Tag Archives: Injury prevention

Physical therapy geek: My new core-hip lineup

Physical therapy fascinates me. I spent a long time in high school and an entire semester in college thinking I’d grow up to be an orthopedic surgeon, and I’ve always been intrigued by how joints and muscles work. As you’re likely aware if you read this blog regularly, I’m also a bit of a workout nerd who privately entertains dreams of becoming a personal trainer. When it’s done right, physical therapy strikes me as a combination of the two: You get to play with people’s joints AND create workouts for them!

This fascination makes me quite possibly the most engaged and motivated physical therapy patient ever. The exercises from my 2007-2008 stint in physical therapy for an sore hip/IT band are still part of my regular core- and hip-strengthening workout.

I had my second session with a new physical therapist yesterday. I’m going to do my best to outline the full hip- and core-strengthening workout I enjoyed yesterday, with the caveat that I can barely perform some of the exercises without aid, much less describe them:

3X10 Cook hip lifts (basically single-leg bridges)

3X10 clamshells with a resistance band (shown here, along with lots of other interesting-looking running-specific exercises)

3X10 hip circles (done on all fours, by rotating one bent leg in circles)

3X10 single-leg squats

Monster walks” with a resistance band. When I proved too proficient at these, my basketball-star therapist put a resistance band around my ankles in addition to the one above my knees. Yeowch!

Farmers walk with kettlebell (you walk around the room holding a kettlebell above your head with one hand)

This crazy, intense version of a Turkish getup with a kettlebell. This one is especially tough to describe here, as New Guy would ask me to hold certain positions for longer periods of time, and would correct my form to ensure the exercise was “hitting all the right places.” Translation: “as difficult as possible.”

Single-leg deadlifts with a kettlebell. Yes, in case you’re wondering, I’m planning to purchase one of these instruments of torture for my house.

Lateral lunges, backwards lunges and leg curls with a towel placed beneath the working foot. I know — unhelpful description. I’ll work on it as I master the exercises.

Planks, with lots of crazy variations. Again, I’ll work on describing these once I’ve mastered the actual motions.

Next up: Speaking of instruments of torture, our hill-loving group-run organizer has apparently designed a doozy of a five-miler for us tonight. After the workout I had yesterday (see above!), I’m guessing tonight is NOT the night I’ll be pushing the pace on the hills.

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A new core workout

Workouts are tricky. If you’re anything like me, you spend a considerable amount of time scoping out new exercises in fitness

I found new twists on my usual BOSU moves. Yesss!

magazines and online, looking for that new twist on the simple squat or that new way to sit on a stability ball that will challenge your muscles in new and unforseen ways.

Then, as soon as you find the perfect workout, your muscles are bored again, and it’s time to change.

I’ve felt that way about my core- and hip-strengthening workout recently. I’ve been committed to a full injury-preventing lineup for several months now, which means I’m getting to the end of my rope as far as tweaking the exercises for maximum impact.

That’s why I was so excited for find this great workout with stability balls, medicine balls and a BOSU in the most recent issue of Women’s Health. I tried it at the gym on Monday, and can confirm that the stability-ball leg raise and the stability-ball hand walks will wake up even the most bored muscles. I mixed it up even more by hopping on the step mill for cardio (when’s the last time you did that?).

Next up: A group run with Pacers Silver Spring tonight, and a physical therapy session with Beefcake Brad on Wednesday. Stay tuned for his killer kettlebell workout later this week.

Have you found any really fantastic core exercises recently? If so, share them by posting a comment!


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Iontophoresis for runners: What P. Diddy and I have in common

After P. Diddy finished the New York City Marathon in 2003, he credited iontophoresis, or the use of a small electrical current to The iontophoresis patch transmits anti-inflammatory medicine to the site of my ankle sprain last year. transmit an anti-inflammatory medicine, with curbing his knee pain enough to let him complete the race.

I was unaware of P. Diddy’s experience before my doctor suggested ionto, as it’s commonly called, for my IT band two years ago, the first time I received this nifty, noninvasive treatment. I’m receiving it again now for peroneal tendonitis and/or an inflamed posterior tibialis (or, to keep it simple, a cranky ankle), and I’m optimistic it’ll get me over the why-does-it-still-hurt hump.

Here’s how the treatment works: A physical therapist fastens a patch with anti-inflammatory ointment to the spot on my ankle that hurts. Then, she attaches a tiny device that administers a low electrical charge for just a few minutes – since I use the self-contained patch, there’s no need to keep it hooked up to the device for long (another version of ionto uses a large machine to transmit the charge, and takes about 15 minutes). I feel a slight twinge — not pain, exactly, but a little sensation that lets me know something’s going on. I leave the patch on for two hours to let the medicine do its thing. Repeat, essentially, every other day for two weeks.

