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PREVENTION OF RUNNING INJURIES

It is two months away from the 25th Steamtown Marathon. This column is dedicated to those dedicated runners preparing for the big day, Sunday, October 9, 2022.

Congratulations and thank you to Bill King, founder and race director, and his band of brothers, for their tireless efforts organizing and sustaining a great race that instills pride for all people of NEPA. It has inspired many people, including me, to transfer the discipline and determination required to complete a marathon by overcoming challenges one mile at a time.

Now, a little marathon history: In 490 B.C. Phedippides, ran 25 miles from Marathon to Athens to deliver an important military message and died immediately. Ironically, the first marathon of the modern Olympic Games in 1896 in Athens was won by Spiridon Louis, a humble Greek peasant, who stopped along the way for a glass of wine and told the owner of the tavern that he would win the race. He was determined to pace himself properly, as he knew the dusty, hilly path better than anyone in the field. He was greeted with jubilation and become a hero and legend.

HOW TO PREVENT RUNNING INJURIES

Avoid the “terrible too’s”

Only run miles needed to meet your goals

Avoid inconsistent training

Avoid repeating hard workouts without any easy workouts in between

Consider cross training to avoid overtraining without compromising fitness level

Treat your feet right

Visit your doctor regularly and listen to your body. 

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”  

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

For all of Dr. Mackarey's articles visit: www.mackareyphysicaltherapy.com/forum

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

Spring is just around the corner so it is time for running enthusiasts to lace up their sneakers, get outside and run! Runners are addicted to running for good reason. There is nothing like it! No exercise offers so much in such little time. For example, the caloric expenditure while running is higher than for most other exercises, including biking. Also, it allows for fresh air and beautiful scenery with a minimal investment in clothing or equipment.  It requires little skill and time to learn. Runners suffer from less depression, colds and flu symptoms, and experience less pain due to an endorphine release (natural chemical in the brain associated with euphoria and pain control) that is greater than found in other sports and activities. These are some of the motives that cause people to run every day, in spite of the constant loading and wear and tear on the joints.

To be a competitive runner and have longevity in the sport, optimal form is necessary. Moreover, a recent study shows that a runner can decrease the stresses on the lower body and reduce the incidence of stress fractures when trained to run with proper form using visual feedback while on a treadmill. The application of this information has significant implications for training programs for runners for the prevention and recovery from injury. One such low impact method is called the “Pose Running Technique,” by Dr. Nicholas Romanov. It is a “soft landing” method which promotes; an S-like body position with slightly bent knees, a slightly forward lean at the ankles to employ gravity and momentum, lifting the feet up under the hips, and landing on the ball of the foot under the body to absorb the center of mass.

It is my opinion, that the best runners, with the least injuries, such as Jordan Hoyt, speedster from Abington Heights, employ these techniques naturally. Additionally, many of the world’s best runners use coaches and trainers to assist them in their quest for success and injury prevention by using perfect form. However, for the rest of us, we must learn to maximize the efficient use of the body as it works with, not against gravity. We must learn to run “soft” to prevent injuries.

PROPER FORM

Head Position

A slight upward tilt of the head to allow a view of the horizon ahead should be most comfortable. Avoid looking down or up to extremes. Do not rock or rotate the head while running.

Shoulder Position

Loose and relaxed shoulders set the tone for a good run. Keep them level without tilting side to side or rotating left to right.  Avoid holding the shoulders in a tight and high position.  

Arms

Loose and relaxed arms also set the tone for a good run. A good arm swing is always in forward motion in a linear direction and stays between the waist and lower chest. Never clench the fist. Do not rotate or twist the arms across the body.

Torso

If the head, shoulders and arms are in correct position, then the torso will be upright. An erect running posture is necessary to promote efficient movement and breathing. The posture that you assume when taking a deep breath is the correct torso position for good breathing while running. 

Hips

The hips will follow the position of the parts above in a linear forward direction. However, if the torso leans forward because the head hangs down then the hips will tilt downward. If the arms swing and torso rotates side to side, then the hips will also rotate.

