Try It: AlterG Treadmill Training

If you follow the training of professional runners, you may notice that many of them utilize an AlterG® at some point or another to either add volume without additional stress on the body or to maintain fitness while recovering from an injury.

Even though the great majority of us are not training to compete at the highest level, we can still take advantage of this technology. Locally, you can run on an AlterG® at Froedtert & the Medical College of Wisconsin Sports Medicine Runners’ Clinic.

Below, Sara Ziegele, DPT with Froedtert & the Medical College of Wisconsin Sports Medicine Runners’ Clinic tells us more about how runners can benefit from this training tool.

Can you start off by telling us a bit about how an AlterG® treadmill works?

The AlterG® is a specialized treadmill that allows an individual to run or walk at partial body weight. For example, an individual weighing 150 pounds can set the treadmill to 50 percent and have only 75 pounds impact the treadmill. The runner wears a specifically designed pair of shorts that zip into a waist-height “tent” around the treadmill. The “tent” inflates with air to place an upward force on the lower body and reduce the weight.

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What are the benefits of using an AlterG® treadmill?

Runners can maintain cardiovascular conditioning while minimizing stress on the lower body, reduce compensations and habits that develop from running with pain and return to running sooner than on the ground.

Can you tell us more about the degree of lift? How is the degree of lift determined for each participant?

The AlterG® can be set between 20 percent and 100 percent of body weight. That translates to more than 80 percent of your weight being held up by the air. The degree of lift will be individually determined by the Runners’ Clinic staff. Usually, runners recovering from impact injuries are set between 50-75 percent. Uninjured runners are set between 75- 95 percent.

Can you tell us more about how an AlterG® treadmill benefits each of the following groups?

  • Injured or recovering runners: Allows the runner to return to training sooner while unloading the injured region
  • Runners looking for a performance boost: Allows the runner to maximize cardiovascular training while reducing lower extremity stress
  • Runners just getting into running/exercise: Allows the runner to gradually increase the training load

How do you recommend runners incorporate AlterG® treadmill running into their training?

Training strategies on the AlterG® are very similar to any other surface. A runner should build up gradually to avoid overtraining. The higher percentage of body weight, the more natural the mechanics.

What’s the procedure for using the AlterG® treadmill at the Runners’ Clinic? Can people use the treadmill even if they are not a current Runners’ Clinic patient?

The AlterG® is available at the Froedtert & the Medical College of Wisconsin Sports Medicine Runners’ Clinic for patients and uninjured runners. Runners currently completing physical therapy (PT) can incorporate the treadmill into their rehabilitation program. To use the AlterG outside of PT, fees range from $15 (single, 30-minute sessions) to $175 (12-60 minute sessions across the course of a month), with additional options available.

Thanks for chatting with us, Dr. Ziegele! To learn more about Froedtert & the Medical College of Wisconsin Sports Medicine Runners’ Clinic, visit their website or call 414.805.7114.

Keep Running MKE – you’re doing great!

Yes, Even Healthy Runners Can Benefit From A Running Analysis

If it’s not broken, why fix it?

For runners, there are plenty of reasons to be proactive about avoiding injuries. As any runner that has ever been laid up and forced to take time off knows, prehab beats rehab any day.

One of the easiest ways to get started is by getting a running analysis. Now, you may wonder, why get evaluated if I’m running healthy right now? For starters, it’s the best way to catch small form issues that can lead to bigger problems later on.

We recently chatted with Calvin Deutsch with Deutsch Physiotherapy about the benefits of getting an expert running analysis. Here’s what he had to say:

“For runners in Wisconsin, the off-season should be about cleaning up all areas of weakness and imperfections in stride to create an invincible runner come spring. Many of us carry injuries from the summer and fall into the winter, that get better because we don’t run as much. Then we’re disappointed when the injury returns in spring as mileage picks up again. Chances are we just lost five months of time that we could have fixed the problem and now the weather is nicer and we’re still injured.

An expert running analysis can detect areas of your running form that may lead to injury, expose neuromusculoskeletal weaknesses or imbalances, and highlight areas of your stride that are doing well. These areas are often undetected and can be exposed via slow-motion video capture tools in combination with an expert eye.

The main point is to ensure that every runner is headed in the right direction specific to their running stride, strength and mobility concerns, form alterations, etc. Arming yourself with this knowledge proves to be invaluable in ensuring the time you spend improving your running pays off directly.