I like that this is noninvasive and basically risk-free. I like that I’m receiving the treatment on my ankle — since the muscles and tendons are closer to the surface there, my chances of it working are greater. I like that I may have the boniest ankles in the history of ankles for the same reason.

Finally, I like that it’s only one way I’m looking to attack the problem. I’m also doing several prehab exercises given to me by the therapist I worked with yesterday, an enthusiastic woman named Toni. Toni told me she embarked on a prehab program to strengthen her own ankles after multiple ankle sprains clued her in to possible weakness.

She gave me a TheraBand, and showed me how to use by pointing and flexing my foot in all four directions: plantar flexion, like pressing on the gas pedal in your car; dorsiflexion, pulling back in the opposite direction; and inversion and eversion, or pulling the resistance band from side-to-side.With the ionto and the exercises, it can only be a matter of time before my ankles are in good working order again!

Thanks to everyone who commented on my post about managing a runner’s stomach. My next experiment, thanks to your thoughtful and interesting suggestions (other ideas still welcome!), will be oatmeal and a banana. Which sounds pretty delicious, even without the run.

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Product review: Trigger Point’s Quadballer

A Running Times story comparing some popular self-massage tools for runners says

The Quadballer: My newest abusive relationship.

The Stick is known as the toothbrush for muscles. The Quadballer, on the other hand, is like a dental tool.

I got turned on to the Quadballer only recently, when searching for a step up from my beloved/much-hated (it’s one of those relationships) foam roller to soothe my often-sore IT band. As soon as I started reading about its hurts-so-good powers, I had to have it. Thanks to a friend with a Trigger Point discount, I bought a Quadballer for a price that fits my race-registration-depleted budget, and it arrived at my front door last week.

The patented material the Quadballer is made from aims to simulate the feeling of an actual massage, and man, does it ever! The diagrams show its usage to be very similar to a foam roller, but this baby ain’t no comfy, cushy foam roller. There’s a reason why the instructional materials note that runners should only spend three to five minutes on each exercise — any more, and you’ll risk bruising.

For that reason, my first night with the Quadballer was kind of difficult.  I didn’t seriously overdo it; I just didn’t realize the extent to which a little goes a long way. I used to spend a good 30 minutes lolling around on the foam roller to work out post-run kinks. With the Quadballer, it’s more like five minutes, which is yet another reason to invest in one. It’s too soon to tell whether it’s the definitive cure to my IT band problems. But I can already tell it’s helping, and can a runner ask for anything better than that?

Have you tried this magical little instrument of torture? Any tips, praise or warnings to pass along?

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Build stronger ankles and feet

My right ankle, which first got cranky on me while running in Rock Creek Park December 2008, was the only part of me that felt a little sore and swollen after the Marine Corps Marathon Oct. 25. So as part of my six weeks of laying low and being smart following the marathon, I’m prehabbing like crazy, attacking foot and ankle exercises with the gusto I approached core- and hip-strengthening workouts with a few months ago.

Here’s a roundup of what I’m doing:

Towel scrunches: Lay a towel on the floor. Move it closer to you by scrunching your toes repeatedly.

Toe taps: Tap your foot for a minute straight. Repeat.

Calf raises on a step: Self-explanatory.

Various resistance-band exercises in which I pull a resistance band toward me or push it away from me with my feet. (Check out a photo of the latter here).

Picking up small items with my toes. This one barely feels like work, so I’m having a hard time committing myself to it.

Tracing the alphabet with my toes. Again, I don’t feel an obvious challenge or benefit here, so I have a hard time making myself do it.

Tons of balance stuff, which was already part of my core- and hip-strengthening workout. And fear not: I haven’t forgotten about the good ol’ core. I even added some new exercises lately: a side plank in which you place a stability ball between your feet, a front plank in which you balance your feet on a stability ball, then bring one knee at a time toward your chest.

Any favorite foot- or ankle-strengtheners I should add to the list? Share them by posting a comment!

In other news: I’ve found a fantastic new pool! The Takoma Aquatic Center, located about 10 minutes from my apartment, or maybe 20 minutes by Metro, is an Olympic-sized pool set up horizontally, so there are something like 12 lanes open for lap swimming at any given time. It’s a fast pool, and I immediately felt awesome once I got in despite a three-week hiatus from swimming. I glided through 2X1,000 yards, and didn’t feel tired and creaky until the end of my 5X200 IM set. I’ll definitely be heading back for more soon.

Finally, my Women’s Running story about sports psychology and motivation, Think Like the Pros, is live online at active.com. Check it out — I got so many helpful tips from it, and hopefully, you will, too!

