PFATS – Mike Ryan Sports Medicine

Time For Change

Football’s in the air. It has a way of making sports seem legitimate again. The buzz of training camp and how “my team” will do this season has dominated social conversations and social media this week.

For me, the excitement for another NFL season is here but for very different reasons.

The year was 1987 and I was a junior in physical therapy school at UConn. That was the last summer I didn’t spend in an NFL training camp up to now. I had spent the previous 3 summers, starting in 1984, as the New York Giants summer athletic trainer intern.

In contrast, I spent that 1987 summer working as a physical therapy intern for the Visiting Nurses of Hartford (CT) as part of my physical therapy school requirements. After 3 summers of living out my childhood dream of working with an NFL team, I was cleaning bed pans, cleaning infected wounds and rehabilitating disabled elderly patients in housing projects. Career Plan: Get into the NFL…and FAST!

This past February I stepped down from my position as Head Athletic Trainer/Physical Therapist with the Jacksonville Jaguars to enjoy my important role as a father and husband. It wasn’t an easy decision after 26 seasons in the NFL but when I see the joy in my two young children and wife’s faces when we have breakfast together every day, I know it was the right decision for the right reasons.

The Jags have their first training camp practice today. I’m cheering for them to have a great season, as I always have. Something will never change. Sure, I’ll miss the guys, my staff, the laughs, the practical jokes, the rush of seeing players overcome injuries to get back on the field, the endless trays of food and, obviously, I’ll miss the energy of game day.

As for me professionally, exciting changes are here. I’ve created a new company, Mike Ryan Sports Medicine, Inc., to manage my new physical therapy clinic and consulting business along with other fun sports medicine projects. As for the details of those “other” endeavors, you’ll have to wait on that….

In the meantime, I’m thoroughly enjoying the change. Change in my schedule, change in my involvement with my family’s lives, change in my stress level, change in my workout routine (!!), and a healthy change in my professional challenges.

Change is good when the passion is enhanced. Mission accomplished.

Fun times are here and it’s only getting better!

Upcoming Sports Medicine Tips!

I stopped by Home Depot on the way home from work last night. This time of the year in the NFL, I have to do most of my home project shopping at night. I ran into a friend of mine who was in obvious pain. He had low back pain that was hurting him 24/7. He asked for my help to decrease his lumbar pain.

I showed with him 2 quick sports medicine tips while standing in the “Electrical Supply” section of Home Depot. The first tip was to increase his pain-free low back range of motion and the second low back technique is specifically designed to decrease his lumbar pain. Bill’s pain quickly decreased “a ton” and he gratefully thank me. It’s always very satisfying to me to help those in pain regain their lives back!

My friend Bill called me early the next morning enthusiastically bragging about how much better he felt. This is the best part of my job, when I see someone healthy and happy after being so debilitated. All it took was about 5 minutes of my time to share simple sports medicine techniques that my staff and I use each and every day with our NFL players.

“I knew you were good at what you do, Mike” he said respectfully, “but I was truly amazed how simple your techniques were and how quickly I felt 70% better”. He went on to say: “You need to tell more people about your physical therapy tricks like I did last night to help them to get better like that” he said snapping his fingers.

I receive about 3-5 sports medicine questions a day from friends, coworkers, friends of friends,…etc via phone, in person, text or email. I view it as an honor that so many trust my medical opinion and I love helping their efforts to be healthy again. It takes little time yet the rewards for both sides of the problem are huge. That’s always been my motivation to create and build MikeRyanFitness.com.

What Am I Going to Do About It?

My friend was right. I need to expand my Personal Mission Statement: To Enhance the Health of Others by going SMALL.

Starting today, I will be Tweeting and posting on my FaceBook page short and effective sports medicine tips. These Tweets will obviously be 140 characters or less so they will be simple and to the point to help you get back to being an athlete again ASAP. I’m excited to share with you quick weekly #SportsMedTip that are designed in the MikeRyanFitness manner: They are easy to understand, simple to apply & provide fast result!

I Need Your Help

My goal is to positive influence 2,000,000 people by the end of 2013. If you like my sports medicine posts and you think they can help others, please take a couple of minutes to share them with others. By doing so, you’re helping me to help others.

Please keep the questions and comments coming. The feedback from you the moms and the dads, the athletes young and old, the runners and the basketball players,…etc that help me to provide you the type of sports medicine advice to keep you in the game.

