How did we get here?

I have recently been inspired to get my blog on. When I started the Doctor G blog, it was a means to consolidate my thoughts after talks to a local team or group. I found it easier to have my key points listed on the blog before the talk so I could refer people to a central place after the talk. More recently, I find the inspiration for my posts to be for the purpose of shaping something bigger such as a book. As I stew over this great idea, I have taken pause to reflect on why physical therapy and running are such a great match. Research has taught us that injuries are very prevalent amongst runners. We have also learned along the way that many physical therapy interventions such as strength training, and movement pattern retraining can change a runner in a very short period of time. Often, PT interventions will help a runner continue to run with diminished or no pain. Keeping a runner running keeps all involved happy.

Overall, I think one of the most important concepts we have learned in sports medicine research is that most runners are vulnerable to injury because of training errors, and also relative instability. Let's review both:

Training errors- This is a simple one. Think too much, too fast. The tissues involved are overwhelmed by the cumulative stress of these increases. A question I always ask runners is what's different? I want to know if they have changed their training distances, surfaces, intensities, frequencies, or shoes. Usually something has changed. Usually something has increased such as one or more of the above components. It is also likely that something has decreased such as recovery, or consistency with stretching or strengthening. These changes cause the involved tissues to be overloaded. Tissue breakdown leads to pain which leads people to the clinic.

Relative instability- This is my favorite point to runners. Most runners are used to running straight ahead. The muscles that lead them in this direction are very well developed. They are very smart in that they know how to work to bring the body forward very well because that pattern of movement has been repeated over and over again. A runner can put thousands of reps on their legs during a race or training run so the concept of muscle memory is very real. However, this repetition is what really dupes most runner into thinking that running is all they need to do. From a stability perspective, the muscles that help a runner remain stable, and "in alignment", are oriented in planes of motion not isolated in running. Think of it this way: If you run North/ South but the stabilizing muscles go East/ West, why would a runner expect to be free of injury? This point highlights why runners need to add to their training some component of strength drills for the hips and core. The hips, specifically the glutes and hip rotators, are the cornerstone of controlling leg movements in standing. Consider them the foundation of the leg, to a degree. I make that qualifier because really the foundation needs to be designated as the glutes, which is part of the larger group of muscles called the core. Strength and stability in these areas position a runner to avoid most common running injuries. Strength and stability in these areas come from doing strengthening exercises moving in planes other than just straight ahead. Consider side stepping with a resistance band, rotating the hips against a resistance band, and adding to that balance work. Balance work is a great equalizer as it teaches a runner to control the strength they are developing. Remember, our goal is strong and smart.