Training for my first marathon was going better than I could have imagined—until it suddenly wasn’t.

The injury happened during a strength session while performing front-racked box squats. I had jumped ahead in my training cycle, progressed the weight too quickly, and was experimenting with a small mechanical change in my squat.

On the last rep of my final set, I stood up and immediately felt pain shoot down the front of my leg.

I was able to rack the bar and walk around, convincing myself it was probably nothing serious.

The next day, I headed out for my scheduled long run at Waterton Canyon. My final five miles were downhill, and with every step I could feel my quad and hip flexor becoming increasingly sore. Over the next few days, the pain continued to worsen. Simple movements—like stepping out of the driver’s seat of my car—became difficult.

Mentally, I felt defeated.

My immediate thought was that I wouldn’t be able to run the marathon I had spent months preparing for.

This training cycle had been different from any before. In previous marathon builds, I consistently struggled around mile 14 because I didn’t have a solid fueling strategy. But this time, working with my coach, Phil Buckley, everything had started to click. I had developed a much better nutrition plan, felt stronger during long runs, and even finished a recent 16-mile run feeling surprisingly fresh.

So when the injury happened, it was devastating.

It took me several weeks to reset mentally and develop a consistent recovery plan. Looking back, I wish I had stopped experimenting sooner and focused on the strategies that ultimately helped me recover.

Here are the three things that made the biggest difference.

1. Fuel and Hydrate for Recovery

One of the most important things I focused on was supporting my recovery through proper nutrition and hydration.

After hard workouts—especially strength training and long runs—your muscles are primed to absorb nutrients that help repair tissue and restore energy stores. If those resources aren’t replaced, recovery slows down and irritated tissues can remain sensitive for longer.

During my recovery, I made it a priority to:

• Eat carbohydrates after training to replenish glycogen stores.
• Consume enough protein to support muscle repair (around 1 gram per pound of body weight).
• Fuel within 20–30 minutes after workouts.
• Increase my daily water intake and supplement with electrolytes.

Hydration also plays a major role in tissue health. Muscles and connective tissues rely on adequate fluid for circulation, nutrient delivery, and elasticity. When you’re properly fueled and hydrated, your body is simply better equipped to recover.

2. Use Tools That Improve Circulation and Reduce Sensitivity

One of the most effective recovery tools I used was Blood Flow Restriction (BFR) training, recommended by Dr. Katie Sasser at Physio Room’s Highlands Ranch clinic.

BFR uses a specialized cuff placed high on the limb to partially restrict venous blood flow while still allowing arterial blood into the muscle. This creates a metabolic response similar to heavy strength training while using very light loads, allowing you to build strength and improve circulation without placing excessive stress on injured tissue.

My BFR program consisted entirely of bodyweight exercises, including:

• Straight leg raises
• Marching
• Step-ups
• Reverse lunges
• Copenhagen planks
• Side planks
• Side-lying leg raises

Despite using minimal resistance, these exercises were incredibly challenging and surprisingly effective.

I also used kinesiology tape and a compression sleeve when I returned to running.

While these tools don’t “hold muscles together,” they can improve circulation and reduce pressure on pain-sensitive receptors within the tissue. For me, they noticeably decreased the sensitivity around my hip flexor and allowed me to run more comfortably.

3. Keep Strength Training (and Cross-Training)

One of the best decisions I made during recovery was continuing to train instead of stopping altogether.

Rather than pushing through pain, I modified my strength program by focusing on:

• Isometric exercises (long holds against resistance)
• Strengthening the muscles surrounding my hip
• Working only within pain-free or minimally painful ranges of motion (no more than 3/10 pain)
• Gradually increasing my range of motion over time

Some of the exercises that helped me the most included:

• Split-stance overcoming isometrics
• Split squats using catch bars to control hip flexion
• Barbell hip thrusts
• Bulgarian split squats
• Barbell Romanian deadlifts
• Landmine single-leg Romanian deadlifts
• Stagger-stance box squats

These movements kept my glutes, hamstrings, and core strong, reducing the workload placed on my injured hip flexor.

I also incorporated stationary bike workouts to maintain my aerobic fitness while temporarily reducing my running volume.

Working closely with my coach to manage training allowed me to stay fit, continue making progress, and maintain confidence throughout the recovery process.

The Biggest Lesson

This injury reminded me that recovery isn’t just about waiting for pain to disappear.

It’s about actively creating an environment that allows your body to heal.

Fueling well, staying hydrated, improving circulation, and maintaining strength helped me continue moving forward—even when my training didn’t go according to plan.

In the end, recovery wasn’t about doing less.

It was about doing the right things consistently.

Written by By Cassie Santana, PTA, CSCS, NASM | Physio Room

The post Marathon Injury Recovery: 3 Strategies That Helped Me Keep Training appeared first on Physio Room.

One of the hottest times of the year is here, and the sunshine just hits differently during the summer months.

Between longer days, outdoor workouts, hiking, running, travel, and busy schedules, summer often means more time spent being active. But as temperatures rise, staying properly fueled and hydrated becomes even more important.

Under-fueling and dehydration can lead to increased soreness, slower recovery, reduced performance during physical therapy and daily activities, and lower energy levels. Simply put, not giving your body what it needs can leave you feeling more tired and run down than you actually are.

The good news? A few simple nutrition habits can help you stay energized, recover well, and make the most of your summer.

Prioritize Hydration

Staying hydrated is always important, but hot weather and increased activity can cause your body to lose fluids more quickly.

Make water a regular part of your day rather than waiting until you feel thirsty. Depending on your activity level, how much you sweat, and the amount of time you spend outdoors, electrolytes may also be helpful.

Hydration doesn’t always have to come from your water bottle, either. Many summer foods contain water and can contribute to your overall fluid intake.