Thank you! MDR

Gameday For An NFL Athletic Trainer

Gameday in the NFL. It’s easily the best day of the week for players, coaches, athletic trainers and, of course, the fans.

I’m often asked: “What do you do on gameday during the season?” I’m currently in Minnesota with the Jaguars as we prepare for our season opener against the Vikings. This is the start of my 25th full-time season in the NFL so I know how blessed I am to be able to work in my dream job for over 1/2 of my life.

Let me show you what a typical gameday looks like for an NFL athletic trainer for a road game.

5:00 AM– Wake-up, workout, do my own core & flexibility exercises and review notes for pre-game injury updates for the head coach. This is the last quiet time I’ll have until later tonight so I enjoy the last of my “me time” while I can.

8:00 AM – Refreshed and relaxed, its time to head to the team breakfast. I check on injured players with my medical staff for any last-minute surprises. Note: we don’t like medical surprises on gameday.

8:45 AM – With medical staff and supplies, we head to the stadium to prepare for the game ahead of the players. The prepping of supplies – about twenty-five miles worth of tape, twenty-five gallons of fluids and forty-five jock straps along with the trunks of emergency equipment is completed the night before by my awesome assistants Justin Bland and Rod Scott. We’re fully dressed in game attire – minus the game shirt in favor of a T-shirt – it’s “work time” to prepare 45 players and staff for the game.

9:30 AM – The first of the buses arrive and it’s “go time” for us athletic trainers. What does this mean? We put to use our sports medicine skills such as taping 80+ ankles, aggressively preparing the players with massage, manual therapy techniques to increase joint range of motions, soft tissue treatment to enhance muscle and fascia blood flow, flexibility drills to promote movement patterns and the many pre-game routines that these world-class athletes need to compete at an elite level for 3+ hours. Most players have little rituals that they need to strictly follow in the athletic training room in order to have that “great game” – some may call it superstitions. Each player has a solid routine that they always follow such as a certain sequence of stretches or exact placements of athletic tape.

10:30 AM – The fast pace and high energy pre-game work continues along with updating the staff about important medical issues related to the players for the game that may impact coaching strategy and player availability.

12:10 PM – As the players head to the field for pre-game warmups, the medical staff follows. The unwritten rule: “If the Athletic Training Room gets quiet, you’re probably last for something.” Run to the field!

12:20 PM – Check every sideline trunk, supply and emergency gear one last time. I like to watch my injuries players to see how they move during warmups as well. I introduce myself to the sideline support staff, review emergency details with the paramedics, meet the airway management physician, review the communication format with the athletic trainer field observer and have fun catching up with the other NFL teams’ medical staff. We traditionally wish them few injuries but the “good luck in the game” is always said with a smile on our faces because we know it’s a lie. As one of my fellow PFATS athletic trainer said to me before a big game: “Don’t give me that BS Ryan! We want to kick your ass just as much as you want to kick ours!” He was 100% right!

12:45 PM – Update the team VIP’s of anything related to the health of our players. I strongly stress to the player the need to hyper-hydrate and to get any needed sports medicine assistance now. The locker room is buzzing with energy as we get ready to take the field and do our job. It an awesome and fun environment to be around. This is the first time I usually put my “To Do List” aside and really get fired up for what’s about to happen on the field!

1:00 PM – The loud “They’re Heading Out!” cries out and the medical staff, with our pockets and medical belt packs properly stocked, excitedly head to the tunnel.

1:04 PM – The traditional high-fives, ammonia caps, words of encouragement and nervous claps on the shoulder pads are handed out as the deafening crowd noise makes it impossible to keep my composure. I shake the Head Coach’s hand as I hand him a drink of water and follow through on a few player pre-game rituals, it’s time for the kickoff. The energy, the noise and the look in our players eyes is addicting! “THIS is why I love this job” echoes in my head and it’s such a rush to be right there as the stadium begins to rock! As to what I scream at that point, I’ll keep that to myself….

1:05 to 4:15 PM – monitoring the field, racing out to evaluate and treat injured players, updating the Head Coach, position coach and special team coach on every injury on issues that affect performance, administering first aid to injured players, conversing with our doctors and assistant athletic trainers on medical injuries, taping/splinting/bracing injuries as needed and providing positive reinforcement to struggling players are just some of the duties that I juggle on the field during a game. It’s multitasking at it’s best in a high energy and testosterone-filled setting with one eye on the field and one eye on the players on the sideline.