Whether injured or not, a running analysis is an essential tool for every runner to gain invaluable information that will either lead to solving an injury, improve current performance or prevent potential injuries down the road.”

During a running analysis with Calvin, he’ll record your form and stride while you run on a treadmill. After, you’ll sit down and review the video together so he can point out any weaknesses or imbalances as well as things you are doing well. After reviewing the video, he’ll prescribe exercises that will help fix the weaknesses and imbalances so you can get back to running your best!

To learn more or to schedule a running analysis at Deutsch Physiotherapy, connect here:

Email: info@deutschphysiotherapy.com

Phone: 414-395-1079

Website: http://www.deutschphysiotherapy.com/

Facebook: https://www.facebook.com/DeutschPhysiotherapyCo

Twitter: https://twitter.com/DeutschPT

Still this week … an MKE runner profile you won’t want to miss! Stay tuned!

Keep Running MKE – you’re doing great!

Preventing Common Running Injuries

Anyone who has suffered a running injury knows – preventing them is far easier than treating them! Below, Calvin Deutsch, a Sports Physical Therapist with Deutsch Physiotherapy Co., offers tips to help prevent running injuries.

This is Part 3 in his series about running injury treatment and prevention. You can read his previous articles here:

Part 1: https://keeprunningmke.com/2014/05/06/treatments-for-common-running-injuries/

Part 2: https://keeprunningmke.com/2014/06/11/what-causes-running-injuries/

What exercises do you recommend to help prevent running injuries?
Yes. I’ve put together a Videos page on my website that includes all of them.

http://www.deutschphysiotherapy.com/#!videos/c1h1x

These exercises hit three main components of running injuries: mobility, neuromuscular strength/control and muscle management.

What pre- and post-run stretches do you recommend runners do to help prevent injuries?
There is a wide variety of pre- and post-run activities. In general, make sure to include a 5-10 minute dynamic warmup and a 5-10 minute cooldown/stretch period.

The main focus of a pre-run program is to generally and literally warm up your body, get your heart and lungs going and prepare your joints/muscles for the activity you are about to perform. There are large variations in dynamic warmups and most of them are ok – you can’t really go wrong.

Follow this link for a pretty good example of a basic warmup: http://runninghutch.com/workouts/runner-warm-up/

The main purpose of a post-run or cooldown program should be to gradually reduce the stress to your heart, lungs, muscles and joints, in addition to allowing clearance of acidic byproducts produced during your run. A large amount of ‘next day soreness’ can be reduced through incorporation of a simple five-minute cooldown.

Traditional static (hold for 30 sec) stretching is best to perform as part of a post-run program to take advantage of the susceptibility of warm muscles to a lengthened position. (Think of heated plastic that cools to a mold). Simple stretching of your calf, hamstrings, quads and hips are good and can be accomplished a variety of ways.

General incorporation of a pre- and post-run program yields high return on time investment and is part of managing your total running plan. Each runner’s plan should involve running, a pre/post-run program and therapeutic elements. The therapeutic elements may include mobility and strength exercises as well as muscle management via foam rolling or similar devices. The actual running part is what we want to spend the most time on and when time is at a premium we think we don’t want to ‘waste’ it on warmup, cooldown, etc. When this view is tweaked to understand that the actual running is only part of the whole program, then the injury risk goes way down and we see happier, healthier runners.

The_Grid_Foam_Roller_by_Trigger_Point_8-sixhundred-1

Are there any other steps runners can take to help prevent injuries?
The biggest recommendation I have is for each runner to make sure that they are headed down the right path via a basic evaluation. You can find 100 stretches and 200 strength exercises and tons of other things to do for each injury or issue you face when you search online or talk to friends. I see a fair amount of consistency with injuries but each injury for each runner is a little different, and the mixture and timing of certain exercises and treatments in the right order seems to be the key. It’s just like ingredients and recipes – you need to mix the ingredients the right way to get the desired product of the recipe.

So a basic initial evaluation or assessment is crucial to outline a personal injury prevention or performance plan. We have all had our share of injuries, aches and pains over the years and those things leave a footprint on our biomechanics. Our daily lives are all a bit different and that has a large effect on our exercise functionality. Finding a good person to perform this evaluation is very helpful and serves as a good resource for future concerns or questions.

