tag:blogger.com,1999:blog-30111410204549980742024-03-05T00:14:41.637-08:003-D RUNNERAs a runner and coach in both high school and college, I understand the frustration of having an injury. Many athletes lack knowledge in anatomy, biomechanics, and injury management. My experience as a physical therapist, a fellow of applied functional science, and a strength and conditioning specialist, allows me to help other runners be more educated about their body. This blog is designed to educate runners on basic anatomy, various injuries, and exercises with the focus in 3 dimensions.Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.comBlogger46125tag:blogger.com,1999:blog-3011141020454998074.post-10893789637459896622020-07-18T17:04:00.001-07:002020-07-18T17:04:52.938-07:00Newsletter Archive: Stop Smashing Your ITB<div style="font-family: "Times New Roman"; font-size: 16px; line-height: 1.4; margin-bottom: 6px;">
From Newsletter 6/28/2020<br />
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I'm so glad you decided to my the 3DRunner team. Here is the newsletter which was send last Sunday! I hope you enjoy it. </div>
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Are you constantly rolling your ITB without resolve? Day after day, you pull out your foam roller, sprawl over the ground, "to make your ITB loose", only to do it again the next day. You've been told to "strengthen your glute". You lunge and bridge and squat, always finding yourself in the same position. You are on the ground rolling your ITB.</div>
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<span style="font-size: 20px;">Try Decompressing the ITB</span></div>
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When you roll over the ITB, the premise is the smashing the tissue will help it loosen. That's what I've been telling my patients for the past 10 years and my runners, even longer, almost 20 years. If you ask me now, I will tell you something different. DECOMPRESSION. There is a nerve, called the lateral femoral cutaneous nerve, which is the ITB with branches which goes through the ITB. The locations of where the nerve goes through the ITB, is the same location of "trigger points" that I release for my clients and athletes. Nerves really don't like to be compressed. When you compress the tissue surrounding the nerve, it will let go slowly and painfully. When you decompress the tissue, it provides more space for your nerves to move. Your body will tissues will relax as a response.</div>
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Here's a photo of the lateral femoral cutaneous nerve from the back view. The white portion on the right is the ITB. The nerve goes through the ITB! The most common tender spot is where the nerve comes out in the middle of the ITB.</div>
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<span style="font-size: 20px;">What to do?</span></div>
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All right team, you want to DECOMPRESS the area. Use a cup to decompress the ITB to give more space for the nerve. If you don't have a cup, you can use a skin lift technique. Click the pictures below for a link to the videos. Here is the link to the <a href="https://www.amazon.com/EDGE-Cupping-Therapy-Sets-Brilliant/dp/B00P6UYGOU/ref=sr_1_3?crid=2G5O7VK1PLCSU&dchild=1&keywords=vacuum+cupping+set+for+massage&qid=1593297242&sprefix=vacuum+cupping+set%2Caps%2C198&sr=8-3" style="color: #0875c1;" target="_blank">cups I use</a>. (No, I don't get kick backs for sharing this.)</div>
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Cupping the ITB</div>
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Skin Lift Technique for ITB </div>
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<span style="font-size: 20px;">STOP Squeezing Your Abs AND/OR Glutes</span></div>
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When you squeeze you abs and/or glutes, your pelvis tucks under your body (a posterior pelvic tilt). Referring to the photo below (looking from a front view), a posterior pelvic tilt will bring the top of the photo away from you and the bottom towards you. This position puts tension on the inguinal ligament (which can give you a host of other problems which won't be discussed here). The inguinal ligament has ATTACHMENTS to the ITB. So by tucking your pelvis under your body, again occurs when you intentionally squeeze your abs and glutes, you TENSION your ITB. </div>
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***The circled area is highlighted because those ligaments gets slacked in a posterior tilted position contributing to increase pressure to the sciatic nerve (again, maybe for another post).</div>
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So STOP TUCKING YOUR BUTT!</div>
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I hope this provides insight into different options besides rolling.</div>
Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com0tag:blogger.com,1999:blog-3011141020454998074.post-709546623043986592020-07-18T16:57:00.001-07:002020-07-18T17:05:24.963-07:00Newsletter Archive: Summer is Coming<div style="font-family: "Times New Roman"; font-size: 16px; line-height: 1.4; margin-bottom: 6px;">
Newsletter Archive 6/8/2020<br />
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We're already a week into June! When did this happened? There has been so many things going on. </div>
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I would be remissed if I didn't mention the social injustice that is recently in the spot light. I have been listening, watching and educating myself on the different obstacles a Black person has to endure. If everyone is talking, no one is listening. I am listening then doing. For those of you who follow me in Instagram, I have been sharing a bit of information, which for a lack of better words, that has caused a light bulb moment. I am thinking of ways to be more inclusive as a physical therapist. If you are interested, here is a webinar on <a href="https://www.crowdcast.io/e/Anti-Racism&AllyshipforRehabandMovementProfessionals/register?fbclid=IwAR11YgsJ7WgkEkfSSNdfLo09Ss_wUZVpjuCIe9mgfhQ4YEolozWqvwyJ_rI" style="color: #0875c1;" target="_blank">Anti-racism and Allyship</a> for Rehab and Movement Professionals.</div>
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Do You Wear Flip Flops?</div>
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It's getting HOT outside. For all you flip flops (sandals, slippers) wearers. I'm sure you've been told that wearing flip flops are bad, but no one ever said why. The reason wearing flip flops can be bad is, your toes curl down to hold on to the flip flop. This will cause over contraction of your toe muscles, especially the muscles of the big toe. The big toe muscle starts at the toe, crosses the foot, wraps behind the ankle and attaches at the outside of the leg. When the muscles over work, it causes poor alignment of the foot and ankle. Here's a video on how to massage your leg.<br />
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Exciting News</div>
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I'm in the hunt for space to open 3DRunner Performance and Rehabilitation. I'm excited to start the process of finding an in-person location to provide hands on osteopathic techniques for clients. I have mentioned osteopathic in prior newsletters. What does it really mean? To me, osteopathic is taking the consideration of the organs and it's nerves, blood and lymphatic supply, to how they can impact your injury. The picture below is directly from my mentorship with Anna Hartman (IG @movementrev). The slide discusses how the ligaments of the pericardium (container holding the heart) is attached to the spine and the rib cage. When those ligaments are tensioned, it can have a significant impact to spinal movement.</div>
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Running Analysis Webinar</div>
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I'm hosting a webinar on how to perform a running analysis! If you want to know how to do a running analysis, this webinar will provide you all the fundamentals and more to get started. I will discussed how to set up your camera, identify running form deviations which contribute to injuries, where to draw your angles and lines to show dysfunction and generalized exercises to improve running form. I'm hosting this on Saturday June 13th at 10am PST ( YES THERE WILL BE A REPLAY LINK SENT AFTER THE WEBINAR). The cost is $15. Below is the link to sign up. This is perfect for a runner who is interested, a coach or movement professional. </div>
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<a href="https://marvelous-artisan-6510.ck.page/33f89ebe7d" target="_blank">UPDATED LINK HERE</a>!!!<br />
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Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com0tag:blogger.com,1999:blog-3011141020454998074.post-43973887953637624352020-04-05T20:38:00.001-07:002020-04-05T20:38:30.086-07:00Lunge and SquatI finally started doing what I have been intending on doing for a few years... Instagram Lives.<br />
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Here's a recorded session on my favorite lunges and squats. It starts with a few minutes of how to self massage to de-stress. If you want more details check out my last post titled <a href="http://3drunner.blogspot.com/2020/04/de-stress-techniques.html" target="_blank">Self Relaxation</a>.<br />
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Here's the exercises that I went over:</div>
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<span style="font-family: "roboto" , "noto" , sans-serif; font-size: 15px; white-space: pre-wrap;">1) Lunge with Overhead Reach</span><span style="font-family: "roboto" , "noto" , sans-serif; font-size: 15px; white-space: pre-wrap;">
</span><span style="font-family: "roboto" , "noto" , sans-serif; font-size: 15px; white-space: pre-wrap;">2) Throwing Squat</span><span style="font-family: "roboto" , "noto" , sans-serif; font-size: 15px; white-space: pre-wrap;">
</span><span style="font-family: "roboto" , "noto" , sans-serif; font-size: 15px; white-space: pre-wrap;">3) Twisting Squat</span><span style="font-family: "roboto" , "noto" , sans-serif; font-size: 15px; white-space: pre-wrap;">
</span><span style="font-family: "roboto" , "noto" , sans-serif; font-size: 15px; white-space: pre-wrap;">4) Curtsy Lunges</span><span style="font-family: "roboto" , "noto" , sans-serif; font-size: 15px; white-space: pre-wrap;">
</span><span style="font-family: "roboto" , "noto" , sans-serif; font-size: 15px; white-space: pre-wrap;">5) Lunge and Reach </span></div>
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<span style="font-family: "roboto" , "noto" , sans-serif; font-size: 15px; white-space: pre-wrap;"><span style="font-family: -webkit-standard; font-size: small; white-space: normal;">I intend on archiving some of the Lives here!</span></span></div>
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Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com0tag:blogger.com,1999:blog-3011141020454998074.post-90575590854973678112020-04-05T20:27:00.001-07:002020-04-05T20:27:16.939-07:00De-stress TechniquesLearning how to relax can be difficult at times when there are so many things going on. However, it is important to learn how to relax and engage the parasympathetic nervous system ( rest and digest). Your parasympathetic nervous system CONTROLS the sympathetic nervous system ( fight or flight). When there is too much sympathetic nervous system activity, a long list of unwanted side effects can occur such as digestive dysfunction, skin disorders, and high blood pressure to name a few.<br />
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A side effect which isn't often addressed is the over activity of the sympathetic nervous system can hinder your body's ability to absorb work. The work can be manual therapy ( massage), a workout or a stretch. Your body is too busy "fighting" to absorb work.<br />
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Check out the link below to a self relaxation and stretch to improve parasympathetic nervous system activity.<br />
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This was recorded for Instagram Live, please bear through the commentating.<br />
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<iframe allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/eE79Jfw6rpY" width="560"></iframe>Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com0tag:blogger.com,1999:blog-3011141020454998074.post-26720727865293269672020-04-05T15:09:00.001-07:002020-04-05T15:09:12.629-07:00Core: Floor to Standing and MORE<div style="background-color: white; border: none; box-shadow: none; box-sizing: border-box; caret-color: rgb(55, 63, 69); color: #373f45; font-family: Arial, Helvetica, Verdana, Tahoma, sans-serif; font-size: 14px; line-height: 1.6em; margin-bottom: 15px;">
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Newsletter Published: 3/16/2020<br />
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Grab your popcorn. Grab your snacks. This is a long one. </div>
<span style="background-color: white; color: #373f45; font-family: "arial" , "helvetica" , "verdana" , "tahoma" , sans-serif; font-size: 14px;">Everyone talks about core strength. We all know we need it, wether it's for overall health or improving performance. What does core strength really mean? How do you attain it?</span><br />
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<span style="background-color: white; color: #373f45; font-family: "arial" , "helvetica" , "verdana" , "tahoma" , sans-serif; font-size: 14px;">After doing more research on motor development, the consensus is core strength develops from the ground up. Development of core strength from baby to child is what grants us to ability to eventually walk and run. Mastery of one position will be the foundation for the next progression. This forces the body to develop strength in these positions, in all directions, prior to the next movement. Rolling from the back to the stomach develops rotational core strength in a position which our body is most supported by the ground. It is the development of this strength which allows an infant to progress onto hands and knees ( less support) to eventually crawl, which is the next rotational challenge. Until there is appropriate amount of strength in rolling, an infant will not be able to crawl.</span><br />
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<span data-redactor-tag="strong" style="border: 0px solid rgb(220, 225, 229); box-sizing: border-box;">What does this has to do with me? An adult? </span></h4>
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We end up being so good at walking however, with various injuries and/or pain we use compensatory strategies therefore losing foundational strength. There is a lot of social media videos showing "extreme" core exercises. You don't have to do that. You may not be ready for that.</div>
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First and foremost, can you roll? I did a post on this a while back, but it's worth re-stating. Can you roll from your back to your stomach with out using momentum or ANY leg use. Start by bringing your head towards the armpit to the side you're rolling towards. Reach your arm across your body. If your upper body has the proper timing, strength and control, you will roll onto your stomach seamlessly without any leg muscle activation. If you can't roll, start your strengthening at the first exercise below. You may also just practice the initiation of rolling.</div>
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Crawling is the next step in the developmental sequence that I like to assess. Are you able to resist rotation on your hands and knees ( in this case, feet)? In this position, your core should be able to remain level as you use opposite arm and leg to crawl forward. The core is weak and/or lacks control when your pelvis rocks up and down or side to side. In my case, shown in the video below, I have a tendency to shift to my right. Umm, it's the hip that has been bothering me for the past 10 years due to a fall. If you have trouble crawling but can roll, I suggest starting at the 2nd video. Yes, it's an "on your back" exercise. It's ok. Start at 1/4 Turkish Get Ups. A resisted rolling exercise will give you the foundational strength needed for crawling.</div>
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The core activation should be gentle. We're looking for your muscles to be REACTIVE. You shouldn't have to think about when to turn them on. Any time you hold your breathe, the exercise is too much for the core. You definitely aren't holding your breathe while you're running. This means your core isn't activating while running. So work on core exercises while breathing. </div>
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<iframe allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/anDhk9e7zvk" width="560"></iframe>
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This is where to start if you absolutely can not roll without the use of your legs. <span class="redactor-invisible-space" data-redactor-class="redactor-invisible-space" data-redactor-tag="span" data-verified="redactor" style="border: 0px solid rgb(220, 225, 229); box-sizing: border-box;">When you hold the cable/band from the side, it is pulling you towards the machine. You have to use your rotatory muscles to resist it. The video below shows the knee straightening alternately. However, you can induce a rotation from the bottom by alternating twisting a bent knee turning towards the ground. First, with the feet touching the ground. To progress, lift both feet so your legs are unsupported. </span><br />
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<iframe allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/Nab1IneiifI" width="560"></iframe> </h4>
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This is a progression of a rolling exercise from the ground, it adds resistance and decreases the base of support. Be on your back with one knee bent, that side arm is straight and above the shoulder. Bring your legs slightly apart. As you come up, shift your weight onto your forearm then up to your hand. Keep your legs relaxed. The compensatory strategy is to push down or lift the leg up.</div>
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Once you've gotten the hang out rolling on your back you can mix in exercises on all fours.<br />
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<iframe allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/bvbcHEs9D8Q" width="560"></iframe> </h4>
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<span data-redactor-style="font-size: 14px;" data-redactor-tag="span" data-verified="redactor" rel="font-size: 14px;" style="border: 0px solid rgb(220, 225, 229); box-sizing: border-box;"><br /></span>
<span data-redactor-style="font-size: 14px;" data-redactor-tag="span" data-verified="redactor" rel="font-size: 14px;" style="border: 0px solid rgb(220, 225, 229); box-sizing: border-box;">Kneel to stand exercises challenges the core muscles because you are moving from a more to less stable position. </span><span data-redactor-style="font-size: 14px;" data-redactor-tag="span" data-verified="redactor" rel="font-size: 14px;" style="border: 0px solid rgb(220, 225, 229); box-sizing: border-box;">The resistance should be set up on the side which the leg is forward. This position will induce a rotation in your core. Your muscles has to meet this resistance. Keeping the elbows straight will challenge the core more. For a further challenge, stand on one leg ( the leg closest to the resistance).</span></div>
