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All Posts in Category: Runners Knee

Ice or Heat for Injuries – Is the medical standard changing

A very interesting article appeared over at Spartan.com posing the question “Is RICE all wrong?”, and jumps to the question of Ice or Heat for injuries and it caught the eye of Dr. Andrew Gross and Dr. Josh Sand at out office because when we were in Chiropractic around five years ago, the automatic correct test answer in a lot of cases for injuries was ICE, there were rumblings that possibly RICE was going to be changed to something different.

For the most part RICE isn’t totally wrong, we just don’t feel it is as correct as it once was for all major injuries. Simply put icing most injuries is not a bad idea and safe. The idea of RICE comes from Dr. Gabe Mirkin MD who published a book about sportsmedicine (The Sportsmedicine Book) and ever since then the standard has been RICE which stands for Rest, Ice, Compression and Elevation. For around forty years now, Dr. Mirkin has been thought of as the authority on immediately icing an injury (along with compression and elevation.

We thought for a long time that icing the injury stopped, or at least limited the flow of inflammation to the injured region but we now understand that it only delays the processes. The newest ideas that numbing the injury only dulls the pain and sometimes does not permit you to feel the warning signs of pain being caused by injured tissue. The article linked below showed that 22 seperate studies found that “ice is commonly used after acute muscle strains, but there are no clinical studies of its effectiveness.” A report in the Journal of Strength and Conditioning Research was even more alarming. Not only does icing fail to help injuries heal, the authors found, it may well delay recovery from injury. In 2017 The Journal of Athletic Medicine Research recently showed that icing actually kills muscle cells when they are iced for too long of a period post injury most likely from the direct effects of the inflammatory response of the injury being “held” directly on the injured tissue and not being pumped around due to the ice holding it there.

Taken directly from the article on Spartan.com —

“You might think that Dr. Mirkin would bristle at this blow to his erstwhile recommendations. Not so—he now openly rejects at least half of the RICE advice that helped make him famous. “I do not believe in cooling anymore,” he explained via email. Nor does he believe in the “R” component of his famous prescription either.
In a foreword to the second edition of Iced!, Dr. Mirkin says most athletes are far more concerned with long-term healing than transient pain relief. “And research,” he writes, “now shows that both ice and prolonged rest actually delay recovery.”

Check out the article for yourself at https://life.spartan.com/post/is-r-i-c-e-all-wrong

 

 

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Villanova University – Day Of Distance Track and Cross Country Coaching Seminar 2018 Recap – The Running Works

For the second year in a row I was able to attend The Running Works Day Of Distance hosted by Marcus O’Sullivan at Villanova University! For the second year in a row I was blown away at the shear amount of running knowledge and sense of community the coaches in Pennsylvania (mainly the Philadelphia area coaches) and New Jersey (mainly the South Jersey coaches).  Shak and Cricket at The Running Works just keep putting on a better coaches clinic each year and it’s a lot of fun to meet the coaches from outside our region, South Jersey, and to see the look on their faces when they realize we are at cross country seminar for the various reasons we attend to better support our team and this year we even took a patient along who is looking to make the leap into coaching other triathletes very soon!

The day overall went by way too quickly! First off, Villanova’s athletic complexes are under a major overhaul right now and the transformation from last year to this year was a huge improvement! The football stadium and track may have been under snow to some extent, but you can see from the pictures below everything keeps getting better! We checked in around 8:00 AM and Craig Virgin, the famous American cross country and 10k meter racer spoke promptly at 9:15am. After a short break we jumped directly back into coaching talk with Chris Fox, the head coach of distance and cross country running from Syracuse University and recent Big East Champion and National Champion coach in Cross Country who politely reminded Villanova fans that to do that, you have to beat Nova and everyone had a good chuckle over that.  Lunch just might be my favorite part of the day because I get a chance to sit with coaches that I don’t know and hear about issues from coaches outside of our region like the western suburbs of Philadelphia and northern New Jersey.  The afternoon seminars I selected were with Phil Warton on Active Isolated Flexibility and Stretching followed by Marcus O’Sullivan on novice coaching solutions. Phil Warton’s session on stretching was very interactive and fun and he focused a great deal of his talk towards keeping young runner legs happy, including the hips! It was fun to see someone else who I have never met before “preaching the gospel” that happy hips make for good runner legs and improved spinal mechanics. The best part of my day, and my guest triathlete also agreed was “Novice Coaching Session with Marcus O’Sullivan” who broke down how easy it is to worry about to many variables when coaching high school cross country and while data and science can be infaliable, don’t forget when you are coaching middle schoolers, high schoolers, or even college kids to support them no matter what and to do the best to keep them healthy! Marcus when into how he almost retired from running and open road racing at age 32 because he had still never found a system of training before that which worked for him and it wasn’t until he started to let someone else help coach him along with decreasing the intensity of workouts from time to time based on blood lactate threshold levels and heart rate that he was then able to prolong her 5k and 10k racing career to the age of 37 and he joked several different times that he did it by listening to his body more and running hard a good bit less. Yes, you read that correctly, at 32 years of age, he ran almost as fast as he did at 22 in the prime of his career by listening to his coach and decreasing his high intensity mileage and working more on staying healthy.

