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Tri Like-a-Pro Lecture Series

Tue, 23 Feb 2010 17:31:42 -0600

Right & Wrong Triathlon Training Methods
Tips & Tricks That Will Increase Your Performance & Decrease Your Injuries
I have lectured many times on Sports Injuries, Injury Prevention, Strength & Conditioning and Flexibility Training but I am ready to put my two Triathlon Coach Certifications to use. The whole reason I got these two certifications was to educate and give back to the triathlon community. So here we go!!! I have 44 lectures so far to squeeze into this triathlon season. Most of these will be Free Lunch-n-Learns on Thursday’s but some of these will need to be combined into longer weekend Clinics due to the content being taught well together. Regardless, my goal is to capture these lectures and podcast them so you can use them as a resource for years to come. My prayer is that you will pass this on to others so more may learn from this. That will make all of the effort worth it! :-)
Available Video Podcasts:
1. Do Your First Ever Triathlon: If You Can Doggie Paddle, Joy Ride a Bike and Walk...You Can be a Triathlete Too!
2. How to Train for Your First Triathlon in 6 weeks...Even if You Haven't Worked Out in Years!
3. The Biggest Mistakes Most Triathletes Make and Don’t Even Realize They Are Making!
4. Pain Free, Injury Free Running
Lectures to Come:
1. Exercise Physiology for Non-Science Majors: Understand What Your Body Does, How it Responds and How it Adapts to Training
2. Check Your Equipment Out Prior to Training: Choosing the Right Swim, Bike, Run Gear for You
• Choosing the Right Shoes for You (Field Trip)
• Getting Your Bike Fit to You (Field Trip)
• Swim Gear: The Must Have’s & The Stuff to Avoid (Field Trip)
1. How to Recognize an Injury...and What to Do About It
2. Swimming for Beginners...without Getting Winded!
3. Swim Longer & Faster with Less Effort
4. Knock Out Your Swim in Minutes
5. Cycling Myths Reveled: Don’t Believe All That Your Hear
6. Heart Rate Training - Basics
7. Heart Rate Training - Advanced Concepts
• Heart Rate Zone Testing - Swim (Field Trip)
• Heart Rate Zone Testing - Bike (Field Trip)
• Heart Rate Zone Testing - Run (Field Trip)
1. How to Design You Own Triathlon Training Plan - Basic
2. How to Design You Own Triathlon Training Plan - Advanced
3. Fuel For the Fire: Exercise Nutrition Basics
4. Super Fuel: Ergogenic Aids & Nutritional Supplements
5. Water You Drinking? Why Sports Drinks & Gels are Tricky and When/How to Use Them?
6. Running Specific Strength Training: Improve Your Minute-Mile Pace
7. Cycling Specific Strength Training: Improve Your MPH Pace
8. Swimming Specific Strength Training: Improve Your 100 Meter Pace
9. How Flexible Are You? How to Assess & Improve Your Flexibility
10. Run Specific Flexibility Training (Stretching)
11. Cycle Specific Flexibility Training (Stretching)
12. Swim Specific Flexibility Training (Stretching)
13. Run-Walk Your Way to Faster, Longer, More Frequent Runs While Recovering Faster & Becoming More Fit...NO JOKE!!!
1. Pre-Race Prep: Tips for Tapering
2. Race Day Prep: What Stuff to Bring & What to be Ready For
3. Race Day Tips: Strategies for Racing without Blowing Up!
4. Run Technique Why It Feels Like Running Uphill All the Time & What to Do About It?
5. Swim Technique: Why It Feels Like Swimming in Mud Without It & What to Do About It?
6. Cycling Technique: What Works & What Is Simply a Myth?
7. Run Faster: Take 60 Seconds Off of Your Min/Mile Pace
8. Cycle Faster: Save $6000 While Taking 5 lbs Off of Your Bike (Free Speed!!!)
9. Healthy Weight Loss Strategies for Triathletes
10. Eating & Cooking Well for Triathletes (Field Trip)
11. Off-Season Training: Best Cross-Training Tips for Triathletes
12. Transitioning from Tri to Marathon

Injury Prevention: Tips & Tricks

Sat, 11 Apr 2009 07:16:04 -0500

This seems to be by far our most popular lecture with Stretching following close behind. Here are our recommendations, tips and tricks to Sports Injury Prevention:
RECOGNIZE:
1. Two-Day Rule: If you have pain, soreness or stiffness that comes on during or after activity (long-run or bike, speed-work, race, working in yard, etc) clue into your body, mentally take note and track the progression. Use the tips under the REDUCE section to assist in reducing the natural inflammatory-recovery process that your body goes through to heal itself. If the pain, soreness or stiffness gets better within 48 hours, that is your body’s natural healing progression...write it off and “fugedaboudit!” If, however, it does not get better in 48 hours, you need to be proactive and seek advice. As your coach, trainer or seek professional advice. Typically, resting longer than 48 hours to see if something will go away on it’s own is futile and simply delays your full recovery and return to training.
REDUCE:
1. Ice: Inflammation is a natural byproduct of physical activity and is crutial for the recovery process. However, when it gets out of control, it becomes destructive. Most of us at one point in time have made one of two honest mistakes: (1) We have reached for the over the counter anti-inflammatories such as Advil (Ibuprofen) or Aleve (Naproxen), (2) We have hopped into a hot tub or used a heating pack to try to reduce soreness and help inflammation and soreness. We have done so without knowing that Item (1) will reduce inflammation but it also slows/prolongs the healing process (no good...especially if you need to train the next day). Item (2) feels good but unfortunately is pro-inflammatory and not anti-inflammatory (also prolongs the healing process). This is why Ice is our first a foremost, Gold Standard, recommendation for inflammation, pain and soreness. It is a powerful anti-inflammatory, pain reliever and YES...it helps accelerate the healing process! There are several ways to use ice for therapy:
• Cold Pack (Gel, Crushed Ice, Frozen Veggies, etc): Use it for 20 minutes with a thin protective barrier between it and your skin (paper towel or tee shirt). You can always do as many 20 minute cycles of cold as you want to, just make sure you allow your tissue to warm back up for at least 40 minutes before you use your cold pack again (Tip: 20 minutes on the hour, every hour until the pain and inflammation reduces).
• Ice Massage: If the area to be iced is small, and near the surface of your body, you can significantly reduce your time of icing by using an ice massage. Take an ice cube, wrap a paper towel around half and use the exposed end to press deep and massage the inflamed area for 5 minutes. To repeat, allow your tissue to warm back up for 15 minutes, then repeat the process (Tip: Some people freeze water in Dixie Cups, tear off enough paper to expose the ice and then massage).
• Ice Bath (Cool Bath): I know what you are thinking...CRAZY...huh? It is NOT as bad as you think...trust me! Here is how to do it: (1) Keep your tri/cycling shorts and top on (2) Sit in your empty bath tub, turn the water on to a temp that feels comfortable (3) Slowly cool down the bath
1. Traumeel: In our mind the works best OTC anti-inflammatory, pain relieving and swelling reducer (get it at Whole Foods or Central Market). It is a topical cream and goes to work right away. It has no smell or heat/cooling sensations. Use it after a long training session, race, speed work day on areas you would normally have pain in the next day. I personally slap it on my shins, knee caps and lower IT Bands after each run I do. You can use it 2-3x a day for an acute injury or a bruise. It also works wonders on mosquito and ant bites too!
2. Sportenine: So Trumeel is for specific areas of anti-inflammation and pain relief, Sportenine is oral and (Wholefoods or CM). If you want something that will generally reduce pain, inflammation and stiffness throughout your whole body, use Sportenine. If can cut your next day’s soreness, stiffness and pain in HALF. Really, works that well!!!
RECOVER:
1. Training Volume & Intensity: Ideal and safe ramp up is 10% per week. Minutes is the best way to modulate volume not miles. Never increase volume and intensity in the same week. Hold volume the same and increase pace or hold pace the same and increase volume. Simply not enough rest and recovery time for recreational athletes to do both in the same week (that is why we call it a hobby and not our JOB). Professional athletes sleep between 10-12 hours a day...usually in 2 to 3 sessions of sleep a day! I don't know about you but I am lucky to get 7 hours a day...which severely limits adaptation to training and advancement of fitness!!!!
2. Rest: The most critical and important aspect of training (training adaptation = physical stress + rest). Less rest equates to less training adaptation, which means less advancement of your fitness. On a side note, stress is stress...physical, emotional, nutritional stress is all the same to your body. If you are working hard, have a lot of things on your plate, are not eating right, have unsettled relationships or tensions inside of you and you are training at the same time....any wonder why your body is not responding and improving in its fitness capacity or that you have gotten sick or have broken down with a sports injury? If you keep your overall stress level in mind you will find it is wise to skip or call off a day or two of training and simply rest/sleep some more. You will advance your body's fitness faster and safer by doing this rather than breaking your body down more but choosing to train. You also have to know when to call it quit from trying to achieve a goal and regress your training to a manageable level to start a safe progression towards a more achievable goal further out on the timeline.
3. Water: Divide your body weight in half and drink that many ounces of spring or filtered water per day (no nasty tap water).
4. Stress: Rescue Remedy (Whole Foods or CM) is one of the best OTC stress relief/anti-anxiety formulas made! It works ASAP (right away)!!! It is nothing more than a homeopathic tincture of flowers that have the most potent effect on stress/anxiety. Take it before bed time, race day, before a big presentation/meeting, give it to your spouse or kids when they are freaking out about something...just use it...like so many of our patients, you will be glad you found this stuff!!! Oh yeah, no side effect...it would be like sniffing flowered too much. Effects last for about 2 hours or more.
REEDUCATE:
1. Stretching & Stability: With flexibility comes instability. You must strengthen if you are going to stretch! You must stretch correctly...if not, you are safer not stretching!!! Hold your stretch for 5-7 mins unless you know how to do PNF, PIR or ER stretching like we demoed....which take 60 seconds or less to perform. Mat Pilates and combined with Yoga is a great alternating to stretching and strengthening. We use a lot of postures and exercises with out own spin on it for our patients.
2. Shoes & Orthotics: 200 miles max then make them kick-around shoes. Never kick-around in you current running shoes...take them off right after your run and do not get back in them for 48 hours. That is how long it takes of the white material in the sole to fully recover and regain its full shock absorption capacity. Have two pairs of shoes if you run back to back days. You can have great shoes but have the wrong shoes for your body mechanics!!! We see it all the time! Also, shoes alone are not the answer...85% would see a drastic improvement in our ease of running (decreased heart rate and using less energy at the same pace or running faster at the same heart rate) and a significant reduction in stress and strain to our body with a prescription orthotic in our running shoes. Look at it as a speed, energy and injury prevention investment.
Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach. Founder of Spine & Sports Therapy and F.A.S.T.