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<iframe allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/Q3vAIJdCJJk" width="560"></iframe>
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The last phase of core development is in standing, the least supported position. This exercise helps to generate power in the standing position and even better on one leg. Hold the cable for resistance and drive the opposite knee up which causes rotation. You body has to generate strength, unsupported, to resist the rotation.</div>
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Do you get the idea? The exercises are on a sliding scale. You don't have to perform all exercises in one category before moving on to the next. There are also subcategories of depending on assistance verse resistance. It is very complex and I had to choose the exercises I like and works best, otherwise this newsletter will be a book. It is already is a short story. </div>
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If you have read this far, you're amazing. </div>
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Questions? Comments? Or Concerns? You can always reach out at info@3-drunner.com or DM me on IG @3DRunner</div>
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Janet Yiu, PT, DPT, OCS, FAFS </div>
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3DRunner... Run Free From Injury</div>
Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com0tag:blogger.com,1999:blog-3011141020454998074.post-87548197966801524012020-02-02T20:46:00.000-08:002020-02-02T20:46:29.559-08:00But Can You Crawl?<div style="font-family: "Times New Roman"; font-size: 16px; line-height: 1.4; margin-bottom: 6px;">
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Newsletter sent on 1/16/2020</div>
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In my quest to learn all the things, I have delved into fundamental movement patterns and explored the impacts of skipping developmental milestones. </div>
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Sure enough, this week I had my first patient of the year who completely reinforces what I’ve been researching. </div>
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My older patient comes into the clinic after a total hip replacement. During the assessment, I realized there is poor control of her ENTIRE leg. Her feet are floppy and weak. Her knees are stiff. Her hips are, of course, weak. I asked her what’s going on. She replied, “I’ve been wearing custom orthotics. I’ve had bad feet forever.” I asked, “ Did you hurt yourself as a kid?” She said, “Actually no, I was strong. I even skipped crawling as a baby. Something must have happened.”</div>
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OMG. This is the moment I’ve been waiting for. </div>
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I proceeded to tell her what I knew about the developmental milestones. </div>
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The basic movements that we develop when we're babies -- rolling, crawling, kneeling, squatting, and so on -- are the foundation to movement for the rest of our lives. Proficiency of one of these movements is the foundation to the next movement. From there, the movement patterns build on top on one another. From infancy to the toddler stage and through the rest of childhood, we develop these skills progressively. Studies have shown that skipping a milestone as an infant can lead to movement dysfunction as an adult.<br />
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In the case of my patient, she skipped crawling. This means she did not develop good push-off with her foot and toes. Since she didn’t crawl, she also didn’t develop appropriate hip flexion drive and opposing arm/leg coordination. Finally, she didn’t develop adequate spine control since she didn’t experience de-weighting of opposite arm and leg (doesn’t crawling look similar to the bird dog exercise often given for core stabilization?!).<br />
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With injury, there’s opportunity for these movement patterns to be disrupted. But unlike infants, as adults, we are strong enough to push through the movement pattern without noticing the compensations. This is how injuries continue.</div>
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In the video below, I show how having long term core injury (from falling onto my back) disrupts my ability to move from all fours position into a high kneel.</div>
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I had a prior injury on my right side hip/thigh from overuse due to change in mechanics from falling onto my back. Going into a right half kneel position from being on all fours is challenging. Swinging my leg forward feels awkward and not smooth. Poor core and hip stabilization from the fall cause my body to find the stability in my legs. To re-establish core and hip drive, I practiced crawling.<br />
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After practicing crawling, going from all fours to a half kneel improved. This is important for running because my body has to develop proper muscle movement strategy to move from a more stable position to one less stable. This happens with each step of running. </div>
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You should have seen the look on my patient’s face when I was able to explain her lifelong foot, hip and back pain.</div>
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Kinda Deep! If you have questions please email me at info@3-drunner.com or DM on Instagram @3DRunner</div>
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Janet Yiu, PT, DPT, OCS, FAFS</div>
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3DRunner.... Run Free from Injury.</div>
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Janet Yiu</div>
Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com1tag:blogger.com,1999:blog-3011141020454998074.post-38015385445371063332020-02-02T20:45:00.000-08:002020-02-02T20:46:14.190-08:00Maximize Your Muscles<div style="font-family: "Times New Roman"; font-size: 16px; line-height: 1.4; margin-bottom: 6px;">
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Published in the newsletter on 1/2/2020<br />
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Welcome to the 3DRunner team! Please email me if you have any questions!</div>
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I have to say, I already love this year. For those of you who may not know, I LOVE even numbers. The fact that 2020 is even and has "round curves" makes me so happy!</div>
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For 2020, I'll be implementing a new concept (new to me) which I started testing with my clients at the end of 2019. What is this concept? While performing strengthening exercises, think about the muscle action not the movement. What does that mean? Focus on giving the muscles instructions on how to work instead of giving the muscles the end result. It's about the journey, not the destination! You might have noticed in my Instagram videos, I started giving instructions by having you visualize what the muscle does. For example, in bicep curls "Bend your elbows while visualizing the muscle shortening from the front of the elbow to the shoulder. " Traditionally the instruction is put simply as "Bend your elbow."</div>
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What is wrong with just "bending the elbow"?</h5>
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"Bending the elbow" is not giving your muscle activation enough focus. Sure, there is muscle contraction when we "bend our elbow". However, by PROVIDING CLEAR DIRECTIONS OF HOW THE MUSCLES WORK you improve connectivity from your brain to your nerves then to your muscles.</div>
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What do I propose?</h5>
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I want you to tell your muscles how to contract, provide them clear instructions on how to achieve the motion you're after. This enhances your brain connection from the nerve to the muscles by giving it a clear pathway to the muscles. You wouldn't tell a friend to meet you at the mall without a map or specific instructions (having them Google Map it). Think of this as providing your muscles a map. This helps develop proper nerve pathways to train the muscle to perform the movement with greater ease. As the movement gets easier, different variables can change, like speed or increasing weight. While working on this movement really think about how your muscles contract to attain the action you're trying to achieve.</div>
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In the clinic, I often hear therapists and trainers tell patients to squeeze their glutes during a squat. I have witnessed the lackluster results of "squeezing the glutes". Most of the time, the feedback is "I kinda feel it." Simply put, "squeezing the glutes" doesn't give the appropriate signal to the nerves to activate the muscle. What do the glutes do while squatting? As you squat down, the glutes stretch away as the hip bone rolls away from tailbone. To stand, the glutes contract as the hip bone moves back towards the tailbone. Making this connection while engaging the contraction will increase the ability to utilize and engage the proper muscle activation.</div>
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Why is this important?</h5>
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Training your nerves to fire to the muscles is how you will get stronger and improve efficiency muscle recruitment patterns. The muscles can't function without nerves. When you provide instructions to the muscles, you're building bigger and creating more wiring from the brain to your muscles. This will carry over from your strengthening program to your running. The muscles will be able to control the movement vs the movement causing a muscle response. </div>
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TRY IT</h5>
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Stand and squat without thinking about the muscles. Now, squat with the visualization that your glutes are stretching while squatting down and contracting from the hips towards the tailbone as you stand up. You can try the same cues with bicep curls. Do you feel a difference? This can be the difference in achieving your next PR, or avoiding that pesky injury!</div>
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Please email me at info@3-drunner.com or DM on Instagram @3DRunner if you have any questions or suggestions for me.</div>
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Janet Yiu, PT, DPT, OCS, FAFS</div>
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3DRunner.... Run Free from Injury.</div>
Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com1tag:blogger.com,1999:blog-3011141020454998074.post-55740851819844213532020-02-02T20:44:00.000-08:002020-02-02T20:47:13.330-08:00Beyond Clams and Bridges<div class="separator" style="clear: both; text-align: center;">
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Here's the first newsletter sent on 12/18/2019<br />
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For those who don't know me, here's a brief introduction. I graduated from the University of Southern California in 2010 and have been practicing in physical therapy for the past decade, specializing in orthopedics and sports medicine. Running has been a part of my life since high school. During undergrad, I competed for San Jose State University's DI cross country team and became an assistant coach. I still run competitively for Wolfpack Running Club, a local USATF team. </div>
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When I began my PT career, it was obvious that I needed to marry my two passions, physical therapy and running, so I chose to specialize in running injuries. In 2014, I was at the height of an injury sustained from a fall in 2009. Sick and tired of getting "I don't know" from physicians, I went on my own path to find a solution. This resulted in the creation of my blog, 3DRunner, to provide information that I learned along my journey to recovery. At that time, I was finishing a fellowship from the Gray Institute which focuses on assessment and treatment in all 3 planes of movement, hence 3DRunner. Since becoming a mom 2.5 years ago, I have developed my skills in pelvic floor therapy and am able to translate those strategies into faster rehabilitation time for runners.</div>
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I know how frustrating it can be to deal with an injury. With my knowledge as a PT and experience in running, I am able to help guide all runner through any stage of their rehabilitation. </div>
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Enough about me. If you want to learn more about my certifications click <a href="https://el2.convertkit-mail2.com/c/preview/e5uph7h9/aHR0cDovL3d3dy4zLWRydW5uZXIuY29tL2Fib3V0Lmh0bWw=" style="color: #0875c1;" target="_blank">HERE</a>. I'm going to move onto glute strengthening.<br />
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Are you beyond clamshells and Bridges? </h4>
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Glute strength is always #1 on a runner's mind. While clams and bridges are good for strengthening the glutes, they don't translate to running. Being on your side or back, while doing clams and bridges, doesn't stimulate the nervous system enough to make appropriate adaptations. Being on your feet helps to stimulate nerve pathways which work your muscles differently which is more similar to running. Exercises such as clams and bridges target the glutes in isolation. In running, multiple muscles work simultaneously to provide shock absorption, stability and propulsion.</div>
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Here are 3 exercises which focus on your GLUTES functionally for running!</div>
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Knee Hover Leg Slides</h4>
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This strengthens the glutes while the leg is working into extension. Being on your hands with knee hovering position recruits the core stabilizers to work with the glutes.</div>
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Get onto hands and knees (hands under shoulder, knees under hips.) Activate shoulders by visualizing your triceps pulling the arms into the shoulder joint. Next, hover the knees off the ground. Keeping the back and pelvis level, straighten one leg. Reach the foot away from the body as you use the inner thigh to pull the leg into the pelvis. Return to start position. </div>
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Standing Hip Rotations</h4>
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Do your knees roll inward while running? This strengthens the hip rotators to help the knee align forward while running.<br />
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Put a band or use a cable machine around the knee and place that leg behind you. Keep the knee straight but not locked. Put your hand on your hip to feel the bone turning in and out. Engage the hip by by using your inner thigh muscles to pull the leg up into the pelvis.Turn your thigh in and out while keeping the foot stationary.</div>
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Wall Press with Ball</h4>
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If you kick your ankles while running this exercise is for you! The wall press with ball recruits the glutes while the other leg is moving forward.<br />
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Stand next to a wall with your knees bent and a ball (I learn the larger the ball, aka stability ball, the better.) above the knee. Have good stance leg alignment with the foot pushing down (more so the toes) into the ground while the knee is facing forward. Use your inner thigh muscle to engage the hip and pull leg into pelvis. Push the other thigh into the ball. Bring the knee up and down as if you were going through a stride.</div>
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Perform 3 sets of 8-15 repetitions</div>
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Please email me at info@3-drunner.com or DM on Instagram @3DRunner if you have any questions or suggestions for me.</div>
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Janet Yiu, PT, DPT, OCS, FAFS</div>
<div style="font-family: "Times New Roman"; font-size: 16px; line-height: 1.4; margin-bottom: 6px;">
3DRunner.... Run Free from Injury.</div>
Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com1tag:blogger.com,1999:blog-3011141020454998074.post-23567873199506344432019-12-18T10:34:00.002-08:002019-12-18T10:34:50.412-08:003D Runner Update<div style="caret-color: rgb(29, 34, 40); color: #1d2228; font-family: "Helvetica Neue", Helvetica, Arial, sans-serif; font-size: 13px;">
It’s been a while since I’ve written in my blog. </div>
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In the past 2 years, I’ve been focusing on family and running. Juliette is now 2.5 years old, and I’ve ran 3 marathons in 11 months, including Boston.</div>
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As far as physical therapy, I’ve grown and developed a lot over the past 2 years. I've been able to incorporate strategies from pelvic floor and neurologic therapy into sports medicine. </div>
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<span style="background-color: white;"><span style="color: #1d2228; font-family: Helvetica Neue, Helvetica, Arial, sans-serif; font-size: x-small;"><span style="caret-color: rgb(29, 34, 40);">Some of you may know, I’m pretty active on Instagram @3Drunner where a lot of my content lives. To be able to better share information, I’m starting a newsletter. Some of the information from the newsletter will be transferred to this blog, but no guarantees! Sign up <a href="http://www.3-drunner.com/about.html" target="_blank">HERE</a> to received my newsletter. It'll be all content, no spam. Don't miss out!</span></span></span></div>
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<span style="background-color: white; caret-color: rgb(29, 34, 40); color: #1d2228; font-family: "Helvetica Neue", Helvetica, Arial, sans-serif; font-size: 13px;">I hope to communicate more with all of you!</span><div class="I_52qC D_FY W_6D6F" data-test-id="message-view-body" style="background-color: white; caret-color: rgb(29, 34, 40); color: #1d2228; display: table; font-family: YahooSans, "Helvetica Neue", "Segoe UI", Helvetica, Arial, "Lucida Grande", sans-serif; font-size: 13px; width: 681.375px;">
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Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com2tag:blogger.com,1999:blog-3011141020454998074.post-6756466271656403542017-08-31T15:25:00.001-07:002017-09-05T15:47:36.754-07:00Tightness of the Upper Spine and Running PerformanceGood mobility through our thoracic spine (upper back) is vital for good spine health. However, the thoracic spine is inherently stiff due to bony anatomy of the spine itself. The ribs, which serves to protect our heart and lungs, also limit thoracic spine mobility. Poor posture and prolong sitting are the typical causes of tightness in the thoracic spine. In my case (and all moms), the increase demand of caring for JuJu has significantly increase the stiffness of my thoracic spine extremely.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPahhaxGDWXfagIjspmIEvLsdJu-4ANr-Uh4Ns8wkisoRuDmL4Jl51UpfLiHApp61wXUPAqD0OwAediVVR-kpsWgoyFPBj1fqH8xMUSMNu8DZjT8c1PNPuyq440NMJP8fQppCokKUienk/s1600/IMG_6842.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1200" data-original-width="1600" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPahhaxGDWXfagIjspmIEvLsdJu-4ANr-Uh4Ns8wkisoRuDmL4Jl51UpfLiHApp61wXUPAqD0OwAediVVR-kpsWgoyFPBj1fqH8xMUSMNu8DZjT8c1PNPuyq440NMJP8fQppCokKUienk/s400/IMG_6842.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">My upper back flexed to play with JuJu.</td></tr>
