Self-Care Tips for Athletes with Joint Swelling

Source: Pixabay

I saw a physical therapy patient this week with a chronic knee injury.  His knee was swollen and stiff, much more than normal.  I know his knee well and it typically has only mild swelling with good muscle tone.  His diagnosis is Grade 1 chondromalacia or irritation behind his kneecap.  It’s an issue which most of us, myself included, over 30 years old commonly have behind our patella or kneecaps.

Puzzled with how his knee looked, I asked: “What have you done to make your knee so cranky?”  “Nothing different Doc,” the 42 year old cross-trainer said frustratingly, “Same damn workouts I’ve done for the past 6-7 weeks.”

Here comes my big question: “What did you do after your workouts in regards to cooling down, rollers, stretching and ice?

There it is….the look of a cow looking at a new fence post!

The answer was clear even before he embarrassingly replied: “I didn’t do anything…I didn’t have time.”  It’s a lame excuse and a common practice for athletes of all ages.  It’s my mission with to change that mindset and behavior.

The Truth about Joint Swelling

There are many sources of joint swelling or effusion.  The extra fluid inside a joint can come from the inner lining of the joint, the bone itself or from an infection.

It’s much easier and less painful to keep swelling out of a joint than it is to get the swelling out of a swollen joint.

The important part to note here is to minimize the reason for the swelling instead of trying to convince your body to reabsorb the fluids after they have filled the joint.  I think of process as similar to a flooded bathroom: fixing the leaky pipe under the sink is a much easier solution than mopping up 20 gallons of water covering the floor and soaked under the cabinets.

Tips to Control Joint Effusion

  1. Roll – using a roller on your muscles before and after a workout is a simple relax muscles and to allow your joints to move normally and to do their job.
  2. Stretch – Five minutes of lengthening muscles and fascia before and after a workout improves blood flow and promotes the drainage of waste products from your hard-working muscles.
  3. IceIce is your best friend so start spending more time with it.  If a joint or soft tissue is either overly warm, red in color or sore after a workout, ice it for 10-15 minutes.  Ice quickly decreases the metabolism or joint activity while also decreasing pain.  Both are important.
  4. Posture – As most of us do after our workouts, sitting in a car or at a desk for prolonged periods of time is not good for our spine or joints.  Sitting shortens some of our major muscle groups like our hip flexors and chest muscles. If you have to sit after a workout, make a point to do some of the following:
  • Use perfect spine posture
  • Consistently engage your core muscles
  • Kneel on one knee every 20-30 minutes
  • Sit on a large therapy ball instead of a chair
  • Get up every 20-30 minutes to stretch hamstrings, hip flexors and chest muscles

These are simple steps which don’t require much time or effort. Keeping our bodies healthy is important for many reasons.  Controlling inflammation and swelling should be a top priority for athletes with the common bumps & bruises and wear & tear that comes along with aging and the sports we love.

Recovering From a Spartan Race: Sports Medicine Secrets

Source; Pixabay
Source: Pixabay

I competed in the big Charlotte Spartan Race with my friend Paul Wilson yesterday. I had so much fun….in a sick kind of way. It was a great race loaded with challenging obstacles, amazing athletes and all the passion that makes Spartan Races so special.

Getting out of the car after the 7-hour ride back home to Ponte Vedra Beach, FL, two things were crystal clear to me:

  1. I’ll be racing plenty of Spartan Races in the near future.
  2. I will be stiff and sore in the morning.

After 26 years as a physical therapist/athletic trainer in the National Football League, a certified Spartan SGX Coach and a veteran racer, I’ve learned plenty of sports medicine tricks to accelerate an athlete’s recovery.

I’d like to share some of those Recovery Tips with my fellow Spartans.

Why am I sore?

Obstacle racing isn’t easy. When you look back on the race, you may focus on the obstacles themselves but the truth is there are plenty of elements during a Spartan Race that factor into why you’re walking like 70 year old on broken glass the next morning!

  • Soft tissue inflammation – the typical result of prolonged stress on tendons, muscles, ligaments and fascia.
  • Scrapes, scratches and bruises – from climbing, crawling and falling.
  • Increased joint stress – arches, ankles, knees, hips, low back,..etc. are aggressively compressed with ever step on ever-changing surfaces.
  • Lactic acid  – your body’s “exhaust” or waste product produced during intense muscle activity.

Sports Medicine Tips to Accelerate your Recovery

Joint Motion – Almost all 360 joints in your body are used in an obstacle course race. Many of those joints were stretches and twisted in a manner quite different than how they move during your 9-5 job. Simple and slow stretches and movements from your neck to your big toe will enhance vital inner-joint lubrication and help restore normal joint motion.

Hydrate & Eat Healthy– Drinking lots of water with healthy foods will help your body flush out the “bad stuff” while replacing the “good stuff” such as inner muscle fluids, healthy calories, sodium (salt) and important electrolytes.