Sports Injuries & Muscular Imbalances

Thu, 1 May 2008 20:33:52 -0500

How Are Muscle Imbalances Related to Sports Injuries?
There is nothing more synonymous with “sports” than “injury.” If you participate in sports long enough you already know that the likelihood of sustaining an acute or overuse injury is virtually inevitable. Sports injuries sustained while training or participating in athletic activities may have symptoms that range anywhere from annoying to disabling. Recovery times range from a few days to several months. Damage to muscles, tendons, ligaments and joints may be minimal to permanent. Treatment and rehabilitation needed for full recovery and prevention may be as simple as self care or as complex as surgical intervention. Interestingly enough, the majority of non-traumatic sports injuries are simply caused by muscle imbalances. Think about it. The human body is a machine designed for movement and propulsion. Just like any piece of machinery, normal wear and tear will occur even with proper alignment of movable parts. If alignment is off, even slightly, it causes the movable parts to wear and tear at a faster rate. You can imagine what would happen if you ran this machine longer and faster than the average…you got it…breakdown! What causes alignment to be off in the body? Muscular Imbalance!
What Are Muscle Imbalances?
Muscular balance is critical for full resolution and prevention of sports injuries. Muscle imbalance may be noted early on as muscle tightness. A large majority of sports medicine therapies and techniques focus on releasing tight muscles through stretching or some sort of myofascial release techniques. Unfortunately, muscle tightness is a compensation that will continue to reoccur if the root cause of muscular imbalance is not identified and eliminated. The reality is that muscle imbalances occur in patterns of threes throughout the body and are always present in sports injuries; therefore, if you only treat the area that is causing obvious pain, you’ll miss the muscles that are critical for fully resolving you condition and preventing reoccurrence. Sometimes you may not even notice muscle weakness until it is tested because for every weak muscle you will always have another muscle that overcompensates to pull the load. This is a synergistic muscle that shortens in length to gain a greater mechanical advantage. This muscle will feel tight and limit your flexibility (feels like a tight rubber band). Unfortunately, if you stretch it or massage it, it will shorten back up to protect for the muscle weakness. When this weakness/overcompensation battle is playing out it strains a third muscle eventually causing myofascial adhesions or intramuscular scar tissue to occur. These muscular imbalances can and will occur all the way down the kinetic chain if left untreated long enough. They are the underlying cause of the “10 Most Common Sports Injuries.”
Where Do I Learn More?
How do you know if you are susceptible to sustaining a sports injury or if you have an injury? How do you know what caused your injury, how bad it is, how much damage has occurred, what your recovery time is or what treatment/rehabilitation option you should follow? This is where the assessment and the advice of a sports injury specialist comes in. If you are looking for full resolution or prevention of sports injuries, come visit one of our doctors at SST. Simply click on “Schedule an Appointment” above.
Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach. Founder of Spine & Sports Therapy and F.A.S.T. (Functional, Athletic, Sports Therapy).

