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Get Fit, Stay Fit Tip of the Week - Overuse Injuries in Distance Runners

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Get Fit, Stay Fit Tip of the Week - Golf Conditioning

Could you be at risk for a labrum tear?  Learn more about what a labrum tear actually is by clicking on the link below.  Listen to SPTNY's Regional Clinical Coordinator, Drew Jenk, DPT, discuss Labrum Tears on Syracuse Sports Talk Radio show 1260 The Score.  With three locations in the Syracuse area Drew is featured on The Score every Friday @ 1:30pm with the Get Fit, Stay Fit Tip of the Week.  If you have more questions on this topic feel free to contact Drew at .

 Get Fit, Stay Fit Tip of the Week - Labrum Tears

The pelvic tilt is an exercise that helps avert back pain by strengthening and stretching the muscles that support the back. This exercise targets the abdominal muscles and buttocks. To perform the pelvic tilt, lie on your back with your knees bent. Then, tighten your stomach muscles and consciously press your lower back into the floor. Raise your hips slightly but do not allow your lower back to come up off the floor. Hold this tilted position for ten seconds, then relax and lower your hips. Repeat three to five times.

This exercise is safe to perform once or twice every hour during bouts of severe back pain. First, however, consult with the physical therapist before attempting this regimen. The movement also can be done while on hands and knees (the common recommendation in pregnancy), sitting in a chair or standing, always tightening the abdomen, rocking the pelvis and pressing the back flat.

There is the general perception that the thickest, spongiest soles offer the most protection. However, according to experts in biomechanics, running shoes with soles that are too thick compromise balance. It has been found that feet naturally strike harder as they struggle to maintain balance. As a result, runners with overly thick soles on their running shoes invite ankle sprains and other running injuries, even if they run only a few miles weekly. Research also shows that runners who wear thick-soled shoes are twice as likely to injure themselves as runners in thin-soled shoes. To see if the soles on your running shoes are too thick, stand on one foot. If you have trouble balancing, think about getting a new pair with thinner soles when you next shop for running shoes.

 Shoes are a runner’s most important piece of equipment. They help prevent injury and they may help the running gait be more efficient. Because of the complexity of individual foot biomechanics and the complexity of running shoes on the market, it is usually a good idea to go to a specialty running shoe store – as they will have the expertise to help you find the best running shoe for your individual needs.

Many athletes complain of shin pain sometime during their training. Athletes usually experience this around the middle and lower third of their shins. It can be very painful and debilitating, especially when an athlete experiences it during his or her sport season.

Here are some tips to help prevent and manage Medial Tibial Stress Syndrome, commonly referred to as “shin splints.”

1. Wear properly fitted shoes and address any arch problems with over-the-counter or custom orthotics. Shin pain can often be the result of a pronated foot, or a flat arch. A good local resource for proper shoe fitting is a specialty running shoe store.
2. Maintain flexibility in the calf muscles. Tightness in these muscles often worsens the stress on the involved tissues at the front of the lower leg. A proper warm-up and stretching routine prior to exercise, followed by a cool-down stretching program afterwards, is important for maintaining flexibility.
3. Running and jumping activities should be eliminated or decreased until pain subsides. Non-impact workouts, such as biking, swimming, or pool running, can be substituted.
4. Ice and anti-inflammatory medications can also be used. You should gradually work back up to full participation following a decreased activity plan.  Wait until the activity can be completed relatively pain-free.
5. Finally, if pain worsens or does not improve, see a doctor. Sometimes the pain can be the result of a stress fracture, especially if it is in just one leg.

Ankle sprains are a very common basketball injury. Proprioception training will strengthen ankles to help prevent injury, and should be part of a comprehensive rehabilitation program following injury.
Proprioception, or balance, is the body’s ability to know where it is in space. Without proprioception, we’d have to watch our feet when we walk.

There are a few simple exercises one can do at home or on their own to help improve their proprioception, which in turn will help strengthen their lower legs.

