A proper warm-up prior to a run is important to increase the heart rate, blood circulation to the working muscles, and joint efficiency. However, cooling down is an essential component of the training process and should be completed at the end of every exercise session. It is important to cool-down after a run to transition the body back to a steady, resting state by decreasing the heart rate, breathing rate, and body temperature. Cooling down also returns the muscles to their optimal length-tension relationships and returns blood from the extremities back to the heart. Skipping a cool-down or performing it incorrectly can cause your muscles to become sorer and stiffer which may lead to unwanted injuries.
The following is a guide for optimal post-race recovery:
1. Slow jog or walk
Immediately at the end of a run, it is ideal to slow your pace down to a jog or a brisk walk to gradually lower your heart rate. Ending your run abruptly may cause blood to pool in your legs instead of returning it to the heart and brain. This can lead to a risk of fainting or feelings of lightheadedness. Jog or walk for approximately 5 to 10 minutes.
Exercising will cause more sweating and loss of fluid in the body which may lead to dehydration. Restore fluid levels in your body by rehydrating with water. It is important to stay hydrated to help manage your body temperature, remove waste from your body, and protect your tissues and joints.
3. Total Body Stretching
a. Pigeon Pose:
Begin in 4 point position on a yoga mat. To stretch the right posterior hip, including the Piriformis muscle, straighten out the left knee pushing the left foot back. Then bring the right knee forward towards your chest while supporting yourself with your hands in front. Making sure that your left and right pelvises are level with each other, bring your right foot across turning it to the left side. Then reach forward on the mat with your hands bringing your elbows towards the mat while keeping both sides of the pelvis level and down. Hold for 30 seconds and do 3 sets on each side 2 times daily.
b. Hip Flexor Stretch:
Kneel down onto your left knee. Then rotate it about 45 degrees past the midline of your body. To keep your posture nice and tall imagine there’s a string pulling your whole spine upwards from your pelvis, right up your entire back and neck and up to the top of your head. Then engage your inner core muscles tight below your belly button and keep your low back flat. Next, bend the right knee forward and keep your posture nice and tall without leaning backwards. Then reach your left arm up pointing the fingers towards the ceiling nice and high and point your right finger tips to the floor. Hold this stretch for 30 seconds and repeat 3 times for each side.
c. IT Band / Lateral Quad Stretch:
Start by lying on your good side with the tight Iliotibial Band or “IT-Band” facing up. Keep your inner core muscles below the belly button engaged while keeping your low back flat. Then, bring the bottom knee towards your chest and with your left hand, reach down and back for your other leg above the ankle. Pull the heel back towards the bum while keeping the core engaged and the low back flat. Keeping the top knee and ankle parallel and level with the floor, lift your bottom heel onto the top part of your knee. Next, guide your lower leg down toward the floor with your heel while keeping the top leg, knee and ankle parallel and level to the floor. As the top leg is lowered down, have the top knee and thigh pointed downwards so it’s in alignment with your whole spine. Hold this stretch for 30 seconds and repeat 3 sets 2 times daily.
d. Lat Stretch:
To stretch the right lat, place the back of your right hand to your left side in front of you while clasping it with your left hand. Reach forward to your left and keep your elbows straight. Keep your knees wide apart and the back of your feet flat on the mat. Reach forward and lean to the right arm pit. Hold for 30 seconds, do 3 sets. Repeat on the opposite side if it’s also tight!
e. Shoulder Stretch:
To stretch out the right side, reach your right hand up and down your back keeping your right elbow pointed upwards. Avoid arching the back by keeping your spine in neutral. Pull the right elbow towards midline with your left hand while keeping the right elbow pointed upwards. Hold this for 30 seconds doing 3 sets on each side daily.
f. Rolling out the Hamstrings:
Put the roller on the ground and bring your hamstring onto it. Roll up and down onto your Hamstring muscle while supporting yourself with both hands. Find the sweet spots (or the areas that hurt in a good way) and continue to roll over these areas for 3-4 minutes in total. Do this 2-3 times a day just before you stretch out the hamstring.
g. Rolling out the Calf Muscles:
4. Additional Measures
Take a 5-10 minute cold water bath to reduce swelling. Allow 1-2 days post-run to allow the body to recover before massaging any tight muscles.
Running is a great way to improve aerobic fitness and cardiovascular health. Running not only burns calories, but can contribute to one’s mental and physical health. However, a large percentage of individuals who run are exposed to a wide range of running-related injuries, most of which are due to overuse. Up to 80% of the injuries occur in the lower extremities with the knee found to be the most commonly injured body part (Callahan, 2018). Patellofemoral pain, medial tibial stress syndrome (shin splints), achilles tendinopathy, iliotibial band syndrome, plantar fasciitis, and stress fractures are the most common diagnoses.
In the majority of cases, pain may arise in the lower extremities due to intrinsic factors such as being overweight, having weak core and leg muscles or with changes in foot type such as having flat feet. Extrinsic factors such as poor footwear, not stretching, or an unbalanced diet may contribute to running-related injuries. The main risk factor to running-related injuries was due to having a previous injury in the last 12 months. It is important for your physiotherapist or coach to be aware of all previous injuries that you may have sustained.
Acute treatment includes stretching the posterior structures, massage, ice, activity reduction, taping, corticosteroid injection, or orthotics. Long-term treatment includes strengthening the intrinsic foot, ankle and hip. New footwear, night splints, or surgery may be indicated if conservative treatments are unsuccessful. Consult your physiotherapist or coach for the appropriate treatment.
RETURN TO RUNNING CHECKLIST
Ensure there are no signs or symptoms of inflammation and you have gained the full ability to weight bear through your legs and feet. You should be able to hop in multiple directions on each leg and should be able to walk at a speed of at least 5.6 km/h (or 3.5 mph). Toe dexterity, or precise control of the toes, should be present in each foot and you should be able to balance in a wobble-free manner for more than 30 seconds.
