Human Performance and Rehabilitation Centers, Inc.

Improve Your Running Through Better Mechanics

Do you feel like you aren’t getting the best results from your morning run?  Maybe you are having a little nagging pain afterwards?  This could be due to poor running mechanics.  Not running properly can lead to a variety of overuse and chronic injuries – Achilles tendonitis, plantar fasciitis, stress fractures, hip and low back pain, etc.  It can also slow down your pace and make your run less efficient.

Most often, we see a patient and learn that they have inefficient running mechanics through treatment of an injury.  We will first treat the injury to get them back to running health and then we will evaluate further to get to the root of the problem. We observe a patient running both on and off a treadmill, slow their pace down to observe their running style, look for compensations and to assess joint movement. We also take a look at their footwear to make sure they are in the proper shoe for their foot type and running style.  This process incorporates everything from their head to their feet.

If there is an issue with your running mechanics, it’s important to focus on correcting it while you are running.  Focusing on the adjustment will improve your mechanics more quickly and will lead to less energy expenditure, less overall fatigue and most importantly less pain, resulting in a decreased chance of injury or reinjury.  Quite often, we have to spend time on running education to discuss running surfaces, road camber, speed and distance training plans, as well as establish frequency and intensity guidelines while making adjustments. Usually after a couple of weeks performing specific exercise techniques and focusing on the change in form, patients are able to report a positive difference in how they feel before and after a run.

Keep in mind, poor running mechanics don’t just show up in adults.  You can spot it in your children as well.   If your child complains of pain while running, anywhere in the body, it can be a sign they have poor mechanics, unless of course, they have pushed their limits in a race or speed workout.  Pain caused by running can present in places one might not expect such as the lower back, shoulders, feet and knees.  Observe their shoulders, hips and knees and also look at their feet.  Having high arches or flat feet can lead to injury in a runner, if not in the proper footwear.   If there is something that just looks a little off, it wouldn’t hurt to have a running assessment done to prevent injuries in your child.

Knee Pain Explained

Knee pain is something nearly every person experiences at one point or another, usually related to a particular injury or provocative activity, such as lots of kneeling for spring planting in the yard or playing the occasional game of basketball. How do you know the difference between a serious injury versus simple overuse? The causes of knee pain typically fall into one of three categories: traumatic, overuse, and degenerative.

Traumatic is self-explanatory; a fall, collision, twist, or awkward landing can create enough force to damage the structures inside the joint. When this type of damage occurs, the person may experience severe and immediate swelling, severe pain, a loss of ability to move the joint, and an inability to bear weight through the limb; a safe bet is when two of the three exist, the person should seek medical attention from a physician and/or physical therapist immediately. Attempting to “walk it off” is not recommended.

An overuse injury can be a little tougher to recognize. Starting a fitness program or a dramatic change in a person’s activity level (more or less) can provoke this type of pain. So can rapid increases in body weight, such as pregnancy. Adolescents who are going through growth spurts will often have pain in the knees because of changes in the way the muscles and joint function together. The pain may show up immediately or gradually, appearing more and more frequently until it is constant. Swelling may appear but is typically not severe and disappears overnight. Depending on the structure inside the knee that is taking the abuse, surgery may be needed, but many times this is treated quickly and effectively with a short course of rest, stretching and strengthening.

“Degenerative” describes the normal changes our joints experience with aging, specifically thinning of the articular cartilage and the loss of quality in the soft tissue of the joint. Knee pain from degenerative changes generally does not produce swelling and is provoked by remaining in one position for a great deal of time.

Besides pain, a problem within the knee (or any joint) will also cause the muscles around the joint to stop working effectively. Over time this will produce a loss of muscle size as well as a loss of control of the joint. The longer the joint remains untreated, the more severe the muscle atrophy and loss in function will become. Other joints may become painful as a result, particularly the areas above and below the injured joint or the opposite side. Medical treatment should begin before the body learns bad movement patterns.

Unless severe structural damage is present, a course of physical therapy will often be successful in getting rid of pain and restoring a person’s usual activity level. Any physician can refer to physical therapy and in many states no referral is required; in most cases, the therapist can make an accurate assessment of the problem and begin treatment immediately. If the problem is severe enough that a specialist should be involved, the therapist can facilitate the referral and also make recommendations for any diagnostic testing.

ACL tears in athletes

“I heard it go ‘pop,’” an athlete says with dread.

That sickening sound and a sudden pain in the knee point to the culprit: an ACL tear. Sports that demand sudden stops and quick lateral movements like football, soccer and basketball are hotbeds for ACL tears. Here’s what an athlete needs to know about recovering from this common sports injury.

About the injury

The anterior cruciate ligament (ACL) is one of four main ligaments in the knee that connect the femur above the knee to the tibia below. Injuries to the ACL can happen to anyone, but they are common among competitive athletes in their late teens to mid- to late twenties. As more young people are participating in sports with higher levels of athleticism, the injury is on the rise. According to the American Academy of Orthopaedic Surgeons, the annual incident rate of ACL injury is about 200,000 with 100,000 ACL reconstructions performed a year.

How it happens       

ACL injuries often occur when an athlete makes a quick stop, plants his or her foot and then changes direction. The abrupt change of speed combined with an abrupt change in direction stresses the ACL, which can tear and make a popping sound. Pain and swelling sets in quickly. Athletes will generally opt for reconstructive surgery of the ligament to maximize their ability to resume competition.

The road to recovery

Orthopedic surgeons thread in a new tendon to replace the torn ACL that is taken from the patient’s hamstring or from a cadaver. A patient will usually be on crutches for the first couple of weeks after surgery. The rehabilitation plan is dependent on the extent of injuries sustained during an ACL tear; it’s not uncommon to also experience damage to the meniscus. Therapy starts with very limited weight-bearing exercises that will slowly increase over time.

Strengthening the quadriceps is the primary goal of first 6 weeks of therapy. This helps provide stability to knee. The physical therapist will then move to short arc exercises, straight leg raises, hip strengthening and some balance exercises.

During the first 6 weeks, the goal is to increase range of motion — helping a patient go from zero to 135 degrees of flexion.

At the 8 to 12-week mark, the healing process is well underway with the reconstructed tendon tightening down as it should. Balance and biomechanics become key therapy priorities. Patients also progress into plyometric training, working their way up to light jogging and mild ladder drills at about the 10-week juncture. After 12-16 weeks, patients get into heavier plyometrics with the intention of soon getting back into their chosen sport. The therapist observes movement and watches for any signs of instability or imbalance.

Listen to your PT

Throughout therapy, it’s critical that a patient stick to the prescribed home exercise program to supplement therapy sessions. It’s also important a patient understand that the adage “no pain, no gain” does not apply to ACL recovery.  Take it slow and allow the ligament to fully heal in place. Patience goes a long way in preventing future injury.