A Case for Changing Cadence: Injury Prevention

Caption: Coach Amy evaluating a client’s running form. Video taping the runner is always useful in a personal run evaluation.

If you’re a runner, you’re probably familiar with most running “lingo.” Cadence is a measurement of run gait that we can easily measure with our smart watches, but knowing what do with the data is a mystery to most runners. A quick Google search reveals debate among coaches and scientists creating even more confusion. Avoiding injury is a runner’s number one goal, but what about energy cost and efficiency?

Read the latest Roadrunners of Kansas City blog post to see how Coach Amy solves the case of what to do with Cadence data, with some run coaching clues! 

Should I Get a Cortisone Injection? Dry Needling vs. Cortisone.

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Many patients in chronic pain ask me whether they should get a cortisone injection. In some cases a cortisone injection can be helpful to break a vicious pain cycle. I recommend it as a last resort, as long as it is followed up with a thorough evaluation and treatment of the causes of the pain and dysfunction. Simply decreasing inflammation isn’t going to solve a problem long term.

I caution against multiple cortisone injections as it can break down connective tissues (muscle, tendon, ligament and nerve). As you can imagine, this can lead to worse problems down the road. Before a cortisone injection is entertained, I recommend dry needling. With dry needling there are biochemical changes that occur resulting in an increase of blood flow to the treated area, including white blood cells which is our bodies’ natural healing agent. Dry needling acts as a non-pharmacological anti-inflammatory.

In a study released in 2017 in the Journal of Orthopedic Sports Physical Therapy*, researchers treated 50 painful hips. Patients were randomly assigned to receive either a cortisone injection or dry needling. During the 6-week study no other forms of treatment were provided. At the end of the study, patients in both groups had the same results for pain relief, ability to move and perform daily activities, and medication use. Patients who went to physical therapy for dry needling had the same outcomes as those who received a cortisone injection.

The results of this study show that patients can get similar results from dry needling as from a corticosteroid injection. Both groups experienced a decrease in pain and an improved ability to move and complete daily activities. Because the outcomes were similar, dry needling may be a good option for those worried about the potential side effects and risks of a steroid injection, or who want to try a lower-risk treatment.

*J Orthop. Sports Phys. Ther. 2017;47(4):240. doi:10.2519/jospt.2017.0504

Physical Therapy or Surgery?

Ever been doing something you love with your kids, like shooting hoops or playing catch, and injury or pain strikes? You’re not alone! Repetitive motion over and over again can take its toll on joints and muscles, especially as we age. Muscle and joint damage that was a minor problem in our younger days can resurface as a major issue.

Most people want get back to “normal” life as quickly as possible and some perceive surgery as the quickest or only route to recovery, but it has its associated risks and is expensive. Is there an alternative to surgery? A way to eliminate pain and return to a full active lifestyle? Yes! Physical Therapy.

CoachAmyPT patient, Kirk E., a former pitcher, wanted to avoid surgery on his shoulder, "The pain in my shoulder began as a gradual soreness, but over a period of a few months the pain became more intense...and the lack of mobility kept me from playing golf and catch with my boys. It eventually got so bad that I had a difficult time sleeping and getting dressed.

An orthopedic doctor diagnosed my issue as Adhesive Capsulitis or Frozen Shoulder and recommended two options: Physical Therapy or arthroscopic surgery to clean it out. I decided to go the PT route first as I wanted to avoid surgery at all costs.

The first phase of my treatment with Amy was [mobilizations]. These sessions were painful, but my mobility improved after almost each session. After I regained some of my mobility we moved onto Active Release Therapy and a lot of...exercises that I did at her office and at home in between appointments.”

After a series of physical therapy treatments with Coach Amy including ART (Active Release Therapy), Kirk was able to regain “pain-free” mobility in his shoulder completely eliminating the need for surgery. "The pain and mobility issues have not come back. I still periodically do some of the...exercises she taught me to prevent any reoccurring issues.”

Kirk returning to doing what he loves with his kids.

Kirk returning to doing what he loves with his kids.

A thorough evaluation is necessary to determine whether physical therapy can help prevent surgery. Each patient is unique and therefore treatment plans and effectiveness can vary. Considering PT treatments as an alternative to surgery?

"Race for the Planet" with RRKC and Athleta Town Center

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Coach Amy would like to invite you to join Roadrunners of Kansas City in partnership with Athleta Town Center, for a “Race for the Planet” 10 mile Training Run on Saturday, August 24th. The event is FREE, and the first 25 to register will receive a $25 Athleta Shop Card to use after the run. Participants can also enter to win a $200 Athleta Shopping Spree at event check in. More information and registration are in the link below.

The course will be set up for 10 miles, but run as as little or as much as you want! Friends and family are most welcome, as this is a community event. Onsite registration/check-in begins at 6:00am, and the group run begins at 6:30am.