Legs/Stride

Sprinters need to lift the knees high to thrust the lower legs forward. Long distance runners cannot maintain a high knee lift for a long period of time, however, a slight knee lift with a shorter but quicker stride is more efficient. Proper running requires the foot to softly strike the ground with the knee slightly bent. If the knee is fully extended in front of the body upon impact, the stride is too long and the force too great.

Ankles/Feet

To excel as a runner, when the foot hits the ground it should land lightly, between the heel and the midfoot. The ankle is flexed and rolls quickly forward to the toes to push off the ground with maximum force. The calf muscle propels the runner forward. Efficient running has a quiet and springy landing. A loud foot slap on impact is a sign of poor form and results in excessive force transferred to the lower leg. The foot should spend as little time as possible in contact with the ground…thus a soft runner “floats” when they run.

SOURCES: Runner’s World, Pose Running Technique (www.posetech.com), Journal of Orthopaedic and Sports Physical Therapy.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”  

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

Pre-pandemic we saw increased popularity of local races such as the Steamtown Marathon and Scranton 1/2 Marathon. With that, local interest in running was exploding and will hopefully return to normal soon. However, during the pandemic, especially when fitness centers were closed, many took seasoned and beginner runners to the streets to improve fitness and alleviate stress. However, as a health care provider, I am seeing a significant number of first time runners visit my office with a wide variety of injuries that are very preventable with a modicum of good judgment.

Runners are addicted to running for good reason. There is nothing like it! No exercise offers so much in such little time. Caloric expenditure is higher than in most other exercises, including biking. Running also allows for fresh air, beautiful scenery, minimal investment in clothing or equipment, little skill and time to learn. Moreover, the benefits are many; runners suffer from less depression, colds and flu symptoms, and experience less pain due to an endorphin release (a natural chemical in the brain associated with euphoria and pain control.)

This column will be dedicated to those who are interested in beginning a running program for all the reasons mentioned above and more. The program is designed to promote a safe and gradual introduction or return to running as form of exercise. The initial goal is to help you attain 30 minutes (approximately 2 miles) of running at a slow, relaxed and safe pace. This 30 minute goal is the standard used in most research that shows improvement in weight control, cholesterol, heart disease, blood pressure and adult onset diabetes.  The 8 week program is a simple and safe program that begins with more walking than running and gradually reverses the proportion. The first two miles are the hardest and once mastered; one can begin to build on mileage and intensity if desired. For those interested in advancing to a half or full marathon, I recommend the book “The Marathon” by Jeff Galloway who advocates a run/walk program as you increase distances. Visit his website at: www.jeffgalloway.com.

Before You Begin

The appearance of an arch in a weight bearing position does not automatically exclude the individual from excessive supination or pronation. Consult a podiatrist or an orthopedic physical therapist to determine the propensity toward supination, pronation or neutrality of the foot and ankle.

Note: New Balance, Brooks, Asics, Mizuno & Saucony all make quality running shoes to accommodate a supinated, pronated or normal foot.

WEEK 1

Mon.Wed.Fri.Sat: Run 1 minute. Walk 2 minutes. Repeat 10 Times

Tues.Thurs: Walk 30 minutes

Sun: Rest

WEEK 2

Mon.Wed: Run 2 minutes. Walk 1 minute. Repeat 10 Times

Fri.Sat: Run 3-4 minutes. Walk 1 minute. Repeat 6-7 Times

Tues.Thurs: Walk 30 minutes

Sun: Rest

WEEK 3

Mon.Wed: Run 5 minutes. Walk 1 minute. Repeat 5 Times

Fri.Sat: Run 6 minutes. Walk 1 minute. Repeat 4 Times

Tues.Thurs: Walk 30 minutes

Sun: Rest  

         

