitness Assessments

USI is now offering fitness assessments for runners/cyclists that are looking to make some positive changes in their training! See below for offerings and prices. (Click on pictures to enlarge)

Does a minimalist shoe decrease impact forces?

Below is an article published in Runner's World. There has been a lot of recent talk about how minimalist shoes decrease ground reaction forces, but a recent study looking at the Nike Pegasus vs Nike Free, found the opposite.

Study: Impact Forces Greater in Nike Free than in Pegasus

Researchers surprised by their findings.

By

Scott Douglas

Published

July 26, 2013

One of the main criticisms of conventional running shoes raised over the last few years has been that they encourage "hard" landings that increase the impact forces of running, especially on initial contact with the ground.Minimalist shoes, some advocates say, can help reduce impact forces, in part by encouraging a "softer" foot strike and more of a midfoot landing.

A new study by two well-known researchers suggests that, as is often the case in matters of shoes, form, and injury, things aren't that simple.

Richard Willy, Ph.D., of Ohio University, and Irene Davis, Ph.D., of Harvard Medical School, had 14 men run on a treadmill for 10 minutes at a time, at 8:00/mile pace. The men were all rearfoot strikers who were accustomed only to conventional running shoes.

For one of the 10-minute runs, the men wore the Nike Pegasus, which the researchers classified as a standard running shoe. On another 10-minute run, the men wore the Nike Free 3.0, which the researchers classified as a minimalist running shoe. According to the researchers' measurements, the Pegasus' heel height was 36.3 millimeters, compared to 17.6 millimeters for the Free. On the basis of compression tests, the Pegasus provided 31% more cushioning, the researchers said.

While the men ran, Willy and Davis recorded impact forces, stride length and other biomechanical data. They took measurements at the 1-minute mark of the run, and again at the 10-minute mark, to see if impact forces, joint angles, etc. changed during the short run.

The results were the opposite of what Willy and Davis had expected. As they wrote, when in the Free "runners struck the ground with a more dorsiflexed foot [toes pointing toward the shin, meaning more of a heel strike], in more knee flexion, and with higher vertical impact peak and higher average vertical loading rate."

These differences remained consistent throughout the run. That is, as the men--who, again, weren't used to running in a shoe like the Free--continued to run in the Free, they didn't adjust their form to compensate for being in the Free. Their stride length and stride rate remained comparable to when they ran in the Pegasus, and their impact forces remained greater than in the Pegasus.

"Absolutely," Willy wrote in an email when asked by Runner's World Newswireif his findings surprised him.

"We expected that impacts would initially be higher in the minimalist shoe than the standard shoe in the first minute of running. After 10 minutes of running, we expected the reduced cushioning of the minimalist shoe would cause heel discomfort, resulting in a less inclined foot at foot strike, perhaps even a midfoot strike pattern. We then expected a likewise reduction in impact forces. Obviously, our results were completely counter to what we hypothesized."

Willy said that he and Davis used the Free instead of a more barefoot-style shoe, such as the Vibram Fivefingers, because of the popularity of the Free and its positioning as a transitional shoe for runners looking to switch from conventional trainers to barefoot-style running.

"These shoes are widely marketed to the general running public to closely mimic a barefoot running experience to gain many of the benefits of barefoot running, i.e., reduced impact forces, without the increased risk of foot injury due to road debris," Willy wrote. "Due to the popularity of this shoe type and industry claims, we felt that it would be an interesting study.

"Another major reason why we wanted to study this type of shoe is that clinicians often prescribe this type of shoe to patients who are recovering from an impact-related injury to encourage a reduction in impact forces during running. Our findings suggest that this practice may not be advisable, at least in the short term."

It's important to keep in mind that the runners in this study were unused to minimalist shoes. It's possible that, over time, they might have altered their form in the Frees to lessen the increased impact forces Willy and Davis measured.

To Willy, that fact provides another important take-away from his research.

"Our subjects were novel minimalist shoe runners and they did not receive any instruction on running mechanics," Willy told Newswire. "In order to see a change in running mechanics, a structured training program focusing on changing a component of gait may likely be needed.

