Runner and Walker Recovery – Hip Pain

At my studio, Koa Fit, we work with not only runners and walkers with hip pain, but also cyclists, dancers, golfers, tennis players and a lot more.  As said before in my previous posts about foot pain and knee pain, “hip pain” is a broad term.  Most importantly, your hip pain could actually be back pain in disguise.  It is important to know if your hip pain is a symptom of overuse/misuse or if it is nerve pain.  A physical therapist can run you through some tests to help you identify where your pain is coming from.

For the purpose of this post, I am going to be addressing the hip pain in the upper hamstring that is usually associated with activity.  It normally comes about during or after strenuous activity and feels like a a deep ache or muscle strain located where your leg meets your bum in the back.  Any pain that feels “sharp” or “burn-y” is most likely nerve pain and you will need more evaluation before getting appropriate exercises.

To help relieve and prevent the onset of hip pain, try the exercises below.  Even with the absence of hip pain, these exercises are good to perform to keep the hips moving smoothly and to avoid over-tightness.

Runner and Walker Recovery – Knee Pain

Let’s move on to the 2nd biggest complaint among runners and walkers, knee pain (if you have the 1st, foot pain, please see my last post).  I know “knee pain” is such a broad term, but let’s start big picture and then move into the details.

Pain in the knee, if not caused by trauma (getting side-tackled for example), comes from a dysfunction of your biomechanics, or movements.  The movement I am talking about most is your gait, whether walking or running.  When you have a breakdown in the mechanics of your gait, that deficiency gets highlighted over thousands, perhaps hundreds of thousands of repetitions with each training session.

It is important to have a professional assess your walking and running patterns to identify any inefficiencies you may have in your stride.  But for now, we are going to focus on one of the more common points of pain, patellofemoral pain.  This is the pain commonly felt just below the kneecap and is usually a signal of over-used quadriceps and an under-utilized posterior kinetic chain (arch, calves, hamstrings, and glutes).

Try the exercises below to help prevent the onset of patellofemoral pain and keep your knees happy!

Runner and Walker Recovery – Foot Pain

One of the main complaints I hear from my runners and walkers is about pain their feet.  Whether it be the heel, arch, or ball of the foot, it seems every pedestrian ends up with foot pain at one point or another.

There are many factors that can cause inflammation on the bottom of the foot.  It is best to get an assessment by a movement specialist to determine your precise cause.  However, there are a few general movements you can start doing to help you keep the pain at bay or even prevent it from starting in the first place.  Check out the video below and follow along to help increase your foot’s flexibility and strength.

Opt Outside! Treadmill vs Outdoor Running

The great debate – treadmill walking and running versus outside.  Well, you can tell by the title, I have my own clear winner.  But, if you are still reading past the headline, I bet you want to know more…you want to know the WHY.

In a nutshell, when you run or walk outside, the muscles of the leg have to propel you forward.  When you run or walk on a treadmill, the muscles of your leg have to catch you as you fall forward.  So even though it looks like the same exercise, they are actually two different exercises using different muscles.

When you are on a treadmill, the floor is moving under your feet.  With each stride your body is hitting this moving surface and getting pushed into a forward motion.  Your opposite leg then has to get out in front of you and hit the treadmill before you fall forward.  So with each stride you are literally just catching yourself from falling instead of running forward.

Outside, the ground is stable, so your foot has to push against that stable surface and push you forward.  For one, this takes a lot more strength and muscle activation to do than running on a treadmill so you will actually burn more calories and get a better workout.  Secondly, and my favorite part, is that it is safer on your body.  By pushing yourself forward, you are using your body the way it was designed to be used, as well as using all the muscles of the back of the leg to help counteract the effects from all your sitting time.  Total win.

When we go around catching ourselves from falling instead of propelling ourselves forward, we put a lot of stress on our hip, knee, and ankle joints.  Not to mention the load we put on our feet.  This extra load leads to some of the most common aches and pains among runners – plantar fasciitis, hamstring tendinopathy, and runner’s knee just to mention a few.  Where as running (correctly, more on that below) outside can actually help strengthen some of the most commonly weak postural muscles in the body.

So you are now convinced to take your run outside.  Fantastic!  Just a quick word…It is also possible to do the “fall and catch” outside as well.  This usually occurs because the mobility in our hips and ankles restricts our body’s ability to move our legs in the appropriate way.  So make sure you spend time opening up your hips (try these hip openers) and your calves.  In fact, you can start right now with the exercise below!

Sore Knees? Try These.

Knee pain.  It has happened to most of us.  1/3 of Americans will experience knee pain at some point in their lives.  It is the 2nd most common cause of chronic pain and new reports show it is affecting more people each year.  So, if you are experiencing a “twinge” or maybe a “tweak” in your knees, it is time to take some action before bigger issues occur.

The greatest cause of knee pain is, by far, poor body mechanics and poor mechanics are  typically caused by a lack of mobility  which leads to a lack of strength.  For example, due to prolonged sitting, a lot of people experience a tightness in the front of their hips.  This tightness in the front of the hips leads to decreased strength in the back of the leg (glutes and hamstrings), which decreases the support in the back of the knee.  Without the support and strength in the back of the knee (posterior), force traveling through the knee joint is pushed into the front of the knee (anterior) and causes pain across the front of the kneecap (commonly called “Runner’s Knee”).  This is not the only cause of knee soreness, but it is definitely one of the most common.

The knee joint is where the femur (thigh bone) and the tibia (shin bone) come together. All 4 muscles of the quadriceps come together to form the patellar tendon which starts at the top of the knee joint, adheres to the patella as it crosses the anterior (front) of the joint until in attaches at the tibia below.  The patellar tendon lies within a grooved-out notch the allows you to bend and straighten your knee without irritation.  A lot of knee pain is caused when the alignment of the patellar tendon and this specially made notch go out of whack.

The inside of your knees is referred to as the medial side and the outside of your knees is known as the lateral side.  Imbalances between these two sides can cause the patellar tendon the shift towards the stronger side.  For instance, if you have had an injury to your knee in the past, you may remember your therapist trying to get the inner-most muscle of the quadriceps to fire.  This needs to be strong, so that your patella does not start to track to the lateral side of the knee joint and cause you more pain.  If this imbalance continues, a person can start to feel tightness in the IT band and other soft tissue on the lateral side of the knee while also experiencing sharp pain on the medial side of the joint.  The knee has to be balanced side-to-side (medial to lateral) to stay pain-free and happy.

Imbalances front-to-back (anterior to posterior) are the usual cause of pain in the first example of our Runner’s Knee.  However, we also see in the example above, that imbalances medially to laterally can cause different, but equally annoying pain.  The routine below starts with releases of the most commonly tight areas of the hip and lower limb that may cause imbalances at the knee joint.  They are followed by exercises that strengthen the muscles that are commonly weak in people with knee pain.  This routine will not help everyone with knee soreness, but if you have been experiencing sore knees after activity or “tweaks” and “twinges”, this is a great place to start.  Even if you have not had knee pain, this routine will help your knees stay happy, healthy and pain-free.

Getting Started – High Intensity Interval Training

If you work out, know people who work out, or ever read anything on the internet about working out, you have probably heard of High Intensity Interval Training or HIIT. I know, it sounds “Intense” for lack of a better word.  Sounds like something crazy bootcamp people would do, or a high school football team, or celebrities.  But I am here to tell you ANYONE can do HIIT and EVERYONE can benefit from it.

The basic application of HIIT is to push yourself into an uncomfortable range during your cardio exercises and then fully recover, and then repeat for a certain amount of time.  That’s it.  That’s the magic equation.

Of course if you really start to dive into it, there is research on heart zones and RPE’s, and on time on vs. time off, and which intervals are better for weight loss and which ones are better to build endurance.  There is so much info on HIIT, that it can be overwhelming and keep you from just trying it and reaping the benefits.  Read below for the great benefits of HIIT and some “starter” workouts to get you going and on your way.

