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CHP Spotlight Interview Series: Dr. Anjali Dsouza

Single-Leg Strength Training Exercises That Reduce Your Risk of Injury

Years of performance physical therapy have revealed that running injuries are often caused by repetitive stress injuries when running. The better you can control the adverse effects of repetitive stress, the fewer injuries you’ll get as a result.

One simple way to control repetitive stress is by implementing single-leg strength training exercises into your training. The benefits of these exercises are numerous. Not only will single-leg exercises increase a runner’s ability to shock absorb in a single leg position, but they’ll also decrease ground contact times, resulting in faster pacing. Lastly, because of your improved capacity to handle stress, your risk of injury is diminished.

Here are some great single-leg exercises to start incorporating into your strength training routine:

  1. Single-Leg Snapback

Single-leg snapbacks help runners improve footstrike mechanics and better understand the impact of different body positions.

Single Leg Snapback

  1. Single-Leg RDL’s

The single-leg RDL is a perfect exercise to train the glutes and hamstrings effectively. This exercise also helps eliminate strength imbalances between the left and right sides of the body, increasing lower-body stability and protecting the knee from injury.

Single Leg RDLs

  1. Single-Leg Bounding Drills

Bounding drills are great for improving force absorption qualities when running or jogging. These drills will help enforce proper trunk, hip, leg positioning, and control needed to land stably on every stride. There are a couple of great bounding drills, but our favorites are Single Leg Forward Bound + Stick⁠, Single-Leg Forward Triple Bound + Stick, and the SL Lateral Bound + Stick⁠.

Single Leg Bounding

Are You Ready to Start Running Again? This Self Assessment will Help!

Are You Ready to Start Running Again? This Self Assessment Will Help 

If ankle injuries occur, it’s important to give your body time to recover. That said, how do you know when you’re ready to run again? This short self-assessment is used in sports physical therapy in Bethesda and Chevy Chase to gauge when patients are ready to return to running after an injury.

  1. Do you have enough dorsiflexion?

Dorsiflexion is the action of moving the foot upwards towards the shin. The degree of dorsiflexion in the foot/ankle plays a major role in avoiding injury, increasing speed, and improving efficiency.

We recommend dorsiflexion of 15 degrees or more before a return to running.

  1. The single-leg hop test

Can you perform a single-leg hop (at least a couple feet) with a soft, steady landing that’s similar between both feet? Athletic physical therapists frequently use the single-leg hop test to determine the patient’s ability to return to high-level athletics after an injury.

In addition to comparing your results to the accept recovery rates, it’s important to measure how your ankle feels when performing a single-leg hop test. Ideally, the pain level during the test should be 0/10.

  1. Is cardiovascular health good enough?

After several weeks or months of inactivity, there’s a good chance the patient’s cardiovascular health has declined. To return to running safely, it’s important to increase running time and distance gradually. This ensures the body has enough time to adapt to the added stress of running again.

Injuries are bound to happen at some point. The key is to give your body enough time to recover by making sure you don’t return too soon. By following this simple self-assessment, you’ll help ensure you don’t re-injure yourself by returning before your body is ready.

A Physical Therapist’s View: How Does LeBron’s Ankle Injury Impact His Season?

Los Angeles Lakers star LeBron James is out “indefinitely” after suffering a high ankle sprain in a recent game against the Atlanta Hawks. “Indefinitely” paired with “high ankle sprain” is usually a bad sign in the sports world. However, from a performance physical therapy and performance training perspective, LeBron’s injury would likely have been much worse had it not been for his rigorous off-season training program.

A high ankle sprain occurs when there’s tearing or damage to the ligaments (known as the syndesmosis) located above the ankle. Less common than low ankle sprains, high ankle sprains caused by a sudden turning, cutting, or twisting motion. Athletes playing high-impact sports that require frequent running and jumping, such as basketball, soccer, football, and lacrosse, are at higher risk for these more severe sprains.

The average recovery for high ankle sprains can take significantly longer than typical sprains. In general, it takes roughly 6–8 weeks to fully, though it can take up to 3 months in severe cases. LeBron is expected to be out “indefinitely” as he recovers from his recent injury. However, given his intense training and recovery regime, it’s likely that he’ll be back on the court sooner than expected.

After watching the gruesome video of Solomon Hill tripping into LeBron’s ankle, it would have been easy to assume a severe injury. However, LeBron’s off-season training program may have kept his ankle sprain from becoming something more serious. Still dominant in his 18th year in the NBA, LeBron’s continued focus on training and recovery is very apparent. For the past 16 years, LeBron has worked with trainer Mike Mancias, who helped LeBron continue to dominate by focusing on nutrition, mobility, and strength training.

Most people think that strength training can prevent injuries. However, strength training often just prevents injuries from becoming more serious. It’s hard to avoid certain things from happening in a game. That said, off-season training can help prevent injuries from becoming severe.

Two Common Reasons You Have Neck Pain (And How to Fix It)

Neck pain is a common complaint of people seeing a physical therapist in Chevy Chase or Bethesda. Although a variety of different factors can cause it, two of the most common explanations of neck pain and discomfort are rib cage stiffness or overtraining.

One effective treatment of neck pain can be to reduce any rib cage stiffness that may be causing a lack of mobility below the neck. The muscles of the upper back and shoulders attach directly to the neck and can cause tension when unable to expand freely. To have pain-free neck mobility, the rib cage must be able to expand 360 degrees.

One simple method to improve rib cage stiffness is with a breathing exercise such as Rockback Breathing off an elevated surface (see below).

Rockback Breathing on a Bench

Another common cause of neck pain in our patients is overtraining. When patients disregard the warning signs and continue to push themselves, there is an increased stress response throughout the body. This causes the accessory respiratory muscles to work harder, thus developing neck stiffness and discomfort.

If overtraining is the issue, it can help take a couple of days to give your body time to rest and recharge. Similarly, it can be invaluable to work directly with a professional to ensure overtraining doesn’t become a long-term issue. Although it’s enticing to continue to train harder, you can usually achieve better results by giving your body more opportunity to recover.

When your neck pain has persisted for longer than a few weeks, it’s time to meet with a professional who can help identify more subtle reasons for the discomfort. If you’re in the Bethesda or Chevy Chase area, our physical therapists can help you get back to living your life pain-free!

Why Your Big Toe Matters

Our poor big toes. They are one of the unsung heroes of our lower extremity and are integral for walking, running, and optimal function during standing activities. We commonly focus portions of treatment within an athletic physical therapy session to big toe function.

The big toe helps with shock absorption and propulsion while often bearing over 50% of our body weight. It provides an essential role in sustaining the arch of the foot, thus setting the stage for optimal function of the rest of the foot.

For these reasons, people that suffer big toe amputations typically experience balance deficiencies and struggle with a variety of upright activities.

The great toe needs approximately 60 degrees of extension for walking, specifically during the terminal phase of gait (push off) when the weight is on the front of the foot and the heel is off the ground.

Even more motion is needed for running and athletic activities like sprinting. We commonly find that our athletic patients have limited great toe mobility which forces the body to compensate, and increases the risk for overuse injuries elsewhere.

A good target for a committed runner or athlete is 90 degrees of great toe extension, which you can test on yourself!

Begin seated with your foot flat and relaxed on the ground. While keeping the balls of your feet on the ground, use your hand to lift your big toe up towards the ceiling. Can it reach 90 degrees and get perpendicular to the ground?

If not, our Director of Education, Dr. Alex Immermann has a fantastic drill to help you! Check it out below!

Big Toe Extension PAILs/RAILs

If this drill created any pain or discomfort, please contact us.