Run Fast and Recover Faster with Apolla Performance Socks

From racing shoes to headlamps and everything in between, runners can be quite picky about their gear. As time goes on and technology advances, runners want the best of the best to be able to perform well, stay away from injury, and recover as fast as possible. Believe it or not, socks play a significant role in foot health for athletes. They are not just made to add a layer of cushion in between the skin and shoe seams. They can provide the feet, and pretty much every joint up the body, with support and injury prevention no matter what your lifestyle dictates.

Comfort is Always Number One

The first thing we aim for when picking out any piece of an outfit, shoes, or socks, is comfort. Runners, in particular, don’t care as much about looks, as long as they can feel comfortable on their long runs and avoid issues like achy joints, blisters, and heaviness. This all can be solved with a good pair of socks. In comes Apolla Performance. Initially created for dancers, who we can all agree get the most beating to their feet, these styles are equally perfect for any lifestyle. Just recently a research study concluded their effectiveness in reducing force and received the American Podiatric Medical Association Seal of Acceptance.

Apolla Performance socks are all made in the USA with REPREVE, which is certified sustainable yarn. Runners are sure to be happy with the Amp (no-show), the Performance (crew), and the Infinite (mid-calf), since they all provide the perfect thickness to protect from impact, blisters, and moisture, without feeling suffocated in running shoes. Each has energy absorption padding in the heel and ball of the foot which helps cushion during both push-off and landing—the parts of the running cycle that damage the feet the most. If you suffer from plantar fasciitis, you will be grateful for this feature!

Instability is the Enemy

As a physical therapist, I am an advocate for creating the most stable surface during the running cycle. This means being extra picky about the shoes and socks you wear. Weak, overused, or tired ankle and foot muscles can lead to ankle rolls and strains in the tiny muscles of the foot from the constant work when your foot and ankle are not supported well. Apolla Performance socks are made with targeted high compression where you need it the most—around the ankle joint and the arch of the foot. The arch actually has three zones of compression to lift and stabilize, which makes a significant difference if you suffer from plantar fascia issues. In these cases you want to prevent your arch from getting too stretched out, which will end up tugging on your heel bone. It’s a tough condition to treat, so you want to do anything you can to avoid too much pressure to this area!

Work Hard, Recover Harder 

The mid-calf Infinite Sock from Apolla Performance is the best choice for both recovery runs and your rest days. Providing your feet and lower legs with compressive support is ideal to help with circulation—the key to recovering faster. This is best done with graduated compression up the calf, which is exactly what this pair provides. Using compression socks during and after runs, especially speed workouts and long runs, is ideal for those suffering from achy calves, shin splints, Achilles tendinitis, and any other foot and ankle conditions. You want good blood flow and comfortable cushioning if you want to be fully ready for your next workout. If you are looking for happy and healthy feet, Apolla Performance has you covered!

Understanding the Female Athlete Triad and How to Beat It

Generally, exercise is known to be a beneficial component to a healthy body. Most people begin an exercise program for the sake of losing weight, which is then coupled with lowering calories and restricting certain types of food. Over time, the weight comes off, you feel more energized, and the benefits of these changes are recognized. Hopefully for the most part these lifestyle habits continue in order to maintain the healthy bodyweight. In the world of sports many athletes, especially women, exercise and diet intensively in hopes to enhance their performance. When it does, the notion is to continue the intense regimen. Little do these athletes know that the long-term effects of these habits become risky, particularly in the female population.

The Female Athlete Triad is a syndrome consisting of three symptoms: energy deficiency, menstrual irregularity, and bone loss. It is significantly common in the running population but can be found in many other sports. Most of these symptoms are ignored initially due to the fact that one is able to perform just fine. The majority will pay attention once an injury occurs. The syndrome usually begins with the intent to lose weight in order to improve performance. For runners, it is the same concept as wearing lighter running shoes—a lower bodyweight versus being overweight generally helps you run faster since your joints have less to carry. Once an athlete realizes the weight loss assists their faster paces, they want to continue getting lighter.

