Browsing Tag

knee pain

foot pain, Health, running

How to Run Better, The Basics

July 19, 2017 • By

There are a few easy things that everyone can apply to their running to decrease injury, pain and simply make running easier and faster! Today we are simply going to show you how to run better

This is perfect for those of you that have regular niggles or if you have plateaued with your running and need a way to step it up. So here is your easy guide on to how to run better and improve your run!

running cadence 1801: Cadence:

This is basically the number of steps that you take per minute and for best efficiency, this should be 90 steps per minute on each foot (180 total per minute). To achieve this, first of all, you need to measure what your current cadence is. You can do this by counting the amount of steps your right foot takes in one minute.

Try then increasing your rate (if needed) and time again in another 5 minutes. The trick is to think like you are running on an icy or slippery surface and your heels are coming up behind you. This could well feel awkward to do at first and can take weeks to get used to, but once you get used to it, running will feel much easier.

Tip: A great way to improve your running cadence and run better is to use a metronome (some examples here)

how to stop overstriding2: Don’t stride out:

When striding out the foot lands on the heel and with the leg relatively straight out. This creates a braking force up through the leg and acts to slow you down, meaning YOU have to work harder.

Run better by kicking your heels up more – don’t run with straight legs!

 

3: Think smooth, light and easy:

If you look at the best medium to long distance runners you will see they have very little upward head movement (less bobbing up and down). This means less wasted energy! So to run better, we need to lean our body weight forward more and imagine projecting yourself forward and slightly up. Practice standing 1 meter in front of a wall and leaning forward through bending at your ankles until you are about to fall forward and then come back again in order to get a feeling of shifting your body weight forward.

Exercise: Practice standing 1 meter in front of a wall and leaning forward through bending at your ankles until you are about to fall forward and then come back again in order to get a feeling of shifting your body weight forward.

Remember – Perseverance is key with this! You will feel like you can just keep running and running when this becomes second nature – and then you tell others how to run properly – I still find it amazing that no one gets taught how to run!

Lastly, check out the video below of what I think is some close to perfect (no one is perfect) running:

 


Back pain, Health, Hip pain, Knee pain

The Wall Sit – Beat knee pain

July 5, 2017 • By

The Wall sit is one of the most do-able exercises and is a brilliant strengthening exercise for anyone with back, hip or knee pain.

Who would benefit from would wall sits, otherwise known as wall squats?

  • Those wanting to avoid or prepare for knee or hip surgery
  • Most with hip or knee arthritis will get massive benefit
  • Those of you that struggle to get up from chairs
  • Anyone at all who wants to strengthen their back and legs from home

wall sit exercise for knee pain arthritisSo what is a wall sit?

It is simple a squat hold with your back leaning against the wall as shown in the video below. the key  things to remember are:

  • Your knees should no go out past your toes. Aim to keep your knees over your ankles or feet
  • Keep your chest up and back straight
  • Do not push into pain
  • Expect some burning in your thigh muscles (this is a good pain and shows your muscles are working hard)

Top tip: Lean into the wall with a Swiss Ball, foam roller, basketball or anything that rolls to minimize friction – this makes the exercise far more effective and comfortable.


The idea for the wall sit is not to repetitively go up and down but squat down and hold for a period of time.

Aim to hold until your muscles start fatiguing and then come back up again and repeat 10 times – over time your hold time will get longer and longer and your back and legs will get stronger! (1)

Tip: Only go down as far as is comfortable for YOU and don’t go past horizontal thighs.

Progression

The one-leg wall squat is often used as a test of lower limb endurance(2,3) and also makes for an excellent exercise when you want to push your leg strength further while still looking after your knees.

All you need to do differently for the one leg hold is lower yourself down, keeping your feet shoulder width apart and then carefully lift one foot just off the ground – hold as long as you can (without losing form).

Below is a table giving average times to gauge where you are at:

wall sit values

The wall squat is a great exercise and well worth persevering with whether you can just hold a double leg wall sit for 20 seconds or a one leg squat for 100! Make it a challenge every night for one month and notice the difference.

References:

 


Health, Knee pain

Torn Meniscus: Self-Treatment Exercises

October 13, 2015 • By

Often, surgery is not the best option – So what should home-rehab exercises look like for a torn meniscus?

In this second post in the series we look at your home rehab programme, covering exercises to reduce muscle spasm, improve balance and strength a well as an effective self-mobilization technique that will help you make big gains.

As we covered in the first post, a torn meniscus is a very common injury and there’s some important points when it comes to anatomy and surgery vs. conservative rehab, so make sure you have a read of that also.

