NSCA Endurance Clinic Summary: Day 2 (I forgot to summarize the final presentation.)

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Maybe I was in a rush to post the Day 2 summary, I’m not sure.  I forgot to summarize the final presentation of the day.

Dr. Jeff Matthews: Running Injuries – The Big Picture

  •  DC, CCSP, CCEP, 1996 USAT National Team, high school track coach
  • Primary shock absorber of the body: FOOT PRONATION
    • Pronation isn’t a bad thing–it’s supposed to happen.
    • Posterior tibialis controls pronation via eccentric contraction
  • Secondary shock absorber: knee flexion
  • Aches & pains of the leg, foot and toes
    • Metatarsalgia
      • Pain at the metatarsal phalangeal joint as the heel leaves the ground too early.
        • Causes
        • limited ankle dorsiflexion
        • tight gastrocnemius
        • weak digital plantar flexors
      • Treatment
        • stretch gastroc with straight leg
        • increase distal plantar flexor strength
        • rigid forefoot in shoes
        • decrease stride length & employ heel strike
      • I have off and on metatarsalgia.  I’m going to work the toe flexors, particularly the flexor hallucis brevis.  I’ll use a band.
    • Hallux limitus and rigidus (aka Turf Toe)
      • Dancers and defensive backs get this as a result of doing a lot of stuff on their toes.
      • Loaded dorsiflexion of the big toe should be 42 degrees at toe off.
      • To check: Sit with knees bent at 90 degrees.  Lift toe with finger while foot is flat on the ground.  If it’s less than 30 degrees then you’ve got a problem.
      • Stretch toe flexors: Pull toe back 20-30x/day.
      • Restore joint motion to big toe.  I’ve been playing with this stuff quite a bit lately.  I’ve got a constantly tight left calf.  I’m wondering if restricted toe dorsiflexion is part of the problem.
      • I’m not only working to stretch the FHB, but also to strengthen it so my big toe can grip the ground.
      • Here’s a good big-toe mobility video:

    • Insertional Achilles tendonitis
      • occurs near the base of the AI
      • common in high-arched, stiff feet
      • common with Haglund’s Deformity.
      • Seems I have a bit of this; more along the lines of a bursitis from what I cant tell.
      • Strengthen with eccentrics.
      • He says “Work on the front of the tendon,” as that’s where the blood flow comes from.
    • Achilles Paratendonitis
      • He describes this as occurring with an audible squeak or creak–I’ve had that!
      • An inflammation of the sheath around the tendon
      • Work on the front of the tendon to increase blood flow.
    • Achilles non-insertional tendonosis
      • degenerative non-inflammatory condition from repeated trauma
      • treatment
        • rest
        • muscle work to stimulate fibrolasts to remodel
        • when appropriate, strengthen posterior tibialis and flexor digitorum longus
        • How do we strengthen the FDL?  Here’s one way:

    • Patellofemoral Pain Syndrome aka runner’s knee
      • comes from abnormal femoral movement
      • hip muscle weakness is the cause; increases with fatigue
      • Testing for PFS: 1-leg squat & check for 3 things:
        • leaning toward stance leg to maintain balance
        • knee caving in
        • falling
      • Treatment
        • retro patellar pain: recruit/strengthen the vastus medialis oblique (VMO)
        • stretch hips, foam roll quads, increase hip flexor strength
    • IT Band Syndrome (ITBS)
      • strengthen hip abductors
      • decrease tension on the tendon with soft tissue therapies
      • stretch glute max and TFL
      • may take 6 weeks (Didn’t take me that long to overcome mine.)
      • Check out my post on IT Band issues for more help.
    • Popliteus tendonitis
      • The popliteous unlocks the knee from the extended position.
      • inserts under the IT band and can cause lateral knee pain
      • if weak then knee may stay locked and send shock to the back
    • Treatment
      • Strengthen the popliteous
      • soft tissue therapy
      • control pronation (probably with foot strengthening drills and more importantly, HIP ABDUCTOR exercises)
      • Here’s a video on recruiting and strengthening the popliteous

  • Hamstrings
    • Hamstring strains have the highest recurrence rate and can take 4 months to resolve
    • Semimembranosus protects the medial meniscus during knee flexion
    • long head of biceps femoris helps stabilize SI joint and is most frequently injured in runners because of the long lever arm decelerates knee extension
    • more proximal the injury the harder to treat
    • Treatment
      • increase length, strength and flexibility
      • evaluate pelvis
      • strengthening abs/stabilizing pelvis can position pelvis correctly thus putting hamstrings at proper length
  • Low back pain
    • Pain causes weakness/looseness
    • Internal or external femoral rotation may become problematic.
    • Treat hips
    • A TFL problem = a glute medius problem.  This is huuuuge to me!
    • Seems to me that sitting too much is maybe the main problem here.

 

 

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