This pattern of dieting and intensively exercising is the beginning of the Female Athlete Triad. This eventually leads to developing eating disorders, menstrual problems and low bone mineral density, yielding a high risk of fractures. For women who were already at a low weight to begin with, the resulting outcomes are expedited. Of course, the end result of a devastating fracture is not something an athlete is seeking by adopting these habits, but in many cases it is inevitable. Although difficult to diagnose early on, this condition is most definitely preventable. The key is to be educated on and aware of the symptoms and what a true healthy body means.

Energy Deficiency

The first and most common symptom of the Female Athlete Triad is energy deficiency. Originally the term used was disordered eating, but over the years, energy deficiency seemed more appropriate because extreme weight loss and poor diet compared to the extreme exercise can exist without an eating disorder in the picture. Younger females already have the pressure these days to be thin, and when sports come into play, the emphasis is much greater. As mentioned earlier, being thinner, rather than overweight, may yield faster finish times for runners. Coaches, teammates, and parents sometimes play a role in the encouragement of “being thin to win”. This along with society’s reinforcement of the beauty of thinness is what eventually leads to eating disorders in young girls.

Anorexia and bulimia are the most common eating disorders among women and are fast and true ways to lose weight. By no means, are these weight loss options anywhere near healthy, though. Restricting calories by extreme dieting and excessive exercise are symptoms that fall into the categories of anorexia and bulimia. The extreme diet will only lead to lack of nutrients, as well as fluid and electrolyte imbalances, that will eventually leave the athlete with very low energy, poor strength and endurance, impaired reaction times, and risk of injury. Initially these outcomes go unnoticed and the athlete is attracted to the improved performance in her sport. The negative outcomes will then arise once there is a significant amount of weight lost.

Menstrual Disorders

Following the poor diet and exercise habits mentioned arises the next component of the Female Athlete Triad. Excessive exercise and calorie restriction leads to extremely low levels of estrogen. Research shows that women in good health who train for marathons can lower their estrogen levels by over 50%. Given this data, it is clear that athletes who are at an unhealthy bodyweight with significantly poor eating habits and incorporate a high level of training, most definitely lower estrogen levels by a much greater amount.

Estrogen is responsible for the growth of reproductive organs, regulation of the menstrual cycle, and the protection of bones. Normally the body will compensate for a large calorie restriction by lowering metabolism in order to maintain body weight. The loss of the menstrual cycle, or amenorrhea, is a sign that the body is in an energy deficient state. Although amenorrhea as part of the Female Athlete Triad is brought about by energy deficiency, it is also linked to low body fat percentage, nutrient imbalances, and physical and mental stress.

Bone Loss

Poor diet and the loss of estrogen are the leading cause of low levels of bone mineral density. Exercise, mostly weight-bearing, is known to be beneficial to bone health. Therefore running should be a healthy sport for the bones. Several studies on the bone health of female athletes have been conducted and the majority conclude that the bone loss occurs in the cases where there are menstrual irregularity, particularly women with amenorrhea. One study even showed that these intense athletes have bone mineral densities comparable to women in their 80s! This low bone density puts females at an extremely high risk of fractures. Stress fractures are in fact more common in athletes who present with menstrual irregularities, due to low estrogen levels.

The cases who eventually gain weight to a healthier point, resume regular menstrual cycles, and get back to a healthy diet for their training improve their bone density levels. Research has indicated that if the negative symptoms of the Female Athlete Triad are not addressed early on there is a chance that some of the resulting bone loss is irreversible. It is crucial to be aware of this condition and the early signs including extreme dieting and excessive training for the means of dropping weight for performance. Although initially an athlete may perform better, the excessive training is not realistic for the long term and will only lead to burnout and injury among other medical problems.

Steps to getting back the much needed energy, a regular menses, and strong bones start with lowering mileage and intensity, adding more calories to your diet, and regularly following up with your doctor, preferably one specialized in sports. It may seem scary to lower your running load and eat more, but taking these steps gradually can assure you get to and maintain a healthy weight and not alter your performance gains.