1. Stand on one foot with eyes open
2. Stand on one foot with eyes closed
3. Stand on one foot while passing a ball with a partner (basketball, baseball, softball, lacrosse ball, etc.)
4. Stand on one foot with a folded towel or pillow under them to create an unstable surface, then progress to eyes closed

All of these should be done with shoes off. Aim for 30-60 seconds standing on one foot without losing balance.

Back strain due to overexertion accounts for an estimated one fourth of all workplace injuries. Many of these injuries are the result of poor lifting technique. With this in mind, remember these simple tips to avoid such injuries.

• To begin with, bring the load as close to your body as possible before you lift. Also, recognize that lifting below knee height or above shoulder height is more strenuous than lifting between these points.
• Since leg muscles are stronger than back muscles, it is better to bend and push off from the knees than the waist. Separate your feet, placing one slightly in front of the other when you lift. Avoid twisting your body when carrying a heavy load.
• Make sure you warm up and cool down for each weight lifting session. Your warm-up session before lifting weights should include stretching exercises, calisthenics and jogging.
• When you begin each lifting exercise, use small amount of weight at first and then progress to heavier weights. Stretching is also important during your cool down.
• Contrary to popular perceptions, a back belt is not a personal protective device that will help avoid lifting injuries in the workplace.

While exercises such as biking and swimming certainly offer many health benefits, they do very little to strengthen bones. Weight-bearing exercise, on the other hand, exerts pressure on the bones, which in turn, stimulates the flow of calcium into the skeleton or retains the minerals there. There are two main types of weight-bearing exercise – resistance workouts (strength training and rowing) and impact workouts (running, walking, and some aerobic exercises).

Research conducted at Washington University shows that after nine months of either resistance workouts or impact workouts, 27 previously sedentary women increased their overall bone density by about 2%. Only the impact exercisers showed an increase in the vulnerable region of the hip that fractures easily. Bone-building activity will not only improve your bone health, but it will also increase muscle strength, coordination, and balance, plus leads to better overall health.

Strength training, particularly in conjunction with regular aerobic exercise, can also have a profound impact on a person’s mental and emotional health. People with health concerns – including heart disease or arthritis – often benefit the most from an exercise program that includes lifting weights a few times each week.

Often mistaken for sprains, Lisfranc fractures (named after the French doctor who first described the injury) occur at the mid-foot, where a cluster of small bones form an arch on top of the foot between the ankle and toes. This type of injury may result from dropping a heavy object on the top of the foot. Lisfranc injury involves a rupture to the key ligament connecting the mid-foot to the forefoot. There may be some bruising, and if the injury is severe, the foot may not be able to bear weight. Left unrecognized, Lisfranc injuries can lead to point degeneration and compartment syndrome, in which a buildup of pressure within muscles can damage nerve cells and blood vessels.

Stress fractures, one of the most common injuries among athletes, occur when fatigued muscles are unable to absorb added shock. As a result, the tired muscles transfer the stress overload to the bone, which results in the tiny crack known as a “stress fracture.”

Studies indicate that female athletes experience stress fractures more frequently than their male counterparts. Researchers have recently found that an underlying cause of this disparity is likely to be the wider prevalence of eating disorders among female athletes. Specifically, it has been found that female college athletes who restrict their caloric intake may be putting themselves at risk for stress fractures. Athletes (women in particular) should bear this in mind as they train for their sports.

Runners who experience injuries such as patello-femoral pain syndrome (“runner’s knee”) may want to avail themselves of a method of rehabilitation that seeks to correct flaws in their strides. Abnormal running mechanics are factors in many running injuries, and in most cases, these flaws can be corrected. The failure to correct form flaws in response to injuries may only invite the same problem to return after the original injury heals.

While many physical therapists try to correct stride flaws indirectly by prescribing strengthening and stretching exercises that are designed to correct muscle imbalances, proponents of gait retraining believe that is just the first step. Modifying running mechanics helps reduce stresses that lead to injury.