Drain your Legs – Elevate your legs straight up in the air while pumping your ankles and toes 3x/day.  Gravity was not your friend in the race but now it’s time to take advantage of gravity to help your lymphatic system to drain “the bad stuff” from your loyal legs.

Just Run – “What?!”  Trust me on this one….running the next day after a race is a key part of your recovery.  It only needs to be an easy 1 mile trot on the soccer field or a 10 minutes of light side-shuffles and agility drills in the back yard. Your legs will thank you two days from now.

Massage and Stretch – Get your feet, legs, hips and low back massaged and stretched as soon as possible to minimize the amount of waste products from embedded in the membranes of your muscles.

Ice and Compression Are Your Best FriendsSure Ice hurts but ice a valuable tool for serious athletes training and racing hard.  If you have localized pain or swelling in a muscle or joint, ice the area for 15 minutes followed by a compression sleeve.

Wound Care – Like friendly reminders, the flesh wounds are there. From the scrapes to the cuts to the blisters to the “where-did-that-come-from?”. Take care of open wounds quickly to avoid complications by cleaning the open wounds thoroughly with soap & water, applying an antibiotic ointment and, if needed, covering them with a sterile dressing.

Spartans Heal Fast

Recovering quickly will get you back to what you want to do: Living a healthy and active lifestyle. Challenges await you and having a plan of attack for the aches and pains that come with those challenges will surely make you stronger.


Smart Start With CrossFit

Source: Pixabay
Source: Pixabay

I did my first CrossFit workout (at CrossFit Pablo Beach in Jax Beach) this weekend….and my ass and hamstrings are killing me!

New to CrossFit

As a devoted cross trainer, I’m very comfortable with my old friends; running, biking, TRX, body-weight exercises, weight lifting, aggressive core work, swimming, trail running and such, but now doing power lifts such as dead lifts, clean & jerks and squats haven’t been part of my workout routine since I was racing as a miler in college.

Fit and/or Healthy?

Enhancing our fitness is a quest for most of us while not getting injured is a key goal for all of us. Avoiding injures is not a passive process.  It’s an active, conscious process which pays off in a big way by keeping you in the game.

I want to show you how easy it is to minimize the risk of injury so you can maintain an active at ANY age. I’ll use myself as an example with my new workout plan. The steps below are exactly what I did to help accelerate my recovery.

Avoiding Injuries: The Appetizer for Injury Prevention

Going into my first CrossFit workout I knew I’d be doing different types exercises which would significantly stress my muscles, tendons, joints, fascia and ego in a new way. I thoroughly reviewed the warm-up, strength exercises and workout of the day (WOD) beforehand.  These are the steps I took to help me avoid an injury:

Pre-Workout Steps

  • Be Real – Understand the newness of the workouts so check your ego at the door.
  • Break a Sweat – Warm-up the muscles and joints from your ankles to your neck with dynamic stretches, shadow boxing, arm circles,…etc. to start the sweating process.
  • Rolling – I’m a big fan of soft tissue rollers. Using a roller on your legs, back, chest and shoulders needs be a part of your warm-up.

During the Workout

  • Keeping it Real – It’s an entirely new workout so the stresses and loads on your body will be very different. Focus on great technique while you learn the details of the workout while keeping the weights low.
  • Listen to Your Body – Trust your body, listen to your body. If something is wrong, your body will know it.
  • Compete With Yourself – This is a perfect example of when you should compete with yourself with every exercise not the dude beside you.  He/she is probably a seasoned CrossFitter so don’t risk an injury as a rookie trying to match up against Joe Muscle!


  • Slow the Train – A 5-10 minute cool down doesn’t sound exciting but it important and it should be a part of every workout.
  • Fuel the Train – Replacing fluids, carbs and protein within 30 minutes after a workout will help your recover and your future performances.
  • Drain the Legs – Lay down and elevate your legs while continuing to bend your knees and pump your ankles. It’s a simple way to quickly reduce the lactic acid and waste products from your hard-working leg muscles.

The Day After

  • Get Moving – Get out, move and get more blood into and out of those recovering muscles. Easy cardio, agility and stretching should be part of your routine the day after a workout. If you want a day off, do it 2 days after the hard workout.
  • Repeat the Movements Minus the Load – Repeating a few reps of some of the exercises you did the day before with minimal, if any, weights. As I like to say: “If you want to get rid of soreness, do what made you sore.”
  • Freeze the Spots – If any areas are overly sore, ice those areas to reduce the pain. Less medicine and more ice is typically a smart plan.

 In closing, it’s as simple as planning ahead, be smart, progress slowly and recover aggressively.

Smart Injury Free Mud Run Racing

Source: Pixabay

This Saturday’s Tough Mudder- Jacksonville is coming to town with lots of hype.  Known for it’s very original and tough-guy obstacles, the Tough Mudder has the local mudders nervous and excited….myself included.

