Building Hip Strength Can Help Reduce Injury in Running.

By: The Sports PT Blog Team

 

Although a large part of running involves the “sagittal” plane (or forward motion), it is actually a tri-planar activity, meaning it combines forward, side-to-side, and rotation motion. Therefore, it is important to consider that running-related injuries could be a result of other plane deficits in runners and not just an issue related to forward motion. This means that, in an effort to avoid injury, runners should specifically train and improve their side-to-side motion and rotation motion.

 

We must also consider the fact that the majority of time spent running is in single-leg stance (i.e., on one foot), so runners need to improve their balance and become more exposed to variable loads while maintaining control in single-leg stance.

 

To help further prepare or rehab runners for the performance demands of the sport, below is a variety of exercise progressions that focus not only on strength but also on motor control and endurance in frontal and transverse plane movements specifically for runners.*

 

  1. Single-leg stance combined with hip abduction: This focuses on postural stability with the addition of transverse and frontal plane control. Add a TheraBand for increased difficulty. Action: Stand on one leg and extend the other leg out to the side (the extended foot does not need to be lifted very high off the ground for this exercise). If using a band for resistance, it can be placed just above the knees, just above the ankles, or around the feet (at the middle of the foot) for added resistance.

    image1

 

  1. Lateral and cross-body toe taps: This exercise increases lateral hip musculature. Hold weights for increased difficulty. Action: Keep one leg stationary and with a bend in the knee while moving the other leg behind it, across the body. Keeping the torso stable, tap the toe and then bring the leg straight out to the side and tap the toe again. Repeat. This can be done with or without holding a weight.

    image2

 

  1. Quick crabwalks with a mini band: Running is about rhythm, timing, and a quick response time. The more time spent on a runner’s feet means the more time the runner needs to maintain control of the hips and lower extremities, thus the more time the hips and lower extremities are exposed for incorrect movement patterns related to their injury. Action: Take small steps side to side in a mini-squat position, using a mini band around the legs as resistance. Start with the mini band placed just above the knees for a few sets, then move it to just above the ankles. Steps should be small enough that the band should not move and the feet should not come together.

    image3

 

  1. Sidestep to lateral hop progression: This exercise increases the demand for dynamic control. Action: To start, take a wide step to one side, tapping the toe of the opposite foot behind the stepping foot. Repeat with the other side. Progress to a slight hop from side to side, still tapping the toe. Then progress to a quicker hop, this time holding the foot in the air rather than tapping the toe. This will eventually progress to a fast hop from side to side with little to no pause in between and again holding the foot rather than tapping the toe.

    image4

 

 

  1. Single leg stance sliders: This exercise resets control through the buttock and creates better buttock control when running. Action: Place a band around the front knee for resistance and, using a Moving Men slider, push the other leg back into an extension. Slide the leg back to the starting position and repeat.

    image5

 

These exercises are higher-level activities that should be led by a physical therapist. For more information on repetitions or specific form for these exercises, contact us at info@sptny.com.

 

*Screenshots for the first four exercises are from the article by Chris Johnson in the references section.

 

References:

Johnson, Chris. “Five Frontal Plane Exercises for Runners to Master.” ZEREN PT & Performance. November 10, 2015, http://www.zerenpt.com/blog/five-frontal-plane-exercises-for-runners-to-master (accessed December 11, 2015).

Kovar, Elizabeth. “How to Correct Form with Reactive Neuromuscular Training (RNT).” ACE Fitness. December 8, 2014, https://www.acefitness.org/blog/5206/how-to-correct-form-with-reactive-neuromuscular (accessed December 11, 2015).

 

 

 

 

Heel Pain in the Morning? A Look at Plantar Fasciitis.

By: Nathan Lennert, SPT

 

Recently, NFL quarterback Peyton Manning was sidelined due to a partial tear of his plantar fascia, a ligament in the foot. It was reported that Peyton Manning had been battling plantar fasciitis for some time and that it had then progressed to a partial tear.1

 

Plantar fasciitis is defined as inflammation of the plantar fascia, but it is better described as a degeneration of the plantar fascia as a result of repetitive trauma. More than two million people in the United States are treated for plantar fasciitis each year, and it is the leading cause of heel pain.2

 

What Is the Plantar Fascia?

image1It is a thickened, fibrous band of connective tissue that attaches from the bottom of the heel to the base of the toes. The main functions of the plantar fascia are to provide support to the arch of the foot and to act as a shock absorber.2

 

Causes.

Plantar fasciitis is typically a result of overuse injuries. The repetitive movement of walking and/or running can cause microtears in the plantar fascia, leading to heel pain. Risk factors for plantar fasciitis include obesity or sudden weight gain, flat feet, reduced buttock or core strength, decreased ankle dorsiflexion (the ankle’s ability to bend toward the shin), working in an occupation that requires prolonged standing, and improper or excessively worn footwear. All of these factors put increased strain on the plantar fascia.2

 

Signs and Symptoms.

The classic presentation of plantar fasciitis is heel pain on the sole of the foot. The pain is usually described as being at its worse when taking a few steps in the morning or after sitting for a long period of time, and then it diminishes after walking for a bit.2

 

Treatment.