4:30 to 5:45 PM – The post-game buzz. No matter a win or a loss, I evaluate and treat post-game injuries and prepare them to fly back to Jacksonville. The use of x-ray, specific sports medicine techniques and supplies helps this medical process run smoothly.

5:45 to 5:55 PM – Strip, run to the shower, put on suit and tie and race to the waiting 5 team buses.

6:30 PM – Security check and board the plane, hopefully with a victory in hand. Update the VIP’s on medical issues, coordinate the icing and positioning of the players with my assistants for the long ride home. Finalize any special tests and morning treatment lists.

30,000 feet – Eat something healthy & relax.

I love my job as an athletic trainer & physical therapist in the NFL. It’s not easy. It’s a 7 day a week job for 6-7 straight months but I’m not complaining. I love the challenge and the responsibility associated with my role. I have an outstanding medical staff with a simple objective: To keep the players in the very best of health to help them to do their job.

#1 Tip to Heal a Hamstring Strain

With the 2012 NFL pre-season in full swing, there is one things you can count on: Hamstring injuries. Anytime you combine highly competitive and dehydrated athletes who sprint for a living, soft tissue injuries such as hamstring strains and groin strains are a realistic result.

A torn hamstring is a common injury for athletes at all levels of sports. We joke in the NFL that the “big guys in the trenches”, the offensive and defensive linemen, are too slow to pull a hamstring but they too are vulnerable. Even the non-athletic person is prone to hamstring tears with slips and falls during activities of daily living.

Recovering from a torn hamstring is no joke and it can prove to be one of the most frustrating injuries to overcome. I can help make your hamstring recovery fast and successful with sports medicine techniques commonly used in the NFL.

The Anatomy

The hamstrings are 3 muscles on the backside of the thigh. They start at the lower back pelvis and upper thigh bone (femur) just below the butt muscles to just below the back of the knee. Two of them swing around the inside of the knee just below the inner knee joint line while the other hamstring muscle anchors to the outside of the lower leg just above the calf muscle.

The function of the “hammy’s” is complex depending upon the position of the lower leg and the combination of the muscles asked to assist the activities. In an effort to keep it simple, lets just think of the hamstrings as having two main functions: Knee flexion and helping with hip extension.

The Injury

Hamstring strains can take place from the origin, the palpable bone just below the butt cheek, to below the knee and anywhere in between. The most common site is in the belly of the muscle themselves about 1/3 of the way down the back of the thigh.

Athletes will report feeling a “grab”, “stab” or “pop” in one location. Due to the important role of the hamstring with running, fast running and changing directions are the most common activities to tear a hamstring. Over-stretching the hamstrings with a fall or forceful hip flexion are also common mechanism of injuries.

A hamstring injury takes place when some of the muscle fibers are torn, resulting in bleeding into the muscle(s). The function of each muscle fiber is to contract and shorten the muscle over the hip and/or knee joint. When the muscle fibers, similar to very small rubber bands, are damaged it can involve as few as a dozen fibers to as many as a few thousands. Muscle strains are graded from 1 (minor) to 3 (severe) depending upon the size of the muscle defect and the resulting limitations.

The Cure
Overcoming a torn hamstring is difficult and often frustrating for an athlete. I have a simple tip that will both improve the symptoms of a hamstring strain and reduce the recovery time by 50%! I learned this trick the hard way while rehabilitating elite athletes in the NFL for 24 years. It may sound way too simple but trust me if you want to cut your downtime in half to return to the sports and activities you love.

The #1 Tip for Accelerated Recovery for a Hamstring Tear: Avoid all hamstring muscle stretching for 72 hours after the hamstring injury.

I know what you’re thinking: “That’s not going to help.” With the disruption of X number of hamstring muscle fibers, acidic blood flows into the surrounding tissue. Besides the mechanical disruption of the muscle(s), the acidic blood and inflammation in the area of the muscle significantly impairs both the healing process and the function of the muscle. It has been my experience that stretching an acute torn hamstring will increase the bleeding, disrupts the initial healing process and increases the neurological protective splinting of the hamstring more than any other muscle in the human body.

The Result
I often tell my athletes as soon as they injure their hamstring to resist the strong urge they will experience to stretch the hammy’s to “just loosen it up.” By avoiding all stretching of the acutely strained hamstring for 3 days, the muscle(s) can properly form the necessary scar tissue and remove much of the waste products from the initial injury. Early stretching will disrupt the scar tissue, increase the bleeding and slow the healing process.