For those of you preparing for your first race in the mud, you’re about to embark on the best workout and challenge of your life!  If you’re a veteran of obstacle races, every race provides you with an opportunity to test the toughness of both your body and your mind.  THAT’s why I continue to sign-up for these challenges and I’m sure I’m not alone in my reasoning.

Keeping it Safe

As a certified athletic trainer and physical therapist in the NFL for 25+ years, I’ve learned a thing or two about staying healthy.  I want to share tips to keep you safe racing in a mud run.  Getting to the finish line is your goal while getting you to that finish line healthy is my goal.

Here’s a few simple sports medicine tips to keep you safer on “race day.”

Before the Mud Run Race…..

Grease Up – Blisters can quickly ruin a great race.  Coating Vaseline on toes, inner thighs and anywhere necessary will enhance your comfort on race day.

Don’t Be a Sponge – Wear thin socks, water-friendly boots/sneakers, non-cotton pants and a thin shirt to avoid carrying an extra 4-5 lbs during the race.

Rollin’ Time – Using a therapy roller before all workouts and races will mobilize your muscles and help you prevent injuries.

Push the Carbs – Bagels, whole-grain cereals and pasta are all smart options. Stop being a “carb hater” and load up the type of fuel that you’ll need during your race.

Be Nice to Your Dogs – Find the right kind of supportive high-top racing shoes and break them in well before the race. Wear thin calf-high socks to reduce your chance of calf and arch strains.

Plank Time – I learned this the hard way. You’ll be doing lots of crawling during the race so performing a few front and side planks before the race.  This will help you engage your entire core musculature for the big race.

During the Mud Run Race…..

Drink Early & Often – In any weather, you need fluids early & often.  A smart plan I use with my professional football players is: “Drink 50% water/50% sports drink before, during & after game day.”  This plan will give you the 4 essentials needed for a hard-working body: fluids, salt, calories and electrolytes.

Smart Footing – Running a more level “line” is not always easy to do with hundreds of athletes around you in the mud.  I rolled my ankle twice in mud runs and both times are when I wasn’t paying attention to where I was running.  A shorter and wider stride will keep your ankles and knees safer on slippery and muddy surfaces.

Climb to the Bottom – I know lots of orthopedic surgeons and lets just say that many of them get lots of customers from mud runs.  Jumping down or climbing off an obstacle is a very common mechanism of injury for mudders.  The solution: Climb down to the bottom of the ladder or obstacle.  Avoid the urge to jump down the last 5 feet just to save an extra few seconds.

Jump Out, Not Down – Water is a common theme in mud races.  Jumping out over the water is safer than jumping down into the edge of the water.  Entering the water away from the closest shore will minimize your risk of being landed on and cut down on your time in the water.

Check out the Scenery During the Race – How is that going to keep me healthy?  High fiving the crowd and thanking the volunteers are two proven examples of ways to slow down, enjoy the fitness fun of a great event and to keep you in the mindset of reaching the end of the race healthy & happy.

Go Time…..

It’s time to get muddy and have some fun.  I hope these tips help keep you healthy and make your race what it’s supposed to be: a fun fitness challenge for you and your friends!

Stay Healthy & Happy!

5 1/2 Tips to Beat Bad Ankle Pain

bad ankle
Source: Pixabay

Too many of us live with daily ankle pain. Usually the factors creating ankle pain are often quite controllable and manageable with the right sports medicine advice.

Both athletes and non-athletes are susceptible to sore ankles, ankle sprains and chronic ankle pain. Controlling the pain and maintaining healthy ankles, feet, toes and calves is not difficult. I’m often asked for tips and suggestions on these body parts by individuals both young and old. Let me share with you the same tips I use on NFL players to help you live a fun and active lifestyle.

1.  Strengthen your Base of Support

Strong arches and toes are key to stabilizing everything above the feet. Any base of support, be it a building or a human body is vital to both stability and function. Simple exercises such as picking up marbles with your toes, barefoot walking/running, toe towel curls and  barefoot balance drills should be done on a daily Basis.

2.  The Right Shoes for Sprained Ankle

Wearing the proper shoe and, more importantly, not wearing the wrong shoe is vital if you want happy “dogs”. Women’s shoes are the best things to happen to pediatrics (foot doctors) because they consistently create ankle, feet and toe pain for women. Spending a little more money on the right shoe is money well spent if an active lifestyle is a priority of you.

3.  Warm-up/Cool Down for Running Ankle Pain

If there’s one thing I’ve learned about my body since I’ve turned 40 is that warming up and cooling down is important. In saying this, I realize it doesn’t require a lot of time to do so. The use of a roller, flexibility exercises, compression sleeves and ice has help me do this quickly and consistently.  Too often ice is not considered an important option for chronic ankle injuries.  That’s a mistake…ice therapy rocks and it should be considered to be one of your best friends!

4.  Embrace your Downward Dog

This could be your most important stretch. Last week I was doing a downward dog stretch in my living room at 4:15 AM when I was startled by the sight of my dog Marshall right next to me also doing a downward dog with me!

