Ten Tips to Prevent Running Injuries

Ten Tips to Prevent Running Injuries:

  1. Improve and maintain your flexibility
  • Daily stretching is essential to improve and maintain flexibility, which in turn will help improve performance and prevent injuries.
  • Focus on dynamic stretching activities such as sports specific dynamic exercises like high knee drills, skipping, bounding, arm circles, and cross body arm swings.
  • Static stretching as a warm up has shown little evidence to benefit runners prior to running.  Running requires spring from tendons and a relaxed muscle belly.  Often over stretching statically defeats this purpose.
  1. Include strength training in your running program
  • Strength training improves a runner’s body strength and overall athleticism. This in turn reduces muscular fatigue that leads to poor performance and injuries. Runners will benefit from a program of 2-3 strength training sessions per week.
  • Strength training exercises should focus on all muscle groups including the trunk and upper and lower body.
  • As Physical therapists we often see weakness in lateral hip/trunk that can often lead to running injuries in the hip/knee/ankle and back.  Some simple strengthening exercise to the lateral hip abductors and rotators and trunk can prevent this.
  • Weight lifting, plyometrics and hill running are all effective methods of increasing strength.
  • Focus on improving strength in the offseason and pre-season and maintaining while in season.

3. Stay hydrated and eat a well balanced diet

  • Avoid heat exhaustion and dehydration by prehydrating two hours prior to practice or competition with 16-20 ounces of fluids and another 8-10 ounces after warm-up.
  • Take in 6-8 ounces of fluids every 15-20 minutes of exercise.
  • Within two hours after exercise, re-hydrate with a pint (20-24 ounces) of fluid for every pound of weight lost during exercise.
  • The best fluids to take before, during, and after exercise are a cooled 4-8% carbohydrate solution.
  1. Warm up and cool down before and after all runs and races
  • Before practices and competitions it is important to warm up. The faster the workout or race, the longer the warm up needed. A warm up of 5-10 minutes helps to flush out lactic acid build-up in muscles and prevents delayed muscle soreness.
  • Dynamic warm up activities have been shown to be more beneficial as a warm up for runners vs static stretching.
  • Sport Legs (supplement) (through my own personal use), has helped significantly with soreness post run especially during longer runs/relays/Ragnar races.
  1. Gradually increase your mileage and periodize your training schedule
  • Good aerobic activity is the foundation of your running performance. The principle of progression and periodization means gradually preparing the body to handle workout stress. You slowly build up the amount of training you do along with bumping up the intensity.
  • Periodization is the structure in a training program to progressively increase the training stress from cycle to cycle.
  • The progression should not be a steady increase in volume and intensity, but instead should be a staircase progression with periods of reduced volume and intensity at certain times during a training period, season, or year.
  • Increases in training volume, duration and intensity should be a gradual increase of 5-10% per week.
  1. Cross-train and include rest days in your training schedule
  • Cross-training helps to maintain your aerobic fitness while avoiding excessive impact forces from too much running.
  • Including rest days in your training schedule allows your body to recover and adapt to a running workout.
  1. Talk with a running expert or coach to analyze your training program (Lisa Keller )
  • Overtraining, running injuries and poor performances are often the result of an ineffective training program.
  • A good running coach can help you develop an appropriate training schedule to meet your running goals and prevent injury.
  1. Wear the correct type of running shoes based on your foot type and running style
  • Not all running shoes are made alike. The type of shoe you need varies depending upon your foot type and style of running. A sports store that specializes in athletic footwear can you help you figure out what style might be best for you.
  • Foot type is based upon the structure of your foot and the degree of pronation. Pronation is the normal inward rolling of your foot in running as your foot strikes the ground and transitions into pushing off. Abnormal pronation can lead to injuries.
  1. Have a formal gait analysis performed and use orthotics if recommended (Physical Therapist)
  • Poor foot biomechanics such as heel strike, excessive pronation, or a very rigid or very flexible foot arch can lead to inefficiency and injuries.
  • Most runners can control these problems by carefully selecting the right shoe type or by seeing an expert that can analyze your running gait and make orthotic inserts specific to your foot structure.
  1. Have your running form evaluated by a running expert (Physical Therapist)
  • Better running economy and body awareness are achieved through developing an efficient and smooth running form. A smooth running form requires less energy and delays muscle fatigue.
  • A person trained in running biomechanics can help detect flaws in your running form and show you how to correct them.
  • Cadence of 168 steps per min has shown to reduce injuries.
  • Decreasing stride length has also displayed reduced injuries.
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Reasons to try Dry Needling for Pain Relief

Reasons to try Dry Needling for Pain Relief

Dry needling is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments. Dry needling (DN) is a technique used to treat dysfunctions in skeletal muscle, fascia, and connective tissue, and, diminish persistent peripheral nociceptive input, and reduce or restore impairments of body structure and function leading to improved activity and participation.  Here are 5 reasons you should try dry needling for pain relief.