Obvious there is much more that needs to be done to properly recovery from a torn hamstring besides not stretching during the first 72 hours. Aggressive icing, compression, massage therapy, strengthening and promoting lymphatic drainage should all be implemented into a successful hamstring strain treatment protocol. As noted in the first paragraph of this article, proper hydration is an important link to both preventing and overcoming all soft tissue injuries.

Paying the Price for Fitness

When someone has the opportunity to spend time in an NFL athletic training room, they usually come away saying the same thing: “I never realized how hard these guys work to stay in shape!” They see the players’ dedication to the maintenance of injuries just to stay healthy enough to play the game of football. Like almost every professions, there’s much more work going on behind the scenes than anyone can see from the vantage point of the fans.

Be it the multimillionaire professional athlete or the weekend warrior, my theory is simple:

There’s a price for fitness & it’s always a winning investment!

Staying on Top of the Maintenance

Professional athletes have had to work extremely hard to get to where they are. Overcoming fierce competition, weathering critical scouting hurdles and managing injuries are common-place to simply get a shot to taste the NFL life. For those who are talented enough to play at this leve of the sport, it’s the injuries that pose the most challenges obstacle for the gifted athletes.

I have a great deal of respect for my Jaguars’ players for their dedication, sweat and tears to get better every day. 90% of them aren’t on the injury report but that doesn’t mean they don’t have extra work to do to address physical issues to be at their best. They come in to see our athletic trainers for assistance with sports medicine needs such as decreasing pain, increasing muscle mobility, improving core strength, increasing flexibility and accelerating their recovery.

It’s common for professional athletes to spend 3-4 hours per day “paying the price for fitness” with maintenance work! They realize the importance of investing in their health for today and tomorrow.

How much of an effort are YOU putting into your health?

Take Home Points

You may not be signing a multi-million dollar professional contract anytime soon but if you want to significantly enhance the likelihood of being healthy and active when you’re in your 50’s, 60’s and 70’s, NOW is the time to develop a physical maintenance plan.

Here are some tips to help you invest in your body and mind for a healthy tomorrow:

Do Something – “Paralysis by Analysis” is a common problem with those looking for the “perfect” workout plan or the dream diet. Getting out and moving while eating very little fat and sweets and drinking more water will enhance the health of all of us quickly and safely.

Lengthen What’s Tight – Stretching will improve posture, increase blood flow, decrease pain and promote the body’s natural endorphins. Find where you’re tight and simply stretch it….that’s an overly simplified statement but I’m sure you understand the concept.

Only the Strong Survive….to Live Better – Nowhere in my medical journals can I find a statement that says: “weakening your body will help you live longer”. We all need stronger muscles, bones, tendons and joints. Adding exercise that improves our overall strength at any age is a good….no, a GREAT thing.

Ice What Hurts – – You know my thoughts on ice: It’s our best friend. Sure it hurts for a few minutes but it can help decrease real pain for hours. Toughen up and ice the joints and soft tissue that’s limiting your lifestyle.

Ask for Help – Google “health tips” and you get 1.12 billion links. Don’t try to figure it all out on your own. Seek the assistance of those who can help you get healthy for the long run. It will prove to be time and money spent wisely.

Make 2012 the year when you turned your health around by taking an active role in determining the path of your health. It’s your body and it’s the only one you’ll get. If you know more about your iPhone, wardrobe and FaceBook page than you do your own body, it’s time to change your priorities! MikeRyanFitness is here to help make it easy and fun for you.

Key to Olympics & NFL Training Camp Success: Rapid Recovery

I received great questions on MikeRyanSportsMedicine.com from Carl in Texas and Maria’ in France related to how world-class athletes recovery so effectively. Recovery is one of my favorite sports medicine topics.

I was talking to our defensive back Aaron Ross a couple of days ago at our Jaguars’ practice about his speedster wife and Olympian Sanya Richards-Ross. He was bragging about her, for very good reason, and how she was racing against the best runners in the world almost every day for over a week. Although the final races get all the hype, each event has preliminary heats that need to be successfully completed for an athlete to qualify for the “big events” in the Olympics.

It got me to thinking how similar that schedule is for high-level athletes in the NFL, in college and on courts around the world. Lots of preparing, training, competing, recovering and repeating it all over again. All it takes is to look at the hectic race swimming schedule of Olympic phenom Missy Franklin to appreciate why the recovery is so important for athletes focussed on performing at a very high level while avoiding injuries.

