Tuesday, August 5, 2014

Feet 101:

It seems to me that when people get injured i see a slew of the same type of injury or body part. This summer I have been lucky enough to have a bunch of feet to see at work! I am happy to report that my pregnancy nose has survived most of the stinky ones!

Feet are often injured because they have to compensate for the weak or tight hips, dysfunctional knees and tight IT bands. It’s common for someone with foot pain to find the cause further up the chain, but you can still do a lot to keep your feet healthy and pain-free. Here are some tips:

Stretch: The gastroc and soleus muscles in the back of your leg often try and do everyone’s job. Keep them quiet and happy. See the runner stretches below. They're so easy, you can even do them in line at the grocery store. 

Get your roll on: The plantar fascia at the bottom of your foot may get tight. Rolling on a tennis ball can often relieve tension and you get a free foot massage at the same time.

Learn a party trick: Then wow your friends by picking up bottle caps with your feet and dropping them in a jar. Strengthening the feet can help fix common problems like flat arches and heel pain. Next time you have to pick up after your kids do it with your toes!

Hide your Achilles heel: Strong calves can help prevent tendinopathies. If you cannot do 25 calf raises with no issues on one foot, it is probably time to work on that. To challenge the range of motion, you can always hang off a step.

Wednesday, April 2, 2014

Stretching 101: Making the warm up and cool down easy!

All too often runners are perplexed when they try to design their own warm up and cool down. We all face the difficult task of fitting our long run around the family's schedule or sneaking in a short one at lunch break. To add a 10 minute warm up and adequate cool down after can be a daunting task, but it can help prevent overuse injuries. Here are some tips to minimize the thinking and motivate you to do it:

Dynamic warm up:

1. Count it in your mileage. As you do your knee ups and butt kicks, keep moving forward. This will help you get warm and not worry about "adding" more to your already busy day.

2. Walking doesn't count. Hip swings, side stepping and lunges hit a variety of muscles that walking alone may not warm up. Get your body ready for the ballistic nature of running.

3. Warm up before you head out. If rolling on the ground at the track or in front of the neighbors is embarrassing, do it in your living room before you head out. After you drive to your local running spot, be sure to do a few minutes of warm up when you get there.

4. Make it a priority. Warming up and cooling down may save you some money that you would usually spend at the chiropractor, massage therapist or physical therapist! One trip to a PT or chiro could cost as much as a new pair of shoes!

5. Still lost? Try this. One of the best dynamic warm ups that I like to give my patients is Lesley Paterson's 10-minute dynamic warm up. There is also a group of high level runners using Meb Keflezighi's active isolated flexibility routine as a dynamic warm up. Coach Jay Johnson also has some tips here.

Cool Down:

1. Get back to normal length. After using your muscles for a certain number of miles where they are contracting extensively to help you move, it is important to restore the length. This can prevent injury, as muscles are not staying shortened over the course of time and pulling on tendons/bone.

2. Do it whenever. My husband regularly performs his stretching routine after brushing his teeth. It is part of the routine and he claims that it relaxes his muscles and helps him sleep better. Whether you read or watch TV at night, make it a part of you daily routine. Whenever you have 10 free minutes post work out, be it before you have to get the kids, before you step in the shower or while you wait for your pasta to cook, do it then.

3. Don't stretch a cold muscle. If you have been walking around the house then you can stretch. If you have been sitting, ease into the stretches gently. Remember - we're trying to prevent injuries, not cause them.

4. Enjoy it. Use this time to do some relaxation exercises, visualization or reflection in your head. Sports psychologists encourage the relaxation technique where you concentrate on the muscles relaxing completely by thinking about the tension leaving each muscle (start at your foot and move up your leg).

5. Still lost? Try this. If you are a very tight person, static stretching that involves holding a stretch for a long period of time may be a good idea. Some ideas of what can be found here. If you are the type who could do all the obnoxious moves in your very first yoga class (i.e. naturally flexible), then foam rolling to target just the tight muscles may be the way to go. Proaxis Therapy has a great foam rolling handout that walks you through the process. For specific tight knots and trigger points tennis balls, lacrosse balls and baseballs can also be used instead of a foam roll. Stay away from bones or anything that feels like a nerve (burning, stabbing, shooting pain).

Monday, March 3, 2014

Core exercises with the swiss ball

Last month we targeted exercises for the weak hips (glute maximus and minimus). This month we focus on the core muscles, as they are another important muscle group to target. For starters, pulling your belly button in and tightening all your abs (lower and upper) is a sure way to make sure they are on. Make sure your pelvis is not rotated forward or back, and is leveled, while you are tightening your core.
Below are some swiss ball exercises that have been seen to have great upper and lower abdominus activation compared to other exercises out there.
1. Swiss ball pike: 
Starting position (make sure tummy is pulled in pelvis is neutral)

Ending position
 2. Swiss ball roll out
Starting Position (Pull in belly button)

Roll out the ball with your abs controlling the ball and pull back in to starting position!
Start with 2-3 sets of 6- 8 reps and build to 2-3 sets of 15-20. Make sure you feel your abs getting tired and not your back. These exercises have been seen to be better than crunches, side sit ups etc in a research study 
(Escamilla RF, Lewis C, Bell D, Bramblet G, Daffron J, Lambert S, Pecson A,Imamura R, Paulos L, Andrews JR. Core muscle activation during Swiss ball and traditional abdominal exercises. J Orthop Sports Phys Ther. 2010 May;40(5):265-76)

Sunday, February 9, 2014

Best bang for your buck...or should i say butt

Strength exercises have often been prescribed to help runners with speed and power as well as injury prevention. There are many exercises out there but not many with the best “bang for your buck”. This month I highlight 3 exercises that will help you get stronger. These exercises have been seen to have the best glute firing (under EMG).

1    1. Single Leg Squat - Running is nothing but doing and plyometric squat on one leg and then switching to the other, therefore this exercise is highly recommended. 
  •     Stand on one leg 
  •     Sit back like you are going to sit on the toilet, you can let your chest come forward (just make sure your are not arching your back- suck in that belly)
  •     Make sure your hip, knee and foot are in line. If your muscles can't do it hold on to the door frame 
  •     As you lower yourself sit back into your hip and squeeze the glutes on the way up
  •     Start with 3x 8 and build to 3x 15-20 as you get stronger (make sure your glutes are doing the work not the quads) 
    2. Single Leg Dead lift: The single leg dead lift is similar to the squat however your are reaching down and squeezing your glutes up with less to no knee bend in the knee 
  •     Stand on one leg 
  •     Keeping your back in neutral core tight bend forward at your hips (not waist) 
  •     Squeeze your glutes as you come up 
  •     If you are too unstable or cannot maintain hip knee and foot alignment hold on to something 
  •     Make sure your feel the glutes more than the hamstrings/ quads
  •     Start with 3x 8 and build to 3x 15-20 as you get stronger (make sure your glutes are doing the work not the quads)    

3.  Transverse Lunge: Is like a regular lunge but your foot reaches diagonally backwards to purposely stick out your hip needing you to squeeze the glutes to bring it back to neutral 
  •     Stand on both legs
  •     Reach diagonally back with the leg you are not working, sit back into your hips
  •     Squeeze your glutes and bring the other leg back to neutral
  •     Start with 3x 8 and build to 3x 15-20 as you get stronger (make sure your glutes are doing the work not the quads)