Treatment for plantar fasciitis typically takes between 6 and 18 months to resolve completely, although early recognition is key, as it leads to a significant reduction in treatment time and a high probability that the condition will resolve with conservative therapies. Conservative therapies include removing or altering the activities or factors that are creating inflammation and physical therapy for the lower extremity. Physical therapy to help with plantar fasciitis could include: strengthening and stretching the hip, foot, and ankle; manual therapy; and switching to proper footwear to support the arch of the foot, along with night splinting. For temporary pain relief, anti-inflammatories may be prescribed and, in more chronic cases, corticosteroid injections may be an option. However, multiple corticosteroid injections have been associated with fascial weakness and can lead to rupture, much like what Peyton Manning is dealing with. In extreme cases, when all other options have been exhausted, surgery may be performed to release the plantar fascia.2

 

Plantar fasciitis is a self-limiting condition, and about 80 percent of all cases are resolved within a year.2 Typically, the sooner physical therapy can begin to reduce inflammation and pain, the better the outcome. For more information or to ask questions about plantar fasciitis, contact us at info@sptny.com.

 

References:

  1. Adam Schefter. “Peyton Manning Has Torn Plantar Fascia in Left Foot, Had Trouble Walking.” ESPN, November 16, 2015. http://espn.go.com/nfl/story/_/id/14143938/peyton-manning-denver-broncos-torn-plantar-fascia-left-foot.
  2. Mario Roxas. “Plantar Fasciitis: Diagnosis and Therapeutic Considerations.” Alternative Medicine Review 10, no. 2 (2005): 83–93.

 

 

 

Wrapping Presents Can Be a Pain in the Neck!!

By: The Sports PT Blog Team

 

The holiday season is in full swing, and as we wrap all of those perfectly selected gifts in their shiny wrapping paper, it can take a toll on the spine! Our patients are asking us this holiday season, “What is the best way to wrap presents without getting sore?”

 

Well, Here Are the Answers:

1.) Choose a workstation where your neck isn’t flexed or looking directly down. Sitting is often a better position because you can wrap at eye level.

 

2.) Stretch and take breaks after 20–30 minutes of wrapping to offset the posture.

 

3.) Be sure that you aren’t slouching! Slouching creates stress on your shoulders and neck.

 

4.) Space out your wrapping over a few days rather than completing all of it in one day or evening.

 

5.) Relax your shoulders! During the holidays, stress can cause us to hike up our shoulders. Keep them down when wrapping.

 

Follow these tips and your neck will thank you! And from all of us at Sports PT, we wish you a happy holiday season!

Why an MRI Can Cause Fear in Patients with Low Back Pain

By: Sports PT Blog Team

 

While diagnostic testing is an important part of recognizing serious pathology, it sometimes causes fear in people with acute low back pain and may slow their healing process and affect their prognosis. Many times, the results of a diagnostic test can “brand” the individual to thinking his or her low back condition is more serious than it is. As a result, the patient may then decide to reduce activity or even have unnecessary surgery.

 

However, some changes in the low back are a normal part of the aging process. In fact, these statistics reveal that people of all ages have experienced a “bulging disc” – not an uncommon condition as we get older – according to their MRIs:

 

  • 30% of 20-year-olds
  • 60% of 50-year-olds
  • 84% of 80-year-olds

 

But it is important to remember that the results of an MRI don’t necessarily equate to function or pain.

 

If the results of an MRI say something scary, contact your physical therapist. The latest research shows that if patients participate in physical therapy before other, more invasive treatment, they can reduce pain and improve their prognosis.

 

Reference:

Brinjikji, et al. Am J Neuroradiol. 2014 Nov.

 

 

 

The Snow Is Coming!

By: The Sports PT Clinical Team

 

Happy December! We are getting closer and closer to having to clear out that heavy, white snow . . . So how do we avoid injury when addressing all of that snow in the driveway?

 

Here Are Some Simple Tips for Shoveling:

 

  1. Prepare
    1. Dress in loose layers that can be easily removed to avoid overheating.
    2. Choose a lightweight shovel with an ergonomic design that allows you to keep the load close to your body.
  2. Plan
    1. Try to stay ahead of the storm by shoveling smaller amounts more frequently.
    2. Rest when you get tired or feel out of breath. Avoid holding your breath when lifting snow, as this increases the pressure on internal organs, especially your heart.
    3. Stay hydrated.
  3. Posture
    1. Lift with your legs from a squat to an upright position.
    2. Avoid bending over, but do maintain a small, inward curve in the low back at all times by tightening the core muscles that surround your spine.
    3. Shift your weight using your legs.
    4. Do NOT twist your spine.
  4. Push
    1. Push snow whenever possible.
    2. Move small amounts the shortest distance you can.
    3. Make sure to hold the shovel as close to your body as possible.
  5. Pace yourself and ask for help!
  6. Pray for an easy winter… 🙂

 

A short video from the American Physical Therapy Association demonstrating the proper shoveling technique can be found here: http://www.moveforwardpt.com/resources/detail.aspx?cid=05759494-38a8-42f7-bc08-bdcceca35fc7.