Hi, I'm Dr. Molly with Your Goals Physical therapy, January is one of my favorite months. This is the month that everybody decides that they want to try to get healthy. They go out and they try to improve their body. They'll pick up a sport. They'll start walking around their neighborhood. They'll join a gym. All these amazing things that are just wonderful for your health and your overall well being. The unfortunate truth is though, whenever you start something new, especially if you haven't done anything recently, or for several years, a lot of people end up with injuries. Over the years I noticed that about February or March, I get a lot of injuries related to running.
In this video, I'm going to talk about five common running injuries that I see and then how to prevent them. Because ultimately what I really enjoy is helping people get and stay active.
It is so common to go full force and start a training program and then have an injury. And it breaks my heart. Every time I hear somebody say, “You know, I'm 40, it was bound to happen.”, “I haven't worked out in forever because my knees are bad. (or my back is bad.) And here I went and tried to go running. What was I thinking?” or “Of course I'm not built for running.” Of course, because I'm this age now I wish I hadn’t tried.” This is very sad to hear. Running is an amazing activity. It is true, however, if you have not done anything in a while, running isn't as easy as it was when you were five or six at the age of 40. You need to do a little prep work to make sure that you do not have an injury.
So let's talk about the five injuries that I'm going to discuss in this video. I see people with 1. muscle soreness, 2. plantar, fasciitis, 3. ankle sprains,4. patellofemoral syndrome, and 5. low back pain. Those are the five common things that I see, but there are ways to prevent all of them. So I want you to stay and listen, because I will talk about how you prevent them going forward.
Again, running is an amazing activity. And just because you're of a certain age or you haven't worked out in a long time, does not mean that you cannot safely get back to running. So let's talk about these injuries.
First muscle soreness, whenever you start a new exercise program, it is very common to be sore. What however can be shocking is when that soreness doesn't show up the same day or the day after the workout. That soreness starts two days after their workout. For instance, they run on Monday. They assume they're going to be sore on Tuesday, but Wednesday when they can't walk. And they're like, I have not worked out. I have not done anything. Why am I so sore today? That is very short. And that's where people get alarmed and start making phone calls. The other scenario with muscle soreness is that they were training for a month or so with no pain and no problems. Then all of a sudden they're waking up with just a ridiculous amount of muscle soreness. As if they get hit by a truck, they feel like they were in a car accident and all they did was work out, but they've been working out for a month. So why is it so bad today? And that's when the fear spiral happens. Muscle soreness is very common, and a lot of times you can track down why something would be so much more sore for you this time once you get a little bit of history from somebody. Muscle soreness is a big problem for some people, when it comes out of the blue or they weren't expecting it.
Plantar fasciitis, so many people suffer from plantar fasciitis even before they run. So then if they go to run and it gets worse, or they have a new bout of it, it basically makes them want to stop running altogether because nobody wants to wake up with foot pain every day. So what is plantar fasciitis? Plantar fasciitis is when the ligament or the fascia rather underneath your foot gets irritated. Now that fascia is supposed to help you keep the arch of your foot intact. Unfortunately, for people who are suffering from plantar fasciitis, what has happened is that that ligament and/or fascia has been stretched beyond its capacity or its level of comfort. And so there's been some irritation that's built up (and inflammation). Typically, you're going to feel point tenderness; there's going to be a spot in the middle of your heel that is very uncomfortable. And then every step you take is uncomfortable. Common complaints are when you wake up first thing in the morning, and you're going to get up out of bed. Those first two or three steps are very, very painful -that is what plantar fasciitis is. It's not fun.
The next one is rolled ankles. So rolled ankles as anybody can expect, if you're essentially hopping from one foot to the next, it would be very easy to allow one of your ankles to roll out to one side or the other. Typically what happens is you roll to the outside of your ankle, very few people roll to the inside of their ankle. And depending on how dramatic that roll is, you can either stretch a ligament or completely tear it. There are grades between that so you can do little bits of damage to a ligament on the outside of your ankle. And that would be an ankle sprain. This is what happens a lot of times when people catch the edge of a sidewalk when running.
