Running-Physio

How long can you hold this quads exercise?! ⏱️ This is one of those exercises that looks like it should be fairly easy but is actually surprisingly hard! It’s a nice option to challenge the quads when people don’t have access to a leg extension machine or want an option that can be done easily at home. It can be used for patients with patellofemoral pain or patellar tendinopathy but the resistance, position and hold time needs to be adjusted to find a comfortable start position. If that’s not possible it’s usually best to start with an easier option. As with all exercises we need to suggest options that are safe and suitable for each individual. I’ve just managed a 1 minute hold and my quads are on fire! 🔥 P.S. if you are currently injured or not sure this exercise is safe for you then check with your physio/ health professional before trying it 👍

4 key ways to strengthen the hamstrings! 🏋️Using these approaches helps to address knee flexion and hip extension weakness plus prepare the hamstring for the demands of top speed running! 🏃🏽♀️Sprint training has been found to increase both eccentric hamstring strength and maximum running speed (Freeman et al. 2019). We know how beneficial Nordic Curls are for the hamstrings, but Mendiguchia et al. (2020) found sprint training to be superior for increasing Biceps Femoris fascicle length (an important factor in hamstring injury). ⚠️ One word of caution though - running speed should be increased gradually for injured runners, especially following hamstring injury. Sprinting should be added at the appropriate time in healing and rehab. Often a period of strength training and power work is needed first to prepare the hamstrings for the high peak loads in top speed running. References: Freeman BW, Young WB, Talpey SW, Smyth AM, Pane CL, Carlon TA. The effects of sprint training and the Nordic hamstring exercise on eccentric hamstring strength and sprint performance in adolescent athletes. J Sports Med Phys Fitness. 2019 Jul;59(7):1119-1125. doi: 10.23736/S0022-4707.18.08703-0. PMID: 31332988. Mendiguchia J, Conceição F, Edouard P, Fonseca M, Pereira R, Lopes H, Morin JB, Jiménez-Reyes P. Sprint versus isolated eccentric training: Comparative effects on hamstring architecture and performance in soccer players. PLoS One. 2020 Feb 11;15(2):e0228283. doi: 10.1371/journal.pone.0228283. PMID: 32045411; PMCID: PMC7012429.

Prone or seated leg curl for Proximal Hamstring Tendinopathy? 🤔 #PHT #proximalhamstringtendinopathy #Running #RunningRehab #RunningInjury #Tendinopathy

‼️NEW STUDY JUST PUBLISHED‼️ Hip Strength Normative Data in FEMALES 🧠Adductors are arguably the most versatile and exciting muscle group of the lower limb. When it comes to sports related injuries involving this muscle group, it is essential to fully understand the interchangeable roles of each of the adductors. 🧠 Now throughout the years research has continued to highlight the role of strength deficits and ratio asymmetry between the adductors and abductors when it comes to ARGP (Adductor Related Groin Pain). However often where things fall short is often when we’re trying to understand what ‘normal’ is for certain sporting populations. Paucity of research is then even further apparent when diving into the literature for female footballers, so new data like this is fantastic to see. 🧠 For anyone dealing with any of the population whether it be general pop to elite athlete, I’d urge you to read this paper. It’s great to see studies like this published where we can use it and apply it straight into clinic. 🤝 Thanks so much to Mehmet @the.hip.physio for the collaboration with this. He’s the brains behind it! Make sure you follow Mehmet for anything hip related! Heijboer et al (2024), Normal hip strength and range of motion values in youth and adult female national football teams: Data from 504 assessments, Physical Therapy in Sport, Tyler T, Nicholas SJ, Campbell RJ, Donellan S, McHugh MP. The effectiveness of a preseason exercise program to prevent adductor muscle strains in professional ice hockey players. Am J Sports Med. 2002;30 (5):680- 683. PubMed ID: 12239001 doi:10.1177/03635465020300050801

If you had to choose one, which would you say is more important in tendinopathy, psychosocial factors or pathology? 