"For instance, increasing step rate during running has been shown to reduce ground reaction forces," Willy wrote. "Therefore, runners who wish to transition to minimalism should consider that a thoughtful and directed gait retraining program may be necessary to mimic barefoot running, regardless of the shoe worn."

Toe Touch Progression

Can you touch your toes? Most people would say no, even seasoned athletes. Tight hamstrings? Probably not the sole culprit. Muscle tone and your body's misuse of stability? Sounds more likely. Give your body credit though, it's pretty good at taking the easy way out and choosing the simpler option. If your core lacks the ability to stabilize your pelvis, the hamstrings take over and create it. This might make your hamstrings feel "tight" but in actuality, they are working non-stop and always "on" so to speak. Try this exercise demonstrated by Paul Gorman from The Tank Gym. If you are able to do the toe touch progression and see a noticeable difference in your ability to reach your toes, you are NOT dealing with a muscle tightness issue; it's muscle tone. Perform this exercise daily to "turn off" your hamstrings and allow your core to be more efficient while stabilizing your pelvis.

The Truth About Barefoot Running: It's not for everyone!

Barefoot running is on an upward trend across the country, however those new to it should beware because it is not for everyone! Before making the transition, an athlete should make an informed decision by understanding the pros and cons of unshod running/walking.

Bob Tank, Doctor of Physical Therapy and orthotic specialist at ProRehab, PC discusses both the facts and his opinions of barefoot running.


The arguments for barefoot running are that it is more efficient energy wise and that it leads to fewer injuries.

I do not believe either of these statements have been scientifically proven and in fact, it can be argued that it may be less efficient since the energy absorbed in barefoot running is an additional load to the calf muscles. In regards to less injury risk, the premise is that barefoot running results in landing more on the forefoot or midfoot as opposed to having the impact at the rearfoot or heel. Heel striking generally results from a longer stride (step length) and results in the foot landing more out in front of the body. This is thought to then result in the body having to exert a “braking” force to maintain our balance and this force is then transferred and ultimately absorbed up to the knees and hips. If in barefoot running the foot lands more on the front part of the foot, it is argued that the foot placement will be more directly under the body (knees) and therefore the impact will be decreased and absorbed by the muscles more than the bones and joints. None of this has been conclusively proven. One of the drawbacks to barefoot running is this can shift the impact stresses to areas that are not accustomed to those types of loads and therefore may result in increased injuries to the Achilles Tendons, Plantar fascia (arch strut) and metatarsals. Because of this, if a runner chooses to change their running style to involve barefoot running, they need slowly transition to this over an extended period of time (months). Greater tension is placed upon the Achilles tendon and arch structures in unshod running simply due to the fact that running shoes keep the heels from dropping down to the normal 12mm heel lift built into the midsole of a running shoe. Minimalist shoes are somewhat of a compromise as they have 0-5mm heel lifts built in (depending on the model) and allow the runner to more comfortably land on their forefoot. They are also more flexible, lighter weight, and have more cushioning that the standard running shoe but, this results in less control over excessive movement or rolling of the foot. They also wear out quicker due to the less durable materials used in manufacturing them.

My opinion is that if a runner is considering transitioning to barefoot running, that they first try to shorten their stride in their regular shoes, which should alter the landing point to more toward the forefoot (away from the heel). They can practice this on a treadmill first with emphasis on quicker turnover, at a set speed, and they should focus on running tall, landing soft and with less noise at impact.

It should be mentioned that foot strike position at initial impact is not solely related to type or absence of shoes but is also related to fatigue, speed, joint flexibility, previous injuries and body structure. Those runners with a foot type that is either extremely flat (pronated) or extremely high arched (supinated) should be especially cautious about trying to run barefoot. In my experience, these runners would decrease their chance of injuries by wearing a shoe designed for their excessive pronation movement (more stability built into the shoe) or one designed for additional cushioning in the case of the high arched foot type. Further protection can be provided through the appropriate use of custom molded foot orthotics which are designed for total contact with the sole of the foot and built with a deep heel cup to not only help absorb impact forces but also to control excessive side to side rolling of the foot (side note, not all custom orthotics are built with these features included). This type of running orthotic is designed to accommodate for faulty foot or leg structure and cannot be used during barefoot running and is less effective in minimalist shoes. 

