Rebuilding Your Body Post-Marathon and Post-Injury

Wilson Kipsang set a world record in the marathon of 2:03:23 in Berlin on September 29, 2013.  Here is your opportunity to learn from the fastest marathoner the world has ever seen!  His philosophy to rebuilding after the marathon applies to both running training and recovery from injury:


"After every marathon, Wilson spends about 2 months going in the gym of Lornah Kiplagat, for rebuilding the level of strength lost during the specific training for long distances, and maintaining high level of flexibility and reactivity.  This is something other athletes don’t do, preferring to rest waiting [until] their body can again be able to work at its best.  Specifically, we can see the difference of mentality between Wilson and other top runners in the behavior after some injury: the most part await [most of them believe that] the time can solve the problem, totally resting and looking for some business, while Wilson has in his mind the priority to attack the injury, giving [it] great importance."

- Renato Canova, coach of many elite runners around the world


When you train for a marathon, you lose muscular strength in the final training period if most of the marathon-pace long runs are performed over flat terrain.  Of course, fast long runs on the flat are exactly what you need to achieve a peak performance in a flat marathon.  Specificity rules!  But, after finishing the marathon (hopefully with a PR!), you are not only extremely fatigued, but also at your lowest level of muscular strength.  The flat long runs and the marathon itself have brought you to this state.  What can you do to make sure that your next race is successful?  Rebuild your strength while slowly increasing the volume of easy running in your routine.  Participating in some cross-training activities (cycling, swimming, rowing, etc.) in replacement of easy running in the first week or two back can be helpful as well.  DO NOT perform fast long runs, intense tempo runs, or any other strenuous running workout that will push you further into the hole.  Your #1 priority needs to be rebuilding your running-specific strength (see Hill Workouts #1 and #2)!

Canova's last line is one of his best.  Remember, resting a running-related injury can only do so much.  We must "attack the injury" through focused interventions to achieve functional, pain-free running.  At FLASH Sports Physical Therapy, we take this approach very seriously.  Even if our patients are taking a brief rest from running, they are performing tolerated cross-training activities and running-specific therapeutic exercises and activities in the interim.  This method enables them to return-to-running even better than before!  Stronger, more stable, and more knowledgeable regarding preventing injury recurrence = consistent, smart training = FASTER TIMES!

Should Runners Learn to Dance? Physical Therapy and Performance Implications (Part 2)

In Part 1, we discussed several observations involving the sports of running and dancing.  These observations lay the groundwork for this post, so if you have not read Part 1 yet, I suggest you at least skim it.

Now....some of you may be asking yourselves, "What do these observations mean to me as a runner!?"  Today I'd like to delve deeper into one of my methods for developing functional single-leg stance (adapted for runners from the Selective Functional Movement Assessment).  Remember, this method also applies to the early rehabilitation of dancers, so if you run by day and dance by night, listen closely!

First, let's take a look at dysfunctional single-leg stance:

Front view                                                      Back view


















Do you see how this runner is leaning away from the leg on which he is balancing?  He is unable to stabilize his body through his trunk and lower extremity.  So, if you exhibit dysfunctional single-leg stance like the runner above, how should you go about developing a functional one?

As a sports physical therapist, my first goal is to help teach my patient the feeling of functional single-leg stance.  In other words, I use inexpensive tools to encourage the body to activate the required stabilizing muscles.  Check out the picture below.

                        Single-leg stance with trunk musculature activation**

**Take note of the 90-degree angle at the L hip and knee as well as the upright trunk position....think of trying to stay pencil-straight from your stabilizing (planted) leg to your head.  Proper positioning of the band involves hanging it around an object like a weight machine or a tree and pulling it towards your body with palms down.  Make sure that you have enough tension in the band.

I am having the patient use a band (can be a piece of Theraband or other stretch-like material) to facilitate activation of the trunk musculature.  One of the main reasons runners display dysfunctional single-leg stance is because they are not able to engage the trunk in concert with pelvic stabilizing muscles and the respective lower extremity.  If you utilize a band as illustrated above, you will notice that you can more easily maintain the single-leg stance position.  At that point, you are beginning to teach your body proper muscle activation patterns, which are extremely important for injury-free running.  How long should you maintain this position?  Enough time to challenge yourself.  Build up to 4-5 sets of 45-second bouts.  When you can maintain functional single-leg stance with the band for 45-seconds at a time repeatedly, retest yourself.  I'll bet that your once-dysfunctional single-leg stance is now functional = minimum of 10-seconds maintaining proper form without losing your balance.  Obviously, additional progressions for this functional movement exist, but the exercise illustrated above is the BASE for more advanced sequences.

Following development of functional single-leg stance, a series of low-level plyometrics is often initiated, beginning with double-leg hops and progressing to single-leg hops.  This portion of the exercise prescription following a running-related injury can be quite tricky and is best completed under the guidance and supervision of a physical therapist who specializes in treating runners.

If you have any questions or comments regarding the information just presented or a personal running-related injury question, feel free to contact me at jrbst2@mail.francis.edu or via DoctorJunes on Twitter.  I would be happy to help you in any way that I can.  And please, don't be like one of the dance accidents in the YouTube video below!