[Updated Case Study] Risk Factors For Shin Splints & How To Prevent

[Updated Case Study] Risk Factors For Shin Splints & How To Prevent

how to prevent shin splints

Shin splints are a common injury for runners. They can also be known as medial tibial stress syndrome (MTSS). Symptoms include pain in the front of your lower leg and at times along the inside of the lower leg, next to the shin bone (tibia). Because shin splints are very common and often discourage new runners from continuing to train, I have put together this comprehensive resource which not only explains symptoms and causes of shin splints, but most important, treatment and prevention.


Self diagnosis of any sporting injury is dangerous. Every injury is different in some way and each requires specific assessment and treatment. It would be irresponsible of me as a certified coach to attempt to manage your injury in an article. So use the following information for guidance. Although I provide much researched details along with a logical and effective rehab program, I encourage athletes to seek professional medical opinion for diagnosis and to confirm treatment protocol for any injuries.


The role of the shin bone during running is to help absorb and dissipate the impact generated with each foot fall. Shin splints are generally an overuse injury that occur when too much stress is put on the tibia or when the muscles next to and around the tibia are overworked. In healthy runners, the stress a bone experiences after a long, hard run is not a problem and doesn’t result in shin pain. However, in less experienced runners or athletes who have a muscle imbalance with weak shin muscles and underdeveloped hip abductors & calves, the shin bone has not yet adapted to the stresses of a high-impact activity like running.

Unfortunately, shin splints often recur with many runners who aren’t able to address their overall weaknesses. This is because, many resources on how to get rid of shin splints (even from trusted medical sources) don’t address the root cause of the problem.

Risk factors for shin splints

The biggest risk factors for shin splints is a rapid increase in mileage or intensity of your running activities, such as a big increase in mileage or over-training on hills or hard/uneven surfaces. However, in order for these risk factors to lead to shin splints a pre-existing muscle imbalance between quads and hamstrings or weak shin muscles and underdeveloped hip abductors & calves will often lead to shin splints.  Other factors include inadequate footwear, poor bio-mechanics such as over-pronation, flat feet or high arches.  Each of these risk factors contributes shin splints.

In a recent study of high school runners, a significant relationship was found between Body Mass Index, internal hip rotation angle and shin splints in females, and between limited single leg raise and stress fractures in males.  This would support the need for strengthening and stretching exercises which are discussed below.

Symptoms of shin splints

Shin splints result in pain in the front of the outer leg below the knee. Typically this pain is located on the outer edge of the mid region of the leg next to the shinbone (tibia). In my experience dealing with runner’s with shin splints, they complain about discomfort in an area of their leg that’s anywhere from 4-6 inches in length (as opposed to a stress fracture which is typically pain in a much smaller area). Oftentimes, the pain the runner is experiencing is at the beginning of the workout, then gradually lessens, but then can reappear at the end of the training session. Most people describe shin splint discomfort as a dull ache at first. However, as the trauma continues, it’s not uncommon for the pain to become so unbearable that it causes the athlete to stop their workout altogether.

Treatment

There are many articles regarding treatment of shin splints. The aim of most “traditional” treatment methods involved rest & ice, which typically reduced the pain. Medical studies of shin splints have attempted to confirm the most effective treatment, but no study is conclusive.

How Middle Age Runners Stay Injury Free

 

The proper progression of treatment and along with a planned exercise program will help alleviate the pain and most important prevent shin splints from recurring. First, I strongly suggest getting a diagnosis from a medical professional.  We must confirm that the trauma is actually due to shin splints and not a stress fracture.  There’s a big difference between the two injuries, especially in the treatment and length of recovery.

Assuming that the injury is shin splints, first order of business is to minimize the pain.

  1. Rest – avoid activities that cause the pain or discomfort. However, don’t give up on all physical activity.  Try low impact exercises like elliptical, swimming or stationary bike.
  2. Ice – apply ice packs to the affected shin for 20 minutes at a time 2-3 times per day.
  3. If the pain persists when you’re not engaged in physical activity, consider taking an over-the-counter pain reliever of your choice. Discuss your best options with a medical professional.

Use of KT Tape

KT Tape can help treat shin splints by relaxing associated muscles, relieving pressure on tissue to reduce pain, and increasing circulation. Although I haven’t tried KT Tape as a means to minimize shin splints, you can follow the directions in this KT Tape video

In parallel to the above pain relieving regime, preventing shin splints involves a program of stretching and strengthening.

