Cold Truth About Ice Therapy

To convince my patients, fellow #SpartanRace athletes and friend that ice therapy works, I simply tell them: “Ice is your best friend”!

Ice is cheap, easy to use, mobile, effective and, most importantly, ice therapy works!  Its time we all stop complaining how “ice hurts” and “it makes me stiff”.  Sure it hurts and it requires some warmup after the 10-15 minutes of ice treatment.  But if ice therapy works, isn’t 4 minutes of discomfort (that’s how long it usually takes for the area of treatment to go numb) a mild sacrifice to feel better?

Smart athletes put pain medicine down and pick up ice to manage their pain.  Follow their lead.

As a Sports Medicine Expert for Spartan Race, I write posts for fellow Spartan racers and SGX coaches related to important sports medicine topics.  Recent posts include topics such as wrist injuries, injury prevention, rehabbing an ankle injury, injury management, and resolving low back pain.

Here’s a link to a recent post I wrote on to keep you “In the Game”!


Keeping you healthy, happy and a helluva lot easier to live with, Mike

Appreciating Assistant Athletic Trainers

John Norwig has the right to be proud.

Playoff football’s in the air. I’m here in Kansas City with NBC Sports’ Sunday Night Football crew to cover this weekend’s AFC divisional playoff game between the Kansas City Chiefs and the Pittsburgh Steelers.

Here’s one story line which probably won’t make the headlines: During Sunday’s clash at Arrowhead Stadium, Steelers’ long-time Head Athletic Trainer John Norwig will be working across the field from one of his former assistants Rick Burkholder, now the Chiefs’ Head Athletic Trainer.

Wait, it gets better.

Last weekend during Pittsburgh’s 30 – 12 Wildcard playoff win over Miami, John watched another one of his former assistants Ryan Grove at work on the opposing sideline. Grove is in his 3rd season as the Head Athletic Trainer for the Miami Dolphins.

By all accounts, this is the first time in NFL history two head athletic trainers (AT) faced their professional mentor in back to back games. Seeing it happen in playoff games makes it that much cooler.

Some may read this and say; “So what!”

I’m willing to bet those same individuals have never spent any time in an Athletic Training Room or had an injury requiring the care of a certified athletic trainer. If he/she had, they would have a greater appreciation for the skills needed to keep elite athletes healthy.

Being Grateful

I could not have done my job as the head athletic trainer/physical therapist for the Jacksonville Jaguars for 20 years without the efforts of my loyal and hard-working assistant athletic trainers. I owe much of my success and blessings to my talented assistants and interns who, from July to January, literally spent more time with me than we did with our own wives and children.

My assistants and interns were part of my family.

Every “head guy” in a professional or college settings will tell you the same thing: Assistant athletic trainers are the backbone of the day-to-day work needed to keep athletes safe.

My Reward

I was thrilled to see two of my assistants – John Burrell (Washington) and Joe Sheehan (Cleveland) – move on to become head athletic trainers in the NFL. They worked hard for the Jaguars and me and I owed them my very best efforts to help them succeed in reaching their professional goal of becoming an NFL head athletic trainer.

I firmly believe this responsibility also applied to interns who have proven themselves worthy of becoming full-time AT’s in the NFL.  An NFL internship is not an easy job. The low-paying position is filled with long thankless days and endless To Do lists.

I’m proud of my two former interns – Marco Zucconi (San Diego….I mean the Los Angeles Chargers) and Doug Quon (Washington) – who are employed as assistant AT’s in the league. A 2009 Professional Football Athletic Trainers Society (PFATS) survey of its members found 88% of head athletic trainers served as interns in the NFL and 86% of assistants were previously NFL interns.  Needless to say, an internship is a proven path into an NFL athletic training room.

Time For Athletic Trainers to Move On

A common goal for most head athletic trainers who truly appreciate and respect their assistants is to help their loyal protégés to move up the food chain.  That means helping their assistants to become a head athletic trainer in the NFL or the college ranks. It’s only fair.

Most of us who were fortunate enough to lead our departments previously worked as interns and assistants doing the same crappy jobs no one else wanted to do. Who do you think is cleaning the storage rooms late at night, packing the travel trunks, taping a majority of the ankles, bringing the injured rookie ice bags at 3 AM and setting up the road game athletic rooms at 5 AM? It’s the assistant athletic trainers!