For a refreshing afternoon snack, try making homemade popsicles with whole fruit, yogurt, or freshly pressed juice. They can be an easy and enjoyable way to cool down while adding additional nutrients to your day.

Eat Enough to Support Your Activity

Longer days and warmer weather often mean more opportunities to move.

Whether you’re running, hiking, biking, strength training, attending physical therapy, or simply spending more time outside, your body needs enough energy to support those activities.

Not eating enough can affect:

• Energy levels
• Workout performance
• Muscle recovery
• Soreness
• Overall mood and focus

Calories aren’t something your body simply “burns off.” They’re the energy your body uses to move, recover, heal, and prepare for whatever comes next.

Don’t Forget About Protein

Protein plays an important role in muscle repair and recovery, making it especially valuable for active individuals.

Try incorporating a source of protein throughout the day rather than relying on one large serving at dinner.

Summer-friendly protein options might include:

• Greek yogurt
• Cottage cheese
• Eggs
• Chicken or turkey
• Fish
• Beans and lentils
• Smoothies with a protein source

After physical activity, pairing protein with carbohydrates can be a simple way to support recovery and replenish energy stores.

Choose Light, Easy-to-Digest Meals

Hot weather can sometimes reduce appetite, making large or heavy meals less appealing.

Instead of skipping meals altogether, try choosing lighter foods that are easier to eat and digest.

Smoothies, yogurt bowls, sandwiches, wraps, salads, fresh fruit, and smaller meals throughout the day can help you continue fueling your body without feeling overly full.

The most important thing is to continue eating consistently, even if that means starting with something small when your appetite is lower.

Keep Simple Snacks Available

Summer schedules can get busy quickly.

Between road trips, sporting events, outdoor adventures, and vacations, it’s easy to go long periods without eating.

Keeping simple, portable snacks available can help you stay fueled throughout the day.

Consider options like:

• Fresh or dried fruit
• Trail mix
• Greek yogurt
• Cheese and crackers
• Protein bars
• Nut butter packets
• Sandwiches or wraps

A little preparation can go a long way toward preventing the afternoon energy crash that often comes from going too long without food.

Take Advantage of Seasonal Produce

One of the best parts of summer is the variety of fresh fruits and vegetables available.

Seasonal produce can add flavor, nutrients, and variety to your meals and snacks.

Some great summer options include:

• Watermelon
• Blueberries and raspberries
• Peaches
• Cherries
• Tomatoes
• Cucumbers
• Zucchini
• Bell peppers

Try adding berries to yogurt or oatmeal, watermelon to a post-workout snack, tomatoes and cucumbers to salads, or zucchini and bell peppers to meals on the grill.

Simple Summer Nutrition Habits to Remember

You don’t need to completely change the way you eat during the summer. A few consistent habits can make a meaningful difference:

• Drink water regularly throughout the day
• Add electrolytes when needed based on activity and sweat loss
• Eat enough calories to support your activity level
• Include protein throughout the day
• Pair carbohydrates and protein after physical activity
• Eat something small when the heat reduces your appetite
• Keep convenient snacks available
• Take advantage of fresh, seasonal produce

The Bottom Line

Summer is a great time to get outside, stay active, and enjoy everything the season has to offer—but your body still needs the right fuel to keep up.

Prioritizing hydration, eating enough calories and protein, choosing foods that feel good in the heat, and keeping simple snacks available can help you maintain energy, support recovery, and perform your best throughout the summer.

Nutrition doesn’t have to be complicated. Focus on consistent habits that help you feel energized, recover well, and keep doing the activities you enjoy all season long.

Written by By Dr. Jessica Hockensmith, PT, DPT, Cert. DN, LMT, WAG | Physio Room

The post Summer Nutrition: How to Stay Fueled, Hydrated, and Ready to Perform appeared first on Physio Room.

When most hikers think about preparing for the trail, they focus on cardiovascular fitness, leg strength, or the right gear. While those factors are important, one often-overlooked component can make a significant difference in both performance and injury prevention:

Ankle Stability

Whether you’re navigating rocky track, crossing streams, descending steep terrain, or carrying a loaded backpack, your ankles serve as the foundation for every step you take. Strong, stable ankles can help you hike more efficiently, reduce injury risk, and improve your confidence on challenging terrain.

Let’s take a closer look at why ankle stability is so important for hikers.

1. Reduces the Risk of Ankle Sprains

Hiking trails are rarely predictable.

Roots, rocks, loose gravel, uneven surfaces, and sudden changes in terrain constantly challenge your balance and foot placement. Without adequate ankle stability, a small misstep can quickly turn into a painful ankle sprain.

Strong ankles help control unexpected changes in foot position and improve your ability to react to uneven ground, reducing the likelihood of rolling an ankle on the trail.

2. Improves Balance and Confidence

Every hike requires continuous adjustments to maintain balance.

Whether you’re stepping across a creek, navigating a rocky section, or descending a steep trail, your ankles play a critical role in keeping you upright and stable.

Improved ankle stability allows you to:

• React more quickly to changing terrain
• Maintain better balance on uneven surfaces
• Move with greater confidence on technical trails
• Reduce hesitation during challenging sections

The more stable your ankles are, the more confident you’ll feel exploring new terrain.

3. Increases Hiking Efficiency

Your ankles are the first point of contact with the ground and serve as the foundation for the entire lower body.

When ankle stability is lacking, the body often compensates by relying on other muscles and joints to maintain balance. These compensations require additional energy and can increase fatigue over the course of a hike.

Stable ankles help create a strong foundation for the:

• Knees
• Hips
• Core

As a result, you move more efficiently and conserve energy during longer adventures.

4. Protects the Knees and Hips

The body functions as a connected system.

When the ankles struggle to provide stability and control, the joints above them often have to work harder. Over time, this can place additional stress on the knees, hips, and lower back.

