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Project Run Rehab and Performance

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Project Run Rehab and Performance

Resources to inspire a healthy community of runners. We can assist with injury prevention, strength Kaitlyn McNamara, DPT is our Project Run Lead.

Kaitlyn focused her post-doctorate education on management of running related injuries and prevention strategies. She is a marathoner, ultra-distance athlete, 3x Boston Marathon qualifier and can often be found at local running clubs or exploring new trails in her free time. Kailtyn’s philosophy is “everyone is a runner”! Her goal is to help create Confidence, Independence and Longevity for every type of runner or athlete.

02/17/2021

*Steps onto soapbox*

When, why, and how did taking “2 weeks off” from running become everyone’s go-to reset button for everything?

For tech-challenged individuals like me, my only solution to any computer/phone problem is to turn it off and turn it back on. If that doesnt work, I might as well throw it out the window because I would rather live without technology than go through “troubleshooting” and be on hold with someone for 2 hours of my day. But I digress.

The “turn it off and back on” fix for technology seems to work for me 98% of the time. However I can’t for the life of me figure out how this became a go-to solution for problems with the human body. If I had a dollar for every time a runner came in and told me “I took 2 weeks off but then I started running again and ____ (hip, knee, ankle, leg, toes, ect), was still hurting” then I would be skiing in the Alps instead of working right now.

Let’s think this through:
1. Runner has pain.
2. Runner stops running (usually after weeks of trying to push through pain) and takes “2 weeks off”
3. Runner (often) does nothing during that time to address the tissue that is the problem.
4. Runner assumes that 2 weeks “did the trick” and starts running again, most often at the SAME mileage and intensity that they were at pre-injury (no easing back in).
5. Runner gets frustrated and stops running, then ends up in medical office or just stops completely.

It’s like shutting the door to a messy room and just assuming if you wait 2 weeks it will magically be clean when you open the door.

If you want to take some time off from running, cool! Do it! But do not assume taking time off on its own will fix an injury or problem. You need a STIMULUS to create a RESPONSE. In some cases, rest may be the right stimulus - but at some point, the tissue causing the problem needs to be LOADED and ADDRESSED before reintroducing or increasing the stress of running.

Long story short, let’s stop with the “2-weeks off” stuff and make a plan to help you run stronger. If you are unsure of how to do this, you know how to contact me. End of rant.

02/08/2021

Hamstring updates: We are up and running people!

Over the last few weeks I have been testing the waters with running again, and am finally back to continuous and comfortable running for 40+ minutes without significant backlash from my hamstring! (For once I was ready for the backlash… )

Everyone’s favorite question… How do you know you are ready to start running??
The short answer… You don’t. BUT - there are easy signs to help you make smart decisions regarding return to run rather than 🤞🏻 and hoping for the best (which btw is not a strategy I recommend)

#1: I can complete all my required daily activities (work, walking, sleeping, ect) without being interrupted by pain.

#2: I can walk for 60+ minutes at a brisk pace, including hills and uneven terrain when necessary, without pain (manageable soreness 👌🏻)

#3: I am tolerating direct loading through exercise to the injured area consistently without reproducing significant discomfort, including jumping, hopping, and skipping.

These are all signs to me that a tissue is ready to be re-introduced to running. Is this a perfect checklist that fits all circumstances? NO. Do these things apply in every situation to every injury? NO. But it is absolutely a starting point.

IN ADDITION: this does not mean I am going to go out for a 5 mile run first thing and assume I can jump back into running 40+ miles/week. I still took the time using a graded walk/run progression to prevent overload of my hamstring resulting in a set back. It is definitely frustrating at first when you just want to go out for a “normal” run, but it’s better to do it right the first time than over-do and be back to walking around in pain.
Oh and I haven’t stopped my strengthening routine now that I can run again 😉💪🏼.

***Again… THIS IS NOT MEDICAL ADVICE. Remember if you have concerns or are dealing with injury, seek consult from a medical professional***

12/23/2020

✳️ Hamstring updates: adding in some movement

This week I have less pain throughout the day with my regular activities, and movements such as getting up/down from the floor are no longer aggravating. These are signs that I look for as indications a tissue is ready for progression of loading in all cases of injury!

Today I am adding movement with an isometric hold at the end.
🔹 With a band looped around the ankle, I keep my leg straight and extend (move it back) to a neutral position under my hip.
🔹 I hold this position against the resistance for 5-10 seconds, then slowly return to the starting position without letting the band pull my leg quickly forward.
🔹 If you try this on your own, USE SOMETHING FOR BALANCE! I am using a dowel but being close to a table or stable surface in case you lose your balance is best.
🔹 I can feel some mild discomfort at “the spot” in my hamstring, but SORE IS SAFE and it is very manageable and does not linger long after I am finished with my workout.