When I asked John Norwig to describe his feelings when he looks across the field to see his former assistants in the role of head AT in the NFL, his reply was filled with passion and admiration. It’s a common trait of John, which makes him so genuine and likeable. “Proud,” Norwig replied, “I’m so proud to have helped them become successful.”

I think Rick Burkholder, Chiefs’ Head Athletic Trainer and current President of the Professional Athletic Trainers Society (PFATS) says it best; “Assistant athletic trainers are the life blood of the sports medicine teams in the NFL.

Like Rick, I was an assistant in the NFL before I headed south to join the expansion Jaguars in 1994. I was so fortunate to learn and grow under the guidance of my mentor and friend Ronnie Barnes with the New York Giants for 6 amazing years.  It was a wonderful opportunity for me and I’m forever grateful to Ronnie for his trust and guidance.

Stay the Course

I applaud assistant athletic trainers at all levels of sports medicine. You work extremely hard for others. It may not seem like it at times but everyone from the head AT’s, players, coaches, families and co-workers see your tremendous efforts and appreciate the positive impact you have on your athletes.

Assistant athletic trainers Note-to-Self:  WHEN you become a head athletic trainer, take care of your assistants and help prepare them to someday move up the food chain as you have done.

Simplify Your Health and Wellness

Image Source: Pixabay

How many of us overthink our wellness, fitness exercises and health maintenance plans?

“Guilty as charged!”

Wake-up Call

I’m writing this blog post from the deck at a special friend of mine’s cabin on Washington Island overlooking Lake Michigan while on vacation with my loving wife and our two active young children; my son is 7 years old and daughter is 5 years old.  It’s been an awesome vacation for all of us.  No phone reception but plenty of wildlife, fresh cool air and the time to run, explore, exercise and play in the cold lake waters.

What does this have to do with sports medicine?” you’re saying to yourself.  Plenty….it has everything to do with enhancing our health and wellness in the simplest of ways.

Value of High-Tech?

I’m here in the woods with no fancy gym, no high-tech workout equipment, no warm ocean waters for long-distance swims, no tough-guy workout buddies or 90+ degree heat/high humidity weather to sweat my butt off in.

Instead, I’m in the beautiful wilderness with long days to have fun with my family while mixing in my daily workouts.  Brag time: my wife Samantha is a 2x Ironman triathlete so I’m certainly not the only parent in our home focussing on fun and fitness with our children!

Keeping it Simple

So much of our professional lives are busy and complicated yet we can’t do a damn thing about it.  With that being said, why do we choose to make our wellness/health/fitness plans equally as complicated?

It’s times like this vacation that wake me up to the reality that I need to lighten-up on my over-thinking and tighten-up my intensity on getting stronger, better conditioned and more limber.

“Simplicity is the ultimate sophistication.” ~ Leonardo da Vinci 

What I Learned at Summer Camp

I don’t need fancy equipment to kick my own ass to get a legitimate workout.  I simply used what I had access to while adding in a combo of creativity, grit and a playful attitude.

  • Logs to cut, lift and carry.
  • 52 degree lake water to swim and recover.
  • Rolling country roads to run and bike.
  • Trees for TRX, pull-ups and stretches
  • Children for resisted carries, pushups and shoulder presses.
  • Fields for burpees, crawls, planks, lunges, star jumps, crunches, agility drills and sprints.
  • Picnic tables for box jumps, dips and low crawls.
  • And my favorite training partner was here waiting for me: Mr. Gravity

Tips to Simplify our Healthy

Eat Better – More plants, veggies, water, fruits and lean meats.

Simplify – Add simple wellness exercises to your routine that force you to work hard for long periods of time while opening up your joints and muscles like crawling, rock climbing and  swimming.

Play Games – Smart phone off, smile on and sweat glands on…..playing fun sports like a teenager.

Do More – Change at least 50% of your present exercise routine, stop counting reps and shorten rest phases while focusing on generating lots of muscle fatigue, not joint pain.

Stop Feeling Sorry for Ourselves – Hundreds of millions of people with handicaps and injuries can only dream of having the physical abilities that we presently have.  Therefore, we all need to stop feeling sorry for ourselves so we can maximize the healthy blessings we currently have.  Amen.

Recovery Harder – If it hurts, ice it.  If it’s tight, stretch it. If it’s stiff, move it.