Choosing the Right Shoes

Tue, 1 Apr 2008 16:07:29 -0500

Many people choose shoes based color, design and how they feel on their feet while walking or running in the store not by what their feet need and how their muscular tension in their leg, hip, low back and shoulder region respond to the shoes. This can often lead to the wrong choice which will cause repetitive stress and strain to your feet and the rest of your body. This will make your chronic injuries worse or bring on new injuries such as Plantar Fasciitis, Shin Splints, Achilles Tendonitis, IT Band Syndrome, Piriformis Syndrome, Low Back Pain and even Shoulder and Neck Pain. The best way to chose shoes is to have a “sports specialist” professional test out your feet as well as check your chronically tight and tender spots before and after trying on various shoes. This will precisely narrow down type of shoe that is right for your body (stability, mobility, overpronation support, over supination control, extra heel cushioning, etc.). This is best done in a shoe clinic at a local shoe store or by bringing several pair of shoes to their clinic for a one-on-one fitting and consultation.
Here are some quick tips for those purchasing running shoes if you are eager to roll forward with buying a new pair before being involved in a shoe clinic or personal fitting. Just be S.M.A.R.T. when choosing your running shoes:
• S is for size; make sure you have your shoe professionally fitted.
• M is for motion control; make sure your shoe provides the proper stability for the way your foot moves.
• A is for ancillary stuff like socks, non-prescription or prescription orthotics; invest in good ones as it can make a big difference in your comfort and ease of running.
• R is for rest or retire; make sure you have two pairs of running shoes so that one pair can "rest," thus providing longer wear. Retire your shoes before wearing is seen on soles.
• T is for terrain; be mindful of where you're running so you can make sure you've got the right shoe for the surface.
Size:
For most mid to long-distance runners, you want to go a half to a full size larger than your normal shoe size. Why? Just ask any one in this category to shoe you their toe nails. To prevent your toe nails from jamming into the front of your shoes and blackening them, increase your shoes size. Please note this procedure can be tricky…if you increase your shoe size too much your foot will slide around inside the shoe. This is something you will have to play with, no one can magically fit your shoes to prevent “black toe” with every brand of shoes. Easiest guide to insure that there is enough room is to have at least one thumb width between your longest toe and the end of the shoe. Most shoe reps only check where the first or big to is. Check yourself; this is especially important for those like me who have a second toe that is longer than their first.
Motion Control:
This topic throws the majority of shoe sales reps, avid runners and pros that have been running for years. Doesn’t everyone pronate and need motion control? Yes, everyone pronates but not everybody “overpronates” and needs a motion control shoe. We have seen several patients who have been misdiagnosed as an “overpronator” and put into motion control shoes, which subsequently caused their IT Band Syndrome. The only way to be completely sure as to what shoe you need is to have a “sports specialist” physical check the mechanics of your foot, analyze the callous on your feet, check the wear patterns on your shoes as well as assess for tension in your plantar fascia, IT Band, shin, calf, hamstring, hip, low back, shoulder and neck muscles. This physical examination and be compared to a computerize gait analysis (contact motion analysis) for the most accurate prescription for “you”. If we were to put you in the right shoes for “your feet”, the majority of your body tight spots would loosen up instantaneously. What do you think would happen if we were to put you in wrong shoes? You got it, all of these spots would get worse! That is why proper shoes are critical for insuring the long-term success of our clinic results.
While we are talking about motion, your shoes should be free and flexible in the metatarsal area (junction of toes and foot – balls of feet) and not any where else. Give your shoes the test, put you hands on either end of your shoe and compress it. Does it move and bend easily? Is the movement in the fore-foot (metatarsal area) or mid-foot (arch area)? If it does not bend easily, you will be wasting too much energy and effort to push off and propel properly. This will lead to overstraining of your calf and the Achilles tendon (Hello Achilles Tendonitis – Ouch!).
The second test, grab your shoe just in front of and behind the arch (mid-foot area). Try to bend it. What happened? Did it bend or stay rigid? “How do I know if I am bending too hard?” Remember this area is supposed to withstand 3-5 times your body weight during running. If it bends with 15-20 pounds of force, it will bend and fold while running. If it bends in the mid-foot or arch area you will hammer your plantar fascia, shins and piriformis muscles by over-straining the muscles that control arch movement and shock absorption.
Ancillary Products:
There is no need for me to preach to you the “sock sermon.” You all know how beneficial the right socks are (especially in the Houston heat) and how detrimental the wrong socks can be to your running or cycling. Make sure you have a sock that is breathable, wicks moisture, and minimizes chaffing. While you are at it, if you have not done so already…make sure all of your athletic clothing does the same thing! This minimizes heat and moisture build up…Lord knows we need all of the cooling help we can get in this humid climate.
Orthotics…are these those big ugly shoes? Go ahead and take out the insert in your running shoe…yes, go ahead and do it. Put it flat on the table and push on the arch area. How much support and shock absorption does it possess? Unless you currently have a pair of orthotics, I think you will see my point clearly. Shoe companies try to design components of shock absorption and motion control in the sole of the shoe. They know they can not build this into the inserts of their shoes without having to triple their shoe options (different arch supports for different people) so they leave most of their inserts with minimal support. Most prescription orthotics have about a 50% success and satisfaction rate. It is a coin toss as to whether or not you will like the device and if you will notice a difference in your body and performance. We have been able to drive that up to a 98% success and satisfaction rate with doing a computer aided gait analysis. Remember those days when your legs had that springy, bouncy feel when running? That is what it feels like with the properly fit orthotics.
How do you know if you need orthotics? How do you know if you a pair of non-prescription (general support) or prescription orthotics (highly specific support)? We base that on the same assessment and data we gather for deciding what type of motion controlled shoe you need (see above).
Rest or Retire:
“Rest what…my shoes? Hey, I am doing all of the work here, not my shoes! Why do my shoes need a rest?” When you pound on your shoes, they are feeling 3-5 times your body weight on impact with the ground. The repetitive impact squeezes critical gasses out of the polymer material in the absorptive portion of your shoe (technically called ethylene vinyl acetate and polyurethane; I call it the white and grey spongy stuff). It takes around 48 hours for these gasses to full reabsorb and bring the shock absorption up to full capacity. If you are going to be wearing your shoes during the day or running on back-to-back days it is wise to buy two pair of shoes. One pair for kick around shoes and one pair for running or flip-flop your pairs on successive running days.
Retiring your shoes really means putting them to use for anything other than running. Half (50%) of the absorptive capacity of your shoes will be lost in the first 100 miles of running or 300 miles of walking (FYI – running puts 3-5x the load on shoes as compared to walking). This means you will be retiring your shoes well before signs of wear on the soles is seen. We recommend you replace your shoes by 250 miles and retire them from active duty to kick-around/yard shoes or donate them to your favorite charity. They still will have some good life in them, just not for distance running.
Terrain:
It really goes without saying, the right shoe for the right surface is important. The amount of shock absorption and traction needed is what you should consider. Here is, in decreasing order of hardness, a list of running surfaces: Concrete, Asphalt, Rubberized Track, Granite Gravel Track, Hard Pack Dirt Trail, Loose Pack Rocky Trail, Grass, and Sand. Stop and think about what your bare feet would be helped most by on each of these surfaces. You will need more shock absorption but less traction for concrete and less shock absorption and more traction for sand.
*Video Podcast: Don’t forget to check out “The Ultimate Shoe Clinic” to watch and learn more about choosing the right shoes for you!
Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach. Founder of Spine & Sports Therapy and F.A.S.T. (Functional, Athletic, Sports Therapy).

Ice or Heat: Which is Best?

Wed, 12 Mar 2008 13:33:40 -0500

Ice vs. Heat - What to Do?
Have ever been confused about when to use ice or heat after an injury or on a body ache? You are not alone! Unfortunately, if these modalities are used at the wrong times you could be damage to your injury or body ache. Let's explore why, when and how to use these home sports injury therapies.
If Ever in Doubt...use ICE!
If you have ever been confused and wondered what to use on your body injury or ache, ice or heat, always choose ice...it is the safer bet. Ice cools down and helps pump blood and inflammation out (vasoconstriction) while heat draws blood and swelling to the area. Think about it...what happens during an injury or irritation to a body part? Increased blood flow, heat and swelling to the body part. Ice slows and reverses this reaction, heat would worsen this reaction. I can not recall the number of times a new patient has desperately called into the clinic in severe pain and when asked what kind of self therapy they have done, their reply has been "heat". We hands down refuse to see these patients and instruct to ice for the next two days and then come in to the clinic. It is amazing how may of them improved significantly after the stopped perpetuating their condition by reducing the swelling with ice.
So When Do I Use Ice?
Use Ice immediately after an injury or overdoing it. Even if you wait a day or two, ice still will help reduce any persisting inflammation and pain. Follow the guidelines under “Cryotherapy”.
So When Do I Use Heat?
Heat increases blood flow and fluid accumulation to an area. This is helpful and important if you use it just prior to athletic activity or stretching due to it ability to increasing tissue pliability and flexibility. Think "Heat Before, Ice After" athletic activity. Avoid at all cost using heat on a freshly injured or overused area after training. It may feel good but you are just asking to be burned...literally!!!
How Do I Use Ice Therapy (Cryotherapy)?
Cryotherapy: Ice for 20 minutes on, 40 minutes off. For overachiever, during the first 48-72 hours after starting ice therapy you can ices as much as 20 minutes on the hour, every waking hour as long as you take 40 minutes between icings to allow your tissue to warm back up. For the rest of us who want to do the minimum, ice 20 minutes 3 times a day with 40 minute rest breaks (can all be done after activity or in the evenings). After this initial intense icing period, you should ice at least 20 minutes per day for the next 2 weeks.
Ice Massage: This is for small, local, close to the surface injuries (tendons, ligaments, etc). Freeze water in a paper dixi cup, tear rim off to expose ice, use ice as a massaging tool to press into and massage injured spot. You can also wrap a paper towel around half of an ice cube. Ice massage the small area for 5-7 minutes. You can follow the same frequency guidelines listed under cryotherapy.
What Forms of Cryotherapy Can I Use?
There is everything from low tech to high tech ways of doing cryotherapy. Here are a few low tech ways we recommend:
• Ice (plastic bag or ziplock with some water)
• Gel Pack
• Frozen Veggies in Plastic Bag
What Do I Do if Ice is Not Working?
If after the initial 48-72 hours of icing your pain and discomfort has not reduced enough to allow you to return to activity, you will want to get your injury checked out by a specialist.
Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach. Founder of Spine & Sports Therapy and F.A.S.T. (Functional, Athletic, Sports Therapy).