🔹 Other exercises I am doing this week:
🔺Double leg bridges, but with a weight shift towards my left side to increase load - single leg bridges are still uncomfortable, so taking baby steps towards being able to do them again!
🔺Sideplanks for hip strength
🔺Wall sits, because why not be ready for more skiing
🔺 As always, calf raises 🐮

❄️Happy training, happy holidays ❄️

***THIS IS NOT MEDICAL ADVICE. Just letting you guys in on what is working for me this week. Remember if you have concerns or are dealing with injury, seek consult from a medical professional***

✳️ questions and consults are always welcome!

12/19/2020

ISOMETRICS: contraction of the muscle to produce force without a change in length.

🔹 AKA one of the easiest and safest ways to introduce load to a soft tissue following injury.

Basics:
🔹Start in a comfortable position and progress to those of less *but still tolerable* comfort.
🔹For me, the more my leg is extended the more I can “feel” the area of discomfort, so I start these exercises with my knee bent and progress towards straight as tolerated. This may be different for each person depending on injury location and extent.
🔹Progress light —> heavy with strength of contraction. This is NOT an all out effort. Start by gently activating the muscle and increase pressure as able - sometimes after the first few repetitions it will even feel better.

🔹 Laying on your back, press your heel into the floor and back as if you are trying to pull it towards your hips - remember your heel shouldn’t actually move. In this demonstration, I am starting with 10 second holds with pressure that is strong but tolerable for 6-8 repetitions, then moving my heel further away from my body and repeating. (Also please ignore how distraught I apparently look in these photos 😂)

🔹 If you were hoping for some fancy magic exercise, sorry to disappoint. Keep it simple, and especially for early stages of injury this can be challenging and uncomfortable.

🔹 remember THIS IS NOT MEDICAL ADVICE. The dosing and positions I am outlining are just what I am using for myself and may not be appropriate for everyone.

🔹 next we will look at progressions and adding movement into our tendon loading journey!

12/17/2020

Hamstring updates:

After going through the stages of runner denial and having a pity party to reach the “acceptance of injury” phase, I came to terms with my fate and started to rehab my neglected hamstring.

Initial goals:
1. Create a healthy environment for tissue healing.

This includes making sure I am making healthy eating choices, sleeping well, and getting my mind right with focusing on the activities I can do rather than pouting over my inability to run (including skiing!).

2. Progressively loading the tissue.

Complete and total rest of an injured tissue is rarely the solution to the problem. You can’t expect a tissue that has been doing nothing for weeks to be ready to jump back in to activity. This week (between ski days) I have been adding in *brisk walks and isometrics within **tissue tolerance.

*brisk - as in walking quickly and getting my heart rate up a little, not just a casual stroll. Even here I can “feel” some stretch in my injured hamstring as compared to my uninvolved side, but without lingering discomfort following the activity.

**tissue tolerance - same concept of being able to “feel” it, but not pushing into pain or having lingering symptoms that interrupt the rest of your day.

We will look further into isometrics and some early loading strategies next!

12/09/2020

WHERE ARE YOUR HAMSTRINGS?

ok may seem simple, but you can’t imagine how many interesting answers I get from patients with this question.

The hamstrings are the large group of muscles on the back of your thigh. In the simplest context, their primary jobs include bending your knee and extending your hip. In reality, our bodies are much more complex than that and these muscles play a variety of roles, especially in the context of running. Because the hamstring group contributes to motions at 2 joints (the knee and the hip), they can be more prone to injury and more difficult to treat.

🔹 So how do you know if you have a hamstring injury?

It is not always a specific moment when a strain or tendon injury occurs. Often they have a gradual onset, or you notice discomfort later following activity. Pain can be felt anywhere along the length of the hamstring muscles down the full length of the posterior thigh, including at their origin at the ischial tuberosity (aka your ‘sit bone’) and the insertion at the back of your knee. Symptoms generally follow patterns of soft-tissue type injuries:

🔺Increasing discomfort with repetitive activities or those that put the tissue on stretch (for me right now, bending down as if I am trying to touch my toes or get something off the floor when my leg is straight)
🔺Discomfort generally feels better with rest (at least in the short term)
🔺Can be stiff after long periods in one position (especially tightness in the back of my leg when I get up from sitting too long)
🔺Can sometimes follow the “warm up” phenomena, where it initially feels better when starting to exercise, but gets worse as you go or afterwards.