So here is your self-treatment:

Rehab for a torn meniscus needs to cover four things:

  1. Muscle spasm
  2. Balance and muscle activation
  3. Graduated strengthening
  4. Joint mobility and meniscus healing

This is the order we need to start them in as well as the first step of your rehab is to settle the secondary symptoms, which is mainly muscle spasm and muscle switching off. This initially reduces pain, improves the range of motion and starts you being able to use it more – which speeds up recovery by helping you optimally load the knee.(1)

RICE injury treatment, heal strong and fastStep 1: Ease pain and improve range

First 72 hours:
As with most acute injuries, you need to first look after it, to allow initial healing – basically where the “scab” forms and to allow it to settle down.

 

Step 2: Switch the muscles back on, decrease spasm and improve balance

After the first 72 hours, it is important to prevent loss of muscle mass and get your muscles switching on again using some simple proprioceptive and stretching exercises:

 

  • Bosu ball, wobble board ankle and calf re-training rehab quickSingle-leg balance: The knee loses proprioception very quickly when injured (you can think of this as the “feeling” or the balance). So to get it back, you need to challenge your balance.
    • Level 1: Stand on one leg on the floor, when comfortable for 1 minute, progress…
    • Level 2: Fold up a towel and stand on this, when easy for 1 minute, fold it up thicker or
    • Level 3: Either roll a towel up tight or use a Balance Board or BOSU ball
  • calf stretch , soleus, gastroc - self treatment for shin splintsCalf stretch: Hang one heel off a step for 30 seconds at a time. Once per side.

 

 

  • Inner range quads torn meniscusInner range quads / Extensions: With knee injuries we lose activation of the distal thigh muscles, just above the kneecap very quickly. This is a nice and easy one (but still very important!). Sitting in a chair, or in bed with a towel under the knee, extend the knee by lifting the foot up to full extension or pain. Repeat this 20 times, every 2 hours.
    • Note: Do not force it, and take it nice and slow

 

Step 3: Start strengthening the knee

This is where it finally starts getting less boring! Start step three when it is comfortable to do the above exercises and remember not to push into pain.

  • correct squat form, strong and safeSquats. Yes these are great for getting your leg stronger again but it is important to start at the right level for you and progress from there through the following:
    • Level 1, Wall squats: Lean against a wall, with your feet shoulder width apart and out from the wall. Slide down the wall 1/2 range and no more. Hold this for 5-10 seconds and repeat 10 times. Tip: make this a bit easier on your knee by having a large round ball or Foam Roller between you and the wall.
    • Level 2, Double Leg Squats: Again, fee shoulder width apart. squat up and down within the comfortable range. repeat 10 times for 3 sets.
    • Level 3, Single Leg Squats: Now, standing on one leg, perform squats, within a comfortable range, 10 reps, 3 sets. Note: with this one you won’t be able to squat very low, and that is perfectly fine!
    • Technique: To take pressure off your knees, don’t let your knee/s go forward past your toes and it helps to stick your bum out further!
  • Cardio: Keep your fitness up and boost healing by utilizing:
    • Biking on a Exercycle ideally is great once you have over 90 degrees range in your knee
    • Swimming is a good one for un-weighted exercise, just stay away from breaststroke
    • Walking, as able. When you are able to walk pain-free for 1/2 hour, you can try a short jog and build from there.

Step 4: Gain full knee range

MTSS shin splints self treatmentThere are three things that will limit range mainly at this point: Joint stiffness, muscle tightness and the knee still healing.

The knee should continue healing, as long as it isn’t overloaded, so let your body get on with that.

Muscle tightness can be addressed by stretching out muscles such as your calf, hamstring and quads and also by foam rolling.

Last but not least, joint stiffness can be helped by self-mobilization to improve it’s bending and get the joint oiled-up. See the below video for a short and easy demo:


Health, Knee pain

Knee pain: This is what works

September 18, 2015 • By

patellofemoral pain knee cap pain exercisesThere is an indisputable amount of evidence now that when it comes to anterior knee pain exercises… we can’t just treat the knee.

Here is a short and sharp explanation of why and what we should be doing:

Often people are told to strengthen up their quads and get their legs strong to help knee pain but really is this the best way to do it?

The answer is no. There is a lot of evidence when it comes to anterior knee pain (also known as patellofemoral pain) that rehabbing proximally is much more effective the strengthening the knee and quads alone. Proximally means working on the muscles further up the chain, closer to your spine, such as your:

  • Core/abdominals
  • Hip abductors
  • Hip external rotators

In fact, a thorough systematic review was published recently which showed that compared to quads strengthening:

  • There is strong evidence that proximal rehab, combined with quads strengthening had better pain reduction
  • Proximal rehab alone and combined with quads strengthening results in better functional gains
  • Proximal rehab, was better in the short and long-term.

