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.

Many junior riders are puzzled by a familiar pattern: they feel fine during long rides but develop low back pain during races or high-intensity efforts.

Especially for juniors, the source often lies off the bike — in posture, movement mechanics, and strength habits formed long before race day.

1. The Posture Problem — Or More Accurately, Poor Movement Awareness

This isn’t the same as simply slouching in class or sitting poorly at a desk. For junior cyclists, poor movement awareness and hip mechanics are often at the root of back pain.

Many young riders haven’t yet developed a strong sense of how their bodies move in space — what we call proprioception. This lack of awareness often shows up as:

• Rounding or over-arching the back without realizing it
• Asymmetric pedaling or uneven weight through the saddle
• Poor activation of larger, power generating muscles during hard efforts

One of the clearest indicators of this issue is an inability to perform a proper hip hinge or deadlift pattern.

When a rider bends forward by flexing through the spine instead of hinging from the hips, the lower back becomes overloaded — on the gym floor and on the bike.

Learning this movement pattern is crucial. A proper hip hinge teaches riders to load the gluteal muscles instead of the adjacent muscles along the spine and generate power efficiently without over stressing the lumbar region.

Simple drills such as hip hinge practice with a dowel, and Romanian deadlifts (RDLs) can retrain this movement and dramatically reduce back strain both in training and racing.

Without this awareness, the erector spinae muscle groups (the small stabilizing muscles along the spine) fatigue early, leading to pain and stiffness — especially during high-power efforts when posture inevitably breaks down.

When this issue is left unchecked, the possibility of strain extending to other structures such as the lumbar discs increases. 

2. It’s Not Just a “Weak Core”

A strong, stable core is vital for transferring power from the legs to the pedals. But calling a back issue a “core weakness” oversimplifies the problem.

Movement awareness will virtually be eliminated from the conscious when under strain or fatigue. If there is no ideal baseline posture to begin with, then the rider has no strategy to know how to correct their form when pain presents. 

Without having a solid position to begin with, an imbalance of our trunk muscles ensues. The muscles in the front and sides of our trunk can’t possibly function properly, the pelvis loses control, and the lower back compensates. That compensation reduces power efficiency and can eventually lead to pain.

For junior cyclists, developing core control and movement awareness together is far more effective than sit-ups or crunches. Furthermore, effective exercises for juniors should be enjoyable, straight forward, and require minimal equipment. The bear crawl is typically a fan favorite with my junior riders.

3. Bike Fit Needs Updated

The relationship between their body and the world is enough of a challenge. Parents need to also stay atop of the relationship between a growing athlete’s bike and their body. 

The most common fit-related causes of back pain for juniors include:

• “Slamming the stem”  It looks cool. But most juniors bodies can’t cash that check 
• Saddle height too high → excessive hip rocking, neck strain, and lumbar rounding
• Seat too low → unable to tap into gluteal muscles, rounded mid back 
• Cranks too long (namely on small and medium sized bikes) → increased hip flexion and tension on the lower back

A professional bike fit — ideally by someone experienced with youth riders — helps ensure a neutral spine, stable pelvis, and efficient power transfer, reducing unnecessary stress on the lower back.

4. Growth Spurts, Clumsiness, and Tight Muscles

Adolescence brings a counterpart to typical bike fit issues. Rapid growth can temporarily disrupt coordination and flexibility. Also, following a growth spurt, the body needs time to adjust to changes to the periphery, during which time a teenager may walk and function (more) awkwardly. Hamstrings and hip flexors often tighten as the nervous system searches for stability. This can compromise pelvic movement, forcing an altered spine position in order to maintain position.

That extra flexion may not seem like much, but over hours of training and racing, it adds up — contributing to stiffness and pain.

How to Prevent and Manage Low Back Pain in Junior Cyclists

The key is a balanced approach — combining smart training, proper bike setup, and targeted strength and movement work.

