Is there one physical therapy intervention for running related foot injuries?

Ice baths, massage, compression socks, orthotics, rolling your feet out on tennis balls…

Have you tried one or more of these without much help?

This is Dr. Kelly, and as a passionate runner, sports physical therapist in McLean, and someone who doesn’t want to be interrupted by injury, I’ve learned foot pain is complex- there’s usually not “just one thing” contributing to it.

Here are a few things I’ve found to be most important in physical therapy when diagnosing foot injuries:

Foot Type, Biomechanics, and Shoe Type: Each runner has a unique foot structure and biomechanics. High arches, flat feet, overpronation, and supination can affect how your foot strikes the ground. It’s crucial to understand your foot type to choose appropriate footwear and support. Here is a link that better explains foot type. Ensure that your shoes provide adequate cushioning, arch support, and fit your foot shape properly. Regularly replacing of worn-out shoes is essential for injury prevention (recommended replacement after 400 miles of running).
Running Surface: The type of surface you run on can impact foot pain. Hard surfaces like concrete can be harsh on your feet, while softer surfaces like grass or trails offer more cushioning. Varying your running terrain can help reduce the risk of repetitive strain injuries.
Running Form and Mechanics: Variations in running form can strain muscles and joints differently. Understanding your form and what muscles are dominating during your run is important to building strength and endurance as well as overall mechanical balance. A Marching, Skipping, and Single leg hopping are great drills that help enforce foot strike directly under your center of mass and tendon elasticity while running.
Training Intensity and Volume: Overtraining or increasing your running intensity too quickly can stress your feet. Gradual progression and adequate rest are essential for preventing overuse injuries. In general, the best guideline to follow is to increase your volume by 10% per week.

Remember that everyone’s body is unique, and what works for one person may not work for another.

If you would like to finally solve the lower body injuries that are interrupting your ability to run successfully, don’t miss this FREE workshop..
“CHP’s Running Performance Lab”
Saturday, October 21st at 9am
Cohen Health and Performance
1401 Chain Bridge Rd, Suite 203
McLean, VA 22101

In this workshop, you will discover the root cause of your injuries and learn exercises to solve them.

We only have 5 slots left, so don’t miss your chance to sign up here.

Nagging injury? Don’t miss this interview!

In this very special edition of the CHP Spotlight Interview Series, I chatted with my physical therapy colleague, Dr. Kelly Henry.

Her recent article about dry needling created a lot of interest and several questions (check that out here). What better way to answer them than to ask the expert herself?

As many of you know, Dr. Kelly is the Clinic Director of our McLean location and an amazing sports physical therapist and strength coach.

In this interview, we tackled many of your questions such as:
-Does dry needling actually work? If so, how?
-Can dry needling help me with my injury?
-Does it hurt?!

If you have a frustrating injury that just won’t go away and/or are considering physical therapy, don’t miss this interview!

To learn more about Dr. Kelly, click here.

Runners rejoice: how dry needling can help you

It must be your lucky day because we have another guest post from the Clinic Director of our McLean location, Dr. Kelly Henry!

Do you have tight muscles or knots that won’t go away? Maybe you have even gone to physical therapy elsewhere but made minimal progress!

If you are anything like me, you have tried massage, foam rolling, stretching, and whatever else you can think of, but they keep returning.

Dry needling could be the solution you are looking for. Running is a very linear and repetitive sport, which increases the risk of developing muscle tightness and symptoms related to overuse. Many runners have experienced relief of chronic quad, calf, hamstring or hip flexor tightness from dry needling.

I recently helped a runner during a physical therapy session at our McLean facility that was experiencing consistent calf pain. It was most intense in the middle of his runs and forced him to reduce his overall mileage. He did everything that he could to fix it. He spent a lot of time warming up before runs, cooling down after runs, and he stretched constantly. But nothing helped.

His first physical therapy session included dry needling for his calf muscles, range of motion drills, and a few adjustments to his running technique, and the chronic calf pain went away!

Dry needling works by targeting a muscle limiting range of motion or causing pain. Your physical therapist will identify which muscle is causing the problem, identify “trigger points” in the muscle, and create a “twitch response” with the needle. A twitch response is a quick contraction that helps the muscle relax. People often feel better just a few moments after treatment! Here are some of the things that my runners have noticed after dry needling:

Less tightness during and after runs
Improvement in muscle soreness
Faster recovery from nagging injuries
Improved range of motion and muscle activation during cross training

Dry needling is best used with other forms of physical therapy and rehabilitation, including exercise and neuromuscular conditioning.

If you are a runner that is struggling with chronic injuries or tightness or is looking to optimize your recovery, contact us for a dry needling session in our McLean facility today.

Speaking of serious runners…we have 2 slots still available for a FREE Resilient Runner Injury screen at our McLean facility. If you want to run injury-free for years to come, don’t miss this!

This screen involves the use of our exciting, new Forcedeck technology. Learn more about that here!

