April 2022

Let’s say you have a group of running friends. There are four of you. Statistically speaking at least one of you will have the unfortunate circumstance of dealing with “Runner’s Knee” or “Patellofemoral Pain Syndrome” each year. Runner’s Knee is typically described as pain around, behind, or under the knee cap. The pain can range anywhere from mild to severe and can be experienced either while running or at rest.

There are many contributing factors as to why Patellofemoral Pain Syndrome can show up. Not all of them are running-related. Most frequently the main driver is a rapid increase in training frequency or intensity. This can be from running or other forms of training too. If this is the case, a temporary reduction in training volume (Number of training sessions per week, length of training sessions, and/or intensity of training) should be the first line of treatment. Typically unloading for 2 weeks seems to do the trick. If not, or if Runner’s knee is something you consistently deal with on a year-to-year basis, then seeking professional help should be considered. 

These treatments can include: 

Get A Running Gait Analysis: Certain running styles can predispose people to certain aches and pains. Increasing your running “Tempo” by as little as 5% has been shown to reduce incidents of Patellofemoral Pain Syndrome in amateur runners. 

Running Shoe Fitting: getting into the proper running shoe for your style and intensity of running can make a world of difference.

Start a well-designed Strength Program: hip strength and control are major indicators of running injury likelihood. A properly designed strength and conditioning plan can be your best friend in terms of running injury prevention. 

Include a Runner Specific Mobility Routine- One study showed that for Patellofemoral Pain Syndrome quad musculature inflexibility was a strong predictor of incidents and that a simple hip flexibility routine performed daily can then reduce the incident rate in athletes. 

Watch Dr. Bobby guide you through KNEE & HIP EXERCISES!

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February 2022

Sarah was an avid runner growing up. She even ran a marathon in her twenties, but eventually, life got into the way of her running routine, and fast forward to today… she hasn’t run a race for years. Occasionally, she’ll go for a short jog (maybe a few miles or so), and every time she does she is reminded of how good she used to feel when she was able to run consistently. She wants to get back to that and, in an effort to get there, she makes a pack with a few friends to sign up for a local half marathon. The only problem is that for the last few years any time she runs more than once or twice a week her right calf would start hurting like crazy! Also, any time she runs more than a few miles, the same thing will happen to both calves and she’ll even limp for a few days. She has taken weeks or even months off before, but regardless of the time off she takes, it seems the same issue persists. Fearing that her medical provider will simply tell her to abandon her goal of racing again with her friends, she looks for another option. That’s when a friend tells Sarah about Dr. Bobby and the Center of Movement.

At her initial appointment, Dr. Bobby and Sarah discuss her running history, her symptoms, her race goals and they even watch her run. It is at this appointment that they diagnose Sarah with ‘Non-Insertional Tendinosis’ a type of Achilles Tendonitis. They come up with a treatment plan to help address the foot, ankle, and calf issues that cause her calf pain to keep coming back year after year. Also, they come up with a training plan to get her to race day without any issues! With her new game plan, Sarah regains her confidence in her ability to run and train towards her goals! Not only did Sarah run her ½ Marathon, but she PR’ed! Now Sarah can run with her friends again without the worry about what it will do to her the next day! Running for Sarah is no longer a stressor, it’s a stress reliever!

Watch Dr. Bobby guide you through ACHILLES TENDON & CALF EXERCISES!

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January 2022

Data

Ankle Sprains are by far the most common athletic injury. On average 23,000 people sprain their ankle each day in the United States alone. The direct and indirect cost associated with treating ankle sprains is estimated to exceed $1.1 billion annually.

Unfortunately, although it is the most common athletic injury, it is grossly undertreated, and in a 2000 study in a 10-year follow-up of patients suffering an ankle sprain, a shocking 72% showed signs of arthritic change and impaired function. By far the greatest predictor of a future ankle sprain is a past ankle sprain with a distant second place predictor being overweight. In fact, athletes with a past history of sprained ankles who also carry a few extra pounds were 19 TIMES more likely to sprain again than their at-weight colleagues.

The vast majority of ankle sprains are what we call an inversion ankle sprain where your foot rolls inwards damaging the anterior talofibular and/or the calcaneofibular ligament. Rehabilitation of an ankle sprain should begin immediately as research has shown that a good rehab program can reduce the time to return of activities by up to 50% as well as significantly improve your long-term outcomes. While people argue which exercises are best all rehab programs should look to address five main components.

Solution

The implementation of a simple foam pad balancing routine done 3x/day for four weeks has been shown to significantly reduce the rate of reinjury. Also, the use of tools like rocker boards or low-level plyometrics (when you’re able to tolerate it) has been shown to significantly improve patient outcomes as well.

References

Michaud, Tom (2021) injury-Free Running 2nd Edition. Lotus Publishing

Watch Dr. Bobby guide you through ANKLE SPRAIN REHAB levels 1-3!

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