Doctor g videos: wall slide with ball

The wallslide with the ball ties together some of the other exercises already introduced. The runner will learn to move through their hips while the back stays straight. The is a key element of low back health: always bend from the hips and knees versus the back. This exercise targets glute and quad muslces, as well as encouraging control of movement patterns.

Place the ball against wall and lean against it. The ball should be between the shoulder blades. Braces stomach muscles, bend at hips and lower down to approximately 85 degrees of knee bend. Pause, and slowly raise back to the top. Emphasize the lowering portion of the exercise as it teaches many muscles to be active and controlling as the musccles get longer. The type of contraction that occurs when a muscles contracts as it gets longer is call a eccentric contraction.

Repeat 15x. This exercise can be done with a theraband around the knee. The strength of the theraband wants to pull the knees together. It is required of the participant to contract against the band, thereby engaging the hip external rotators. This is a very function exercise because the feet are on the ground, aka closed chain, and you move in a very functional motion- a squat. Use this exercise to get strong, AND, more importantly, also change a movement pattern. It is possible to be strong and have crummy movement patterns. We are trying to avoid that by engaging in exercises like this. Enjoy!

Doctor G videos: sidestepping with band

Another solid exercise I commonly give to runners is the sidestepping exercise using a theraband. The reason I like this exercise is that is does a great job of stengtheing the hip abductors. As I have previously mentioned in the clam video, having strong hips is vital for runners staying injury free. Consider that 50% of all running injuries occur at the knee. Common examples include IT band syndrome, and patellofemoral syndrome aka runner's knee. Both of these injuries have been shown to be associated with hip weakness. More specifically, both syndromes have been shown to be commonplace in runners that have weak hip abductors. When the abductors are weak, the knee tends to drift into adduction creating strain on the knee.

This exercse is performed in standing with a theraband around the ankles. Gently brace you ab muscles and pull right leg away from the left against the resistance of the band. The left leg follows making sure not to drag it or let them snap together. This is repeated multiple times after which the direction is changed. Initiate the movement from the power in the hips, not by sidebending the torso, or hiking the hip. Work the motion back and forth in a room to the point of fatigue.

Doctor G video: the clam

The "clam" exercise depicted in the attached video is a great way to strengthen your hip external rotators. Many of the common movement faults seen with injured runners entail excessive internal rotation. By strengthening the muscles that oppose this internal rotation, namely the external rotators, you start to see the value in this exercise. This concept is at the cornerstone of running sports medicince today: when you have a strong hips, you have happy knees. A strong hip give a runner better control of how the leg is moving, thereby minimizing the abnormal stressors crossing the knee.

The "clam" exercise is performed in a sidelying position with knees and hips flexed as shown. Brace your abdominal muscles and slowly raise the top knee against the resistance of the band. Pause at the top of the motion and then slowly and smoothly lower down. The top knee should lift up without the pelvis moving. At the start, the pelvis is perpendicular to the floor. This position should be consistent throughout the exercise. As muscles fatigue, there is a greater tendancy to use the trunk muscles versus the hip muslces to lift the leg. This will be evident by the pelvis rocking backward leading the leg. Repeat the up and down 10+ times focusing on control and apropriate movement patterns.

The Bridge Video

Many thanks to my brother John for helping me to produce these videos. Additional thanks goes to his colleagues Andy for help in editing the material. I have always felt that the powerpoint slides I use to educate clients on exercises were quite good. However, a video ties it all together is a more meaningful way. I was able to shoot a few videos with John. I chose to start with some of the fundamental exercises which isolate muslces and movement which are important for

runners.This video depicts the BRIDGE exercise. This is a great exercise to begin to train the gluteus maximus. This is an important muscle for hip and low back stability. Having a strong hip, as well as lower back is vital to the heatlh of a runner. Another reason this muscle is so important is what it does. The gluteus maximus actually helps to move the hip in multiple different directions. Bottomline is that strengthening this muscles gives you much bang for your buck.

Start in a supine position with knees flexed. Brace stomach muscles. Lift hips off floor such that you creat a straight line from the torso to the knee. Hold this position for a 5 count, squeezing checks together. Slowly lower, and repeat 15x. This can be done on a swiss ball to add an element of balance. It can also be performed single legged.

The bridge is an exercise which helps to teach someone to move through their

Staying focused

During the time period that an athlete is dealing with an injury it is essential to stay focused. All too often my sense is that an athlete is dwelling on what they can't do versus what they CAN do.
Currently in my PT practice I have the opportunity to work with many injured runners. These clients typically fall into two camps: those willing to cross train when injured versus those unwilling. Rather than fight with the injured area by carelessly continuing to run, I would like to suggest cross training with purpose.
Most running injuries are made worse by the impact of the foot hitting the ground. To a degree this is because it is estimated that 3x your body weight of force goes through the leg when it hits the ground during running. Instead of trying to handle this stress on an injured extremity, switch gears to another mode of exercise. For a runner, the elliptical closely mimicks the running motion without the impact stresses. Using a stationary bike is another way to keep the legs active without overly stressing them. Do not just get in a bike and spin. saddle up and consider what you would be doing if you were running. If Tuesdays are track days, consider intervals on the bike. If it is a tempo day, try to duplicate this on the elliptical.
If a runner has access to a pool, I often suggest getting in the deep water to "run". This requires a buoyancy belt to stay afloat. This environment allows the legs to move freely in the running patterns without impact stress. As an injury improves, running in shallow water is great exercise. With water up to the chest, the buoyancy effect allows a runner to gently get back into weightbearing. This progression is often a bridge to normal running. This enables an athlete to relearn the movement patterns of running without pain. This is important because studies suggest that pain, OR the fear of pain, often impair normal movement patterns and muscle function. If a runner can go through the motions of running in a pool without pain, there will be great value.
When dealing with my ankle injury recently, I fell into the typical trap. I was dwelling on what I could not do versus the modes of exercise that would help me. As I try to prepare for Boston, I have learned that there is plenty of cross training I can do as my ankle becomes more stable. This will help me stay fit. When I am ready to go full bore, I expect to have more kick in my stride as a result.
Hopefully in the next few weeks I can be back into a run-focused training program. In February I will decide if it is realistic to go for a companion belt buckle for the one pictured above. The one above is from completing the Leadville 100 mile mtn bike race in '99. There is a 100 mile trail run on the same course which is run in August. We'll see if it is in the cards for me this year depending on how the return to running goes.