Below are some key exercises to stretch and strengthen muscles essential to improving running performance and reducing the risk of running-related injuries:
A) Wall Squat
The exercise shown above can help with the retraining of the core stability, hip, leg and ankle muscles.
B) Psoas March
The exercise shown above helps increase hip flexor and core strength.
MUSCLE STRENGTHENING & STRETCHING
A) Bridging Hamstring Curls
The exercise shown above helps strengthen the hamstrings, glutes, and core stability muscles to help protect the ligaments of the knee.
The exercise shown above helps strengthen the hip, quad, and core muscles to prevent leg injuries.
C) Wall Plank Resisted Knee Highs
The exercise shown above helps reduce anterior hip pain and weakness that may contribute to running-related injuries.
D) Lateral Quad Stretch
The exercise shown above is particularly helpful if the Iliotibial Band is tight due to stiffness in the lateral quadriceps muscle. Overuse knee pain can be caused by excessive running.
Knee and ACL injuries commonly occur in sports such as soccer, ultimate, and rugby. Athletes may require months to even more than a year to recover and to be able to return to play. There is a vast amount of literature describing a number of ways on how to prevent knee and ACL injuries. However, the most effective prevention strategies are the ones that are based on scientific evidence, a thorough assessment made by the coach and medical team, and the individual’s input.
Strongly suggested by research, programs most beneficial in preventing injuries consist of flexibility drills, running drills, strength training, core strength, and plyometrics. Each session should last approximately 20 minutes with a goal of exercising a minimum of 30 minutes per week. Programs should be implemented through out the year from preseason to regular season. Although most research studies focused on athletes between the ages of 12 and 25 years, these programs may benefit older individuals.
1) Toe Taps: Standing tall, kick one leg up and touch your toes to the palm of your hand. Alternate legs. Repeat 10 times on each side.
2) Reverse Lunge & Hop: Step back with one leg until you get into a lunge position. Swing the back leg forward until your knee is bent at a right angle by your chest. Maintain an upright body and repeat on the other side. Perform 10 repetitions on each side.
3) Calf Stretch: Standing tall on one leg, extend the other leg forward with only the heel in contact with the floor. Gently bend forward at the hips and feel a stretch along the front leg. Hold for 30 seconds and repeat on other leg. Perform 3 times on each side.
Perform running drills such as forward and backward running or bounding. Watch Physiotherapist Claire lead two athletes through a series of running and other dynamic drills below.
1) Planks: Begin on the floor resting on your forearms and knees. Extend both legs until your whole body forms a straight line from the top of your head to your feet. Engage the core and glute muscles. Begin by holding this position for 30 seconds. Progress to 60 seconds or more to increase difficulty.
2) Glute Bridge: Begin on the floor with your back flat, legs bent at approximately 90 degrees and both feet on the ground. Place both arms to the side then engage your core as you lift your hips up. Hold for a second or two at the top as you squeeze your glute muscles.
1) Box Jumps: Use a box that is around your knee height or higher. Stand in front of the box with your feet shoulder-width apart. Bend slightly downwards, swing your arms back, then swing them forward and explode up off the ground onto the box. Repeat 10 times.
2) Lateral Skater Jumps: Begin by standing on one leg and bend the other leg. Jump sidewards and land on the leg that was bent. Then switch sides. Repeat 10 on each side.
Ever feel pain or swelling on the side of your foot? These symptoms may be due to a condition called Cuboid Syndrome, also known as cuboid subluxation or lateral plantar neuritis. In addition to pain in the lateral mid-foot, redness and a restricted range of motion in the ankle may be present. This syndrome is typically associated with an inversion sprain of the ankle. This is when the foot is forced inwards causing the cuboid bone to sublux, or partially dislocate. The cuboid bone is located near the mid-point of the outer side of the foot and is one of the seven tarsal bones that make up the arch of the foot. It connects the foot and ankle as well as provides stability to the foot.
The peroneus longus muscle is a muscle that runs along the outer side of the lower leg and attaches to the lateral side of the foot. Repetitive strain of this muscle due to activities such as ballet, jumping, or running, may place tension on the cuboid bone. Commonly found in athletes, Cuboid Syndrome may also occur in sports such basketball, football, or soccer. Weight-bearing, uneven pavement, or quick changes in direction that occur in sports may aggravate symptoms. A third cause of this syndrome may be an individual’s altered foot biomechanics. Athletes who have over-pronated feet, also known as flat feet, may be more prone to cuboid subluxation.
Imaging such as x-rays, MRIs, and CT scans can be used to rule out other causes of pain. However, a cuboid subluxation can be difficult to diagnose and therefore, must be carefully assessed by a general physician or other health care professional.
Daily strengthening and mobility exercises should be performed on a pain-free basis to prevent the foot and ankle from becoming weak or stiff. Watch the videos below on how to properly perform strengthening exercises:
Other treatment options include foot support such as padding, taping, or orthotics to help stabilize the bones of the midfoot or correct for over-pronation. Rest from repetitive, weight-bearing actions such as jumping or running may help alleviate pain. Ice affected area for 10 minutes at a time to reduce swelling and inflammation. Consult your family physician, physical therapist, or podiatrist to perform a manipulation if the cuboid bone is suspected to be dislocated.
Insync Physiotherapy’s Michelle Robichaud, RMT, recently returned from her amazing trip to Northern Europe and back in time for the 2018 BMO Vancouver Marathon where she completed an 8-km run! Congrats Michelle!
Check out the photos below of Michelle in Iceland, Scotland, and Denmark: