Ask a Physical Therapist

Is it best to stretch before or after a run?

“One way to engage and warm-up or stretch a muscle prior to an athletic event is to complete dynamic warm-up exercises. There are several that we like to do including “shoe sweep” , “lunge twist” and “high kick walkouts”. Always perform long static stretches after a warm up such as a short run or after the entire run. It is best not to perform long static stretches prior to a run when muscles are “cold” because this could cause injury. Also, new research shows that performance is hampered by static stretching prior to an athletic activity,” Shelley Hanchett, PT, CHT Advanced Physical Therapy Center – Clio.

Here is a video with a sample dynamic warm-up:

Ask a Physical Therapist

Scott Boyer

What are some good foam roller exercises for runners?

I find that the IT band stretch with a foam roller is the best and most useful.To do an IT band stretch with a foam roller, lay a foam roller on a firm surface.  Then stride one foot in front of the roller from a kneeling position, and twist so the outside of your opposite leg will come in contact with the roller. Use your supporting leg to help roll yourself forward and back along the length of your leg with the amount of pressure you are comfortable with.  There is also a foam roller exercise that is great for the hamstrings.   Many folks complain of soreness in their hamstrings after a race.  This is because their hamstrings are not strong enough, fatigue, and become tight.  Sitting on a foam roll and rolling up/down toward the knee really helps stretch that muscle tissue and allows blood to flow again, ” Scott Boyer, PT, DPT Advanced Physical Therapy Center of Davison Clinic Director. 

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Dane Potochny

What can runners do to prevent or heal Achilles issues?

“A key way to prevent Achilles issues is adequate flexibility.  Proper stretching can alleviate many Achilles pathologies.  Also, proper warm up is important to reduce strain.  Another factor is proper footwear and orthotics.  The right shoe can reduce tension on the Achilles.  The final factor is stride length.  Always compete at the same stride length that you train with.  Changing stride and running/walking form in a race is a recipe for trouble,” Dane Potochny, MPT Advanced Physical Therapy Center – Grand Blanc

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Image

What can runners do to heal shin splints?

“What can runners do to heal shin splints?…The best answer is to avoid them! And to do that, you need to be careful when it comes to increasing your mileage.  Increase your mileage slowly, especially when you are a beginner.  You should increase mileage no more than 5-10% per week.  Also, make sure you have a good fitting shoe for your type of arch and foot strike. If it is too late and you have already have shin pain, you must reduce mileage in half until the pain reduces.  Ice application, calf sleeves and the use of self-massage to the calves may help as well. When pain is significantly improved, you may increase mileage by 5-10% as per above instructions. If the pain persists, visit your physician.  Most likely, it is a muscle imbalance, and a prescription for physical therapy can often help to correct that,” Shelley Hanchett, PT, CHT, VP of Operations for Advanced Physical Therapy Center and Clio Clinic Director.

Ask a Physical Therapist

SteveNahsFINAL

What can a runner do to prevent or heal IT band syndrome?

“Illiotibial Band Syndrome (ITBS) most commonly occurs on the outside of the knee or just above it.  ITBS accounts for 8-10% of all running injuries and can affect  both recreational and elite runners.  IT band syndrome typically occurs after a set distance into the run – you’ll feel okay for a mile or two, but then the outside of your knee will begin to ache, progressing from a dull stiffness to a sharp or burning pain. 

Factors such as old running shoes, running on cambered roads, and tight turns on indoor tracks have all been thought of as risk factors for ITBS, but there is a lack of scientific evidence to back them up.  Recent studies have linked hip abduction and external rotation weakness with ITBS. 

While the painful area is the outside of the knee, the real problem lies further up the leg.  The best current research-approved protocol for ITBS (Fredericson Protocol) is a simple program that consists of two stretches and two strengthening exercises.  Stretches are preformed three times a day holding the stretch for 15 seconds on each side.  Strengthening exercises start with one set of 15 repetitions every day, increasing by 5 reps. Daily, building up to three sets of 30 over time.  The entire program lasts six weeks.

Stretches:

Lying rope hip stretch
Lying_rope_hip_stretch

Standing hip cross-over stretch
standing_hip_crossover_stretch

Strengthening:

Side-lying hip abduction
Lying_hip_abduction

Standing hip hike
standing_hip_hike

Your ability to return to running will be determined by your progress in hip strengthening.  In the beginning, you may need a few days to a few weeks off for the initial inflammation to calm down.  Once this irritation is gone, you may find your IT band still gets irritated after a few miles of running if you haven’t worked on your hip strength.  It may take 4-6 weeks of daily hip strength exercises to completely recover, and you may be able to continue running during this time.  You may need to keep you runs short enough as to not irritate your IT band,” Steve Nahs, PT, DPT Advanced Physical Therapy Center – Grand Blanc.    

References:

1) Gaudette, J., IT Band Syndrome Injury in Runners: Stretches, Preventive Exercises, and Research-Backed Treatments. Runners Connect 2012.

2) Fredericson, M.; Cookingham, C. L.; Chaudhari, A. M.; Dowdell, B. C.; Oestreicher, N.; Sahrmann, S. A., Hip Abductor Weakness in Distance Runners with Iliotibial Band Syndrome. Clinical Journal of Sports Medicine 2000, (10), 169-175.