1. Get a professional bike fit.
   Choose someone experienced with junior cyclists — youth proportions, flexibility, and coordination vary widely.
2. Build true core stability.
   Incorporate fun exercises like forward and lateral crawl variations and lunge variations 2–3 times per week.
3. Develop movement awareness and hip control.
   Practice neutral spine alignment, learn proper hip hinge mechanics, and use light-weight or bodyweight deadlifts to refine form before adding load.
4. Strengthen key muscle groups.
   Focus on the posterior leg muscles such as hamstrings, and glutes to maintain pelvic mobility and balance.
5. Train smart, not just hard.
   Schedule recovery days, monitor load, and prioritize quality of movement over quantity of miles.
6. Practice good posture — everywhere.
   Postural awareness off the bike supports better form on the bike. Strength and flexibility only matter if you can control how you move.

Final Thoughts

Low back pain in junior cyclists isn’t just “part of the sport.” It’s a signal that something — whether posture, awareness, strength, or setup — needs attention.

By addressing these underlying factors early, young riders can not only ride pain-free but also unlock greater power, endurance, and control on the bike.

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

The post Low Back Pain in Junior Cyclists: Causes and Solutions appeared first on Physio Room.

Winter in Colorado brings more than just snow and cold temperatures. Early mornings, dry air, shorter days, and lower overall energy can quietly take a toll on recovery, immune health, and general well-being. During this season, nutrition plays a key role in helping the body stay resilient, heal efficiently, and maintain steady energy levels.

Rather than focusing on restriction or rigid rules, winter nutrition should emphasize support—support for tissue repair, inflammation management, and sustained energy when the environment is working against us.

Why Winter Nutrition Matters

Cold temperatures and dry air can increase muscle stiffness, slow recovery, and raise hydration needs. At the same time, many people experience changes in appetite, motivation, and activity levels. Adjusting nutrition to match these seasonal demands can help:

• Improve recovery from training and daily activity

• Support immune function

• Reduce inflammation and joint stiffness

• Maintain consistent energy throughout the day

Key Nutrition Priorities in Winter

Adequate Protein
Protein is essential for muscle and tissue repair, especially when training continues through colder months. Including protein consistently throughout the day supports recovery and helps stabilize energy levels.

Healthy Fats
Healthy fats play an important role in managing inflammation and supporting joint and overall health. Prioritizing quality fat sources can be especially helpful when winter training feels harder on the body.

Warm, Nourishing Meals
Warm foods are often easier to digest and more satisfying in cold weather. Soups, stews, roasted vegetables, and slow-cooked meals can support digestion while providing comfort and nourishment.

Helpful Late-Winter Nutrition Habits

• Include a source of protein at every meal

• Choose cooked vegetables more often than raw to support digestion

• Stay hydrated—dry air increases fluid needs

If ice-cold water sounds unappealing in the winter, try alternatives like:

• Herbal tea

• Warm water with honey and lemon

• Turmeric golden milk

• Bone broth

These options still contribute to hydration while providing warmth and added nutrients.

Seasonal Produce to Incorporate

Winter produce offers powerful nutrients that support energy, digestion, and recovery. Consider adding:

• Sweet potatoes

• Winter squash

• Brussels sprouts

• Kale

• Carrots

• Beets

• Citrus fruits (oranges, grapefruit)

• Apples

These foods are rich in fiber, antioxidants, and micronutrients that help the body handle seasonal stressors.

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

The post Nutrition in the Wintertime appeared first on Physio Room.

High school athletes are pushing their limits more than ever. Whether they’re logging miles in cross-country, battling in basketball, or perfecting routines in gymnastics, one thing is clear: injuries are common and preventable. While athletic trainers and strength coaches play crucial roles, weekly physical therapy (PT) adds a level of expertise in recovery, biomechanics, and movement correction that can make a significant difference.

Injury Risks Across Sports

Overuse injuries are especially prevalent in endurance and skill-based sports. Consider these injury rates per 1,000 athletic exposures (AEs):

• Girls’ Cross-Country: 17.0

• Boys’ Cross-Country: 10.9

• Basketball: ~6.8–7.8

• Soccer: ~6.2–8.5

• Gymnastics & Cheer: High rates of both acute and overuse injuries

Many of these involve lower-extremity stress injuries like shin splints, tendinopathy, and stress fractures. Studies show up to 50% of runners and 30% of court athletes report injuries in a given season, often from repetitive loading and alignment issues.