  • Relax Tight Muscles

Dry Needling is like a reset button for your muscles. Physiotherapists can identify these ‘knots’ or ‘trigger points’ and can use dry needling to help restore the muscles to its normal length. The mechanism of action is not fully understood but is thought to work by altering the electrical activity in the region which results in a twitch response which effectively “resets” the muscle back to a normal resting length.

  • Improve Blood Flow

Muscles that are ‘tight’ can cause pain that refers to other areas of the body. Dry needling seeks out trigger points and releases them using an ultra-thin acupuncture needle. With relaxed muscles comes improved blood flow!

  • Decrease Pain & Release Neurotransmitters

Dry needling activates the body to release opiate peptides like beta-endorphins, enkephalins, and dynorphins. These neurotransmitters work to block transmission of pain information to the brain and spinal cord.

  • Improve Movement

Patients that undergo dry needling typically see an improvement in their range of motion, or how much they can move. This improved movement is due to dry needling releasing trigger points, increasing blood flow, and reducing pain.

  • Treat Chronic Pain

Dry needling can treat a variety of pain, both acute and chronic. It’s used as part of a larger treatment plan to effectively manage conditions like shoulder pain, back pain, neck pain, whiplash disorders, headaches, plantar fasciitis, tennis/golf elbow, sciatica and more.


–       We will take an individualized approach to treating your dysfunction and pain. We will look not just at your area of pain but consider the muscle and its relationship to surrounding muscles and bones. We are your movement specialists.

–       We offer Manual Therapy and Dry Needling services to target areas of tissue restriction or where trigger points have developed.  Specific therapeutic exercises will be designed just for you! Please call any time. 907-748-0022

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Quadratus Lumborum (QL)

Where is it?

There are two QL muscles: each located on either side of your lumbar spine (lower back). These muscles run from the top of your pelvis up, along the lumbar vertebrae, up to your 12th rib (the very last rib).These are the deepest muscles of our back.

QL viewed from the front side

What does this muscle do?

Both QL muscles work together to extend our spine. Independently, the QL muscle can elevate your hip to do a “hip hike” or it can help you bend your trunk to the same side. This muscle can also become activated to help you compensate when other core stabilizing muscles become weak such as your abdominal muscles.

The Quadratus Lumborum (QL) has been known to cause a  variety of symptoms depending on the individual. Hence the name “Trickster Muscle”.  It can cause:

  1.     Bloating/Nausea/Abdominal cramps
  2.     Low back pain
  3.     Groin pain (in men testicular pain)
  4.     Lateral Thigh and Hip Pain
  5.     Buttock Pain
  6.     Iliosacral Pain

Trigger points (knots) within the QL muscle can even cause other muscles nearby to become “agitated” such as the gluteus medius, a key “hipster” muscle.  While often overlooked, the quadratus lumborum muscles play a vital role in your body mechanics. They connect the spine, hips, and ribs, and allow you to move your body laterally, or side to side. Tightness in your QL muscles can cause back pain as well as affect your movement patterns resulting in pain in other areas as well.

Trigger Point Areas of Referred Pain from deep within the QL muscle


Trigger Point Areas of Referred Pain from superficial QL muscle area

What can I do about this?

      Look at how you’re sitting throughout the day- are you sitting shifted over to one side of your hip? Do you sit on a big bulky wallet?

      Positions like this can cause the QL to tighten. Try to sit with weight distributed equally on both sides of your pelvis.

      Standing: Do you stand shifted over to one leg? Do you “drop” one side of your pelvis when you’re standing?  Try to stand with your weight equal between both legs, keep your hips level

–       Fortunately, stretching can help alleviate QL tightness.

   Progressive PT can help!

      We will take an individualized approach to treating your dysfunction and pain. We will look not just at your area of pain but consider the muscle and its relationship to surrounding muscles and bones. We are your movement specialists.

