What You Really Need to Run

What do you really need to run? According to Guillermo Pineda Morales, a.k.a. Memo, all you need is two things: hard work and never giving up. Memo is one of the top 10 runners in the world in his age group. In preparation for last weekend’s New York Marathon, the New York Times featured his inspirational story and training method. The video is a must watch!

https://www.nytimes.com/2019/11/01/opinion/memo-nyc-marathon.html

The video announcer says, “You know what Memo really believes in? Memo believes in running." I think it goes beyond that. I think he believes in himself. That’s the most powerful belief you can hold. 

I agree with Memo. It all comes down to hard work and never giving up. Memo can train and perform with a minimalist approach but some runners may need a little more guidance. Some of us need the support, accountability and motivation that comes from the metrics of our smart watches, a coach, a training plan, running buddies, group runs, and posting on social media. No matter what it is you need, believe in yourself, do the work and never give up!  

Completing the Trifecta to Pain-Free Function and Injury Prevention: Proprioception

Welcome to the third installment of our trifecta to pain-free function and injury prevention! While there are many components to injury prevention and healthy movement, our trifecta covers mobility, stability, and, in this installment, proprioception.

Proprioception incorporates agility, balance, and coordination.

You know about the five senses: hearing, taste, sight, touch and smell. Proprioception is your sixth sense. It is your unconscious and conscious ability to know where a given body part is in space. For example, if you close your eyes and your friend moves your thumb, you can report, without looking, that it is pointed up or down, left or right.

Your sense of proprioception provides approximately 70% of your ability to react to your environment. That's a lot more than the mere 10% provided by sight and 20% provided by hearing! Your muscles and joints relay information to your brain. Your brain uses that information to decide what action to take and relays it to your muscles and joints.

If the proprioceptive system is damaged or out of practice, connections are disrupted. Your muscles can’t fire at the right time to make use of the strength, even with you have strong muscles around your joints. This can lead to poor balance, lack of coordination and decreased agility. These deficits can cause and/or contribute to injury and negatively affect sports performance.

Proprioception can be disrupted with injury, surgery and declines with age. We all depend upon this sense operating at capacity for daily activities such as using stairs, standing and putting on shoes and socks. We require it for work-related functions, hobbies, and sports. Imagine a quarterback with a recent knee injury that has disrupted proprioception. If his brain cannot interpret which direction the knee is moving and adjust, he is at risk for injury when trying to pivot on one foot to throw the ball.

The great thing about proprioception and balance is that we can restore it! I use a combination of progressively challenging dynamic and functional exercises that stimulate the proprioceptive system. I balance proven exercises with exercises that I create and personalize to each unique patient and case. In some cases, neurological dry needling is helpful to facilitate the function of the proprioceptive pathway.

About Physical Therapy. Physical Therapy addresses function in daily lives, whether it’s our ability to unload the dishwasher, walk without a limp, or run an ultra marathon. Physical therapists work not only with injured patients but also preemptively with patients to prevent injury. This can prevent long periods of pain and time off of sports and work. Periodic PT visits focusing on prevention save time and money on the higher frequency therapy appointments required with chronic injuries.

Stability: Another Key to Pain-Free Function and Injury Prevention

Just because we can, doesn’t mean we should! We may have the ability to lift the laundry basket and carry it up a flight of stairs or run ten miles, but without proper body mechanics and stability, injury can ensue.

Prevention and rehabilitation from injury involve addressing mobility, strength, and balance. We discussed mobility last week. Achieving proper mobility of the tissues doesn’t ensure safety. In fact, some people have too much mobility but can’t support the joints or get power from their muscles. This causes them to compensate elsewhere and/or fail to support the joints. This is when injury can occur.

Let’s use another rubber band analogy. Imagine shooting an older rubber band that is super stretched out, maybe even saggy or brittle. When we pull back on it, the band stretches only a bit. The rubber band has lost power and elasticity, and it will not fly very far. Its mobility is useless because it lacks integrity.

In our mobility article we discussed how people who sit for long periods of time at desk jobs, lose mobility in key muscles on the front of the body with sitting. The opposite is true for the muscles on the backside of the body, namely the glutes (bum muscles). If poor posture is involved, the muscles of the back and the front of the neck elongate as well. These muscles are like the rubber band: they become too long and weak. As a result, they do not provide adequate support (stability) during activities like walking with the dog, kicking the ball with the kids, and playing sports. This is when injury is possible.

Many activities that involve holding a position for a long time can cause muscle imbalance and reduced stability. For example:

• Wearing high heels often or for an extended period of time. This creates a long term stretch for the muscles at the bottom of the foot and front of the hip. These lengthened muscles weaken when engaging in activities like walking the dog, running, climbing steps, and attending exercise classes. Injuries such as pain in the lower back or the bottom of the foot can surface.

• Participating in triathlons, as mentioned in our mobility article. Being in aero position for 100 miles stretches the back muscles and glutes for hours. These lengthened muscles are needed to support the back, and for power with push off for the 26.2 mile run segment.