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What does it mean?</h4>
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Stiffness in the thoracic spine can cause low back, neck and shoulder pain. Limited motion in the thoracic spine forces the adjacent joints to compensate. These joints move more in order to make up for the lack of motion. This can lead to numerous injuries ( we can save this for another post). <br />
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In runners, a tight thoracic spine can hinder taking a proper breath and loading the core.<br />
Typically the thoracic spine is stuck in a forward position ( mostly form sitting all day) which limits the body from sitting in a proper upright posture. Proper posture allows the body to take a full inhalation. Try sitting slouched and taking a deep breathe. Now, sit up straight and take a deep breathe. Notice the difference between the two. Being in a slouched position while running will limit your ability to inhale which hinders performance.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjB2Bz87OPj_vKPj3kMyE4JRjkJHVQbwurRBBlEt18cMCeRxswBJbbR7DF1Rwx-viKJwsZtdcmhn2qKaVpa2Mo7jnNqH94aX0_SUxvAbWklnNTwX9ugjCFOk4KbMSrckUMVjboF5_wU1D0/s1600/E93EC638-D8C2-41B9-870E-818C0351B655.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1600" data-original-width="1600" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjB2Bz87OPj_vKPj3kMyE4JRjkJHVQbwurRBBlEt18cMCeRxswBJbbR7DF1Rwx-viKJwsZtdcmhn2qKaVpa2Mo7jnNqH94aX0_SUxvAbWklnNTwX9ugjCFOk4KbMSrckUMVjboF5_wU1D0/s400/E93EC638-D8C2-41B9-870E-818C0351B655.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">L: Pre mobilizations in below video- It was more difficult turning with my upper back. More of my sports bra can be seen. It's also harder to turn my neck. R: Post mobilizations in below video- There is improve mobility in the thoracic spine. My spine is turned making it more difficult to see the back of my sports bra. It is also easier to turn my head.<br />
***BONUS- Look at my left foot. In the left picture it is more flat. In the right picture there is a greater arch. Being able to rotate through the spine helps to transmit forces into the foot to support the arch. </td></tr>
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Having proper rotational mobility also helps to load the core. The arm swings backwards as the leg drives forward. A rotational stretch is then placed on the core. This stretch helps to provide energy to the opposite leg to help drive it forward. When the core is not properly loaded, it places an extra rotational stress to the low back leading to pain. Poor loading of the core can also lead to improper running mechanics contributing to different injuries throughout the body.<br />
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The Science</h4>
The spine has motions which are coupled. When the spine is straight, side bending one direction will cause a rotation to the same side ( Type 2 motion). When the spine is extended, side bending one direction will cause a rotation to the opposite side (Type 1). These movements are hardly noticeable but necessary for proper mechanics. In running type 2 motion occurs. When you are landing on your left leg, gravity pushes down on the right shoulder. This will cause your head to be tilted. To get your head pointed straight, your body will have a slight lean to the left. Side note-When the glutes are weak causing an extreme pelvic drop, the spine has to excessively lean to compensate which leads to injury.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjhkUrMK9q4PTX267aU_s-RFTg0Zx1UfuUlU0RcXUBLKQIHtkPttDAoNj4FTaxi74nsfFQPoLFDv_PyTV5OnZuCs0vah_Ctq4rjqqcOUUrJZ9Bfbb9wbCPEv02Rf5vZTCHWxPpBEakssaU/s1600/IMG_8548.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1600" data-original-width="1600" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjhkUrMK9q4PTX267aU_s-RFTg0Zx1UfuUlU0RcXUBLKQIHtkPttDAoNj4FTaxi74nsfFQPoLFDv_PyTV5OnZuCs0vah_Ctq4rjqqcOUUrJZ9Bfbb9wbCPEv02Rf5vZTCHWxPpBEakssaU/s320/IMG_8548.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">When gravity pushes on the R shoulder <br />
L: Shows the spine without a lean<br />
R: Shows the spine with a lean </td></tr>
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At the same time, the right arm swings forward to generate a left rotation. The left lean of the spine and the right arm drive to the left causes a type 2 motion of the spine. Where you place your legs is also important. Mobilizations in a staggered stance verses a squat stance most replicates how the body is moving while running. When the right leg is forward, the right arm swings backwards while the left arm swings forward. The arms are used to drive rotation in the thoracic spine.<br />
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Mobilization</h4>
One of the exercises to loosen up the thoracic spine is to foam roll. However, this only mobilizes the joint in one dimension. Imagine a drawer which is stuck. Do you keep pulling it straight out or do you wiggle it all directions until the drawer opens. I don't know about you but the later has worked for me.<br />
At 3DRunner we're going to mobilize the thoracic spine functionally in all 3 planes of motion.<br />
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Since the arm swing generates a rotation in the spine I decided to check rotational range of motion.<br />
As you can see with my left hip forward, I have slightly less rotation. After the mobilizations, my spine has increase mobility.<br />
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Type 2 motion Stand with the right leg forward and left arm next to your ear. Use your right arm to swing backwards. The backwards arm swing will gently mobilize your spine. Try swinging at different angles. Keep the same posture, right arm slightly behind, reach left arm upward towards the ceiling.<br />
Type 1 motion Stand with the left leg forward and left arm next to your ear. Use your right arm to reach forward. With this mobilization, it is more effective to reach as oppose to swing. Reach at different angles. Keep the same posture, right arm forward, reach left arm upwards towards the ceiling<br />
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Perform 10-20 of each then switch sides ( right leg forward, right arm next to ear and left leg forward. right arm next to ear)<br />
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Mobilizations for the thoracic spine will improve your posture resulting in better core recruitment and breathing to enhance running performance. Improve mobility will promote proper running mechanics to decrease injuries.<br />
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<span style="background-color: #bd081c; background-position: 3px 50%; background-repeat: no-repeat no-repeat; background-size: 14px 14px; border-bottom-left-radius: 2px; border-bottom-right-radius: 2px; border-top-left-radius: 2px; border-top-right-radius: 2px; border: none; color: white; cursor: pointer; display: none; font-family: "helvetica neue" , "helvetica" , sans-serif; font-size: 11px; font-style: normal; font-weight: bold; line-height: 20px; opacity: 1; padding: 0px 4px 0px 0px; position: absolute; text-align: center; text-indent: 20px; width: auto; z-index: 8675309;">Save</span><span style="background-color: #bd081c; background-position: 3px 50%; background-repeat: no-repeat no-repeat; background-size: 14px 14px; border-bottom-left-radius: 2px; border-bottom-right-radius: 2px; border-top-left-radius: 2px; border-top-right-radius: 2px; border: none; color: white; cursor: pointer; display: none; font-family: "helvetica neue" , "helvetica" , sans-serif; font-size: 11px; font-style: normal; font-weight: bold; line-height: 20px; opacity: 1; padding: 0px 4px 0px 0px; position: absolute; text-align: center; text-indent: 20px; width: auto; z-index: 8675309;">Save</span>Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com10tag:blogger.com,1999:blog-3011141020454998074.post-53725457671644219692017-08-26T15:58:00.001-07:002017-09-05T15:48:00.757-07:00Improving Hip Mobility using StrengthStretching is overrated! There I said it!<br />
Stretching helps to improve muscle length but most runners are looking to loosen up muscles by helping muscle fibers glide better. This is accomplished through rolling. If you are generally a stiff person by all means, stretch. BUT, if you're an athlete or a runner who had a muscle or a joint suddenly tighten up on you, you can probably benefit from strengthening. Strengthening will provide stability to the region which allow the muscles and connective tissue to relax.<br />
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In the past several days I noticed my right hip is acting up again only when I carry JuJu (14lbs) in her Ergobaby. Mostly, my hip feels sore and stiff. I figure once I return to a consistent core workout routine the hip tightness will go away. Side note- I have a tendency to skip my core exercises as my run milage goes up. The next day while I was rocking JuJu to sleep, I notice my right hip wasn't moving. My right hip felt stuck when I moved side to side with my feet turned out.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEibtcPlGIGdvm100UUZNptOn-isQDbg3cb-8ZpBg-gcxSjz8jDCxDPlQmCkOwhyphenhyphenrnCWytZE54dsZR5LPy9M5pFTfFl3tDDdCB8I2VuTw2VMaQI6ET7XT56QFOOEHq140N2wdGDGIdt409w/s1600/IMG_6616.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1200" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEibtcPlGIGdvm100UUZNptOn-isQDbg3cb-8ZpBg-gcxSjz8jDCxDPlQmCkOwhyphenhyphenrnCWytZE54dsZR5LPy9M5pFTfFl3tDDdCB8I2VuTw2VMaQI6ET7XT56QFOOEHq140N2wdGDGIdt409w/s400/IMG_6616.jpg" width="300" /></a></div>
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Why it's important for running?</h4>
When the leg lands on the ground a load is place upon it. Your body weight shifts slightly over that leg and rotates over it. The rotation in the hip is internal rotation. Ok, so why is external rotation important? External rotation is needed to internally rotate. Put your hand on a table and lift one finger up and let it hit the table. Now, use the other hand to lift one finger and let it hit the table. Notice the difference in power. The opposite motion in needed to generate power in the direction you want.<br />
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Stability is a key factor in how loose or tight a joint or muscle is. Strong muscles provide stability to joints and surrounding tissue. Weak or inhibited muscles do not provide enough stability to the region and the body will reflexively tighten to provide stability.</div>
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In my case, external rotation was limited which most people would stretch. Since I want to strengthen my muscles I decided perform strengthening in the opposite direction of the limitation, internal rotation. The improve mobility may be an affect of autogenic inhibition. Autogenic inhibition is when the sensors in a muscle are activated during a high stress load to shut down the muscle. It is a protective mechanism to avoid tearing a muscle. In my case, activating the muscle will trigger it's relaxation. Strengthening in the opposite direction helps re-train proprioceptors of the muscles to work in a greater range of motion allowing for improve stability.</div>
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<h4>
Exercises</h4>
Here are a few exercises I performed accentuating internal rotation of the hip. The end of the video shows my hip mobility post exercises. The above video ( purple tank) was filmed earlier in the day. There is a big change in right hip range of motion.<br />
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Forward lunges with rotation - Lunge forward and use your arms to rotate the body towards the front leg. This places the front hip in internal rotation.<br />
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Side lunges with internal rotation - Perform a lateral lunge with foot pointed in. This will also create an internal rotation at the hip. For greater internal rotation, reach your arms toward the leg.<br />
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Cross body lunge - As you lunge forward turn your hips inward. This will create an internal rotate of both hips. This is the best exercise for runners as it most replicates what the hips do in running.<br />
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Perform 2-3 sets of 8-10 reps<br />
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So when you feel like your muscles are tight and stretching isn't helping, try performing strengthening exercises. Stretching is a short term solution to a long term problem. Strengthening is a key component to keep muscles relaxed.Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com4tag:blogger.com,1999:blog-3011141020454998074.post-16355818555282836642017-08-22T08:49:00.000-07:002017-08-22T08:49:08.091-07:00Transverse Abdominals- The Real Core<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: 12pt;">Returning to running after pregnancy has been an amazing journey. Due to a previous back injury, which was just resolved in 2016, I was nervous and anxious about returning to running postpartum. To my delight, re-gaining my fitness has been relatively straight forward ( as much as it can be with a newborn). A large part of my success has to do with making sure I did my core stability exercise. No, I'm not talking about planks, crunches, Russian twists, etc. I'm talking about real core stability, the transverse abdominals (TrA). I know, I always mention the TrA but these muscles literally held me together. </span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: 12pt;">Core stability is important to provide a stable center for the legs to move. There are a lot of core exercises, however the muscles which provide stability can be easily compensated for by other stronger abdominal muscles. The muscles which help provide core stability is the transverse abdominal muscles. They are the deepest layer of the abdominal muscles. When these muscles are engaged it provides a stable core allowing proper mechanics of the legs. People have a tendency to contract all of their abdominals too hard, over shooting the TrA. Contraction of the TrA requires a gentle squeezing of the musculature of the lower abs. Also, we think of abs as one unit, these muscles function separately left and right. So one side can be weaker then the other side. </span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEirWyuIafc4DoEXqJprZytNaYlzfx7ei3mqgqHOL6jD5gbvwgETGFM3ZLuRlCpv7028cu0-5VyGhJLze3wYO336VgkVYNb3_MO82HfUBxriBAFpYcr8j1pLhKWzAVkH77H2HGgSQf-wGpQ/s1600/IMG_3390.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1600" data-original-width="1374" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEirWyuIafc4DoEXqJprZytNaYlzfx7ei3mqgqHOL6jD5gbvwgETGFM3ZLuRlCpv7028cu0-5VyGhJLze3wYO336VgkVYNb3_MO82HfUBxriBAFpYcr8j1pLhKWzAVkH77H2HGgSQf-wGpQ/s400/IMG_3390.jpg" width="342" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">One of my 1st runs with the stroller... Want a workout?!</td></tr>
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: 12pt;"><span style="font-family: "arial" , "helvetica" , sans-serif;">I incorporated these exercises while pregnant to maintain my core strength and minimize diastasis rectus. I was able to resumed these exercises within 3 days post partum (consult with your physician post c-section). I was able to return to running 1 month post partum. </span>The best news of all, I didn't have the dreaded diastasis rectus. <span style="font-family: "helveticaneue"; font-size: 12pt;"></span></span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: 12pt;"><span style="font-family: "arial" , "helvetica" , sans-serif;">Here are the basic exercise to engage the transverse abdominals. I know where are the 3D exercises? There is a time for 3D functional exercises. To activate the TrA will allow the 3D exercises to work better. </span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhAHwYRxa2wTbmvDgweVc4Y-7B3yzzx-edATroM2yoPxSeCHENT4lXQ2JjVeeZ1yvg2Qkd7YQWmVF_2xa1_tFGm7nBNuSiRmXdwtX-C5CZIEuHIDrutyYdfLS228Ka_t6UQLCHI_6q5YOw/s1600/IMG_7826.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1600" data-original-width="1200" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhAHwYRxa2wTbmvDgweVc4Y-7B3yzzx-edATroM2yoPxSeCHENT4lXQ2JjVeeZ1yvg2Qkd7YQWmVF_2xa1_tFGm7nBNuSiRmXdwtX-C5CZIEuHIDrutyYdfLS228Ka_t6UQLCHI_6q5YOw/s400/IMG_7826.JPG" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Feel the TrA on the inside of the pelvic bone</td></tr>
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: 12pt;">To best place to feel the transverse abdominals contraction is right to the inside of the pelvic bones at the bony marker called anterior superior iliac spine (ASIS). To contract the TrA imagine those bones coming together. Another cue is to pretend to put on a pair of pants that are just slightly too small. </span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: 12pt;">Exercises</span></span></h4>
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: 12pt;"><span style="font-family: "arial" , "helvetica" , sans-serif; font-size: 12pt;"><span style="font-family: "arial" , "helvetica" , sans-serif;">Marches - Lay on your back with knees bent. Tighten your TrA. Lift one leg up while keeping your abs contracted. Return to resting position and switch sides. Key is to not let pelvis down towards ground. 3 sets of 10.</span></span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: 12pt;"><span style="font-family: "arial" , "helvetica" , sans-serif;">Fall outs - Lay on your back with knees bent. Tighten your TrA. Let one knee fall to the side, then return to neutral. Alternate legs. perform 3 sets of 10.</span><span style="font-family: "helveticaneue"; font-size: 12pt;"> </span></span></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="font-family: "helveticaneue"; font-size: 12pt;"><br /></span></span></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="font-family: "helveticaneue"; font-size: 12pt;">Bridges - Lay on your back with knees bent. Tighten your lower abs. Weight shifted towards the forefoot ( heels rem</span></span><span style="font-family: "helveticaneue"; font-size: 12pt;">ain on the ground) Lift pelvis o</span><span style="font-family: "helveticaneue"; font-size: 12pt;">ff </span><span style="font-family: "helveticaneue"; font-size: 12pt;">the ground. Hold 10 seconds perform 10- 15 times.</span></span></span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: 12pt;"><span style="font-family: "arial" , "helvetica" , sans-serif;">Heel slides - Lay on your back with knees bent. Tighten your lower abs. Slide one leg straight
and return to neutral. Alternate legs. 1-2 sets of 15. Start with sliding your heel on the ground
then progress to keeping the leg up. </span></span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: 12pt;"><span style="font-family: "arial" , "helvetica" , sans-serif;">Performing exercises with intent and control will lay the foundation for proper mechanics while running. Good activation of theTrA muscles will minimize injury for not only your back but also your legs.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Let's get the transverse abdominals activated!</span><br />