 

Check out the pictures below!

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The New York Times – Bring On the Exercise, Hold the Painkillers

Over the weekend a fantastic article that speaks to a team of chiropractors like we have at the office appeared on my social feeds! On The New York Times Running Newsletter the following article was published about exercise and why some forms of NSAID’s and Painkillers and endurance athletes like runners, swimmers, and cyclists should think first before just dismissing the issue and reaching for ibuprofen or naproxen in most cases.

Taken directly from the article by Gretchen Reynolds:

Taking ibuprofen and related over-the-counter painkillers could have unintended and worrisome consequences for people who vigorously exercise. These popular medicines, known as nonsteroidal anti-inflammatory drugs, or NSAIDs, work by suppressing inflammation. But according to two new studies, in the process they potentially may also overtax the kidneys during prolonged exercise and reduce muscles’ ability to recover afterward.

Direct Link: https://www.nytimes.com/2017/07/05/well/move/bring-on-the-exercise-hold-the-painkillers.html?em_pos=small&emc=edit_ru_20170707&nl=running&nl_art=1&nlid=80378830&ref=headline&te=1&_r=0

NSAID use is especially widespread among athletes in strenuous endurance sports like marathon and ultramarathon running. By some estimates, as many as 75 percent of long-distance runners take ibuprofen or other NSAIDs before, during or after training and races.

Being a marathoner myself I cannot refute the fact that on occasion I do take the label dosage of ibuprofen but understand that in most cases this is a poor choice for dealing with a running issue.  While most outsiders think of our office as “just another chiropractic office” we also offer Active Release Technique, commonly referred to as “ART” and in sports like running, cycling, and swimming, we usually offer a huge amount of upside with treatment to all sorts of issues commonly encountered.  I have even broken myself to some extent to not use ibuprofen (advil) or naproxen (aleve), which at times is tough with very small injuries that often times only slow me down, but do not keep me from running and going to the gym.

Some other valuable links about “pills” and runners / endurance athletes to check out are the following!

The Pill Problem – The right drug can relieve pain and discomfort—or put you in a world of hurt.

Direct Link: http://www.runnersworld.com/injury-treatment/what-runners-should-know-about-pain-medications

From the article written by Christie Ashwanden:

After winning a 24-hour track run in record time, Stephanie Ehret should have been celebrating. Instead, she was in a Phoenix emergency room, vomiting up a strange substance, which a doctor informed her was part of her digestive-tract lining. Feverish and nauseous, Ehret could barely move. “I’d never felt so bad,” she says. “I was pretty sure I was dying.”

A few hours later, doctors diagnosed the problem—rhabdomyolysis, a potentially fatal precursor to kidney failure. Though dehydration and overexertion contributed to Ehret’s condition, doctors told her that the 12 ibuprofen pills she’d taken during the 24-hour race had pushed her kidneys into the danger zone.

When used properly, over-the-counter pain medications can be a godsend. Acetaminophen (Tylenol) can tame many pains. And non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin, and naproxen can reduce pain and swelling in the first few days following an acute injury like an ankle sprain. The trouble comes, doctors say, when people, like Ehret, misuse these drugs. “A couple of ibuprofens really helped, so I figured more was better,” Ehret says. Indeed, many runners treat anti-inflammatory drugs like “vitamin I,” says pharmacologist Joe Graedon, coauthor of The People’s Pharmacy book series. “They think, I’m putting my body through a lot, so I’ll just dose up on ibuprofen, without appreciating how potentially dangerous this drug can be.”

The Dangers Of Mixing Meds While Running

Direct Link:  https://houseofrunning.com/the-dangers-of-mixing-meds-and-running/

From the article written by Laurie Villarreal for House of Running –

I was at the start of the CPC half marathon last weekend when a runner said to me that she had just taken some ibuprofen for a headache. I immediately thought, “oh no, bad idea.” While ibuprofen might help with a headache or with post-race inflammation, it can be too risky to take before a running event. This is something that I never do. Before mixing medication with running, it’s quite important for you to know the risks as well.