      We offer Manual Therapy and Dry Needling services to target areas of tissue restriction or where trigger points have developed.  Specific therapeutic exercises will be designed just for you! Please call any time. 907-748-0022

Authors: Phyllis Ploudre and Aurora Gargagliano

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Performance Screening- Train smarter, stronger, and avoid injuries

T R A I N  S M A R T E R ,  S T R O N G E R

&  A V O I D  I N J U R Y

Want to improve your exercise performance or train

better for an upcoming event without injury? Have

an old injury that no longer hurts, but never really

feels like it has fully resolved? Studies show that

previous injury is one of the strongest predictors of

future injury.”

This “Tip of the Month” explains how

Performance Screening can help to identify

underlying deficits in strength, mobility, and

movement dysfunctions. These may be holding you

back from your peak performance. Performance

screens are a great way to identify faulty movement

patterns, then correct them so that you can perform

at your best and injury free!

Screens identify athletes that are at risk of injury in

their sport by finding weakness and asymmetry in

the body. You will participate in a variety of

movement tasks. When a task proves difficult, this

task becomes your home exercise program. This

screen applies to all athletes in all sports.

However, if you are training for a specific sport, your

PT will include the specific requirements that the

sport demands.


C A L L  T O D A Y  A T  9 0 7 – 7 4 8 – 0 0 2 2

O R  S T O P  B Y  T O  M A K E  A  3 0 – M I N U T E

P E R F O R M A N C E  S C R E E N  F O R $ 50 . 0 0

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What every patient with health insurance needs to know but is afraid to ask.


Here’s wishing everyone a Happy New Year and now for some not-so-exciting

Tip of the Month:” Health Insurance 101

We here at Progressive Physical Therapy would like to help you obtain what you are entitled to if you have health insurance for the year.  (We promise the next Tip of the Month blog will be more interesting!)

So, our advice is for you to go right now and: Open the link below, find your insurance card, a pen and a piece of paper, and write down your ID# and Group#.  Then call your insurance company because this is the best divergence strategy and ask them these questions and keep the information handy because you will need to know this to help us help you.

 Health Insurance Worksheet 

Now, because our staff has really worked hard to inform you about insurance coverage, here is some helpful health care insurance terminology.

Benefit Year:  The annual cycle in which a health insurance plan operates. At the beginning of your benefit year, the health insurance company may alter plan benefits and update rates. Some benefit years follow the calendar year, renewing in January, whereas others may renew in late summer or fall.

Benefit:  A term referring to any service covered by a health insurance plan in the normal course of a patient’s healthcare.

Deductible:  A specific dollar amount that your health insurance company may require that you pay out-of-pocket each year before your health insurance plan begins to make payments for claims. Copays are not credited toward your deductible.

Coinsurance:  The amount that you are obliged to pay for covered medical services after you’ve satisfied any co-payment or deductible required by your health insurance plan. Coinsurance is typically expressed as a percentage of the charge or allowable charge for a service rendered by a healthcare provider. For example, if your insurance company covers 80% of the allowable charge for a specific service, you may be required to cover the remaining 20% as coinsurance.

Co-pay:  A set fee that your health plan may require that you pay at each visit for a covered service.  For example, your health insurance plan may require a $35 co-payment for an office visit.

Maximum Out-Of-Pocket Costs:  An annual limitation on all cost-sharing for which patients are responsible under a health insurance plan. This includes deductible, copays and coinsurance.

Medical Necessity:  A basic criterion used by health insurance companies to determine if healthcare services should be covered. A medical service is generally considered to meet the criteria of medical necessity such as teen depression rehab when it is considered appropriate, consistent with general standards of medical care, consistent with a patient’s diagnosis, and is the least expensive option available to provide a desired health outcome.

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Why every runner should run in the water

Want to better your running performance?

We’ve teamed up with Lisa Keller, a Certified Level 1 USA Triathlon, USA Track and Field and Road Runners Club of America Coach and Owner of Multisport Training of Alaska to get you ready for your next big run. Lisa has been helping athletes and ex-couch-potatoes train for triathlons, marathons and many other athletic events for over 20 years.

Click the image below to read the full article on how running in the water can make you a better runner on land by our Scandinavian provider netent!

Or Click HERE. You can also learn more about Multisport Training of Alaska HERE.

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Pain in the Rear: Rehabilitation for Hamstring Injuries

This “Tip of the Month” is all about hamstrings; a group of 3 muscles that run along the posterior thigh.