A Runner's Guide to a Healthy Immune System: COVID-19 Edition

The truth about the coronavirus pandemic is one that’s hard to believe. While this disease continues to spread, people all around the world are wondering how the massive changes are going to affect their lives. We are already getting a glimpse of the effects on society—closed restaurants, bars, and venues, canceled events, and limited interaction with friends and family. The effects on the economy don’t seem so big now, but as the pandemic continues to spread, the shut down of everything around the globe, including our very own jobs, is going to have a major impact on our individual incomes and economics as a whole. I mean, have you seen the stock market recently?!

As athletes, we should already treat our immune system as a priority to our health for two reasons: 1) We enter an immunocompromised state every time we train intensely, and 2) Getting sick keeps us from our regular training schedules. Most people don’t realize that it takes more than popping a vitamin C supplement every day to keep our immune systems healthy. Our sleep patterns, diet, training regimen, stress levels, and hygiene all play a big role in immune health. During a crisis such as what the world is going through now with COVID-19, we have to pay even more attention to each factor.

Diet

We all know how important a healthy diet is in general but it’s actually specifically linked to our immune function. Our immune system relies on white blood cells to create the antibodies that fight off bacteria and viruses and, believe it or not, certain foods can impair this white blood cell function. Studies have shown that a high fat diet can weaken the immune system. You may have read that a full-on plant-based diet is the way to go, but this is mainly due to the fact that plant-based diets generally have less dietary fat and more fiber—two factors that help improve immunity. You can still eat a high fiber, low fat diet and not specifically be plant-based. Loading up on fruits and veggies is also key to protecting immune health, since they are full of vitamins and minerals.

Sleep

The immune system is pretty complex, and so is the link between its health and our sleep patterns. The basic premise is that with sleep deprivation, our T-cell development is diminished. T-cells are the soldiers of the immune system that attack bacteria and viruses, and help keep us from getting sick. On top of limiting T-cell growth, sleep deprivation increases inflammatory cytokines in the immune system, leading to the development of colds and flus from the viruses that could not be fought off by the T-cells. Sleep is also when we experience our highest fever during illness. We tend to think fevers are a bad part of being sick, but it’s actually our bodies way of fighting off infection. If we don’t get good quality sleep, we can end up with a longer dose of the flu or seasonal cold. Aim for 7-9 hours each night for a stronger immune system.

Supplements

It is not absolutely necessary to take vitamins and other supplements every day in order to be healthy. If you regularly eat a wholesome diet—the right amount from each food group, then you most likely get all of the nutrients your body needs. The problem is the majority of people do not eat a wholesome diet, so taking a daily dose of the right vitamins is essential to good health and organ function. For immune function in particular, a good starting point is adding in vitamin C, zinc, and magnesium. One nutrient that is often overlooked by athletes is glutamine. This vital amino acid works directly with immune cells to fight off infection. Our body naturally produces it already, except that during times of stress, less glutamine is produced. This happens during both physical and emotional stress—intense training, sickness, cancer treatment, or even simply just being mentally stressed on a daily basis from work and family obligations. It can be helpful to add in a glutamine supplement after hard training sessions, especially during cold and flu season.

Training During the Outbreak

How many of us have had to change our training plans because either our local running routes have closed or our cities have gone on lockdown at this time? If the case is that you cannot run outside, then there are other options to get in your endurance training. Of course if you have an at-home treadmill, you are saved—you can keep your same training plan as if there was no crazy outbreak. Most of us, though, don’t have this luxury so we need to find another way. If you live in an apartment building, run laps through the parking garage. It’s not only a way to keep up your training program, but you get the added bonus of working on a hilly route!

If you are heading outdoors for your run, do your part and practice social distancing (6 feet apart from anyone!) and good hygiene. Here are some tips to follow to help keep you at low risk of catching and/or spreading any viruses:

✖️RUN SOLO - stay away from group runs, even if you think you are all healthy. Remember you can be carrying the virus around without knowing (zero symptoms!).
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✖️Don’t drink from water fountains - they are rarely cleaned and you can’t count on absolutely no one having put their mouth on the spout, and some people even spit in the fountains too! Just deal with carrying your own bottle for now.
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✖️Keep social distance - 6 feet away from every person! If you have to pass someone, try to hold your breath for a few seconds and look the other way.
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✖️Wash your hands immediately when you get home and get out of your run clothes—you don’t know what has dropped onto you while running.
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✖️Stay hydrated ALL DAY & keep a healthy diet—As stated above, this helps keep a strong immune system!

