This post discusses how to introduce/re-introduce running into your life. Running may seem like a basic task, but in reality, it is a skill. Learning how to decrease your injury risk is important and the topic of this post.
Running in any form is a serious undertaking for the body. Each step sends forces through your ankles, knees, hips, and spine that equate to roughly 3x your body weight (1). Due to the high levels of forces it is important that you properly warm-up before you go for a run.
Warm-ups should be considered active, not passive. They should include movements that prime the nervous system and promote active mobility. In general, the intensity should increase as the warm-up progresses, and take roughly 10 minutes.
Following the warm-up, ease into your run with a light jog or a 5-10 minute walk. This will help further prime the muscles used while running.
There’s many ways to carve a turkey, just as there’s many ways to gain mobility in a joint. The major-key is having a reason for each movement. Below are some selected mobility drills for ankle, hip, and thoracic mobility.
HOW MANY: Do 2 sets of 10 repetitions for each movement.
- Starting Position: Stand with toes 6” from a wall. Foot pointed straight ahead.
- Movement: Try and get your knee as close to the wall as possible without lifting your heel.
- Starting Position: On the hands and feet in the quadruped position.
- Movement: Example - Left Hip
- Bring left leg to outside of left hand
- Rock the body 5x front/back, and then 5x left/right
- Switch legs
Thoracic Spine Mobility:
- Starting Position: In side lying with your top leg crossed over the body and rested on a foam roller (leg height should be at waist height).
- Movement: Start with your one hand on top of the other. Rotate your shoulder towards the ground. Make sure your focus is on rotating from the shoulder, not the arm.
- Tip: Don’t forget to breathe! Inhale when arms come together, exhale while arms are spreading apart and thoracic spine is rotating.
- Starting Position:
- Side-side swings: Facing a wall/fence with enough room between you and the wall to swing your legs.
- Front-back swings: If swinging left leg, stand so the wall/fence is to your left.
- Movement: side-side and front-back
- Side-side swings: Drive your leg towards the mid-line of the body, let the elastic energy at the end help you drive your leg back out. Repeat in a dynamic fashion.
- Front-back swings: Drive your leg backwards, let the elastic energy at the back help you drive your leg forward. Repeat in a dynamic fashion.
- Tip: This movement uses momentum to open up the hip, as well as mobilize the ankles. Work within your given range, don’t compensate, and don’t overdo it.
Your neuromuscular system plays a huge role in running. The nervous and musculoskeletal systems work together to create stability, mobility, elasticity, and regulatory roles. “Priming” this system prior to your workout helps get blood flow to the muscles and ramps up the neural drive.
HOW MANY: 2 sets
DISTANCE: about 50 feet, or half a basketball court distance
- Alternating lead legs, with twist over lunging leg
- Knee shouldn't lurch over the foot, lead heel should stay on ground
- Backpedal back to start
- Like regular skips, except you're really trying to cover a large amount of horizontal distance with each skip
- TIP: Land softly, be cautious on uneven terrain
- Backpedal back to start
- Instructions: Direction going to the RIGHT >>
- Cross left leg in front of the right leg
- Step open with the right foot (to start position)
- Cross left leg behind the right leg
- Step open with the right foot (to start position)
- Repeat (in front, open, behind, open > in front, open, behind, open, etc.)
- Back to Start: Facing the same direction! The opposite leg will be crossing over/behind on the way back
Wait - what about stretching?
In general, holding a static stretch increases flexibility in both the short term and long term, however several recent reviews have agreed that static stretching for greater then 45 seconds immediately before performance either; 1) negatively influences maximal strength, power, muscular explosive performance (e.g. jumping or sprinting), balance and agility, or 2) has no effect on performance.
Shorter duration static stretches are also hard to justify immediately before participation given the potential for decreased performance and lack of clear benefits(2). Stretching certainly has its place, however it should be purposeful. To quote our blog on stretching, “Remember, the why in what you do is everything. Random assortments of mobility drills, with random time periods because Joe Schmoe told you to do so is not good enough.”
Give the above warm-up routine a shot before your next running workout. It focuses on mobility deficits commonly seen with runners, and ramps up in intensity leaving you feeling fit and ready to roll.
- Nilsson, J., and A. Thorstensson. “Ground Reaction Forces at Different Speeds of Human Walking and Running.” Acta Physiologica Scandinavica, vol. 136, no. 2, 1989, pp. 217–227., doi:10.1111/j.1748-1716.1989.tb08655.x.
- O'Sullivan, Kieran, et al. “Injury Prevention and Management Among Athletic Populations To Stretch Or Not To Stretch?” Aspetar Sports Medicine Journal, pp. 624–628.
When you think Physical Therapy, what do you think? If you imagine it is a place where you get a massage, do the same exercises as everyone else (on a table) for an hour, or simply a place where you are told what you cannot do/should stop doing, you are thinking of an older model of care.
It seems more and more that the gap between the rehabilitative field and the strength and conditioning field is becoming narrower by the day, and for good reason. Rehab IS strength and conditioning, just on the opposite side of the continuum.
When tissue gets injured it is our job to influence the healing process while maintaining progressive overload to create resiliency. Better known as the act of accepting the demands of weight training, running and sports without being re-injured or suffering set backs. In order to do this we must use the appropriate load, intensity and volume that challenges the injured tissue without irritating their symptoms.
- LOAD >> CAPACITY = INJURY
- LOAD = CAPACITY = REHAB
- LOAD << CAPACITY = PREVENTION
This sounds a lot like what I used to do as a strength and conditioning coach. Create an exercise program that uses the appropriate loads, intensities and volumes that will help create positive adaptations without hurting my clients.
The goal of rehab after all is to get the person in front of us back to their prior level of function. This can be anything from being a desk jockey to the All-American Jockey.
When healthcare professionals do not understand strength and conditioning protocols, it will be hard to help that patient to continue to train around injury.
This is an e-mail that I received this morning from a trainer that I work closely with:
"Hey Joe. I have a question. I have a client that is seeing a PT for some shoulder issues. The client introduced us through email so we could work together to figure out an alternate plan of training that would allow her to get the treatment she needs for her shoulder while continuing her training. The PT responded that he wants the client to abstain from any and all exercise, like do nothing at all."
No one should ever have to hear that have to abstain from all exercise unless it is 100% warranted. If I person can go into the gym and perform pain free movements, they should, not just to keep their body some-what conditioned, but to help keep them sane. There are plenty of activities one can perform while still "protecting" healing tissues.
This is where a healthcare professional who also has experience as a strength coach can really help. It becomes very easy to understand regressions and lateralizations of exercises that will allow them to still have some training effect while recovering from their injury.
For these reasons, it becomes highly important for rehabilitation providers to understand performance, and on the flip side strength coaches and trainers to understand more of the rehabilitation world. This will allow for better communication, and make for a much better transition from being hurt to getting back to your previous self.
It is okay to not know everything, actually it is perfectly normal. However, identifying areas of opportunity in our practice and linking them with patient's needs should force us to build a reliable network of providers in order to ensure that each and every patient receives optimal care and has the greatest chance for success.
When it comes to mobility work and stretching, your goals should dictate what you do. These goals direct your prescription of the type of mobility work and how long you should hold your stretches for.
Joe Gambino and Vikash Sharma review their learnings from the Titleist Performance Institute Level 1 seminar.