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.

Key Facts About This Common Knee Issue in Young Basketball Players

If your child—especially between the ages of 8 and 15—is complaining about pain in the front of their knee or you’ve noticed a bony bump just below their kneecap, they may be dealing with Osgood-Schlatter disease (often called “Osgood-Schlatter’s”).

This condition occurs when fibers of the patellar tendon begin pulling on the tibial tuberosity—the bony part of the shin bone just below the kneecap. It’s most common in active adolescents, particularly boys ages 10–15, but it can also affect girls ages 8–13.

Why It Happens

Osgood-Schlatter’s is often triggered by repetitive stress from activities that involve running, jumping, kneeling, or squatting. These movements can irritate the growth plate at the top of the shin bone, where the tendon attaches.

Because of this, the condition is especially common in basketball players, who perform frequent explosive jumps, sprints, and directional changes.

One of the major risk factors is abnormal leg alignment. Kids who are knock-kneed or flat-footed tend to have a sharper angle between their quadriceps muscle and patellar tendon, which increases tension on the growth plate and raises the risk for developing Osgood-Schlatter’s.

Common Symptoms

• Pain and tenderness below the kneecap

• Swelling or a visible bump on the upper shin

• Discomfort during activity (especially jumping or running)

• Relief with rest

How It’s Managed

In the past, complete immobilization was common—but today, we know that rest and activity modification are the best first steps. Limiting high-impact activities that cause pain gives the body time to heal and reduces inflammation.

The recovery timeline varies: some athletes improve in 2–3 weeks, while others need 2–3 months (or longer) for full relief. This time allows for revascularization and ossification—essential steps in the healing of the tibial growth plate before returning to unrestricted activity.

Treatment Strategies

A well-rounded rehab plan often includes:

• Stretching tight muscles (especially the quadriceps and hip flexors)

• Strengthening weak areas like the hips and ankles

• Pain-free quadriceps exercises to restore strength

• Balance and coordination training to improve movement control

If your athlete needs to keep playing during the season, a patellar strap can help. Worn just below the kneecap, it reduces pulling stress on the tibial tubercle and can significantly decrease pain during activity.

The Good News

Roughly 90% of young athletes with Osgood-Schlatter’s recover fully with non-surgical treatment. Once the growth plate closes, symptoms almost always resolve completely.

When to Seek Help

If your child’s knee pain is interfering with sports or daily life, it’s important to get it checked. At Physio Room, our team specializes in assessing movement mechanics, identifying underlying causes, and developing personalized treatment plans that help your child return to sport safely and pain-free.

Stretching, strengthening, and improving hip and ankle stability can make a big difference—but the best next step is a thorough evaluation to rule out other causes of knee pain and guide recovery.

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

The post Osgood, What? appeared first on Physio Room.

If you’re an athlete, CrossFitter, runner, or someone who pushes your body to perform at a high level, an injury can feel like a major roadblock. The last thing you want is to be told to “just rest” or give up the activities you love. That’s why working with a performance-based physical therapist—someone who not only understands movement but lives it—is essential for your recovery and long-term success.

Getting to the Root Cause of Your Pain

Pain is often just a symptom of an underlying dysfunction. A traditional rehab approach may focus on symptom management, but a performance-based physical therapist takes it a step further by identifying why the pain is happening in the first place.

Beyond Pain Relief: Building an Intentional Program

Getting out of pain is only part of the equation. The real goal is to get you back to your sport better than before. A solid and intentional rehab plan doesn’t just focus on passive treatments—it builds strength, mobility, and confidence in your movement patterns.

A performance-based PT understands the demands of Olympic lifting, running, or functional fitness, and they design a plan that ensures your return to sport is seamless and strong. This means:

• Addressing muscle imbalances and movement deficiencies
• Progressive loading to rebuild strength and resilience
• Intentional programming that integrates rehab into your training
• Education on injury prevention so you don’t end up back at square one

Knee Pain Is More Than Just Knee Pain

Too often, knee pain is treated as a localized issue when, in reality, it is usually a symptom of a bigger problem. Whether it’s patellar pain, quad tendon pain, or patellofemoral pain syndrome, the key is to understand why the knee is under stress in the first place.

A performance-based PT will assess factors such as:

• Hip and ankle mobility
• Core and glute stability
• Squat and lunge mechanics
• Running gait and loading patterns

Instead of generic rehab exercises, you need a specific plan tailored to your movement, goals, and sport. For example, if your knee pain stems from poor quad load distribution in Olympic lifts, your program should include tempo squats, controlled eccentrics, and proper bracing drills. If the pain is linked to running mechanics, then cadence drills, single-leg control work, and plyometric progressions should be incorporated.

