Tag Archives: running injuries

Elite PT Newsletter August 18′ – Running Injuries: Preventing Lower Back Pain

We’re continuing with our series on running injuries – this month focusing on how to prevent lower back pain.

But first:

I want to welcome our new PT student Charlie Crockatt

Charlie CrockattCharlie is in his third and final year of Grand Valley State University’s doctorate of physical therapy program, and is with us until October for hands-on clinical experience. He grew up in Livonia Michigan, playing football and baseball for the Stevenson Spartans. After high school he completed his undergraduate work at Central Michigan University, studying athletic training. After graduation from PT school, he is interested in working with athletic populations of all ages and hopes to travel outside of Michigan. In his free time, he enjoys the outdoors and also plays drums for an indie rock band called Birdie Country.

Charlie will be a great fit at Elite PT and will be here through October 5th.
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Running Injuries continued:  Preventing Lower Back Pain

Unfortunately lower back pain is a frequent problem for runners especially as distances increase.

As you’ve learned from our previous articles on running injuries, having good joint mobility and flexibility are very important for injury prevention.  When it comes to your lower back, the more mobile and flexible you are through the joints above and below – specifically ankles, hips, and thoracic spine – the better.

Another important consideration is core stability.  I prefer to use the term ‘stability’ over the more common term ‘strength’ because that’s really what we are after.  Stability, in this case, is the ability of the muscles of the trunk to maintain a safe position of the joints of the spine while you alternately swing your arms and legs to run.  In simpler terms:  to keep your lower back relatively still while the rest of you moves.

One of the best ways to train for stability is to use a variety of plank exercises to challenge the various muscle groups on the front, back, and sides of the trunk.  These are known as Bunke Planks and are pictured below:






Use a small box or chair approximately 12-18″ high (the higher it gets the easier it tends to get).

These exercises were introduced a few years back as a way of developing stability and endurance through the trunk muscles but also to compare how stable a runner was right to left.  Everything is done on one leg and compared to the opposite side.  Competitive runners should be able to hold each position 40 seconds at a minimum on each leg.  Asymmetries right to left (i.e. hold on left leg 40 seconds but only 25 seconds on the right) was thought to put runners at a substantially higher risk of injury.  Not being able to hold the full 40 seconds was not as big a deal but still thought to increase risk of injury.

So that’s the quick and dirty history of the Bunke Planks in one paragraph.  Competitive runners should be able to hold each plank 40 seconds on each leg in each position.  This can be very challenging, and very eye opening as some folks think they are quite ‘strong’ through their core until they try these!

For the rest of us, these planks can be very difficult and in some cases way to advanced.  Luckily there are a number of regressions possible that can be used to build up stability and endurance and maybe eventually work up to the full blown Bunke plank.

The easiest thing to do in some cases is just to do the plank in the pictures on both legs and work up to 40 seconds before trying to lift a leg.

From there alternate lifting legs up to 10 reps each leg.  You will only be holding a few seconds each leg before switching to the other.  If your on your side you would lift the top or bottom leg 10 time then switch sides.

The next step would be to start working in longer holds.

The shoulders can often be limiting factors in performing the Bunke planks – here are some regressions to take the shoulders out completely or at least to decrease the total amount of body weight you must hold up:

Hamstring Bridging

Single Leg Hamstring Bridge

Lift the tailbone but not the lower back!

 

 

 

 

 

 

Side Plank (from the knees)

Side Plank from knees

Hold the hips high and lift the top leg up and down

 

 

 

 

 

Front Planks (from the knees)

Kneeling Front Plank

Keep the hips high and back flat

 

 

 

 

If you have any questions at all or are suffering from lower back pain feel free to email me:  Joe@elitepttc.com

Keep running and stay healthy!

 

Joe Heiler

231 421-5805

Joe@elitepttc.com

Elite PT Newsletter April 2018 – Running Injuries Part I – Foot/Ankle

Running Injuries – a Spring time tradition

Like the rest of you I’m done with the cold and snow and ready for some nicer weather. It’s that time of year to start thinking about summer which usually means being more active.

For you runners out there it will mean getting outside more and probably increasing your mileage.

For you athletes, it’s time to start thinking about what you’re going to do this summer to make you a better athlete for next year.