Poor ankle control may contribute to:

• Excessive knee movement
• Altered walking mechanics
• Increased stress on the hips
• Reduced efficiency on uneven terrain

Developing ankle stability helps improve alignment throughout the lower body and promotes more controlled movement with every step.

5. Helps When Carrying a Backpack

Adding a backpack changes more than just the weight you’re carrying.

The additional load shifts your center of gravity and increases the demands placed on your ankles with every step. This is especially noticeable during steep climbs, technical descents, or multi-day hiking trips.

Strong, responsive ankles help you:

• Maintain balance under load
• Adapt to changing terrain
• Improve control on descents
• Reduce the risk of slips and falls

The heavier your pack, the more important ankle stability becomes.

The Bottom Line

Strong ankle stability is one of the most valuable—and often overlooked—components of hiking performance.

Stable ankles can help you:

• Reduce your risk of ankle sprains
• Improve balance and confidence
• Hike more efficiently
• Protect your knees and hips
• Stay stable while carrying a backpack

Whether you’re preparing for a weekend hike or a multi-day backcountry adventure, investing time in ankle strength, balance, and stability training can help keep you moving confidently on the trail.

After all, every great hike starts from the ground up.

Written by By Dr. Karissa Deptula, PT, DPT, Cert. DN | Physio Room

The post Why Ankle Stability Matters for Hiking appeared first on Physio Room.

“If you want to go fast, go alone. If you want to go far, go together.”

One of the greatest predictors of running success isn’t talent—it’s consistency.

The workouts that truly move the needle aren’t usually the spectacular ones. They’re the countless runs completed week after week, month after month, and year after year. Consistent training builds fitness, resilience, and confidence over time.

But let’s be honest: not every training day feels exciting.

When every run starts to feel like work, it takes more mental energy just to get out the door. Motivation can fade, consistency can suffer, and burnout becomes a real possibility.

That’s where community makes all the difference.

Training alongside others can transform a difficult workout into something you genuinely look forward to. Whether you’re chasing a new PR, training for your first race, or simply looking for some accountability, finding the right running group can make the journey more enjoyable—and more sustainable.

If you’re looking to connect with other runners, here are some of our favorite run clubs in Colorado Springs and the Denver area.

Colorado Springs Run Clubs

Aravaipa Running Group

When: Mondays at 5:30 PM
Where: Fossil Craft Beer Co.

Aravaipa offers 2-, 4-, and 6-mile routes through Red Rock Canyon Open Space. It’s a great option for runners looking to explore local trails while connecting with fellow outdoor enthusiasts.

Cooldown Running Group

When: Wednesdays at 6:30 PM
Where: Red Leg Brewing Co.

This social run club features 1–4 mile routes through the stunning Garden of the Gods. If you enjoy a welcoming atmosphere and a post-run beverage with friends, this group is worth checking out.

Fleet Feet Run Club

When: Thursdays at 5:30 PM
Where: Goat Patch Brewing (Lincoln Center)

Fleet Feet welcomes runners of all experience levels and provides a supportive environment to stay accountable, improve your fitness, and connect with the local running community.

Orangetheory Fitness

With multiple locations throughout Colorado Springs, Orangetheory offers running-focused classes and hybrid strength-and-conditioning workouts designed to improve endurance and performance.

Contact your local studio for schedules, membership options, and class availability.

Denver Area Run Clubs

Embrace the Pace

Embrace the Pace hosts meetups at various locations throughout the Denver metro area, offering different distances and formats each month.

Their welcoming community makes it easy for runners of all abilities to get involved. Check their Instagram page for the latest schedule and event details.

Runner’s Roost

When: Thursdays at 5:15 PM and 6:00 PM
Where: Lone Tree Location

Runner’s Roost offers structured group runs and opportunities to connect with other local runners. It’s a longstanding favorite within the Denver running community and a great place to find training partners and support.

Fleet Feet

Cherry Creek: Tuesdays at 6:00 PM
Littleton: Saturdays at 7:30 AM

Fleet Feet’s free community runs are a fun and accessible way to meet other runners, stay motivated, and explore new routes. Whether you’re training for a race or simply looking to stay active, runners of all experience levels are welcome.

Why Run Clubs Matter

The best training plan is the one you can consistently follow.

A supportive running community provides encouragement on the tough days, celebrates your victories, and reminds you that you’re not doing it alone. The friendships, accountability, and shared experiences often become just as valuable as the miles themselves.

If your motivation has been lagging or your training feels stale, consider showing up to a local run club. You might find a training partner, a new friend, or simply the spark that keeps you moving forward.

Because while running may be an individual sport, the journey is often better together.

Written by By Dr. Drew Short, PT, DPT, CMFA | Physio Room

The post Finding Your Place in the Running Community: Colorado Run Clubs to Join appeared first on Physio Room.

For experienced cyclists, single-sided knee pain is actually the norm—not the exception.

When only one knee hurts, it often points to an asymmetry somewhere in the system. This could be a dominant leg, a subtle pelvic imbalance, differences in foot mechanics, or even a small leg length discrepancy.

If both knees hurt equally, the issue is more likely to be a global bike fit problem, such as saddle height or position. But when only one knee is painful, something is usually different between the left and right sides of the body.

Let’s look at some of the most common causes of single-sided knee pain in cyclists and why these asymmetries matter.

1. Leg Dominance and Compensation Patterns

One of the most overlooked causes of single-sided knee pain is leg dominance.

Most cyclists naturally favor one leg over the other without realizing it. Over thousands of pedal strokes, the body develops compensation strategies that often increase asymmetry rather than reduce it.

For many riders, the right leg tends to be stronger, more coordinated, and capable of producing more power. As a result, the body may rely on the dominant side while the opposite leg absorbs more stress and operates with less efficient mechanics.

This is one reason why left-sided knee pain is often more common in cyclists. The non-dominant side may struggle with force production, control, and stability, placing additional strain on the knee over time.