For clarification, in my mind I would classify minimalist shoes as Nike Frees, other light weight shoes with minimal structure but nonetheless they have a full outersole, just minimal heel lift built into the sole. The Vibram 5 toed shoes I would classify as more of a barefoot shoe. 

Part 2: America's Best Kept Secret...Urinary Incontinence

Last week Lisa Kiesel, physical therapist at ProRehab, wrote a great article on Urinary Incontinence. You can reference her first article below. Today, she is talking about what foods are good and what foods you should avoid for optimal bladder health. Enjoy!



Bladder habits are also very important to consider. Certain foods and drinks can be irritating to the bladder and cause you to urinate more often. Some examples of these are spicy and citrus foods, tea, coffee and soda (caffeinated and decaffeinated), foods and drinks with artificial flavoring, coloring and sweeteners, alcoholic beverages, milk products and chocolate. You may say “What CAN I eat?” The key is a balance between these irritating foods and drinks and plenty of water. One common mistake people make with bladder control issues is to limit their fluids. This causes the urine to be more concentrated and irritates the bladder which causes an increase in frequency. If you wake up a lot at night to urinate, drink most of your fluids during the day and limit what you drink after dinner, making sure most of it is water.

Some foods that promote bladder health include fresh fruits and vegetables, whole grains, foods high in Omega-3 fatty acids and water. Fruits and vegetables high in vitamin C, E, magnesium, potassium and fiber include carrots, sweet potatoes, strawberries, blackberries, cranberries, blueberries, mustard greens, turnips and cabbage. Whole grains such as rye, wild and brown rice, barley, brown pasta, oatmeal and whole grain breads promote liquid and solid waste removal from your body and promote a healthy bladder and colon. Foods high in Omega-3 fatty acids such as nuts (Brazil nuts, almonds, peanuts, macadamia nuts) and fish (trout, salmon, mackerel, tuna, herring, halibut, sardines) are helpful to reduce inflammation to enhance bladder health. Water is also very important because it flushes harmful toxins and bacteria out of the bladder and urethra.

You don’t have to live with it…remember that 80% of incontinence cases can be improved by a combination of behavioral changes and pelvic floor exercises when done correctly. Talk to your health care provider today and see if you can improve your symptoms.


Lisa Kiesel, PT, DPT, BCB-PMD

ProRehab, PC

812-476-0409

lisa@prorehab-pc.com

www.prorehab-pc.com




National Kidney and Urologic Diseases Information Clearinghouse

1-800-891-5390

www.kidney.niddk.nih.gov




National Association for Continence (NAFC)

1-800-BLADDER (252-3337)

www.nafc.org

America's Best Kept Secret...Urinary Incontinence!

This is the first article in our series of pelvic health. Although it is sometimes embarrassing to talk about, incontinence is a problem that both men and women face and can be a common topic around runners. Seasoned runners or athletes may even jokingly say that it's an initiation of sorts to pee while you're racing or training.

This article is courtesy of Lisa Kiesel, PT, DPT, BCB-PMD; ProRehab's pelvic health specialist. Her contact information is listed at the bottom of this article.

Would you wait an average of 3-6 years to talk to your doctor about your knee or back pain? Most would say no! Then why would you wait that long to talk to your doctor or health care provider about urinary leakage. Many men and women have one thing in common…they would rather not talk about their urinary leakage with their health care provider. Incontinence can be an uncomfortable topic for many people but it does not have to be because it is a common, treatable occurrence. Some people remain quiet about their bladder control because they believe it cannot be improved or that it is a “normal part of aging”. Men and women of all ages have trouble with urinary incontinence but it is more common in women. THE GOOD NEWS IS THAT 80% OF ALL INCONTINENCE CASES CAN BE SIGNIFICANTLY IMPROVED!

The Agency for Health Care Policy and Research (AHCPR) reports that one in four women age 30-59 have experienced urinary incontinence. A March 2011 report provided by the United States Food and Drug Administration (FDA) states that up to 50% of the female adult US population experience some form of urinary incontinence. The annual cost for caring for people with urinary incontinence in the community is $11.2 billion (an additional $5.2 billion spent on those in nursing homes). The majority of this money is spent on management measures such as pads for protection vs. treatment.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has developed an organization (The Women’s Urologic Health Program) with two goals in mind:

Increase the number of people reporting and seeking treatment for urinary incontinence.