In an NFL training camp, the 90 players on each roster will practice twice a day for as much as 4 hours per day in extreme heat wearing full football gear, lift weights 3-4 days per week, attend 3-4 hours of classroom meetings per day, study their playbook 3 hours per night and spend 3-4 hours per day warming-up and recovering. I have a huge amount of respect for these players and their dedication to the game of football!

Sports Medicine Applied

Bigger, faster and strong is the goal for most of us. Elite athletes recognize that sports medicine techniques emphasize the RECOVERY to make it all happen faster. Recovery is not as sexy as running up a mountain or lifting 300 lbs but its necessary for successful athletes at any age.

Recovery in the NFL

I’d like to show you how NFL athletes recover so quickly and effectively. These are some of the tools commonly used by elite athletes to maximize their recovery:

Cryotherapy – Cold whirlpools, ice baths, ice massage and ice bags to decrease pain and inflammation.
Rollers – To loosen the body and extremities.
Elevation – Raising the legs after a workout to promote blood flow out of the legs and speed the recovery process.
Contrast Baths/Showers – Alternating hot & cold baths or showers to flush the body’s waste products from the muscles.
Compression – To maintain tissue temperature while minimizing extremity bloating and blood pooling.
Flexibility Exercises – To lengthen the body’s muscles and enhance one’s blood flow.
Manual Therapy – Soft tissue mobilization, massage, myofascial techniques and biomechanical therapy.
Cardio Exercise – To improve increase muscle temperature and blood flow while enhancing the ridding of the body’s waste products.

In Closing

If you only remember one thing, it’s recovery is a simple process that every athlete should implement to stay healthy. It doesn’t require expensive equipment or time-consuming efforts. Make it part of your routine and you’ll be feeling like a champ!

Achilles Tendonitis vs Achilles Bursitis

This past weekend while vacationing with my family, I was introduced to Terry while we worked out at CrunchGym in Danville, CA. He is a close friend of Cindy, one of my dearest friends I’ve known for 20 years. Terry is a former elite power lifter and present fitness enthusiast. Terry approached me after our workout and respectfully asked for my medical opinion of a chronic heel injury that was significantly hampering his active lifestyle.

I was more that happy to help him and I think it will prove to be a useful example of a long-term dilemma experienced by many: “Is the pain in the back of my ankle Achilles tendonitis or Achilles bursitis?”

I’d like to share with you what I did with Terry by listening for 1 minute, asking questions for 1 minute and examining his lower extremity for 1 minute. This is just another reason why I’m so fortunate to be in the sports medicine profession and a proud member of PFATS. I’m very blessed to have the opportunity to change someone’s life by simply sharing what I love to do in just 3 minutes!

Complaints:

Terry noted lower Achilles pain behind and below the base of the Achilles tendon. Walking down stairs and ramps hurt, tight shoes made it worse and palpating the “back ridge” of the heel bone (calcaneus) increased the pain.

Terry was convinced he would need surgery and was actually calculating his downtime after surgery!

Exam Findings:

I found a tight calf muscle, a thick and firm Achilles tendon, and a puffy and tender swelling in the calcaneal bursa located at the bottom of the Achilles tendon and back of heel bone.

The “50 something” mature athlete was pain-free with a 1 legged calf raise, he noted that his calf and Achilles were stiff and sore upon waking in the morning but those symptoms quickly passed with walking. A bilateral comparison demonstrated symmetrical size and appearance with both calf muscles and feet alignment.

Diagnosis:

Retrocalcaneal bursitis, commonly referred to as Achilles bursitis.

Retrocalcaneal Bursitis Rehab Plan:

I like to keep my rehab plans simple when starting with an athlete at any age. I find this to improve the success rate significantly for two reasons. First of all, the athlete is more likely to be compliant and consistent with an easy to follow plan. Secondly, a simple 3 step plan will allow the athlete to clearer recognize improvements in their symptoms related to their rehab actions.