2. Leg Length Discrepancies

Even a small difference in leg length can have a significant impact on cycling mechanics.

A discrepancy of just a few millimeters may go completely unnoticed during daily activities, but cycling involves thousands of repetitive movements in a fixed position. Small asymmetries become magnified over long rides.

When one leg is longer than the other, the pelvis may sit unevenly on the saddle, causing one knee to travel through a slightly different path with every pedal stroke.

Single-sided knee pain is often the result of these repetitive asymmetrical loading patterns, especially when combined with other muscular or mobility imbalances.

3. Foot and Ankle Mechanics

Sometimes knee pain isn’t really a knee problem at all.

The foot and ankle serve as the foundation of the lower extremity. If one foot pronates more than the other or has reduced stability under load, the knee may be forced into a less efficient movement pattern.

Common foot and ankle issues that can contribute to one-sided knee pain include:

• Excessive pronation
• Collapsing arches
• Limited ankle mobility
• Differences in foot stability between sides

Because most people have some degree of asymmetry in foot mechanics, it’s common for only one knee to experience increased stress during cycling.

4. Pelvic Obliquity

Pelvic obliquity refers to a subtle tilt or asymmetry of the pelvis.

This can occur because of structural differences, muscle imbalances, or bike fit variables such as saddle position and Q-factor.

One of the challenges with pelvic obliquity is that it can be difficult to identify without a detailed assessment. The pelvis may appear level while riding, but small compensations can alter hip motion and knee tracking throughout the pedal stroke.

Over time, these changes may lead to excessive loading on one side and contribute to persistent knee pain.

5. Hip Muscle Imbalances

The hip plays a critical role in controlling lower extremity alignment during cycling.

When one side is weaker or less stable than the other, the femur may rotate excessively during the pedal stroke. This changes the position of the knee and can increase stress on surrounding tissues.

A common example is weakness of the gluteus medius, which helps stabilize the pelvis and control leg alignment.

When the hip loses its ability to provide stability, the knee often becomes the joint that absorbs the resulting movement and stress.

The side with poorer hip control is frequently the side that develops symptoms.

The Bottom Line

Single-sided knee pain is usually a sign that something is different between the left and right sides of the body.

Whether the source is leg dominance, a leg length discrepancy, foot mechanics, pelvic positioning, or hip strength, the underlying issue is often asymmetry and the compensation strategies that follow.

The goal isn’t simply to treat the painful knee. The goal is to identify why that knee is being asked to do more work than the other.

This is where working with a physical therapist who also understands bike fitting can be especially valuable. By evaluating both the rider and the bike simultaneously, it’s possible to identify the source of the asymmetry, improve positional stability, and create a more efficient and comfortable ride.

Written by By Dr. Tim Tracy, PT, DPT, OCS | Physio Room

The post Why Does Only One Knee Hurt While Cycling? The Hidden Causes of Single-Sided Knee Pain appeared first on Physio Room.

When we analyze movement in Olympic weightlifting, the conversation usually revolves around bar path, speed under the bar, hip and shoulder mobility, or pulling mechanics.

But one of the most important pieces of the lift often gets overlooked:

Your Feet

What exactly are they supposed to do?

Your feet are the foundation for every position in the snatch, clean, and jerk. They influence how you produce force, absorb load, stabilize under the bar, and transfer power from the ground upward.

If the foot and ankle aren’t doing their job efficiently, you’ll often see it show up elsewhere in the lift—sometimes subtly, sometimes dramatically.

Understanding foot mechanics can improve performance, positioning, efficiency, and even reduce unnecessary stress throughout the kinetic chain. And if you’re missing lifts without knowing exactly why, this may be the piece you’re overlooking.

The Foot’s Role in Weightlifting

The foot and ankle constantly shift between two critical functions:

Mobility & Adaptability

and

Stability & Force Production

A successful lift requires the foot to transition between these roles at the right time.

During setup, lifters are often coached to keep the entire foot connected to the floor with pressure distributed through the midfoot—not excessively on the heels or toes. This creates a stable platform to push force into the ground.

As the lift progresses through triple extension and into the receiving position, however, the demands on the foot change significantly.

Let’s break down these two movement strategies and why both are important.

Mobility & Adaptability: Understanding Pronation

Pronation occurs when the midfoot rolls slightly inward, the arch lowers, and the heel subtly everts outward.

In many fitness circles, pronation gets labeled as “bad.” In reality, controlled pronation is both normal and necessary.

The problem isn’t pronation itself—it’s excessive or uncontrolled pronation that can create issues.

Controlled Pronation Helps the Foot:

• Adapt to the ground
• Absorb load during squats
• Achieve better squat depth
• Distribute force through the midfoot

During the descent of a squat or receiving position, the foot needs some adaptability to allow adequate ankle dorsiflexion and efficient force absorption.

A completely rigid foot often struggles to absorb force and can make reaching proper squat depth more difficult.

Pronation isn’t inherently problematic. The challenge arises when an athlete cannot transition out of pronation effectively or when the movement becomes excessive.

In some cases, a stiff or overly rigid foot may actually contribute to discomfort by pushing stress upward into the knees or hips.

If one side struggles more than the other, you may also notice weight shifts, asymmetrical squatting patterns, or reduced control as the body compensates.

Stability & Force Production: Understanding Supination

Supination is essentially the opposite strategy.

During supination, the arch becomes more rigid, the foot stiffens, and the foot functions as a powerful lever for force production.

Just like pronation, supination is often misunderstood. A high arch or rigid foot isn’t automatically “good,” just as pronation isn’t automatically “bad.”

The goal isn’t living in one position—it’s having access to both.

Controlled Supination Helps the Foot:

• Create a stable platform
• Transfer force efficiently
• Improve power production
• Support heavy loads

This becomes especially important when:

• Standing from the squat
• Driving in the jerk
• Producing force during the pull

A stable foot allows force generated by the legs and hips to transfer efficiently into the barbell.