Raise health professional’s awareness and knowledge about urinary incontinence.

There are many systems that must work together to provide control of the bladder. The pelvic floor muscles hold the bladder in place. The sphincter muscles keep the urethra (tube that carries the urine out of the bladder) closed. The bladder muscles relax as the bladder fills with urine and these same muscles contract when it’s time to empty the bladder. Nerves carry signals from the brain to tell the bladder when it’s time to empty. Hormones help to keep the lining of the bladder and urethra healthy. Bladder control problems occur when any one or combination of these systems are not working correctly.

There are six types of urinary incontinence. The three main types of urinary incontinence are stress, urge and mixed incontinence. Stress incontinence occurs during physical activities that cause an increase in intra-abdominal pressure such as coughing, sneezing, exercise, lifting or laughing. Normally the pelvic floor and sphincter muscles are strong enough and can handle the extra pressure (or “stress) from a cough, sneeze, or laugh but when these muscles are weak, that sudden pressure can push urine out of the bladder.

Urge incontinence is leakage caused by a sudden, strong desire to urinate. This type of incontinence is generally caused by either an involuntary bladder contraction or neurological impairment common with diabetes, a stroke, an infection or another medical condition.

Mixed incontinence is a combination of stress and urge incontinence. You may leak urine with a laugh or sneeze one time and at another time you may have a sudden uncontrollable urge to urinate just before you leak.

There are many ways to treat urinary incontinence including changing daily habits, exercises, medications, using a device such as a pessary or surgery as a last resort. As reported above, 80% OF ALL INCONTINENCE CASES CAN BE SIGNIFICANTLY IMPROVED through a combination of behavioral changes and pelvic floor exercises.

Exercises that strengthen the pelvic floor muscles are called “Kegel” exercises. They don’t require any equipment and can be done in any position at any time and if done correctly. The key is finding the correct way to contract these muscles. Without proper education or instruction 50-70% of women do Kegel exercises incorrectly and 25% of those do them in a manner that makes their leakage worse. There are several ways to find your pelvic floor muscles. Women will feel a slight pulling in the rectum or vagina. Men will feel a pulling in the rectum or a movement in the penis. One of the most common mistakes people make when trying to do a pelvic floor contraction is using the wrong muscles. Many people use their upper abdominal muscles, buttock muscles or hold their breath. If you are using the correct muscles, no one should be able to tell that you are squeezing your pelvic floor muscles – except you! The nice thing about doing these exercises is that you can do them in any position at any time. Make these exercises part of your daily routine so that exercising your pelvic floor muscles becomes a habit. Some good times to do them are standing at the sink when doing dishes or washing your hands, sitting on the couch during a commercial, sitting in your car at a red light, sitting at your desk when checking your email or while standing in the grocery line.

Lisa Kiesel, PT, DPT, BCB-PMD

Doctor of Physical Therapy, Board Certified in Biofeedback for Pelvic Muscle Dysfunction

ProRehab, PC. 

Indiana St Clinic 476-0409

If this is something that speaks to you, it is time to get help. Talk to your physician about a referral to see Lisa!! 

6 Best Mobility Exercises

OUTSIDE MAGAZINE, JUNE 2012
FRIDAY, MAY 18, 20123

6 EXERCISES FOR MAXIMUM MOBILITY

Why a Bay Area gym has ­become a destination for the world’s

top athletes

Kayaker Brad Ludden, pro cyclist Levi Leipheimer, Olympic rowerErin Cafaro—they’re not coming to CrossFit San Francisco for traditional coaching. They’re seeking out Kelly Starrett, a doctor of physical therapy, to glean his tips on natural mobility. Starrett preaches that joint range of motion matters beyond just injury prevention or rehab. The real benefit of mobility, he says, is the mechanical advantage: ideal positioning allows for optimal power output. Until you’ve got proper range in all your joints, you simply haven’t discovered your body’s real potential. “The typical athlete is brutally inefficient,” says Starrett. “Improving mechanics by resolving problems with tissue restriction and positioning is like taking the emergency brake off a Ferrari.” Running? Let’s see what you’ve got when a tight hip capsule isn’t ruining your extension. Rowing? Healthy dorsiflexion means you move more water. 

