Running & Lifting Injuries: Q&A with a Physical Therapist

One of my many favorite aspects of working for my gym is that we have the opportunity to work in conjunction with the Physical Therapists at the YMCA Healthy Living Center if needed.  As a personal trainer, I've found this to be beyond helpful in approaching client programming when specific health conditions and/or injuries are present that are beyond my scope of practice.  

One topic that comes up often with clients and the general public alike, is how to tackle muscle or joint stiffness and soreness.  Ultimately, I felt this question was best answered by my physical therapist, Abbey.  And….since I had her attention for that question, I threw in a couple bonus ones too.  I love Abbey's well rounded approach to both lifting and running, and I think you will too!  

Annie: Stiffness, soreness, and sometimes pain seem to be reoccurring part of many gym goer's routines. When, if ever, is it ok to work through aches and pains and how do you know when to seek medical attention?

Abbey: It depends on where the stiffness or soreness is. For example, if the soreness is in a muscle (ex. quadriceps, gluts, and hamstrings) after strength training, it’s okay to work through that. Keep in mind that it’s suggested to wait 24-48 hours before working the same body part to allow muscles to rest and rebuild. It would be advisable to cross train as a means to ease up on the soreness, for example: swimming, Yoga, Pilates, and cardiovascular exercise.

If it the stiffness and pain feels more in a joint (shoulder, knee, hip, back/spine, elbow) vs in a muscle, you should NOT work through the pain. Commonly, continuing to "work through” the pain can lead to more complicated injuries and intensify the level of discomfort for the exerciser. For example, if an athlete’s knees are sore after or during running, it would be best to discontinue running at that time and focus on the cause of pain. Seeking medical advice from a physical therapist and physician can help to address the issues and correct any faulty mechanics or muscle imbalances unknown to the exerciser.

Annie: Your experience, what is one or two of the most common injuries you see in runners? Is there any way to prevent this injury from happening?

In my experience, I have treated mostly patellar tendonitis and ITB syndrome. Prevention is key since these are both overuse injuries which take time to heal. The best way to stay ahead of injury is to cross train. It is crucial that the athlete/ exerciser take both strength training and flexibility into consideration. Assessment of hip range of motion, hamstrings and quadriceps length is a good place to begin. Basic muscle length tests include: quadriceps= lie on your stomach and pull your heal towards your buttocks; hamstrings= lie on your back, flex your hip to 90 degrees and try to straighten out your knee; hip external rotation= flex and abduct the hip as you laterally rotate the leg (the figure 4 position). If any of these cause discomfort, it's time to incorporate them into your routine, especially post exercise.

Strength of glut max, glut med, quadriceps, VMO, hamstrings, and gastroc is also crucial. Weight lifting in addition to stability training should be incorporated into cross training to give the runner proper support. The muscular system supports the skeletal system so it only makes sense to work on strength training in addition to running. I personally believe core training is a crucial component in a well-rounded program as back pain can arise from spinal compression forces occurring as the runner impacts the ground.

Annie: In your experience, what is one or two of the most common injuries you see in lifters? Is there any way to prevent this injury from happening?

Abbey: Shoulder impingement and tendonitis of the rotator cuff and biceps. Prevention and treatment should both include correct posture, body mechanics awareness, and strengthening shoulder stabilizers (rotator cuff, lower and middle trapezius, rhomboids and the posterior deltoids). Incorporate shoulder stability exercises into the workout or warm-up to prevent shoulder injuries and enhance performance. If a painful condition develops, an evaluation by a physician and/ or a physical therapist can determine the severity of injury and plan of care for treatment. An Easy rule to follow is RICE: rest, ice, compression and elevation.

Annie: Core stability is of course popular for many reasons and relevant to many actives. Do you have a favorite core stability move you use with your clients?
Abbey: Core stability IS popular with the general active community, and that’s a good thing!

I am trained in STOTT Pilates which will bias my answer.J STOTT PILATES emphasizes stabilization of the pelvis and lumbar spine (lower back) in either a neutral or an imprinted position. In neutral the normal curve of the lower back is maintained. When lying on your back, front of hip bones and pubic bone should lie parallel to the mat, and your lower back should not be pressed into the mat. This is the most stable and optimal shock-absorbing position for your back The imprinted spine involves flexing/ moving the lower back towards the mat with the recruitment of your abdominal oblique muscles. Avoid pressing your lower back all the way into the mat or tilting the pelvis too far by overusing the abs or glutes.  

After he or she learns the basics of pelvic/ spinal movement, I like to begin with basic exercises such as: hip bridge, hip roll, ab prep (crunches), prone back extension, and swimming or superman’s. Moving into more intermediate to advanced core exercises, my favorites include: Planks, Side Planks, rotating planks, quadruped position (hands and knees) balancing, and stability ball training.

A huge thank you to Abbey for taking the time to thoroughly answering these questions!