I see a lot of patients that have minimal or no real injuries, but they come in 4-10 times per year to ensure that they are doing everything they need to do, keep their muscles healthy and fine-tune their biomechanics.

Of course I’m biased to seeing a good physical therapist who knows a lot about athletes and running, but a good personal trainer, massage therapist, chiropractor or athletic trainer are usually good people to look for and maintain contact with.

Thanks so much for all the great information, Calvin! For more information on  running injuries or for answers to specific questions, you can connect with Calvin here:

Website: http://www.deutschphysiotherapy.com

Email: info@deutschphysiotherapy.com

Phone Number: 414-395-1079

Keep Running MKE – you’re doing great!

What Causes Running Injuries?

Understanding what causes common running injuries is the first step in preventing them. Below, Calvin Deutsch, a Sports Physical Therapist with Deutsch Physiotherapy Co., explains common causes of running injuries.

This is Part 2 in his series about running injury treatment and prevention. You can read Part 1 here: https://keeprunningmke.com/2014/05/06/treatments-for-common-running-injuries/

What are some of the most common reasons runners get injured?
The number one reason I think runners get injured is loss of mobility/flexibility somewhere in their body that drives some type of compensatory reaction somewhere else. A perfect example is how low back and hip stiffness mixed with mild overstriding can cause IT Band Syndrome. The IT Band is put on repetitive excessive tension because the hip/low back cannot move appropriately at the end of the stride and it is only a matter of time before that runner develops outer knee pain. Another example is loss of ankle mobility causing overpronation at the foot which will result in a number of issues including Plantar Fasciitis.

Plantar Fasciitis

Follow this link to see good video examples of mobility exercises:
http://www.deutschphysiotherapy.com/#!videos/c1h1x

Watch:
Hip Flexor Stretch
Prone Press Up
Ankle Mobility

The number two reason is weakness, primarily of the hips. Performing the right strength exercises can remedy this deficit, but it takes time. Weak hip muscles allow excessive motion of the leg during the landing phase and this can cause repetitive strain to the back, hip, knee and lower leg.

Follow this link to see good video examples of strengthening exercises:
http://www.deutschphysiotherapy.com/#!videos/c1h1x

Watch:
Hip/Trunk strengthening

Third would be simple training errors. This includes improper progressions in mileage, inappropriate speed/track/hill workouts, lack of variation in training route, etc.

The biggest thing to understand about injuries is that exercise is a balance between tissue damage and repair. Exercise therapeutically micro-damages your muscles, tendons and bones. This damage stimulates your body to repair and improve itself by building bigger muscles and tendons that can handle more strain and build stronger denser bones. Balancing your training load with active recovery strategies is fundamental.

Can you talk a bit about the roles that diet, sleep and stress play in running injuries?
Diet, sleep and stress are fundamental elements for any person and even more relevant for an athlete.

I used to view food as primarily fuel and always thought that your diet’s main purpose was to provide energy. As I obtained my education, I came to understand food as not only fuel, but as the literal building blocks of tissue health, repair and sustainability. There is no way that your muscles, bones and other systems can function at a high level within the context of a bad diet.

Sleep is an integral part of our daily lives and many of us do not get enough of it. Outside of mood, emotional state, level of focus, concentration, attention, etc., sleep will have an impact on other physiologic functions such as heart rate, metabolism, cell function and so on. We continue to see emerging research on how sleep is necessary for athletic performance in addition to living a happy life.

I’ve had many patients turn to running as their main stress relieving activity. So when they get injured they really depend on me to help get their life back in order. Physiologic and psychologic stressors are necessary to have optimum functioning systems. Whether it may be a resistance training program or a needy boss, we need to stress ourselves in order become better. You will not become faster if you don’t push your limits, just as you won’t be comfortable handling stressful situations if you haven’t had the opportunity to practice handling psychologic stress.

Follow this link to a fantastic Ted Talk about how viewing your stress as a helpful thing can change the physiologic impact of your stress:

https://www.ted.co/talk/kelly_mcgonigal_how_to_make_stress_your_friend

So the goal would not be eliminate stress, but understand how it can affect us and how we can harness its positive effects.