My Loyal Dog Marshall

It’s a great stretch that addresses muscle, tendons, joints and fascia from your toes through your arches, over your heels, through your calves, into the back of your knees, throughout your hamstrings, behind your hips and all though your low back…..just to name some of the locations.

5.  Self Traction and Mobilizations

These require more skill or may require the assistance of a friend although they are priceless for maintaining normal ankle mechanics. With the sore ankle at approximately 90° or a “neutral position”, gently pulling on both the heel and the top of the foot together.  This will create a gaping of the ankle from the lower shin. This can be accomplished with the help of an assistant or by placing the foot under a bed or couch to stabilize the foot and ankle.

Another mobilization move which is helpful to maintain the mechanics of a sprained ankle is to gently move or mobilize the lateral ankle bone both directly forward and more importantly directly backwards. This lateral ankle bone or lateral malleolus is a common source of a sore ankle.  Increasing its mobility is one of my favorite tricks to decreasing pain in a chronically sore ankle.

Bonus Tip –  Aggressively Directed Massage

If you really want to loosen up chronically stiff ligaments and muscle, aggressive massage should be included. Once a sore ankle, shin and arch are warmed up, apply a moderately aggressive massage with your thumbs to the locations around your ankle locations noted below.

Focus on the areas on both sides of the Achilles tendon that forms the backside of the ankle joint, the entire edge surfaces of the lateral ankle bone and the front of the ankle joint.  Including the arch and the great toe is always an added bonus. After these areas have been loosened up, it’s important to get all those moving parts active and functional to both normalize range of motion and to re-program the entire leg how to move pain-free.

Runner’s Guide to Managing Calf Pain

Source: Pixabay
Source: Pixabay

It wasn’t a good workout but it was a great run.  I just finished a 5:30 AM run in Santa Clara, CA for 3 1/2 miles and I was thrilled.  Sure, it was only 58 degrees with no humidity, a nice treat from the Florida heat I’m used to, but my excitement was from the fact that I was able to run without calf pain.

I’m out in California with the Jacksonville Jaguars as we prepare to play the Oakland Raiders tomorrow.  I had a few quiet hours this morning before rehab for the players so the timing was perfect for my daily workout.  I didn’t run hard nor did I even burn many calories but I RAN and that was the best part.

Calf Strain Made Easy

Ten days ago I started my day with a calf strain 3 miles into an early 5 mile run.  When I look back at the run that started the pain in the calf, the reasons it happened were obvious.  I suffered a calf strain because I did the following stupid things:

  • Poor Warm-up – I got out of bed at 4 AM and was literally running 11 minutes later.  I skipped my morning soft tissue rolling and stretching routine.  I had to be at the Jags’ EverBank Field earlier that day so was trying to save some time.  Big mistake!
  • Shoe Change – I ran in a new pair of running shoes.  “It wasn’t the time to be breaking in new shoes, Einstein.”
  • Started Too Fast – I was convinced I could finish my 5 mile run in record time and that mindset started as soon as I took the key out of my front door.  I have a steep downhill incline at the end of my driveway.  I remember feeling both of my calves and hamstrings tighten as I ran down that section of my driveway at a 5:30/mile pace 20 yards into my run.  How smart am I??
  • Ignored the Blinking Light – I recall feeling leg pain in both of my calves along with low back tightness about 1 mile into the run.  What did I do?  Nothing.  The dashboard warning light was blinking and I ignored it.  It proved to be the final step in a bad sequence of events on my part that resulted in a calf strain.  I knew better and I only have myself to blame.

Managing Calf Pain

When an athlete hit the 3 decade mark in life, leg pain isn’t too far away.  Calf pain and a pulled hamstring are at the top of the list.  Managing a calf strain is not difficult if you start the sports medicine the right way immediately after the injury.  If not, the pain in the calf becomes chronic and the recovery time is tripled.

  • Ice Immediately – Stop the bleeding and minimize the inflammation.  Pack it in ice for 15 minutes or ice massage it for 10 minutes as soon as possible.
  • Shorten the Heel Cord – Adding a bilateral 1/2″ heel lift in both shoes will decrease the tension on the heel cord – includes the Achilles tendon and the two calf muscles – when walking throughout the day.
  • Apply Compression – Compressing an injured muscle is always a positive thing to do.
  • Lengthen to Strengthen – With a calf strain, gradual lengthening of the fascia and muscles should always take place before calf strengthening begins.  I love the downward dog stretch for this injury to elongate the fascia from the low back to the arches.  This is a key step to decrease calf pain after the initial symptom of muscle “grabbing” is gone.
  • Think Functional – Avoid the urge to aggressively stretch and strengthen a calf strain. Boring functional activities like bike riding and walking will get you pain-free sooner than trying to run while the muscle continues to “knot-up” or “grab”.
  • Soft Tissue in Time – Any early massage or soft-tissue work should be minimal for the first 3-4 days post-calf strain. Trust me, I’ve been there with the mindset: “If I could just get this little knot in the calf muscle to relax, I’ll be fine”.  Digging into the muscle early on will only delay the healing and triple the length of your time to return to pain-free running.