Best Prevention Strategy

Improving calf strength, abductor strength and strengthening shin & hip muscles are the best approach to preventing shin splints. The calves are the largest muscle group in the lower leg, when we strengthen them along with hips and shin muscles, we help stabilize the tibia with each impact.

  1. Regularly stretch your calves and hamstrings.

Use the stretching routine below to help avoid tight muscles in your leg that can put you at greater risk for shin splints and other lower leg injuries.

  1. Avoid sudden increases in physical activity.

Gradually increase your weekly mileage & the intensity of your workouts. The rule of thumb for most runner’s is to limit weekly mileage increases to 10%.  More experienced runners can increase by slightly more, but it’s always best to err on the conservative side.

It’s also very important to ensure proper recovery after long & hard runs.  This not only includes spreading out days between hard activities, but also completing alternate forms of exercise (like elliptical, stationary bike and swimming).  It’s also really important to run slow on your easy days.  Bottomline, getting sufficient rest will ensure proper recovery and help to avoid injuries.

  1. Run on softer surfaces whenever possible.

This tip isn’t just for runners that are experiencing shin splints.  It’s a good idea to try to minimize running too often on hard surfaces, such as concrete (sidewalks & bike paths). These hard surfaces over time will increase the amount of force that your bones and muscles have to absorb which can cause muscle fatigue and overuse and ultimately possibly result in shin splints.

Choose soft surfaces like dirt, grass and synthetic tracks.  Make it a goal to go for a weekly run on a nice wooded trail to break up the monotony of running on surface streets. This will help to prevent your bones, muscles, tendons and joints from having to absorb so much shock.

  1. Complete exercises that will strengthen your foot, ankles and the arch of your foot.

The arch of your foot forms by the time you are 7 to 8 years old. Injury, age, and other health conditions can alter the structure of the arch; lack of physical activity can actually create weakness in the muscles of the foot, lower leg, thigh, and trunk. These changes can affect your lower leg and is often why beginner runners experience shin splints.

Strengthening your foot important. An excellent exercise is using your toes to pull a towel on the floor closer to your foot while sitting. This helps to strengthen the arch muscles. Stronger arch muscles ensure the arch works more effectively.

Foot orthotics (ie, arch supports) may be prescribed by your doctor or physical therapist if you pronate or require additional support for low arches. Alternatively, orthotics help with  high arches by helping the foot absorb more shock and decrease stress.The use of orthotics should be prescribed by a medical professional.

  1. Strengthen your hip muscles.

Strengthening your hip muscles will help your legs absorb more of the shock and pressure during running. Below are some excellent exercises that will help.

  1. Ensure you are wearing running shoes that are right for you.

Shoes that don’t fit right or that lack proper features can contribute to shin splints. Speak with your physical therapist about the right shoe features for you. I also recommend rotating your running shoes. One strategy is to rotate your shoes. This means having 2 pair of the same or slightly different shoes and use them each 3 – 4 times per week.

It’s essential to regularly replace worn running shoes. Typically replacement is recommended every 350 to 500 miles (560 to 800 kilometers). You can find a detailed article discussing how to buy new running shoes.  It’s a quick, but informative read that will help you get the appropriate shoes to accommodate your gait and size.

  1. Maintain a healthy body weight.

Increased body weight, being overweight, or obesity can lead to a higher risk of shin splints. Even if you if you run or exercise regularly, you should still regularly consume a well balanced diet.  You can find some suggestions about How To Improve Your Diet Right Now.

  1. Have your running technique analyzed and corrected by a physical therapist.

Incorrect running, jumping, and landing techniques can cause shin splints. Your physical therapist can help you understand how to improve your exercise technique to avoid shin splint pain. Your physical therapist also can check to see which muscles are tight or weak, and teach you how to stretch and strengthen them.

Physical therapists can observe how a person moves, determine how their body reacts, and then establish a program of care for prevention, recovery, and progression of desired activity.

A formal video analysis of your running technique can help to identify movement patterns that can contribute to shin splints or other injuries. In many cases, a slight change in your running can help decrease your risk.

How to Prevent Shin Splints Routine

So now that we know all this information about the cause of shin splints, it’s essential to develop a routine to prevent them. Below is a recommended strength training program. The exercises shown will strengthen and stabilize your legs, ankles, hips and core. They will help prepare your legs and body to deal with the high-impact of running.