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</span>Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com2tag:blogger.com,1999:blog-3011141020454998074.post-67978638428833133592017-07-26T21:01:00.001-07:002017-07-27T06:25:37.574-07:00Return to Running After Injury and Pregnancy<br />
In 2016, I went from running 1 mile with pain to running 13 miles without pain.<br />
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The past 2 years have taught me a lot about running, injuries, and recovery. Like many of my fellow runners I was plagued with a chronic injury preventing me from peak training and performance. My most recent injury was traumatic, and it took me 6 years to recover. Years of seeing physicians, getting injections, exercises didn't help.<br />
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A little background... In August 2009, I slipped and fell on my back. Like most runners, I continued to run despite having pain in my right side sacrum (tailbone). I remember running on the Great Highway and thinking "ouch", some times out loud, each time I stepped on a patch of sand that had washed onto the path. I decided to change my form so my sacrum wouldn't hurt so much, and it worked for a very short period of time. About 2 months of pain free running into my training I suddenly started having what I call "dead quad' syndrome. My right side quadriceps felt like a brick. From there I had countless MRIs, x-rays, injections, chiropractic work, physical therapy unfortunately none of it helped. Flash forward to 2015. I started seeing an osteopath for prolotherapy with mixed results. One day he decided to check my glute strength in a way I never have seen. While on my stomach, with a towel roll under my ankle, I had to straighten my knee using my glute, and I couldn't do it on my right side. I had been performing clams, leg lifts, bridges...the typical glute strengthening exercises. It was at that point I realized I wasn't weak; I had trained my body to not use my glute muscles.<br />
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Once injured, we all want to resume our normal running routine as quickly as possible. Then we end up with injury after injury. I was one of those runners who felt fully recovered from my injury and returned to my "normal" running routine. However, my injury would just return in a matter of weeks sometimes only days. This was not good for the body (or the wallet with countless race entries that went unused). An injury, chronic or acute, changes our movement pattern, which in turn stresses our muscles differently. This quickly leads to imbalances and overuse injuries. Starting slow and focusing on form will help the body relearn the appropriate movement patterns, thus reducing the chance of re-injury.<br />
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In 2016, I decided to start at square one. This was a huge investment of time into my physical and mental health. At the beginning I always wanted to run more than the 1 or 2 miles I limited myself to. However, by the end of my program, I felt the best I ever had. The discipline was worth it! I even ran several cross country races, continued running during my pregnancy, and was able to quickly return to running post-partum.<br />
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<tr><td class="tr-caption" style="text-align: center;">Cross country race in San Francisco</td></tr>
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<h4>
My Plan</h4>
January:<br />
- Run 2 miles 6 days a week.<br />
- Pick a pace 1 minute slower than comfort level for a 5 mile run.<br />
- Focus on FORM.<br />
- 1st week, no faster then 9 minute mile pain.<br />
- 2nd week, no faster then 8:40<br />
- 3rd week, no faster then 8:20.<br />
- 4th week, I was able to run at 8 min mile pace.<br />
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February:<br />
- Up mileage to 3 miles 6 days per week but slow pace down to 9 min miles<br />
- Followed the progression above with adjusted times<br />
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April:<br />
- I was able to transition to a more traditional running program.<br />
- One long run, 3 easy runs and 2 challenging runs ranging from 4-6 miles. <br />
- I increased my long run by 1 mile every week ( with a month vacation in June) so by September I was running 13 miles.<br />
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During this time frame I felt the best that I ever have! Even running in college I had a lot of aches and pains running that distance.<br />
The fitness gained from the first 9 months of 2016 set me up to be able to run 8 of the 9 months of my pregnancy.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjYoXaJUcDnm9LZjwssjmU6dOYPG9V9_Kzhv1Ek4BVpjMSbzyyACkbM09pdNGx_Z8L_pbXb165DHjGUrhYQQbnq6BJFjEHC6_4hewp11SwseIheWVyQBbRaxuv2ELEPKDu0rVF7z5Wlfbg/s1600/IMG_2198.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1600" data-original-width="1600" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjYoXaJUcDnm9LZjwssjmU6dOYPG9V9_Kzhv1Ek4BVpjMSbzyyACkbM09pdNGx_Z8L_pbXb165DHjGUrhYQQbnq6BJFjEHC6_4hewp11SwseIheWVyQBbRaxuv2ELEPKDu0rVF7z5Wlfbg/s320/IMG_2198.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Running at 8 month. I could not avoid heel striking!</td></tr>
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<h4>
Post Partum </h4>
Month 1- I'm not going to lie. When I started walking 3 days post-partum, it was HARD. My neighborhood has slight inclines ( ~2-3%) and my legs were tired walking "uphill" and shaking when going "downhill". I kept my plan. Walk for the 1st month. There was no minimum. Just get out and walk what I felt like.<br />
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Month 2- I was released to run at 4 weeks post-partum. My goal was to run every day of June. I start running 1 mile for 10 days, then 2 miles for 10 days finally 3 miles. Then I transitioned to a traditional training program. My goal was to run in a race by the end of July ( 7 weeks of training). That first mile was a challenge. I was sore. But my focus was on my FORM. After about 4 days, my soreness went away and the runs felt good.<br />
Then came 2 miles. I thought it was going to be painful but to my surprise my 2 mile pace was faster then my 1 mile pace. Running 2 miles felt great. I felt my body get stronger and there was better control of my body. I was even able to join my team mate part of her easy runs.<br />
Last, I had 3 mile runs planned for the final 10 days June. There were certain days that I had to slow down to focus more on form. It was most likely the days which the baby was up during the night crying. I adjusted my workout to make sure I was able to maintain my form at the pace I was running.<br />
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Month 3 - Over the next 20 days or so I ran 3-5 miles a day making sure I didn't increase my mileage too rapidly.<br />
The week before the race I was able to comfortably run 5 miles in 8:30 pace. So I set a goal of running the 6 mile course in under 50 minutes.<br />
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<h4>
Race Day</h4>
It was a long night with the baby the night before the race. My plan was to start slow so I can focus on my form and allow my muscles warm up. I gradually picked up the pace. With the help of a couple of ladies who I coached while they were in college I was able to push my last 2.5 miles. A couple days shy of 12 weeks post partum, I finished 6 miles in 48 minutes! My time was 2 minutes faster then my goal time. I also negative split the race ( 8:10, 8:07, 7:59, 7:55, 7:47, 7:28). My body wasn't sore. But, it's better to test my body then to go all out with the possibility of being so sore I couldn't run for a few days.<br />
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<tr><td class="tr-caption" style="text-align: center;">Post race sweaty cuddles<br />
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What I learned was a slow return to running with a focus on form was the best way to recover from an injury. All the times of jumping back into a running" once I felt better" made it so my recovery was longer. It took months of slow, controlled running to get back on track. I wish I knew this years ago!<br />
Please let me know your thoughts on recovering from an injury and return to running.<br />
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Stay tuned. Next blog post is on the core exercises.<br />
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Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com3tag:blogger.com,1999:blog-3011141020454998074.post-31677008440630358832017-06-13T07:59:00.001-07:002017-06-13T11:06:51.551-07:00My Running Analysis<div style="color: #26282a; line-height: normal;">
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<span style="font-kerning: none;">I'm back! Some of you who have been reading my blog may have noticed I took a hiatus. Well, I now have a little to take care of. She is 6 weeks old today. </span></div>
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<span style="font-kerning: none;">I was feeling feeling miserable towards the end of the 1st trimester but able to resume running in the beginning of the 2nd trimester. I ran until I was 7 months pregnant. Then I decided it was time for my body to transition to walking. I resumed running at 4 weeks postpartum . For the most part, I feel pretty good. However, there is a bit of nagging foot pain on my right side. I decided to do my own running analysis. </span></div>
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<span style="font-kerning: none;">Like I suspected, the angle that my right foot contacts the ground is much steeper, 20 degrees vs 12 degrees, then my left (Bottom photos). The steep angle suggests a decrease in surface area that my foot has to dissipates force when it hits the ground. This causes increase stress to the structures on the outside of my foot. If left unattended, it can eventually lead to inner foot pain due to the larger distance my big toe has to reach the ground. </span></div>
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Why is My Foot Doing That?</h3>
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<span style="font-kerning: none;">During swing phase my right foot turns out more that my left (top photos, a little confusing but the "right" and "left" is for stance leg). This is a sign that I circumduct or "circle" my foot as I swing my foot from back to front. The foot naturally turns up to make sure the big toe clears the ground when the foot makes contact. </span></div>
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<span style="font-kerning: none;">Circumduction occurs due to an improper push off from the ground. This is a result of ... WEAK GLUTES. When the glutes are strong the muscles function to control extension of the femur as the leg pushes back. However, when the muscles are weak, the femurs not properly controlled by the glutes. Due to gravity and weight of the leg, the foot turned outward.</span></div>
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Treatment</h3>
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<span style="font-kerning: none;">The best way improve form is to focus on proper muscle recruitment. I don't see this as changing my form. I see as training my body to use the appropriate use muscles. </span><br />
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<span style="font-kerning: none;">Stand tall and lean forward from the pelvis from both sides. You would be surprised at how different each side can be. Then "cycle" the knees. I use the cue "push the knee back" as it contacts the ground. Don't worry, your knee will never fully straighten. Using the "push the knee back" cue will force the femur to extend straight back. Having the appropriate posture will allow your body to be in proper alignment to use the gluteal muscles. If you were to stand up without a forward lean, you will most likely feel your quadriceps when you "push the knees back" cue. </span><br />
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<span style="font-kerning: none;"></span>In latter part of the video, you can see in the "normal form" my body is behind my pelvis and I land with a heel contact. This leads to instability of my core and lack of control of my lower extremities. In the "cycling knees", my body is over my pelvis and I land with a mid foot contact. There is improve core stability and control of my legs ( and no pain in my foot) Now, I have to be able to maintain muscle recruitment through my run. Research shows initially the muscles will be activated for 20-30 seconds before fatigue onset (muscle and nervous system). I remind myself every few minutes to stand up straight, push my pelvis forward and cycle my knees.<br />
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The above pictures shows a change in angle after cycling the knees using the "push the knees back" cue. The angle of the right foot during swing went from 17 degrees to 10 degrees ( and left leg 8 degrees). The angle of the foot during initial contact with the ground went from 20 degrees to 8 degrees (left leg 12 degrees). There is a 2 degree range<br />
in the different positions that I measured.<br />
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<span style="font-kerning: none;">Please let me know what you think. </span></div>
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<span style="font-kerning: none;">With these techniques, during 2016 I went from running a mile with pain to being able to run 13 miles without pain in 6 months.</span></div>
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<tr><td class="tr-caption" style="text-align: center;">Here's baby JuJu ( 5 weeks 6 days) and I post videoing</td></tr>
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Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com1tag:blogger.com,1999:blog-3011141020454998074.post-80518470540845752962017-01-07T07:12:00.000-08:002017-06-12T12:02:20.539-07:00Properly Performing Squats to Recruit Glutes<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; line-height: normal;">
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<span style="-webkit-font-kerning: none; font-family: inherit;">Gluteal activation seems to still be a mystery. There are new terms like “Dormant butt” syndrome or “Dead butt” syndrome, but the problem is still the same. Our butts aren't working! We perform strengthening exercises but the strength doesn’t translate to running. </span></div>
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<span style="font-family: inherit; font-kerning: none;">Over the past year, I have been researching the best way to get the glutes recruited while exercising and running (also cycling). </span></div>
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<span style="font-family: inherit; font-kerning: none;">The first thing I look at in my patients is “Can they isolate their glutes independently?”. This is important because when the foot makes contact with the ground, the glute contracts. Meanwhile, the other glute relaxes to allow the swing leg to move through the air. If the gluteals do not function independently, our body will allow the leg to swing and the stance gluteal will not contract. This is the basis of why we don’t recover from a gluteal strength based injury.</span></div>
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<span style="font-family: inherit; font-kerning: none;">My first exercise seems easy, but requires a lot of focus. It lets me know if my client is able to independently contract the glute and if there is a difference in contraction between the sides. This exercise is a prone single leg glute set.</span></div>
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<span style="font-family: inherit; font-kerning: none;">Lay on your stomach with a foam roller under the ankle. On one side straighten the knee then contract the glute muscle ONLY on that side. Hold it for 10 seconds. Now try the other side. Is there one side that is harder then the other? There usually is! Perform this exercise 10 times each ( no matter which side is weaker) 10 seconds 2-3 times a day. If you don’t have a foam roller, a rolled towel can be used. To make this more challenging put 2-5 lbs ankle weights behind the knee or use a theraband and use the opposite knee to anchor the band.</span></div>
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<span style="font-family: inherit;"><span style="font-kerning: none;"></span>My next exercise is bridges. People commonly dig their heels into the ground when they lift up to bridge. This engages the hamstrings. Usually my older patients get hamstring cramps when bridging up. To focus on the glutes, shift the weight into the forefoot as you lift your pelvis up. Perform this exercise with a 10 second hold 10 times. To advance rest ankle weights (or text books) across the abs. To further advance, perform a single leg bridge.</span><br />
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<span style="font-family: inherit; font-kerning: none;">What about the squat? The squat is a basic exercise to strengthen the legs and glutes. We SHOULD feel the exercise in our glutes since they are typically weaker then the quadriceps. However, when I ask my clients which muscles do they feel when squatting, they say quadriceps. I often have to cue my patients to squeeze their glutes. The quadricep are much stronger then the gluteals, so why is the work felt in the quads? I would like to argue it's mechanics and body positioning. </span></div>
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<span style="font-family: inherit; font-kerning: none;">The ready position in most sports, such as football, volleyball, tennis, involve being a squat position with weight shifted onto the forefoot. The legs can spring off the forefoot and push forward. With the foot fixed on the ground on the body in a forward lean position, the gluteals are forced contract to extend the leg.</span></div>
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<span style="font-family: inherit; font-kerning: none;">My believe is squat form changed to compensate for preventing our knees from going over our toes. The easy fix is simply instructing people to sit back in the heels. This simple cue to save our knees in the short-term, may have doomed our butts. By shifting our weight into the heels we end up engaging the thighs, the quads and hamstrings. I started performing squats with my weight shifted into my forefoot while keeping my knees behind my toes. As I stand, my focus is to straighten the knee. Voila! I feel my glutes engage NOT my quadriceps.</span><br />
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<span style="font-kerning: none;">For the past several months, I have been re-cuing my clients and patients to squat and lunge with their weight shifted forward and straightening their knee to stand up. They have been able to recover from their injuries faster. </span></span></div>
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<span style="font-family: inherit;">By using the cues to shift weight into the forefoot and focus on knee straightening to stand up, the gluteals will be better isolated. To add a variation I use these cues for a lunge matrix and single leg squat as well as jumping drills. By keeping these cues in mind, you'll be able to recruit the glutes and keep running!</span><br />
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<span style="font-family: inherit;">Side note: If shifting weight towards the forefoot to recruit the glutes work, does this make an argument for forefoot (or mid foot) running?</span><br />