What Existing Staff Cover

• Athletic Trainers (ATs) handle on-site care, injury triage, and referrals

• Strength Coaches focus on performance, conditioning, and mechanics

They’re vital—but neither specializes in rehabilitation, gait correction, or managing chronic or recurrent injuries.

The PT Advantage: Movement & Rehab Experts

Physical therapists are licensed doctors (DPTs) trained to:

• Analyze gait, alignment, and movement dysfunction

• Design individualized rehab and corrective plans

• Implement return-to-play protocols

• Provide manual therapy and neuromuscular re-education

PTs ensure that injuries don’t just “heal”, they heal right. Their presence supports recovery and prevents breakdowns in form that lead to future injury.

Why Weekly PT Is Worth It

Prevention

PTs catch biomechanical problems early, like pelvic drop, valgus collapse, or asymmetrical stride, before they cause injury.

Recovery

PTs guide athletes through progressive rehab, targeting the root cause, not just the symptoms.

Integration

Weekly sessions allow PTs to sync with ATs and coaches for consistent, team-aligned care that elevates performance and safety.

Conclusion

Whether it’s distance running, basketball, or winter sports like wrestling and cheer, high school athletes face real physical demands and high injury risks. Weekly PT support enhances injury prevention, improves recovery, and bridges the gap between injury and performance. For programs where families and boosters have funded this added support, it’s a wise investment that pays dividends all season long.

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

The post Why Weekly Physical Therapy Support Is Essential for High School Athletes appeared first on Physio Room.

CrossFit classes offer well-designed, functional programming that builds strength, power, and conditioning. But even with great programming, one important area is often overlooked: single-leg and single-arm strengthening.

Adding unilateral training outside of class can significantly reduce injury risk, improve movement quality, and unlock performance gains that bilateral lifting alone can’t provide.

Why Unilateral Strength Matters

Most CrossFit workouts emphasize bilateral movements, where both arms or both legs work at the same time. Think classic barbell lifts like:

• Push press

• Strict press

• Snatch

• Clean

• Deadlift

While unilateral patterns do show up—lunges, step-ups, and occasional dumbbell work—they’re programmed far less frequently.

Because bilateral movements dominate, the body naturally relies on its stronger side, especially when intensity and fatigue increase. We’ve all experienced it: pushing off the “better” leg during step-ups or leaning into the dominant arm to get through a tough WOD.

Over time, this leads to imbalances in single-leg and single-arm strength, which can result in:

• Increased injury risk

• Reduced lifting efficiency

• Compensatory movement patterns

• Plateaus in strength and performance

Addressing these weaknesses outside of class builds stability, control, and balanced strength that carries over to everything from squatting and running to Olympic lifts and gymnastics.

How Often Should CrossFit Athletes Train Unilateral Movements?

2–3 times per week is ideal.

This doesn’t need to be a full workout. Even 10–15 minutes before or after class, done consistently, can make a meaningful difference.

Best Single-Leg Accessory Exercises for CrossFit Athletes

These movements strengthen the hips, knees, and ankles while improving balance and control:

• Bulgarian split squats

• Single-leg Romanian deadlifts (RDLs)

• Lateral lunges

• Step-ups

• Single-leg glute bridges

Best Single-Arm Accessory Exercises for CrossFit Athletes

These help correct upper-body imbalances and improve shoulder stability:

• Dumbbell or kettlebell shoulder press

• Resisted shoulder internal rotation

• Resisted shoulder external rotation

• Dumbbell chest press

• Forward and lateral raises

• Bent-over dumbbell rows or single-arm ring rows

Sample 10-Minute Pre- or Post-WOD Accessory Routine

A quick, effective session could look like this:

Single-Arm Dumbbell Bench Press
2 × 8–10 reps per side

Bulgarian Split Squat
2 × 6–8 reps per side

Single-Arm Bent-Over Row
2 × 8–10 reps per side

Single-Leg Romanian Deadlift
2 × 6–8 reps per side

Final Thoughts

Unilateral training isn’t about replacing your CrossFit workouts, it’s about supporting them. By dedicating a small amount of time to single-leg and single-arm strength, you can move better, lift more efficiently, and stay healthier long-term.