If you're running on dirt or uneven pavement, and you catch a crack or a rock, you can roll your ankle. Ankle sprains are very common when you're running. It's just a matter of watching where you step. In some cases, they just can't be helped.
Patellofemoral syndrome. That's the third thing that I see very often. And I will say this is typically seen more often with women, but men do get this. It is when you're having popping and clicking in your knee. The other common complaint with this, it's not just the popping and clicking, it's that when they sit for a long period of time, we'll say 30 minutes, you'd go to get up and your knee does not, it just doesn't feel right. It works. It bends and it extends. It just feels really stiff and not good. It does not feel comfortable to get up and walk after 30 minutes, which makes commuting in the city of Houston, not fun. But what is patellofemoral syndrome, other than just the achiness in your knee and popping and clicking? Your knee cap has its own groove; so on the front of your femur, there is a groove for your knee cap to shift up and down on. When your knee is bending, that knee cap is supposed to slide up and down and stay in its groove. If you have patellofemoral syndrome, for some reason or another, that knee cap is sliding out (under normal circumstances, what's happening is it’s sliding to the outside of the knee) and it pops. So the pop sound is the kneecap moving in and out of that groove. For some people, the pop isn't very painful or annoying, but for others, it can be very dramatic and very uncomfortable. It's all stemming from the same thing. Something is causing a misalignment of where that knee cap is tracking causing a pop sound.
Low back pain is the last thing I want to talk about. If you're getting low back pain, it can be before, during or after. Well, probably not before, but it can be during or after your run. If you're feeling that, then the sensation that you're feeling is from your back muscles tightening up, essentially, it's a muscle spasm. The little muscles that keep your spine stable so that there's no shifting and moving around, they are tightening up really hard. And so if you're getting that ache either during or after your run is basically like your low back muscles are telling you, “Hey, we’ve been squatting.” We've been stuck here in this squatting position, just holding everything as steady as we can for however long they've needed to while you're running and they're uncomfortable, they're sore. They're overworked. Now, why would your back muscles be doing that much work? Well, something is not doing its job because if your back muscles think that they need to clamp down that hard, then there's nothing that's helping them do that job. And there are lots of things in your hips and your abdomen that help stabilize your spine. But if your back muscles are feeling the need to be the only things doing that, then that's saying that there's some form of imbalance that's happening and your back muscles are being overworked. And that's where that achiness is coming from.
So those are the five things. So just as a recap, muscle soreness, plantar fasciitis, ankle sprains, patellofemoral syndrome, and low back pain, are very, very common injuries to have for running. Now, how do you prevent those? Because ultimately, if the goal was for you to be healthy, nobody wants to be injured in their pursuit of health. And so let's talk about how to prevent these.
I have about eight suggestions to prevent running injuries.
If you're going to start a running program, number one priority, you need to make sure that you have a very good training program. That means that when you pick whatever program that you're going to pick, that you find that there is enough rest between your runs. If you run on Monday and you're a little sore on Tuesday, that's one thing. But if you're still really sore on Tuesday, then maybe you don't need to run on that Tuesday. Because you need to make sure that you're recovering from each of the previous runs. The other thing with the training program is you need to make sure that you do not increase your distance the same time you increase how fast you're running. You can decide this week, “Hey, I'm going to increase my run distance”, but then you need to keep your pace the same as it was the week before.
Because if you increase both at the same time, the amount of muscle soreness you'll be in, the over-training that happens when you do that is very dramatic. So again, that goes with what kind of training program are you using and how are you progressing yourself?