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Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com6tag:blogger.com,1999:blog-3011141020454998074.post-75918740567606365692016-11-24T20:23:00.000-08:002016-11-24T20:23:03.273-08:00Mizuno Wave Rider 20 Review<img src="https://www.findyourinfluence.com/trackrun.aspx?tcode=MTgwODItV2F2ZVJpZGVyLTY1OTctQy0x" style="margin: 0px; padding: 0px;" />
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<span style="-webkit-font-kerning: none;"><span style="font-family: "verdana" , sans-serif;">The Mizuno Wave Rider was my training shoe of choice for years while racing in college and post collegiately. When I heard the Wave Riders were getting a complete makeover, I was so excited to check them out. As a Fitfluential ambassador, I got the opportunity to review the new Wave Rider 20. </span></span></div>
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<span style="font-kerning: none;"><span style="font-family: "verdana" , sans-serif;">Running shoe companies like Mizuno have continuously evolved their running shoes as new technology is developed, and this newest iteration of the Wave Rider is no different. The Wave Rider showcases their </span></span><span style="-webkit-text-stroke-width: initial; font-family: "verdana" , sans-serif;">new Cloudwave Geometry, a new midsole and updated mesh.</span></div>
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<span style="font-kerning: none;"><span style="font-family: "verdana" , sans-serif;">Although the Wave Rider is categorized as a "neutral" or "cushioning" shoe, the Rider provides a level of ground response that makes these shoes feel more alive when running, and enough support which kept my foot on an even keel after stepping on a rut on the road or a rock on the trail. This does not mean that the shoe lacks cushioning; The legs rolled on and the miles kept accumulating without excessive fatigue associated with shoes that have gone thin. It is not a stretch to say the feel of this shoe is attributed to the new Cloudwave Geometry, it certainly did not make it worse. </span></span></div>
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<span style="font-kerning: none;"><span style="font-family: "verdana" , sans-serif;">The fit is amazing! Through long runs the Wave Rider feels snug without rubbing my feet. The tongue stays up providing a nice padding for the front of the ankle through rolling hills. </span></span></div>
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<span style="font-kerning: none;"><span style="font-family: "verdana" , sans-serif;">The only real critique is that while the shoe is responsive, the Rider has a heel bias typical with shoes of this type. During fast interval runs or runs trying to maintain mid-foot strike, this shoe can feel cumbersome, even tiring.</span></span></div>
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<span style="-webkit-font-kerning: none;"><span style="font-family: "verdana" , sans-serif;"><span style="-webkit-text-stroke-width: initial;">Overall, they provide great support and </span>cushioning for most of my running up to fast tempo runs.<span style="-webkit-text-stroke-width: initial;"> </span></span></span></div>
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<span style="-webkit-font-kerning: none;"><span style="font-family: "verdana" , sans-serif; font-size: x-small;">Note: I received these shoes for a review at a small fee.</span></span></div>
<span style="-webkit-font-smoothing: antialiased; background-color: #bd081c; background-image: url(data:image/svg+xml; background-position: 3px 50%; background-repeat: no-repeat no-repeat; background-size: 14px; border-bottom-left-radius: 2px; border-bottom-right-radius: 2px; border-top-left-radius: 2px; border-top-right-radius: 2px; border: none; color: white; cursor: pointer; display: none; font-family: 'Helvetica Neue', Helvetica, sans-serif; font-size: 11px; font-style: normal; font-variant-caps: normal; font-weight: bold; line-height: 20px; opacity: 1; padding: 0px 4px 0px 0px; position: absolute; text-align: center; text-indent: 20px; width: auto; z-index: 8675309;">Save</span><span style="-webkit-font-smoothing: antialiased; background-color: #bd081c; background-image: url(data:image/svg+xml; background-position: 3px 50%; background-repeat: no-repeat no-repeat; background-size: 14px; border-bottom-left-radius: 2px; border-bottom-right-radius: 2px; border-top-left-radius: 2px; border-top-right-radius: 2px; border: none; color: white; cursor: pointer; display: none; font-family: 'Helvetica Neue', Helvetica, sans-serif; font-size: 11px; font-style: normal; font-variant-caps: normal; font-weight: bold; line-height: 20px; opacity: 1; padding: 0px 4px 0px 0px; position: absolute; text-align: center; text-indent: 20px; width: auto; z-index: 8675309;">Save</span>Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com2tag:blogger.com,1999:blog-3011141020454998074.post-17338022578191651672016-06-29T21:44:00.002-07:002016-06-29T21:45:26.809-07:00Hydration and Performance Gels/DrinksAs the weather is getting warmer as summer begins. The key to a successful long run or race is good hydration and sports performance gels/chews. This is especially true for long distance runners. Since returning from the Western States 100, I thought it is a perfect time to discuss this topic. I started running in an era that sports gels and hydration packs were just blossoming, so it has been a learning experience over the years. I remember when Power Bar came out with Power Gel and tested it at Stanford Cross Country Invitational (1996?). Then hydration packs became more popular (2000?).<br />
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It seems very simple. Drink water... Or is it?<br />
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Dehydration </h3>
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Dehydration is a common ailment among athletes. This occurs when there is more fluids lost then ingested. Athletes, of course, are most vulnerable during intense exercise in the heat or in cold weather when athletes don't feel as thirsty. Newer athletes may be more susceptible to dehydration as they may not be as adjusted to drinking the amount of fluid they need. For runners, it can be difficult to carry water and the desire to keep running over powers stopping for water. However, proper hydration allows the body to function properly. The current guidelines is about 4-6 oz of fluid for every 15-20 minutes of exercise lasting > 30-45 minutes in duration. 1 gulp of water is 1-2 oz of fluid.<br />
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Signs and Symptoms </h4>
In mild to moderate cases dizziness, headache, confusion and cramping are some signs and symptoms. In severe cases the athlete stops sweating and blood pressure decreases.<br />
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Hyponatremia </h3>
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The condition that is less heard of is hyponatremia. It translates to too little sodium. This occurs when there is too much fluid and not enough electrolytes. The first time I heard this was my senior year in high school when a former California State Champion (competing at Stanford) couldn't finish her race because she drank too much water and her electrolytes were imbalanced. She drank 1 gallon of water before her race.<br />
Runners who run longer then 4 hours are more susceptible to hyponatramia. Since they are on the course longer they tend to take in more water not realizing that sodium is important too. To avoid dehydration runners will drink water at every aide station. However, ingesting more water compared to how much you are sweating will increase the chances of becoming hyponatremic. This will increase the amount of water in the body but the sodium level decreases from sweating causing hyponatremia. An improper balance of water to electrolytes can cause a number of different symptoms and can lead to coma. This is why it's important to have sports drinks along with water.<br />
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Signs and Symptoms</h4>
<span style="color: black; font-family: inherit;"><span style="background-color: white;">Headache, nausea </span><span style="background-color: white;">and vomiting, lethargy, and confusion, </span>seizure are symptoms of hyponatremia.</span><br />
<span style="background-color: white;"><span style="font-family: inherit;">The excess fluid moves from between cells to inside the cells causing the above symptoms. When it is severe it can move fluid into the lungs and brain.</span></span><br />
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Dehydration vs Hyponatremia</h3>
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The symptoms of dehydration and hyponatremia are very similar. In the past, the best way to monitor is to weight your self before and after running. If you weight less, there is less water. You're dehydrated. If you weight more, this means have you're over hydrated possibly leading to hyponatremia. However, this way of checking is unreliable. The latest research supports moving away from using weight as the sole monitor.<br />
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You can be dehydrated AND hyponatramic (weighing less). In the past, the athlete would have been given more water. However, drinking more water can further put you in hyponatremia. Being more aware of your hydration strategies is the best option. Make sure you drink a adequate balance of water and sports drinks/gels.<br />
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Sports Drinks, Gels and Energy Chews</h3>
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For long distance events (> 60 minutes), sports drinks, gels and chews are important to provide your body with energy and keeping a good electrolyte balance. They contain a specific percentage of carbohydrates. Research shows that 6-8% carbohydrates is the best for the stomach to absorb. A 100ml drink should have 6-8 grams of carbohydrate or 14.2 - 18.9 grams per 8 oz of fluid. Higher percentage decreases gastric emptying which leads to gastrointestinal stress (cramping, vomiting). With the increase in GI stress, the amount of fuel being delivered to the muscles is decreased. So you're left with GI issues and lead legs. Fruit juices and soda contains 10-12%. They can contribute to GI stress if they are not diluted.<br />
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If your gel pack states to drink 6 oz of water. Drink 6 oz. of water. This ensures the proper percentage of carbohydrates. That is 3-6 gulps of water per pack. If you ingest multiple gel packs, let's say 3 over an hour, that would be 18 oz of water which can be a lot if you're not use to it. Or, if you drink a performance drink with the gel, it will increase the concentration of carbohydrates to an undesirable amount. If you're not use to drinking water with your gels or chews and/or use more then you would typically, you can be causing GI stress on race day.<br />
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For example- A GU pack typically has 22 grams of carbohydrates, you should have approximately 10 oz of water with the GU for proper percentage carbohydrates. If you ingest 2 packs, you should have 20 oz of water.<br />
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Of course, everyone is different. Some athletes feel fine with more or less then the recommended amount. Know your body. If you end up with GI problems you can rebalance your body by drinking more water if you have had a lot of sports performance drinks/gels or taking more sodium if you haven't had electrolytes with your water.<br />
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***These are the basic of hydration and performance aides. There is a lot more detail such as protein ratio, caffeine, etc, but would make this post into a book. Please contact me if you have further questions.<br />
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<span style="font-family: inherit;"><span style="background-color: white; font-size: 12px;">Leiper JB, Prentice AS, Wrightson C, et al. Gastric emptying of a carbohydrate-electrolyte drink during a soccer match. </span><span style="font-size: 12px;"><i>Med Sci Sports Exerc</i></span><span style="background-color: white; font-size: 12px;"> 2001;33:1932-1938. </span></span><br />
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<span style="font-family: inherit; font-size: x-small;"><span style="background-color: white;">Murray R, Bartoli W, Stofan J, et al. A comparison of the gastric emptying characteristics of selected sports drinks. </span><i>Int J Sports Nutr</i><span style="background-color: white;"> 1999;9:263-274.</span></span>Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com2tag:blogger.com,1999:blog-3011141020454998074.post-44322028712665823202016-05-29T20:21:00.001-07:002016-05-29T20:21:36.606-07:00Posterior Tibialis Tendonitis<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: Times; font-size: 14px; line-height: normal; text-align: center;">
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<span style="font-kerning: none;"><span style="font-family: inherit;">Tibialis posterior tendonitis is an injury that affects a few runners a year. This injury affects mostly people who have pes planus ( flat feet) and/or over pronate. Tibialis posterior tendinitis is painful on the inside of the foot and ankle region. The most stress is during mid-stance, when body weight is fully on the foot. </span></span></div>
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<span style="font-family: inherit;"><span style="font-family: inherit;">What contributes to </span><span style="font-family: inherit;">Tibialis posterior tendonitis?</span></span></h3>
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<span style="font-kerning: none;"><span style="font-family: inherit;">Limited ankle dorsiflexion</span></span></h4>
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<span style="font-kerning: none;"><span style="font-family: inherit;">Dorsiflexion is the movement of your foot towards your body, or in standing, when the shin bone moves over the foot. Dorsiflexion is required for proper walking and running mechanics. When the ankle is limited, the body makes up the motion elsewhere. One compensation is the foot splays outward. This will increase stress to plantar fasciitis and posterior tibialis tendon. Over time, the stress leads to injuries of those structures as it is unable to tolerate the load.</span></span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6RyJ7mtj1h4kQReVhOo7-nK_lY6rRuBA837Uexhnnhp9gXzYHrRbuNoVGqLusmeK6NC0mz0e_I2OMW9BKLn8BRf51EtD-MDPwHYJCupjbYm5cgneGhcRXdfi4TrNQsiBfKnx-eINH6hY/s1600/IMG_0707.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><span style="font-family: inherit;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6RyJ7mtj1h4kQReVhOo7-nK_lY6rRuBA837Uexhnnhp9gXzYHrRbuNoVGqLusmeK6NC0mz0e_I2OMW9BKLn8BRf51EtD-MDPwHYJCupjbYm5cgneGhcRXdfi4TrNQsiBfKnx-eINH6hY/s320/IMG_0707.JPG" width="320" /></span></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: inherit;">The top picture shows the ankle joint when the foot is pronated.</span><br />
<span style="font-family: inherit;">The bottom picture shows the ankle joint when the foot is </span><br />
<span style="font-family: inherit;">supinated. Less ankle dorsiflexion is shown when the foot is</span><br />
<span style="font-family: inherit;">pronated. The motion is taken up at the foot stretching the</span><br />
<span style="font-family: inherit;">tibialis posterior.</span></td></tr>
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<h4>
<span style="font-kerning: none;"><span style="font-family: inherit;">What contributes to limited ankle dorsiflexion? </span></span></h4>
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<span style="font-kerning: none;"><span style="font-family: inherit; font-weight: normal;">High Heels</span></span></h4>
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<span style="font-kerning: none;"><span style="font-family: inherit;">When you wear heeled shoes, the foot is constantly pointed downward in plantarflexion. Over the course of the day the ankle joint progressively stiffens in that position. Even if you’re sitting with your shoes on, the foot is always pointed down. When you are out of the heel shoes and in running shoes, your heels are now closer to the ground. This requires more dorsiflexion at the ankle joint and muscle length of the calf. In order for the body to move over the foot, the ankle needs to bend. But when ankle dorsiflexion is lacking, the motion is achieved by bending at the foot, specifically the navicular bone. This is the bone which the tibialis posterior tendon attaches to. With each step, the tendon is getting stretched. Over time this strain leads to tendonitis.</span></span></div>
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<span style="font-kerning: none;"><span style="font-family: inherit; font-weight: normal;">Prior Injuries </span></span></h4>
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<span style="font-kerning: none;"><span style="font-family: inherit;">Have you ever had a mild ankle sprain that you just ignored? There was a little swelling and pain but symptoms subsided. The swelling limits your ankle mobility and within a couple of days your ankle will get stiff. Your body compensates by getting the motion in your foot. Over time the mobility of the ankle will be more limited. Like above, the tibialis posterior tendon gets stretched. </span></span></div>
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<h3>
<span style="font-kerning: none;"><span style="font-family: inherit;">Weakness of Glutes </span></span></h3>
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<span style="font-kerning: none;"><span style="font-family: inherit;">Our body is connected by muscles, fascia and bones. If there is weakness in one region, it can affect another body part several joints away. The gluteals can affect the ankle. One of the functions of the gluteals is to externally rotate the thigh. Since the femur is attached to the shin, the lower leg bone will lift the arch up when the glutes contract. When the glutes are weak, the femur rotates in, which causes the lower leg to rotating in. This will allow the arches flatten. Try this at home. Squeeze your glutes and watch what your foot does. </span></span></div>
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<h3>
<span style="font-kerning: none;"><span style="font-family: inherit;">Pelvic Mal-alignment</span></span></h3>
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<span style="font-kerning: none;"><span style="font-family: inherit;">The pelvis is made of the ilium on each side and is separated by the pubis in the front and sacrum in the back. The ilium moves independently but one side affects the other.</span></span></div>
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<span style="font-kerning: none;"><span style="font-family: inherit;">When the pelvis is rotated, the hip socket, which is on the illium, moves up or down relatively. This affects the entire leg. When one illium rotates backwards, it makes the leg longer and the other leg shorter. This is called a functional leg length discrepancy. There there is actual difference in the length of the leg bone, it is called anatomical leg length discrepancy. This causes a problem for the body because it wants to stand level. The side that longer will pronate while the side that is shorter will supinate. The prolong pronation will stretch the tibialis posterior tendon. </span></span><br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiBHpIJd1Rjv_h2wqbIjisWMGh-7eCMHbRZixs4uYKzmGgkwmd5mwsmbkIp5ZpRQOGucO23Rk86yncY3O2KdfcSa2lCa1VBPbbb9QZeuBEkTVuGgigGM-ER0lyY6oy2e7FsDOIYyN_fvCw/s1600/FullSizeRender.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><span style="font-family: inherit;"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiBHpIJd1Rjv_h2wqbIjisWMGh-7eCMHbRZixs4uYKzmGgkwmd5mwsmbkIp5ZpRQOGucO23Rk86yncY3O2KdfcSa2lCa1VBPbbb9QZeuBEkTVuGgigGM-ER0lyY6oy2e7FsDOIYyN_fvCw/s400/FullSizeRender.jpg" width="400" /></span></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: inherit;">Placing the book under my foot, makes my leg functionally longer. My right foot is</span><br />