Avoiding Pain in the Calf

Calf pain sucks.  Preventing leg pain is a high priority for Here are a few sports medicine tips to help you avoid calf pain:

If the Wrong Shoe Fits, Give it Away – Use common sense when it comes to shoes, athletic and dressy.  Why use a “light weight” racing shoe for a training run?  Maybe that new minimalist shoe feels good walking around the house but is it the best shoe to do a CrossFit workout after work?  The pretty dress shoes may look good but spending 8 hours a day in a high heel will benefit the foot doctor’s W2 more than it will your 10 km time this weekend.

Rule-Out a Blood Clot – If deep calf is experienced, especially after prolonged inactivity or a surgery, see your doctor ASAP to ensure the pain in the calf is not a blood clot.  This is a very important point to stress.

Spend Time With Man’s Best Friend – The downward dog stretch should become part of everyone’s daily routine.  That’s how strongly I feel about its effectiveness in keeping calves healthy for athletes of all ages.  Stretching may not be as sexy as doing curls for the girls but if you want to keep running pain-free, flexibility needs to part of your plan.

Support Early & Often – Whenever possible, calf-high compression socks should be worn.  To work, especially on an airplane and during workouts, compression socks/sleeves will help support the entire shin and keep your calves happy.



Appreciating the Gift of Good Health

It didn’t take long before I knew it would be a special day.

This past Sunday morning I lined up to start the 5th running of the Run With Donna 1/2 Marathon in Jacksonville, FL.  It was 29 degrees, windy, still dark and exciting when the 4500+ runners started the dash towards the bridge.  All of us were cold but alive with dreams of a fast race.  My wife and I joined many of our friends for the annual event to raise money and awareness to fight breast cancer.

With not many miles logged this year, I focussed on starting the race slower than normal.  As the lead packs crossed over the intercostal bridge, the sun slowly started to rise and I came through the first mile at 7:16, one second slower than I had planned.  That was a great sign for the 12.1 miles to follow.

A smile warmed my face as I floated down J. Butler highway because I knew how lucky I was to be exactly where I was at that moment.  I had just turned 49 years old exactly 1 week earlier and here I was racing side-by-side with young speedsters, many of them less than 1/2 my age.  I loved every minute of it because I knew that these types of athletic experiences are special at any age.

Good health is a gift not to be taken for granted.  We’ve all done it.  Personally, I made a conscious effort to never make that mistake again.  I made a promise to myself  5 years ago to always appreciate my health, each and every day.

My deal with myself has proved to be one of my greatest gifts and I often ask others to make such a pact with themselves: To Truly Appreciate the Gift of Good Health

How Did I Demonstrate my Appreciation for the Gift of Good Health:

  • I thanked those who cheered for the runners.
  • I encouraged (most of) the runners who passed me.
  • I thanked the hundreds of volunteers who handed out drinks and directed the runners.
  • I high-fived fellow runners as we passed each other on the road.
  • I smiled more than I ever have in a race….true that it also helped warm my face as the windchill temperature dipped into the teens.
  • I joked with my fellow runners in the pack as we raced down the beach and through the streets of Jax Beach.
  • I clapped for the many bands that occupied the street corners and perched on the top of the bridge.
  • I laughed and waved at the drunk surfer dudes on the balcony  proudly displaying their “Show Me Your Mammogram” signs.
  • I ran as hard as I could finishing in 20th place overall in 1 hour and 28 minutes to win my age group.  I’ve found that the races that I ran with a grateful heart and a fun-loving attitude usually my most successful races!

The Rewards of Good Health

As a father of two young children and the husband of a loving younger wife, I have so much to live for.  Staying in shape and being physically capable of competing in athletic events is important to me and my family.  God has blessed me and, contrary to what seems to be the norm these days, I’m not afraid to thank God for my blessings in public.

I have many friends who are unable to be as active because of physical ailments so I know how fortunate I am each and every day.  My personal and professional Mission Statement is “To Enhance the Health of Others“.  If I can continue to share my sports medicine expertise with others to allow them to experience the joy of good health in whatever physical endeavors they chose, I know that I can change their lives as well.  That vision is why I created

Can You Help Me?

My goal with is to significantly enhance the health of two-million (2,000,000) people by the end of 2013.  You can help me to help others by sharing my message to others through my website and my Facebook page.  Just think of how rewarding it will be for you to help your friend to quickly eliminate his chronic knee pain or your favorite aunt to reduce her low back pain by 75% in 2 days or to provide a sports medicine resource to your neighbor with no insurance looking for a way to rehab his heel pain!