At-Home Workouts

If you can’t run outside, lack a parking garage, and don’t have enough space to jog around your home, it’s okay ! Don’t worry about losing fitness or getting out of running shape! There are plenty of exercises you can incorporate every day that will keep you in good form. You can make it a goal to maintain your endurance and strength as much as possible by combining a mix of moves. Thankfully you can still place orders online for workout equipment. My go-to tools are resistance bands and medicine balls. Click here to shop these and so many other options! To get the best out of your workouts, make sure to incorporate short rest breaks and keep your heart rate up as if you were running. Explosive moves such as plyometrics are extremely useful for runners and torch more calories than static moves. Try to keep your body moving for the same amount of time you usually run every day.

We are all hoping this virus will get under control within a matter or weeks, so it won’t be long before you can get out for a run again! The positive side of switching up your program for the time being is that you can give your body a break from the constant pounding of running and work different muscle groups. You’ll be surprised how much it will help with your form, strength, and pacing once you’re back out on the road! Endurance may lack bit when getting back into it, but it’s a part of fitness that quickly returns after just a few weeks off. The key is to keep your body moving!

Sources

1. Berenbaum, F.; van den Berg,W.B. Inflammation in osteoarthritis: Changing views. Osteoarthritis Cartilage 2015, 23, 1823–1824. 

2. Rinninella E, Cintoni M, Raoul P, et al. Food Components and Dietary Habits: Keys for a Healthy Gut Microbiota Composition. Nutrients. Published online October 7, 2019

Running with Arthritis? Here's All You Need to Know to Stay Healthy

One of the most common complaints of pain for most adults is caused by arthritis. This condition can become extremely debilitating and limit the ability to enjoy even the simplest activities. It has been a common thought that running is harmful to joints and causes arthritis. Recent research has shown the opposite results. Running can actually help control the symptoms of arthritis. Early signs are often ignored as they are usually short-lived and infrequent and can mimic other conditions such as overuse symptoms and muscle soreness. If you are a runner or partake in other activities, it is beneficial to understand the causes, symptoms, and management options available in order to avoid requiring invasive treatment.

What is Arthritis?

According to the Arthritis Foundation, the condition is just a term used to described joint disease and includes over 100 different types. It is most common in adults, but many of these types of arthritis can be found in children, as well. The cartilage located in between bones, which acts as a “cushion”, is lost creating constant pressure during activities. The earliest symptoms include joint stiffness, pain, and swelling. As mentioned, these can last a short time and occur infrequently. Stiffness is usually felt the most after prolonged positioning such as sitting or when getting out of bed in the morning. When in motion, the stiffness is usually relieved. In more advanced stages of arthritis, significantly prolonged activities can make the pain worse. Over time, arthritis can cause visible joint changes such as enlarged knuckles. Other joint deformities are only visible with X-rays.

Unfortunately, arthritis cannot be cured, but there are several management strategies available that can allow you to live comfortably without sacrificing your desired activities. The most important treatment approach, especially in the early stages, is balancing aggravating activities with rest. The key is to control the buildup of inflammation in order to avoid extreme pain to the point where you must take too much time off. For runners, this means if you are beginning to feel symptoms during or after a 10-mile run or longer, than you should be cutting back to shorter runs and adding in other cross-training activities, including strength training.

Strength Training is a Must

The constant grinding of bones with arthritis is what naturally causes pain and swelling. Getting the surrounding muscles stronger can help relieve this pressure. Stronger muscles also mean you can tolerate activities for a longer period of time, such as getting back to those 10-mile runs and racing marathons. Yes, this is possible, but runners must understand that strength training needs to become part of their regular training regimen. It is also the best way for non-runners to help control their symptoms and possibly avoid worsening arthritis and requiring surgery.