• Patients recovering from abdominal surgery, such as a cesarean section. It takes time for abdominal muscles and tissues to heal from surgery. Gradual strengthening is required. These weakened muscles cannot support the spine adequately for activities of daily living, including bathing and lifting the baby, or even walking. Injury of the back and hips can occur.

One of the first things I assess when evaluating a patient is how they move. I look for faulty movement patterns that could cause injury or worsen a current injury. Poor mobility or lack of stability (or both) may contribute to the problem. I attack a lack of stability with progressively challenging dynamic and functional exercises within the patient’s tolerance. I like to use a combination of proven exercises, with exercises that I create and personalize to each unique patient and case. When pain is contributing to weakness, neurological dry needling can be helpful. Active Release Technique may also be used to treat injured joints and ligaments that result from lack of stability.

Faulty movement patterns can also be the result of poor proprioception and balance. Stay tuned for more on that in our next post!

About Physical Therapy. Physical Therapy addresses function in daily lives whether it’s our ability to unload the dishwasher, walk without a limp, or run an ultra marathon. Physical therapists work not only with injured patients but also preemptively with patients to prevent injury. This can prevent long periods of pain and time off of sports and work. Periodic PT visits focusing on prevention save time and money on the higher frequency therapy appointments required with chronic injury.

Where Shall We Run? Course Map Challenge.

We are on the lookout for new course maps for our weekend group runs. If you know of a great route that we’ve yet to explore or are interested in creating a run course from a new location, we’d love to hear from you.

Guidelines Include:

• Safe places to put aid stations out at 2 mile intervals.

• Bathroom opportunities along the way.

• Start location that is safe and not restricted (ie. starting from Town Center is a no-no as it requires a retail sponsor).

• Course allows for at least a 10 mile route out and back.

Thanks for your input and creative ideas to help keep our Saturday group runs motivating and adventurous. Email Howie at howieerenberg@gmail.com with your course map details by Oct. 22nd so we can implement for November runs.

Join the Get Lei'd Aid Station Oct. 19th!

Roadrunners will be cheering, supporting, and having a blast next Saturday October 19th at the KC Marathon.

Here’s what you need to know:

• Look for us EAST of the Meyer Blvd Fountain (Meyer Blvd and Ward Parkway).

• Station will be up and hopping from 7:00 AM to 12:00 PM.

• Park WEST of Ward Parkway on a numbered street to avoid the marathon route.

Please email JJ at jennifer.wolf74@gmail.com if you are able to help. Thank you for supporting our local KC community of runners. Your efforts are helping these athletes reach their running goals.

Mobility: A Key to Pain-Free Functional Movement and Injury Prevention

Prevention and rehabilitation from injury involve addressing mobility before strength and balance. Mobility is a prerequisite to strength. When joints, muscles and nerves don’t move properly, we compensate elsewhere. This is when injury can occur. 

Imagine trying to shoot a rubber band across the room. If it’s as dense as a tire, it will not go anywhere. It doesn’t have the ability to stretch and load energy. Any strength it has is useless because the structure lacks mobility. 

Many people have desk jobs that require sitting for long periods of time. Key muscles shorten throughout the day, namely the muscles in the front of the hip and the back of the thighs. If poor posture is involved, the abs, chest and muscles of the back of the neck shorten as well. These restricted muscles are at risk for injury when they are engaged for other activities like gardening, playing catch with the kids, and playing sports. 

Many activities that involve holding a position for a long time can cause muscle imbalance. For example:

• Biking in a triathlon. The athlete is in aero position for 100 miles and then moves to an erect posture to run a marathon. 

• Texting. The front of the neck, elbow, forearm and thumb muscles are held in a shortened position for hours throughout the day. 

• Carrying a heavy backpack on one arm. This creates long term shortening of muscles on one side of the spine and the hip on the opposite side.

• Carrying a baby on the same hip for an extended period of time. As with carrying heavy backpacks, this causes muscles on one side of the spine and the hip on the opposite side to shorten long term.

One of the first things I assess when evaluating a patient is how they move. I look for faulty movement patterns that could cause injury or contribute to a current injury. Then I determine which structures are preventing that motion such as muscle, nerve, tendon, fascia, ligaments or all of the above. Then we set about restoring mobility. This may involve the use of deep tissue techniques such as Active Release Technique, neurological dry needling, and/or dynamic stretching, both passively and actively. 

Strength, balance and coordination also come into play once a healthy amount of mobility is restored. More on this in our next post!  

About Physical Therapy. Physical Therapy addresses function in daily lives whether it’s our ability to unload the dishwasher, walk without a limp, or run an ultra marathon. Physical therapists work not only with injured patients but also preemptively with patients to prevent injury. This can prevent long periods of pain and time off of sports and work. Periodic PT visits focusing on prevention save time and money on the higher frequency therapy appointments required with chronic injury.