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Health Matters: Runners, Get Back in the Race with Physical Therapy

By John Frank, PT

From helping to protect against heart disease to boosting your mental health, there seems to be no finish line to the benefits of running.

However, running injuries are common and whether you are a long-timer runner or new to the sport, if left untreated, injuries can leave you limping along.

In fact, at any given time, 25% to 36% of runners have a running related injury, according to the American Academy of Orthopaedic Surgeons.

Often, physical therapy can get you back in the race.

Penn Medicine Princeton Medical Center Princeton Rehabilitation offers a physical therapy program for runners that focuses on running biomechanics for the treatment and prevention of running-related injuries.

Proper Alignment is Key

While running may appear to be a simple exercise that requires little more than a pair of sneakers, healthy running requires complex body mechanics to keep your body aligned and injury-free.

And typically, it all starts in your gluteal muscles.

Your glutes are the main muscles in your hips that power your legs. Weak gluteal muscles, often caused by prolonged sitting, can result in misalignment of your pelvis.

When this happens, it can cause hip and knee problems. A common condition associated with improper alignment is iliotibial band syndrome, which occurs when the iliotibial band – the tendon that runs from your pelvis to just below your knee – stretches and pulls, resulting in inflammation and pain in the side and front of your knee.

Additionally, improper foot alignment may cause hip pain, which may then lead to knee pain.

For runners over age 40, the most common sites of injury, according to the American Physical Therapy Association, are the Achilles tendon and calf muscles. These are soft tissues that are more vulnerable to injury as we age.

Injuries to the Achilles tendon and calves are usually caused by overpronation — a condition in which the arches of the feet turn inward and downward when walking and running.

When to Seek Help

Some muscle soreness is to be expected when you start out on a run, but it typically eases as you keep going. If you are experiencing pain, however, it could signal a problem that needs attention.

The American Physical Therapy Association recommends seeking the help of a physical therapist if you are experiencing pain, especially pain that:

• Does not go away after running.
• Exceeds a score of three on a pain scale of one to 10 (10 being the worst) while running.
• Is sharp.
• Wakes you up at night.
• Persists and worsens when you run.
• Occurs and continues in the same area every time you run.

At Princeton Rehabilitation, skilled physical therapists provide a comprehensive assessment of posture, range of motion, strength and flexibility. The assessment may also include video analysis of your gait and running technique to help identify inefficiencies in your form.

Treatment may involve hands-on techniques such as joint mobilization and soft tissue mobilization, as well as stretches, exercises, and education on proper form.

Patients can also expect to receive a comprehensive home exercise program.

Six Tips for Healthy Running

Though running injuries are common, there are steps you can take to stay healthy. Here are five tips from the American Academy of Orthopaedic Surgeons and the American Physical Therapy Association to help prevent running injuries:

1. Whenever possible, run on a smooth, resilient, even, and reasonably soft surface. Avoid running on hills, which increases stress on the ankle and foot. When running on a curve, such as running track, reverse directions halfway through your run so you put even pressure on both feet during the run.

2. Walk before you run. Warming up with a brisk walk or light running drills for five or 10 minutes before a run can help activate your muscles and prevent injury. Stretching is recommended after your run to improve flexibility.

3. Build strength, balance, and coordination in the muscle groups used most while running by performing exercises that target the hips and core. These exercises may include lateral leg lifts, squats, deadlifts, bridges and one-leg balances.

4. Pay attention to your form while you run. Instead of zoning out with your headphones in, listen to how your feet strike the ground and notice where they land relative to your body. Striking the ground closer to your body is often less stressful, and strikes should sound the same on both sides. Your knees should not drift inward.

5. Wear appropriate sneakers. When selecting a running shoe, look for good shock absorption and construction that will provide stability and cushioning to the foot. Keep in mind that 60% of a shoe’s shock absorption is lost after 250 to 500 miles of use, so people who run up to 10 miles a week should consider replacing their shoes every nine to 12 months. Also keep in mind that overly cushioned shoes can skew your perception of the ground and may lead to harder strikes, which could lead to injury.

Running through pain increases your risk for serious injury. If you have persistent pain when you run, talk to a physician about your treatment options and to determine if physical therapy is right for you.

For more information about Princeton Rehabilitation or to find a physical therapist with Princeton Rehabilitation, call 609-853-7840 or visit www.princetonhcs.org.

John Frank, PT, is a licensed physical therapist with Penn Medicine Princeton Medical Center Princeton Rehabilitation.

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