If you want to keep showing up consistently, pushing intensity, and progressing without setbacks, unilateral work isn’t optional, it’s essential.

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

The post Why CrossFit Athletes Should Prioritize Single-Leg & Single-Arm Strength appeared first on Physio Room.

The concept of cross-training is very prevalent in the sport of running. Working with runners in both performance and injury/rehab settings, I’m often asked:

“What kind of cross-training should I be doing?”

The answer really comes down to why a runner is cross-training in the first place.

Are you:

• Trying to gain additional fitness without the impact of running?

• Maintaining fitness because you can’t run right now?

• Cross-training to prevent injury and build stronger, more resilient bone?

In my experience, these are the three primary reasons runners (or coaches) incorporate cross-training—and each one requires a different approach.

Cross-Training to Improve Running Fitness

When runners think of cross-training for fitness, they often gravitate toward:

• Cycling

• Swimming

• Rowing

• Elliptical

• SkiErg

While none of these options are inherently bad (and some are quite useful, as we’ll discuss later), I don’t believe they’re the most effective way runners can spend their time to improve performance.

The Most Overlooked Tool: Strength Training

One of the most underutilized aspects of a runner’s training program is consistent strength training.

Historically, runners want to run—not lift heavy weights. Many will perform light band work or basic dumbbell exercises, but very few incorporate meaningful resistance training into their routine.

Running is a high-impact, high-force sport. With every step, the body absorbs significant loads. To truly gain the benefits of strength training, runners should be lifting at 70% or more of their one-repetition max for most compound movements.

While research on other forms of cross-training shows mixed results, studies on strength training for runners are overwhelmingly positive—and there are many of them.

Proven Benefits of Strength Training for Runners

• Improved muscular endurance

• Increased power and explosiveness

• Improved running speed

• Improved running economy (efficiency)

Perhaps most importantly, consistent heavy strength training significantly reduces injury risk. And the number one requirement for a great race day? Making it to the starting line healthy.

My Favorite Strength Exercises for Runners

• Hex Bar Deadlift

• Box Squat

• Rear-Foot Elevated Split Squat

• Single-Leg Calf Raises

• Heavy Carries

Cross-Training When You Can’t Run

With all this talk about cross-training, it’s important to remember one key principle:

The most effective way to get better at running is running.

The majority of your training time should be spent in the sport you’re competing in. But what happens when you can’t run due to injury?

The Best Alternative: Cycling

When maintaining cardiovascular fitness during an injury, the goal is to choose an activity that most closely resembles running.

My top choice is cycling.

Cycling is:

• Unilateral

• Cyclical

• Low-impact

• Highly transferable to running mechanics

For trail runners especially, I’ve seen strong carryover from cycling to improved strength and endurance on steep climbs—as long as biking is safe for the current injury.

What the Research Says

A widely referenced 2009 study suggested minimal VO₂ max transfer from cycling to running, which caused many runners (myself included) to question its value.

Fortunately, research didn’t stop there.

More recent studies have demonstrated meaningful fitness carryover from cycling to running. While running and strength training will always provide the greatest performance benefits, cycling is an excellent option when running isn’t possible.

Cross-Training for Injury Prevention & Building Strong Bone

This category is especially important for adolescent runners.

Humans typically reach peak bone mass between the ages of 25–30, meaning everything before that window plays a crucial role in long-term bone health.

How Bone Gets Stronger

Bone adapts to the forces placed upon it. While running is great for cardiovascular fitness, it is extremely repetitive and unidirectional. Bone does not become optimally robust from running alone.

What does improve bone strength dramatically is multidirectional movement.

Multiple studies—and even side-by-side imaging—show significantly greater bone robustness in athletes who play multidirectional sports compared to runners. For example, the tibia of a soccer player versus a distance runner tells a compelling story.

Best Cross-Training Options for Bone Health

• Soccer

• Ultimate Frisbee

• Basketball

These sports challenge the body in multiple planes and directions, providing the stimulus bone needs to adapt and strengthen.