For hip and knee arthritis, which is one of the most common areas affected, especially in runners, it is important to alternate between bodyweight and resistance exercises. Both offer strength gains but give the joints a break from too much impact. Exercises should incorporate the larger muscle groups such as the quads, hamstrings, glutes, and calves, as well as smaller muscles that play a role in hip and knee stabilization. These smaller groups are the hip abductors and adductors, internal and external rotators, and the core muscles. Besides squats, lunges, heel raises, and step-ups, which all target the larger muscle groups, floor exercises for the lower body are an easy way to get in strength training at any time. Bridges, clamshells, and hip extensions are all great exercises that can be done with or without a resistance band. Core exercises such as planks and leg raises are also good additions.

Management for Runners

Besides alternating runs with lower impact cross training, there are several other strategies to help relieve symptoms. Using hot packs before activities can help ease pain and stiffness and the use of ice afterward can help control inflammatory buildup from your workout. Over-the-counter anti-inflammatory medications can also help manage symptoms. Below are other methods specifically for runners with arthritis.

• Use a run-walk method during most runs

• Eat a low-inflammatory diet. Examples of foods that help lower inflammation in the body include fruits, vegetables, whole grains, nuts, beans, and fish. Foods that can increase inflammation include fried foods, high gluten foods, processed and high-fat meats, dairy products, and foods with trans fats.

• Run on softer surfaces. Consistent road running causes repetitive pounding on joints. Try alternating running on trails, grass, and the treadmill.

• Warm-up properly. Getting right into running on stiff joints can exacerbate symptoms. Incorporate dynamic stretches such as leg swings, lunges, hamstring and quad pulls, and ankle rolls before every run.

• Exercise consistently. Avoid taking long breaks in between workouts. Even if you do not have time for your training runs due to a busy work and family schedule, you can increase the amount of walking during the day by parking further from your destination, stretching while cooking dinner, or waking up 15 minutes earlier to add in a few exercises before starting your day.

Sources

Paul T. Williams, Effects of Running and Walking on Osteoarthritis and Hip Replacement Risk, Journal, Sep 2019

Ponzio DY, Syed UAM, Purcell K, Cooper AM, Maltenfort M, Shaner J, Chen AF, Low Prevalence of Hip and Knee Arthritis in Active Marathon Runners, Journal , Sep 2019

Arthritis Foundation, What is Arthritis?, Website, Sep 2019

Hypothermia in Runners is a Thing: This is What You Need to Know

Since the Boston Marathon is quickly approaching, many runners are being reminded of the tortuous weather from the 2018 race, where hypothermia struck a great deal of racers. Most research emphasizes the importance of understanding how to deal with running in warm weather and the detrimental effects heat illness has on the body. Although it seems it is more common to suffer from dehydration and a heat stroke, the opposite is also quite often experienced in runners. Hypothermia occurs when the body temperature drops to below normal levels, which is about 98.6 degrees, and the body is unable to produce heat at a faster rate than it is losing it. The reason it may be less common for hypothermia to occur in runners is because our bodies naturally produce heat while in motion. This does not mean that outside factors cannot contribute to causing more heat loss while we are running.

Year-round many races are scheduled far away from the hot summer months to avoid heat illness, but what about the races that fall during drastically cold temperatures? Many runners who train up north may get used to running in cold temperatures but will often skip running outside when temperatures drop too low or during rain or snow. The worst cases of hypothermia occur with a mixture of temperatures below 50 degrees, wet conditions, and significant wind. Although your body is producing heat while running, the mixture of these cold and wet conditions will eventually cool the body down at a fast rate, especially during long races such as marathons.

Symptoms of Hypothermia

Mild Hypothermia

During hypothermic states, when the temperature drops below 95 degrees, symptoms experienced can include shivering, slurred speech, loss of coordination, fatigue, and pale skin. During the start of decreasing body temperature runners may simply feel shivering which normally creates body heat along with goosebumps from heat loss in the skin.

