TIPS ON STARTING A WALKING OR RUNNING ROUTINE
RUNNING AND WALKING YOUR WAY TO WELLNESS
Working with running-related injuries has fascinated me for a
long time. Runners, whether they are seasoned athletes or recreational weekend
warriors, are some of the most self-motivated and resilient people I know. For
years, I have gradually seen an increase of injuries among runners in the
clinic.
Back in 2008, I suffered from an Achilles tendon (calf) strain
with some affectation along the plantar fascia (bottom of the foot) while
training for a run. It caused me to stop running for a few weeks to gradually
heal myself and retrain back into shape. This led me to further seek out
experts in the physical therapy realm and to understand the concept of injury
prevention with running. I found I was able to apply this not only in my
practice but in my personal life as well. I now run recreationally as a means
to enjoy the outdoors.
Running outdoors allows me to vary my workouts and take me
beyond the four walls of a gym. It’s a more scenic workout, depending on where
you go. I like doing a jog/walk interval, as it allows me to rest in between
and enjoy the trails of the Pacific Northwest. I was born and raised in Iloilo,
the third fastest growing city in the Philippines, and coming to this part of
America is a treat. Having lived in both Washington and Oregon, I feel that
Southern Oregon has a good pace, more inclination for outdoor activities,
moderate winters, and the people are definitely warm.
I really love trail running and walking more than anything.
Cooper Creek Trail in Sutherlin, Oregon, is one of my favorites, as well as
some of the trails along Highway 38, where you get to visit about 10 waterfalls
on the way to Crater Lake. Each waterfall has its own trail too. I especially
love the trails of Susan Creek Falls and Toketee Falls in southern Oregon. Both
are perfect for more moderate hikes.
WALK TO START GETTING HEALTHIER
If you are starting to become more active outdoors, start with a
simple walking routine. Start with walking at a comfortable pace for 10–15
minutes on level ground, and do it every morning and afternoon to slowly
improve your endurance. Doing this routine for 30 minutes a day helps you
slowly progress toward jogging or running, if that is your goal.
You can progress by either increasing your time to 20–30 minutes
in the morning and afternoon or by slowly incorporating inclines or slightly
hilly ground. Make sure to maintain a good pace to further improve your
cardiovascular capacity. Ensuring the proper progression helps you prevent
injuries and opens up more opportunities for transitioning to jogging or
running.
Walking has more benefits than you think. In a meta-analysis
study, walking reduced cardiovascular events by 31%, and it cut the risk of
dying during the study period by 32%. These numbers were equal in both men and
women.
When transitioning from walking to jogging, it is important to
slowly progress your routine so that your cardiovascular system adapts as you
increase your speed. Try doing a walk/jog pattern at a 2:1 ratio of walking to
jogging. That means walk two minutes followed by jogging for one minute. Do
this for 20 minutes and slowly progress toward 1:1 ratio of walking to jogging.
Try this out for at least two weeks and then progress to adding more time to
jogging as you feel better.
RUNNING
INJURY PREVENTION
5 TIPS FOR SUCCESS
1. Dynamic Warm-ups.
Maintaining good flexibility aids in the prevention of musculoskeletal injuries
and improved sports performance. Stretching as a form of warm-up prevents
sports-related injuries (1). When it comes to stretching, dynamic warm-ups proved
to be superior compared to static stretching and it improved performance in
three different sports tests versus static stretching and no warm-ups (2). The
stretching routine should allow for 15 minutes and immediately followed by the
actual sport or physical activity (3). Furthermore, not only does it help in
overall flexibility of your body prior to a sport, dynamic warm-ups have been
shown to increase flexibility of the hamstring and the quadriceps muscle groups
more significantly than static stretching (4). Here are three of my favorite dynamic
warm-ups:
a. Walking knee tucks: Standing on one leg, grab the knee of
the opposite leg and pull toward your chest until a stretch is felt in the
glutes. Keep head and chest upright. Hold stretch for 1-2 seconds. Step forward
and pull knee to chest with other leg. Alternate legs as you walk forward.
b. Walking quadriceps pull with
overhead reach: Standing
on one leg, bend the opposite knee and bring your heel toward your bottom. Grab
the ankle and pull until a gentle stretch is felt in the front of the thigh.
Next reach the opposite arm overhead. Hold stretch for 1-2 seconds. Alternate
legs as you walk forward.
c. Spidermans with trunk rotation
(Advanced): Get down in a push up position, Step forward
with your left foot so that the knee forms a right angle. Push your hips back and come up on your heel and toes
(heel in the front and toes in the back). Drop your hips back down and raise
your left arm up while twisting back until you feel a tight stretch. Hold the
position for 1-2 seconds. Perform the same on the other side and continue to
alternate for about 2-4 repetitions.