How I ran through my achilles injury

We have another special guest post for you! Dr. Kelly Henry is the clinic director of our McLean location, in addition to being an amazing sports physical therapist and strength coach. Kelly was a successful collegiate swimmer at Virginia Tech and now spends much of her free time dominating triathlons (placing 2nd in her most recent race!). Enjoy!

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Most runners know what I’m talking about – that dull, nagging pain at the back of your heel that does nothing more than get on your nerves. It’s usually not enough to stop you (or send you to physical therapy), but you spend a few miles during each run just waiting for the pain to subside or stretch before a run, hoping you don’t feel it.

This is how I felt for months while training for my first triathlon. I blew through the initial weeks of my training, adding mileage with no problem – until I started to feel pain in the back of my heel at the beginning of a long run. The pain disappeared during the run, so I thought, “no big deal.” Until the pain returned the next morning, and the morning after that, until it was interfering with my daily training schedule. I refused to change my volume or intensity of running because I was determined to complete my training program and hoped the problem would resolve itself. When it didn’t, I sought the advice of one of my physical therapist colleagues. Going from a provider to a patient was humbling, but here’s what worked for me:

1) I adjusted my volume

Many of my symptoms decreased once I admitted I needed a little rest. Combined with the two tricks below, I added running back in small chunks at a time. In general, I tried to increase my mileage by no more than 10% per week.

2) I gradually improved my calf and lower leg strength

Tendon injuries happen when a muscle isn’t ready for the physical demand being placed on it. Isolated calf and lower leg strengthening is crucial for improving the tolerance to load and decreasing the demand placed on the Achilles tendon. Exercises I added to my daily routine included bent knee heel raises and different split squat variations with my heel elevated.

3 I addressed the factors contributing to the cause of my injury

Besides strength and volume, there were specific mechanical changes I needed to make to optimize my running form and prevent this injury from happening again. I improved my ankle range of motion and learned to absorb the impact of the ground more effectively. Some drills to improve this included single leg box jumping and weighted single leg hopping.

Are you a serious runner desperate to overcome an injury?

If you are someone that wants to run injury-free for years to come, our Resilient Runners Movement Screen is a cannot miss!

This screen involves the use of our exciting, new Forcedeck technology. Learn more about that here!

CHP Spotlight Interview with Dr. Jamie Grossman

What can you do to prevent common upper and lower body injuries? When is it time for you to see an orthopedic surgeon? Are there surgical procedures that can preserve the lifespan of a joint?

I sat down with Dr. Jamie Grossman to tackle these questions and more in the latest CHP Spotlight Interview series edition. Dr. Grossman is an orthopedic surgeon with OrthoVirginia specializing in the field of joint preservation. Her areas of interest include sports medicine, joint reconstruction, and hip preservation.

The mission of the CHP Spotlight Interview Series is to share information with you from local experts in the fields of sports medicine, physical therapy, personal training, and sports performance. Now, more than ever, a seemingly infinite amount of information is available, and finding credible information is challenging. But we have good news. We are here to help you find the best information about physical therapy, personal training, and sports medicine from experts in Bethesda, Chevy Chase, DC, McLean, and Northern Virginia.

If you or someone you love has had a shoulder, hip, or knee injury, don’t miss this interview!

To learn more about Dr. Grossman, click here and check out our interview below!

My shoulder pops. Is that bad?

I call these rice crispies. Snaps, crackles, and pops are typical in the shoulder and a concern for many physical therapy patients.

Rice crispies occur in the shoulder for many reasons. The shoulder joint has the most range of motion in the entire body. But with great mobility comes great responsibility!

The large amount of motion in the shoulder provides many ways to compensate. If the quality of shoulder movement is poor, it risks becoming unstable. Excellent movement quality is challenging in such a mobile joint, so the shoulder is commonly injured.

But before you worry too much about rice crispies in the shoulder, ask yourself if it is painful. If it is painless, it may only be a harmless joint noise known as crepitus, simply pressure released from the joint. Crepitus is what happens when you crack your knuckles.

But, if there is pain with the noise, consider seeing a physical therapist like our team here at CHP.

Movement compensations in the shoulder and repetitive use can irritate several tissues within the shoulder. One example is rotator cuff tendinitis, which is a common sports physical therapy injury in Bethesda and McLean.

Tendons are the cords that connect muscle to bone. The rotator cuff tendons can become worn down over time, much like the sole of a shoe that eventually wears apart. If left untreated, the result is a tearing of the rotator cuff tendon, resulting in increased pain and an inability to exercise or train fully. Limitations can progress further, affecting sleep, strength, and the ability to use the arm with daily activities.

The most important thing is to figure out why the pain or rice crispies started in the first place.

Small rotator cuff tears, arthritis, and joint damage is expected within the shoulder. But there is still a great deal that you can do (without surgery) to get out of pain and back to performing the activities that you love.

A great sports physical therapist will help you identify the root cause of your symptoms so that you can continue to exercise and enjoy your active lifestyle.

Contact us if you have questions about how we can help you with shoulder pain/popping and get you back to doing the activities you love.