Moderate Hypothermia

Once a runner begins to experience numbness and fatigue, hypothermia is continuing to advance. The fatigue that sets in causes one’s pace to slow which will end up generating even less heat in the body. Even worse is if the fatigue causes a runner to slow to the point of walking or stopping altogether, even if just at the aid stations. This will eventually lead to a severe sensation of cold deep to the core of the body and result in chattering of teeth and uncontrollable shaking that although produces heat will only cause more loss of energy.

Severe Hypothermia

When body temperature drops into the 80s and no medical treatment has been sought, one may develop a significantly low pulse and breathing rate and eventually end up unconscious.

Preparing for Cold Weather Running

Of course, the first piece of advice given to runners is to layer their clothes according to the weather. Since hypothermia is more common during cold AND wet conditions the best layers are those that are thin and waterproof, although this may not even help you during a torrential downpour. The idea is to not wear too much clothes thinking it will keep you warm as all the constant rain will do is weigh you down and end up slowing your pace as well as keeping you cold. Besides opting for the most waterproof and windproof clothes, below are other tips for preparation.

▪  Wear several extra layers before the start of the race to ensure to retain as much heat in your core as possible. Once you start running you can begin to shed these items as you go. If the start of the race is going to be a wet one, wearing an old pair of socks and shoes is best. Change into your race shoes and one or two thin layers of socks before heading to the start line.

▪  Wear proper gloves and a hat or two. The areas of the body where heat is more easily lost are the head and hands so keeping those areas covered is important. Just as with waterproof clothes, having a waterproof hat is ideal. It is important to try an keep gloves as dry as possible, so reaching for drinks at aid stations should be done carefully as to not spill liquids onto the gloves.

▪  Use hand and toe warmers. These nifty sacks are great to stuff into your gloves, hat, and shoes for extra warmth. Taking your own bottle of fluids on race day may be a better option if you have the hand warmers as it will keep your fluids at a warmer temperature. This is ideal since chugging the water or electrolyte drinks at aid stations may be too cold and cause a faster drop in body temperature.

▪  Wear a neck gaiter or scarf to cover your face. In cold, windy races the constant breathing in of that cold air may cool the body down even faster and cause abnormal breathing throughout the race. This is especially important for those with asthma.

▪  Hydrate as needed. As mentioned, the fluids at the aid stations may be cold but turning them down at every stop may not be a good idea. You can still develop dehydration when in a hypothermic state. Our bodies actually require more energy and electrolytes in order to keep warm and running.

Treatment

If you develop any moderate or severe symptoms of hypothermia during a race or other training run, seek medical attention as soon as possible. During these severe conditions, the medical teams are all prepared to assist athletes and bring their body temperatures back up. Once in the warmer medical tents, the first thing that should be done is shedding of all of the wet clothes immediately and get wrapped in warming blankets and hot packs. Temperature should be taken frequently, and if body temperature does not begin to rise within 20 minutes, the athlete should be transported to a medical facility. Treatment will also include drinking hot fluids to get the core warm more quickly.

It is important to understand the symptoms of hypothermia and when it is safe to run. If you develop any of the initial symptoms of a significant drop in body temperature and quickening your pace or ingesting warm fluids while running is not getting you warm, it is imperative to stop running and head indoors or to the medical tents if racing. Although it is easier to warm yourself back up than it is too cool yourself down if experiencing heat illness, it is not a reason to ignore the symptoms of hypothermia. Doing so will lead to serious health risks.

Sources:

Jessie Fudge, MD, Exercise in the Cold: Preventing and Managing Hypothermia and Frostbite Injury, Journal, May 21, 2018

Achilles Issues & How to Fix Them

Some muscles work harder than others during running. One of these star players is the calves. Well, they pretty much work during every movement we do. Crossing both the ankle joint and knee joint, the calf is involved with any activity that requires us to push off of our toes. Not only that but they are also highly active when trying to control our descent during downhill running or walking. Since they play key roles during every part of running, we should be taking very good care of them every day. Strengthening and stretching the calves on a regular basis is an important part of training.