<span style="font-family: inherit;">pronated and the heel is angled away. </span></td></tr>
</tbody></table>
<h3>
<span style="font-family: inherit;">Running Form </span></h3>
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<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjuJ33vtYkSYKOu3JkHAI2wLoJ_JMkWIMlwsyChFGDDH0egcNtjBVocvqBVv0OfJ3VGhFDO43XNkeaC8oTGURUbclOqTAn37vwv6KyXOhG4Ph5oEMEdQvrx94LMZl9nl4jJFE6pV8xqGGk/s1600/FullSizeRender+3.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><span style="font-family: inherit;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjuJ33vtYkSYKOu3JkHAI2wLoJ_JMkWIMlwsyChFGDDH0egcNtjBVocvqBVv0OfJ3VGhFDO43XNkeaC8oTGURUbclOqTAn37vwv6KyXOhG4Ph5oEMEdQvrx94LMZl9nl4jJFE6pV8xqGGk/s200/FullSizeRender+3.jpg" width="200" /></span></a></td></tr>
<tr><td class="tr-caption" style="font-size: 13px; text-align: center;"><span style="font-family: inherit;">Landing excessively on the outside of<br />the foot increases stress to the Tibialis<br />Posterior tendon.</span></td></tr>
</tbody></table>
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_xi4GGv-1on7lVmax3LnQK70B_moyVgubnskwvkyxCCwZoK3EW_a-tDfUYX1hyphenhyphendeMxh3XqvYpRI9Em7DxhoZffJxXug4fw3DWm48wxx6TKz2zS-CL0ZqmsU5PXii8zmxes3uDHGLHn98/s1600/FullSizeRender+4.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><span style="font-family: inherit;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_xi4GGv-1on7lVmax3LnQK70B_moyVgubnskwvkyxCCwZoK3EW_a-tDfUYX1hyphenhyphendeMxh3XqvYpRI9Em7DxhoZffJxXug4fw3DWm48wxx6TKz2zS-CL0ZqmsU5PXii8zmxes3uDHGLHn98/s200/FullSizeRender+4.jpg" width="200" /></span></a></td></tr>
<tr><td class="tr-caption" style="font-size: 13px; text-align: center;"><span style="font-family: inherit;">Landing equally across the foot decreases<br />the stress to the Tibialis Posterior tendon.</span></td></tr>
</tbody></table>
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_xi4GGv-1on7lVmax3LnQK70B_moyVgubnskwvkyxCCwZoK3EW_a-tDfUYX1hyphenhyphendeMxh3XqvYpRI9Em7DxhoZffJxXug4fw3DWm48wxx6TKz2zS-CL0ZqmsU5PXii8zmxes3uDHGLHn98/s1600/FullSizeRender+4.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="font-family: inherit;"><br /></span></a>
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<span style="font-family: inherit;">Normal running form is to strike the ground on the outside of the foot, then roll to the inside. This is called pronation. However, some runners strike the ground too far on the outside portion of the foot.This places a lot of stress on the tibialis posterior tendon whose role is to slow down pronation. The more the foot strikes on the outside, the tibialis posterior has to work more to control the motion. </span></div>
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<span style="font-kerning: none;"><b><span style="font-family: inherit;">Treatment</span></b></span></h2>
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<span style="font-family: inherit;">1) Improving <b>ankle</b> mobility and strength will decrease strain on the tibialis posterior tendon. Follow the video in this <a href="http://3drunner.blogspot.com/2016/03/runners-knee.html" target="_blank">blog post</a>. </span></div>
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<span style="font-family: inherit;"><span style="font-kerning: none;"><span style="font-family: inherit;"><br /></span></span><span style="font-family: inherit;">2)<b> Gluteal and core</b> strengthening program is important to indirectly control the lower leg. There are numerous post on how to strengthen the core. The <a href="http://3drunner.blogspot.com/2016/02/transitioning-to-forefoot.html" target="_blank">core video</a> in this post is a great progression. </span></span></div>
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<span style="font-kerning: none;"><span style="font-family: inherit;">3)<b> Correct a pelvic malalignment</b></span></span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTfu4kJ1TTPyugvSEiWSXaHEWD1zm-BcgGUz8ls9vXYv1dTG4P7V7J5UFJ7HgBGrp-VME9YVjVw10ARdCtLDybVF5yuO18qeYO9wKdN3czfMWXDKa8YvqwCGgJhkz5-K6W3Dp7y2Ia0ww/s1600/FullSizeRender+2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: inherit;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTfu4kJ1TTPyugvSEiWSXaHEWD1zm-BcgGUz8ls9vXYv1dTG4P7V7J5UFJ7HgBGrp-VME9YVjVw10ARdCtLDybVF5yuO18qeYO9wKdN3czfMWXDKa8YvqwCGgJhkz5-K6W3Dp7y2Ia0ww/s320/FullSizeRender+2.jpg" width="320" /></span></a></div>
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">Put your hands on your hips and feel for a bony landmark on each side with your thumbs. This landmark is called posterior superior iliac spine, PSIS for short. If your right side is lower, that leg is functionally longer (shown above). If your left side is lower, that leg is functionally longer.</span><br />
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</span>
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">To correct a right posteriorly rotated SI joint, we are going to use the right hip flexors to rotate the illium forward and counter using the glutes/hamstrings to rotate the left side backwards. Lay on your back with your knees bent. Bring your right leg up and use your hands to resist at the knee. At the same time dig your left heel into the ground. Hold this for 6 seconds and repeat 3 times. Next take a hard object ( I like using my foam roller) and squeeze between your knees for 6 seconds 3 times. </span></div>
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<span style="font-family: inherit;">4)<b> Form</b></span><br />
<span style="font-family: inherit;">Practice landing with equal force across the foot. This decreases the distance the medial side part foot has to lower to the ground which will lessen the stress to the tibialis posterior tendon.</span><br />
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<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">These are some of the contributing factors I look at when assessing a runner with tibialis posterior tendonitis. </span></div>
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<span style="font-family: inherit;">Please let me know if you have any questions.</span><br />
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Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com3tag:blogger.com,1999:blog-3011141020454998074.post-81934131023300323002016-04-30T23:35:00.002-07:002016-05-01T19:36:53.331-07:00SciaticaSciatica is a common injury that can impact up to 40 % of people at some point in their lives. For runners, it can be devastating as it impacts training and preventing participation in the "goal race". Sciatica is merely a description of a symptom, which is inflammation of the sciatic nerve. It does not provide a cause. The sciatic nerve can be pinched in the hip region or the back. This article is going to focus on the back. There is an article I wrote which discusses how <a href="http://www.3drunner.blogspot.com/2014/11/i-have-sciatica-why-are-you-grabbing-my.html" target="_blank">ankle stiffness can lead to sciatica.</a><br />
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A number of nerves exit the spine and come together to make up the sciatic nerve. The nerves exit between lumbar spine 4- sacral spine 2. It travels through the pelvis and descends down the back of the leg. Pinching of the nerve causes pain, numbness, tingling and if severe enough, loss of strength. There is a distinct pattern of pain, weakness and loss of sensation which allows the clinician to know which nerve root(s) is affected.<br />
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<h3>
Causes</h3>
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<h4>
Herniated disc</h4>
A herniated disc is when the disc between the spine pushes into the space where the nerves live. Due to the the structure of the disc, the soft material gets pushed backwards onto the nerves. This usually happens when the body is forward flexed and there's a force. Squeezing or coughing while bent forward is a common way to sustain this injury. When the disc is herniated, any sitting or bent forward position increases pain. This position puts more pressure onto the disc which pushes onto the nerve.<br />
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<h4>
Stenosis</h4>
This injury occurs when the space the nerve exits the spine narrows. This happens when the disc looses it height or when the arthritis in the joint. When the disc loses it height the ligaments surrounding the spine buckle which takes up space where the nerves are. Imagine a curtain on a wall and what it would look like if the ceiling height got lowered. The curtain will buckle. This type or injury gets inflamed with upright activities and be more comfortable sitting.<br />
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<h3>
Treatment </h3>
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<h4>
Alleviate the pain</h4>
This is the 1st step! The body will compensate and muscles are shut off when there is pain. Number one goal is to decrease the pain to allow the nerve pathways to the muscles. This can be achieved by using ice/heat, resting positions and taking pressure of the nerve.<br />
People often think they are improving because their pain is decreasing. In reality, they may not feel pain because MORE nerve fibers are being pinch and they are losing sensation. Eventually the muscles no longer get the signal from the brain and will get weak.<br />
For a true herniated disc, laying on your stomach will help to take pressure away from the disc. These are known as Mckenzie Extension exercises. While for stenosis, sitting or laying with the legs at 90 degrees will allow opening of the joints. These are called William Flexion exercises.<br />
Traction in these positions will further accelerate the healing process.<br />
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<h4>
Core stability</h4>
Focus on developing the muscles that stabilize your spine not move your spine. People have a tendency to perform big movements like back extensions and sit- ups. However, when your back isn't stabile these movement can contribute to shearing of the spine leading to early degeneration arthritis. Poor posture allows the core stabilizers to atrophy. Bigger muscle groups function as stabilizers. This contributes to nerve pain as the spaces narrow.<br />
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Mobility Above and Below</h3>
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You want to make sure the area above and below the region is strong and mobile. This helps to take the pressure of the spine. Often the areas above and below a painful segment is stiff and tight which forces the injured area to move more. This leads to over use and also lead to early arthritis<br />
Most commonly the thoracic spine and hips have limited mobility.<br />
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<h4>
Hips </h4>
The hips and pelvis are important region as it serves as a base for the lumbar spine to sit on. However, it's mobility is often limited. When I walk into an exam room, I see my client's back rounded. To improve posture, hip mobility needs to be assessed.<br />
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<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjG-eHAAEW0cIbjOx1d2jGQFDaBmCxyG8zdHRwyl_QlBqr7yBkkMu5iic5jUhUbmwsdtQTRVJr6LyVrPsQjGqD2j78acyQs7enfmWosbKh8bCx-TIYHpvRBrjDMb7oToyO8u7BeOnp6Sgk/s1600/IMG_8842.JPG" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjG-eHAAEW0cIbjOx1d2jGQFDaBmCxyG8zdHRwyl_QlBqr7yBkkMu5iic5jUhUbmwsdtQTRVJr6LyVrPsQjGqD2j78acyQs7enfmWosbKh8bCx-TIYHpvRBrjDMb7oToyO8u7BeOnp6Sgk/s320/IMG_8842.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Good sitting form: Hips are at approximately<br />
90 degrees and back has good curvature</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjJ733UDkOeV7MLosoSVB1NcCD0D0lhM5YI_yYTNGC1lZcDeYWDzPRPFE8deD9iuo5ofHtpP2JINj_ApKTy6G4p82f4lEuDJKKCSZS-4JMurBSVRhUD7UYKcAYRYiGn1Aban9eEcBP3lEg/s1600/IMG_8844.JPG" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjJ733UDkOeV7MLosoSVB1NcCD0D0lhM5YI_yYTNGC1lZcDeYWDzPRPFE8deD9iuo5ofHtpP2JINj_ApKTy6G4p82f4lEuDJKKCSZS-4JMurBSVRhUD7UYKcAYRYiGn1Aban9eEcBP3lEg/s320/IMG_8844.JPG" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Poor sitting form: Hops are rounded forcing the<br />
back to round.</td></tr>
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They are unable to get > 90 degrees of flexion in the hip. This is problematic because it leads to poor posture. There is an increase stretch to lower back, poor alignment and shuts down muscles.<br />
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<h4>
Thoracic spine </h4>
The thoracic spine area is a victim of gravity. Gravity pushes down on the shoulders while we sit and standing causing the thoracic spine to curve forward. The thoracic spine is also stiff due to it's job as the protector of all things vital... our heart and lungs. Due to the rib cage, the thoracic spine doesn't have a lot of motion compared to the neck and lumbar spine. However, this area should have the most ROTATIONAL motion of the spine. It's inherent stiffness limits mobility forcing rotational motion upon it's neighbors, the neck and low back. Have you ever heard of anyone with thoracic spine arthritis? It's highly unlikely because the low back and neck usually works harder to make up make for the lack of motion in the thoracic region. That is the reason arthritis is so prevalent in the low back and neck.<br />
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****Stay tuned for the next post! I'm traveling for 7 weeks! How to stay injury free and fit while on the road!<br />
<br />Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com4tag:blogger.com,1999:blog-3011141020454998074.post-65725261527543170022016-03-29T07:51:00.000-07:002016-04-07T01:44:59.671-07:00Runner's KneeOne type of knee pain is patellofemoral joint pain. This occurs when the tissues on the underside of the patella ( the knee cap) is inflamed causing pain. It plagues many runners limiting their training and sidelining them from racing. When the area is really aggravated, it can hurt to sit and negotiate stars. The patella and the femur (thigh bone) make up the patellofemoral joint. When the knee bends, the patella slides up and down in a groove of the femur. There are several ways the patellofemoral joint can be aggravated. There can be compression from the quadriceps (which can also lead to patella tendonitis), lateral compression from the illiotibial band (ITB) and poor mechanics.<br />
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<h3>
Causes</h3>
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<div>
<h4>
Quadriceps Compression </h4>
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<div>
The patella 'floats' in the connective tissue of the quadriceps. The quadriceps transitions into the quadriceps tendon then attaches to the patella then becomes the patella tendon. When the quadriceps are over worked, it puts an increase pull to the tendons. The tension from the tendons compresses the patella into the femoral groove resulting in grinding. The grinding causes degeneration of the tissue behind the patella leading to pain and arthritis.<br />
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<tr><td><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg2pzpEQap1XhZ4hAOop-FqlMPwfpIaSJMjkl98l_WptiEvLfH8A-nC0nSnOTr6N8bZlWaaoBx0NaXEL41CzjTO3LMYIdJFu_bUo_YFKOnMyh_V_kkgZLy_iVsQcDdQemsRft0O6amCOSk/s1600/Quadriceps_VMO.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="297" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg2pzpEQap1XhZ4hAOop-FqlMPwfpIaSJMjkl98l_WptiEvLfH8A-nC0nSnOTr6N8bZlWaaoBx0NaXEL41CzjTO3LMYIdJFu_bUo_YFKOnMyh_V_kkgZLy_iVsQcDdQemsRft0O6amCOSk/s320/Quadriceps_VMO.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="font-size: 13px;">http://physioworks.com.au/injuries-conditions-1/chondromalacia-patella</td></tr>
</tbody></table>
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<h4>
Lateral compression </h4>
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<div>
Due to imbalance of muscles, the tissue on the lateral (outside) of the thigh can get stiff pulling on the the patella. This structure is known as the ITB. The ITB has fibers which attach to the patella. Cadaver studies have shown a variation in how much of the ITB tissue attaches to the patella. You can't stretch the ITB because it is not a muscle, it is fascia. There is no elastic tissue to stretch. This is why foam rolling is so important ( we'll get to that in a minute). When the ITB pulls on the knee cap it cause pain on the either side of the knee cap. The lateral tissue pull the kneecap to the outside which can stretch the medial structures causing pain on the inside. On the other hand, the pull of the ITB can cause the knee cap to rub again the femur causing pain on the outside of the knee. Stiffness of the ITB can be a result of poor muscle activation.<br />
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<h4>
<span style="font-family: inherit;">Biomechanics</span></h4>
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"The knee is a stupid joint."- Gary Gray. It is influenced by the hip from the top down and the ankle from the bottom up. The knee comprises of the tibia (shin) and femur. These bones make up the ankle and hip respectively. Any biomechanical deviations above and below has a direct affect on the knee.<br />
<span style="font-family: inherit;"><br /></span><span style="font-family: inherit;">Pronation of the foot is normal in the stance phase. However, excessive or prolonged pronation leads to injury. When the foot over-pronates, the foot rolls towards the ground bringing ankle joint in. The tibia (shin bone) follows along. Since the tibia makes up the knee, the knee follows along and collapses inward. This is called the valgus position and causes abnormal stress to the knee. </span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbTJ9eYr6Hq6HBCYWVGaxGX__yw9YAvPf1eU1Lcuz_85DAQZ5zz0a7iYXJ-5a144PBVfOnF98SbEa4iFYwUVnFZvOgJ0EQ3cYwxLkNfDjqEABdbhrhQ0KQMWayrrqWgctn845SM9ZW3Hc/s1600/Hip-Weakness-Pronation.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbTJ9eYr6Hq6HBCYWVGaxGX__yw9YAvPf1eU1Lcuz_85DAQZ5zz0a7iYXJ-5a144PBVfOnF98SbEa4iFYwUVnFZvOgJ0EQ3cYwxLkNfDjqEABdbhrhQ0KQMWayrrqWgctn845SM9ZW3Hc/s320/Hip-Weakness-Pronation.jpg" width="256" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">http://www.fixflatfeet.com/hip-weakness/</td></tr>
</tbody></table>
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<span style="font-family: inherit;"><br /></span><span style="font-family: inherit;">From the top down, the gluteal muscles can play a role in knee pain. The gluteals originate from the pelvis and attaches to the thigh bone. When the glute muscles contracts, the femur (thigh) bone rotates keeping the knee forward. Activation of this muscle keeps the femur aligned forward and the knee in a good line of pull. However, when there is weakness of the gluteals, the femur is allowed to drift inward. This causes the knee to fall inward, again, causing increase stress to the knee.</span><br />
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<h3>
Treatment</h3>
<h4>
What to do now?</h4>