Psychological factors matter in tendinopathy! My previous posts on Gluteal Tendinopathy have been focussed on diagnoses, pain distribution and early rehab but so far I’ve omitted something key - psychological factors like pain catastrophising, self-efficacy and depression can be associated with symptom severity. We’ve seen this in Achilles tendinopathy too where a psychosocial dominant subgroup had the worst symptoms and poorest quality of life despite minimal tendon structural changes (Hanlon et al. 2021). Activity modification and a loading programme are still important to improve strength and function but we should also address the psychological impact of tendinopathy, including people’s concerns and fears about the injury and its impact on their mental wellbeing. Key Reference: Plinsinga, M.L., Coombes, B.K., Mellor, R., Nicolson, P., Grimaldi, A., Hodges, P., Bennell, K. and Vicenzino, B. (2018), Psychological factors not strength deficits are associated with severity of gluteal tendinopathy: A cross-sectional study. Eur J Pain, 22: 1124-1133. https://lnkd.in/eRtB6Y6i

Hip & core exercises may help prevent running injuries! 🏃♂️🏋🏾♀️ New research from Mari Leppänen and colleagues just published in @BJSM_BMJ has encouraging results. They utilised 8 exercises which could be progressed over 4 levels of difficulty (front plank, side plank, pelvic lift (bridge), band squat/ band walks, banded hip flexion, lunge,side lunges and deadlifts). The programme was completed 2 to 4 times per week. It was designed to be challenging, “The strength exercises were instructed to feel heavy and to be performed until fatigue, but with good quality”. 2 of the rehab sessions per week were supervision by physiotherapists and tended to be before running. All groups performed the same running programme to help reduce the effect of different training loads on running injury. What about the foot and ankle strengthening? The results weren’t as positive here and they actually faired worse than the control group in some areas. A possible reason for this is that the foot and ankle exercises may not have had sufficient load to prepare for the demands of running. For example calf work was very low level and it doesn’t appear that any additional load was added. Did the stretching in the control group help? The authors commented on this, “We observed a notably low number of acute thigh and calf injuries in the stretching group supporting the previous findings of possible beneficial effect of stretching on the risk of muscle injuries”. It didn’t seem to have an impact on reducing overuse injuries which are far more common in runners. Important Considerations The strength exercises were performed before running training which may not be ideal as it can cause fatigue. There were 8 exercises in total which took 20 to 35 minutes to do. A shorter programme may be more realistic, particularly for those with high ‘life load’! Despite this these are positive findings that hopefully can be built upon with future research Reference: Leppänen M, Viiala J, Kaikkonen P, et al. Br J Sports Med Epub ahead of print: [7/6/24]. doi:10.1136/bjsports-2023-107926

🏃♂️Cadence is a continuum not a magic number for all runners to aim for! As cadence tends to change with speed, incline, body height and age it doesn’t make sense to suggest a rigid target for all (such as the ever popular 180 steps per minute)! Instead we should look at cadence (AKA step rate/ stride frequency) in the context of the individual, their other gait characteristics and their needs. Let’s illustrate this with a couple of clinical examples: 🏃🏽♀️Runner 1: Cadence of 156 at their preferred pace on the flat. Over-strides and reports patellofemoral pain when running. Goal, reducing knee pain. Increasing cadence by 5 to 10% may help address over-striding, reduce knee load and decrease their symptoms. So we could test it and see how the runner responds but remember it’s likely to be most beneficial when used at a similar pace, incline etc. 🏃🏾♂️Runner 2: Cadence of 178 at goal pace on the flat. No over-striding and not injured at present. Goal, enhancing performance. Cadence is high so a further increase may actually be detrimental to performance. If we increase it too much then there is less time to push on the ground and as a result the runner may lose flight time and stride length. There are better options for improving performance for this runner such as optimising their training and recovery, including S&C or adding plyometrics. And lastly… a practical point for gait analysis 👇 Make sure you record speed when assessing running gait and determining cadence. This is easy to standardise on a treadmill so you can get consistent results and see a more reliable response to your gait retraining cues. #Running #RunningGait #RunningCadence #RunningSteprate #RunningInjury #RunningRepairs #RunningRehab