Dr. Michael Morrison, PT, DPT
Physical Therapist at Red Hammer
www.redhammerrehab.com
720.722.0793

• Injury Prevention/ Self management/


• Injury Rates:
• Most runners who run at least 30 miles/ week will have at least 2 injuries a year that will force them to miss about a week of running.


• Common----types of injuries for runners (emphasis on distance runners)
• Muscle strain: most common place for a muscle to tear/ strain is at the musculotendinous junction where the muscle is turning into a tendon to prepare for attachment to a bone grade I- III grade I= about 0-25% fibers are torn, grade II= about 25-75% of the fibers are torn, grade III is about 75% to full rupture
• Tendon inflammation: the longer this goes, the more possibility of bony fragments forming on the tendon (called calcific tendonitis)
• Stress fracture: starts as pain after a run, often progresses as more painful and earlier onset with each subsequent run. If you suspect this at all, get it evaluated, as it si very unsafe to try and run through this
• Mis-alignment, typically at the sacroiliac joint which is where the legs connect to the pelvis. Usually presents as a sense of poor power and lack of trusting the side of the misalignment to hold your body weight. Can lead to nervy/ tooth ache like feel down the thigh, often outer and wrapping around to the front/ outside knee.


• Risk factors------that INCREASE your risk of injury:
• RUNNING TOO FAST!!!! Roughly 75-80% of your weekly mileage should be EASY. This means 2-3/10 on an effort scale (0 is sitting on the couch, 10 is all out speed for 10 seconds or so. OR youshould be able to tell a story to your friends while running without any need for pausing to catch your breath
• Increasing mileage too fast: try not to add more than roughly 10-15% running mileage or time to the previous week. (so if you are at a 40 mile week, don't jump to a 50 mile week) This really matters even more on a month to month level of time. A nice feature with Garmin and similar programs is to be able to check your mileage over the past few months.
• Too long of a long run: slightly related to above: no one run should be more than about 25-33% of your weekly mileage
• Adding too much speed to fast and too often in your workouts
• Sudden changes in terrain (that new cement path they finished out your back door is not a great idea if you have been running on crushed gravel for years
• Sudden changes in shoes, especially drop in shoes. Drop is how high your heel is off the ground compared to your forefoot. Traditional was 12mm before Barefoot Ted and Born to Run came along :) Try not to change drop by more than 4mm at a time. If you are in a 12mm and like a 4mm shoe, go to an 8mm shoe for about 3 months first


• Ways-------to REDUCE injury risk:
  • Obviously reverse/ avoid above
  • Good run technique: try to land and get off the ground as quickly and softly as reasonable. Typically a 10 minute/ mile or faster should be at least 170 steps/ minute or more on EASY runs Over 10 minute/mile should shoot for at leat 160 if possible
  • Land with your foot underneath of you and not in front of you. Think about the portion of the run stride where you are kicking the heel behind you towards your butt
  • Do some form of mobility/ stretching, especially mobility such as a good yoga class (flow or Yin are solid forms for this)
  • Strength training: 2 months of 2 sets of 20 reps at really light weight, then go to 1-2 months of heavier weights where 8-10 reps are quite challenging, finished with 1 month of power: 4-6 reps that are quick and challenging. You can repeat this cycle over and over
  • Good diet: always can have more green leafy veggies :) my favorite way to sneak good fiber and foods is a smoothie
  • SLEEP: try to find your best time that your body wants to fall asleep at night and honor that.
  
  
• How to self treat:
  • PEACE and LOVE: Protect Elevate Avoid anti-inflammatoriesCompression Educate (see a health professional who can educate you on the injury and how to move forward). After the early phase (usually only a couple days if that) Load the tissue Optimism Vascularization Exercise
  • In general, heat is going to be your best bet to help relax strained tissues, encourage blood flow, and speed up healing. You can ice immediately after runs for about 10 minutes.
  • Ice bath: I like a 1x/ month ice bath: 3-5 minutes, then sit on the couch for an hour, then go to bed. Have a couple towels in dryer and a cup of hot tea ready for the 1 hour on the couch.
  
  
• When to seek treatment:
  • - Rest option: rest 5-7 days from first onset of pain. If still the same or worse, seek treatment
  • - Try to run through it, but if after 3 runs there is no obvious improvement, seek treatment
  
  
• Why PT? A decent PT will be able to do joint work (like a chiropractor), soft tissue work (like a massage therapist) and exercise prescription (like a personal trainer). You get all 3 of these in one stop. You also get someone who is trained to diagnose if your shin pain is simply a tight posterior tibialis tendon or the beginning of a stress fracture which needs an MRI (not an x-ray) to get the best information on prevention of injuries as well. if that's the case. It is also an awesome idea to see us for