Benefits:

  • You’ll Burn More Calories – Not only do you burn calories while you are performing your HIIT workout, but that burn will stay with you for up to 2 hours after your finish your workout.  That means you can do your workout, shower, and head to work and still be getting a high calorie burn.
  • Great for your Heart – Due to its high demand on your blood vessels, HIIT can increase the flexibility and the elasticity of your arteries and veins.
  • Adaptable – You can do an HIIT workout on the treadmill, during a hike, in the middle of a bike ride, in a pool, everywhere and any movement can be turned into an HIIT session.
  • Reduces Blood Sugar Levels – After just 2 weeks of HIIT, one study found that there was an increase of glucose metabolism in the muscles, bringing sugar levels back to normal.
  • Saves You Time – Because you are working harder, you don’t have to work for very long.  You can get most of the same benefits in 15 minutes of HIIT session that you can get in 1 hour of jogging according to a 2013 study.
  • More Weight Loss – According to one study of persons with Type 2 diabetes, HIIT training has a bigger affect on weight loss than steady cardio.
  • Increased VO2 max – This means your body can utilize oxygen better during intense exercise.  You will be able to work harder and harder, but it will start to feel easier.
  • Increased Endurance and Stamina – Just 1 minute of high intensity work can improve your endurance.  The benefits of your quick HIIT workout will carry over to your next big hike, bike ride, run.
  • Reduces Liver Fat – According to a 2015 study, HIIT can help reduce the fat surrounding your liver by up to 16% in just 12 weeks of training.

The bottom line is…If you are not doing HIIT…START.

Here are a 3 HIIT workouts for the beginner/intermediate athlete (and by athlete, I mean you, not Tom Brady).

Walker’s Delight Routine

  • 0-5 Minutes – Walk at Regular Pace.
  • 30 seconds High Intensity – Uphill walking, quicker pace, skipping, big arm swings, anything that gets you heart pumping really nice.
  • 1.5 minutes Low Intensity – Regular walking pace or slower, dynamic stretching, backwards walking.  Just don’t stop moving.
  • Repeat Step 2 and 3 for a minimum of 10 minutes or a maximum of 20 minutes.
  • Last 5 minutes – Walk slow or stop and stretch to cool down.

Rainy Day Treadmill Routine

  • 0-5 minutes – Warm up with brisk walking or slow jog.
  • 45 seconds High Intensity – Increase the incline or speed to get your heart pumping.
  • 2 minutes Low Intensity – Back to your brisk walking or slower jog.
  • Repeat Step 2 and 3 for 6 circuits.
  • Walk slow for the last 3-5 minutes.

New Runner Neighborhood Blitz

  • 0-5 minutes – Warm up by walking a 2×1 block circle around a neighborhood (2 block straightaway to a right turn to a 1 block straightaway to a right turn to another 2 blocks, followed by a right turn to  1 block to bring you back to the beginning of your circle.)
  • 5-10 minutes – Walk the 2 block straightaway, run the 1 block straightaway.
  • 10-15 minutes – Run the 2 block straightaway, walk the 1 block straightaway.
  • 15-16 minutes – walk
  • 16-18 minutes – run
  • 18 – 20 minutes – walk
  • End at 20 minutes or repeat steps 2 and 3 to make it a full 30-minute workout.

New to Running? Try These 10 Steps and Get Going!

1) Have a goal!  Whether you want to run a mile or a 5k, having a goal helps to create a routine, a sense of purpose and accountability. This marks your first point to success. Instead of setting large, potentially unattainable goals, just start with daily or weekly ones that prevent discouragement and your motivation to wane. Write down your goal for each day or week, post it somewhere visible and tell others about what your goals are. This creates accountability and helps break intimidating aspirations into smaller, more achievable ones.

2) The Right Shoe  Do I pronate or supinate and what does that mean? If you are a pronator, then you have a tendency to drop you ankle inwards with each step. If you are a supinator, then you are probably running on the outside of your feet. With pronation, your best bet would be a ‘stability’ running shoe. This type of shoe has posting built into the inside area of the sole of the shoe and can help keep you from rolling your foot too far inward. If you are a supinator or a neutral runner, you need a ‘neutral’ shoe. This type of running shoe has no posting and the sole is all one material. Most people have a tendency towards pronation, but a gait analysis can help you determine which shoe is the best for you. Overall, comfort is number one.