Clams

Clams for Hip Strength

Clams for Hip Stregth

Start by lying on your side, legs stacked on top of each other with your knees bent at around 45 degrees and pulled slightly behind you.

Put your bottom hand under your ear to support your head or along the floor and use the upper hand to push into the ground right in front of your chest.

Keep your heels together, slowly open and close your upper knee up and down. Switch sides and repeat, opening out the opposite leg for the same amount of reps.

Clams help to maintain hip flexibility and provide knee stability. The small controlled movements activate all the small muscle groups in your glutes and inner legs to improve strength and range of motion without any impact.

How Middle Age Runners Stay Injury Free

 

Wall Press

Wall Press for Shin Splints

Stand approximately 18 inches from a wall with both feet shoulder-width apart, toes pointed inward.

Press your pelvis to the wall, adjusting the distance from the wall and the angle of the toes to gain the best stretch of the soleus muscle. Keep your heels on the floor.

Hold stretch for 15 – 30 seconds and repeat.

Donkey kicks

Donkey Kick Glute Strengthening

Donkey Kicks for Glute Strengthening

Get on all fours with your hands under shoulders and knees under hips.

Keep right knee bent 90 degrees, flex right foot and lift knee to hip level.

Lower knee without touching floor and lift again. Complete 15 reps.

Switch legs and repeat.

Standing Calf Stretch

Standing Calf Stretch calf injury prevention

Stand, facing a wall with one leg extended backward, foot planted on the ground. The other leg, flexed at the knee, has the foot planted on the ground straight down from the hip.  Arms are extended forward at upper chest height, shoulder width apart. Hands are placed on the wall.

Press gently into the wall and gradually press your heel of the extended leg into the floor. A stretch should be felt through the length of the calf muscle.

Stretch statically for 15-30 seconds, repeat multiple times and then switch legs after every rep.

Runners with either neutral or underpronoted biomechanics often suffer from tight calf muscles. This stretch will help to alleviate the pain associated with recurring calf injuries.  This stretch will also help to prevent calf injuries by keeping the calf muscle supple.

Hip thrusts

Hip Thrust for Glute Strength

Hip & Glute on Ground

Hip Thrust for Glute Strength

Thrust Hip Up, Point Toe Forward & Hold for 5 seconds

This exercise helps to improve glute strength

Standing Heel Raise with Eccentric 

standing heel raise for calf stretching and strengthening

standing heel raise with eccentric component

Stand with both feet on a step with the heels off the step. Hands are pressed against the wall in front.

Raise up onto your toes of both feet to full extension

Lower gradually to full extension (dorsiflexed).

This exercise both shortens the calf muscle and then lengthens it.  Including an eccentric (or negative) component adds value to the the calf. Performing exercises with an eccentric component actually shortens the time it takes to heal an injury.

If you’re currently experiencing shin splints or they have plagued you in the past, incorporate the above routine into your training two to three times per week. Now you’ll be targeting the real cause of your shin pain rather than strengthening a muscle that really doesn’t contribute to the injury.


References:

Zimmermann WO, Helmhout PH, Beutler A. Prevention and treatment of exercise related leg pain in young soldiers; a review of the literature and current practice in the Dutch Armed Forces. J R Army Med Corps. 2017;163(2):94–103. Free Article.

Yagi S, Muneta T, Sekiya I. Incidence and risk factors for medial tibial stress syndrome and tibial stress fracture in high school runners. Knee Surg Sports Traumatol Arthrosc. 2013;21(3):556–563. Article Summary in PubMed.

Authored by Andrea Avruskin PT, DPT.

Claude T Moorman III, ScientificAmerican.com/article/what-cause-shin-splints. May, 2004.

Mayo Clinic Staff, https://www.mayoclinic.org/diseases-conditions/shin-splints/symptoms-causes/syc-20354105

Shin splints, SSD Patil – Foot and Ankle Sports Orthopaedics, 2017 – books.google.com

Running Anatomy, Joe Puleo & Dr. Patrick Milroy, 2010 Human Kinetics.