<span style="font-family: inherit;">Foam rolling is a type of myofascial release. The science is unclear on it's exact mechanism. My belief is the compression provided restores fluid ( think about squeezing a kitchen sponge) between the connective tissues which improves the ability for the tissues to slide. It is good at managing symptoms but will not get to the root source. There is a reason why the muscles and tissues get unusually tight. Foam rolling is still beneficial because you want the muscles and connective tissue slide better. For quadriceps compression roll over the quadriceps and for lateral compression roll over the ITB.</span><br />
<span style="font-family: inherit;">*** For the optimal benefits make sure you are hydrated when foam rolling. </span><br />
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<h4>
<span style="font-family: inherit;">Long term</span></h4>
<br />
<span style="font-family: inherit;">Exercises </span><br />
<span style="font-family: inherit;"><br /></span><span style="font-family: inherit;">Research has shown glute strength has a direct affect on knee pain. Due to the attachment of the gluteals, it has direct control of the femur. Proper glute strength and activation keeps the femur in a forward position. This aligns the femur the the patella can stay within it's groove. </span><span style="font-family: inherit;">This leads to less strain in the knee joint.</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">However, when the glutes are weak, the femur is allowed to roll inward which leads to mis-aligned position increasing stress to the knee. Also, energy absorption from ground forces is more evenly dispersed to the glutes and away from the knees. I have written posts on <a href="http://3drunner.blogspot.com/2016/01/glutes-how-to-transition-from-exercise.html" target="_blank">glute strengthening exercises.</a></span><br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">Limited ankle dorsiflexion is a contributing factor in foot pronation which can impact knee position. Dorsiflexion is the ability to pull the foot towards your body. While you are running, as your foot hits the ground, your shin moves over the ankle as the knee bents. This movement is also ankle dorsiflexion. If there is inadequate ankle dorsiflexion, the foot will pronate to compensate for the loss of movement. In a tight ankle the tibia comes forward but there is a stop in the ankle. Momentum will carry that energy forward in the form of foot pronation. Due to the bony structure of the ankle, when the foot pronates the ankle with rotate along with the tibia. This will result in knee valgus (see above picture) leading to increase stress to the knee. In order to resolve the mechanics from the ground up you have to perform ankle mobilizations to loosen up the joint then restrengthen the foot. Here is a video to demonstrate ankle exercises.</span><br />
<span style="font-family: inherit;"><br /></span>
<iframe allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/taLn9MyjhM0" width="560"></iframe>
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<span style="font-family: inherit;"><br /></span><span style="font-family: inherit;">Form </span><br />
<span style="font-family: inherit;"><br /></span><span style="font-family: inherit;">Running form has a big influence on injuries. Over striding places a bigger emphasis on using the quadriceps for propulsion. This leads over use injuries of the quadriceps. Over-striding brings the ground reaction forces in front of the knee creating more strain in that joint. People who over stride tend to be heel strikers. Research has shown that heel strikers have more knee pain then forefoot strikers. By heel striking, the ground reaction forces goes anteriorly placing more stress on shin, knees and quadriceps. However, forefoot running brings the body over the ground reaction forces which allows the energy to be disperse through the entire leg. This occurs because the body mass is over the foot. Meanwhile in heel strike the body is behind the knee, which makes the quadriceps work harder to propel the body over the foot.</span><br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">Proper forefoot strike also works the muscles (tibialis posterior) that hold up the arch limiting the amount of pronation. This leads to better knee alignment. BUT beware, if there is weakness of the muscles you can get aches and pains in the lower leg in the transition. Having good core strength takes the pressure off the lower leg.</span><br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">My recent post discusses the benefits of </span><a href="http://3drunner.blogspot.com/2016/02/why-forefoot-strike.html" style="font-family: inherit;" target="_blank">forefoot running</a>.<br />
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Our body is all connected. The regions above and below the pain typically contributes to injury.<br />
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Please contact me if you have any questions.<br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;"><br /></span><span style="font-family: inherit;"><br /></span><span style="font-family: inherit;"><br /></span><span style="font-family: inherit;"><span style="font-weight: normal;"><span style="font-size: small;">Kulmala JP<span style="background-color: white;">, </span>Avela J<span style="background-color: white;">, </span>Pasanen K<span style="background-color: white;">, </span>Parkkari J</span><span style="background-color: white;">. </span><span style="font-size: small;">Forefoot strikers exhibit lower running-induced </span></span><span style="font-weight: normal;"><span style="font-size: small;"><br /></span></span></span><br />
<span style="font-weight: normal;"><span style="font-family: inherit;"><span style="font-size: small;">knee loading than rearfoot strikers. </span><span style="font-size: small;"><span role="menubar">Med Sci Sports Exerc.</span><span style="background-color: white;"> 2013 Dec;45(12):2306-13.</span></span></span></span><br />
<span style="font-weight: normal;"><span style="font-family: inherit;"><span style="font-size: small;"><span style="background-color: white;"><br /></span></span></span></span><span style="font-weight: normal;"><span style="font-family: inherit;"><span style="font-size: small;"><span style="background-color: white; font-family: inherit;"><span style="color: #222222;">Daoud, Adam I., et al. "Foot strike and injury rates in endurance runners: a retrospective study." </span><i style="color: #222222;">Med Sci Sports Exerc</i><span style="color: #222222;"> 44.7 (2012): 1325-34.</span></span></span></span></span></div>
<a href="http://www.pinterest.com/pin/create/extension/?url=https%3A%2F%2Fwww.blogger.com%2Fblogger.g%3FblogID%3D3011141020454998074%23editor%2Ftarget%3Dpost%3BpostID%3D6572526152754317002%3BonPublishedMenu%3Dposts%3BonClosedMenu%3Dposts%3BpostNum%3D0%3Bsrc%3Dpostname&media=https%3A%2F%2F1.bp.blogspot.com%2F-7rM914lO-fU%2FVvqTbJ6ggvI%2FAAAAAAAAAfs%2FeONZV7dof38-GcxoD_1FBegsY50wEgGnQ%2Fs320%2FHip-Weakness-Pronation.jpg&xm=h&xv=sa1.37.01&xuid=pzHUtYoKghwY&description=" style="background-color: transparent; background-image: url(data:image/png; border: none; cursor: pointer; display: none; height: 20px; left: 225px; opacity: 0.85; position: absolute; top: 1472px; width: 40px; z-index: 8675309;"></a><a href="http://www.pinterest.com/pin/create/extension/?url=https%3A%2F%2Fwww.blogger.com%2Fblogger.g%3FblogID%3D3011141020454998074%23editor%2Ftarget%3Dpost%3BpostID%3D6572526152754317002%3BonPublishedMenu%3Dposts%3BonClosedMenu%3Dposts%3BpostNum%3D0%3Bsrc%3Dpostname&media=https%3A%2F%2F1.bp.blogspot.com%2F-7rM914lO-fU%2FVvqTbJ6ggvI%2FAAAAAAAAAfs%2FeONZV7dof38-GcxoD_1FBegsY50wEgGnQ%2Fs320%2FHip-Weakness-Pronation.jpg&xm=h&xv=sa1.37.01&xuid=pzHUtYoKghwY&description=" style="background-color: transparent; background-image: url(data:image/png; border: none; cursor: pointer; display: none; height: 20px; left: 225px; opacity: 0.85; position: absolute; top: 1472px; width: 40px; z-index: 8675309;"></a>Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com4tag:blogger.com,1999:blog-3011141020454998074.post-36527258886209031882016-03-12T18:43:00.003-08:002016-03-12T18:44:05.351-08:0030 day 3D Exercise Challenge<span style="font-family: inherit;">While I'm working on my next post, I'm going to do a 30 day 3D exercise challenge on my Instagram starting 3/13/15 (3drunner, also link located on the right). </span><br />
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<div style="line-height: normal;">
<span style="font-family: inherit;">What is 3D? Our body moves in 3 main planes of motion - sagittal, frontal and transverse ( forward/back, R/L and twist). And our muscles, joints, bones are 3 dimensional! Unfortunately a majority of us assess, treat and train primarily in the sagittal plane while the frontal and transverse planes are under utilized. In running (and walking), we move in the sagittal plane, but the other planes work to support forward movement. I think weakness of frontal and transverse planes leads to early fatigue and even injury. Performing exercises with the 3 dimensions in mind strengthens more muscle fibers!</span></div>
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Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com1tag:blogger.com,1999:blog-3011141020454998074.post-49357405034998228422016-02-25T18:25:00.004-08:002016-04-10T11:14:14.764-07:00Exercises to Transition to ForefootDid I convince you to try forefoot running? Have patience, this transition should take several months. You have been landing on your heels for years, it's not going to change in a couple minutes. It takes time for your brain to change the firing patterns of the nerves, your muscles to build strength and the movement to become natural.<br />
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If you're not already walking at home barefoot, DO IT every day. Actually, think about landing on your forefoot while you walk.<br />
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<h3>
Core</h3>
Good core strength and stability is the most important aspect in maintaining a forefoot strike running pattern. Due to the inherent forward lean of this running style, the core is always engaged. The onset of fatigue leads to poor form. The chest starts to hutch over (as oppose to forward pelvis over the foot) and hips shift backwards which leads to heel striking.<br />
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<iframe allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/sJ6r3KtEsCc" width="560"></iframe>
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For clams, side lying leg lifts, fire hydrants and bridges:<br />
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stage 1 - perform 3 sets x 12 reps<br />
- hold plank 10 x 10 sec<br />
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stage 2 - hold 10 reps for 10 seconds<br />
- hold plank 3 x 30 sec<br />
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stage 3 - add band repeat stage 1<br />
- progress to single leg bridges<br />
- add squats and lunges: use <a href="http://3drunner.blogspot.com/2016/01/glutes-how-to-transition-from-exercise.html" target="_blank">push knee back cue</a><br />
- add plank - add knee bent plank and rotation 10 each side<br />
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stage 4 - repeat 2 with band<br />
- continue single leg bridges, squats, lunges and plank (lunges and squat add weight or bend knees more)<br />
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*** Perform stage 1 every day. Stages 2-4 perform 3-4 x week.<br />
*** Do not progress stage until the current stage feels easy.<br />
*** You should have glute soreness after each session.<br />
<i>This should take a minimum of 8 weeks!!! Spend about 2 weeks per stage. </i><br />
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<h3>
Ankle Strength and Drills</h3>
To land on your forefoot you have to have excellent calf strength. Forefoot strike puts extra stress to the calf muscles and Achilles tendon. You are performing an eccentric heel raise with each stride! These drills help with proper form and getting the neurologic input to land on your forefoot.<br />
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<iframe allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/-CfkcOXm_eY" width="560"></iframe>
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Calf Raises - With a twist! By turning left and right as you come up, different muscle fibers are being used. In running, the twisting motions occur when your foot lands and when it lifts off the ground. It happens so fast you can't feel it. Start with double leg 2-3 sets of 10, then at stage 3 of core, try single leg 3 sets of 10 reps.<br />
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Wall Falls - Forefoot running requires eccentric strength of the calves. Eccentric strength is when the muscle is working while it's stretching. This strength is required during the time the forefoot hits the ground and when the heel lands. 2-3 sets of 10 reps<br />
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Falls Into Strides - This takes wall falls to the next step. Fall forward until you can't hold yourself up, then stride for about 20 yards. Keep your back straight and core tight. Please don't fall on your face!<br />
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High Knees - This works on front side form. Bring your knee up to your chest without leaning backwards and land on your forefoot. Keep your feet under your body and don't reach forward. This drill is about speed not distance of each step. 10-20 yards<br />
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Butt Kicks - This works on back side form. Kick your heel towards your glutes. The tendency is to arch your back because of tightness in the quadriceps and hip flexors. Keep your core tight and back in neutral. Land on your forefoot. Again, this is about quick feet and not distance. 10 - 20 yards<br />
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<h3>
Running Program</h3>
Start slow and forefoot run for a 2-3 minutes then return to your normal form for 5 minutes to allow the new working muscles to rest. Repeat until you reach 30 minutes. Increase the amount of time you forefoot running by 1 minute each week as long on there is no pain. So forefoot run 3-4 minutes then walk 5 minute.<br />
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<br />
<b>Week 1</b><br />
Barefoot walking in the house using a forefoot pattern.<br />
<b>Week 2</b><br />
2-3 minutes forefoot running 5 minutes running normal x 3 - 4 for 30 minutes total 2-3 times a week<br />
<b>Week 3</b><br />
3-4 minutes forefoot running 5 minute running normal x 3 - 4 for 30 minutes total 2-3 times a week<br />
<b>Week 4</b><br />
4-5 minute forefoot running 5 minute running normal x 3 for 30 minutes total 2-3 times a week<br />
<b>Week 5</b><br />
5-6 minute forefoot running 4 minute running normal x 3 for 30 minutes total 2-3 times a week<br />
<b>Week 6-12</b><br />
6-7 minute forefoot running 3 minute running normal x 3 for 30 minutes total 2-3 times a week<br />
Repeat until you reach 3 x 10 minutes of running forefoot<br />
<b>Then transition</b><br />
15 minutes of forefoot running 3 x week<br />
18 minutes of forefoot running 3 x week<br />
add 3 minutes to each run each week until you reach 30 minutes.<br />
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Do not move forward if you have pain. You should be able to comfortably run forefoot for 30 minutes without discomfort before incorporating it into harder runs.<br />
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There are a lot of different core and ankle exercises, as well as, running drills. However, I believe these are the fundamentals which build a good base for forefoot running. Remember this takes time to transition!<br />
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<b style="font-family: inherit; white-space: pre;">Look out for a future post on how footwear ( heel drop) can change your strike pattern. </b><br />
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<b><i>References</i></b><br />
<i><br /></i>
<i>The core exercises are a modified version of Dr. Chris Powers's Course <span style="font-family: inherit;">Evaluation and Treatment of the Injured Runner: A Biomechanical Approach</span></i><br />
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<span style="font-family: inherit;"><i>The running program is a modified version from Dr. Irene Davis's running lecture <span style="white-space: pre;">Spaulding National</span></i></span><br />
<span style="font-family: inherit;"><span style="white-space: pre;"><i>Running Center - Barefoot running Training.</i></span></span><br />
<span style="font-family: inherit;"><span style="white-space: pre;"><i><br /></i></span></span>
<span style="font-family: inherit;"><span style="white-space: pre;"><i><br /></i></span></span>
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<br />Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com2tag:blogger.com,1999:blog-3011141020454998074.post-75084776212068099122016-02-21T17:48:00.001-08:002016-03-07T08:57:10.692-08:00Why Forefoot Strike<br />
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In recent years, there has been significant increase in the media about forefoot strike. Is forefoot running good for you? Will it lead to injury? Is it just a fad? Research seems to show forefoot strike decreases injury and improve running performance.<br />
I was already adjusting my stride to manage my own injury. I've tried shifting my hips side to side to load my hips, but that just gave me a bunion. I tried kicking my leg to the side as it went behind my body, but that didn't work. My recent glute activation cue of "push the knee back"while running seems to be alleviating my symptoms. I also notice this cue made me strike more forward on my foot. So I decided to investigate. Here are the benefits I learned about forefoot running.<br />
<b><br /></b>TO BE CLEAR<br />
<b>*** Forefoot strike is not running on tip toes. Forefoot running is landing on your forefoot then allowing the foot to come down.</b><br />
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<h3>
Why Forefoot Strike? </h3>
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<h4>
Decrease Forces</h4>
<i>For every action there is an equal and opposite reaction.</i> That is Newton's 3rd law of motion. How does this relate to running? When looking studies using force plates, there's a big difference in forefoot strike vs. heel strike. During forefoot strike there is 1 smooth peak of force. However, in heel strike there are 2 peaks of force. This means there is more force when you heel strike. Your muscles work harder have to absorb extra force. It doesn't seem like that extra force is a lot but if you multiple how many steps you take per minute ( ideally 180 steps) that is over 5,400 steps over 30 minutes multiplied by that extra force. By forefoot striking, you use less energy because there is less force.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjp-TT4iUVpFDwxqn71sOND55kW6RALo3wzuEqKY-SjT5YWUGLhvCh245dsB54Cog1meZS5RguN2yHbxNvVIkZ0OsPCYTV0YTiq9nbhKAwz3ZsbY9u2XBAO91SefaFUAzPPpvs1WiP_NxQ/s1600/FullSizeRender+3.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="283" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjp-TT4iUVpFDwxqn71sOND55kW6RALo3wzuEqKY-SjT5YWUGLhvCh245dsB54Cog1meZS5RguN2yHbxNvVIkZ0OsPCYTV0YTiq9nbhKAwz3ZsbY9u2XBAO91SefaFUAzPPpvs1WiP_NxQ/s400/FullSizeRender+3.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">This chart shows the double peak vs single peak <br />
difference in heel strike vs forefoot strike.</td></tr>
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<h4>
Better Body Position </h4>