For the past year, Starrett has posted daily mobility workouts on his MobilityWOD.com website, and the videos have become a viral sensation in the CrossFit community. Here he offers six exercises to increase mobility for specific sports—everything from running to climbing. Spend just two minutes a day on each move—the 10-minute squat requires more time, of course—and make sure to contract and relax in each position. Also, test your range of motion before and after: you should notice improvements almost immediately.

1. Posterior hip mobilization
On all fours, position a stretching band around one quad, then place that foot in front of the opposite knee. Oscillate your hip against the band’s pull. GOOD FOR: Loosening up a stiff hip capsule or making you more efficient on a bike, in a kayak, or whenever you are in hip flexion.

2. Shoulder extension, external rotation
Place your hand through a stretching band and rotate your palm up. Grip the band and lean back, stretching your arm above your head and engaging the lat muscle. GOOD FOR: Opening up shoulder joints, which are particularly tight among swimmers and climbers. 

3. Anterior hip mobilization
Place the stretching band around one quad’s hip crease and stretch that leg back, placing the knee on the ground and slowly rotating the hip forward. GOOD FOR: Loosening up tight hip flexors, common among runners, cyclists, and rowers.

4. Ankle dorsiflexion
Standing up, place stretching band just above the ankle and step forward with that leg. Move knee forward and oscillate outward. Repeat facing the other direction. GOOD FOR: Ankle flexibility, which helps save runners tremendous energy.

5. 10-minute deep-squat test
Stand with your feet shoulder width apart and lower your hips to your ankles, making sure to keep your feet flat on the ground. Remain in that position for 10 minutes, moving slightly to stimulate circulation. GOOD FOR: Increasing mobility in the ankles, knees, and hips.

6. Couch stretch 
Start on all fours with your feet against the wall. Raise one leg so the shin and foot lie flat against the wall, then step the other leg forward, foot beneath you. Engage glutes, quads, and hip flexors by arching and relaxing your back. GOOD FOR: Opening up the entire anterior muscle chain, allowing you to fully extend your hips, knees, and ankles.

Article written by David Steinberg

Why are my feet numb?

Numbness and tingling in the feet is not necessarily common while running, but does occur. It's alarming to feel those "pins and needles" but it doesn't always mean that something serious is wrong. If you experience this, try to loosen your shoe laces and see if this makes a difference. Pay particular attention to how tight the laces are across the toe box (the widest area of the foot near the toes). If there is too much compression of the toe box, it pushes all of the smaller bones in your feet together. This puts pressure on the nerves that run between your toes. If simply loosening the laces doesn't work, the next step would be to have a specialty running store evaluate you to determine the right shoe for your foot. Proper shoe wear is important because it not only helps with mechanics, but also can improve the health of your foot. Also, breathable socks are also a must, especially in the summer. Heavy socks will make your feet warm and too much material in the shoe could cause compression as well, which may lead to the tingling sensation. Opt for lightweight socks with a breathable mesh. If these simpler options don't provide any relief, it may be time to see your doctor. Compression syndrome, inter-compartment swelling of the lower leg muscles, could eventually lead to numbness and tingling in the feet. This is a serious condition and needs to be evaluated right away if conservative treatment wasn't helpful.

Bike Rental

A bike rental program will soon be coming to Evansville! Channel 14 announced the partnership between the YMCA and the Welborn Baptist Foundation's Upgrade campaign which will provide bicycle rental at the Downtown YMCA.

Bikes available soon to rent in downtown Evansville

Posted: May 21, 2012 11:51 AM CDTUpdated: May 21, 2012 12:22 PM CDT

By Brad Conaway - email

 

EVANSVILLE, IN (WFIE) -

Partnering with The Downtown YMCA, the Welborn Baptist Foundation's Upgrade Campaign will roll out a new bike rental program tomorrow at the YMCA located on Northwest 6th Street.

The Upgrade Campaign had learned that local bike shops frequently receive inquiries on the availability of a bike rental program. The demand for such a program, along with a desire to promote bicycling in the community, prompted the partnership with the YMCA.