Final Thoughts

When it comes to improving running performance, running will always be the top priority. However, when cross-training is indicated—and in my opinion, it always should be—choosing the right type of cross-training matters.

By aligning your cross-training strategy with your specific goal—whether it’s performance, injury recovery, or long-term resilience—you can train smarter, stay healthier, and ultimately become a better runner.

Written by Drew Short – PT, DPT, CMFA| Physio Room

The post What Is the Most Effective Form of Cross-Training for Runners? appeared first on Physio Room.

Are you sick of dealing with knee pain every time you squat?
Maybe you’ve started avoiding squats altogether… or you keep the weight below a certain number, hoping you can “save your knees” for the long term?

Whether you’ve been told to steer clear of squats because of arthritis or you’re an athlete who needs to fix this to stay competitive — this one’s for you. Let’s break down what’s really going on and what immediate, actionable steps you can take today.

Where People Usually Feel Knee Pain

Front of the knee — around or below the kneecap
On top of the knee — at the bottom of the quads
Inside or deep within the joint — near the meniscus or tendon attachments

Short-term rest or reducing load can help calm irritated tissues — that’s valid. But avoiding load for too long stalls progress. Your knees need load to adapt and stay strong. When tissues are challenged, they remodel, strengthen, and become more resilient.
Avoiding load entirely tells your body it no longer needs to maintain that strength — making you more sensitive over time. The key? Finding the right dose of load and movement your knees can handle, then building from there.

The Problem Isn’t the Squat

Here’s the truth:
The squat isn’t bad. Your knees aren’t broken.

All bodies are designed to squat — it’s one of the most fundamental human movements. Pain usually isn’t about a “bad” squat; it’s about how your body manages force through the movement. That can be influenced by:

• Your movement patterns

• Load management and programming

• Coordination and control throughout the lift

And no — this isn’t just about “fixing your form.” The goal is to match the movement to the athlete, not the other way around.

4 Key Factors to Look At

1⃣ Body Positioning

Foot width, weight distribution, lat engagement, and hand placement all change how force travels.
→ Think “balanced tripod foot” and “stay connected to the floor” rather than “knees out” or “sit back.”

2⃣ Bar Placement

A lower bar shifts your center of mass backward, engaging the hips more.
A high bar or front squat loads the quads, increasing knee stress but improving upright mechanics.
→ The “best” setup depends on your anatomy and goal.

3⃣ Descent Pattern

Instead of “sit back,” think “sit down.”
Let the knees travel forward naturally — it keeps tension balanced front to back and helps maintain control.

4⃣ Tension Control

Do you drop to the bottom of the squat?
Does your speed change throughout the rep?
Managing tempo and breathing helps muscles absorb force instead of dumping it into the joints.

Regional Influences to Consider

Hips:
Limited hip flexion or rotation can cause compensations down the chain. Sometimes mobility drills help, but often adjusting your bar position or stance makes the biggest difference.

Ankles:
The ankle isn’t just a hinge — it’s designed to pronate slightly during a squat. Without that motion (or with too much), stress shifts toward the knees.
Try a slight heel lift, maintain midfoot pressure, and keep your big toe grounded for balance.

How to Start Restoring Squat Tolerance

Set up your stance and bar position for your anatomy — not what you saw online.
Find a range of motion and load that’s challenging but tolerable. Mild discomfort is fine; sharp pain is not.
Gradually build range, load, and tempo as symptoms improve.

Takeaway

Knee pain doesn’t mean you have to stop squatting — it just means something in the system needs attention.

By addressing your hips, ankles, and movement control, you can restore load tolerance, reduce pain, and rebuild confidence under the bar.

Strong knees don’t come from avoiding squats — they come from learning to move with your body, not against it.

Written By Dr. Jessie Czarnecki, DPT, OCS, CSCS, USAW-L1, CF-L2 | Physio Room

The post Knee Pain During Squats? Here’s Why (and How to Fix It) appeared first on Physio Room.