Our Patient: Liz Garcia’s Cancun Half Ironman Article...Hilarious!!!

Thu, 28 Feb 2008 08:36:04 -0600

Liz is a Marathoner, Triathlete, USA Triathlon Coach & TNT Coach as well as a patient of ours (busy girl!). Here is her fun and amusing article she wrote for Houston Racing Triathlon Club newsletter on her experience at the Cancun Half Ironman (HIM):

Return to Run Progression: The Pain-Free Way to Start Running

Tue, 26 Feb 2008 07:34:30 -0600

What is a Return to Run Progression?
It is a properly paced ramp-up to safely get your body into running without causing undue, unnecessary and excessive inflammation.
Why Do a Return to Run Progression?
Most of us would normally start our running program with a 20-30 minute run 2-3 times a week and wonder why our feet, shins, knees, hips, low back and/or neck are killing us after 6-8 weeks of running. The answer: TOO MUCH, TOO FAST!
Who is This For?
This is for those who have not been running consistently (2-3x/week) for more than a 6 week period.
What is the Purpose?
This allows your bones, ligaments, cartilage, tendons and muscles to battle the inflammation that comes with training as well as gradually strengthen these tissues to handle the volume (mileage) or intensity (pace) most of us would like to run. This will minimize mid-to-late season joint and tendon pains as well as stress fractures.

P1: 4:1 (Walk:Run) for 20 minutes; 3x/week
This is Progression 1 (P1). If 20 minutes it too much for you, then do 5, 10 or 15 minutes until you work up to a 4:1 (Walk:Run) for 20 minutes; three time per week. If 20 minutes sounds like a piece of cake, trust me, you will know the difference in how your body feels 8 weeks down the road. Three times a week, walk for 4 minutes followed by a 1 minute run. Your run should be slow and easy (more like a jog). You will repeat this 4:1 interval four times to finish a total of 20 minutes. If you want to do more cardio than this, choose to walk, bike, swim, or do elliptical for no more than 40 minutes total.
Self Assessment:
After One Week at this progression, ask yourself these assessment questions:
(1) Did I have any difficulty finishing this progression?
(2) Do I have any aches or pains that have persisted more than Two Days (2-Day Rule...See “Injury Prevention Tips”)?
(3) Am I feeling excessively tired the day after my progression?
If you answer “NO” to all of these questions, then move on to the next progression. If you answer “YES” to any of the questions stay at this progression until all answers are “NO”.

P2: 3:2 (Walk:Run) for 20 minutes; 3x/week
You will be subtracting a minute of Walk and adding a minute of Run to this progression. You will repeat this 3:2 interval four times to finish a total of 20 minutes. If you want to do more cardio than this, choose to walk, bike, swim, or do elliptical for no more than 40 minutes total.
Complete the “Self Assessment” (see P1) before progressing.

P3: 2:3 (Walk:Run) for 20 minutes; 3x/week
You will be subtracting a minute of Walk and adding a minute of Run to this progression. You will repeat this 2:3 interval four times to finish a total of 20 minutes. If you want to do more cardio than this, choose to walk, bike, swim, or do elliptical for no more than 40 minutes total.
Complete the “Self Assessment” (see P1) before progressing.

P4: 1:4 (Walk:Run) for 20 minutes; 3x/week
You will be subtracting a minute of Walk and adding a minute of Run to this progression. You will repeat this 1:4 interval four times to finish a total of 20 minutes. If you want to do more cardio than this, choose to walk, bike, swim, or do elliptical for no more than 40 minutes total.
Complete the “Self Assessment” (see P1) before progressing.

P5: Run for 20 minutes; 3x/week
Notice it has taken 4 weeks to progress to a a solid steady 20 minute run. Most of us would jump right to P5+ at Week 1. If you want to do more cardio than this, you know the drill...no more than 40 minutes total.
Complete the “Self Assessment” (see P1) before progressing.

P6: Run for 25 minutes; 3x/week
If you want to do more cardio than this, you know the drill...no more than 40 minutes total.
Complete the “Self Assessment” (see P1) before progressing.

P7: Run for 30 minutes; 3x/week
you want to do more cardio than this, you know the drill...no more than 40 minutes total.
Complete the “Self Assessment” (see P1) before progressing.

P8: Run for 35 minutes; 3x/week
If you want to do more cardio than this, you know the drill...no more than 40 minutes total.
Complete the “Self Assessment” (see P1) before progressing.

P9: Run for 40 minutes; 3x/week
You are now ready to add a long/slow run one day a week (preferably during the weekend) and make sure to have a full day of rest after this run (little or no activity - a day of reading, napping, television watching, sun bathing, etc.).
Complete the “Self Assessment” (see P1) before progressing.

At this point in time you are ready to hop into any sound half marathon, marathon or triathlon program so be it does not progress you more than 10-20% per week in volume or intensity each week.
You are also ready for speed work at this point (NO SPEED or TRACK WORK prior to this progression).
Never increase volume and intensity in the same week. It is a one or the other deal. Either increase your milage or pace during a one week period. Always keep the other steady that week. (Example: Increase from 45 to 50 minutes in Run; Hold Pace 10 min/mile or Hold 45 minutes Run; Increase Pace from 10 to 9:45 min/mile.
Enjoy your new found pain-free running! Time to start working on your Running Technique so you can learn to run using less effort!
Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach. Founder of Spine & Sports Therapy and F.A.S.T. (Functional, Athletic, Sports Therapy).

