The Problem with Hip Drop and How to Fix It

Running form is a hot topic in the running world these days. As common as it is to hear and read about, it’s not so common that runners actually fix their faulty form. Whether you are experiencing pain, recovering from an injury, or interested in improving your running form to avoid any mechanical issues, correcting an existing hip drop is essential. Most injuries and overuse pains from running are caused by muscle imbalances and weakness, that unfortunately, are not addressed until you’re actually injured. Read on to learn the steps to take to identify and fix your hip drop.

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Running with IT Band Syndrome: A Step by Step Approach to Treatment

IT Band Syndrome (ITBS) is one of the most common injuries in runners, especially in those new to the sport. The Iliotibial Band is a thick tendon that runs from the outside of the outer hip bone all the way down to the outer knee. Repetitive motions, such as in running, can overuse this area and cause inflammation. Read on to learn what steps to take whether you are just experiencing new symptoms or have been dealing with them for a long time.

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Healthy Hamstrings for Fast Running

Weak areas of the body will show their deficits once there comes a task that the body is not used to—like those last few miles of a marathon. Hamstring injuries and pain are one of the most common complaints among distance runners. This group of muscles plays a vital role in the running cycle, yet many athletes do not prioritize hamstring strength during training. Read on to learn why this muscle group is so vital to the running cycle and how you can keep yours healthy.

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How I Healed My Plantar Fasciitis for Good

It makes sense that foot problems are as common as any other issue in runners since it’s the body part that carries the most weight. It’s the first point of impact, too, so you can imagine how it looks on the inside with the dozens of components that make up just one foot. Yikes! Well, plantar fasciitis is on the top of the list of common running injuries and usually the most frustrating one to deal with. Read on to learn more about how I healed mine for good.

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Can Diet Help Speed Up Injury Recovery?

The worst part about getting injured as an athlete is the thought of the amount of time it will take to get back to our previous fitness level. In order to come back to your healthiest self in the shortest time frame possible, you may want to include a nutritious diet as part of your rehab program. Continue reading to learn why and how to quickly get back to into shape.

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Low Back Pain in Runners: Prevention & Treatment

If you’ve dealt with low back pain, then you know how debilitating it can be to do even the simplest daily activities. Improving core strength, flexibility, and correcting poor body mechanics are the key to managing and preventing pain. Continue reading to learn the exact exercises I prescribe to my clients that lead to maximum relief.

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Wake Up Those Glutes! Why & When You Should Include Hip Activation Exercises

Struggling with knee pain or tired legs post-run? What about having a hard time improving your pace? The answer may have a great deal to do with your glute strength. Waking up these very important hip muscles with activation exercises and general strengthening should be a part of every runner’s program.

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Keep Your Feet Happy with Superfeet ADAPT Run Insoles

This post is sponsored by BabbleBoxx on behalf of Superfeet


Foot pain—one of the most common limiting issues, not just for runners, like me, but for anyone who spends much of the day on their feet. After all, the feet are what carry our entire body weight all day, so they are bound to take a beating. I’ve dealt with plantar fasciitis for over 10 years and I’ve tried all types of recovery tools. As a physical therapist, I’ve learned how it’s truly a combination of treatment strategies that helps manage foot problems.

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After trying a variety of shoe insoles, I’ve had a hard time finding a pair that can comfortably fit in my sneakers without feeling tight. Most will end up digging into my heel and causing even more pain. Luckily I got my hands on a pair of Superfeet ADAPT Run Insoles, which are extremely thin and feel like they are barely there. The heel cup of the insole is cushioned, so instead of increasing pressure throughout the run, they actually help maximize energy by dispersing the impact with every step. This is important for runners because significant impact that is localized to just one point of the foot can lead to strains and other injuries higher up in the body such as patellofemoral pain syndrome (runner’s knee), IT band syndrome, and low back pain.