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Why Weak Glutes Are a Runner’s Biggest Enemy and How You Can Fix
How to use a foam roller
Four Great Ways to Avoid Running Injuries
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Simple Strategies To Prevent Shin Splints

Simple Strategies To Prevent Shin Splints

Last week, I presented a video and discussed the difference between shin splints and stress fractures.  That video reviews in detail the differences, which is really important because the treatment is so different and it’s possible for shin splints to lead to a stress fracture if not treated properly.

One of the root causes of shin splints is a muscle imbalance in leg with calf muscles being much stronger than muscles that surround the shin (tibia).  Because these muscles are under developed with beginner runners and athletes like weight lifters who try to run, shin splints are very common.

The following video provides 3 easy exercises that should be regularly completed to help prevent shin splints.

Other strategies to help prevent shin splints include:

1) Avoid or at least minimize running on hard surfaces, instead opt for softer surfaces like crushed gravel or well worn dirt trails.
2) Run in shoes that aren’t worn down.  The general rule of thumb is to replace running shoes between 350 – 500 miles.  Take a look at the soles and if they’re showing signs of wear, replace your shoes.  Even if the soles aren’t worn down, the inserts inside will be after about 350 – 500 (tops).
3) Give yourself enough time to recover from long and/or hard workouts.  Go easy and try to stay on softer surfaces after putting a lot of stress on your legs.
4) Stay at a healthy weight.  This will also help avoid or minimize many other running related injuries to the knees, hips, back, etc.

The following video is a short view, but I’m sure you’ll find it to be very informative with exercises you can start doing immediately.

Related Posts
The Difference Between Shin Splints & Stress Fractures
Why Weak Glutes Are a Runner’s Biggest Enemy and How You Can Fix

Difference Between Shin Splints & Stress Fractures

Difference Between Shin Splints & Stress Fractures

Shin splints are very common with beginner runners. Both shin splints and stress fractures are considered overuse injuries. They are both very painful, but the treatment protocol for these injuries are very different.

A shin splint is an inflammation of the tissue running along the shin bone, whereas a stress fracture is a very small crack or group of cracks that form in the bone itself.  Typically, a stress fracture shows itself as pain in a specific location along your shin.  Shin splints tend to hurt as you rub your finger/thumb along the shin.  Often, shin splints hurt a lot when you wake up, whereas a stress fracture won’t.

This video goes into great detail discussing the differences between both injuries.  The treatment of a stress fracture and start with a boot.  Non impact exercise may be allowed (bike, eliptical, swimming).  I strongly recommend consulting with your Doctor for a full recovery plan.

My youngest son experienced a stress fracture last year.  He was not able to run for 10 weeks.

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Why Weak Glutes Are a Runner’s Biggest Enemy and How You Can Fix

Why Weak Glutes Are a Runner’s Biggest Enemy and How You Can Fix

Standing Glute Test – Right

Glutes are arguably the most important muscle group for runners. Unfortunately, they are also the most neglected in terms of maintenance and strength. Studies link glute weakness to achilles tendinitis, runner’s knee, iliotibial (IT) band syndrome and other common injuries.

If you glutes are so important and their weakness contributes to many injuries, why are they neglected.  Simply put, most athletes of all ages are unaware of the role their glutes play in their running performance. The goal of this article is to create a better awareness of the function of glutes for runners, what causes glute weakness or imbalance, how to identify if you have a problem and how to stretch & strengthen your glutes.

GLUTES 101

Your gluteus maximus is your butt, the two smaller, glute muscles (called glutes) are located on the side of your butt, near and slightly above your hip joint. When we run, the glutes’ job is to hold our pelvis level and steady. The gluteus maximus is responsible for hip extension, or raising your leg behind your thigh and knee behind you after pushing off with your foot. Good hip extension creates the energy of that leg swing into forward motion.

The problem is, without good hip extension you won’t have a powerful stride, which means your speed will be limited. The other key role of glutes for runners is providing stability for the pelvis and knees and keep our legs, pelvis and torso aligned. If you have strong glutes, side-to-side motion will be limited and you will be a more efficient runner because your energy is directed forward. Basically you can faster at the same effort level.

Also, when the glutes aren’t working properly, some of the impact forces are transmitted elsewhere down the legs. It’s common for many runners to have strong abs and back muscles but weak glutes.

How does this Glute dysfunction occur?

It’s common for the gluteal muscles to become inhibited which will prevent them from properly engaging and being able to perform their role.

