This month in Ask the Practitioner, we inquired about high hamstring tendinopathy with Renee Songer, Clinical Director of Agile Physical Therapy. 
How to treat the IT band - The most effective treatment is rest.
If your knee is swollen, ice, compress and elevate.
If you can find a pool, you can swim to maintain aerobic conditioning.
Get a massage on your quads, hips, and hamstrings
Foam roll 2-3 times per day
Perform IT band, glute stretngth exercises
Video demonstrating Hamstring Bridge (also works glutes)
Video demonstrating Single Leg Squat
Video demonstrating Glute Stretch
Let's talk about Plantar FasciitisWhat is Plantar Fasciitis?
Most often felt in the heel, over 50% of Americans will experience this pain during their lifetime.
Plantar fasciitis (PF) is a condition caused by drastic or sudden increases in mileage, poor foot structure, and inappropriate running shoes, which can overload the plantar fascia (the connective tissue that runs from your heel to the base of your toes), resulting in heel pain.
Self Identify PF:
- Sharp stab or deep ache in the heel
- Pain on the bottom of the foot in the arch
- Worst in the mornings. First few steps out of bed are excrucating
- Pain experienced during "push off" while running
Common causes of plantar fasciitis:
PF occurs due to a variety of reasons: overuse of improper, non-supportive shoes, over-training in sports, lack of flexibility, weight gain, too much standing.
Plantar Fasciitis Treatment:
As with any pain ice and rest is the first step. Fill a bucket of water and add ice to it. Stick your foot in. Another option is to freeze a plastic bottle of water and roll your foot with it.
Other options:
- Use a lacrosse ball or golf ball to massage your foot. Gently roll over the pain spots.
- Use an Arch support
- Update your shoes
If pain is present for more than three weeks, see a medical professional about the problem. Treatment options such as orthotics, foot taping, cortisone injections, night splints, and anti-inflammatories can help.
We are beginning a new column where we will dive into some of the most common running injuries. First up: Shin Splints.
This is the pain felt along the front of your lower leg, at the shin bone.
Shin splints are common among runners who increase frequency, volume, or intensity of training, along with improperly fitting footwear or worn out shoes can cause problems. Also frequent running on hard surfaces can cause shin pain.
How to prevent them?
The first thing is to understand what they are. Then you know what stresses you are putting on your body. Consider the age and appropriateness of your shoes and review your training to make sure you aren’t making any huge sudden jumps. Many runners with shin splints also report tight calves and relatively modest strength in the lower leg muscles. Proper stretching and strengthening of the calf muscles can help. One productive exercise is heel walking. [Check out our Heel Walking Demo Video here.]
If we feel shin splints coming on, what should we do?
There is an inflammatory component here, so ice can help a lot. A reduction in training intensity and a change in running surfaces may be required to allow the symptoms to subside. Anti-inflammatories may be appropriate, but consult your physician to ensure they are a safe choice for you. If symptoms persist or become steadily worse, make an appointment with your doctor.
Your doctor will often suggest that you do the following:
Check with your doctor before restarting any activities. Warming up before exercising is also a good way to make sure your legs aren’t sore.
Clyde Wilson was a naval service member who enjoyed weight training and working out, when his doctor on the USS Carl Vinson informed him he was on the verge of needing medication for high blood pressure and cholesterol. After making a transformative change in his nutritional habits, he went on to study chemistry and cell biology at Stanford and now teaches there and the University of California San Francisco Medical School. In addition, he runs The Center for Human Nutrition and Exercise Science in Palo Alto, California.
This month, we asked Dr. Clyde to weigh in about the lethargy many runners struggle through after a long run.
1. When many runners finish a big long run, often they report feeling extremely lethargic and low energy for much of the rest of the day, even after eating. From a nutrition perspective, what may be going on here?
Athletes need to replace their carbohydrate losses from training at a rate that their muscles are willing to absorb those carbohydrates. If you burn 1000 calories in a workout, roughly 800 calories of which are carbohydrate, and attempt to replace all of those carbohydrates at one sitting, the over-flow of calories into your bloodstream will send more than half of it to fat cells, where the carbohydrate will be converted into fat.
Therefore, eating enough calories is not enough.
The calories have to go into lean tissues to actually help you recover. Not eating enough is another way to fall short. So the athlete has to eat enough carbohydrate, but spaced out over time or eaten with vegetables so that the carbohydrate calories enter the body at a rate muscle is willing to absorb them. Protein helps re-build lean tissue but is unrelated to the feelings of lethargy after hard training.
2. What are some best bet tips on things runners can do after the run to avoid that day-long bonky feeling?
What is a Runner’s High?
When we exercise, we expect to feel better as a result. We achieve a fitness or time goal and are fired up by the accomplishment. We lose weight and like the result in the mirror. Maybe, we just do something we have never done before and appreciate the new mental or physical dimension in our lives. Some athletes, however, claim to feel better after exercise because the exercise itself makes them feel better. Significantly. Commonly, this is called a “Runner’s High.”