Having limited strength and flexibility in the calves leads to numerous injuries and pain including shin splints, plantar fasciitis, tendonitis, knee issues, and even hip and back issues over time. One common injury experienced by runners and many other athletes is Achilles’ tendinitis. The Achilles tendon is a thick band that connects the calf muscles to the heel of the foot. It is a prominent tendon in most people. All of the forces generated during running, especially during the push-off phase, are transmitted to the Achilles’ tendon. Faster running usually transmits more forces leading to injuries in the area.

What is Achilles’ Tendinitis?

When there is increased strain to the Achilles’ tendon, inflammation, irritation, and degeneration occur. The overworking of the tendon creates tiny microtears that weaken over time and can eventually lead to larger tears and ruptures. The most notable symptoms of Achilles’ tendinitis is visible swelling in the tendon, tenderness, and pain when first getting in up in the morning and when trying to stand on toes. Once it is warmed up the pain will usually subside and runners are able to run through it. As the condition worsens, the pain will gradually reappear and eventually limit the volume and speed of running. Tendon tears and ruptures will either have a visible bump over the area and commonly a gap where the tendon is ruptured.

Biomechanics

Although high volume training, speed training, and lack of strength are all causes of Achilles’ tendon issues, many physiological and biomechanical factors can increase the strain on the tendon and risk developing these problems.

Foot Strike

You have probably heard about how terrible heel striking is for runners. Well, the truth is that the research is inconclusive and heel striking actually works for some people. The reason this type of foot strike is related to Achilles’ tendon pain is that it involves increased stretching of the tendon. So if you already have tight calves to begin with, then the constant pulling during heel striking can lead to overstretching. The opposite type of foot strike, forefoot striking, actually creates a worse strain on the Achilles’ tendon. With this motion, you are basically landing on the toes and pushing off for the next stride all without giving the calves a break.

Pronation

Foot form is different for everyone. Flat-footed people or those with pronated feet (foot is turned inward when standing) will have a more strained Achilles’ tendon, as well as impeded blood flow to the area. There is already an area with limited blood supply, termed the “watershed area”, where the majority of tendon ruptures occur. This area is located about 4cm above the end point of the tendon on the heel. Limiting blood flow further as in the case of pronation will increase the risk of damage and slow healing on the tendon. Using supinated running shoes or inserts to decrease the amount of pronation is a treatment strategy.

Treatment & Prevention

Runners should focus on incorporating calf strengthening a couple of times every week, especially during their training seasons. Heel raises in all planes—toes pointed straight, toes pointed inward, and toes pointed outward are the main exercise for the calves. Seated heel raises or while in a squat position will help strengthen the soleus muscle, which is a muscle found deep under the gastrocs, the main calf muscles, that also connects to the Achilles’ tendon. Eccentric heel raises are the best way to strengthen the calf muscles as this will prepare the tendon for activities in which it is required to control the descent from extreme positions. To perform eccentric heel raises follow these steps:

1. Stand on a step with both heels hanging off.

2.  Lift both heels together.

3. Once completely on toes, shift all weight to only one leg and slowly lower the heel to just below the edge of the step.

4. Repeat 10-20 times on one leg, then repeat the same with the other leg.

Essentially this exercise will create a type of damage in the tendon, which strips away the previously damaged fibers and encourages the development of new fibers as a form of healing.

Runners should also incorporate stretching after every run and activity that highly involves the Achilles’ tendon such as hiking and climbing stairs. Stretching with both the knee straight and bent is important in order to include both the gastric and soleus muscles. Foam rolling is also helpful to break up any adhesions and extreme tightness in the muscles. Although strength training is time-consuming during training season, it is very important in order to prevent injuries. Achilles’ tendon injuries can be frustrating as they are frequently overlooked since the initial stages involve pain-free running. Taking care of Achilles’ issues from the start will involve a short rehab time while waiting until the pain is unbearable and affecting your running can leave you out of the sport for several months.

