When Pain Becomes an Injury. What Next?

By Jessica Green

Returning to running after pregnancy is hard . . . even 8 months postpartum. Pregnancy is one of many things that can seriously throw your body out of whack. Don't let life events damage your running career long term. Take control and see someone before it's too late.

If you're reading this, then chances are you enjoy running and you have a long term goal to run for the rest of your life. I share that long term goal with you, but over the last few months I've been wondering why my body feels like a 55 year old body rather than a 35 year old body.  More specifically, I was afraid to try new workout classes or do intense speed workouts for fear that sporadic aches and pains that I've been dealing with since the birth of my second daughter 8 months ago would manifest into full blown injuries.  And then it happened . . . I got injured after throwing caution to the wind and doing an intense stair workout.

After two weeks off from running, I felt new again, but deep down I knew my body wasn't whole. In reality it hasn't been whole since the birth of my first child almost 3 years ago. Despite a marathon PR 14 months after her birth, I've felt muscular imbalances and weaknesses since her arrival that didn't exist pre-pregnancy.  As time progressed, I began to wonder how these would effect me down the road. Unless I did something to address them, they would only get worse. I started worrying about how I will feel by the time I really am 55 and beyond? The answer wasn't pretty. 

The recent injury coupled with the same on again/off again aches and pains since my first childbirth led me to seek out a physical therapist this month who is as committed as I am to helping me fit the puzzle pieces of my body back together. To an outsider, I don't appear injured. I'm able to comfortably power up huge hills on the trails, complete interval workouts and enjoy long runs on the weekends. Dig a little deeper though and you will find major deficits in some areas of my legs and glutes as a result of compensation and lack of strength. As long as I don't do anything, the chances of more serious injuries and discomfort only increase down the road - and my body will feel older than it should!

The takeaway, if you find yourself with nagging aches and pains that don't necessarily stop you in your tracks, but do prevent you from engaging in certain activities or feeling 100%, then take some time to fix them! This doesn't mean you have to stop running. For me, this means making a plan with my physical therapist. I see her once a week - It's basically the same commitment as a weekly workout class.  I have had tremendous success with my physical therapists in the past for both rehabilitative work and preventative work. Good ones are worth every penny.

Don't have a physical therapist? Not all PT's are created equal. Ask around for recommendations and find one that you connect with. If you don't like the first one you go to, keep trying. You're not locked in. It took me a couple tries to find a new one after moving to Portland, OR from NYC and leaving my favorite PT behind. Yes, I miss you Erica Meloe!

I'm not necessarily thankful for my injury, but I am thankful that it inspired me to take control of my body and reminded me that the more I "enable" my imbalances and weaknesses the more I throw off my game and limit myself in the future. I'm also thankful for these two little rugrats despite the chaos they imparted on my body!

My new long term goal? To feel 35 when I'm 55, not the other way around!

Interview with a Physical Therapist

Erica Meloe is a physical therapist and the co-founder and Director of Velocity Physiotherapy in New York CIty. She is an innovative physical therapist who combines her knowledge of orthopedic and neurological assessment and applies this model to treating pain in all areas of the body. She calls herself the "non-traditional", "traditional" physical therapist and gets results when others therapists do not. Erica believes in treating the whole patient, not just the body part in question.

Why do you like working with runners?
I really enjoy working with runners because they are a highly motivated group of individuals. They understand what needs to get done to put themselves back into the "game". I would say that the more experienced the runner is, the level of understanding with regards to rest and cross training is higher and more of a priority. However, no matter what level of running, their passion for the sport is incredible! Runners are a focussed group and "in touch" with how they feel when they run. It's this body sense, that makes them interesting and fun to work with!

If you could tell a runner one piece of advice, what would it be?
Prevention. Do not always wait to seek out a physical therapist until you are in pain. Engage a physical therapist ahead of time for a preventative musculoskeletal screen to determine if there exists any dysfunction in your body that may predispose you to an injury. Poor running mechanics in addition to ineffectual training methods can pose a significant injury risk. A physical therapist can formulate an individualized program that can address these dysfunctions and make your running a much more pleasurable activity. Furthermore, they can introduce you to some alternative techniques such as focussed breathing when you run that will also help make your running more efficient. Depending on the state you live in, you can access a physical therapist without a doctor's referral for a limited period of time.

What is your go-to fitness activity and why? 
I enjoy running, Ashtanga Yoga, hiking and tennis because the majority of those activities get me outdoors. I love being outside! But if I can't do that, I will get on the elliptical.

What is your favorite post workout meal?
I don't have a specific meal after a workout, but I do drink lots of water. The only thing I would recommend is to keep it light.

Base Training 101 - Prepare for Race Season

Marathon Season is approaching fast! What are you doing now so you’re ready to hit the ground running (literally) once race training formally begins? The answer - invest in a solid base training program.