Lately, there’s been a lot of discussion about how many running injuries stem from weak hips/glutes. What can runners do to strengthen these areas of the body?
Yes, weak gluteals can cause a number of different issues for runners and many other athletes. We saw some good academic research come out in the early 2000’s about this and it unfortunately takes about 10 years for that to hit the general public.

Your hip muscles steer your whole leg. If those muscles are strong and your brain can fire them in concert with other key muscle groups of the lower leg, thigh and trunk, then your leg will be stabilized. If those muscles are weak, or not well coordinated with other muscle groups, then your leg will not be stabilized and that will cause excessive motion within the leg resulting in the potential for a number of injuries.

Follow this link to see good video examples of strengthening exercises:
http://www.deutschphysiotherapy.com/#!videos/c1h1x

Watch:
Hip/Trunk strengthening

In general, you want to activate your gluts in a running specific or single-leg scenario while simultaneously activating trunk muscles. Ideally, heavier strengthening periods should coordinate with lighter mileage periods as to control the total level of strain to your body.

Thanks so much for all the great information, Calvin! For more information on other running injuries or for specific questions, you can connect with Calvin here:

Website: http://www.deutschphysiotherapy.com

Email: info@deutschphysiotherapy.com

Phone Number: 414-395-1079

Stay tuned, runners! Calvin will provide a third post about running injury prevention in the next few weeks.

Keep Running MKE – you’re doing great!

Treatments for Common Running Injuries

Show us an injured runner and we’ll show you a frustrated runner!

Run long enough and you’ll likely be sidelined with an injury at some point. Fortunately, there are steps you can take to get back to the roads, trails and track.

Below, Calvin Deutsch, a Sports Physical Therapist with Deutsch Physiotherapy Co., explains how to treat some of the most common running injuries.

What are some of the most common running injuries?

The most common running injuries have to do with the knee joint. About 45 percent of all running injuries are associated with the knee, thus the myth that running is “bad for you knees”. The odd part is that most of these knee injuries are not a fault of the knee itself, and running is not bad for your knees. The knee joint is simply sandwiched between the hip and the foot/ankle, so many abnormal forces from above and below make their way to the knee and produce some type of pain. This underscores the importance of evaluating and treating each patient’s whole leg and trunk when working with most running injuries.

Patello-Femoral Pain Syndrome, Patellar Tendonitis and IT Band Syndrome are the most common injuries at the knee.

Plantar Fasciitis (heel pain), Achilles Tendonitis, lower leg muscle overuse and some hip issues round out the bulk of running injuries. About 5 to 8 percent of running injuries involve repetitive stress, i.e. stress fractures. There are also a wide range of foot conditions and some infrequent back problems that can present when running.

Nearly 70 percent of runners will suffer an injury at some point in their running career. So this means that either running is a higher injury risk sport, we are doing a bad job to promote/follow injury prevention programs, our daily lives are becoming less conducive to successful running (long-term postural adaptations due to prolonged sitting) . . . or a combination of all the above.

Small effective interventions can go a long way for runners, so there is huge potential to follow proven injury prevention/performance programs that create a high return on investment for runners.

Can you talk a bit about the symptoms and treatment for these injuries?

Patello-Femoral Pain Syndrome
This is just a fancy Latin name for “Knee Cap Pain”, so it is pretty easy to diagnose when the patient points to their knee cap and says, “It hurts here”.

PatelloFemoralPainSyndrome

Symptoms: Pain anywhere around the knee cap can be sharp or stabbing at times, usually occurring upon landing during running, negotiating hills/stairs, getting up/down from chairs, squats or lunges. Mild swelling can occur around the knee cap region and patients usually describe the pain as “under the knee cap”.

Treatment: Local anti-inflammatories are helpful (icing the painful area) and NSAIDS (Ibuprofen) but these things do not address the cause of the problem.
Evaluation of each runner’s hip strength and mobility are very important and might lend a treatment program towards hip/trunk strengthening or improving the mobility of the hip/lower back. Your hip muscles control rotation of the long thigh bone (femur) which makes up the top half of the knee joint. If this bone rotates too far, it alters the interaction of the knee cap joint, causing higher forces over a small surface area (PAIN). So the correct hip/trunk strength exercises when indicated can correct this and alleviate the problem in most cases.