This basically shows us that when it comes to knee pain, it isn’t often the knees fault. We need to look up the chain at what controls the knee – The hip. Including rehab exercises that improve him strength and neuromuscular control has much better effects in outcome in both the short and long-term and cannot be ignored.

 

So what exercises should you be doing?

Type of exercise: This should be a combination of closed chain (feet/foot in contact with the ground) and open chain exercises in a comprehensive rehab program.

Frequency of exercise: Exercises that aim at neuromuscular training and stretching/foam rolling can be performed daily, whereas strength training should be aimed for 3 x weekly.

What knee pain exercises work well?

Follow this link for a great post for the rehab exercises to get you started!

 

Conclusion: Proximal rehab should be included in all rehab programs for anterior knee pain and if in doubt, go and see your local physio for best results.


Health, running

Running Myths Busted

December 8, 2014 • By

Follow my blog with Bloglovin
From heel landing, stretching to make you faster and shoes for different arch heights, we aim to clear up these murky waters with 5 of the biggest running myths busted.

running myths busted

It is estimated that over 35 million people run in the USA alone for exercise or for sport(1). Runners are living in a confusing, challenging and ever-changing world. There are so many conflicting opinions out there about what shoe you should wear, how your foot should be landing, whether you should lean forward or not, stretching is bad for you… I could go on but, but I’m sure you get my point!

This conflicting information needs to be cleared up. For you, the runner – whether it be for fitness or competition – and for us health professionals, because we as often as anyone else are always on the look out for the exciting new bit of research, the next quick fix or magic bullet for running injuries. With the incidence of running injuries ranging from 26% upwards, we need to be doing the right things and know what will and will not help us.(2)

 

So what are the biggest 5 running myths busted?

1. Buying running shoes based on arch height help prevent injury

pronated foot - 5 running myths bustedWhether you have high arches, low arches or neutral feet – Having shoes prescribed for this does not reduce your injury risk. Between us we all have such a great variety of foot shapes,  which obviously can’t be nicely placed into 3 boxes(6).

You can read more here.

 

2. Stretching helps prevent injury

Even though this is the factor most often thought of as the cause behind running injuries, it is simply not true(3). There is a very common belief around the world that stretching before, during or after exercise decreases the chance of injury and improves recovery, but in actual fact it has been shown that stretching is not protective of running injuries (4). Static stretching could even affect your performance.(12)

It does need to be mentioned though that often stretching is mistaken for warming up. Warming up is defined as a period of prepatory exercise to enhance subsequent training or exercise(5). Warming up does help and has been shown to significantly reduce the risk of injury.

 

Mo-Farah-core strengthening3. Runners don’t need to strength train

Good, run-specific strength and conditioning can really help your running.

Your joints will be better protected, you will have less injuries and you will run faster! Ideal (7, 8, 9, 10).

Just remember, it isn’t all about the strength, you need to have neuromuscular control. This means making sure that you training is functional and running specific.

 

4. Minimalist/ Barefoot shoes make you run better

It isn’t about the shoe, it is about HOW you run. Yes, landing on your mid-foot when running reduces the load though your lower limb and reduces risk of injury, but this is altered through your technique (such as increasing your cadence or driving through with your knee) and not through shoes.(11)

First, look at you running technique, then your shoes.

 

Mo Farah5. One running pattern is right for everyone

As Bryab Heiderscheit writes “There is too much heterogeneity among runners to believe that one running pattern is universally ideal”(13). For example, changing running style to promote forefoot or mid foot strike may unload the knee and shin pain but it would be wrong for someone with  for example a stress reaction or inter-metatarsal bursitis.

Rather, this paper suggests that we may be better off showing people how not to run, giving a couple of things that do lead to poor economy and increased injury risk. These would be things such as not over-striding (foot landing well ahead of the center of mass) and not bouncing up and down too much.

You simply cannot put everyone into the same box – but there are some aspects that do benefit the majority, and these should be promoted.

 

So there are your 5 running myths BUSTED – what do you think? Surprised?

 

 

It is important that we embrace an approach that is not one size fits all, and that is holistic in nature, that takes into account nutrition, goals, ability etc. The other big thing that needs to be looked into further is training error, which has been estimated to account for over 70% of running injuries. This is a huge amount of injuries that are due to training error (running too far, too fast, too long, too soon) – Maybe more needs to be done to place some guidelines around training progression and the best way to go about this. Especially for beginners as they have a 2-3 x higher risk of injury.

 

I would love to hear your thoughts and feedback on these running myths, see the comments section below or find me on twitter.

 

Yours in good health,

Shaun