Athletes that participate in “sprinting sports” are most susceptible to hamstring injuries, including a few of our newest patients. However, any participant in activities involving hamstring activation is also at risk. This includes flexion (bending) of the knee joint and extension of the hip joint (pressing leg back behind you). … All you Alaskan hikers, we’re taking to you!

The recent increase we have seen in hamstring injuries heightens the importance of injury prevention programs, and rehabilitation outlets in Anchorage’s athletic community. We are here to help because hamstring injuries don’t need to be a ‘pain in the rear!’ nor apain in your ear so check out tinnitus911 reviews.

Take a look at the full article written by our very own, Alisa Carroll, PT, DPT and Pre-Physical Therapy Student Dayana Hernadez, CTRS——–> HERE.

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4 Tips to Prevent Running Injuries

Running season is here and this great weather may make you want to dust off your shoes and hit the trail after a long winter and rainy spring.  Before you do, take an inventory of any orthopedic issues you might be having.  Being mindful about how you return to running might save you a lot of aches and pains.  Here are 4 tips to consider when getting back into running:

1.) Running is landing with three times your body weight on one foot, over, and over, and over. Are your joints up to the tasks? Consider your alignment from the ground up: ankle stability, knee alignment and the flexibility and strength of your hips.

Do you have one ankle that has been sprained one or more times?  Does one hip collapse or one foot turn out more when you run? This may be a result of muscle/strength imbalance. Do you swing your arms symmetrically?  How is your spinal posture when you run? If you are returning to running after pregnancy remember that your pelvis might still be hyper-mobile especially if you are still nursing a baby.

These are just a few body mechanics that greatly impact your risk of getting injured from running. It’s not that you can’t start to run with these conditions, but go easy and seek professional guidance.  Start lightly with distance and speed. Focus on being graceful and light. A physical therapist can provide a running gait analysis as well as advice about interventions that work to get you back on track.


2.) Consider your shoes and what’s inside them.  Not all feet are the same. The running shoes your friend swears by, might not be the best fit for you.  Some things to consider are the shape of your feet (high or low arches) and the strength of your ankles (stiff or wobbly when balancing on one leg). You might like a very supportive shoe or your foot might be more suited to a minimalist running shoe.  How strong are your feet? The best support comes from the muscles in your feet.  Forces from your feet and shoes travel up the “kinetic chain” and can make a difference in how your knees, hips and back feel after a run.  If you are having pain in your feet, legs or back, you might try strengthening your feet and/or a new pair of shoes. Visit our friends at Skinny Raven Sports to find the perfect shoe for you!


3.) Warm up and Cool Down. Before you take off, take your joints (ankles, hips, knees, spine and arms) through a simple range of motion warm up routine to check in with the symmetry of your body. A light jog, high marching, swinging your legs/arms/ankles in circles and gentle rotation of your spine can help get things moving before running.  Stretch after your run: Address asymmetries and tight muscles with a good stretching cool down after running.  Take care of those sore and stiff spots so they don’t become chronically strained.   Using a foam roller or tennis ball to target trigger points can help release unwanted tension.


4.) Good runners have strong hips. Hips guide the alignment of your knees. If a hip is weak it might fatigue after a couple miles and then next thing you know your knee will collapse inward and all kinds of unwanted torque will result in your knee cap, cartilage and tendons. A Physical Therapist can design a hip strengthening program specific to your body.


Alignment, Good Shoes, Flexibility and Strength.  If you have these four items covered then you should be off to a great start as you get back into peak running shape.  Progressive Physical Therapy is here to help you optimize your running technique, and figure out any aches and pains as you increase your mileage.

By: Alisa Carroll, PT, DPT


Progressive Physical Therapy offers running and gait analysis! Swing by after visiting Fire Island Bakery or give us a call at (907)748-0022 for more information!


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I want to ride my bicycle, I want to ride my bike (without pain)!

Cycling 101:  Proper Bike Fit

To prevent injuries when cycling, a fitted bicycle, accurate body positioning and proper knee alignment are essential. A proper bike fit depends on accurate frame and handlebar heights as well as seat height, position and tilt. The most common overuse injuries from biking affect the neck (48%), knee (42%), groin/buttock (36%), hands (31%) and back (30%). Often, overuse injuries can be resolved and future occurrences prevented by adjusting postural alignment and parts of the bicycle.