My other favorite part about the Superfeet Run Insoles is the flexibility, which moves with the foot from heel to toe, so it doesn’t limit pace when I want to run fast. I’ve tried countless insoles that feel extremely stiff, making it hard for your foot to move naturally through the running cycle. The Adaptive Comfort Technology of these allows them to bend sufficiently to assist with push-off and have a good amount of cushioning at the balls of the feet. After using these for several runs, I noticed my foot joints were much less achy post-run thanks to the dispersion of the overall impact and cushioning at the right places.

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The ADAPT Run Insoles are also made with the best materials when it comes to running. MoistureWick™ does an amazing job during these hot and humid summer months to help keep your feet dry, which is ideal to prevent blisters and odor. I’ve had to avoid wearing other insoles while running because of the lack of odor and moisture control, so I am happy I found this perfect pair for my injury-prone feet! If you’re looking for a comfortably light insole that you can wear with any shoe, including zero-drop styles, AND a pair you can wear right away without breaking in, I highly recommend Superfeet ADAPT Run Insoles!

Feeling Sore Days After an Intense Workout? It's Probably DOMS. Here's How To Beat It

Soreness can be a sign of a good workout, but not all soreness is a good thing. When you first begin an exercise program or get back into it after a long break, experiencing a bit of muscle pain later that day or the next is normal. This specific pain should not be so uncomfortable that it limits being able to move around as usual and should subside within a day or so. If the soreness causes you to not be able to lift your arms or go downstairs without severe pain, and lasts longer than two days, your workout may have caused delayed onset muscle soreness (DOMS for short).

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Causes and Symptoms

Typically, delayed onset muscle soreness begins within 8 to 12 hours after intense exercise and peaks to its worst symptoms at 24 to 48 hours. The pain from DOMS subsides by around 72 hours, but may last longer for some individuals. This pain is normally felt with active movement and stretching the muscles. Along with muscle pain, other symptoms that come along with DOMS are a temporary loss in muscle strength, decreased range of motion, and possibly swelling in the muscles involved in the exercise. The sore muscles may feel as if “bruised” when touched with light pressure. This combination of symptoms may even last up to 10 to 14 days in severe cases.

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What exactly is the “intense exercise” that can causes DOMS? Studies show that the usual type of exercise that causes this condition is eccentric movements, which is when the muscles lengthen during the contraction (think: the movement on the way down from performing a bicep curl). Although this is the most common exercise to cause DOMS, many other forms of workouts can lead to this intense soreness, such as running downhill, high intensity sprinting or plyometrics, and heavy weight lifting. Most of the time, this condition arises after performing new exercises at too high of an intensity that the body is not used to.

What Exactly is DOMS?

In the past, it was believed that delayed onset muscle soreness was the result of the so-called lactic acid buildup in the muscles during exercise. This buildup occurs during any exercise, but returns to normal levels as soon as an hour after the completion of the workout. Therefore, DOMS is not related to the lactic acid accumulation in muscle that occurs during physical activity. Unaccustomed eccentric exercises cause damage beginning at the muscle’s cell membrane, which results in inflammation that expands out to the entire muscle and surrounding areas, creating metabolic waste. This waste product stimulates the nerves surrounding the muscles causing pain. Keep in mind this type of damage occurs with certain forms of exercise as explained above, not with all exercise as with the regular lactic acid buildup.

Treatment

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Although the first line of defense used when feeling this kind if pain is to take an anti-inflammatory pill, it may not be the best option. This route may help ease symptoms in most cases, but is shown to have the unattractive side effects of stomach issues and can eventually lead to poor healing capabilities in the future. The best initial treatment options are rest and ice—which is a safe, natural anti-inflammatory agent. Another go-to pain reliever sought out by most athletes is massage. Gentle massage helps ease DOMS pain, swelling and tightness in most individuals, reducing the severity and duration of symptoms. Massage has been shown to help decrease the compound in our muscles that causes inflammation. Deep tissue massage that is typically used by athletes for tight muscles is not advised for this condition due to the intense pressure that may exacerbate the pain.