The other big thing is to make sure you have proper shoe wear. Now, I have a video that talks about how to make sure that your sneakers fit right. But ultimately the big thing is that you want to make sure that your shoes are not worn out and that they fit you correctly. When you're running in your sneakers. One, if you're going to be running every day, you should probably have two pairs. So you can alternate them. The other thing is that you don't want to run in them if you've had them for more than 500 miles. So, unfortunately that does mean you need to do some math, depending on how many miles a week you're doing. You need to invest in those shoes, because if you're running on cement, which is the other thing you can pay attention to, especially depending on if you're having, a lot of joint achy pains afterwards, running on cement is a lot harder on your body than running on a treadmill and or running on like dirt or grass, grass paths. So that can be something to consider…”what terrain are you on?” But you want to make sure that your shoes are good and that they're in good condition; the cushioning in them is still doing its job and average manufacturers tell you that's about 500 miles. That just depends on how long it takes you to put that 500 miles on there.
The other big thing is ice at the end of the day. If you notice that from your run, your little sore ice, ice is nice, 10 minutes. I know we're all in Houston and nobody likes ice, but It’s amazing for reducing muscle soreness. The other thing that's also amazing for muscle soreness, which would be another suggestion is stretching. Now I know from personal experience that if I've set up time for a run, I inevitably forget to add time for stretching at the end. So if that is also the reality that you are sitting with, then you need to make sure that you set up a day that is dedicated to stretching, because stretching is vital to keeping your muscles and ligaments healthy as you're running. Stretching helps you reduce muscle soreness and all sorts of other things. If you are intentional about spending time, stretching is very, very important. And again, I know from my own personal experience, setting that time up can be very difficult because that's not the fun part, but it's much better than having an injury. So stretching.
Another part that is often missed in a running program is strengthening. Nobody ever thinks about how hard it is to run, but you are effectively doing single leg squats for however many miles that you're running. If you do not have the proper hip strength, ankle strength, knee strength, trunk stability, then running will add a lot of wear and tear on you that you weren't prepared for. So having a good overall strengthening program is vital to preventing injuries while you're running.
Now, I just gave you a whole lot of information and some of that can be very confusing. And sometimes you can be further down this path or at the beginning of this path. And so how do you navigate all of these things? There is no shame in seeing somebody about how to run. I offer a running clinic. It's a 30 minute assessment where I look at how people are running. I check out the mechanics, check out global strength and that helps guide them on the way of training for their runs. So they know where maybe they have some areas that they need to work on, whether that'd be strength or stretching or some mechanical issues, maybe they need to work on. I know it seems silly, but just how they're running so that they're not making themselves work harder than they need to. So that is something that is a very viable option.
Just seek a little bit of help having somebody else help determine what's going on while you're running. So at three miles, you're having a problem. Why are you having a problem at three miles? Maybe see somebody needs to be with you to help you with that and assess that. That's what I help many, many people with so that they can prevent injuries going forward and stop the injuries that they're having currently. If that's something that you're interested in, there'll be a link somewhere below so that you can get in contact with my office and we will set you up with an appointment for that.
I also save these visits every week. They're called discovery visits because a lot of people find me on the internet. And it's really hard to tell whether or not you're talking to an actual person or what information somebody can actually give you. I completely understand that it's a very weird world that we live in right now. where we get everything from the internet, but we never know exactly how much truth is in what we're getting. So I offer discovery visits and why I call them discovery visits is because they allow us to discover if we're going to be a good fit for each other. You get to ask me questions. I get to find out about what's going on with you specifically. And we get to decide whether or not what I can do for you is what you, what you really need. So I saved those also, and there'll be a link below so that you can access those appointments as well in the show notes below.
Well, I hope that you’re having a fabulous first of the year, and that if running is something that you just picked up, that you are thoroughly enjoying it because ultimately I think running is just an amazing, amazing, amazing activity. I just love running. You guys have a great day. Bye.
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WE HELP ACTIVE ADULTS OVERCOME THEIR ACHES AND PAINS TO GET THEM BACK TO THEIR FAVORITE ACTIVITIES WITHOUT MEDICATION, INJECTIONS OR SURGERIES.
Dr. Molly McDonald