Set Hefty Goals Then Quickly Share Them – Dream bigger than big to set a physical goal(s) that will change your life. Before your find the how’s or the “what if’s” creep in, quickly post your goal on FaceBook and email your family and friends with the details so they will hold you to that goal.  Sure you’ll have sweaty palms typing the words but that person looking back at you in the full-length mirror will thank you for the rest of your life.

It’s time to get busy….

Time For Change

Football - injury 101Football’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!

How I Got My Ass Kicked in a Mud Run

Source: Pixabay
Source: Pixabay

Last weekend was the big local mud run, the MuckFest MS here in Jacksonville, Florida. It’s a great event thoroughly embraced by the local community to raising money for Multiple Sclerosis.

This was my fifth year in a row running the wonderful event. Last year I won the competitive division so I was very excited to race this year with the opportunity to defend my title.

That didn’t happen!

What did happen was I got my ass kicked….and I loved it.  I had to literally dive across the finish line to tie for third place, while my chip time earned me fourth-place.

Finishing video:  Mud Run Ryan Jax 2013

As crazy as it sounds, I actually had more fun battling it out for second place with Jesse Davis and Ashton Manly this year than I did winning the race solo last year. The truth of the matter is it’s the competition and the challenges that gets me excited to both train and race.

I tip my hat to Joe Rivera who demonstrated his fitness, his ex-Marine toughness and his competitive nature in winning this year’s race.  He ran hard from start to finish and earned the victory.

Lessons Learned for This Mudder

I learned a lot from last week and race that will make me better mud racer in the future. I like to share those lessons with you.

1.  Train Your Engine Like You Race Your Engine

I have a great running group here in Ponte Vedra Beach that I trained with 2-3 times per week. We get great distance work in but mud runs are very stop and go races.

Getting long slow distance is perfect to build the base but if your race is higher intensity with short intervals, you need to train that way. In other words I didn’t train my body/legs/heart to go to 90% effort and then allow my heart rate to go down to approximate 50% as it will when I’m was maneuvering an obstacle in the race.

2.  Air Is Thinner Than Water

This one sounds too simple but it could have saved me 5 to 20 seconds per obstacle. It’s a lot easier to sail through the air than it is to trudge through water and mud.

Jump as far as possible out over the water to shorten the distance I needed to do to get out of the mud and water.  Increasing your distance through the air will decrease your time in the water and significantly shorten how long it takes you to exit the obstacle.

3.  Attack the Obstacles Or They’ll Attack You

I lost second place in last weekend’s race because of my effort on the last three obstacles. If I had been more aggressive attacking the last three obstacles, it would have given me ample time to solidify the silver medal position.

A higher tempo approach on the challenges will help you carry more momentum through the obstacle and keep you sharper when you start to run again. I think this has a lot to do with having an offensive mindset instead of a defense of mindset on challenging obstacles.

4.  Know the Home Stretch

I didn’t know all the obstacles in the last half-mile the race and that was a mistake. Briefly seeing what’s in store for the last part of a race is a smart decision. Knowing that homestretch prior to the race is a much-needed confidence booster during the middle race when things start to get tough.

Mudder Closing

Mud racing is one of the fastest growing sports in the world for good reason. Learning ways to make it more fun and safer for my readers is very important for me.

I’d love to hear your thoughts on valuable tips and suggestions that you’ve learned from your workouts and races.  Please share your thoughts.  Stay healthy and happy, MDR.


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.



Torn Meniscus: To Scope or Not to Scope?

Source: Pixabay
Source: Pixabay

I received a call from a dear friend of mine regarding his knee injury.  I get lots of these.  He had some anterior knee pain during his long runs over 10 miles with minimal swelling.  As an Ironman triathlete, this guy is a machine.  He swims, bikes and runs….almost every day!  That is not a typo.

Needless to say, my friend “Tom” is not your typical weekend warrior and his pain tolerance is quite impressive.  With this being said, when Tom complains of pain, it’s not taken lightly.

Tom had already been evaluated by an orthopedic surgeon and an MRI was ordered.  The MRI revealed a kneecap stress fracture, a knee cartilage injury and a knee scope was schedule.  Tom’s question to me was simple: “Do you think I need a knee surgery for a torn meniscus?”

I get lots of knee torn meniscus management questions on  I think Tom’s knee injury is a perfect opportunity to help many of my readers by sharing my thoughts on knee cartilage injuries.