Part of the problem is that glutes aren’t as active as other running muscles during routine activities. This leads to your hamstrings, quads, and calves becoming disproportionately stronger (also called an imbalance).

This imbalance limits the effectiveness of the glutes. The end result is that if we aren’t aware of this imbalance and subsequently correct it, typical movement and habits will place increased emphasis on the stronger muscle groups such as the Quads, rather than allowing the glutes to contribute properly within the running motion.

 

I saw it on Bauerfeind USA Inc

Sports Compression Socks Ball & Racket | Compression | Medical aids | Bauerfeind B2C US

 

 

This kind of strength imbalance can cause injury problems over time as the body learns not to use the glutes as it tries to favor the stronger quads. If not properly identified, a glute weakness/imbalance typically doesn’t get corrected on it’s own because most runners don’t perform strength training exercises that isolate and strengthen the glutes. Exercises you can complete to fix this problem are listed below.

Additionally, excessive sitting can cause tight muscles, in particular the hip flexors, which will then inhibit the glutes, making them weak and ultimately pulling your pelvis out of alignment.

Bottomline, you need to work the smaller glutes to stay injury-free. The following video helps to explain the issue.

Glute Strength Tests

To see if you have weak glutes, you’ll need to perform the following glute strength tests.

Standing Glute Test – Left

Standing Glute Test – Right

Stand with your hands over your head, palms together. Lift your right foot off the ground and balance. Watch the left side of your hips to see if it dips down. If it does, it’s a sign of glute weakness.

In these photos, I’ve inserted a YELLOW HORIZONTAL LINE, to help identify whether or not my hips are dipping.  You can have a friend take a photo while performing this test or you can complete the test while in front of a mirror to observe results yourself.

I recommend the photo, so you can look at the results more closely.

Try it on the other side, too. Next, do this: While in the same position, lean to the right of your body, checking to see if your left side dips. Move your hands to the left of your body and see if your right side dips. If your hips dip, it’s a sign that your glutes need work. Try this test also after a long or hard run to see how your glutes perform when fatigued.

 

Glute strengthening and stretching exercises

For each exercise start with 10 reps the first week and then progress to 15 reps (switch legs), rest for 30 seconds and complete 3 total sets.

Watch this video for a modified lunge stretch using a chair:

 

Tight hip flexors can inhibit the firing of your glutes. Complete this stretch after every workout (crossfit/conditioning or run)

Step forward and lower your back knee. Keep your knee over your ankle. Hold for 30 seconds on each side.

Glute & Hip Strengthening Exercises 

This video shows some exercises that are completed with a stretch cord.  Stretch cords may be available at your gym.  If you don’t have access to a stretch cord, you can complete the exercises below (see photos and descriptions).

Kick Backs – This exercise engages the middle-butt and low back.

Kick Back Glute Strength Exercise

glute strength exercise for runners

Start on all “4s” by placing your hands under your shoulders and knees under your hips.

Extend your right knee and hip to even your right leg with your torso. Be sure your foot is flexed and your neck is neutral by looking down towards the ground. Hold momentarily. Return to starting position.

How Middle Age Runners Stay Injury Free

 

 

Leg lifts:

This exercise is a variation of kick backs. While your elbows and right knee are on the ground, lift your left leg until it is parallel with the ground. This is your starting position. Lift your left leg up about 6-12 inches while keeping it straight and then return to your starting position.

Fire Hydrants:

Glute Strengthening Exercise

This exercise strengthens the gluteus medius and minimus (smaller muscles in the butt).

Start on all “4s.” Next, make a 90 degree angle with your right leg and then lift your right leg up 6-12 inches while keeping your knee bent. Hold momentarily, then return to starting position.

Bridge:

Lie flat on the ground with your hands by your sides and your knees bent. Pushing up mainly with your heels, keep your back straight and raise your hips up off of the floor. Hold there at the top for a few seconds and then go back to where you started and repeat. For an added bonus, try this exercise with only one foot on the ground at a time!

Single Leg Squat:

Stand on your left leg. Lift your right out in front of you. Stand tall (don’t round your shoulders), and keep your left knee over your ankle as you lower down into a squat. Your hands can extend out for balance.

Modified Single Leg Squat:

Glute Strengthening Exercises for runnersGlute Strengthening Exercise for Runners

Stand on edge of curb as shown in image. Raise right leg slightly and squat slightly with left leg (note how right foot is higher in 1st photo, side view). Start with 8-10 squats/leg and after completing this exercise 3 times/week for 2 weeks, increase to 15 squats/leg.