"The Y is thrilled about the partnership with the Welborn Baptist Foundation'sUpgrade Campaign", says Barb Dykstra, Downtown Branch Director of the YMCA of Southwestern Indiana. "The bicycle rental program will allow us to provide the community with yet another healthy lifestyle option. The Greenway is easily accessible from the Y and will give riders a safe and scenic route to explore."

The project involved the purchase, customization and installation of 20 bicycles ranging from children's to adult men's and women's and bike lockers. Each bike rental includes a helmet and a lock. The rentals can be made at the front desk of the Downtown YMCA. The Upgrade Campaign will also introduce bicycle maps and a "Rules of the Road" bike safety video.

"It's no secret that increasing physical activity is imperative to living a healthy lifestyle", explains Kevin Bain, Executive Director and CEO of the Welborn Baptist Foundation. "By providing new and engaging opportunities to be active, the Upgrade Campaign hopes to improve the health of Tri-State residents."

The Upgrade Bike Rental Program was made possible with funding from the Centers for Disease Control and Prevention's Communities Putting Prevention to Work (CPPW) grant program which focuses on decreasing overweight and obesity rates through improved nutrition and increased physical activity. The Welborn Baptist Foundation, in collaboration with the Indiana State Department of Health, received a $2.5 million CPPW grant in March 2010 to apply best practice strategies toward improving nutrition and increasing physical activity in Vanderburgh County.

"With the continued expansion of the Pigeon Creek Greenway, as well as the network of marked bicycle routes, much of Evansville can be experienced by bike", says Andrea Hays, Director of the Upgrade Campaign at the Welborn Baptist Foundation. "We believe that providing a low cost bicycle rental program will get our residents and visitors out to enjoy the city using a physically-active form of transportation."

The Upgrade Campaign was designed to help area residents achieve health improvements by making small lifestyle changes. The Upgrade Bike Rental Program gives residents and visitors yet another way to actively enjoy Evansville.

To learn more about the Upgrade Campaign, please visitwww.upgradenow.org 

Copyright 2012 WFIE. All rights reserved.

Blisters

Blisters can sometimes be a disabling problem for runners. I know personally I've finished a run bleeding and immediately dreaded the next training session. In order for blisters to form they need FRICTION and MOISTURE. Friction is just excessive rubbing to one local area in the shoe. Generally blisters pop up on the heel, but you can get them under the big toe and on the bottom of the foot as well. The moisture that builds up in and around the foot can be controlled well with moisture-wicking socks. There are a few different ways to minimize friction while running:

1. Make sure your shoes fit well, not too big or small
2. Cut your toenails!! The slight change in the size of your foot can alter it's position in the shoe
3. Socks should be form fitting. If they're too baggy, they may bunch under the foot
4. Try Body Glide, Petroleum Jelly or other products that reduce shear

Warm-Up Strategies

I posted this video on the "Weekly Tip" page, but thought it was a good share for the main page too. Brian MacKenzie of Crossfit Endurance is an Ironman finisher, Ultra Marathoner, and great resource for the running community. He posted a 5 minute video on his take to the ideal "runner's warm-up".  I believe this is the first video in a series, so I can post more as they are made. Enjoy!

Running Strong

I came across this article, and thought it was worth sharing! It discusses the use of the Functional Movement Screen and how strength training affects running performance.

Leslie Mellet

Intensity is not a perfume!

It's All About the Run: How Strength Training and Core Exercises Helped Me Achieve My Fitness Goals

I am sure you have noticed that as we get older our bodies do not perform as they did in our 20s, 30s, and yes, 40s. Not a big news item but it is important to bear in mind as you work to stay fit after 50.

When I started running again, I noticed that I could no longer pound out a 7:30 or 8:00 minute mile -- I had lost a step or two, or possibly three. In addition to my slower pace, I experienced frequent injuries (aging is not fun). As I discussed in my previous posts, triathlons are all about the run! I competed in three triathlons my first year racing. My run time for each was terrible, with an average pace of 9:30 miles. I didn't expect to have blazing speed after swimming and biking, but 9:30 miles seemed crazy! Additionally, no matter if I ran on fresh legs or tired legs, my hamstrings felt like they were on a rack.