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Lessons learned

After the Marine Corps Marathon Oct. 25, I exchanged a few e-mails with my friend Kaveh, who had to defer his entry until next year thanks to an ankle injury. We traded notes about how we ended up injured in the first place, and what we learned from those injuries. Here’s the parade of horribles that followed my Nashville Country Music Marathon in April 2007, after which I proceeded to:

Run two days after the marathon, a hard 30 minutes with Steve
Run my usual 6-mile route several times per week, with a semi-long run on weekends, because I wanted to “keep up my mileage,” doing absolutely zero cross-training
Go to a wedding in June wearing these *adorable* espadrilles, enjoy a few glasses of wine at said wedding, twist ankle on espadrilles, spend week on crutches courtesy of a doc in a box while awaiting a visit to the sports ortho (advice to you: When you have a drink in one hand, your high-heeled shoes should be in the other)
Resume running schedule immediately after getting doctor’s OK, with no physical therapy, apparently worsening some crazy muscle imbalances caused by a week of not using my left leg
Backpack 26 miles with a 30-lb pack the weekend after doctor’s OK
Be really surprised when my hip hurts so bad I can’t walk after the Marine Corps Half Marathon in Jax in October.

Shocking I ever managed to hurt myself. I was being so smart.

I’ve wised up since then, cross-training like crazy with only three quality running days per week, doing all sorts of core- and hip-strengthening exercises and sitting out as soon as something starts to hurt.

But I’m realizing I still have a lot to learn. The one thing that does kinda hurt post-marathon is the ankle I sprained running in Rock Creek Park in December 2008, which seems to be a sign that I should lay low for six weeks or so, skipping long runs to let my body completely heal itself. More importantly, I need to add some ankle- and foot-strengthening exercises to my repertoire, even though these are so boring, they make core work seem like a costume party. Take towel-scrunches: You place a towel on the floor in front of you, then proceed to pull it toward you by flexing and scrunching your toes. Thrilling. But I’m hoping exercises like these help end my foot/ankle problems for good. If you know of any great foot- or ankle-strengthening exercises, pass ’em along.

I also think I need to start speedwork earlier; nagging injuries kept me from adding speedwork to my training until halfway through my training schedule for MCM. My plan in training for the spring is to lay low for maybe six weeks to let my body fully recover from the last marathon, then start speedwork immediately in December.

I need to ask for a little help from my friends. I try to avoid boring my non-running friends with details about my training, but I realized I’ve done so to a fault, failing to even mention to many close friends that I’d be running a marathon until the weekend of. When my friend Jessica asked what we were up to Sunday, Oct. 25, and I told her it was Marathon Day, she immediately offered to come watch. I said that would be cool, if she wanted to; no big deal if not. I saw Jessica at mile 19, right after a major low point on the National Mall, and it just about saved my race. That’s one of the reasons it’s looking like the National Marathon in March is the revenge race for me; though it’s hilly and can be sparse in the final miles, it’s also located in a place where I can ask my friends to come support me in exchange for a nice pasta dinner the night after.

Finally, about those hills: I need to make my training all hills, all the time, so I’m not intimidated by the somewhat hilly course. My plan is to identify the biggest and most intimidating hills on the course, and to Metro downtown and do hill repeats on them. I don’t want to be wondering how I’ll do on the inclines; I want to know.

Which lessons have you learned from marathons past? Share them by posting a comment below!

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My revamped IT band plan

The BOSU and I will become close friends over the next two weeks.
Strengthen your core with the BOSU.

Back in July, when I was struggling to get past a flareup of an old hip injury, I decided to embark on an amped-up core- and hip-strengthening routine to get my body in the best possible running shape before starting to train for the Marine Corps Marathon on Oct. 25. I’ve culled a few new exercises from the pages of Runner’s World and the collective wisdom of other runners since then, and wanted to pass along the plan I’m convinced has kept injury at bay as I’ve tackled 15-, 18- and 20-mile runs.

3 X 25 walking lunges
3 X 25 single-leg presses
3X 25 single-leg squats
Hamstring curls
Leg lifts with weights (I do these on each side, on my stomach and on my back. Here’s a how-to for the side-lying lifts.)
Clamshells (shown here, along with lots of other interesting-looking running-specific exercises)

On the BOSU, flat side up, blue side on the floor:

-Squats with 10-lb med ball: 3 sets of 8
-1-leg raises in following positions: 3 sets of 15 seconds/each
(all of these require you to balance on one leg in the middle of the ball while doing something else with other leg)
-leg bent 90 degrees at knee (shin parallel to ground)
-leg bent 90 degree at hip (quad parallel to ground)
-leg extended 45 degrees out from side of body
-leg extended back 45 degrees/body forward (think swan)
Feel easy? Close your eyes, which makes it harder to balance.

What’s your favorite core- or hip- strengthening exercise? Share it by posting a comment!

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