How Middle Age Runners Stay Injury Free

 

Sources:

www.runnersworld.com
www.kinetic-revolution.com
www.sportsinjurybulletin.com

4 Great Ways To Avoid Running Injuries

4 Great Ways To Avoid Running Injuries

How To Prevent Running InjuriesLast year when I surveyed hundreds of runners who visit middleagemarathoner.com, to no surprise, I found that injuries were the biggest obstacle faced by middle age runners. Coach Greg McMillan is currently conducting his own survey and he shared with me that his initial results showed a similar finding.

The purpose of this article is to provide four different strategies to help you avoid injuries. These aren’t the only four strategies you should use and you may already be using a few of these strategies yourself, but hopefully I can share something new that you can try to further injury proof your body.

Background: For the longest time, I felt like I was a slave to nagging injuries. It was one of my biggest challenge that was preventing me from regularly racing 1/2 and full marathons. Being a busy professional, I simply didn’t have time to implement a comprehensive injury prevention routine. About 99%+ of the middle age runners whom I coach don’t have a lot of time either. However, it’s important for any runner to engage in some kind of program that involves some of the strategy that I discuss in this article.

Over the years, I worked with my primary physician, physical therapist, athletic trainers and running coaches in addition to completing a lot of my own research and trial/error to finally develop my own injury proofing regime. There’s not a “one size fits all” solution when it comes to middle age runners and injury avoidance.

Bottomline, I eventually “cracked the code” of injury-free running. Since 2012, I have been injury free.

Note, that I didn’t say I have been pain free. There’s a difference and it’s how you manage your pain that greatly contributes to remaining injury free. It’s remaining injury free that allows runners to build consistency and reach their goals.

Following are four of the strategies that I use in parallel to remain injury free.

1. 3 Too’s – I’ve read this from a few sources as the leading cause of running injuries.

a) Too much – mileage – depending on your base, athletic ability and running experience, running too much weekly mileage can lead to injuries.

b) Too soon – weekly increases should be limited to no more than 10% of the previous weeks’ total mileage. Increase your weekly and monthly running totals gradually.

c) Too much – change – although it’s important to vary your weekly workouts (discussed below), going from the couch to running every day and also completing heavy conditioning workouts will likely lead to injury. It’s important to gradually (over several months) increase the intensity of your training. Your body needs to be ready to increase mileage, run intervals or perform intense conditioning workouts.

How Middle Age Runners Stay Injury Free

 

2. Vary the intensity, mileage & route of your workouts. This is essential in my training plans. Changing pace, intensity and duration of runs will help ensure you improve. You can’t expect to improve if you run the same route at the same pace, day after day.  Simply varying the routes or running surfaces is one of the best ways to spread out the various forces on your lower body so that no one tissue or tendon gets overworked.

3. Practice proactive recovery – along with the 3 too’s, you should regularly use a foam roller and an occasional ice bath. I use compression socks to help me recover from both hard and long runs. However, to truly be proactive, you need to complete workouts at a level where your body is ready. This means scheduling workouts based on other workouts you will or have already completed that same week or in previous weeks. Coach Jay Johnson says, “keep the hard days hard and easy days easy.” I also recommend taking at least 1 day off (no exercise) per week.

4. Listen to your body – along with being proactive you need to also be reactive with your recovery. If something you’re doing is resulting in pain that forces you to alter your running form, I strongly recommend stopping that particular activity, identifying the root cause of the pain and seeking professional medical advice to eliminate the issue. If the rigors of training for a particular race like a full or half marathon become too painful, you may need to postpone the race or simply run a shorter race like a 5 or 10k.

BONUS: 5. Use a coach – A good running coach can provide you with a training plan that meets your athletic ability, goals and helps to prevent injury. Sometimes I adjust scheduled long runs, speed work and some of the scheduled high-intensity training. This allows more time to rid yourselft of the pain and get healthy so you can get back to your training.

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If you’re not doing so already, implementing these strategies will make a big difference to your performances over time. Although each strategy isn’t a “cure-all.” If after working these strategies into your plan and you still are fighting the injury bug, then I would replace one of the days you run with a cross-fit/aerobic (eliptical, stationary bike or swimming) and conditioning workout. If after making this change you still continue to get hurt, then I would visit with a medical professional and if you’re not with one already, I would speak with a coach who can take a look at your training and suggest some alternative workouts that may help you train injury free.