Picture this: it’s mid-cross-country season, and your young runners are logging miles, tackling hills, and racing hard week after week. Many assume that running alone is enough to keep improving. But as Dr. Stacy Sims highlights in her Next Gen course, strength and performance training isn’t optional—it’s essential. Not only does it boost resilience and power, but it also supports athletes through the natural ups and downs of adolescence.

Performance Decline Is Normal

One of the most important lessons Sims shares is that a dip in performance is completely normal, especially for young female athletes. Growth spurts, hormonal shifts, and the stress of heavy mileage can all cause race times to plateau—or even slow temporarily.

This isn’t a sign that training isn’t working. Instead, it signals that the body is adapting and needs smart support. Rather than increasing mileage, it can be more beneficial for athletes, coaches, and support systems to focus on strength training. Building a solid strength foundation protects tissues, improves mechanics, and allows athletes to come back stronger once their bodies recalibrate (drstacysims.com).

Performance & Resilience Through Strength

Here’s how strength and performance training can help young athletes thrive:

• Build Robust Muscles & Joints: Hip thrusts, split squats, planks, and deadlifts protect knees, hips, and the core under high running loads.

• Develop Power & Agility: Plyometrics, medicine-ball throws, and Olympic lifts sharpen neuromuscular coordination for race surges and fast finishes.

• Boost Confidence & Sustainability: Sims emphasizes celebrating strength over appearance, helping girls stay engaged and view training as empowering.

Quick Guidelines for Coaches & Athletes

• Focus on movement quality first.

• Train 2–3 times weekly.

• Be flexible with hormonal cycles.

• Normalize ups and downs in performance.

Strength and performance training for young female athletes isn’t just about improving race times—it’s about building resilient bodies, confident minds, and a lifelong love of sport. By giving these athletes the tools and guidance they need now, we set them up for stronger, healthier, and more sustainable performance both on and off the course.

Ready to Support Your Young Athlete?

If you want to give your runner a customized Strength and Conditioning program designed to build resilience, power, and confidence, schedule a session with Coach Cassie today!

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

The post Strength & Performance Training for Young Female Athletes appeared first on Physio Room.

Shoulder injuries are one of the most common upper-body issues among sport climbers — second only to finger injuries. Taking extra time to properly prepare your shoulders before a hard climbing session is worth the effort.

A solid warm-up isn’t just about getting the blood flowing — it’s a key part of your overall training and injury prevention strategy. Try adding these three shoulder-focused exercises to your warm-up routine to improve mobility, activate stabilizers, and get ready for climbing-specific loads.

1. Thoracic Rotation Arm Circles

While overly complex combination exercises aren’t always necessary, this movement is an exception — it pairs thoracic spine mobility with shoulder control, giving you the benefits of both.

We spend a lot of time on the wall in near end-range overhead positions, which require mobility and stability through the thoracic spine, scapula, and glenohumeral joint.

When to use it: Early in your warm-up to prime your shoulders for overhead movement.

2. Swimmers

This exercise is a great follow-up to the first one, activating the muscles responsible for moving the scapula through overhead ranges of motion.

There are a few variations — try it standing or lying face down. For an extra challenge, add a hollow-body hold or child’s pose position to limit compensation from your lower back.

Why it helps: Builds active control through your shoulder blade and strengthens your rotator cuff for better positioning on the wall.

3. Dead Hangs

Dead hangs are one of the best later-stage warm-up drills once your muscles are warm and mobile. This exercise mimics the load you’ll experience while climbing and helps build foundational rotator cuff and scapular strength.

Start with a two-arm hang, working through gentle scapular engagement. As you progress, experiment with single-arm hangs, rotations, and different planes of motion (vertical and horizontal).

Pro tip: Dead hangs have even been proposed as a test of requisite rotator cuff strength for climbing.

Final Thoughts

Warming up properly before climbing can make a huge difference in performance and longevity. Taking 10–15 minutes to mobilize and activate your shoulders not only helps you climb stronger but also keeps you climbing longer — injury-free.

Enjoy, and happy climbing!

Written By The Physio Room Team| Physio Room

The post 3 Shoulder Warm-Ups Every Climber Should Do appeared first on Physio Room.