Luckily, we’ve got something this month for both of you!

Common Running Injuries
1. Patello-Femoral Pain Syndrome (anterior knee pain)
2. Achilles Tendinitis
3. Plantar Fascitis
4. Hamstring Tendinitis
5. Shin Splints
6. IT Band Syndrome (pain at the hip or lateral knee)
7. Stress Fractures
8. Patellar Tendinitis
9. Lower Back Pain

These are the most common running injuries I found searching running sites and this order is fairly consistent from site to site. We see our fair share of each of them here at Elite PT.

These are also known generically as ‘over use injuries’ – meaning that they are caused over time by repetitive stresses that gradually break down the various tissues involved (tendon, muscle, fascia, bone, etc).

These are also the most common injuries we see in high school sports that involves a lot of running, i.e football, soccer, basketball, track and cross country. So if you’re an athlete of any kind, at some point you are either going to be dealing with one or more of the above OR you should be working to prevent them.

Prevention starts from the ground up

How your foot and ankle function are huge for preventing the obvious conditions in that area but also those further up the chain in the knee, hip, and lower back.

The joints of your foot and ankle must move appropriately and the muscles must do their job to stabilize those joints as your foot hits the ground and then progresses to push off. This is a two pronged approach since the joints require adequate mobility and the muscles must stabilize at just the right times.

This month we’ll cover a few ankle/foot exercises you can use to prevent injury or to rehab from it. Sorry if I get a little deep in the ‘why’ sometimes but I do think its important to know ‘why’ you should perform these exercises.

Ankle Mobility

Here’s a great example of what good ankle mobility looks like. The knee should be able to travel 4″ past the big toe without the heel coming up or the arch collapsing.

Athletes need this much ankle mobility to squat deep, sprint, jump, cut, and so on. If you don’t then your body is going to find a way to compensate around that so you can still squat, sprint, jump, etc. Our compensations are usually what get us into trouble. In this case the common compensations are:

  •  arch of the foot collapses (excessive pronation)
  • foot turns out
  • heel comes up too soon
  • knee collapses inward

There are others but these are the easiest to see. Watch anyone with stiff ankles try to squat deep – its not uncommon to see all of the above.

These compensations put the tissues of our foot, knee and even higher up the chain into more stressful positions. With repetition, i.e. lots of mileage, this will eventually catch up with most athletes causing pain.

What to do about it?

There are two main reasons why your ankle joint may not move enough:

tightness through the muscles of the calf (will feel like stretching in the back of the lower leg)
limitations involving the ankle joint (will feel a pinching sensation in the front of side of the ankle when bending it all the way)

Tight muscles are something you can deal with fairly effectively yourself. Using foam rollers or massage sticks to loosen up the calf muscles followed by stretching are the easiest things to do. Working on ankle mobility in a kneeling posture as in the picture below is one of my favorites.

Kneeling Ankle Mobility

The goal is to get your knee as far past your big toe as possible without your heel coming up. Placing the stick at your 5th toe and taking your knee around the outside of the stick forces you to work the muscles of the foot and keep the arch high. I prefer shoes off so you can actually see what your foot is doing. It could also be done standing if kneeling causes knee pain.

If you experience that pinching sensation in the front or side of your ankle – that is going to be a tougher fix. That’s usually not something you can stretch out on your own. It’s actually a good reason to give us a call because you will need some manual therapy to deal with that stuck joint.

In conclusion

What is happening at your foot and ankle affects every other joint in your body so this is a great place to start. See how far your knee can go past your big toe – if it’s not 4″ (heel down and good arch) then it’s time to get to work.

If you want some other ideas, catch the video below featuring our former student Scott McKeel (who just ran the Boston Marathon this week) demonstrating some great ankle mobility drills.

And even if you don’t consider yourself a runner or an athlete, you still need a mobile ankle and stable foot to walk normal, go up and down stairs, and balance. These are for you too!

If you’re struggling to make gains or you do have that ankle pain I mentioned earlier, feel free to give us a call (231 421-5805). We can set up a free 30 minute assessment to determine if you just need more advanced exercises or you may need physical therapy to break through and get moving again.

I’ll leave this offer open through the end of April so get cracking!.

Have a great rest of April and be sure to look for the next article in our series on running injuries.

Joe Heiler PT