Diabetes poses an increased risk for many health problems – including hip fractures. According to the American Diabetes Association, people with diabetes have about twice the risk of hip fractures as the general population. To protect against these fractures, the association suggests that people get the recommended daily amounts of calcium (1,000–1,500 milligrams/day) and vitamin D (400–800 international units). The vitamin D is particularly warranted for those with little sun exposure, as sun exposure helps the body to manufacture the vitamin. Getting regular exercise also helps to maintain bone strength. Such weight-bearing exercise as walking is best for the hips and spine. It also helps maintain muscle coordination and balance, which decrease the risk of falls.

As people continue to embrace modern technology, we are no doubt going to encounter some physical problems that we never before faced. One such malady is called “Blackberry Thumb.” This increasingly common repetitive-stress injury stems from the use of the popular electronic devices known as PDAs (personal digital assistants). No longer limited to use during the eight-hour workday, people are increasingly using PDAs, such as Blackberrys and iPhones, to communicate with friends and family before and after work, as well as on weekends. Blackberry Thumb overtaxes the least dexterous part of the hand, which is used to type on a very small keyboard. At the very least, users of PDAs should use their fingers to type instead of their thumbs.

There is research to suggest that the use of certain antibiotics called quinolones may increase the chances of rupturing the Achilles tendon, which is the strap-like tissue behind the ankle that works to extend the foot. This serious orthopedic injury requires surgical repair. Because pain can be mild at first, such ruptures are frequently misdiagnosed as a sprained ankle. One fairly reliable symptom, however, is the inability to stand on the toes of the affected foot. People who used quinolones were more than four times as likely as nonusers to sustain a tendon rupture. Past treatment with quinolones also made rupture more likely, but the effect was not nearly as strong as current use.

Older patients can benefit just as much as younger patients from surgery to repair unstable fractures. So says a study that analyzed data showing that patients over the age of 60 do just as well clinically as younger individuals one year after their surgeries, with few complications. All the patients in the study wore a brace and did not bear weight on the affected ankle for six weeks after their surgeries. It was found that the stabilizing surgery resulted in steadily improving function for all patients, although to a lesser extent for the older patients. However, they benefit from an intensive rehabilitative program early in their recoveries.

Ankle fractures are common injuries among people of all ages, interests, and lifestyles. People involved in a wide range of athletic activities are at high risk of ankle fractures because of the physical demands placed on their ankles. Ankle fractures also occur during slips on icy pavement and falls from a high place. If an ankle fracture is treated promptly and properly, the prognosis is good.

A study shows that healthy nerve fibers ­– not damaged ones – are primarily associated with chronic pain. Researchers now have more reason to scrutinize intact nerve fibers when developing new treatments for back pain and other chronic pain conditions. Among the factors to be studied are nerve cells called nociceptors, which are, in effect, “damage detectors.” When activated by disease or injury, they send electrical impulses to the brain. The faster these undamaged nociceptors fire electrical impulses, the stronger the chronic pain. Inflammation is thought to be the primary cause of the firing of nociceptors. These findings provide researchers with new avenues of approaching the problem of addressing chronic pain.

While runners often experience heel pain, it can happen to anyone. Persistent heel pain should prompt an assessment by a physical therapist to see if poor biomechanics is a contributing factor. Abnormalities in a person’s gait stress the heel bone and attached tissues. Among these abnormalities may be excessive pronation, which means that the feet roll inward too much when a person walks or runs.

The heel should be the first part of the foot to hit the ground when walking. Ideally, the arch distributes the weight first toward the outside of the foot, then toward the ball. If the feet roll inward or outward too much, the plantar fascia and the heel bear the excess stress. Being overweight or habitually carrying heavy loads may also lead to heel pain by putting added pressure on the heels.

Treatment of excessive pronation focuses on corrective footwear and orthotics. Shoes with adequate padding and support help most people with excessive pronation.