TNT Stretch Clinic: Summary Notes

Sat, 23 Feb 2008 11:57:08 -0600

Here are the “bullets” from Kimberly Sefcovic’s & Dr. DeWalch’s Team in Training (TNT) Stretch Clinic:
NO BOUNCING:
You don’t ever want to bounce when you stretch. Bouncing while you stretch actually makes your muscles constrict due to the volatile quick movements. The muscles do this to protect themselves from tearing, which is good to prevent injury, but works against your stretch.
10/2 RULE:
It can take 6 minutes or longer to achieve a good full stretch on one muscle if you’re holding a static stretch. To stretch FASTer and more efficiently hold a stretch for 10 seconds then contract the muscle you are stretching (EX: lifting your heel off the ground while doing a calf stretch) for 2 seconds, then stretch that same muscle some more. Repeat this pattern 3 to 5 times per muscle. You should notice that after you contract the muscle you are stretching and you go back into your stretch that you can actually go deeper into your stretch.
WARM UP BEFORE/STRETCH AFTER:
Warm up your joints with some gentle range of motion exercises and do a good long warm up before getting into the core of your workout. Save your stretch time for after your workout. Your muscles have been through a lot and need to cool down. If you jump right into your car after a workout you shorten your hip flexors and then they cool down and stay shorter. Cool down while elongating your muscles with stretching.
WHEN TO STRETCH:
I like to stretch if I have a little break in the day and I know I’ve been going a million miles a second (anyone know that feeling?). It’s good to start with a full stretch routine and be consistent with it for a while so that you can learn which stretches work for specific areas, then you can be more specific and it won’t take long to hit an area while you’re taking that little break in the day.
I also like to stretch in the evenings. Our bodies don’t know the difference between a workout and a day of work; even if all you did that day was sit. Stretching and opening up the muscles at the end of the day elongates the muscles, brings new fresh blood to otherwise stagnate congested areas, and really helps boost your energy!

Authors: Dr. Daniel DeWalch & Kimberly Sefcovic

Injury Prevention Tips Clinic: Summary Notes

Fri, 15 Feb 2008 08:02:07 -0600

These are some tips and tricks that Dr. Hasenbank gave to the Team in Training & Houston Fit group at an “Injury Prevention Clinic”:
1. Two Day Rule: If an ache or pain goes away within 2 days and does not return...write it off (forgedaboudit). If it doesn't...do not wait around and waste time off training, get it checked out and fixed!
2. Traumeel: In our mind the works best OTC anti-inflammatory, pain relieving and swelling reducer (Wholefoods or CM). Works within hours. Had no smell or heat/cooling sensations. Use after a long training session, race, speed work day on areas you would normally have pain in the next day. I personally slap it on my shins, knee caps and lower IT Bands after each run I do. Can use it 2-3x a day for an acute injury or a bruise. Works wonders on mosquito bites too!
3. Ice/Ice Massage: You can use ice as a local anti-inflammatory after training or racing. Your options are (1) ice with some water in a large ziplock bag (2) gel pack (3) frozen bag of peas, corn or carrots (4) ice massage. Items 1-3 you will use for 20 mins for a maximal effect...for acute injuries let tissue warm back up for 40 mins...repeat as many times as wanted for 48 hours then back off to 3x day until all swelling and pain is gone. For the ice massage...have ready and waiting Dixie cups with frozen water in the freezer or use an ice cube. With Dixie cup tear off the top half of cup and with ice cube use paper towel to hold onto half of it. Use the exposed piece of ice to press into and massage the area of pain and inflammation. Use for 7 mins...rest/warm tissue back up foe 15 mins and repeat if needed.
4. Training Volume & Intensity: Ideal and safe ramp up is 10% per week. Minutes is the best way to modulate volume not miles. Never increase volume and intensity in the same week. Hold volume the same and increase pace or hold pace the same and increase volume. Simply not enough rest and recovery time for recreational athletes to do both in the same week (that is why we call it a hobby and not our JOB). Professional athletes sleep between 10-12 hours a day...usually in 2 to 3 sessions of sleep a day! I don't know about you but I am lucky to get 7 hours a day...which severely limits adaptation to training and advancement of fitness!!!!
5. Rest: The most critical and important aspect of training (training adaptation = physical stress + rest). Less rest equates to less training adaptation, which means less advancement of your fitness. On a side note, stress is stress...physical, emotional, nutritional stress is all the same to your body. If you are working hard, have a lot of things on your plate, are not eating right, have unsettled relationships or tensions inside of you and you are training at the same time....any wonder why your body is not responding and improving in its fitness capacity or that you have gotten sick or have broken down with a sports injury? If you keep your overall stress level in mind you will find it is wise to skip or call off a day or two of training and simply rest/sleep some more. You will advance your body's fitness faster and safer by doing this rather than breaking your body down more but choosing to train. You also have to know when to call it quit from trying to achieve a goal and regress your training to a manageable level to start a safe progression towards a more achievable goal further out on the timeline.
6. Water: Divide your body weight in half and drink that many ounces of spring or filtered water per day (no nasty tap water).
7. Stress: Rescue Remedy (Whole Foods or CM) is one of the best OTC stress relief/anti-anxiety formulas made! It works ASAP (right away)!!! It is nothing more than a homeopathic tincture of flowers that have the most potent effect on stress/anxiety. Take it before bed time, race day, before a big presentation/meeting, give it to your spouse or kids when they are freaking out about something...just use it...like so many of our patients, you will be glad you found this stuff!!! Oh yeah, no side effect...it would be like sniffing flowered too much. Effects last for about 2 hours or more.
8. Stretching & Stability: With flexibility comes instability. You must strengthen if you are going to stretch! You must stretch correctly...if not, you are safer not stretching!!! Hold your stretch for 5-7 mins unless you know how to do PNF, PIR or ER stretching like we demoed....which take 60 seconds or less to perform. Mat Pilates and combined with Yoga is a great alternating to stretching and strengthening. We use a lot of postures and exercises with out own spin on it for our patients.
9. Shoes & Orthotics: 200 miles max then make them kick-around shoes. Never kick-around in you current running shoes...take them off right after your run and do not get back in them for 48 hours. That is how long it takes of the white material in the sole to fully recover and regain its full shock absorption capacity. Have two pairs of shoes if you run back to back days. You can have great shoes but have the wrong shoes for your body mechanics!!! We see it all the time! Also, shoes alone are not the answer...85% would see a drastic improvement in our ease of running (decreased heart rate and using less energy at the same pace or running faster at the same heart rate) and a significant reduction in stress and strain to our body with a prescription orthotic in our running shoes. Look at it as a speed, energy and injury prevention investment.
Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach. Founder of Spine & Sports Therapy and F.A.S.T.

Trigger Points: The Athlete’s Nemesis

Sat, 1 Dec 2007 11:00:01 -0600

This is an article we wrote for the Houston Racing Triathlon Club newsletter:
What is a Trigger Point?
A trigger point is an active individuals smallest and sneakiest nemesis! It is a commonly occurring dysfunctional muscle adaptation pattern (a.k.a. muscle memory gone wild). Anatomically speaking it is a micro-spasm deep within the belly of a muscle that does not “feel” like a spasm but rather like a tender nodule. When a trigger point is “active” it is painful to compress and produces referred pain in a predictable pattern. Also, when activated, trigger points weaken muscles by 40-60%, which causes another muscle to overcompensate to pull the load for this weak muscle.
What Causes Trigger Points?
A trigger point develops in two ways as a result of (1) Immediate Muscle Overload or (2) Repetitive Muscle Overload. Immediate muscle overload is a result of a speed work, hills, strength training, lifting or moving something too heavy, a slip or fall as well as any traumatic injury. The causes of these trigger points are quite obvious and result in immediate pain, discomfort and tenderness. Repetitive muscle overload is a result of using the same muscles over and over and over again. (ANYONE DO THAT HERE? Yea…me too!) This can come from prolonged sitting, standing, walking, training with bad posture as well as using improper shoes, and bike set-up and last but not least poor sport technique and excessive levels of stress or overtraining. Think you have any trigger points yet? Chances are you have several…just start poking around and you will find them!
Trigger points can take on an Active (painful) and Latent (non-painful) state. Latent trigger points hang out and wait to rear their ugly head until you start overusing your body in the same position or with the same activity over and over again (a.k.a. ramping up your training and competition schedule). This is called “Muscle Memory;” your muscle remembers the last time you overused it and activates the sirens the next time you do the same thing. This is like the “Check Engine” light going on and off in your car. Eventually, it come on and stays on all the time. Unfortunately, trigger points do not go away with rest…they require Neuromuscular Re-education to erase these muscle memory patterns.
How is a Trigger Point Released?
There are a number of ways to release a trigger point. The ultimate goal is to interrupt and reeducate the abnormal muscle memory pattern causing the trigger point. Each method of trigger point release varies in its number of treatments needed for full resolution as well as the amount of pain created to get a desired neuromuscular re-education. You can release your own trigger points via foam rollers and other devices…that is if you can find them and apply the corrective neuromuscular re-education on your own. On average, it will take you 10-12 times longer to get your own trigger point released than to have someone else do it for you. I don’t even waste the time to release my own trigger points even though I know when they crop up and where they are. It just simply faster to have someone else find and release them.
How Do Various Methods of Trigger Point Release Compare?
You can do a side-by-side comparison study on the various practitioner methods of trigger point release. Compare the level of discomfort with receiving the treatment as well as the number of sessions needed for full resolution and the cost per treatment session and the total cost for a full and complete resolution of a trigger point. We have pioneered and developed the last method because of athletes demanding to have there trigger points eliminated faster and longer lasting relief.