3 Step Plan for Achilles Bursitis:

Loosen Up the Anchor – Massage and roller on his calf muscle 1-3 times per day will reduce the upward pull from his two calf muscles and his thickened Achilles tendon. A 1/4″ heel lift will decrease the pull of the calf and Achilles and help with symptoms of Achilles bursitis and Achilles tendonitis.
Minimize the Pressure – Avoid the shoes and activities that put pressure on his lower Achilles and the back of heel bone. Terry told me he had a pair of running shoes that he loved but they put a lot of pressure on that area.
Reduce the Swelling – Ice and lots of it. Ice massage, ice backs and ice baths are all great. As you know, I’m not big fan of taking medicine. I like to positively influence swelling and inflammation from the outside-in (ice, modalities and manual therapy) compared to those that look for a shortcut working from the inside-out (medicine and injections)

Take Home Points:

The back of the ankle is a busy area and, although the Achilles tendon is a common source of pain in that area, injuries there can involve many types of tissues.
The fear of surgery is common when pain becomes chronic and an active lifestyle is hampered. Find a trusted sports medicine resource quickly to help you get back to doing what you love to do: Being Active & Healthy.
Improper footwear and poor progression of exercises are common factors related to non-professional athlete injuries. Focussing on having the proper fit with the right shoes compared to how the shoes looks will save your lots of $$ and downtime with useless injuries. This applies to you too, ladies. Dress shoes and workout shoes included.

Avoid Running Injuries By Running on the Right Surface

We spend thousands of dollars a year on our running shoes to maximize our comfort and cushioning to protect our feet, knees, hips and low backs. If we learn how to wisely use the surfaces we run on, we will easily save lots of $$, eliminate most running injuries and continue to enjoy an active lifestyle.

Is that a plan that would make you happy? I thought so….

As your physics teacher told you years ago, “energy is neither created nor destroyed.” As it relates to your running, when your foot strikes the ground, the energy is transferred to the ground. Depending upon your running style, speed, body weight, shoes and ground surface, much of that energy is transmitted back into your legs. The less absorption that takes place by the running surface itself, the higher the stress/force applied to your joint surfaces and soft tissue.

Minimizing Joint Compression

Changing the surfaces that you run on is a simple and very effective way keep your joint surfaces healthier and your entire body healthier. Typically, the softer the surface the better, especially for the older runners. In this era of minimalist shoes with very little shoe cushioning becoming so popular, selecting the proper running surface has never been more important if you want to avoid running injuries.

Here is a list of seven (7) different running surfaces and how each surface affects your body. I’m not interested in which surface is faster or more responsive. As your sports medicine resource, I’m looking at each surface and how it positively impacts your ability to stay healthy and avoid injuries. That is the objective of MikeRyanFitness.com and a it’s a role that I thoroughly enjoy.

Picking the Best Running Terrain for You:

Ratings from 1 ( poor) to 10 (best)

1. Natural Grass

Open grass parks, golf courses and sports fields are ideal for soft and leg-friendly running. A well nurtured grass field can be your best training partner and a priceless tool to keep you healthy.
Pros: Grass is soft and very easy on the legs in terms of stress and impact. The subtle unevenness of grass is an excellent way to add additional strengthening for the feet, lower extremity and core. For the larger runners, grass is even more important.
Cons: Uneven and irregular surfaces may increase the risk of ankle sprains.

Sports Medicine Rating:9.0

2. Off-Road Trails

Running off-road, for me, is a dream come true. The soft dirt trails are easy on the legs and the changing of directions is great for improving agility and lower extremity balance. Including a sense of adventure with wildlife all around you and so much to see, running off-road can help pass the time faster during those long slow runs.
Pros: Usually easy on the legs and the mind as you get away from the crazy world for some “me time”. Because of the altering terrain, your stride length is shorter and your turnover is faster.
Cons: Ankle sprains, bug bites and getting lost are minor risks for getting away on a “mini vacation” with Mother Nature. Mud and slippery surfaces will increase the risk factors while they often prove to be helpful elements that slow you down by making you work harder.

Sports Medicine Rating: 8.5

3. Cinder Track/Trails

These fine-rock and packed sand is an easy to maintain running surface that many of us grew up racing on in high school. Rain, snow or sunshine has little impact on this type of surface and that’s a good thing when it comes to avoiding injuries. The footing is often consistent and more energy absorbing than the harder surfaces found on roads and treadmills.
Pros: If they are well-maintained, cinder surfaces allow for a somewhat consistent footing and are much easier on the legs than roads and treadmills. Cinder tracks and trials will help keep you healthy if longer runs are in your plans.
Cons: Cinder surfaces can allow for softer areas if the drainage is poor so slipping is a concern. The traction on the bottom of the shoe will greatly impact the traction when hills and turns are involved with cinder trails.