Here’s just an example of what programming may look like from Dr. Ally and her student Ansley:

Goals: 

• Power clean
• Full clean
• Split jerk
• Push press
• Jerk
• Sumo squat
• Wall sit pain-free (on balls of feet, back slide down wall)
• LIFT HEAVY
• MOVE FAST
• RUN
  

Warmup: 

x2-4 rounds

QUADS- ISO leg ext (15 seconds MAX push) w/ reverse hyper

GLUTES- x 20 reverse hypers

Day 1:

I want you to try… 

Block A: 

• Clean + front squat complex 

• 6 rounds, 2-3 min rest between sets: 

• • • • 2 power clean
      • 5 eccentric front squats w pause at bottom
  • Week 2 complex (if tolerated)

• 6 rounds, 2-3 min rest between sets: 

• • • 2 power snatch
    • 5 overhead squat w pause at bottom

***If the cleans are more than a 2-3 knee pain, rack the bar and do 6×5 front squats w 5 second eccentric + PAUSE 

Block B: 

• 4×12 hip thrust 
• 4×8 Bulgarians + 8 jumps 
  • progression= walking lunges for 16 reps

Block C: 

• x 3 rounds 
  • 8 DB snatch (4 each arm)
    •  these should be heavy + explosive

The Bottom Line

Rehab should not just be about getting out of pain—it should be about getting back to performing at your highest level. A performance-based physical therapist who lifts, runs, and moves like you do will create a plan that is effective, realistic, and tailored to your goals.

If you’re struggling with pain and feel like you’re not getting the right guidance, it’s time to seek out a Physical Therapist who understands the demands of your sport and is committed to helping you bridge the gap from rehab back to peak performance.

Written by Dr. Ally Nelson – PT, DPT, OCS, CSCS, CIDN| Physio Room

The post Why a Performance-Focused PT is the Key to Reaching Your Goals appeared first on Physio Room.

Introduction

Pickleball is a fast-paced, dynamic sport, but the quick lateral movements, sudden stops, and repetitive stress can take a toll on your knees. Whether it’s from overuse, poor mechanics, or underlying conditions like arthritis, knee pain is a common challenge for players. In this article, we break down the root causes of knee pain and share expert strategies to manage and prevent it—so you can stay strong, pain-free, and active on the court!

Common Causes of Knee Pain in Pickleball

1. Overuse & Repetitive Stress (most common) – Playing too often without adequate recovery can lead to inflammation and pain.
2. Hard Court Surfaces – Pickleball courts are typically hard, which increases joint impact and stress on the knees.
3. Muscle Weakness & Imbalances – Weak quadriceps, hamstrings, or glutes can force the knee joint to compensate, leading to strain.
4. Improper Footwear – Worn-out or unsupportive shoes fail to absorb shock and may contribute to knee pain.
5. Underlying Conditions – Issues such as arthritis, meniscus injuries, or patellar tendinitis can be aggravated by pickleball play.

Immediate Pain Management Strategies

P.E.A.C.E & L.O.V.E.: A modern approach to managing pain and recovery.

• Protect: Avoid aggravating movements for the first few days.
• Elevate: Keep the affected area raised to reduce swelling.
• Avoid Anti-Inflammatories: Let the body’s natural healing process occur.
• Compress: Use bandages or sleeves for support.
• Educate: Understand the injury and seek proper guidance. 

After the initial phase, focus on L.O.V.E.:

• Load: Gradually introduce movement and resistance.
• Optimism: Maintain a positive mindset for recovery.
• Vascularization: Engage in low-impact cardiovascular activity.
• Exercise: Strengthen surrounding muscles to prevent future injuries.

• Supportive Gear: KT tape or knee braces can provide additional stability during play.
• Modify Play Style: Avoid excessive lunging, pivoting, and sudden stops if experiencing pain. 

Strengthening, Stability, and Aerobic Fitness for Pickleball

Building strong muscles around the knee helps absorb impact and reduce strain. Consider incorporating:

• Quadriceps & Hamstring Strengthening: Squats, leg presses, deadlifts. 
• Glute Activation: Single leg Romanian Deadlifts, hip thrust, lateral band walks, split squats.
• Calf Strengthening: Weighted heel raises to improve shock absorption.
• Balance & Proprioception Training: Box jumps, lateral bounds, depth jumps, and single-leg hops to improve stability and explosive movement on the court. 
• Meeting the recommended guidelines of 150 minutes of moderate-intensity aerobic exercise per week helps improve stamina, circulation, and recovery while reducing the risk of injury.