What is base training? Base training involves a healthy combination of strength workouts, longer distance runs, stamina building tempo and interval runs and hill work during the weeks leading up to formal race training. During this time, you work on strengthening and balancing major running muscles, safely re-introducing intervals and hill workouts at medium intensity and improving your stamina with weekly runs at a harder, sustained effort.

Why do I need it? The goal of base training is to develop your muscular strength and cardiovascular endurance to enter race training with a proper foundation. This way you can jump into higher intensity workouts without risk of injury, and effectively execute each workout to reap the most benefits.

When to implement? Six to nine weeks before race specific training begins. We recommend a solid nine weeks for maximum strength and endurance adaptations.

Who is it for? Anyone who can comfortably run at least three times per week for a total of 10-15 miles a week and is beginning a formal race training program in the upcoming months.

The month of May at Hot Bird Running is all about base training. Whether you’re coming off a spring half marathon and ready to get back into running or you’re in the final count down before your marathon training starts this summer, base training is for you. Maintain a year round, balanced approach to running with a proper base training plan. Stay tuned all month for our base training tips - get the base before the race.

Injury Prevention: Dynamic Warm Up Video

Risk of injury increases anytime you try new training techniques, ramp up the intensity of your training, or take on familiar, yet hard workouts on a weekly basis.  To reduce the risk of injury and give your body a chance to perform its best, make sure to include more than just a slow warm up jog before you pick up the pace.   By more, we mean include some dynamic warm up exercises to get the glutes, abdominals quads, hips flexors and hamstrings warmed up and ready for action in workouts such as hill training, track workout, strength exercises or even tempo runs.

A few of our favorite dynamic warmup exercises include high knees, butt kicks, side to side, karaoke and single leg swings.  Watch our video for demonstrations of each or read our descriptions below.  Either way, make sure to incorporate some sort of dynamic warm up before your high intensity workouts!

High Knees: Stand with your arms by your sides. Raise one knee up and forward, swing opposite arm.  Bring this foot down and raise the other.  Repeat movement coming forward. Continue for 30 seconds.

Butt Kicks: As you run, kick your heels to your butt. Goal is to kick your butt as many times as possible in 30 seconds. Keep back straight.

Side to Side:  Stand with feet shoulder-width apart and up on your toes.  Swing your arms up over your head opening up your abdominals and spine as you hop off one foot taking a wide step.   Let your arms swing down and back up again as you continue to slide side to side for 30 seconds up to one minute.  Repeat facing the opposite direction.

Karaoke:  Stand with feet shoulder-width apart, and cross your right foot in front of your left foot keeping your hips and upper body straight and facing out. Continue to cross the opposite foot in front of the other.  Continue for 30 seconds and then repeat facing the opposite direction for 30 seconds.

Straight Leg Swing:  Stand with feet hip-width apart.  Swing one leg straight in front of you and then swing back behind you keeping back straight and pelvic square.   Repeat for 30 seconds to one minute on each side.  Modified:  Find something on the same side as the leg you are swing to hold on to for balance.

Tip of the Week: Tools to Aid Recovery

Recovery is a major aspect of any training plan (from a 10k race to a marathon). It's just as important as the long run or the weekly tempo run. Recovery can be an overlooked and often forgotten part of your training.  Here are a few recovery products that travel with us and can be used just about anywhere - we highly recommend all of them!

What our Run Recovery video to see our favorite products.

The Stick: we use the "Sprinter Stick" because it's firm and short. You control the pressure, either getting a light or deep massage. Great to use on the legs and easy to pack!

The Grid, from Trigger Point Therapy. This is a light weight, versatile foam roller. We like it because it's a 1/4 of the size of a foam roller, firmer and hollow (great for packing!)

Airex Balance Pad.  This balance pad, which we bought at the suggestion of our Physical Therapy, is a training tool that combines exercise and balance skill to improve strength and coordination. We love it for strengthening our ankles and knees.

7 Reasons Why Massage is Great for Runners

We asked one of our favorite Brooklyn massage therapists (who has helped us recover from many a long run) to discuss the merits of massage and why it's great for runners. 

by Jennifer Mayer, LMT

PREVENT: Massage can help prevent injuries by increasing fluidity in tissues, increase range of motion and increase flexibility. Additionally, massage is an excellent way to gain valuable information about the condition of your muscles and work out any potential areas of tightness that could lead to an injury.

STRETCH: Stretching improves range of motion, muscle flexibility and prevents injury. All three are important factors to keep you running healthy and injury free.

FLUSH: Running produces lactic acid, a metabolic waste product the gets stuck in the muscles. Lactic acid causes pain and discomfort by irritating the nerves in the muscle tissue. Massage flushes lactic acid out of the muscles, enabling you to recover quicker, with less pain and discomfort from workouts.

EASE: Massage helps the body move freely and with more ease. When muscle repairs itself after exercise and strength building, the muscle fibers are misaligned. Massage helps realign these fibers.