  • To prevent neck pain caused by prolonged, excessive neck extension, raise the bicycle handlebars, raise the seat post or tilt the saddle, slide the seat forward or shorten the stem. Wear the helmet further back on the head and remove the visor. Maintain a straight upper back with the chin tucked down.
  • To prevent knee pain, slide the bicycle seat back and raise or lower it and lengthen or shorten the cranks connected to the pedals to maintain knee flexion at 25 degrees at the down stroke with the heel at three o’clock in line with the forefoot. Also, pedal with knees in line with toes, ride in lower gears and on flatter surfaces and use shoe cleats.
  • Overuse injuries to the hip can be prevented by adjusting the bicycle seat height, leveling the seat tilt to neutral, raising the handlebars or installing a shorter stem and shortening the pedal crank length. Intermittently standing up while cycling and using a softer, wider seat also may help.
  • Hand pain and tingling can be reduced or eliminated by wearing gloves, using padded handlebar tape, frequently altering hand positions, replacing the seat stem with a shorter, adjustable or more upright version and rotating the entire handlebar forward.
  • Low back pain while bicycling often is due to excessive bending for long periods of time. To reduce low back pain, raise the handlebars, tilt the saddle nose down, properly adjust the seat height, limit the use of aerobars and dropdown bars and install shorter cranks.
  • Foot pain is most commonly caused by weak calf muscles and improperly fitted shoes. Foot pain while bicycling can be reduced by inserting metatarsal pads or rigid arch supports if cycling shoes have enough room and moving shoe cleats back. Sometimes, just loosening the front strap of the shoe can relieve pain.

Overuse injuries also can be alleviated and prevented by performing strengthening and stretching exercises that target specific parts of the body and improve range of motion. Physical therapists, who are experts in human movement, function, wellness and fitness, can demonstrate proper body alignment for bicyclists and recommend individualized stretching and strengthening exercise programs.


Originally from: MoveCalifornia: Educate and motivate the community on the need for an active, healthy lifestyle, as well as the fundamental role physical therapists play in helping

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5 Tips to Avoid Chronic Pain

PPT Tip of The Month!

Chronic pain is defined as pain that last longer than 6 months. Maybe you’ve experienced chonic pain before. If you have, you are not alone. According to the American Academy of Pain Medicine, more than 100 million Americans suffer from chronic pain.

What if we told you there were ways to avoid chronic pain? Good news… We do! These 5 tips by the American Physical Therapy Association’s can help you elude long-lasting discomfort:

5 Tips to Avoid Chronic Pain

Know pain, know gain

There is a growing body of evidence suggesting that understanding how our pain systems work is an excellent strategy in managing it. The great news is that you don’t need to know a lot! Simply knowing the basics of how our brain and nerves work, and their role in pain, can help reduce your chance for developing chronic symptoms.

Keep moving

Gradually and steadily. Living an active, healthy lifestyle not only improves our general well-being and health, but can also reduce our chances of developing chronic pain. Our body was built to move, and we need to understand that not all aches or soreness is cause for concern.

Spend time with a good PT

If you experience an injury, or develop the onset of pain, seeing a physical therapist (PT) early on can help address and manage your symptoms. PTs are movement experts who can diagnose and treat injuries and help you identify strategies to better manage your pain. The earlier you seek care, the better the chances you have for not developing chronic symptoms. And there’s no reason to wait: you can see a physical therapist without a physician’s referral in all 50 states and the District of Columbia.

Don’t Focus on an image

While most of us want a diagnostic image (ie, x-ray, MRI) to tell us “why we hurt,” images actually give us little information about what’s causing pain. A study performed on individuals 60 years or older, who had no symptoms of low back pain, found that more than 90% had a degenerated or bulging disc, 36% had a herniated disc, and 21% had spinal stenosis. What shows up on an image may or may not be related to your symptoms. Once imaging has cleared you of a serious condition, your physical therapist will help guide you back to the life you want to live!5. Addressing depression and anxiety helps. Your chances of developing chronic pain may be higher if you also are experiencing depression and anxiety or consult fix body group website. A recent study in the Journal of Pain showed that depression, as well as some of our thoughts about pain prior to total knee replacement, was related to long-term pain following the procedure. Make sure that you talk to your medical provider about your mental health throughout your treatment; it can help make your journey go much more smoothly following an injury or surgery, ZetaClear side effects are a no.

Written by Joseph Brence, PT, DPT, FAAOMPT, COMT, DAC
(*more information can be found at http://www.moveforwardpt.com/Resources/Detail/top-5-tips-to-avoid-chronic-pain) 



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