Mobility & Stretching Routine

A proper warm-up and cool-down routine can improve flexibility and reduce stiffness. Here are some of my favorite movements to perform before and after a game.

Dynamic Warm-Up Before Playing:

Perform each of the following exercises for 30-45 seconds to properly prepare your body for play:

• Leg swings 
• Walking lunges
• High knees
• Jumping jacks

Post-Game Stretching:

• Quad stretch
• Hamstring stretch
• Hip flexor stretch
• Calf stretch

Footwear & Equipment Adjustments

• Choose pickleball-specific shoes with ample cushioning and lateral support. Unlike running shoes, which prioritize forward motion and extra cushioning, pickleball shoes are designed for the lateral movements required in the game. Running shoes lack the necessary side support, increasing the risk of ankle rolling and instability during quick directional changes on the court.
• Consider orthotics to improve foot alignment and reduce knee strain.
• Wear a knee brace or compression sleeve for extra joint support.

When to Seek Professional Help

If knee pain persists despite self-care, consult a physical therapist or doctor. The physical therapists at Physio Room specialize in screening injuries and are experts in treating and managing serious conditions that could affect your game. Warning signs include:

• Persistent pain lasting beyond a few weeks.
• Swelling, locking, or instability in the knee.
• Worsening pain during or after activity.

Conclusion

Knee pain doesn’t have to sideline your pickleball game. By managing activity levels, strengthening key muscles, improving flexibility, and using proper footwear, you can reduce pain and prevent future injuries. At Physio Room, we specialize in helping pickleball players stay pain-free and at peak performance. Our team can create a personalized treatment plan tailored to your specific needs, ensuring you stay strong, mobile, and on the court. Listen to your body, take proactive steps for knee health, and let Physio Room help you keep enjoying the sport you love!

Written by Seth Hagan – PT, DPT, OCS | Physio Room

The post Stay in the Game: Top Tips to Beat Knee Pain in Pickleball! appeared first on Physio Room.

Win a $750 Visa Giftcard or a pair of Normatec Boots

We’re feeling the gratitude this season, so we’re giving back to YOU with our Thankful Thanksgiving Giveaway! Enter for a chance to win some amazing prizes that’ll keep you motivated and moving through the holiday season. Whether you’re looking to level up your recovery game or just treat yourself, we’ve got something special lined up!

Look below for full rules and guidelines, and make sure to enter by December 6th! Winners will be announced on December 11th. Let’s make this Thanksgiving one to remember—good luck!

Tag us on Facebook at Physio Room or on Instagram @physioroomco.
Share your experience and leave us a review here: Google Review.

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How Does Hip Pain Happen for Runners?

Hip pain in runners can often be linked to tight or weak hip flexors or issues with running form. If you’re experiencing pain in the front of your hip or near your groin or lateral hip, it could be related to how your foot strikes the ground.

Check if the foot on the affected side is turning outward (external rotation). This might be due to increased tension or weakness in your glutes or because your body is trying to avoid hip flexion pain by altering your movement. When the glutes aren’t doing their job properly, the TFL (a muscle on the side of your hip) might take over during the running stride, which can lead to pain on the lateral or posterior hip, as well as with hip flexion.

How Do We Fix It?

Hip flexion pain can occur when the posterior capsule of the hip tightens, with glute tendinopathies or a true hip impingement (FAI). All of these diagnoses can cause the hip flexor muscles to feel pinched because the head of the femur can’t move freely in the hip joint. 

To address this, we need to strengthen and coordinate all the muscles around the hip joint, not just the glutes or hip extensors. This includes the adductors, hip flexors, abductors, extensors, and the glutes responsible for internal and external rotation.

Exercises to Consider:

• Eccentric banded hip flexion
• Yoga block hip internal rotation (IR)
• Copenhagens
• Romanian Deadlifts (RDLs)
• Squats
• Bulgarian split squats

These exercises help improve strength and coordination in the hip area, which can alleviate pain and improve running form.