Follow this link for some great examples of runner specific hip/trunk strengthening: https://www.youtube.com/watch?v=bOzhXX9JvuE

Foot and ankle factors can also be present. Namely, excessive pronation causing the same rotational issue at the knee. Current research supports a greater influence from the hip than the foot/ankle, however I have seen both areas clinically relevant. Footwear selection is very important and full-length inserts can be helpful in some cases.

Some training errors can tease this problem to the surface, mainly hill work or stairs, in which corrections in the training program can then be helpful.

Patellar Tendonitis
This means inflammation of the Patellar Tendon, which sits below the knee cap and anchors into the top of the shin bone.

Symptoms: Pain below the knee cap which can be described as burning or aching. This is made worse by running, jumping, stairs/hills, getting up/down from chairs, squats, or lunges. Swelling is more likely here and the tendon can be very tender to the touch making kneeling difficult.

Treatment: Local anti-inflammatories, as mentioned above, are also helpful here to help with symptoms. A patellar tendon strap can help with force dispersion at the tendon’s insertion into the shin bone, but is only a band-aid to the problem. As with patellar-femoral pain, similar factors at the hip and lower back need to be evaluated to determine the real cause of the issue. Quad muscle strengthening can be helpful, but needs to consist of the right exercises introduced at the right time. Runners should not do seated knee extensions while they have patellar tendonitis as this will directly strain an already over-strained tendon. Incorporation of the right hill work, squat, lunges, etc, when introduced at the right time can be helpful.

IT Band (Friction) Syndrome
Symptoms: Sharper pain or rubbing/snapping sensation at the outer—>front of the knee. This pain is usually worse at a specific point in the stride, occurring when the knee is bent about 35-40 degrees (landing or lift-off of the leg). It can also be pain full with getting up/down from the floor, squats, lunges, etc.

IT Band SyndromeTreatment: Again, local anti-inflammatories can help. ITB strap or taping can help with symptoms only. Mobility of the hip and low back, as well as strength of the hip, are crucial to normal function of the IT Band during running and are common causes to the problem.

Follow these links to see good video examples of hip and low back mobility exercises.

Foam rolling the thigh and the hip, in addition to footwear and altering your training route (avoidance of running on the same side of a cambered road every time) are also important. Lastly, cadence is very relevant here and improving your foot strikes per minute can be beneficial.

Follow this link to see how to use a foam roll on your thigh: https://www.youtube.com/watch?v=w-50YlLbIa0

Plantar Fasciitis(osis)
This means inflammation/breakdown of the Plantar Fascia, which is a connective tissue at the bottom of the foot that anchors into the heel bone. This tissue helps support the arch and gets abused when the arch is collapsing for one reason or another.

Plantar Fasciitis

Symptoms: The hallmark complaint is pain at the bottom of the heel with the first few steps in the morning, or after a prolonged period of sitting. This pain can be sharp and will cause a limp.

Treatment: Local anti-inflammatory treatment to help pain, however this problem is no longer thought to be an inflammatory issue, so it is most likely that icing helps to reduce pain or surrounding fat pad irritation. Footwear or insert selection can make a big change in symptoms. There is not any evidence for custom vs. over-the-counter orthotics at this point, but I have found results with either dependent on the patient. Rigid night splinting is well supported in the research, but can be inconvenient to use. Improving ankle, hip and low back mobility, calf stretching, and foam rolling the back of the lower leg can be very helpful.

Follow these links to gain ankle mobility and use a foam roll to the lower leg;

As with all running overuse injuries, your training plan and weekly-monthly-annual mileage plan is very important. Many times, I will spend as much time with a patient talking about mileage quality and quantity as we will on items specific to their injury.

Many overuse injuries start slowly, with mild symptoms at the onset and finish of a run. As the injury progresses, the symptoms last longer at the beginning and show up earlier at the end of the run. Finally, symptoms are present with non-running activities.

It is not advised to run through any symptoms that have become consistent and more frequent. This is a sign of a problem that will only build as you continue to run, costing more time, effort, energy, and money to figure out.

Thanks so much for all the great information, Calvin! For more information on other running injuries or for specific questions, you can connect with Calvin here:

Website: http://www.deutschphysiotherapy.com

Email: info@deutschphysiotherapy.com

Phone Number: 414-395-1079

Stay tuned, runners! Calvin will provide a second post about running injury prevention in the next few weeks.

Keep Running MKE – you’re doing great!