Want to Learn More and Play Around with Your Trigger Points?
We have podcasted our Trigger Point Clinic for you to learn more about the most common trigger points we see in our athletes. We also play around with the most popular self-therapies as well as show you demos of some of the methods listed above for releasing trigger points. Hope you learn a ton and have fun in the process!
Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach. Founder of Spine & Sports Therapy and F.A.S.T. (Functional, Athletic, Sports Therapy).

Sciatica...it’s a Pain in the Rump!

Sat, 1 Sep 2007 11:11:12 -0500

This is an article we wrote for the Houston Racing Triathlon Club newsletter:

What is Sciatica?
The term sciatica is not a specific diagnosis but rather a set of symptoms stemming from irritation to the sciatic nerve; the longest, thickest nerve in the body. The sciatic nerve is like the “Interstate-10” of nerves; combining over half a dozen nerves originating from your low back and pelvis. The sciatic nerve runs from the pelvis, through the buttock, and down the backside of the leg, where it splits into various branches down to the foot. It ultimately controls over 80% of your lower leg muscles, which means when it is irritated or compressed...YOU FEEL IT! Generally, it sends pain from the buttock down into the back of the leg (hamstrings). With sciatica, normally, the pain never travels further than the back of your knee.
What Does Sciatica Feel Like?
When you have sciatica the sensation can range from a mild to moderate ache (Pain in the Rump), to numbness and tingling in the hamstring area, to even a deep throbbing and burning type pain. Symptoms usually are typically limited to one side and begin gradually and intensify during or after activity as well as with direct compression from prolonged sitting. Additionally, muscle fatigue or weakness typically accompanies these symptoms.
What Causes Sciatica?
The most common cause of sciatica is excessive pressure and chaffing across the sciatic nerve from the piriformis muscle and the sacrotuberous ligament. The muscle and ligaments of the pelvis become tight and reactive ass a result of overuse, repetitive activity, poor core strength, failure to stretch as well as incorrect biomechanics and run/bike technique. Once these muscle memory patterns lock into place it is quite difficult to break and re-educate these muscles patterns. Rest makes it feel better but the symptoms usually return once you ramp your training back up.
Other causes of sciatic-like-symptoms (pseudosciatica) can be a result of a herniated lumbar disk, trigger points in the hip and pelvis muscles, lumbar or hip fractures, tumors, or direct trauma to the sciatic nerve.
Is There Any Good News?
The majority of sciatica is treatable without surgery or cortisone injections. It will resolve on it's own with rest but in order to fully resolve your symptoms and keep them from coming back you will need to get your pelvic/hip muscles and ligaments released and reeducated. We have a 97% success rate at doing this as well as offering dramatic symptomatic relief. If you or anyone else you know is struggling with sciatica, Spine & Sports Therapy would love to help! If you have any further questions or concerns, please email me or check out our website: www.FixMySportsInjury.com
Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach. Founder of Spine & Sports Therapy and F.A.S.T. (Functional, Athletic, Sports Therapy).

Shoulder Impingement Syndrome: What You Should Know

Sun, 1 Jul 2007 11:20:51 -0500

This is an article we wrote for the Houston Racing Triathlon Club newsletter:
Why This Common Overuse Sports Injury is often Overlooked, Misdiagnosed, and Mistreated.
What is it?
Shoulder impingement syndrome is a repetitive overuse injury that affects the rotator cuff, causing shoulder pain. The rotator cuff is an important group of muscles that secures the ball to the socket joint in the shoulder and allows the arm to rotate and move in multiple directions.
Who gets it?
Impingement syndrome is more likely to occur in people who engage in physical activities that require repeated overhead or rotary arm movements; such as swimming, tennis, golf, weight lifting, throwing a ball or repeated overhead lifting.
What Causes it?
Impingement syndrome is caused by compression and irritation to the tendons of the rotator cuff between the acromion (part of shoulder blade) and the head of the humerus. Normally, there is enough space between the cuff muscles and the acromion. However, factors such as poor shoulder posture (rounded shoulders), weak shoulder and scapular muscles, tight chest muscles, improper biomechanics (scapulohumeral rhythm), or pathological changes (acromial bone spur, coracoacromical ligament hypertrophy, trauma, etc.) are major contributors which need to be addressed for a full and complete resolution.
What Are the Symptoms?
In the beginning, the pain occurs whenever the arm is raised over the head. The pain may not occur when the arm is at rest but it may flare up when sleeping due to direct pressure on the shoulder during side sleeping or sleeping with arm under pillow. The pain can start from the top or front of the shoulder and extend to the middle deltoid or even down to the elbow. With time and repeated aggravation, the arm becomes weak and shoulder motion is limited and painful. Eventually, tiny tears in the fibers of the rotator cuff can progress to a larger tear in the tendon or even pull the tendon off the bone. Impingement syndrome is usually accompanied by shoulder tendonitis and bursitis.
Why is it Often Overlooked?
Impingement syndrome is often overlooked by those who suffer with it as well as their healthcare providers and is usually written off as a normal part of training or aging. Patients may live with not being able sleep on their sides and modifying their daily activities as well as their sports technique to get by. Most athletes will not address the subtle signs of impingement until they can not longer find a comfortable sleep position at night or until it gets so bad they developed tendonitis, bursitis or tear a rotator cuff muscle.
Why is it Often Misdiagnosed?
Shoulder impingement is often misdiagnosed or mislabeled due to its’ similarity to several other conditions that cause pain in the shoulder. The following conditions can cause pain in the shoulder similar to rotator cuff impingement syndrome but require a full work-up and clinical history by a sports specialist to rule out:
• Acromioclavicular Joint Injury (Shoulder Separation)
• Bicipital Tendonitis
• Brachial Plexus Injury
• Cervical Disc Injuries
• Cervical Discogenic Pain Syndrome
• Cervical Radiculopathy
• Cervical Spine Sprain/Strain Injuries
• Clavicular Injuries
• Contusions
• Infraspinatus Syndrome
• Myofascial Pain in Athletes
• Rotator Cuff Injury
• Shoulder Dislocation
• Superior Labrum Lesions
• Supraspinatus Tendonitis
• Swimmer's Shoulder
• Thoracic Disc Injuries
• Thoracic Discogenic Pain Syndrome
• Thoracic Outlet Syndrome
Why is it Often Mistreated?
There are three primary reasons why shoulder impingement is often mistreated: (1) Misdiagnosed - an incorrect diagnosis will always lead to the right treatment being used on the wrong condition. This happens often in sports medicine, no wonder certain conditions never fully recover or reoccur once training resumes. (2) Symptomatic Treatment – where as R.I.C.E. therapy, anti-inflammatory medications and even cortisone injections are beneficial for eliminating the inflammation, most athletes and providers shoot for symptomatic relief. Unless factors like posture, muscle weaknesses, trigger points, myofascial adhesions, overcompensations, limited range of motion and improper biomechanics are addressed shoulder impingement will always plague your endeavors to train harder and go further with your sport. (3) Shoulder Impingement (Primary or Secondary) – you are only half way to a solution after determining you have shoulder impingement and not another condition. The majority of practitioners are not trained to accurately examine and differentiate between primary and secondary impingement syndrome.
Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach. Founder of Spine & Sports Therapy and F.A.S.T. (Functional, Athletic, Sports Therapy).