Too Much Supination Can Create Problems

An excessively rigid foot may contribute to:

• Limited squat depth
• Poor load distribution
• Reduced adaptability in the receiving position
• Excessive stiffness throughout the lower body

Like most aspects of movement, the goal isn’t choosing one strategy over the other. It’s developing the ability to transition between them when the lift demands it.

Force Transfer During Triple Extension

As a lifter moves into triple extension—simultaneous extension of the hips, knees, and ankles—the foot transitions toward plantarflexion as force is directed vertically into the ground.

At this stage, efficient force transfer becomes critical.

The foot should remain balanced and connected to the floor without excessive movement into either pronation or supination.

Most lifters will naturally demonstrate a slight bias toward supination during this phase because rigidity helps maximize force production. However, moving too far in either direction can reduce efficiency.

When the foot collapses excessively into pronation or remains overly rigid in supination, several issues can arise:

• Reduced connection to the ground
• Inefficient force transfer
• Increased stress on the knees, hips, or lower back
• Altered timing during the pull
• Loss of balance under the bar

Small changes at the foot can create significant consequences throughout the entire lift.

The Body Will Always Find Motion Somewhere

One of the most important principles in movement is this:

If the body lacks motion in one area, it will find it somewhere else.

For example, limited ankle dorsiflexion often forces the body to borrow motion from neighboring joints and tissues.

This compensation may appear as:

• Excessive arch collapse
• Increased midfoot pronation
• Early heel rise
• Forward trunk lean
• Knee valgus
• Medial knee shifting
• Altered balance during the catch

Sometimes what appears to be a foot problem is actually an ankle mobility limitation, hip control issue, or motor control strategy occurring elsewhere in the body.

What Should Your Feet Feel Like During a Lift?

A well-functioning foot should feel:

• Connected to the floor
• Stable without being rigid
• Adaptable during receiving positions
• Strong during force production
• Balanced through the tripod foot

The tripod foot consists of:

• The heel
• The base of the big toe
• The base of the little toe

The goal is not to aggressively grip the floor or force a perfectly flat arch.

The goal is dynamic control—the ability to move seamlessly between mobility and stability as the lift demands.

Final Thoughts

The feet are often overlooked in Olympic weightlifting, but they influence nearly everything happening above them.

A lifter who understands how to use the feet effectively can:

• Improve positional stability
• Transfer force more efficiently
• Reduce compensatory movement patterns
• Improve balance and barbell control
• Create more consistent lifts

In weightlifting, power starts from the ground up.

And the feet are where that process begins.

Written by By Dr. Jessie Czarnecki, PT, DPT, OCS, CSCS, CIDN | Physio Room

The post Power From the Ground Up: The Feet in Weightlifting appeared first on Physio Room.

With HYROX continuing to grow — and HYROX Denver coming up this November — more and more athletes are beginning to prepare for the demands of the sport.

One of the biggest misconceptions I still hear, though, is that HYROX is simply “CrossFit plus running.”

It’s not.

HYROX places very specific demands on the body through repeated:

• Running
• Sled pushes and pulls
• Carries
• Lunges
• Rowing
• SkiErg intervals
• High-volume fatigue work

The combination of endurance and strength creates stress patterns that require far more than just general fitness.

Why HYROX Training Feels Different

I see this all the time with athletes who begin preparing for HYROX by simply adding more running or increasing intensity in their current workouts.

Initially, performance improves quickly.

But eventually many athletes begin dealing with:

• Calf and Achilles tightness
• Knee pain
• Low back stiffness
• Hip overload
• Shoulder fatigue

Usually, the issue is not a lack of effort.

In fact, most HYROX athletes are highly motivated.

The real problem is that the body often is not specifically prepared for the unique demands of the sport.

Why Tailored HYROX Training Matters

The best HYROX athletes are not always the fittest people in the room.

In my experience, they are usually the athletes who:

• Move efficiently
• Recover well
• Train consistently

Good HYROX preparation should include much more than hard conditioning sessions.

It should also address:

• Mobility
• Running mechanics
• Strength endurance
• Deceleration and plyometric training
• Trunk stability
• Recovery strategies

There is no one-size-fits-all approach.

Some athletes need:

• Better ankle mobility for running efficiency and sled work
• Improved hip stability for lunges
• Better trunk control under fatigue

If those weaknesses are ignored, they eventually become overload patterns.

Where Performance Physical Therapy Fits In

One of the biggest reasons I value performance physical therapy is because it focuses on keeping people training — not just treating injuries after they happen.

That may include:

• Identifying mobility restrictions early
• Improving movement quality
• Modifying training loads
• Building tissue resilience
• Improving recovery capacity

The goal is simple:
Help athletes continue progressing without constant setbacks.

Consistency matters far more than random bursts of intensity.

The athletes who improve the most are usually the ones who can train week after week without getting sidelined.

Why I Know This Matters

I’ve worked from multiple sides of performance and rehab:

• Strength and conditioning coach
• CrossFit coach
• HYROX performance coach inside a CrossFit gym
• Physical therapist assistant working with active adults and athletes

What I consistently see is that people do not fail because they lack motivation.

Most people are willing to work hard.

What they often need is a smarter, more individualized approach that matches:

• The demands of their sport
• Their current movement capacity
• Their recovery ability

With HYROX Denver approaching this fall, many athletes are increasing training volume right now.

That makes this the perfect time to focus not only on conditioning, but also on:

• Movement quality
• Recovery
• Durability

Train for HYROX the Right Way

HYROX athletes benefit tremendously from combining:

• Performance training
• Movement assessment
• Recovery strategies
• Rehab principles

The goal is not just to help athletes compete harder.