Another helpful treatment option is light exercise such as cycling, pool exercises, and gentle stretching. These approaches will help maintain good circulation and keep the muscles warm to be more prepared for the addition of intense exercise once the DOMS has subsided. Intense exercise, especially the type of workout that initially caused the pain, should be avoided, as one of the symptoms of DOMS is a temporary muscle weakness. This decrease in strength causes delayed shock absorption, which can lead to injuries such as a muscle strain or tear.

Prevention

Performing a proper warm-up before any exercise is the first thing that should be done to prevent delayed onset muscle soreness. A warm-up, as in its name, basically increases the temperature of muscle, which improves its elasticity, making it more resilient to tearing. The effects of a proper warm-up lead to improved muscle contractions and better performance during the workout. Research states that warming up for an eccentric-type workout with concentric moves is effective in helping prevent DOMS. A good warm-up for running consists of more dynamic moves such as walking lunges, legs swings, and military marches. Static stretches, where you hold a fixed position for several seconds is not recommended, as this will cause muscles to elongate and remain in a more relaxed state. Save these for after your run.

If you are beginning a running or exercise program for the first time or after a long break, it is advisable to gradually ease into the intensity and make sure to include that warm-up. It is important to note the difference between DOMS and other causes of muscle pain. If you are experiencing pain during a specific exercise, it is most likely due to improper form, a muscle strain, or other injury. DOMS symptoms occur between 8 and 12 hours after the completion of exercise. You are able to perform lower intensity exercises with DOMS without continued muscle damage, whereas with a muscle strain, further exercise will continue to impair the muscle.

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DOMS is not necessarily a bad condition since it involves a natural effect of new exercise, but it should be avoided when possible as it prevents any higher intensity exercise to be performed for several days or weeks. If you want to go “all-out” during your track day with brand new sprint intervals that you have never done, and you develop DOMS, expect to not be able to get your long run done even if it is a couple of days after the track workout. A good rule of thumb when increasing intensity of your workout program is to increase sets, reps, resistance, or mileage by only 10% or less each week. This is the safest way to help prevent the unwanted limitations of DOMS.


Sources

Miles MP, Clarkson PM, Exercise-induced Muscle Pain, Soreness, and Cramps, Journal, May 6, 2020.

Connolly D, Sayers SP, McHugh MP,Treatment and Prevention of Delayed Onset Muscle Soreness, Journal, May 6, 2020.

Zainab Zainuddin, Mike Newton, Paul Sacco, Kazunori Nosaka, Effects of Massage on Delayed-Onset Muscle Soreness, Swelling, and Recovery of Muscle Function, Journal, May 6, 2020.

Running & Rehab: Peroneal Tendon Injuries

A true runner without a history of pain or injuries is one in a million. The constant pounding on the ground through all of the joints in the body is bound to put stress on some area of weakness and eventually cause discomfort. If you have searched for the most common running related injuries or pain, you have probably come across knee or IT band issues. The ankle and foot are almost, if not just as common as those two. It makes sense why—the feet take on the most pressure during running since they carry our entire body weight throughout the running cycle. Foot structure and deformities are one of the main reasons injuries to this body part occur. Unfortunately once you injure the foot or ankle once, you are prone to getting injured again, especially if you do not take care of the cause.

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Besides foot structure, general ankle instability is a problem for runners, causing a large percentage of traumatic injuries such as sprains and tears, as well as overuse injuries and pain like plantar fasciitis and tendonitis. An overlooked and often misdiagnosed issue is peroneal tendon dysfunction. The two peroneal tendons run along the outer side of the lower leg, one connecting to the side of the foot and the other underneath the foot. These tendons are responsible for eversion of the foot, which is the movement of rotating the foot out to the side. It is quite common for peroneal tendon issues to be mistaken for ligament injuries (sprains). Understanding the causes and how to address instability is key to full recovery from and prevention of peroneal tendon dysfunction.