Sources:

Răzvan Aniţaş And Dan Lucaciu, A Study Of The Achilles Tendon While Running, Journal, Sep 07, 2018

Physical Therapists: The Experts of Movement

Pain or injury can strike just about anyone at any stage in life. Whether you are a professional athlete, weekend warrior, or even a sedentary person, your body can suffer aches, strains, overuse, or accidental injuries with any move you make. The good thing is for most of the everyday aches and pain many go through, as well as muscular and joint-related injuries, a physical therapist can come to the rescue.

Not only can physical therapists help with hands-on techniques to relieve pain and improve joint and muscle mobility, but they are well-educated in exercise rehabilitation for the prevention of issues in the future. You can definitely learn helpful tips from these professionals on how to keep your body healthy and be stronger at your sport of choice. There are many physical therapists who specialize in orthopedic problems as well as sports-related injuries. This may come in handy for those who have experienced issues with injuries resulting from poor posture and mechanics, or specific weaknesses in certain muscle groups.

Manual Therapy

Soft tissue injuries usually require some form of hands-on therapy to relieve stiffness in joints, tightness in muscles, or scar tissue development from surgery or old injuries. Many people think that physical therapy is just about massage and stretching, but it is the conjunction of these techniques with exercises that relieve pain and dysfunction for the long term. If a therapist solely uses a joint mobilization technique to increase the range of motion of a shoulder, for example, the stiffness will just return if no exercises are used to strengthen the joint to remain in that loosened position.

The massage used in physical therapy is not your typical massage you get at the spa. Soft tissue mobilization is the proper term and is used specifically for loosening tight muscles and tendons, especially at their connections to the bones, as well as for flushing out toxins and inflammation to relieve pain and improve movement. It is not typical for a physical therapist to be spending more than 10 or 15 minutes “massaging” one area. This technique is frequently used as part of a warm-up for exercises and stretching.

Specialty Techniques

Active Release

You have probably heard of ART before, which is a common form of therapy used by physical therapists, chiropractors, and massage therapists. This form of massage is where deep pressure is applied to an area of tightness or pain while instructing the patient to actively move as if stretching the area. This technique, by no means, feels good as most massage does. The patient will usually feel an uncomfortable stretching sensation. ART helps to break up any adhesions and scar tissue that is causing limitations in mobility.

Graston Technique

This form of soft tissue mobilization uses an instrumental tool to produce microtrauma to an area that already has scar tissue and adhesions present. It may not make sense to cause further injury to an area, but it will actually restart the healing process by increasing blood flow and supply the nutrients needed to properly heal the area. Studies have shown that many common running-related injuries respond well to the Graston method such as Achilles tendonitis, runner’s knee, plantar fasciitis, shin splints, and hip flexor strains.

Dry Needling

Similar to acupuncture, this technique has more recently been used by physical therapists to address trigger points in the body. Trigger points are usually sensitive to the touch and may sometimes produce pain in other areas of the body. Dry needling does not use any form of medication along with the injection and can be performed superficially or deep in the affected tissue. The idea is that this needle injection helps release the tension in the trigger point to improve pain and relax the nerves that are transmitting the pain impulses to the muscles. Therapists can actually feel the extent of tightness in muscles, which is invisible to other diagnostic tools such as MRIs, CT scans, and X-rays.

Exercise

The treatment approach of exercise is the most important part of physical therapy as it is what will bring long-term results. Manual therapy and modalities, including hot and cold pack treatment, will usually only provide temporary pain relief and joint mobility. Without the exercise portion of physical therapy, your body will just return to its original state of joint limitation and muscle tension once you resume your regular activities. Physical therapists are the experts in exercise for flexibility and strengthening, as well as the safe transition back into your sport. Unlike personal trainers, physical therapists are highly trained in injury prevention and can guide patients with a healthy approach to returning to their activities. For these reasons, when choosing a trainer to help you get into shape, a physical therapist may be a better option over a certified personal trainer.

Sources:

1American Physical Therapy Association, The PhysicalTherapist’s Guide to Healthy Running, Website, Jul 08, 2018

James Dunning, Raymond Butts, Firas Mourad, Ian Young, Sean Flanagan, and Thomas Perreault, Dry Needling: A Literature Review with Implications for Clinical Practice Guidelines, Journal, Jul 08, 2018