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Why Weak Glutes Are a Runner’s Biggest Enemy and How You Can Fix
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How to use a foam roller

How to use a foam roller

Foam Rolling is great for injury prevention and rehab

In this article, I will discuss how to use a foam roller and why a foam roller is my “secret weapon.”  Foam rollers are great tools for both injury prevention and performance enhancement. Foam rollers are the poor man’s massage therapist.  They can provide soft tissue work to help many athletes, in any setting.  Sources & references that I used to help me complete this article are listed at the end of the article.

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A foam roller is simply a cylindrical piece of extruded hard-celled foam. Think swimming pool noodles, but more dense and larger in diameter. They usually come in one-foot or three-foot lengths. I find the three-foot model works better, because I can roll on both legs at once, but it obviously takes up more space.

Foam Roller Basics

Foam rolling is a form of self-massage that helps to relieve muscle tightness. Rolling applies pressure to specific points on your body that helps loosen the muscles and assist in returning them to normal function. When I think of normal function, this means your muscles are elastic, healthy, and ready to perform at a moment’s notice.

However, for me, a foam roller is more than a tool to rehab injured muscles, I believe it should be used by healthy runner’s to warm-up and cool-down after workouts.  Rolling properly on foam can improve circulation. Rolling breaks down knots that can limit range of motion and it can prepare muscles for stretching. Foam rollers, when used correctly, can release tension and tightness between the muscles and the fascia (which surrounds the muscle or group of muscles). Foam rolling, as well as dynamic stretching (after a run or after foam rolling) can help improve flexibility and range of movement, and actually decrease the risk of injury.

It’s important to move slowly and even stop and hold the roller on tender spots.  Ensure you breathe through the discomfort.  If an area really hurts, go gentle on it and support some of your weight elsewhere, using your arms. One thing you want to avoid is rolling on an injured or inflamed area of your body.  For this reason, I recommend to those that I coach to go indirect before direct.  This means that if you find a spot that’s particularly sensitive, ease away from that area by a few inches. Take some time to work a more localized region around areas where you feel discomfort.  Work these “neighboring areas” before using larger, sweeping motions.  Eventually work to keep pressure on the affected area with the foam roller.  You can add more “weight” as the muscle relaxes by stacking your legs.  With a foam roller, you can basically work to your own pain threshold.

I know many people that don’t want to roll, because they think it will hurt.  This may be true, especially when you start rolling for the first time. There can be some discomfort, but this is often because these muscles are tight.  Once loosened, rolling is rarely painful.  Instead it feels very good on tired muscles.

The foam roller is a critical part of my marathon training. Just remember that your legs are “round” and not “flat.”  This means that you shouldn’t roll on one side of your leg.  Work all sides of your legs.  Especially the IT Band (discussed below).

How Middle Age Runners Stay Injury Free

 

If you’re new to foam rolling, start out gradually with lighter pressure and a shorter session. In time you can progress to more intense pressure.

While foam rolling can be done both before and after a workout, pre-workout sessions should focus on problem areas whereas post-workout sessions can focus on all of the muscle groups worked that day.

The key to foam rolling is to use your body weight on the roller.

I’ve attached a few videos from various sources to help demonstrate how to properly use a foam roller.  These are my favorite foam roller exercises:

1. Warm-Up – Use the foam roller prior to running.  Complete light rolling with long, sweeping strokes to the long muscle groups like the calves, adductors, and quadriceps.  Focus on areas that are particularly stiff.  Be careful not to roll on your lower back.  If you feel stiff, rolling increases blood flow and helps to relieve muscle tightness that can interfere with proper running form.

2. Cool-Down – Use the foam roller after running and stretching. Similar to warm-up, lightly roll with long strokes all around your legs.  You can roll on your upper back because the shoulder blades and muscles protect the spine, whereas there is no similar protect if you were to roll the lower back. Concentrate rolling on areas that seem particularly stiff or sore.

3. Calves – This is the most common foam roller exercise along with hamstrings.  Place the roller under one or both of your calves. If only doing one calf at a time, rest your other foot on the floor.  Roll all the way from your ankle to below the knee. As discussed above, your legs are round and not flat, so rotate your legs in and then out. If you want to add pressure, simply stack your ankles.