Types of Peroneal Injuries

Tendonitis

This diagnosis presents itself with inflammation in one or both tendons and is usually caused by activities that involve repetitive overuse of the peroneal tendons. Trauma, such as an ankle sprain, can also cause tendonitis since when rolling the ankle the tendons must powerfully try to control from rolling too far. Pain is normally felt behind or underneath the outer ankle bone during activity, and subsides with rest. Treatment involves using anti-inflammatory pain medication, rest, and activity modifications. If the tendonitis is severe, immobilization for four to six weeks in a walking boot may be necessary.

Dislocation

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Also called ‘subluxation’, this injury consists of the tendons snapping out of place over the outer ankle bone. There is a sheath that holds the tendons in place at all times that may tear with traumatic events and cause this dislocation. Already present deformities such a shallow or nonexistent groove where the tendons lie or a loose sheath to begin with can also be the cause. After the initial trauma, it may be difficulty to diagnose this issue since there is subsequent inflammation throughout the entire joint. The snapping is felt during forceful dorsiflexion and inversion, or flexing the ankle joint upwards as if raising the toes while rotating the foot inwards. Runners will feel the snapping during the push-off phase of running since it is a forceful movement from heel strike or a neutral position to pointing the toes downward.

Treatment for initial encounter subluxations can and should be treated conservatively with rest, immobilization in a cast or boot, and anti-inflammatory medications. For injuries involving a tear of the sheath, chronic dislocations due to ankle deformities, or failed conservative treatment, surgery will be the only option to repair the cause. After surgical repair, physical therapy will be necessary to manage pain and inflammation and restore motion and strength. Individuals who experience chronic dislocations of the peroneal tendons should seek treatment as soon as possible as this consistent snapping can lead to tears.

Tendon Tears

This peroneal tendon diagnosis can be a result of an acute traumatic injury such as a severe ankle sprain. Chronic issues such as consistent dislocations or weakness and instability in the ankle joint can also cause tears by means of overuse leading to fraying and splitting of the tendon. Individuals with high arches are more prone to this type of overuse and should consider using arch support orthotics in their shoes especially for running and other high impact sports. Surgery is usually required to repair the torn tendon, followed by immobilization and physical therapy.

Ankle and Foot Strengthening

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Since instability and weakness are a main cause of most foot and ankle issues in runners, it makes sense to incorporate direct strengthening exercises for these areas. A simple strategy is to perform a few before an easy run about three times per week. Resistance bands can be used to target the main movements of the ankle as shown below. Heel and toe raises will also strengthen the calves and dorsiflexors (muscles along the shins). The smaller muscles of the foot can be strengthened with toe curls using a towel on the floor and trying to pick it up with your toes for up to ten repetitions for two to three sets. More advanced exercises consist of using unstable surfaces such as a balance disc or foam mat to perform exercises.

Ankle pain and instability is often diagnosed as a sprain, especially if there was a trauma. It is important to keep in mind that sprains can also involve tendon injuries. If you are diagnosed with a lateral ankle sprain and have done all treatment correctly but continue to have pain, the next step should be to follow-up with your doctor to check for any peroneal tendon injuries. Most cases with minimal symptoms do well with conservative management. Unfortunately if there is a greater loss of function, especially for athletes who want to continue their demanding sport, surgery may be necessary. As mentioned above, the foot and ankle joints are very important for runners, therefore any instability or weakness should be taken care of to avoid injury. If not taken are of, foot problems tend to lead to issues in higher joints such as the knee, hip and back. It is useful to remember that healthy feet leads to healthy running!

Sources

Kinner Davda, Karan Malhotra, Paul O’Donnell, Dishan Singh, and Nicholas Cullen, Peroneal Tendon Disorders, Journal, Apr 28, 2020.