Ibuprofen is an NSAID (non-steroidal anti-inflammatory drug), which can be particularly risky for runners. NSAIDs also include the common drugs aspirin and naproxen, as well as many others. When taken before or during a run, it can cause harm to your kidneys, increase your blood pressure to risky levels, and put you at greater risk for hyponatremia. No matter the reason for taking an NSAID, it is not often worth the risk.

The best part about being a chiropractor who specializes in Active Release Technique here in South Jersey is that more than likely we can correct most running issues using hands on Myofascial Manipulation coupled with treatments like Instrument Assisted Soft Tissue Manipulation and some NATURAL anti-inflammatories to keep you running, biking, swimming, cross fitting, ninjaing and more at a very high level!

Questions?  Give our front desk a call at 856-228-3100 or use the contact us link below!

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Haddon Heights FireCracker 5k – Fourth of July Race – Haddon Heights, NJ

Need a great little 5k to get your blood pumping the morning of the Fourth of July, look no further than the Haddon Heights FireCracker 5k.  This race has been going on for several years now and is always a local favorite with our patients and friends who like to run.  This race is a very big draw due to it’s proximity with Cherry Hill, Haddonfield, and Haddon Township, so be sure to sign up as soon as you can!  Online registration closes on SUNDAY JULY 2ND!

Run Sign Up Link: https://runsignup.com/Race/NJ/HaddonHeights/FireCracker5k2?remMeAttempt=

Place
625 Station Ave
7th & West High St. (Hoff’s Park)
Haddon Heights, NJ US 08035

Description

Sponsored by the Haddon Heights Municipal Alliance.

New race morning Registration, Start, Finish, and Awards Ceremony location – Hoff’s Park (7th & W High St.)

Amenities
T-Shirts; Refreshments; Water Tables on Course; and Course Police Controlled.

Online Registration, Timing/Results, & Finish Line by L & M Computer Sports. www.LMSPORTS.com

Information
Questions? Bridgette Griffith (856) 655-5988

ONLINE Registration closes midnight Sunday night, July 2.

Race Day Info
July 4th 6:30am – 7:45am at Hoff’s Park (7th & West High St), Haddon Heights, NJ. “Rain or Shine”

Race Day entry fee: $25.

Flat, fast & mostly shaded – point to point. Ends at Hoff’s Park, which is also the parade finish. Course roads are police controlled.

Early Packet Pick-Up & Entry
July 3rd – Avoid race day lines, stop in Monday night 6pm to 7:30pm at the Haddon Heights Borough Hall, 625 Station Ave. Haddon Heights. Entry fee still $20. (Race Day $25.)

ONLINE Registration closes 10pm, Sunday, July 2.

Awards

1st Male & Female – $150. ea 2nd Male & Female – $100. ea 3rd Male & Female – $50. ea

Age Groups: Top 3 M & F in each of the following divisions: 14 & under; 15 – 19; 20 – 29; 30 – 34; 35 – 39; 40 – 44; 45 – 49; 50 – 59; 60 – 69; 70+

Special Award Divisions: Top 3 M & F Public Safety Personnel (Police/Fire/EMS/Federal LE); Top 3 M & F Military

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Pitman NJ Freedom Four Miler – July 4th 2017 – 8:30 AM

Looking for a great fourth of July race for actual day of Independence Day? The Pittman Freedom Four Miler is just the ticket and very well revered as a fast, local race that a lot of runners love year in and year out! What better way to get you July 4th celebrations started than by a nice run through historic and picturesque Pitman!

Facebook Link:  https://www.facebook.com/PitmanFreedomFour/

Run Sign Up Link:  https://runsignup.com/Race/NJ/Pitman/PitmanFreedomFourMilerRun?remMeAttempt=

Place
110 S. BroadwayPitman, NJ 08071
Pitman, NJ US 08071
Description

The 36th Annual Pitman Freedom Four Mile Road Race
An Independence Day run through one of South Jersey’s most picturesque towns!

WHEN: 8:45AM – Tuesday, JULY 4, 2017 * Rain or Shine
Paper Registration Form: Printable version of registration form
WHERE: Start and Finish near Broadway Theatre, Broadway, Pitman NJ

COURSE: Challenging, accurately measured 4 miles through Pitman. Our race is now more accurately timed using chip timing with jbsportstiming.com.

This course is not certified with USATF:

ONLINE REGISTRATION close at 7pm on July 2, 2017: Cost will be $25.00 before July 2, 2017. Come out on July 3, 2017 to the Pitman Middle School Gym from 4pm -8pm last chance to save some money on registration price of $30. Day of Registration will be at Borough Hall from 7:00am to 8:15am. Race day price will be $35.