It’s to help them stay healthy enough to:

• Keep showing up
• Train consistently
• Recover effectively
• Enjoy the process long term

Because HYROX is more than just adding running to CrossFit.

It is a unique sport with unique demands — and athletes deserve training strategies that reflect that.

Written by By Jack Butler, PTA, Strength Coach | Physio Room

The post HYROX Is More Than Just Running Added to CrossFit appeared first on Physio Room.

If you are an athlete experiencing pain in the front of your knee—especially when jumping, landing, squatting, or getting up after sitting—you may be dealing with patellar tendinopathy, commonly known as jumper’s knee.

This condition is common in sports that involve repetitive jumping and explosive movements like:

• Basketball
• Volleyball
• Track & field
• CrossFit
• Soccer

In this blog, we’ll break down what patellar tendinopathy is, why it happens, and how to start fixing it.

What Is Patellar Tendinopathy?

Patellar tendinopathy is a condition involving irritation and overload of the patellar tendon, which sits just below the kneecap.

Pain is usually localized:

• Directly below the kneecap
• Occasionally above the kneecap in the quad tendon

The biggest symptom?
Pain with activities that demand force from the quadriceps (quad muscles), especially:

• Jumping
• Landing
• Cutting
• Sprinting
• Single-leg movements
• Deep squatting

The tendon becomes overloaded when demands exceed the body’s ability to recover.

As training intensity, jumping volume, or sport demands increase, the tendon may not get enough time to adapt—leading to pain and irritation over time.

Why Does Jumper’s Knee Happen?

While the pain is felt in the knee, the problem is often bigger than just the knee itself.

At Physio Room, we evaluate the entire movement system, including:

• The hips
• The knees
• The ankles
• Foot mechanics

Research has shown several common factors associated with patellar tendinopathy, including:

Hip Weakness

Weakness in the hip abductors (side hip muscles) can reduce lower body stability and increase stress on the knee.

Quad Weakness

The quadriceps are responsible for absorbing force during jumping and landing. Weakness or poor load tolerance can overload the tendon.

Ankle Stiffness

Limited ankle mobility changes movement mechanics and can shift more stress into the knee joint.

Flat Feet or Foot Instability

Poor foot control can create instability through the ankle and lower leg, increasing force demands at the knee.

How to Start Fixing It

The first step is making sure the pain is truly patellar tendinopathy.

Not all front-of-knee pain is the same, which is why a proper evaluation matters. Other knee conditions may require a different treatment approach.

Once we identify the root causes, treatment focuses on:

• Reducing pain
• Improving tendon load tolerance
• Restoring strength and stability
• Gradually returning to sport-specific activity

Start With Isometric Exercises

One of the best early-stage tools for tendon pain is isometric loading.

Isometric exercises involve holding a position under tension without movement and are often very effective for reducing tendon pain.

Example: Isometric Knee Extension Hold

• Slightly extend the knee against resistance
• Hold for up to 45 seconds
• Stop if pain significantly increases

The goal is to work in a:

• Pain-free range
• Mild pain range only

If symptoms worsen significantly, the exercise is likely too aggressive.

Progress Into Strength Exercises

As pain becomes more manageable, we progress into:

• Eccentric exercises (controlled lowering)
• Concentric exercises (strengthening while lifting)

One of our favorite exercises is the Spanish Squat.

Spanish Squat Benefits

• Loads the quads safely
• Builds tendon tolerance
• Improves lower body strength

During these exercises, it’s important to monitor knee angle and symptoms.

Understanding Knee Flexion and Pain

Once the knee moves beyond roughly 60 degrees of flexion in weight-bearing positions, pressure inside the knee joint increases significantly.

If deeper bending aggravates symptoms:

• Reduce squat depth
• Return to more open-chain exercises
• Continue building tolerance gradually

Pushing aggressively through pain usually slows recovery.

The Biggest Takeaways

If you’re dealing with jumper’s knee, remember:

Avoid Constantly Aggravating Symptoms

You do not want to repeatedly overload the tendon with painful jumping or explosive activity.

Stay Active in a Tolerable Range

Movement is important—but exercises should stay within a mild-pain or pain-free range.

Address the Entire System

Hip strength, ankle mobility, foot stability, and quad capacity all matter.

Get the Right Diagnosis

Not all knee pain is jumper’s knee. A proper assessment helps determine the true cause and the best plan moving forward.

Get Back to Jumping Stronger

At Physio Room, our goal is not just to calm symptoms down.

We want to help athletes:

• Jump confidently
• Cut explosively
• Move efficiently
• Return stronger than before

If knee pain is limiting your training or sport, let’s figure out why and build a plan that gets you back to doing what you love.

Written by By Dr. Chris Hildenbrand, PT, DPT | Physio Room

The post Why Your Knee Hurts When You Jump (And How to Fix It) appeared first on Physio Room.

One of the most common questions we hear at Physio Room is:

“I’m feeling good. Should I run more often, or is it okay to return to my long runs?”

For most runners, the answer is clear and evidence-based:

Increase frequency before increasing duration.

Here’s why this approach works — and how performance physical therapists recommend applying it safely.

Why Increase Frequency First?

When healing tissues are reintroduced to running, how load is applied matters just as much as how much load is applied.

1⃣ Lower Stress Per Run

Short, frequent runs allow your body to adapt gradually. They promote recovery between sessions while rebuilding tolerance.

More frequent but shorter sessions:

• Build consistency

• Create manageable fatigue

• Reduce early overload

• Make future increases in intensity or duration safer

2⃣ Better Tissue Healing & Adaptation

Tendons, bones, and connective tissues respond best to consistent, submaximal loading. Running more often at low intensity supports tissue remodeling without overwhelming the previously injured area.

3⃣ Earlier Warning Signs

Frequent short runs make symptoms easier to catch early.

Pain after a 30-minute run is far easier to manage than pain that appears 60 minutes into a long run.