Strength Training for Runners with Hip Pain

• How does this happen?
  • Hip pain can occur for many reasons, but for runners it can be due to tight/weak hip flexors or impaired running form. 
  • If you’re a runner and you start to notice hip pain in the front of your hip or near your groin, take a look at your foot strike. You might notice that the foot on the affected side is turned into external rotation. This can be from increased tension/weakness in the glute muscles or because the body has sensed weakness or pain with hip flexion and is trying to find a way to avoid moving in that plane of motion. In order to fix this problem the body might start relying on the TFL muscle (lateral hip) to assist more with bringing the leg forward during the eccentric phase of the gait cycle. This can cause pain at the lateral/posterior hip in addition to pain with hip flexion. 
• How do we fix this?
  • Hip flexion becomes painful when the posterior capsule of the hip becomes tight, causing the hip flexor muscles to feel “pinched” because the head of the femur cannot move far enough back in the capsule to allow pain free range of motion when bringing the leg forward.  
  • Like any other joint in the body, when a muscle becomes weak/tight other muscles need to work harder to stabilize or move the joint. 
  • In traditional PT a practitioner might only focus on strengthening the glutes, or hip extensors, because this is the opposing muscle group for the hip flexors. 
  • However in order to truly fix a hip impingement we need to strengthen and improve the coordination for all of the muscles surrounding the hip joint: adductors, flexors, abductors, extensions, and the glute muscles that manage internal and external rotation. 
    • eccentric banded hip flexion 
    • yoga block hip IR 
    • Copenhagens 
    • RDL’s 
    • Squats 
    • Bulgarian split squats 

Targeted strength training can be a game-changer for runners with hip pain. By strengthening and coordinating the muscles around the hip joint—flexors, extensors, adductors, abductors, and rotators—you can reduce discomfort, restore proper movement, and improve performance.

Incorporate exercises like eccentric banded hip flexion, yoga block hip IR, Copenhagens, RDLs, squats, and Bulgarian split squats to build strength and move pain-free. Need help? Our team is here to guide you to stronger, healthier running!

The post Strength Training for Runners with Hip Pain appeared first on Physio Room.

Will lifting heavy help you PR at your next race?

The goal of every good strength and conditioning coach is to enhance the physical preparedness of athletes for their sport. This kind of  training is done outside of working with a technical coach, in this example – a running coach. S&C coaches have three primary goals for their endurance athletes: improve performance, improve capacity for training, and lower the risk of injury. 

Myths about strength training for runners: 

• Will adding heavy lifts to my training program cause more soreness, and affect my ability to complete longer runs? No. An effective S&C program will focus on intensity over volume through selecting exercises that are pertinent to improving strength and coordination of movements that are specific to runners. There will not be a lot of time wasted on “junk volume,” and adequate recovery time will be built into the program. 
• Will lifting heavy add unwanted muscle bulk that will slow me down? No. A well designed S&C program for endurance runners would focus on power production, strength, and functional exercises to improve performance without increasing bulk. 

How does strength and conditioning benefit running performance? S&C programs are designed to cause several adaptations to the neuromuscular system. They will improve your body’s ability to generate force, more effectively use elastic energy from tendons, and help you run with more efficiency which will help you run farther by preventing muscle fatigue. 

All of this is to say – If you are an athlete, you should train like an athlete. Here is how you can incorporate S&C into your endurance training program:

If you want to run farther… 

Plyometrics/Power: Plyometrics: 3x/week @ 50 reps per session// Power: 30-70% of 1RM performed @ high velocity for 3-5 reps per set. 

Plyometrics are exercises that are used to make you more explosive in your movements – like pushing off the ground more forcefully as you’re running, and accepting the force through your tendons as you land. When you teach your body to rely on the elastic properties of tendons to repeatedly create force off the ground, your muscles will fatigue at a slower rate and you can run farther. 

Power exercises should focus on lifting a lighter weight fast. Because of the focus on speed you should reduce weight to 30-70% of your 1RM and focus on patterns that include “triple extension” (more on that later). Including plyometrics and power in your training benefits your feet, achilles/calves, hips, knees, and ankles which are all common sites of injury for endurance runners. 

If you want to run faster… 

Strength training: 2-3x/week @ 80% or more of your 1RM for 3-6 reps/set

Strength is required for muscle groups to produce force during coordinated movements. If you want to run faster, you need to be able to produce a high level of force rapidly. Running speed is directly related to the amount of force your body is able to produce against the ground. Also, it is no surprise that runners tend to suffer from common overuse injuries, known as tendinopathies. These occur due to the high volume and repetitive loading on the body (joints and lower limbs in particular for runners). When you strength train you are strategically placing load through a muscle with the goal of increasing its tolerance to repetitive stress. Training in this way helps reduce the risk of injury. 

My advice is to focus on one major lift, that you will perform heavy, per training block (4 week period). If you are training for strength you should focus on 80% or more of your 1RM for 3-6 reps/set. A heavy stimulus and fewer reps per set are required to create these adaptations. 

If you want to focus on running mechanics to make your body more resilient… 

Dynamic warm up/functional exercises: 3x/week @ 15-30 minute sessions. These can be performed after a short duration/high intensity training run. 