Sports Medicine Rating: 7.5

4. Synthetic Track

Speed and consistency are the two major advantages to today’s modern track. The ability of this type of track to absorb “the pounding” from your legs is very good but the tendency to wear a lighter and less cushioned shoe often leads to injuries for runners training on this type of surface more than two times per week.
Pros: Level, stable and consistent surface allows for a runner to control his/her biomechanics better than on an uneven surface.
Cons: The curves often made at faster speeds with an increased traction often contributes to arch, ankles, knees and low back pain. Long distances run on this surface, if run in the same direction, will have a tendency to lead to over-use syndromes. Larger runners will find this surface less appealing in regards to injury prevention when compared to grass or trails.

Sports Medicine Rating: 7

5. Sand

All sand running is not created equal. Depending upon many factors related to the sand, this surface can be ideal or concerning. Soft and deep sand, lowers the impact while stressing both the cardiovascular system and the muscles of the lower extremity. The view, the change of pace and the additional upper body involvement make a sand surface almost a must-do for runners at least 1 time per week.
Pros: Soft sand absorbs a higher % of forces, therefore, puts less stress on his/her lower extremity. Elevated heart rates and greater effort to run both add to the positive attributes with running on a sand surface.
Cons: Although it’s great for building leg strength, the softness of the sand means a higher risk of Achilles tendonitis and foot blisters. When running on the water’s edge at the ocean, the tilt of the surface puts uneven stresses on the body. This bilateral asymmetry may lead to lateral leg, hip and low back overuse injuries.

Sports Medicine Rating: 6.5

6. Treadmill

“But I was only running on a treadmill” is a common explanation I hear from runners confused to why their legs hurt or an injury occurred. The convenance of running indoors is a big plus for many runners for obvious reasons. All the fancy feedback (heart rate, calories burned, incline, pace,…etc.) displayed is nice but it often comes with a price if the frequency is too high or the miles are too long.
Pros: The surface moves for you and you simply need to keep your legs moving at the same speed. The smooth surface makes the risks lower and the weather is never a factor. The less experienced runners can exercise for longer periods of time on a treadmill compared to running outside.
Cons: The surface firmness can be quite high (that’s not good) and that will vary with the type of treadmill being used. It’s boring and the fact that the treadmill is moving for you will tend to make a runner strike the ground harder by over-striding.

Sports Medicine Rating: 6.0

7. Asphalt

Asphalt is the most common road surface in the modern world so it’s the most common running surface for most of us. It is quite hard and not considered to be a friend of runner’s legs. It’s difficult to avoid but if you want to stay healthy, minimize your mileage on this type of surface as much as possible.
Pros: It’s a fast and predictable surfaces. A runner’s pace and footing is easy to maintain on asphalt. Often well maintained and well-marked, an asphalt surface can make you look good and feel fast in both training and in a road race.
Cons: Ankle sprains, stress fractures, road holes, traffic/bike and road trash add to the risks of running on the road. Traffic free asphalt will eliminate some of those risks but the hard black road is an unforgiving surface that put significant strain on the body.

Sports Medicine Rating: 5.0

The Homestretch

I had running poster on my apartment wall during my freshman year in college with a picture of a solo man running up a massive hill. The caption on the bottom of the poster read: “The race is not always won by the fastest of feet but by those that keep running.”

Keeping you healthy and running, that’s my job. What you do with your running and your body, that’s your job.

Insider Medical Questions with the NFL Draft

NFL Draft Day is here and I think it’s safe to say that most football fans are tired of the Mock Draft-mania. We’ve heard plenty of football “experts” give their opinions on why this or that player should or shouldn’t be Drafted based on their running speed, physical size and football talent.

Who’s asking the medical questions about these potential NFL players?

Forget about the specific injuries and the medical grades on these players. I can’t disclose any of that info for obvious reasons. It’s the “other medical issues” that often separate the players that come into the league for a quick drink of Gatorade and those that have long successful careers as professional football players.

Key Medical Questions Related to the NFL Draft

“How will the player hold up to a much longer & more demanding NFL schedule?”

A college season has 8 to 12 games. Meanwhile an NFL season includes 4 pre-season games, 16 regular season games along with up to a 4 game post-season. With an extensive off-season workout program, training camp and an additional Bye week practice schedule, a rookie can easily double the length of their season when compared to their college season.