3) Essential Gear  Whether you are running at night or in the early morning, gear that has reflective accents is the safest bet. When running in the dark, be sure to wear a headlamp to alert cars and to help prevent falls. If you are running during daylight hours, wear sun protective gear like long sleeves and a hat. At higher altitudes, we are more prone to harsh sun exposure, so remember your sunscreen! You also want to find materials that are moisture wicking for comfort. These materials dry faster than cotton and can also prevent uncomfortable chaffing.

4) Know Your Runner’s Lingo  There are many terms and phrases that you will hear when discussing running. Here are just some to help jump-start your vocabulary:

  • Repetitions/Intervals: these are often used interchangeably in running jargon. This type of training refers to workouts in which you run several short segments at a given pace, separated by recovery periods during which you jog or walk.
  • Split: this generally refers to the pace you run at evenly spaced junctures. It takes your total time and divides it into smaller parts (i.e., miles, half miles, etc.)
  • Tempo Run: this is a sustained running effort lasting from 10 to 40 minutes at a pace that you can sustain for at least an hour. This is your ‘threshold pace’ meaning that it is the effort level just below the body’s ability to clear lactate.
  • Fartlek: the Swedish work for ‘speed-play’ and it is an unstructured run that combines different paces aimed at challenging both aerobic and anaerobic fitness. Besides being a funny term, it can help defeat boredom on some runs.

5) Warm-up/Cool-down  Running can be tough on your joints if proper preparation guidelines are not followed. Be sure to warm up before each run. Walk for 5 minutes and/or do a series of active-isolated stretches. This gives your joints the chance to build up their synovial fluid for cushioning during impact, gets your heart rate up for the activity ahead, and helps you psychologically prepare for your run. Cooling down after a run is equally as important. Spending at least 5 minutes walking afterwards helps to prevent venous pooling and allows your heart rate and breathing to return to normal.

6) When/how do I increase my mileage?  The 10-percent rule is an important principle with running and it states that you should only increase your weekly mileage by no more than 10 percent each week. If you are a new runner, try to keep your mileage consistent for the first 3 weeks; this allows your body time to adjust to your new sport. Once you feel comfortable and are running without pain, you can safely add mileage to your weekly runs to help meet your running goals.

7) How fast should I be running?  Basically, you should be running at a pace that matches your comfort level, and works in relation to your goals and preferences. If just getting out the door and jogging is your goal, then stay at a pace that you feel you can maintain without causing injury. If your goal is to run a faster mile, then try speed work at a track or fartlekking. It’s only a competition with yourself, so stay within your comfort zone and just have fun with it.

8) How often should I run?  The bottom line is that you can run three to four days per week with rest days and cross-training in between. At least one rest day should be incorporated into your schedule to allow your body to recover. Cross-training can be resistance training or cycling; basically anything that helps keep your cardiovascular and muscular strength maintained.

9) Hydration and Fuel  If you are running/jogging for 30 minutes, you usually only need water (be sure to have plenty at higher altitudes). Running over half an hour generally requires carbohydrate replenishment. You can replenish your energy stores through gels, sports drinks or anything that can quickly digest. If you choose gels, remember to drink plenty of water (preferably 16 ounces of water to each gel pack). Finding the right amount of replenishment for your body is something you can play with on your runs, but generally you should have something for every 30 to 40 minutes of activity. Electrolyte replacement after a run is also essential. We lose a lot of our electrolytes through our sweat when we run and these are essential for maintaining our body’s water balance. You can buy tablets for your water or you can replenish these through a well-balanced meal afterwards.

10) Have fun!  Last, but definitely not least, is to remember to have fun! Running is not only a great all over body workout, but it also can be incredibly therapeutic. Whether you are running with a group, a friend, or enjoying some needed alone time, remember that you are running because you want to, not because you have to. You made the decision to run for a reason. Whatever that reason may be, take ownership of it and know that you are doing something that is great for your body, mind and spirit!