As discussed above, we want to focus on selecting exercises specifically for runners so we don’t waste time/effort on “junk volume.” For runners, a dynamic warm up should include hip mobility, single leg stability, hamstring activation, calf strength, and trunk control. Strength that you acquire in the gym does not always translate to activity unless you train it to do so. We want to make sure the strength you are acquiring from heavy lifting can be used to express force well during running. 

So for endurance runners it is important to choose exercises that will develop force to improve running and should involve the lower body producing “triple extension,” which is the action of the ankles, knees, and hips straightening in a coordinated pattern. Think of jumping straight up to create this movement. This type of training allows your body to accelerate at a high level of force similar to a running stride.  

In conclusion… 

No one falls in love with strength training by doing bridges or core work. Lifting heavy, training for powerful movements, and teaching our bodies to absorb and use high forces is vital to causing adaptations that will benefit your running performance. So will lifting heavy help you PR? If you follow a well designed S&C program, progressively increase your lifts, and provide plenty of recovery time… then yes, it will. 

P.S. Don’t forget to check out the Runner’s Checklist for a complete guide to running.

Sources: “Strength and Conditioning for Endurance Runners,” (Blagrove)

The post Endurance Athletes: The Common Disconnect With Strength Training.  appeared first on Physio Room.

Before picking up a kettlebell to complement your endurance training, the first step is often to unravel suboptimal movement patterns. 

What causes these patterns? 

The human body’s desire for efficiency (when cycling and running) tend to enhance movement patterns unique to each person, a.k.a a neuromuscular rut. 

Challenging and changing default patterns is the hardest part of any rehab or performance program. It only gets harder with age. 

Are weak muscles to blame? 

Unlikely. For cyclists, poor awareness with the sport’s primary movements, hip hinge and lunge, are often the root cause of knee or low back pain. Layering weights on top of bad movement patterns exacerbates issues, or at best, performance and wellness benefits are mitigated. 

Most that struggle with low back pain don’t realize that “the core” includes our gluteal muscles. The hip hinge for cyclists is a key comment to more fun on the bike with less pain. 

The first step, which is common even among elite athletes, is for clients to proficiently recruit and identify well with the left and right side glute complex. Then have the glute be the primary sensation during functional movement patterns such as hip hinge, squat and lunge. 

Mentally and physically reorganizing how we move is often the most powerful, and most challenging, component towards resolving long standing low back pain. 

Learning to move better is a skill. This is where a great physical therapist can use their expertise in identifying detrimental movement patterns to help you move more efficiently and maximize your athletic performance. 

Check out this article by Training Peak for the best strength exercises for cyclists.

The post Endurance Athletes: The Common Disconnect With Strength Training.  appeared first on Physio Room.

Do you have low back and/or knee tightness when riding? 

The gist: There are 6 primal functional movements of the human body. Of those, the hinge and lunge are the two primary movements for mountain biking. Mastery of these two movements off the bike provides numerous riding advantages, but ultimately leads to more fun and less back pain on the bike. 

Squat vs Hip Hinge:

The What: Squat biases the knee and quads whereas the hinge biases the hips and glutes. 

The Why: Joint angle influences muscle function = Put your body in a position that takes advantage of our workhorse gluteal muscles to reduce back pain on the bike. .

Part 1:(Hip hinge vs squat) 

Part 2:(cycling specific hip hinge)  

Lunge Pattern:

The What: Pedaling is essentially a lunge pattern performed over and over. And over. 

The Why: Large left vs right lunge asymmetries and poor dynamic control are also present during the pedal stroke, leaving untapped performance and comfort on the table. 

Part 1: (click here and watch the pedaling dynamics self assessment)  

Bike Fit for High School Riders

Why are bike fits important for all ages and levels of riders?

The latest and greatest bike doesn’t mean much if the rider is not set up to take full advantage.

Comprehensive bike fitting not only involves adjustments of the bike itself (biomechanical), but also teaches riders about their compensatory movements (proprioception) and how to move well (neuromuscular) on the bike once it has been fit. 

Physio Room Bike Fitting: Biomechanical changes + Neuromuscular Awareness 

How a rider pedals, functions, and feels on the bike are often overlooked components during a bike fit. As a physio and experienced bike fitter I can help ensure form and function meet.  

How a bike fit can improve performance

• Reduced injury risk allows training consistency without unwanted time off 
• Improved posture and body position aids breathing pattern and oxygen delivery 
• Improved efficiency via improved muscle recruitment and load distribution through muscles and joints
• Less overall energy waste 

Rundown

Ultimately,  preparation and recovery and optimizing riding comfort and efficiency equates to performance and fun for any rider. 

Tim Tracy, DPT, OCS, CSCS: Physical Therapist, Bike Fitter

The post #1 way to prevent low back pain on the bike appeared first on Physio Room.