Details and course map at RRKC Events Page. Printed copies of the map will be provided at the run. See you at the starting line of this FREE fun event! Registration is required.

Power of "The Walk"

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When I suggest an athlete walk for cross training or an injured runner walk in lieu of a run, they typically respond with a furrowed brow and the stink eye. I get it. For most runners, walking is akin to quitting; it feels like a failure. It certainly doesn’t come with the same post workout Serotonin high, but hear me out. Walking is running’s first cousin. The mechanics are very similar with two major differences: at least one foot stays on the ground and there is no jump. These two factors considerably minimize the strain on the joints.   

Walking Benefits for Runners:

  • Recovery during and between workouts and races.

  • Adding volume safely for new runners.

  • Alternative for injured runners. 

  • Cross training for healthy runners.  

I didn’t personally experience the benefits of walking during my training season until recently. Last year, whilst training for my first half Ironman triathlon, I bought a puppy. Everyone told me, “It’s never a good time to buy a puppy.” At the time I was thinking this was especially dumb. Or was it? Walking the dog is important to their well-being, especially for a working breed like my Aussie.  

It turns out walking also became beneficial for my well-being! I enjoyed meeting new neighbors and noticing details in nature, landscaping and architecture in a way I don’t when running by at twice the speed. Even better, I noticed a significant improvement in post workout soreness and enhanced recovery between workouts (which were sometimes two per day). With improved recovery, one minimizes injury but also enhances performance by being ready for the next workout!  

There are lots of ways to add walking to your training regimen. Be sure to wear supportive footwear and use good form. Vary the terrain for maximum strength benefits. To add this to a current training regimen, consider walking a distance or time equivalent to twice that of a run distance or time (see below). Consult your coach if you need help. If you are injured, be sure to check with your physical therapist for how best to add walking to your “return to run” program.   

How to Boost your Run with a Walk: 

  • 10 min of walking = 5 min of running. 

  • Vary terrain for added strength benefits: steps, hills, technical trail.

  • Avoid over striding.

  • Wear run shoes e.g. not flip flops (you’d think I wouldn’t have to say this, but if I made that mistake, then someone else probably will). 

  • Consult your coach if you are a new runner using walking to increase fitness. 

  • Consult a physical therapist if you are injured and using walking as an alternative to running or as a strategy to return to sport.

Walking is highly beneficial for use in recovery, injury prevention and run strength, because it is similar to running yet less stressful on the joints. Take advantage of the “power of the walk” not just for your run health, but for your mind and soul. 

Stinky Shoes!?

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Running shoes got the funk after a muddy, sweaty or rainy work out? Read these quick and simple tricks of the trade to dry them out, freshen them up, and get them ready for the next run.

This works for drying out any athletic shoes. So if you packed lightly for vacation, and need to restore wet shoes for the next day’s adventures, these tips could save the day!


Such a Pain in the Knee Cap!

My first serious running injury was a pain in the knee cap! I was 17 years old running my fastest mile times during the indoor track season. This came to a halt with patellofemoral pain syndrome AKA Runner’s Knee.

Back in the 80’s the advice from the orthopedic specialist was, “Stop running.” Sadly, some physicians still give that same advice. But I say, no! Don’t hang up your run shoes. Seek an alternative. I wish I’d known back then that physical therapy was an option.

With early intervention, physical therapy can prevent or decrease time off. In chronic cases, modification or a break from training may be necessary, but physical therapy can help return runners back to sport earlier and healthier. 

My battle with Runner’s Knee was thirty years ago; now I regularly treat athletes suffering from the same condition. CoachAmyPT patient, Alyssa, suffered from Runner’s Knee and writes, “I’ve been doing the stretches you showed me, squatting properly and taking my pace slow.... excited to report that I ran my first pain-free three miles [in months].” Alyssa went on to run a half marathon this Spring. 

The first sign of Runner’s Knee is usually mild pain behind the knee cap after running. As it worsens, pain can become severe and occur after AND during running. A hallmark sign of this condition is pain in the knee while standing after sitting for long periods of time. Climbing up and down stairs can also be uncomfortable. 

There are many causes of Runner’s Knee including training errors and poor bio-mechanics. 

The pain in the knee is a result of altered positioning of the knee cap on the lower part of the thigh bone. This altered position means that forces are not evenly distributed on the underside of the knee cap; wear and tear and irritation result as it glides over the thigh bone improperly. Over time this can result in tears of the cartilage surface.  

What is causing this altered position? Weakness of the hips, imbalances in mobility such as tight Achilles and hamstrings, and poor dynamics at the foot with running are some of the possible culprits. A physical therapist that specializes in running injuries can accurately determine the contributing factors, and provide treatment that addresses them specifically. Proper diagnosis and treatment can also help prevent the injury from coming back.