What’s Up With My Knees?

Fri, 1 Jun 2007 11:54:07 -0500

This is an article we wrote for the Houston Racing Triathlon Club newsletter:
Most Common Cause of Knee Pain: Patellofemoral Syndrome (Runner’s Knee)
Why Do My Knees Hurt So Much?
I live to run, cycle, do brick, track workouts, hill training, race and be with those who like to do the same! It hurts me to go up or downstairs. It hurts me to get out of my chair. My knees pop and crack. It hurts me to squat deep and stand back up. It hurts me to kneel on my kneecaps. It hurts me to train/race long and hard. In fact, it also hurts me when I sit still for a prolonged time. What is going on? What are my knees trying to tell me? Is this a part of getting old? Am I doing something wrong or is there something more I should be doing differently for my knees? Does this sound like you? If so, read on…
Where is the Patellofemoral Region?
The cartilage under your kneecap (a.k.a. patella) is a natural shock absorber that unfortunately does not come with a lifetime guarantee. Overuse, poor body mechanics/alignment, poor technique, muscle imbalances, injury and other factors can cause accelerated wear of your cartilage. If you ignore the warning signs and let it go, your lifespan in sports may be cut short.
What is Patellofemoral Pain Syndrome?
Patellofemoral Pain Syndrome (PFPS) is a term used to describe pain in the region of your patella (kneecap) and femur (thigh bone). This is an extremely common condition and one of the most common complaints of athletes and nonathletes. In the US alone, over 25% of all athletes in will experience this condition. You have a 1-in-4 chance of developing PFPS if you do nothing to assess your risk factors for the common causes of this condition. Other names you may have heard for PFPS: Retropatellar Pain, Anterior Knee Pain, and Chondromalacia Patellae. None of these terms accurately describe the mechanism of injury or cause of this pain.
What Causes Patellofemoral Pain Syndrome?
When you flex and extend you knee, your patella glides through a groove in your femur. When the bone in your lower leg is not lined up ideally with the bone in your thigh, it can cause the gliding between your patella and femur to become abnormal. This "malalignment" can lead to overloading of the articular cartilage in your knee, generally on the outside or inside of the knee. This abnormal patellar tracking can be painful and lead to accelerated wear on the cartilage between your patella and femur. Eventually, the protective articular cartilage surface over the bone can wear away, leading to arthritic degeneration.
Your knee alignment is assessed by looking at your Q-angle, which is the alignment between your thigh and lower leg bones. An average Q-angle for a male is 14°, while that for a female is 17°. Q-angles greater or less than average can cause abnormal patellar tracking on way or the other.
You should also be assessed for several other anatomic and congenital factors may cause you to have a greater predisposition towards patellofemoral pain and/or instability. Factors such as tightness of the quadriceps muscles, hamstrings and iliotibial band, and relative weakness of the medial quadriceps muscle are probably the most common causes. Other factors that can contribute to your problem include femoral anteversion (excessive rotation of your hips), tibial torsion (excessive rotation of your shin bone), genu valgum (if you are knock kneed), genu recurvatum (if your knees hyperextend) and excessive pronation (if the arch in your foot drops too much).
How Do I Learn More About Patellofemoral Syndrome?
If you would like to learn more about detecting and preventing this condition, standards for conservative versus aggressive care, exercises and stretches, pictures showing the causative factors, link to additional articles, as well as how to proactively get screened for Patellofemoral Pain Syndrome go to the resources section of our website: www.FixMySportsInjury.com
Train Long & Hard…but Train Safe!!!
Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach. Founder of Spine & Sports Therapy and F.A.S.T. (Functional, Athletic, Sports Therapy).

Aches & Pains: Common Cycling Injuries

Sun, 1 Apr 2007 13:26:32 -0500

This is an article we wrote for the Houston Racing Triathlon Club newsletter:
Aches and pains associated with training and participating in athletic activities like the MS 150 are normal and common. As long as you know how to listen to your body, decipher the difference between normal and abnormal aches and pains as well as take care of them before they become sports injuries, you will stay ahead of the curve. If you can hold fast to an early detection and prevention type of mentality, you will minimize your aches and pains as well as be able to enjoy your training and MS 150 ride without the interference of a common overuse sports injury.
What are the Most Common Aches & Pains?
The most common aches and pains associated with the endurance cycling events are: (1) Low Back Pain, (2) Sciatica (3) Neck Pain, (4) Knee Cap Pain, (5) IT Band Pain, (6) Achilles’ Tendon Pain, (7) Quadriceps Pain (8) Hamstring Pain (9) Calf Pain and (10) Diaphragm Pain (a.k.a. Side Stitch).
What are Normal Aches & Pains?
Normal aches and pains are felt during activity, especially when you are getting tired or fatigued. This can occur if you are riding faster than normal, riding in the hills, riding in a head wind or at the end of a long, hard ride. It can also occur if you are getting low on fuel or fluids. Your symptoms will feel like a slow, steady increasing ache that will eventually progress to an intense burning pain. If you keep pushing it, your muscles will cramp or spasm, which is your body’s way of saying, “You’ve Bonked”. Rest, fuel and fluids will generally alleviate your symptoms and facilitate your body’s recovery.
It is also normal to feel aches and pains combined with stiffness 48 hours after a long, hard training session or ride. This is known as Delayed Onset Muscle Soreness (a.k.a. DOMS) and is a part of your body’s natural healing and recovery process. This is self-limiting and is usually gone within 48 hours. Ice Baths, Epsom Salt Baths, Arnica (topical or oral – find at Health Food Store), NSAID’s (if needed – Advil or Aleve) and a “Day of Rest or Light Spin” will generally alleviate your symptoms and facilitate recovery.
What are Abnormal Aches & Pains?
Abnormal aches and pain are generally localized and pin-point in nature (e.g. right side of low back or left outside knee). They can start with a dull, deep, aching sensation and progress to a sharp, stabbing, throbbing type pain. They will sometimes stay the same or even get worse over the 48 hour post-training/ride period. If the standard Rest, Ice, Compression and Elevation (RICE) does not completely eliminate your symptoms within 48 hours or it returns upon training, daily activity or even bothers you at rest; you will want to seek professional advice from a sports injury specialist. These abnormal aches and pains will lead to common sports injuries and will cause permanent tissue damage if overlooked and ignored long enough.
What Should You Do?
The first thing you should do is ask yourself some diagnostic questions: (1) Are my aches or pains felt evenly on both sides of my body? (2) Did I ride at a different speed, on a different terrain or in a head wind recently? (3) Did RICE completely alleviate my symptoms? (4) Did most of my symptoms dissipate within 48 hours post-ride/event? (5) Am I able to go back to daily activities and training without any pain? If you can answer a solid “YES” to all of these questions, you are in the clear and on the right track.
If you COULD NOT answer yes to all of the previous questions, then as yourself: (1) Are the majority my symptoms localized to one particular area of my body? (2) Does RICE help temporarily but not fully alleviate my symptoms? (3) Does the pain return with training, daily activities or does it even bother me at rest? (4) Have I experienced this same type of pain more than once since I started training? If you can answer “YES” to any of these questions, you will want to seek professional advice from a sports injury specialist.
What Can You Do?
If caught early enough, there is a lot you can do for yourself so that you can continue to train and ride. Most patients would like to seek help but fear the proverbial response, “Well…if it hurts to ride, then stop riding.” We only take those who are in the Acute Phase off of their activity but quickly put them back on a modified return to riding schedule once we get them into the Sub-Acute Phase. The majority of your sports injury care can be executed while you continue to train.
Where Do You Go from Here?
Educate yourself! Go to our website www.FixMySportsInjury.com and read our articles on the most common sports injuries. Start listening to your body, ask yourself questions and apply what you learn. Best wishes in your training and ride.
Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach. Founder of Spine & Sports Therapy and F.A.S.T. (Functional, Athletic, Sports Therapy).