HEAL: By increasing blood flow, massage helps injuries recover faster by bringing essential nutrients and tissue repairing cells to the injury site. This increased flow also removes wastes created by the injury quicker, further supporting the healing process.

SUPPORT: Massage with an emphasis on structural alignment helps runners keep good posture and structural integrity by releasing tightness throughout the body. Releasing tight feet can do wonders for your gate and low back or hip pain.

DOWN TIME: Rest is an important aspect of any training regime. Massage encourages time for rejuvenation to restore your reserves.

Jennifer Mayer is a licensed massage therapist practicing in Brooklyn, NY. Over the past 8 years as an LMT Jennifer has had the pleasure to work with athletes from all backgrounds. From eager rock climbing kids, to professional cyclo-cross racers to individuals training for 10ks and triathlons to Olympic runners. Jennifer also specializes in prenatal and postpartum massage. You can visit her website www.mamamoonnyc.com for more information.

Update on 2013-04-02 15:48 by Hot Bird Running

As we focus on recovery this April, Jen Mayer's advice is just as practical and needed! Reward yourself post race with a relaxing, soothing, vital massage.

Our Favorite Core Strength Exercises

We love our core strength workouts. We recommend working your core at least 5x a week - yup, 5x a week. That doesn't mean busting out 100 crunches and calling it a day.  Instead, we want our clients (and everyone) to do concentrated, effective core exercises.  A strong core helps increase your running efficiency, lowers the risk of back and pelvis injuries and increases your stability.

Here are our other favorites:

• Plank: Begin on elbows and toes (make sure elbows are directly underneath your shoulders). Hold for 15-20 seconds and work up to 45 seconds.


• Side Plank: Begin by laying on your side. Push your hips up so you are on the outside of your right foot and right elbow is underneath your right shoulder. Hold for 15-20 seconds, switch sides; work up to 30 seconds. Repeat 2x.


• Knee to Elbows Reverse Crunch: Begin on hands and knees. Bring opposite knee and elbow in towards your center, crunching in your abs and hold for 3 seconds, straighten leg and elbow out away from center and then bring back in again and hold for 3 seconds. Do 10 reps on each side, 2x.


• Superman: Raise arms and legs off the ground (keeping neck in line with your spine and relaxed) and hold for 3-5 seconds. Repeat 10 times.

Women's Health has some great exercises that you can do standing up. Check em out and remember, perform core exercises 5 times a week!

Strength Exercises for Runners

Runners are lean and strong, right? Wrong. Most of us don't have the core strength or gluteal (buttocks) strength to run faster, stronger and efficiently. The gluteal muscles are commonly left out of runners' strength programs. The glutes are a key muscle in our running movement because they keep our pelvis level and steady, extend our hip, propel us forward, and keep our legs, pelvis, and torso in alignment. So when our glutes are weak, our entire movement chain is disrupted and at risk of injury (IT syndrome, runner's knee and Achilles tendinitis). Have no fear, you can develop that strength within a few weeks.

Key exercises for runners: squats, lunges, planks, side planks and pushups.

Squat:
Body part:Buttocks/Hamstrings/Quads
Stand with your feet slightly wider than hip-width apart, and point your toes slightly outward. Sit back as if you were sitting in a chair that is slightly too far behind you. Keep your knees over your ankles. Keep your back straight and as upright as possible.

Lunges:
Body part: Buttocks/Hamstrings
Take a good size step forward with one leg. The front leg is bent so that your knee is directly over your ankle (forming a 90-degree angle). The rear leg is straight. Return to a standing position by pushing backward with the heel of your forward leg. You should feel the exercise in the buttocks and backs of legs. Repeat with the other leg (15 reps each leg).

Forearm Plank:
Body part:Abdominals
Begin with your forearms and toes on the ground. Make sure your elbows are under your shoulders. Keep your body in a straight line from torso to toes with no sagging or bending. Hold for 30 seconds. Optional: Raise one leg off the ground for 10-15 seconds.

Side Plank:
Body part:Obliques
Begin with one forearm on the ground, with your elbow under your shoulder. Place top foot directly on top of the bottom foot. As you exhale, lift your hips off the floor. Keep your body straight and hips lifted for 30 seconds. Optional: Raise your top leg a few inches off your bottom leg.

Pushups:
Body part:Pectorial muscles (chests), biceps
Lie chest-down with your hands at shoulder level, palms flat on the floor and slightly more than shoulder-width apart. Have your feet slightly apart with toes tucked under. Inhale as you lower your chest to the ground, bring your nose to the ground. Exhale as you push up. If you can't do a full motion pushup, bring your knees to the ground.

There are many, many other phenomenal exercises for runners but these are the key ones that we focus on and make sure we integrate into our daily workouts. Join us for our Hot Bird Workout every Tuesday at 7am or 7pm at Pier 1 of Brooklyn Bridge Park!