This “high” has been explained through the years as a rush of endorphins, neurotransmitters secreted by our bodies during things like pain, excitement, and sex. Endorphins act a bit like morphine chemically, so the conventional wisdom has been that they feel like it as well.
On the other hand, Jude Dickson and her University of Edinburgh colleagues, in their paper Does Exercise Promote Good Health, propose three hypotheses about the Runner’s High: the distraction hypothesis (it takes our attention away from painful things at the time), the mastery hypothesis (we learn new things and achieve a goal), and the social interaction hypothesis (things are often more fun and seem easier in a group). So, is the Runner’s High a chemical reaction via endorphins, or a psychological reaction that is somewhat coincidental to running? Regardless, all runners have days where we feel better than others, but the feeling of euphoria associated with this phenomenon can be fleeting or nonexistent for some runners, and relied upon as a pick me up for others. But, can it be captured, quantified, and achieved systematically?
Although an internet search of “endorphins” and “runner’s high” yields 70,000 results, that close association has been only modestly borne out by research. For one thing, it is hard to quantify what exactly a “high” is, as the reflections of athletes differ widely as to how a Runner’s High actually makes them feel. Secondly, although endorphin levels seem to elevate after exercise (likely because of the stress or pain the body has undergone during the exercise), that elevation doesn’t seem to have a uniformly positive result on mood, according to Sarah Willett in an oft cited article from Lehigh University.
The strong association between endorphins and Runner’s High in the wider public view persists. However, despite a well respected 2008 study by German researchers which found a strong correlation between endorphin production and the bloodstream of runners during and after two hour runs, not all agree that the correlation equals causation for the elusive high, in part because the large size of endorphin molecules make them difficult to pass the blood – brain barrier. And, after all, if there was such a strong direct result, wouldn’t we all enjoy Runner’s Highs after / during every hard workout or run?
Other relatively recent studies have linked the same type of brain receptors that play well with marijuana use to a naturally occurring endocannabinoid, which appears to be produced in the bloodstream in large amounts during exercise. A 2003 study with Georgia Tech college students yielded this finding, as have several subsequent similar or related studies with mice both in the US and abroad. These molecules appear to be much smaller than endorphins. If they can pass the blood-brain barrier, does this mean that all the times we’ve joked that “running was our drug” we weren’t really too far off the mark?
Ultimately, questions remain to be answered about how a Runner’s High occurs, why, and frankly, what it is, exactly. Runners are like snowflakes. Each of us is at least slightly different from the rest both psychologically and physiologically, and it might not be unreasonable to think that the difficulties science has had in firmly establishing a cause and effect with this phenomenon lies is the infinite amounts of ways in which running can create a positive effect in our lives. While we wait to find out what the chemical cause is once and for all, we encourage you to enjoy your Runner’s High not because of why you have it, but for the fact you have it at all.
In the weeks and months ahead, hundreds of thousands of runners will travel to the location of their upcoming goal race. In previous blog posts, we have touched on how to generally plan your goal race travel and have given advice for family and other supporters on ways they can organize to best effect on race weekend.
Before you bundle yourself into the car or head to the airport, take a moment to scan our goal race travel packing list – plan ahead and be prepared with everything you need for a great day!
Plan ahead and don’t forget:
Shoes
Training shoes and racing shoes, if those differ. Both should be broken in at least a week or two beforehand. Neither should ever be checked if flying. Seems self-explanatory, but in the rush to remember the odd, weird things, sometimes we forget about first things first.
Race outfit with cold and hot variations
Make sure your favorite long run shorts and top are in the bag. For the women, make sure that non-chafing sportsbra is packed. Think through your options if the weather ends up differently than expected, and pack your favorite tights, hat, arm sleeves or long sleeved shirt, and or gloves. Do not forget about the socks.
Pre race and post race clothes
Throwaways and/or warm clothes might be needed before the race, and will be very likely welcome after the race. An extra pair of dry socks in the bag can really help your post-race spirits as well. If the weather is cold, a hooded top or a beanie can really help when the post-race chill sets after when the body temperature drops following the race.
Snacks/ mid race fuel
Even if the race has your favorite brands offered on the course, it is helpful to have packed some favorite snacks and fueling options in case you miss the table, drop your item, or just want to top off your tank before or after the race.
Roller or rolling / stretching device
Watch
Bodyglide
Sunscreen
Water bottle
…and / or fuel carrying device for the day if using one
Something to sit on, such as a blanket or old finish area space blanket
…for the pre and post race area if no chairs or benches are available
Travel first aid kit
…hobbling around the hotel looking for a band-aid can and should be avoided
Earplugs and eye shade
….or anything else that might help with a better night’s sleep before the race
Preferred breakfast food
…if packable – save time and money on race morning
While this list probably doesn’t cover every need for every athlete, checking off the major items early in the packing process can alleviate stress and allow time to remember some of the more individualized items each runner hopes to not leave home without.
Runners often complain of hamstring tightness. Avoid this problem at all costs! No
muscles group is an island - over time tight hamstrings will cause your hip rotators and
glutes to overcompensate and shorten. So stay on top of stretching this important
muscle group!