While I understood why I was slower (I didn't want to accept it, but did comprehend it) I was concerned about my hamstring issue. I came to the conclusion that if I wanted to continue with another season of triathlons I needed a running coach.

Enter John Goldthorp. John is a local Philadelphia running coach and came highly recommended. For our first session he had me take a Functional Movement Screen to locate my areas of weakness. I was surprised to learn that my core strength and core timing were lacking (how could this be, I swim, bike, and run). Core timing is very important for running, it is the "firing" or "engaging" of your core. One image I like to use for core timing is the ignition of the car -- once you fire up the ignition you are ready to go.

To address my weaknesses, John started me doing exercises that at the time seemed rather silly. From my hands and knees, with a water bottle at the base of my back, I had to lift my right leg and left arm and point them in opposite directions and the water bottle had to stay on my back. Try it and you will be surprised at how hard it is. He gave me various other core strengthening exercises to do daily (AND yes, they all seemed silly). What made sense to me is something that I now do every day before I workout -- a dynamic six minute warm-up. Instead of doing static stretches on cold muscles, I now warm up with movement. This type of warm-up gets me into the flow of the run before I start (as well as the swim and bike).

After a few sessions John introduced weights for strengthening. One exercise in particular helped my hamstrings -- the dead lift. After a couple months my hamstrings felt stronger and didn't hurt when I ran. Another bonus -- I could keep the water bottle on my back. Realizing that maybe John was on to something, I faithfully did strength training twice a week along with core strengthening. We also talked a lot about running form, power from the core, and core timing. I kept these concepts in mind every time I ran. John told me that I shouldn't be running fast every work-out, that I should mix it up and run slow, at least two minutes slower per mile than I would run in a race. I didn't need to beat myself up with every work-out -- a revelation!

Hermes also went to John for a couple of sessions. He was experiencing different running issues -- planter fasciitis and he was a heel striker. John gave Hermes exercises for his planter fasciitis and taped Hermes running so he could see what he was doing wrong. Hermes spent last year doing the exercises and changing his running form to a mid-foot strike. Hermes ran his first marathon last October, the New York Marathon, in 4 hours and 5 seconds after only 6 weeks of training -- and faster than our 30-something son who trained for months.

My first big running test after I started training with John came last June at the PHYLYTRI. I was doing the Olympic distance, .9 mile swim, 24.8 mile bike, and a 6.2 mile run. Drum roll -- my average running pace was 8:45 minute miles. Forty-five seconds faster per mile than the prior year. All the hard work and silly exercises paid off and then some!

The second big test came in August at the SheROX Triathlon in Philadelphia. SheROX is a sprint distance race and I had done the race the prior year and averaged a 9:30 pace. Drum roll again -- this time I averaged a 8:29 pace -- 59 seconds faster per mile. Note to any woman who is considering a triathlon. TheSheROX triathlon series is awesome - no men allowed!

So what is the big take away here? For me the first big step came when I recognized that I had to change my approach to running rather than giving up running. I couldn't take my body for granted anymore, I had to help it along with strengthening and core exercises. I learned to be patient and remind myself that this process would get me to my fitness goals, running without pain and running faster. I also learned not to beat myself up during every work-out. I know now that it is still important to work hard and push my lactate threshold pace to improve endurance, but it is just as important to go slow.

Finally, setting fitness goals is very important. What do you want to achieve? In my case the first goal was to run without pain. Once achieved, I was able to run faster. To avoid setting yourself up for failure, fitness goals should start small, and escalate as you accomplish each goal. The sense of each accomplishment is very rewarding.

Kick Your Glutes In To Gear

If you're looking for a new exercise to wake up your glutes, try doing a single leg deadlift. Stand on your right leg and kick the left one behind you, keeping the knee straight. With your shoulders, back, hip, and knee all in a straight line, reach forward towards the ground. Repeat 10 times, then switch legs. To add difficulty try holding a medicine ball or weight in your hand. CAUTION: if you're holding a weight to make the exercise harder and your back starts to arch, or you can't keep your body in a straight line, then you're not ready to add weight. Remember, never sacrifice quality!!

Training Errors and Overuse Injuries: Why do they occur?