Now when you add in extra special team reps, the stress of being a “new guy” in a new setting and the increased intensity of the NFL, a rookie season is tough indeed.

“What does a player’s medical history not tell you?”

With the player’s permission, we review hundreds of player medical reports, files and tests. In doing so, we gain great insight into his medical history. Those mountains of reports often give us more questions than answers about a player’s medical status.

How much did injury X limit their ability to play at a high level? Did the player practice with this injury or did he simply rest the injury during the week and play in the game on Saturday? Is a player’s injuries chronic problems all the way back in high school where most athletes don’t have complete medical records?

An inability to find the answers to medical questions such as these may hamper a team’s ability to have a clear picture of a potential employee.

“What will impact the longevity of this player career more, the volume or the intensity of his college career?”

Today’s college football player has an impressive resume’ often extending from their playing days as a young teenager. Highly competitive youth football, high schools and colleges result in many long and intense seasons. That often results in lots of hits and lots of miles on those knees, ankles and shoulders.

“How educated is this player with the sports medicine art of taking care of himself?”

A few years ago I called one of my fellow Professional Football Athletic Trainers Society (PFATS) colleagues with an NFL team. He had 2 very old, by NFL standards, players who were playing at a very high level. “How are they doing it?” I asked. From both a professional and a personal perspective, I was very interested in learning how these dinosaurs were competing with the young bucks in this league.

“They work hard 11 ½ months a year” he said. They knew that fitness and maintenance was their ticket and they knew how important it was to take care of their bodies TODAY.

When I see a young rookie come into the NFL with the knowledge and, more importantly, the appreciation for good nutrition, NFL athletic trainers and recovery, I see a young man who has already greatly enhanced his ability to stay healthy and to become very wealthy.

Show Time

Each year NFL medical staffs get the opportunity to enhance our skills of assessing new players to help make our teams better. The art of reading “between the line” is often the trick to strengthening our rosters heading into the fall NFL season. As with most professions, there’s much more work than one would expect preparing for the big event but it’s necessary to be properly prepared.

Let the fun begin!

Inside the Mud Run

This weekend’s mud run race is a big deal in Jacksonville. Organized and run by the Northeast Florida Chapter of the National MS Society, the local mud run is an extremely popular race for many reasons. From the raising of the much-needed money to combat Multiple Sclerosis to the physical challenge of a brutal 6.2 mile race through the mud and challenging obstacle to the bonding opportunities involved with such a unique event, the MuckRuckus MS Jacksonville is special.

Yesterday at work, one of my co-workers told me that he was thinking about not racing in the race and “waiting until next year.” “Don’t even think about it” I said firmly. Explaining how much fun it is, the fellowship associated with the event and the ability to raise $$ for a crippling disease was much more important than a few nervous butterflies. He’s in.

This will be my 4th time I’ve competed in this event. The first year I raced on a 5 man team with 4 local firefighter friends. I was hooked 2 miles into the race. I love running off-road and I’m a huge fan of total body challenges that include mental toughness to do well. Hence the reason why compete in multi-sport events and why I don’t work in a cubicle in a high-rise office building downtown.

The Fun in the Mud

The sport of mud running is one of the fastest growing sports in the world. Everyone talks about the popularity growth of mixed martial arts (MMA). Mudders will tell you that they are very different sports for obvious reasons. MMA is a sport that people watch dudes getting kicked in the head where mud running gets you off the couch and into the sport. We have no shortage of reasons to keep people sitting on their butts. We need more activities to get all of us off the couch and back into enhancing our health.

I’ve finished in 2nd place the last two years in the MS Society mud run’s individual race. Each race has been very challenging, lots of fun and extremely competitive. All three reasons are why I keep coming back.

Tips to Get the Most Out of the Mud

If you’re new to the sport and you’re nervous, it simply means that you’re human. Here are a few tips to help make this race less stressful and more fun. As the Sports Medicine Advisor to the National MS Society, I enjoy sharing sports medicine tips to help the racers to stay safe and avoid running injuries.

Sports Medicine Tips for the MuckRuckus MS

Last Tip

Have fun. Having a healthy mindset is the best place to start for these type of races. Enjoy the challenge, laugh with your fellow racers, thank the volunteers, acknowledge the fans cheering for you and be proud of what you’re accomplishing. You’re stepping out of your comfort zone to make your body stronger, your mind dream bigger and the quality of life for those stricken with MS so much better! I’m proud of you and you should be proud of yourself.

Let’s get dirty!!