I know that good health is a gift for today and we all know it’s not guaranteed for tomorrow.  I believed in myself, regardless of my age, and I will continue to focus on enhancing my own fitness and anyone else who sees the quality of their life as a high priority.

Let me show you simple sports medicine tips to help you to do the same.

Running Foot Pain or Foot Stress Fracture?

As a runner, pain is often your most loyal training partner.  Pain has no social calendar to work around or a sleep disorder to leave you pounding the pavement all alone during those early morning 5 milers.

Determining which pain is your friend and which one merits a visit to your local sports medicine specialist is the difficult part of that relationship.  I’d like to help you with this problem to keep you healthy and happy….and running pain-free.

The Inside Scoop on Foot Stress Fractures

Stress fractures in the foot are usually characterized as an overuse injury of weight bearing bones.  High impact sports involving running and jumping contribute to simple foot pain and, if left untreated, it can contribute to a stress fracture.

Bones generally respond to stress by hardening along the outer margins of those bones.  When bones are suddenly exposed to great forces or repetitively exposed to increasing stress, there is insufficient time for those bones to adapt.  Meanwhile, when the muscles associated with the feet become fatigued, they lose their shock absorbing capacities. These uncontrolled forces are inadvertently transferred to the nearby bone and possibly resulting in small cracks in the bones, better known as stress fractures.

A common location for stress fractures for distance runners is along the outer ridge of the forefoot over the 5th metatarsal bone.  This is often called either a Jones Fracture or a Dancer’s Fracture, depending upon the location of that metatarsal fracture.

Statistically, women are more prone to stress fractures than men.  The reason for this increased risk factor is based on biomechanics, nutrition and possibly menstrual cycles. Excessive miles in a short period of time with insufficient rest will increase the risk of generalized foot pain, plantar fasciitis, turf toe, metatarsalgia and stress fractures.

Obviously any underlying bone diseases or disorder will drastically increase the risk got a painful foot.

Signs & Symptoms of Stress Fractures in the Foot

  • Localized pain on any bone of the foot, especially during running.  The pain can be dull aching or sharp, occur during activity and may persist with rest.
  • Mild widespread swelling and tenderness over the foot.
  • The pain may worsen with prolonged exposure to ice and during sleep.
  • An initial sensation of sharp pain followed by intensifying aching is common.
  • Associated lower extremity symptoms such as lateral thigh/knee pain, low back tightness and/or Achilles tendonitis due to an alteration of a runner’s foot mechanics.

Professional Treatment for Running Foot Pain

  • Rest and Ice.
  • Avoid excessive weight bearing on the affected foot.
  • Wear shock-absorbing footwear with walking and if symptoms worsen, a walking boot is a great tool to help control the stress on the injury site.   
  • Eat healthy and ingest Recommended Daily Allowance (RDA) amounts of calcium and vitamin D can help restore bone integrity.
  • Strength training for the arch, toe flexors and weak muscles, which may have contributed to the initial injury.
  • Maintain range of motion of the surrounding muscles and joints.  This especially relates to the Achilles, calf, plantar fascia, great toe and ankle joint.

Asking the Right Questions like a Pro

Here’s what a smart pro athlete would ask his/her sports medicine specialists to ensure a fast and safe return to sports:

  1. What would you consider to be the main reasons why this injury occurred?
  2. How can I best manage this pain and to safely return to running?
  3. Do I need orthotics and if so, who is the very best foot doctor for runners to discuss this option?
  4. Do I need to be concerned with any long-term issues with this foot pain?

Elite Sports Medicine Tips from Mike Ryan

  • Reporting Time – See a sports medicine specialist as soon as symptoms appear to manage this foot pain quickly.
  • Rest Rocks – It’s the boring option but REST is the #1 tool to quiet down a stress fracture.  For how long?  It may be 2 to 6 weeks if the symptoms persist.
  • Return to Running – Resume your running slooooowly. Include pool running, run/walk routines and running off-road while increasing your miles by no more than 10% per week.
  • Cross Train – Cross Training is King. Adding biking, swimming, yoga, strength training, Elliptical trainer,…etc. are great ways to stay in shape and to save your marriage during this “downtime”.
  • Stability – Wear stable and proper fitting shoes upon your return.  It’s not about needing a feather shoe, it’s about protecting your feet.
  • No Big Break – Stress fracture can easily develop into a typical bone fracture if gone untreated.  Limitations early can help you to easily avoid the “big break”.

Running at Record Times []

You cross the finish line, achieving your goal of finishing the race. What Next? Well if you are like most avid marathon runners you’re looking for ways to improve your performance. Runners are always looking for ways to improve their performance and time. We all know that feeling of accomplishment after we do something to the best of our ability. It’s one of the greatest feeling and experiences a runner can have after recording a record best.

Running a Record Time

You cross the finish line, achieving your goal of finishing the race.  Millions of thoughts are racing through your mind: “Did I do as well as I had hoped to?”, “Did I train as hard as I could have?” or  “What’s next?”