A great article from Competitor Magazine about training errors, overuse injuries, and the benefits of seeing a physical therapist. 

Should I Wait And See Or Go Visit A PT?

• By Dana Reid, DPT
• Published 4 hours ago

• 0 comments
 
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Acute pain can usually be easily resolved by correcting a training error, while long-term pain often requires long-term care.

Many of the injuries athletes sustain fall into two categories: training errors or overuse.

Training errors commonly occur when athletes add mileage, intensity, or speed too quickly or do not allow for enough recovery time – either on a daily/weekly basis or within an overall periodization program.

Overuse injuries are those nagging but consistent pains that we put off, sometimes for years.  The pain may be minimal or it may stop you in your tracks.  Overuse injury is often like the constant companion – and ignored until it is too late. While many argue that overuse injuries are caused by overtraining, I look at things a bit differently.  Overuse injuries are indicators of a more global systemic problem, muscular balance issues, poor biomechanics, or poor sport-specific mechanics.  Overtraining is often an isolated (or very sporatic) episode of pain caused more directly by a training error.

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The pain that comes from training errors is usually a surprise.  You have been training well, likely gaining fitness and speed, and you have been feeling good.  Then you go out for that one swim, bike, or run and come home in pain.  This can be a frustrating and scary moment.  The good news is that if treated quickly and appropriately, these injuries will usually resolve in short order.  In times like these the best course of action is to reduce the inflammation as quickly as possible.  We have all heard it – Rest, Ice, Compression, and Elevation.  This is the time to think of your long-term training and racing plans, then truly take a break to recover from the injury.

Rest – Often this means taking 1-3 days completely off; however, active recovery can be a part of this equation as well.  Use caution with active recovery because pushing into or through pain will only delay or prevent healing.

Ice – Extremities do well in 10-minute ice baths. Use ice packs for generalized areas up to 20 minutes or perform 5-minute ice massages for localized areas.  Icing several times daily is important, but wait a minimum of two hours between treatments so tissues may warm and blood flow increases to the area.

Compression – Compression is not just for swollen ankles anymore, and a plethora of garments is available to help.  Supporting the injured area with compression can help decrease inflammation, decrease the workload of the area, and improve the lymphatic system’s ability to clear waste products.  When done correctly, it should never be painful.

Elevation provides relief comparable to compression and helps at day’s end when swelling and inflammation are often highest.  During this time, anti-inflammatory medications can also be very helpful.

By helping to reduce inflammation with proper care, injuries from training errors may heal within 7-10 days. If after 10 days a return to the inciting activity is still painful, I recommend seeking medical advice to ensure no underlying biomechanical issue exists.

Overuse pain is something athletes often chalk up to being ‘in training’.  Often they have sought tests, had massage, chiropractic, or physical therapy, but the pain continues.  The key to changing overuse pain is persistence.  Find a physical therapist who understands your goals and will work with you to reach those goals. I have treated people who have had knee pain for 20+ years and just want surgery to ‘fix it’.  These types of injuries are frustrating and often prevent athletes from returning to their chosen sport.  I believe the vast majority of overuse injuries can be helped by physical therapy.

The most difficult aspect of treating this type of injury is the time it takes to make a difference.  In the case of the patient with 20+ years of knee pain, walking down a flight of stairs without pain was an issue. We treated twice a week for 3 months.  Yes, that’s a long time and a lot of treatment… but this person climbed Denali with no pain one year after ending treatment.  Changes in muscular balance, joint mechanics and motor control take time.  Long-term complaints of pain can require long-term care and occasionally intermittent check-backs.  Having said this, gains should be regular and noticeable.

While I personally enjoy utilizing a variety of body-work professionals, I do believe physical therapists are the movement specialists.  They are trained to look at muscular balance, fatigue, neuromuscular control and much more.  Changing the way the body moves in order to reduce the chance of injury or improve acute and chronic pain can require multiple aspects of care.  Physical therapists are not just for surgical recovery anymore!  In many areas your physical therapist can be your first entry point into medical care and help get you back to moving pain-free!

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About The Author:

Dana Reid is an avid endurance athlete and Doctor of Physical Therapy in Hood River, Oregon.