Proper running form is having foot under you as your body moves over your leg with a slight forward lean from the hips. Foot placement under the body is critical because it allows smooth transition of force. The ankle is used and a spring. In heel strike, there is a "braking" involved when the foot hits the ground. Landing on your forefoot helps to bring the body forward into slight forward lean. A forward lean helps to activate your core muscles to stabilize your body while running.<br />
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In heel strike the body trails behind the leg, this causes increase demand in quadriceps. However, during a forefoot strike the body is over the leg which allows improve loading of the whole lower extremity. Clinically this is important because many injuries arise from over use of the quadriceps and under-utilization of the gluteals. Forefoot striking improve posterior chain activation.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOwnjTZQaZj54BX7o0xFTHy10KcLylqNtLlS2pB-S13LSqhX73RhMxgYVR7KJTDHSVWacVt7UBJ8yKQGJiX-rqy1jwvt06FwS0SIBapX7yheuq4Qb71CAD6_io1uSno515KS06iC95gyY/s1600/IMG_5540.PNG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOwnjTZQaZj54BX7o0xFTHy10KcLylqNtLlS2pB-S13LSqhX73RhMxgYVR7KJTDHSVWacVt7UBJ8yKQGJiX-rqy1jwvt06FwS0SIBapX7yheuq4Qb71CAD6_io1uSno515KS06iC95gyY/s320/IMG_5540.PNG" width="262" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><b>Forefoot strike</b> The upper torso is over<br />
the ankle. This allows force to smoothly<br />
transition over the foot.</td></tr>
</tbody></table>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoZNAnfUx8PIB57DHo70cZr3eWJHYaU66ZJ6xwDc6tSvCG4Zg-21BM3I8u6pAPCxgYUEhlWqyGZAknyR0M4IzNfdnBvaCAbhI-Rwfoo6iMLkVkwlyWup1qXQeQNvx8bswh58wbM5VrqqU/s1600/IMG_5542.PNG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoZNAnfUx8PIB57DHo70cZr3eWJHYaU66ZJ6xwDc6tSvCG4Zg-21BM3I8u6pAPCxgYUEhlWqyGZAknyR0M4IzNfdnBvaCAbhI-Rwfoo6iMLkVkwlyWup1qXQeQNvx8bswh58wbM5VrqqU/s320/IMG_5542.PNG" width="266" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><b>Heel strike</b> The upper torso trails behind the<br />
contact leg which increases the work load.</td></tr>
</tbody></table>
<br />
<br />
<h4>
<span style="font-weight: normal;">*** TRY this: 1) In standing shift your weight towards your heels. What do you feel? I feel my quadriceps engage. Now shift your wight into your toes. What do you feel? I feel glute and core activation . 2) Walk with the forefoot hitting the ground first. What do you feel? I feel my body lean forward and my abs are activated. Now, walk exaggerating a heel strike. What do you feel? I feel my body leaning back Or my chest comes forward and my hips move back ( this creates lumbar lordosis which leads to low back pain).</span></h4>
<div>
<span style="font-weight: normal;"><br /></span></div>
<h4>
Preserving Forward Momentum </h4>
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRwpQcecntBVvB4lcCVQPIEp2Zwedoah_R1bYn-fwTA8WCvtfztfj6-NZCgR9B2fDaXO256tfn1jUX685cMDHQu_AIfVPQ76CzcrIeFbfRmhS__g0thLT_9-EIniupdTJMjHLqgxcGPuM/s1600/IMG_5543+2.PNG" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRwpQcecntBVvB4lcCVQPIEp2Zwedoah_R1bYn-fwTA8WCvtfztfj6-NZCgR9B2fDaXO256tfn1jUX685cMDHQu_AIfVPQ76CzcrIeFbfRmhS__g0thLT_9-EIniupdTJMjHLqgxcGPuM/s320/IMG_5543+2.PNG" width="274" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><b>Heel Strike -</b> red line demonstrates gravity pushing<br />
down at the shoulder. The line falls behind the foot.<br />
This means your body weight is you and<br />
your muscles has to work harder to<br />
push you forward.</td></tr>
</tbody></table>
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwwdzxAiyGPFvIsRs2U2ZWFKB7RvWu6Y8y-HVGOjrrNymigaVFYEbGkq4n34VITxLK_2xFbMp-M6OCLhFa0Akiw5RGUi7BIkFHdkdHZD1HC0Cst2foqzjxvCJ1PGMlZ0E1xSYn1mUu5l4/s1600/IMG_5545+2.PNG" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwwdzxAiyGPFvIsRs2U2ZWFKB7RvWu6Y8y-HVGOjrrNymigaVFYEbGkq4n34VITxLK_2xFbMp-M6OCLhFa0Akiw5RGUi7BIkFHdkdHZD1HC0Cst2foqzjxvCJ1PGMlZ0E1xSYn1mUu5l4/s320/IMG_5545+2.PNG" width="241" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><b>Forefoot Strike - </b>red line shows gravity pushing<br />
down through the foot. This gets your weight<br />
forward which is easier for your muscles<br />
to propel. </td></tr>
</tbody></table>
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<div style="text-align: right;">
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<div class="separator" style="clear: both; text-align: center;">
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To run with proper forefoot strike, you have to lean forward at your pelvis. This moves your center of mass forward over your base of support. This allows gravity to work in your favor by pushing your body forward. When you heel strike, typically, your center of mass is behind your base. You are fighting ground reaction forces and gravity to move forward. Gravity is actually pushing you backwards. It's hard to land heel strike while maintaining a forward pelvic lean. When you forefoot strike, you lean forward at your pelvis allowing gravity to help which makes you more efficient while running.<br />
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<h3>
Tips</h3>
<h4>
Lean forward at pelvis</h4>
When you bring your pelvis over your feet you bring your center of mass over your base. This helps to keep your feet under your body which allows you to forefoot strike. At the same time, as mentioned above, you allow momentum to carry you forward. Make sure to keep your core tight by bring your pelvis under your body.<br />
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<h4>
180 steps per min</h4>
Research has shown 180 -190 stride rate is most effective. To establish this frequency you have to take shorter strides which help with landing forefoot. When you heel strike, the length of your stride is longer making it difficult to increase frequency. A quick Google search shows <a href="http://running.about.com/od/musicforrunning/a/Running-Songs-At-180-Bpm.htm" target="_blank">Play list for songs with 180 beats per minute.</a><br />
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<h4>
Be light on your feet</h4>
<div>
This seems obvious. But when you're landing light and soft, it's hard to land on your heel. Landing light also decreases the time your foot spends on the ground. This will help decrease the forces your body has to absorb.</div>
<br />
<h3>
Conclusion</h3>
My conclusion is running with a forefoot strike is better for body alignment and efficiency. This can in turn decrease injury and improve performance. However, it requires A LOT of ankle and core strength. FOREFOOT RUNNING ISN'T FOR EVERYONE. It takes time to get your body moving in a different pattern! In order to transition to forefoot strike safety, you be have patience and have good strength. I recommend forefoot strike only if you have a GOOD core stabilization program and calf strength. It is my personal belief that some one who has pain while attempting to forefoot strike is not strong enough to maintain this pattern.<br />
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<b>Please have your form evaluated by a professional. It is critical that you get feedback on your form.</b><br />
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<i>I am working to transition myself to forefoot running. Those who know me know I have been battling a 6 year injury from a fall. I've had numerous imaging and injections without answers or resolution. Through the past 6 years I have been able to run but always with some symptoms. Recently, I have been focusing on REALLY improving my core and glute strength because of the possibility of a hip labral tear. I have been incorporating fore foot strike into my runs focusing on proper form. I have not had ANY symptoms. As soon as I can't maintain my form my quadriceps symptoms return.</i><br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">"PEOPLE RUN TO GET FIT BUT YOU HAVE TO BE FIT TO RUN" - Chris Powers, </span><span style="font-family: inherit;">PhD, PT, FACSM, FAPTA</span><br />
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<span style="font-family: inherit; font-size: large;"><b>STAY TUNED FOR MY NEXT POST ON STRENGTH EXERCISES AND DRILLS TO SAFELY BEGIN FOREFOOT RUNNING</b></span><br />
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<span style="font-size: x-small;"><span style="font-family: inherit;">----</span></span><br />
<span style="font-size: xx-small;"><span style="font-family: inherit; font-size: xx-small;">References</span></span><br />
<span style="font-size: xx-small;"><span style="font-size: xx-small;"><span style="font-family: inherit;"><br /></span></span>
<span style="font-size: xx-small;"><span style="font-family: inherit;">Altman, A.R. Davis, I.R. Barefoot Running: Biomechanics and Implications for Running Injuries. Current Sports Medicine Reports. </span><span style="white-space: pre-wrap;">Am. J. Sports Med</span><span style="font-family: inherit;">. </span><span style="font-family: inherit;">Volume 11 </span><span style="font-family: inherit;">& </span><span style="font-family: inherit;">Number 5 </span><span style="font-family: inherit;">& </span><span style="font-family: inherit;">September/October. 2012 (244-50).</span></span></span><br />
<span style="font-size: xx-small;"><span style="font-family: inherit;"><span style="font-size: xx-small;"><br /></span></span>
<span style="font-family: inherit; font-size: xx-small;">Davis, Irene. Lecture Foot Strike, Footwear, Treatment of the Foot- An Evolution of Thought.</span></span><br />
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<span style="font-family: inherit; font-size: xx-small;"><span style="font-family: inherit;">Divert, C. et al. Mechanical Comparison of Barefoot and Shod Running. </span><span style="font-family: "dtlargot";">Int J Sports Med 2005; 26: 593 – 598.</span></span><br />
<span style="font-size: xx-small;"><span style="font-family: inherit; font-size: xx-small;"><br /></span>
<span style="font-family: inherit; font-size: xx-small;">Powers, C.M. Functional Biomechanics of the Lower Quarter Lecture.</span></span><br />
<span style="font-family: inherit; font-size: xx-small;"><br /></span></div>
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</div>
</div>
<span style="font-family: inherit; font-size: xx-small;"><span style="font-family: "arnopro";"><span style="font-size: xx-small;">Rooney, B.D. Joint contact loading in forefoot and rearfoot strike
patterns during running. J Biom</span></span><span style="background-color: #f9fbfc; font-size: xx-small; text-align: center; word-spacing: -0.15ex;">,V46, 13. September 2013, Pages 2201–2206.</span></span><br />
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Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com2tag:blogger.com,1999:blog-3011141020454998074.post-86697019326185806572016-02-08T16:53:00.002-08:002016-04-18T09:10:06.119-07:00STOP Stretching Your IliopsoasIt's all over the internet. You've read about it on numerous blogs. I've even talked about it. There's stretches. There's lacrosse ball rolling. There are standing desks. It's all to resolve tight hip flexors (Illiopsoas). "The tightness is killing you!" You're doing everything you can ... But WHY is it still tight?<br />
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When we roll, stretch and use a standing desk, are we REALLY solving the issue? There has to be more to the story then hip flexors contractures from sitting.<br />
<br />
Yes, sitting can contribute to tight hip flexors. However, instability of the core and back can also cause the hip flexor to be tight. The hip flexor originates from the lumbar spine. It is a massive muscle in the center of our body. When the core is unstable the hip flexor compensates by tightening to provide the stability needed. Our body wants to be stable. Could it be that our hip flexor doesn't get tight because of the position itself? Or does it tighten because the way we sit causes or back stabilizers to shut off so the hips stiffness to provide stability?<br />
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<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv9eKOPbLz9TWXtsUAzu6G05eWBne3U2mCzVccjOmsmHA5zyZuE9v0In93kJZ1EEj8Xdb1mRsf22_XEmiRoLOKLl8crLDzQ_MW-dQG9aYL7TZKG2oYWJj59yEGX1s4Q6ILif1A3e6kByQ/s1600/FullSizeRender.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="319" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv9eKOPbLz9TWXtsUAzu6G05eWBne3U2mCzVccjOmsmHA5zyZuE9v0In93kJZ1EEj8Xdb1mRsf22_XEmiRoLOKLl8crLDzQ_MW-dQG9aYL7TZKG2oYWJj59yEGX1s4Q6ILif1A3e6kByQ/s320/FullSizeRender.jpg" width="320" /></a></div>
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<h3>
Core Stability vs Core Strength</h3>
Core stability is the ability for the small intersegmental muscles to stabilize the joints while moving. This is important for proper bone mechanics. Core strength is the ability of the large muscles groups to the body in a big range of motion. Stabilizers are the multifidus which are short muscles that attach a every 2-3 bone segments and the transverse abdominals (TrA) which is the deep layer of the abs. Strength muscles are erector spinae and rectus abdominals (6-pack).<br />
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<div style="text-align: right;">
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<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiO7MXjAtb_38Y643x0LVb_69vyAZnJL8kC3nHcnpMTG7NOeFmDLUCaa9aDhBxXF3MzehV-Akjbugc0TpFwVWgSsfBNMXVd0dbq0wCrWmP7c4f27CeFadfE6E5ClX3AqqAEpuqjgfzzn9Y/s1600/iliopsoas-13FC60D0F4B58B2B4F5.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiO7MXjAtb_38Y643x0LVb_69vyAZnJL8kC3nHcnpMTG7NOeFmDLUCaa9aDhBxXF3MzehV-Akjbugc0TpFwVWgSsfBNMXVd0dbq0wCrWmP7c4f27CeFadfE6E5ClX3AqqAEpuqjgfzzn9Y/s320/iliopsoas-13FC60D0F4B58B2B4F5.jpg" width="167" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Note how parts of the psoas originates<br />
from each of the vertebra </td></tr>
</tbody></table>
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgblPI-FIPjYmZZAmOQUiFNKSMfUIC0Cwj6m7v3Ns0D6VOWjchfQ_sSY4akbL-lfmZHybw_xO1WBkfhWa9ZejKuM0I9BCCLIp26lD5okNgMj-JYAnjZK-_J4xv_U4usIe6wSHI9fI6LwiQ/s1600/Unknown-3.jpeg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto; text-align: center;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgblPI-FIPjYmZZAmOQUiFNKSMfUIC0Cwj6m7v3Ns0D6VOWjchfQ_sSY4akbL-lfmZHybw_xO1WBkfhWa9ZejKuM0I9BCCLIp26lD5okNgMj-JYAnjZK-_J4xv_U4usIe6wSHI9fI6LwiQ/s320/Unknown-3.jpeg" width="292" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Note the attachment of multifidus spans<br />
3 segments</td></tr>
</tbody></table>
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<h3>
</h3>
Performing crunches and back extensions will improve your core strength but not stability your core. Lack of balance between the stabilizers and strength muscles can cause shearing of the lumbar joints causing pain. This will also contribute to the tightness. Performing stability exercises will decrease low back pain and hip tightness.<br />
<br />
<h3>
Which Exercises?</h3>
<br />
<iframe allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/6nP9EkCn7zE" width="560"></iframe>
<br />
<br />
The best exercises to improve stability are marches, bent knee fall out and various planks. The key is to keep the core neutral and tight during the exercises. There are many other stability exercises such as bird-dog and dead bugs. Choose 3-4 of them 3 times a week. Progress to standing functional exercises such as a variation on a chop. You can continue other core strengthening exercises but also include spine stability exercises.<br />
<br />
Go ahead, stretch and roll out your hip flexors. It will help to manage your symptoms. But, if you find yourself constantly rolling and stretching your hip flexor, ask yourself, how is your core stability. In order to resolve the tightness, you have to stabilize the spine by improving the endurance of the stability muscles.<br />
* Pictures from www.studyblue.comJanet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com3tag:blogger.com,1999:blog-3011141020454998074.post-51804206989493813382016-01-29T15:52:00.001-08:002016-04-16T07:18:14.514-07:00Glutes - How to Transition From Exercise to RunYou've been told you have weak glutes. Whether it's hip pain, knee pain, ankle pain, it all can be "healed" by improving glute strength. You are prescribed clams, side lying leg lifts, bridges then progressed to squats and lunges. You feel stronger and released to go for a run. Your symptoms feel better but returns after getting back to your routine.<br />
<br />
<h3>
Recruiting Glutes vs. Quads</h3>
Is your strength transferring from a basic clam exercise to running? Are your glutes REALLY activating when you run? For most of us, we are very quad dominant. This means we over use our quadriceps when we should be using other muscles such as our glutes. Our sedentary lifestyle of sitting at work or relaxing on the couch has us disengaging our glutes. The quads have at a mechanical advantage to work. Also, the habitual use of quadriceps enhances the neural input from the brain is going to the quads and not the glutes. In other words, the wiring to the quads is better then wiring to the glutes. When running, demand on the muscles is so high we use whatever muscles are the easiest to recruit. The Quads.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjYTjPC7dQeNQJHhmyP16jSEg07GUpukB-NjMPrDPJxaLZYDLX3bLvTvC8JYU08EhnUT4BI-WAyDFsKb7KZ1j9_v2M169x1JrLzyNtNK4N0FkpBbKkHkBSLAQpohWCYMBSeKrTxf4fVhi8/s1600/FullSizeRender+2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="314" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjYTjPC7dQeNQJHhmyP16jSEg07GUpukB-NjMPrDPJxaLZYDLX3bLvTvC8JYU08EhnUT4BI-WAyDFsKb7KZ1j9_v2M169x1JrLzyNtNK4N0FkpBbKkHkBSLAQpohWCYMBSeKrTxf4fVhi8/s320/FullSizeRender+2.jpg" width="320" /></a></div>
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<br />
I have seen and used different cues such as "stick out your butt"or"squeeze your butt as you stand up". However, most of my patients and clients have a difficulty "feeling the exercise". AND, the improved strength doesn't seem to translate to running.<br />
<br />
<h3>
PUSH YOUR KNEES BACK</h3>
I have been using a different cue to activate the glutes while performing standing exercises such as squats and lunges. While you are performing squats or lunges (or any standing hip exercises i.e. box step ups), pretend like there is an object behind your knee and push back as you stand up. The gluteus maximus is responsible for hip extension, getting your thigh behind you body. However when your foot is fixed on the ground and the knee is given the cue to push back, this extends the knee AND hip. This will engage your gluteus maximus.<br />
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<iframe allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/K6V2OTFFIEA" width="560"></iframe>
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Stand up and perform a squat. When you stand up, you feel your thighs press down into the ground and push up. Now try a squat but give the cue for your knees to push back.<br />
<br />
FEEL the burn in your glutes.<br />
<br />
Now, think of this cue when running. You want to let your knee land normally (with a soft bend), then push back with the knee as your body is moving over your leg. You should feel like your legs are moving in a circle, almost like pedaling a bike. At first, I recommend incorporating this during a warming up, then into sides and finally into your short normal runs. The best way to feel this is up hill sprints!<br />
THIS CUE WORKS BEST IF YOU MIDFOOT OR FOREFOOT STRIKE!<br />
<br />
So on top of performing clams, leg lifts and squats add this "push your knee back" cue to the standing exercises.<br />
<br />
Please contact me if you have any questions or concerns.Janet Yiuhttp://www.blogger.com/profile/10886926085452829017noreply@blogger.com3