Hydration for Endurance Athletes

Sat, 12 Aug 2006 16:17:07 -0500

These are notes from a lecture we gave to the In Flight Running marathon training group on hydration:
Hydration Facts:
o May loose up to 2-3 liters of sweat per hour (Hot/Humid Climates)
o 70-100 oz of fluid loss
o Impaired Performance – Fatigue, Increased Heart Rate, Greater Energy Expense
o With 2% fluid loss:
♣ 100 lb. athlete = 2.0 lb.
♣ 150 lb. athlete = 3.0 lb.
♣ 200 lb. athlete = 4.0 lb.
o Fluid Loss – Increases with Higher Heart Rates and Workloads:
o Long (Group) Runs – Zone 1 Pace (if you have had a VO2Max Test)
♣ Zone 1 = 180 - Age +/- Fitness Factor (MAF Calculation)
♣ Example = 180 – 30 years old = 150 beats per minute (bpm) max
• Range for Zone 1 roughly 140-150 bpm
o Humidity - Effect on Heart Rate & Workload:
o Decreases ability to cool and raises heat index
o Heart Rate rises by 1 bpm for every degree above 25C (77F)
♣ July/August Morning Runs = 80F @ 90% humidity = 88F HI
• +6 bpm at same pace
♣ July/August Afternoon Runs = 95F @ 60% humidity = 115F HI
• +19 bpm at same pace
Hydration 101 for Endurance Training:
1. Pre-Extended Training/Competition (Hot/Humid Environments):
o 2 Hrs before exertion – 16 oz water
o 15 Mins before exertion – 16 oz water
2. During Training/Competition (Hot/Humid Environments):
o Every 15 Mins during exertion – 6-8 oz water
3. Post-Extended Training/Competition (Hot/Humid Environments):
o Replace 1.5 times sweat loss w/in 6 hrs (1 lb loss = 1 Liter = 32 oz / So…replace 48 oz of fluid for every pound lost)
Hydration 201 – The Fluid Balance Test
The goal is to see exactly how much dehydration you incur during your workout. Don't try anything new just yet. Make sure that you are in good physical condition or check with your doctor. Now follow instructions from USATF Self-Testing Program for Optimal Hydration:

Once you have calculated your hydration needs per hour, now calculate what percentage weight you lost during your exercise session:
1. To find out what percentage of your weight you lost during exercise, you’re your original weight _____lbs. and subtract you post-exercise weight _____lbs. Now divide you pounds lost by your original weight and multiply time 100 to get the percentage.
Example: 200 lbs – 196 lbs = 4 lbs loss (4 lbs/200 lbs) x 100 = 2% loss
The following table and graph relate % body weight loss to performance and symptoms. Relating % loss of body weight to symptoms and performance in the heat from Nutrition for Cyclists, Grandjean&Ruud, Clinics in Sports Med. Vol 13(1);235-246. Jan 1994
• 0% -- normal heat regulation and performance
• 1% -- thirst is stimulated, heat regulation during exercise is altered, performance begins to decline
• 2% -- further decrease in heat regulation, increased thirst, worsening performance
• 3% -- more of the same
• 4% -- exercise performance cut by 20 - 30%
• 5% -- headache, irritability, "spaced-out" feeling, fatigue
• 6% -- weakness, severe loss of thermoregulation
• 7% -- collapse is likely unless exercise is stopped
The Heat Index:
Ambient temperature is not the only factor that plays a role in creating the potential for heat injuries, humidity is also important. Since our bodies rely on the evaporation of sweat as a major method of cooling, high humidity reduces our ability to cool the body, increasing the risk of heat illnesses. The Heat Index shows the relative effects of temperature and humidity.

Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach. Founder of Spine & Sports Therapy and F.A.S.T. (Functional, Athletic, Sports Therapy).

Early Injury Detection & Treatment: Saves Time & Money

Sat, 1 Oct 2005 20:12:48 -0500

This is an article we wrote for the In Flight Running marathon training group:
Intro:
The majority of sports or activity-induced injuries do not occur overnight but typically result from overuse. These soft tissue and joint injuries can result from overusing a specific body part/region or from a change in daily activities or training regimen. Such injuries can result from excessive running, swimming, cycling, fitness walking, rollerblading, repetitive job duties, gardening, yard work or housework.
These injuries gradually come on and get worse over time without there seeming to be a specific identifiable cause. The gradual onset of pain and stiffness leaves most individuals confused about the origin of the symptoms.
The majority of progressive injuries can be avoided or the severity reduced with early detection and treatment, which reduces pain, stiffness and limitation of movement. Additionally, this also saves time, energy and money that will be needed to treat these injuries as they worsen.
There are four stages associated with a sport or activity-induced injury (see chart below). By identifying the correct stage of injury, one may begin proactive treatment, which will eliminate the cause of the injury. Those who ignore the symptoms, hoping they will go away on their own, will pay the price with more extensive treatment and a longer road to recovery.

Tips for Proactive Prevention and Treatment:
1. Acceptance: Accepting and admitting that you are no longer invincible (like you were in your youth) and are susceptible to injuries is the first and largest step in prevention
2. Awareness: If you can detect an injury “in-the-making” during or after an activity, you can seek a proper course of treatment
3. Preparation: Keep first aid supplies on hand; these include paper cups with frozen water for ice massages (tear top of cup off), gel ice packs (zip lock bags with ice or pack of frozen veggies work as well), ACE compression bandage.
4. Ice Rules: Ice is used as an external anti-inflammatory agent. Ice immediately after activity if you detect an injury “in-the-making.” Ice for 15-20 minutes (use paper towel or thin cloth between ice and skin for frostbite protection). Allow tissues to warm up, after icing, for at least 60 minutes before repeating. Repeat several times a day if necessary.
5. Compression/Elevation Rules: These are used to reduce swelling. If you are going to ice…why not compress and elevate at the same time? This is called “combination therapy” and gives you the biggest bang for your buck.
6. Anti-Inflammatory Rules: This is to combat inflammation form the inside. Most anti-inflammatories are also painkillers. You should not use anti-inflammatories and continue to participate in activities that normally cause you discomfort or pain. Masking the pain during activity can lead to further injury and irritation.
7. Seek Professional Advice: Do not be afraid to seek the advice of a healthcare professional. Make sure to seek a professional with a background in physical or sports medicine as well as one that is interested in finding the cause of your problem. This person will be able to help you return to your sport and activities more quickly with less pain and limitation.
8. Return with Caution: After taking time off to rest or seek treatment, return to your sport or activity with caution. Reduce the time and intensity of the activity and gradually work back into your pre-injury level.
Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach. Founder of Spine & Sports Therapy and F.A.S.T. (Functional, Athletic, Sports Therapy).