Most running injuries are caused by a combination of things, and training errors typically do play a part in Runner’s Knee. Common errors include increasing volume and intensity too quickly, and lack of recovery between and within training seasons. A physical therapist with a background in run coaching and training can be helpful in assessing if training error is part of the puzzle, and work with you to make necessary changes. 

So what to do if you suspect you have Runner’s Knee? At the first sign of a problem, it is best to rest for a few days, take NSAIDS (nonsteroidal anti-inflammatory drugs), and apply moist heat (soak in Epsom salts). After a few days, resume activity gradually. If symptoms continue, seek evaluation and treatment as soon as possible. The longer this problem persists, the greater the potential for more damage, and the longer the rehabilitation process will take. Not all knee pain associated with running is due to Runner’s Knee, so an evaluation by a professional is important.

Note: Running while taking NSAIDS is not recommended.

Alyssa listened to her body, sought treatment, put in the work, and went on to run a half marathon this Spring. “I missed running so much and I feel more like myself than I have in months... thank you so much for helping me get back in the game.” -Alyssa. Don’t let a pain in the knee cap put an end to your running game either.


Personalized Coaching Makes Doing the Hardest Thing You’ve Ever Done Stress Free and Fun

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My favorite part of coaching is helping people achieve goals they previously thought impossible. Through Personalized Training Plans and Individual Coaching, I work with athletes to develop short-term and long-term goals. Each plan considers your personal lifestyle, and your running history including prior injuries.

Individual coaching is designed to help runners reach their performance peak, while taking the stress and guess work out of training. Following is a Q&A with Kathryn, a CoachAmyPT client. Her motivational journey outlines the logistics of how individual coaching works, as well as the benefits.

Read on, dream on, and reach out to Coach Amy to personalize YOUR plan.


Staying Cool on the Run

Coach Amy Staying Cool on a Hot Run

Coach Amy Staying Cool on a Hot Run

“Bzzz” my smart watch alerted me three miles into a grueling hot and humid run. I looked down to see what all the “buzz” was about: my fitness level was a negative 3! What the heck? Despite all my recent training, my watch determined that my current fitness level was down. URGH!

The fact is my pace WAS slower and my heart rate WAS higher, as was my RPE (rate of perceived exertion). It was not due to lack of training but rather the heat and humidity. I know I’m not alone and it’s completely normal as our weather shifts from spring into summer.

Check out the article on the Roadrunners of Kansas City blog for strategies on how to properly and safely acclimate to running in the heat and humidity.

Glitchy Technology? Temporarily Go “Old School.”

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Imagine this…after a long day at work, you muster up the willpower, throw on your running garb, squeeze your feet into your bike shoes or yank on your swimsuit for a workout. Against every fiber of your being, you pull energy from seemingly nowhere and step outside, hop on the trainer, or jump in the water. You turn on your training device and wah wah wah, it stops working! You don’t receive heart rate, pace, cadence, power…whatever it is that you want or NEED to track. 

We’ve become evermore reliant on technology to provide us with helpful data. Coaches prescribe, tailor and assess workouts based on a number of parameters such as cadence, pace, power, and heart rate. As athletes we rely on this information to meet goals during the workout, but the completed workout also becomes part of our log. We even tease each other, “if your device didn’t record it, it didn’t happen.”

So what to do when our training device fails? It inevitably does, whether it’s a connectivity problem, a battery problem or even worse a software programming issue! Should we take a hammer to the device and pulverize it? Oh, I’ve recently spent several trainer rides envisioning that option when my device kept failing. Thankfully, I didn’t follow through with my grand plans for a temporarily gratifying solution. Several chats with helpful and knowledgeable tech support and a software update later; it’s working and I’m back on track.

When technology fails, what can an athlete do besides exclaim obscenities? Use it as an excuse to bail altogether? My advice is to just press on. Not the “ON” button - maybe pressing OFF would be good actually. What I mean is, just keep going.

Don’t give up. Instead, go “old school.” In the not too distant past we trained with nothing more than a stop watch. In the pool, we used a poolside timer. For heart rate, we stopped and counted beats per second. We didn’t have power output on our road bikes, unless we were in a research lab. 

Use what you have on hand like your phone’s stopwatch (another piece of tech that is hopefully charged and working), and your brain. Do the math to determine your splits. Take your pulse at your wrist: count the beats for 15 seconds and multiply by 4 to get your beats per minute. 

Most importantly, listen to your body. It will tell you what to do. How do you feel? What is your rate of perceived exertion (RPE)? Are you supposed to be pushing your threshold? If so, go for a “feels like” hard difficulty level.  Be flexible, and know it’s not just ONE workout that makes or breaks your training. It’s consistency and effort that lead to success. So allow yourself a moment of frustration when things don’t work as planned, and then let it go, press on and go “old school.” Soon you will get your device working and will have that precious data  back. Even though you may end up without any technological proof of your workout, you know you did it and so does your body, and that’s really all that matters.