Inspiration- John Kelley

I was able to spend the Christmas holiday in Newton, Mass. I was staying less than a mile from Commonwealth Ave so I used it as an opportunity to do some recon on the Boston marathon course. Though I have run the marathon the past two years, a race day experience is so different than a training run.

Being familiar with a race course has always been something I felt really helps. So much of marathoning, to me, is about being focused and calm. Without the jitters of an unfamiliar course, I feel my race management is that much easier.

Lance Armstrong was always on target with this approach. Say what you will about Lance and all doping craziness, but the guy knew how to train. He studied a race course to familiarize himself with the terrain. He rode coming moutain stages in the off season to really know how they felt. This was how I approached my time in Boston: get time on the course is a relaxed, yet focused manner. With this goal in mind, off to heartbreak hill I went.

Initailly I ran backwards on the marathon course. This brought me to the Newton firehouse, and the start of the hills. With just a few miles on my legs, the hills felt pretty easy. No real huffing and puffing. I tried to focus on absorbing the landscape to make if more familiar. I stayed light on my feet, tapping out a quick but silent cadence. My breath was steady as I imagined race day. My posture was helping me to keep a steady pace, versus fighting the effort of the hill. Overall, the hills were great. Total time on the course was 75 minutes which I was happy about given recent injuries.

During the run I noticed the above statue of John Kelley. Both runners in the statue are John. On the left is john at age 27, winning the Boston marathon. On the right is John finishing the race at age 84. he competed in the Boston marathon 61 times, finishing 58 times. Wow! That is a remarkable track record. Truly inspirational. To be so dedicated for so long is impressive. Makes me wonder what I will be doing at age 84, or 74 for that matter. I also wonder what he thought when he started his streak.

Many thanks to John, and his spirit, for the inspiration. I will think of him when I toe with line with Nick, Roo, and Bill this year, my third......

A new season awaits....

This is a great time of year. It feels good to wrap up 2009, and feel recharged for another season of racing. I have rested and now it is time to ramp things back up. 2010 promises to be another great year. Looking back, it will be hard to top '09: a PR at Boston, and running my first 100 miler were huge achievements, just like starting up a new practice at the Water Street gym. Realistically, however, there will more PR's, more bostons, and maybe even more 100 milers.

The above painting is of Mount Alto, which is adjacent to Monticello in Charlottesville. There have been many rides and runs to the top by your truly and crew. The Mount, in a way, represents my outlook for the coming year and training cycle. There is a defined path to the top where goals are achieved. To get to the top does not come without effort yet the view is sweet. To get there I know that I need to be focused and dedicated. There is no substitute for hard work. Ask Nick about that. He was out this morning in the 20 degree temps running his 800's. Focused and dedicated, hell yeah and that is why he runs in the 2:40's.

My first goal for the year is to run sub 3 at Boston. I have been chasing this goal for a couple years now which adds a level of excitement to thinking this is my year. I have a firm handle on what needs to be done so now it is time to start putting one foot in front of the other up that path.

The start of a new year, or new season, is a great time to reflect on what you want to achieve. Make a list which has realistic and objective goals outlined. Take the list and write a plan as to how you will achieve these goals. Making a goal is relatively easy. Writing the story of how you achieve it is decidedly more difficult. However, this is what champions do- they write their own story to accomplish goals. For me, the story starts with dedication and ends with hard work. It starts at the bottom of the mountain, and leads to the top. The next challenge brings me back to the bottom.

Take a moment to put pen to paper for this year's goals. See where your story takes you.

Recommended by the Washingtonian!

Check out the latest issue of the Washingtonian. There is a piece about sports medicine which discusses what it takes to stay healthy and actively engaged in sport. There is also a listing of recommended experts within the different fields of sports medicine. I am happy to report that I was listed for the recommended sports medicine physical therapists!
There are many great PT's in the greater DC area. which could also have been listed. Fortunately, I have had the good fortune to work with, and learn from, plenty of stellar therapists throughout my career. It is an honor to be recognized by the Washingtonian. I love being a physical therapist with passion for helping people. Whether a person is a sub 3 hour marathoner, or just an average Joe, the satisfaction of helping them learn how to overcome an injury is the same.
In a piece about sports medicine, it is nice to see physical therapy getting its due. Without PT, the recovery from most injuries, both surgical and non-surgical, would be drastically delayed. Physical therapy is more focused than ever on providing evidenced based care. This allows the focus of intervention to be on treatment which has been proven in research. I would suggest that anyone seeking out a qualified PT should insist on working with a clinician who practices this way. Care should be centered less on symptom management, and more on the mechanics of why the problem exists in the first place.
Thanks again for the acknowledgement!

http://www.washingtonian.com/articles/coverarchive/14463.html