4⃣ Improved Running Mechanics

Time off often disrupts coordination and efficiency. Running more often helps restore neuromuscular control — something we regularly address during return-to-run rehab.

Pain Guidelines for Returning Runners

Understanding pain signals is critical during recovery.

Generally Acceptable:

• Mild stiffness that eases during warm-up

• No change in running form

• Symptoms resolve after the run

Not Acceptable:

• Sharp pain

• Worsening pain during the run

• Pain that alters walking or running mechanics

The 24-Hour Response (Next Morning Check-In)

Green Light
Soreness is gone or back to baseline → Continue progressing.

Yellow Light
Mild soreness that warms up quickly → Repeat the same run. Do not progress yet.

Red Light
Pain is worse than the previous day or stiffness lingers for hours → Contact your physical therapist. This typically indicates a need to temporarily reduce load and adjust your progression.

When Frequency May Need to Be Limited

Certain injuries require a more conservative approach, including:

• Stress fractures

• Significant tendon injuries

• Post-surgical recovery

In these cases, both frequency and duration may need strict control early on — which is why working with a running-savvy provider matters.

A Simple Framework for Return-to-Run Progression

At Physio Room, we typically guide runners through a staged approach:

Step 1: Start Short & Easy

Begin with short runs at a comfortable, conversational pace.
The goal is exposure — not fitness.

Step 2: Increase Days, Not Distance

Add running days per week while keeping duration consistent.

Example Progression:

• Week 1: 3 runs × 15 minutes

• Week 2: 4 runs × 15–20 minutes

• Week 3: 5 runs × 20 minutes

Step 3: Increase Duration Gradually

Once you’re running most days without symptoms, begin lengthening one run per week, keeping others short and easy.

Step 4: Add Intensity Last

Speed work, hills, and workouts should return only after frequency and duration are well tolerated — often under the guidance of a physical therapist.

How Physio Room Helps Runners Return Stronger

At Physio Room, we specialize in:

• Return-to-run programming

• Running gait analysis

• Tendon and bone stress injuries

• Sport-specific strength and mobility

• Long-term injury prevention

Our performance physical therapists build individualized plans so runners don’t just return to running — they return stronger, more efficient, and more resilient.

Written by Tim Tracy, DPT, OCS, CSCS| Physio Room

The post Injured Runner: Frequency or Duration First? appeared first on Physio Room.

How Multidirectional Movement and Strength Training Shape Lifelong Bone Health

When we think about kids’ sports, we often focus on performance, confidence, and teamwork. But one of the most powerful — and lasting — benefits of physical activity during childhood, especially during puberty, is its impact on bone health.

Puberty represents a finite window where the body is uniquely primed to build bone mass that will determine skeletal health for decades to come.

Bones Are Extra Responsive During Puberty

Throughout childhood, bones are constantly growing and adapting. During puberty, however, bone enters what researchers describe as a “growth-first” state. Hormonal changes dramatically increase how responsive bone tissue is to mechanical loading — meaning the forces placed on the body through movement matter more now than at any other time in life.

Research shows:

• Peak bone mass gain occurs around 12–13 years in girls and 14–15 years in boys

• Approximately 40% of adult bone mass is gained during the four years around peak height velocity

• Nearly 95% of adult bone mass is established within a few years after puberty

Once this window closes, the opportunity to meaningfully increase bone mass is greatly reduced. Bone can be maintained later in life — but building it becomes much harder.

Why Multidirectional Movement Matters

Bones respond best to high-impact, multidirectional forces — the kinds of forces that challenge the skeleton in different directions and planes.

Sports that involve:

• Jumping

• Landing

• Cutting

• Sprinting

• Rapid deceleration

provide a strong signal for bones to grow stronger and denser.

This is why activities like gymnastics, soccer, volleyball, basketball, and martial arts consistently demonstrate higher bone-loading effects than repetitive, straight-line activities like steady-state running.

Variety matters. Bones adapt most when loading is dynamic, unpredictable, and progressively challenging.

Strength and Conditioning: A Universal Bone-Building Tool

Here’s the key point: strength and conditioning can help all kids build bone mass — regardless of the sport they play, or even if they don’t play one at all.

Well-designed programs introduce the exact stimuli bones need during puberty:

• Jumping and landing mechanics

• Plyometrics (hops, bounds, skips)

• Resistance training that loads the skeleton

• Multidirectional movement and controlled deceleration

Importantly, research shows that bone responds quickly and efficiently to loading. It doesn’t require marathon training sessions or excessive volume — just brief, high-quality exposures to meaningful force.

When coached appropriately, strength training is both developmentally safe and highly effective.

Supporting Sport — Not Replacing It

For kids in multidirectional sports, strength and conditioning amplifies bone-building effects and helps distribute stress more evenly throughout the body.

For kids in low-impact or single-direction sports, it fills critical gaps, exposing bones to forces they might not otherwise experience.

In both cases, strength training supports:

• Healthier growth and development

• Reduced injury risk

• Improved movement quality

• Long-term skeletal resilience

The Long View

Peak bone mass is one of the strongest predictors of lifelong bone health. Higher bone mass built during puberty lowers the risk of stress fractures in youth and osteoporosis later in life.

The takeaway is simple but powerful:

Movement quality and variety during puberty matter.
Multidirectional sports and age-appropriate strength and conditioning aren’t just about performance — they’re about building a stronger foundation for life.

The window is short.
The opportunity is huge.
And the benefits last a lifetime.

Written by Cassie Santana – PTA, CSCS, NASM| Physio Room

The post Strength & Conditioning: A Critical Window for Youth Bone Development appeared first on Physio Room.

When Training Stress Doesn’t Fully Resolve

Most athletes don’t struggle because they train too hard — they struggle because their bodies don’t fully resolve the stress of training.