PACKET PICKUP: July 3, 2017 at the Pitman Middle School Gym from 4pm – 8pm.

T-SHIRTS: Each runner will receive a race performance shirt.

PRIZES: $100 – To the 1st Male & Female finisher. Prizes to the top 3 finishers in the following age groups: 14 and under, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 plus. All age group will get there award mail to them. The only awards that will be giving out day of is the top overall winners.

TROPHIES: Top Pitman Male/Female

RACE DIRECTORS: Andy Fox, Allison Kostiuk, Eric Stanwood

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Science Says Running Helps You Live Longer – MapMyRun.com

Link to original study: https://www.ncbi.nlm.nih.gov/pubmed/28365296

Original Study Title: Running as a Key Lifestyle Medicine for Longevity.

Journal: Progressive Cardiovascular Disease

While the doctors here aren’t totally surprised to see an article like this one go online, we do like the idea that walking or running at a high level for around two hours of time weekly greatly help your heart stay in better shape which then adds years to your life!

From the Article written by Lara Rosenbaum:

The benefits of running are countless. Easy and obvious ones are improved cardiovascular health — including lower levels of cholesterol, better moods and increased bone density. And now there’s another major plus to regularly lacing up your sneakers and racking up some miles: a longer life.

THE LATEST STUDY

If you already love running, here’s another reason to dig it: A new study published in Progress in Cardiovascular Disease, revealed that running may add about three years to your life, and reduce the risk of early mortality by up to 40%. “Running decreases many risk factors for cardiovascular disease, and it strengthens the heart more so than other forms of exercise given its ability to drive the heart rate up and keep it sustained at a high rate,” explains exercise physiologist and running coach, Jason Karp, PhD, author of “The Inner Runner.” “Running also increases aerobic power (VO2 max) more than other forms of cardio — and VO2 max is the single biggest indicator of a person’s aerobic fitness.”

Link to original article: http://blog.mapmyrun.com/science-says-running-helps-live-longer/?utm_source=mfp&utm_medium=email&utm_campaign=workouts20170603

Looking for our previous articles on running?  Please see below.

Running actually lowers inflammation in knee joints – Running may also slow the process that leads to osteoarthritis

Dr Craig’s favorite prehabilitation exercise – Monster Walk with Theraband

 

The Running Works Day Of Distance Wrap Up – Villanova University

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Dr Craig’s favorite prehabilitation exercise – Monster Walk with Theraband

I teach this exact exercise several times a day as well as a few variations almost on the daily since the basis of most of our patients are runners.  This exercise can never be done slowly enough, anyone can do this movement quickly but slow down and act like you have a hot cup of coffee in your hands.  Almost everyone does these exercises quickly and while there is nothing wrong with that, slower is almost always better.  Check out all the following videos on how to practice this excellent prehab movement for most runners struggling with “typical runner stuff”.

If you are a South Jersey runner struggling with pain and tenderness as we lead up to the big part of summer running season which is just ahead (Broad Street Run, Philly Rock N Roll Half, Chicago Marathon, Philly Half and Philly Marathon are all on the horizon) give us a call at 856.228.3100.

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The Running Works Day Of Distance Wrap Up – Villanova University

The RunningWorks Day Of Distance on March 17th was AWESOME!  If you are high school track or cross country coach you need to be at this event next year!  The speaker lineup was great and I didn’t even need an afternoon coffee to get through this event which almost never happens at a seminar being the father of two young children!  The event kicked off promptly at 8am with breakfast and small talk at the  Jake Nevin Field House at Villanova University.  At 9am the day promptly started with Marcus O’Sullivan greeting the seminar and talking about how important coaching is for young athletes.

At around 9:30am Steve Magness took over and discussed “The ART and science of coaching track athletes” and discussed many of his findings and experiences as the head distance track coach at the University of Houston as well as a private coach to several Olympians.  Steve’s professional coaching career involves athletes like Sara Hall, 3:56 miler Tommy Schmitz, 3:58 miler Jake Edwards and has served as a consultant to many Olympic runners and triathletes.  His website and books are available at the popular running website, ScienceOfRunning.com

Next up on the docket was Tom Schwartz discussing coaching techniques and Critical Velocity Training as it applies to Type 2A Muscle Fibers and some of the research he has been using using for runner training the past 20 years.  Some of Tom’s best insights were on knowing how long you can effectively kick for during a run based on the distance of your race versus the conditioning of the athlete.  The Tinman further explained some of his insights gained over a lifetime of training and coaching as well as being a featured contributor to TheRunZone.com

Lunch was served at noon with a lot of veggies and fruit which helps someone like me who at least attempts to eat healthy at seminars.  There was also some pretty awesome pizza because simply put, a running seminar full of runners, needs pizza.