WEEK 4

Mon.Wed: Run 8 minutes. Walk 1 minute. Repeat 3 Times THEN: Run 3 minutes

Fri.Sat: Run 10 minutes. Walk 1 minute. Repeat 2 Times THEN: Run 8 minutes

Tues.Thurs: Walk 30 minutes

Sun Rest  

WEEK 5

Mon.Wed: Run 12-13 minutes. Walk 1 minute. Repeat 2 Times THEN: Run 2-4 minutes

Fri.Sat: Run 14-15 minutes. Walk 1 minute. Repeat 2 Times THEN: Run 2 minutes

Tues.Thurs: Walk 30 minutes

Sun: Rest    

WEEK 6       

Mon.Wed: Run 16-17 minutes. Walk 1 minute. THEN: Run 12-13 minutes

Fri.Sat: Run 18-19 minutes. Walk 1 minute. THEN: Run 10-11 minutes

Tues.Thurs: Walk 30 minutes

Sun: Rest

WEEK 7

Mon.Tues.Wed: Run 20-22 minutes. Walk 1 minute. THEN: Run 7-9 minutes

Fri.Sat: Run 24-26 minutes. Walk 1 minute. THEN: Run 3-5 minutes

Thurs: Walk 30 minutes

Sun: Rest

WEEK 8

Mon.Tues.Wed: Run 27-28 minutes. Walk 1 minute. THEN: Run 1-2 minutes

Fri.Sat: Run 29-30 minutes. Walk 1 minute. THEN: Run 0-1 minutes

Thurs: Walk 30 minutes

Sun: Rest

TRAINING TIPS:

SOURCE: Runner’s World

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”   NEXT WEEK…RUN WITH GOOD FORM!

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

Due to social distances and other appropriate precautions during the COVID-19 pandemic, many people are filling the void in their lives with outdoor endurance exercises such as running, cycling, hiking etc. However, as summer is in full swing, with temperature and humidity rising, remembering to properly hydrate is essential.

Next to oxygen, water is the nutrient most needed for life. A person can live without food for a month, but most can survive only three to four days without water. Even though proper hydration is essential for health, water gets overlooked as one of the six basic nutrients. Dehydration occurs when the amount of water taken into the body is less than the amount that is being lost. Dehydration can happen very rapidly (i.e. in less than eight hours); the consequences can be life threatening and the symptoms can be alarmingly swift.

In the body, water is needed to regulate body temperature, carry nutrients, remove toxins and waste materials, and provide the medium in which all cellular chemical reactions take place. Fluid balance is vital for body functions. A significant decrease in the total amount of body fluids leads to dehydration. Fluids can be lost through the urine, skin, or lungs. Along with fluids, essential electrolytes, such as sodium and potassium, are also perilously depleted in a dehydrated individual.

The risk of dehydration is not limited to endurance athletes and outdoor enthusiasts. Dehydration is the most common fluid and electrolyte disorder of frail elders, both in long term care facilities and in the community! Elders aged 85 to 99 years are six times more likely to be hospitalized for dehydration than those aged 65 to 69 years.

Is water adequate to prevent dehydration? Will a sports drink improve my performance? While some answers to these questions apply generally to all, others vary according to the temperature, humidity, length of time and intensity of the activity and condition of the athlete. 

Proper hydration is essential for the comfort and safety of the recreational and serious athlete. Hydration is critical to maintain cardiovascular function, body temperature and muscle performance. As temperature, humidity, intensity, and duration of exercise increase, so too does the importance of proper hydration. Excessive sweating can lead to a loss of blood volume which requires the heart to work much harder to circulate you blood through your body.

Dehydration is a major cause of fatigue, loss of coordination, and muscle cramping leading to poor performance. Prehydration, (drinking before exercise) is the first step in preventing dehydration. Marathon runners, other long-distance runners, and cyclists often prehydrate1-2 days before a big event. Rehydration, (drinking during or after exercise) is the second step in preventing dehydration. While athletes may be more vulnerable to dehydration, all persons engaging in exercise would benefit from increased performance, delayed muscle fatigue and pain by maintaining adequate hydration. Proper prehydration would include drinking 12-16 ounces of water 1-2 hours before exercise.  Athletes with other health issues should consult their family physician before engaging in long distance endurance sports.

American College of Sports Medicine Hydration Recommendations:

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

For all of Dr. Mackarey articles visit https://mackareyphysicaltherapy.com/forum/

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor  in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.