These aren’t always injuries. They’re recovery bottlenecks — points where the body gets stuck instead of adapting. Left unaddressed, these bottlenecks quietly slow progress and increase wear over time.

At Physio Room, we see these patterns every day — and we address them with a clear, repeatable process.

The Physio Room Approach

Reset → Restore → Reload

(Or, if not injured: Rehab → Perform → Recover)

Rather than chasing symptoms, we identify where the system is stuck — and help move it forward.

Problem 1: Pain That Lingers Longer Than It Should

After hard training, soreness is normal. But when pain:

• Feels out of proportion to the workload

• Limits movement days later

• Creates guarding or hesitation

…it’s often the nervous system staying on high alert, even after tissue is ready to move again.

This isn’t always a tissue problem — it’s often a signal regulation problem.

How Physio Room Addresses It: RESET

We begin by calming the system:

• Reducing excessive protective tone

• Improving pain modulation

• Restoring movement confidence

This may include hands-on treatment, movement-based interventions, and clinic tools such as electrical stimulation or manual techniques — always guided by assessment, not protocols.

The goal: create safety in the system so healing can proceed.

Problem 2: Slow Recovery Between Training Sessions

Recovery depends on circulation. When blood flow is limited — or when recovery strategies add stress instead of relief — athletes may experience:

• Heavy or sluggish muscles

• Lingering fatigue

• Longer warm-ups just to feel normal

Without adequate circulation, tissue can remain stuck in inflammation and never fully transition into repair.

How Physio Room Addresses It: RESTORE

Once the system is calmer, we restore:

• Circulation

• Tissue mobility

• Normal movement patterns

This is where we layer manual therapy, soft-tissue strategies, and recovery tools when appropriate to help tissues move through repair and into remodeling.

The focus isn’t doing more — it’s doing what helps the body recover between sessions, not just during them.

Problem 3: Muscles That Feel “Off” or Inhibited

Sometimes muscles aren’t painful — they’re just not firing well. This can show up as:

• Weak or delayed activation

• Poor coordination

• A sense that the body isn’t responding the way it should

This often follows fatigue, travel, or injury — and it increases injury risk if ignored.

How Physio Room Addresses It: RELOAD

Once tissues are calmer and moving better, we reload them by:

• Restoring activation and coordination

• Reinforcing efficient movement patterns

• Progressively reintroducing strength and speed

This is where rehab blends seamlessly into performance, helping athletes not just feel better — but move better under load.

Why This Works

Healing follows a predictable process:

Inflammation → Repair → Remodel

Physio Room’s process respects that biology:

• Reset supports inflammation resolution and nervous system regulation

• Restore supports repair through circulation and tissue mobility

• Reload guides remodeling so tissues tolerate future training demands

Tools may support the process — but the process itself is the treatment.

Recover Smarter, Not Softer

Athletes who last don’t avoid stress — they resolve it efficiently.

At Physio Room, we don’t just treat pain. We help athletes:

• Recover between sessions

• Train with confidence

• Build long-term resilience

That’s not soft recovery.
That’s smart performance care.

Written by Dr. Nate Henry – PT, DPT, DSc, Board Certified OCS & SCS, CSCS| Physio Room

The post Three Common Athlete Recovery Problems (and How to Fix Them) appeared first on Physio Room.

As a sports performance physical therapist, I often get asked:
“How do I know if my knee or ankle is broken?”
“Do I need an X-ray?”

After an acute injury, it can be difficult to know whether you’re dealing with something that needs medical imaging or something that can be treated conservatively with physical therapy. Fortunately, there are clinical guidelines that help healthcare providers — and patients — make safer decisions about when an X-ray may be necessary.

Two of the most widely used guidelines are the Ottawa Knee Rules and the Ottawa Ankle Rules.

The Ottawa Knee Rules

The Ottawa Knee Rules are a set of criteria used after an acute knee injury with localized pain to help determine whether an X-ray is recommended.

An X-ray may be indicated if any of the following are present:

• Age 55 or older

• Isolated patellar (kneecap) tenderness

• Fibular head tenderness (the bone on the outside just below the knee)

• Inability to bend the knee to 90 degrees

• Inability to bear weight, defined as taking fewer than four steps immediately after the injury or in a medical setting

If one or more of these signs are present, imaging may be recommended to rule out a fracture.

The Ottawa Ankle Rules

The Ottawa Ankle Rules help determine whether an ankle injury may involve a fracture.

An X-ray may be needed if there is:

• Bony tenderness along the posterior edge or tip of the lateral malleolus (outer ankle bone)

• Bony tenderness along the posterior edge or tip of the medial malleolus (inner ankle bone)

• Inability to bear weight for four steps

The Ottawa Foot Rules

These guidelines also apply to potential foot fractures.

An X-ray may be recommended if there is:

• Tenderness at the navicular bone (midfoot)

• Tenderness at the base of the fifth metatarsal (outer edge of the foot near the little toe)

• Inability to bear weight for four steps

When to Consider Getting an X-Ray

If you’ve recently been injured — for example, during a run, workout, or basketball game — and you notice sharp, localized bone tenderness or difficulty putting weight on the injured area, it may be worth getting evaluated for a possible fracture.

These rules don’t replace a professional evaluation, but they can help guide decision-making and reduce unnecessary imaging while still catching injuries that need medical attention.

We’re Here to Help

If you’re unsure whether you need an X-ray after a knee, ankle, or foot injury, the Physio Room team can help guide you through that decision. We can assess your injury, help you understand what might be going on, and determine whether imaging is appropriate — or whether the injury may involve muscles, ligaments, or other soft tissues that physical therapy can address.

Getting clarity early can help you feel confident about your next steps and get back to moving sooner.

Written by Dr. Dr. Chris Hildenbrand – PT, DPT| Physio Room

The post Do I Need an X-Ray? Clinical Guidelines for Knee and Ankle Injuries appeared first on Physio Room.