If you’re like most avid runners, you’re always looking for ways to improve your performance. Competitive runners are always thinking”what can I take from this race that will help me train and perform better at the next race?”  Runners, young and old, are always looking for ways to ultimately improve their performance.

We all seek the feeling of accomplishment after doing something to the best of our ability. As a runner, we are all seeking “the perfect race”.

With more and more people becoming runners and competing in races, the experience of crossing the finish line with a personal best time is the common quest for all.

These key training tips on how to get the most of your training and to improve your running performance.


Self-improvement is a fun and exciting adventure. It’s a great feeling when you achieve a personal record (PR)!! And it doesn’t take long after celebrating one performance that you’ll want to set your next running race goal.

If you want to improve your performance, you’ll likely focus on stamina or speed…or a little of each. You’ll want a training plan that improves your overall fitness level gradually. As you introduce these changes and improvements in your training, your muscles will get more efficient and productive at the running motions and the removal of wastes in the muscles (lactic acid).

Measuring and improving our fitness level can be a bit complicated on paper. Our fitness level can be measured by the amount of oxygen that our bodies use while exercising at our maximum capacity. This is called VO2 Maxand it’s usually measured in units of milliliters of oxygen per kg of body weight per minute. Many elite athletes will have in-depth medical studies conducted to test their VO2 Max and gauge its improvement during their training. Thankfully for us, there’s a simpler way…

If we want to improve running performance, we need to find a way to increase our ability to do more work with less effort. Studies show that we’re able to improve our VO2 Max when we workout for 20 plus minutes, three times per week at 60-85% of our maximum heart rate (MHR). You can figure out your MHR by subtracting your age from 220, or use this heart rate calculator to determine your MHR and various levels of intensity.

If you have access to a piece of fitness equipment with a heart rate monitor, these are also good tools for monitoring your heart rate. By periodically doing similar workouts, you can measure your heart rate to see if your body is applying more or less effort to do the same amount of work. Keep in mid that your heart rate can get elevated by a number of outside factors, including physical and mental stresses. Therefore, it’s near impossible to draw an accurate conclusion on your running improvement from just one or two workouts. So monitor your heart rate over the long-term to get a more accurate assessment. If interested, there’s also a very good site, Sport Coach, which has a lot of good information on the science and physiology behind running performance.

Now that we know the science of the matter, here are a few physical measures that we can take to improve running performance. The workouts below are strenuous and should be combined with an ample amount of rest and recovery. It’s the stress plus the rest that leads to improvements that we all seek. Try adding these to your weekly routine and you’ll be sure to improve running performance:

  • More Miles!:
    Running more mileage does more than just increase your performance for the long races. I found that my 5k times improved quite a bit when my weekly mileage climbed into the 40+ range. The long slow distance runs improve your muscle’s efficiency at burning the glycogen and fat stores and can help prolong the on-set of lactic acid build-up. Even if you’re goal race is a middle distance run, you can improve running performance by gradually increasing your mileage. Be conscious of your mileage increases and try not to increase your long run more than 2-3 miles over your previous week’s long run, and make sure that the total weekly increase doesn’t exceed 15-20%.


  • Hills
    Hills are tremendous way to build leg strength and ultimately improve running performance. Look at hills like strength-training in disguise. Focus on running form and treat each hill as an interval. By running hills, your legs will are going through the running movements against gravity…which is more efficient and effective than stationary leg lifts and leg curls in a gym. Hill intervals are used by almost all of the world’s elite distance runners as a method to improve their efficiency, strength, and ultimately…their times. Find a good hill that’s 200-400 meters long with a decent upgrade slope. Start with 2-3 intervals based on your fitness level and increase by a repetition or two each week during the strength-building part of your training plan. Make sure that you get a good 1-2 mile warm-up and cool-down jog in before and after any hill interval training to prevent injuries.


  •   Intervals
    Intervals are like a dress rehearsal for your race and they should be the foundation of your plan to improve running performance. Interval distance should vary based on your goal race. For example, ¼-mile intervals are good repetitions for a 5k race, while mile intervals are more suited for a marathon. Like the hill intervals, start with 2-4 repetitions and increase weekly. The interval portion of your training plan is the heart of the schedule and should take you to the taper period (2-3 weeks) prior to your goal race. The goal for your intervals should be 70-85% effort with sufficient rest between each repetition. The pace for your intervals should be slightly faster than your goal pace for your race. For example, if you want to run a 3:10 marathon (7:15 pace), your goal mile intervals should be run at a 6:30-6:45 pace; of if you want to run a sub-20 minute 5k (6:27 mile pace or 1:37 ¼-mile pace), try running your ¼-mile intervals around 1:20 – 1:30.