4. Hamstrings – Along with calves, another very common rolling exercise. Place the roller under your thighs. Roll from the knees to the buttocks. To increase the pressure, roll one leg at time while turning your leg in and out.

Foam Roller for Hamstring Tightness

5. Front Shins – If you are suffering from shin splints, then you should roll on the outside part of your lower leg (the part associated with shin splints).  Besides biomechanical inefficiencies, the primary reason for shin splints is a muscle imbalance in your lower legs.  Shin splints typically occur with beginner runners or a runner who’s returning from a lengthy layoff.  When running on hard surfaces with worn out or ill-fitting shoes, the weaker front “Anterior Tibial” muscles are overloaded or shocked by the stronger calf muscles.

I go into detail about how to rehab for shin splints in the injury prevention portion of my marathon training e-book.

In this article, I want focus less on rehab and more on how to use a foam roller for the Anterior Tibial muscle.  If you are suffering from shin splints, take this exercise slow to prevent further injury.  Start at the top (near the knee) and work down then up again along the outside front of your leg. You can do this in a kneeling position or a position similar to a plank.   However, as with most foam rolling stretches, you might need to adjust to target the muscle (and not fall over in the process).

6. Iliotibial (IT) Band – Until I successfully loosened up my IT Band with the foam roller, I experienced what felt like, never ending foot and ankle discomfort.  My Doctor had confirmed that I wasn’t injured.  However, it was my Physical Therapist who connected my tight IT Band as the root cause of my aches and then showed me how to properly roll on and loosen up my IT Band.  After working on this for a few weeks, I noticed that the foot and ankle pain that I had experienced for 2+ years, finally went away.

Foam roller for IT band

To work the IT Band, lie on your side with the roller near your hip, rest your other legs foot on the floor and then move along your outer thigh. For most runners, working the IT Band with a foam roller is particularly painful.  This is because the IT band is often too tight.  IT Band injuries are more painful than rolling over a tight IT Band, so it’s well worth your time to perform this exercise regularly.  If you don’t feel much discomfort when performing this exercise, then try increasing the pressure by stacking your legs. When you feel discomfort, go slow and let IT Band loosen itself.  Don’t forget to breath while performing this exercise.

 

Foam rolling quads

7. Quads – Because your legs are round and not flat, we must also roll on our quads.  This is a simple, but slightly awkward exercise.  Lie on your stomach with a roller placed under the front of your thigh and slowly roll up and down from the bottom of your hip to the top of your knee.

 

8. Inner Thighs or Adductors – I rarely perform this exercise, but I do know others who work their adductors to rehab groin injuries or strains.  Lie on your stomach with one leg extended slightly to the side, knee bent. Place the roller in the groin area of the extended leg and roll the inner thigh.  You’ll have to brace yourself with your elbows (like a plank) to complete this roll.

9.  Gluteus or buttocks – your butt does a lot of work when you’re running, so you need to treat it with some foam rolling. You should also take the time to roll on your lower back.  Make sure that you roll slowly.  You get more benefit from the foam roller when you go slow over the tightest or most painful areas.

10. Other areas to roll – neck, hip flexors and feet

Assessing Effectiveness of your foam rolling efforts

As discussed, it can be hard to use a foam roller, especially if it’s slightly painful. Massage work and even some stretching can also be uncomfortable, especially with stiff or “knotted” muscles.  Therefore, it is important that runners learn to distinguish between a moderate level of discomfort related to working a muscle’s trigger point and pain or discomfort that can lead to injury.

When you complete a foam rolling session, you should feel better, not worse. The roller should never cause bruising. The first thing you should do after foam rolling is ask yourself how your muscles feel.  Once you start feeling the awesome effects of rolling, you’ll want to make it a part of your regular training regime.  Remember to be patient.  Becoming mobile and strong requires a long-term commitment to foam roller deep-tissue massage and other recovery work.

If you continue to feel pain after your foam rolling sessions, you should visit a physical therapist.   You may have an injury or it might be possible that you’re simply not rolling correctly.

In addition to my vast experience of training with a foam roller, I used the following sources & references to assist me in completing this article on how to use a foam roller.

  • Runner’s World
  • Usatriathlon.org
  • Peak Fitness by Mercola.com
  • FoamRollerCoach.com
  • Dailyburn.com

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