The afternoon was great, my first break out session was with Dr. Greg Biren of Rowan University who discussed “Fueling Athletes for Maximum Performance” in Villanova’s amazing Bartley Hall. Dr. Biren’s presentation was great and packed about as much basic athletic runner performance nutrition that you can pack into 59 and half minutes before needing to release us.  Dr. Biren keeps a wealth of basic runner information, primarily sourced around and related to nutrition at his personal website at Rowan University, http://users.rowan.edu/~biren/

My second break out session was lead by Dr. Dennis Whitesel who practices in Delaware.  Dr. Whitesel’s session was “When You Foot Hits the Ground Everything Changes” and the information discussed was great and focused on lower body bio-mechanics for runners.  Dr. Whitesel discussed many things and had several videos in his presentation of runners that he commonly sees.

 

Marcus O’Sullivan, Cricket Batz, and several others had an advanced coaching session and Q&A with the speakers which focused a lot on continuing the topic of influencing VO2 training and distance running training in general.

Flat out, this was one of the best seminars that I have attended in a few years.  If you are some how interested in running at a higher level, coaching athletes who are involved with running and need some refreshing points of view, this seminar was GREAT!

Twice in the past Dr. Mark Kemenosh has been a featured speaker at the day of distance discussing Active Release Technique and common runner injuries.  We hope that he gets invited back again, here are a few photos of the speaking he discussed during his last invite in 2015.

 

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Don’t forget! We will be in the basement of the Haddonfield Running Co after the Adrenaline Run 5k this Saturday!

Just a quick reminder that Dr’s Andrew Gross, Tim Legath, and Craig Evans will be hanging out after the Adrenaline Run in the basement of the Haddonfield Running Co, this Saturday (03/18/2017) helping out runners, talking about conditions and doing our part to help the running community of South Jersey.  The Training Room of Haddonfield will also be sharing space with us as well and sending at least two DPT’s (Doctors of Physical Therapy) who will most likely be Kiersten Langel and Matt Hinsey!  Upstairs Dave Welsh and his team will be offering discounts to race participants and talking about all things running!  You have to remember that this marks the 20th anniversary of the store (1997 — 2017) so you can be sure it will be a great time to pick up some running shoes or gear.

We plan on being in the basement of the running store from 9:40 – 11:30 and may possibly stay until noon depending on how long everyone hangs around to chitchat.

Facebook Adrenaline 5k Event Link:

https://www.facebook.com/events/785611054929033/

Details:

The 12th Annual Haddonfield Adrenaline 5K Run will be held Saturday, March 18, 2017. The 5k starts at 9am in front of Haddonfield High School and is followed by a kids 1/4 mile and 100 meter races on the Haddonfield High School track.

The 5K race is USATF certified, and serves as the MidAtlantic 5K Championship. This event is sponsored by the RunningCo. of Haddonfield.

Kick off the 2017 running season with an adrenaline pumping race!!! This race is already sold out!

If you have questions for us, please shoot us a Contact Us email at the following link!
Here is another older blog post about the event with links for lots of videos pertaining to the Adrenaline 5k including a course preview with Dave and the gang!
In one other side note, be sure to be extra nice to the store owner Dave Welsh, he just turned 40 yesterday and we aren’t sure if it has truly set in just yet.
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We plan to set up in the basement of the Haddonfield Running Co after the Adrenaline 5k!

After the Haddonfield Adrenaline 5k, Dr. Craig Evans, Dr. Tim Legath, and Dr. Andrew Gross will be set up to help with post race discomfort and talk about runner related injuries if you would like to meet with us!  We will be in the basement with the DPT’s from the The Training Room of Haddonfield, Cherry Hill and Washington Township.  Chiro’s and Physical Therapists under one roof!  We also hope to have a Sports Medicine Orthopedic hanging out as well to make sure the post race hang out session is as well rounded and beneficial for all as possible.

The Haddonfield Running Co was started in 1997, so this marks the 20th anniversary of the store and we are very excited to be a part of the event.  Come on out to the store after the race and have a look around!  The race is currently sold out and is always a very good time.  Check out the videos below from past years!

Links:

The Training Room Physical Therapy of South Jersey

The Haddonfield Running Co Facebook Page

Check out the videos of past races below!  We look forward to seeing you on Saturday, March 18th, 2017!

 

 

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