***THIS IS NOT MEDICAL ADVICE. Just walking you through general info on common running injuries. Remember if you have concerns or are dealing with injury, seek consult from a medical professional***
P.S. FREE injury screens are available if you have questions or concerns :)

12/04/2020

Now that I have your attention with cute photos of the Project Run mascot dog…

I apologize for the dry spell on posts and info lately - I have been trying to juggle a few too many projects these last few weeks that all seem to have come on at once. Such is 2020 though, and just wanted to let you know we are still alive and kicking down here for all your rehab-related needs!

In other news, I have been dealing with a hamstring strain the last few weeks that has sidelined my regular running routine. At first I went through the typical runner denial, thinking if I just kept running or warmed up differently it would be fine. Then went into the “pity party” stage where I was irritable and frustrated in all aspects of my life (sorry, family and co-workers!) when trying to take a break from running. I have finally reached the stage of acceptance and have started working on rehabbing the way that I should have from the beginning.

Although injury is never fun, I always try to appreciate the insight and empathy it gives me to work more effectively with my patients. Everyone’s experience is unique, but regardless if you are coming back from a hamstring strain or a broken ankle, we all feel the frustration that comes with having the normalcy and freedom a healthy and functioning body provides for us taken away.

Over the next few weeks I’ll be walking you all through my rehab with my own hamstring injury. Hopefully this will help give some insight into the process we go through as PTs and principles to help you better manage injuries in the future.

And not to worry, will still be happening, with follow-ups to keep you moving forward!

Hope everyone is navigating this holiday season safely and happy running!

11/24/2020

Small goals are what keep me going these days. No matter how the rest of my day turns out, getting out the door even for a short run is a built in . Lace up your shoes and take time for your and today (and maybe channel some warmth and sunshine from this throwback photo).

10/26/2020

Try out a new trail. Get rewarded with all the views 😱

Whether you’re a seasoned trail expert or considering getting off the pavement to mix up your routine, check out some tips and tricks for trail running on our story this week.

10/24/2020

HATS 🙌🏼 ARE 🙌🏼 IN!

Stop by, say hi, and check out our new family of snapbacks available for purchase!

$20 in a variety of colors/styles. We are excited to see you and please remember to WEAR YOUR MASK when coming to the clinic.

M-F, 8-5pm.

10/19/2020

WHERE ARE YOU RUNNING THIS WEEK?

I don’t need to remind anyone how ridiculous this year has been. Especially for those who have transitioned to working from home, you might be losing your mind looking at the same walls all day.

* The same applies to your running. If you are running the same route every time you go out, your body gets BORED. It’s a basic principle and applies to all things in the universe - you must have a STIMULUS to create a RESPONSE. If you are using the same stimulus every time, you will no longer get a response that creates change or growth.

* When living in what feels like a twilight zone, make time to change up your routine. Turn the other direction out of your neighborhood for once. Look up a new route on or . Drive to a park to get your afternoon miles in. CHANGE THE SCENERY. Give your brain and your legs a new stimulus.

10/09/2020

FIT TEST FRIDAY is here with one of my favorite ways of testing AND training the lateral hip - side planks!

🟢 Basics: the musculature of the lateral hip complex ( medius being the most commonly cited culprit) is a key group of for any athlete putting weight bearing demands on their body. As , we ask our hips to complete this task over and over again for extended periods, or each and every time your foot contacts the ground! In other words, those hips have to be to meet the demands we are asking of them.  
🟢 Side planks are a great way of strengthening this muscle group in a CLOSED CHAIN or WEIGHT BEARING position.   🟢 The test:
Elbow is stacked directly under the shoulder, feet are stacked one on top of the other. Lift up into your side plank. The body should stay in this straight line, without letting the hip sag towards the floor or rotating forward or back through the hips or the trunk.

🟢 GOAL is to maintain this position for 60 seconds on each side. 
🟢 If this is a challenge for you, start by holding until you start to break form, then rest. Another option is to start using your knees as the ground point, stacked on top of one another as you would with your feet. As you get stronger, you will be able to increase your hold times and/or rise into the full position on the edge of your foot.  
🟢 Happy Fit Testing! And because I love simplicity, this test transitions seamlessly into a exercise for your program. Stay tuned for progressions to challenge your side plank coming next week.

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100 Dennis Street SW, Ste. A
Tumwater, WA
98501

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Monday	7am - 6pm
Tuesday	7am - 6pm
Wednesday	7am - 6pm
Thursday	7am - 6pm
Friday	7am - 6pm

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