  •  Strength & Cross Training
    Adding some calisthenics and cross-training to your routine can also improve running performance by strengthening the supporting cast muscles. Strong arms and abs may not win a race for you, but weak ones can help you lose it. The same goes for the muscles on the front of your leg – they may not be the prime movers in running, but they assist, and you’ll want all the assistance you can get when gunning for your PR! Add some basic exercises like squats, bike riding, elliptical, leg lifts, calf raises, toe curls, pull-ups, and crunches to your repertoire. It’ll be a nice change of pace from running and it’ll increase your performance level.


When you start trying to improve running performance, you’re going to want to cram as much in as you can in the shortest time possible…that’s natural. But if we try to streamline this process and reduce the rest or if we introduce too many hard workouts in a short-period of time, we will become more prone to injury and could set ourselves back many months. So please take the time needed to make gradual improvement and increases in stress – you’ll make out much better in the long run!

Article Source:

Taming the Fire of a Painful Heel From Plantar Fasciitis

Understanding a Plantar Fascia Strain

Plantar fasciitis is a painful condition with localized pain in the backside of the arch where it attaches to the underside of the heel bone or calcaneus.  It is often the result of overstretching, overloading or tearing of the origin of the arch, which runs from the heel to the front of the foot under the toes.

This band of tissue stretches every time weight is applied to the foot with standing and walking.  It helps to stabilize and propel the foot forward in movement. Plantar fascia strains can result excessive trauma to the band or the result of culminated effect of repetitive stress placed on arch over time. A plantar fascia strain usually gives rise to sustained inflammation of the front of the heel and back of the arch.  This results in excessive pain in this location, especially after prolonged non-weight bearing inactivity such as sleeping and sitting.  This is based on the simple fact that the band tightens when you don’t move it. If left untreated, a plantar fascia strain can become a chronic and troubling ailment.

Causes: The most common cause of plantar fasciitis is doing too much running, walking and/or jumping in poor footwear. Also, beginners attempting to go overboard in their chosen physical activities are likely to stretch the band too much the first time.   Additional predisposing factors include obesity, rapid weight gain, flat feet, and excessive exercise with insufficient progression.  With some chronic arch pain conditions, as the band of tissue continues to pull on the heel bone, it can result in a heel bone spur.

Signs & Symptoms of Heel Pain From Plantar Fasciitis

  • Perception of burning, stabbing, or dull aching pain at the front of the heel and along the band of tissue in the backside of the arch.
  • Difficulty bearing weight on the foot without shoes.
  • Arch pain with heel raises and with flat foot squatting.
  • Localized swelling and tenderness under the heel and arch.

Professional Treatment for Plantar Fasciitis

Plantar fascia strains usually respond well to conservative treatment methods. However, recovery times do vary from individual to individual.

  • Rest in the form of avoiding weight-bearing will help improve heel pain.
  • Utilize the latest physical therapy modalities and rehab devices to reduce swelling and decrease pain.
  • Repetitive icing with the arch and toe flexor tendons in a stretched position will reduce inflammation and pain while helping to elongate the sore plantar fascia tendon.
  • Proper footwear for your sports.
  • Taping the foot will assist in supporting of the arch, to reduce inflammation and decrease the risk of further injury.
  • Progressively aggressive transverse friction massage to the posterior arch along with a moderate massage for the ankle and lower shin.
  • Strengthening and stretching exercises for the arch and calf muscles will help a painful heel.
  • Arch support inserts can be helpful.
  • Arch taping, if done properly, can effectively support the arch and reduce the amount of heel pain with weight-bearing.
  • Minimize weight-bearing activities.
  • Weight loss, if overweight or obese.

Asking the Right Questions like a Pro

Here’s what a smart pro athlete would ask his/her sports medicine specialists to ensure a fast and safe return to sports:

1)   Does this heel pain have anything to do with my pelvis, lower extremity or foot alignment?

2)   What forms of physical therapy do I need to do to quickly resolve this injury so I can get back to my sport(s) pain-free?

3)   What are my options besides surgery?

4)   Are there any long-term complications from a sprain?

5)   Will I benefit from the use of anti-inflammatory medicine?

6)   Is this painful heel a result of some other biomechanical abnormality that needs to be addressed?

Elite Sports Medicine Tips from Mike Ryan

  • Fast Treatment/Fast Recovery: The sooner you address plantar fascia sprains the quicker they resolve.  Don’t let it become chronic.
  • Minimize Newton’s Laws: Aggressive weight-bearing activities will prolong the time for recovery and increase the risk of long-term complications.
  • Template for Post-Workout Therapy:Immediately after all of your workouts or treatments do the following:
    • Elevate your foot for 3 minutes.
    • Stretch for 5 minutes
    • Ice the arch and heel for 7 minutes.
  • Stretch: Aggressive stretches for the calves, arches, big toe and toe flexor tendons will go a long way in maintaining healthy tissue involving the entire foot.
  • Eat and Drink Right: It’s easier and safer to control inflammation and promote healing by being well hydrated and with a healthy diet compared to taking all sorts of pain pills.