2.
Conditioning.
Perform strengthening and conditioning exercises at least twice a week to
prepare you for running. It can be very simple and easy to follow. Studies
showed that the wall squats, forward step ups (not listed below) and lateral
step ups produced significant activation of the Gluteus medius and Gluteus
maximus muscles (6).
a.
Wall
squats – Single leg: Stand
with back and head flat on the wall with both feet about 1-2 feet away from the
wall. Lift the left leg up as shown in the picture and slowly lower your body
until your right knee is at a right angle like you are sitting on a chair. Hold
the position for 2 seconds. Repeat for about 8-10 times and perform on the
other side. If this is too difficult, you can partially squat the knee that is
weight bearing (before you reach right angle). If this causes symptoms like
pain or cramping, discontinue the exercise.
b.
Lateral
lunges: This is a good basic drill for both beginner’s
conditioning as well as a warm-up for more advanced athletes. Stand with both
feet aligned with your shoulders. With the feet parallel to each other and
facing forward, step the right foot to the side and lunge over on that leg with
the weight on the right heel (with foot flat on the floor). This will force the
weight to be transmitted to the gluteal muscles on that side. Hold the position
for 1-2 seconds and perform on the other side. Perform alternating side lunges
for 8-10 repetitions.
c.
Lateral
step ups: Find a step that is between 6-12 inches in
height. With both feet facing forward and parallel to each other, step the
right foot up shifting your weight onto the right leg and lifting your entire
body weight with that leg. You may step the left leg up or keep it off the step
for a more challenging exercise. Step the right leg down. Repeat 8-10
repetitions and perform on the left leg as well. Progression will be increasing
the height of the step.
3. Cool down: Foam rolling. Foam
rolling allows your body to prevent tightening after a run or walk and improves
the circulation after an active activity. Some people use this as a warm-up. I
prefer using this method as a way to cool down and improve muscle flexibility,
therefore, preventing future injuries. See our website for short videos on how
to do foam rolling.
4. Running shoes. If
you are a new runner, look for a shoe that is comfortable to you. Do not
believe in the latest hype. Having 2-3 shoes in rotation is important because
each shoe vary in cushioning and support, thus creating different types of loads
on your joints, tendons and ligaments. Rotating through different shoes through
the week alters the different forces applied to your body and allows different
tendons and ligaments to handle the load. This may help prevent overuse
injuries. I encourage patients to bring their running shoes to their PT appointment
so we can evaluate them and give advice on choosing the right shoes.
5. Persistently recurring injuries. If
you continue to experience discomfort, pain or difficulty in your run, it may
be time to consult with someone who understands movement patterns, body mechanics,
and training habits. People vary in their body types, nutrition and fitness
levels. I may recommend coming in for an evaluation with a specialist and have
some testing done. Call and ask your local physical therapy office to see if
they have a running injury specialist.
In the
last decade, I have really enjoyed working with runners of all levels and I
encourage you to get out there and experience the joy of running. Be sure to
follow the 5 tips for success to train safely!
1. Woods K, Bishop P, and Jones E. Warming-up and stretching for improved physical performance and prevention of sports-related injuries. Sports Medicine Journal, 1985 Jul-Aug 2(4):267-78 Aukland, NZ
2. McMillan, DJ and Moore. Dynamic vs Static Stretching warm-up: The effect on power and agility performance. Journal of Strength & Conditioning Research / NSCA. 2006 Aug 2003(3):492-9
3. Woods K, Bishop P, and Jones E. Warming-up and stretching in the prevention of muscular injury. Sports Medicine Journal 2007:37(12):1089-99
4. Aguilar AJ, DiStefano LJ, Brown CN, Herman DC, Guskiewicz KM, Padua DA. A dynamic warm-up model increases quadriceps strength and hamstring flexibility. 2012 Apr 26(4):1130-41
5. Boren K, Conrey K, Le Coguic J, Paprocki L, Voight M, Robinson TK. Electromyographic Analysis of Gluteus medius and gluteus maximus during rehabilitation. Int J Sports Phys Ther. 2011 Sep; 6(3): 206-223
6. DiStefano LJ, Blackburn JT, Marshall S, Padua D. Gluteal muscle activation during common therapeutic exercises. J Orthop Sports Phys Ther. 2009 Jul; 39(7):532-540
7. MacAskill M, Durant T, Wallace D. Gluteal muscle activity during weightbearing and non-weightbearing exercise. Int J Sports Phys Ther. 2014 Dec; 9(7): 907-914
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