Tom’s Knee Cartilage Injury Facts

No Known Mechanism – No falls, no twists and no knee injury history.

Knee Pain – Anterior pain only after 10+ miles running.  No joint-line pain over the medial or lateral menisci.

Symptoms – Patella soreness after long runs only.  No catching, no joint locking, no giving way and no swelling inside or outside the joint.

Torn Meniscus Management

If It’s Not Broke, Don’t Fix It – If there is no mechanical signs or concerns related to a knee meniscus tear, I’m a firm believer in not bothering it.  There’s an old saying in sports medicine: “Don’t do surgery on an x-ray or MRI.”  In other words, trust you evaluation and what the patient is telling you not just what the film looks like.

Common Findings – A great deal of individuals, athletes and couch potatoes alike, are walking around with pain-free meniscal tears, myself included.  It’s very common and not a reason to do a surgery compared to so many more serious knee injuries.

Location, Location, Location – The knee cartilage is a valuable piece of real estate.  Where the tear is located will have a huge impact on the person’s symptoms and the need for surgery.

Lateral vs Medial – A tearing of the lateral or outside meniscus is more concerning than a medical or inside meniscus tear.  This is because the outer compartment of the knee bears more weight and is much more prone to knee arthritis.

Happy Knee? – If there is no inner “locking” or “catching” of the knee, no pain over the inner or outer joint lines and no significant swelling within the joint, a scope is probably not necessary.  In most cases, scoping a happy and asymptomatic knee will simply create problems for the athlete.

Ice + Strength – Controlling swelling by applying 15 minutes of ice every hour and increasing quad strength with limited range of motion (ROM) leg exercises are crucially important sports medicine tricks to help avoid surgery for a torn cartilage.

In Summary

My recommendation to Tom: To pass on the knee scope, avoid running until the doctor clear him to do so, get aggressive with his pain-free leg exercises to keep his legs strong, utilize Russian electrical stimulation to assist with this quad and hamstring strength, focus on his swimming, use a bone-growth stimulator to help speed the healing of the patella and to be consistent with his knee icing.

What did Tom do?  He had the scope to trim his meniscal tear.  It’s been about 2 month since the knee surgery, he’s now has joint-line symptoms where his meniscus was cut during the scope and he’s still trying very hard to regain the quad strength he had before the scope.  He recently return to running.  He’s a great person and we all hope to see him back to competing aggressively at a very high level.


(Lame) Reasons People Commonly Give for Not Exercising []

This is a fun and interesting article on the 10 most common reasons why people don’t exercise. It not only describes the lame excuses many people give for not working out but it also gives a solution to overcome those barriers. Whether by giving instruction on how to overcome the given obstacle or by added encouragement, this article breaks down common inhibiting factors of exercise.

Give it a read, delete these excuses from your vocabulary & get out there and move!  MDR


1.  I Don’t Have the Time to Exercise

Research documents the fact that exercising does not have to be time-consuming to be beneficial. For example, engaging in physical activity for as little as 15 minutes a day (either on a continuous, nonstop basis or cumulatively in several increments) can help you be heart healthy.

2.  I Don’t Know How to Exercise

Truth be known, exercising is not a particularly complex undertaking. The basic key is to just get moving. Walk, run, swim, join a group-exercise class. . . whatever rings your motivational bell. If you want sound advice and guidance on your exercise efforts from an expert, you should consult a health/fitness professional who has been certified by a credible professional organization (e.g., ACSM, ACE, NSCA).

3.  Exercise is Too Inconvenient

No muss, no fuss, no way. In contrast to the expectations of those individuals who feel that life’s rewards should be handed to them in a neatly packaged, effortless way, most things worth having are worth making some sacrifice (e.g., time, money, energy) to obtain. The health benefits associated with exercising on a regular basis are no exception.

4.  I’m Not Fit Enough to Exercise

Simply stated, you don’t have to be fit to get fit. Regardless of how physically fit you are at any given point in your life, you are never so out of shape that you can’t or shouldn’t exercise. You may not be a viable candidate for running a marathon, but you can engage in physical activity at a safe exercise intensity level that is appropriate for your level of fitness.

5.  Exercise Can be Painful or Even Dangerous

Exercise will not harm you. While you may experience some degree of discomfort (as opposed to pain), such a feeling is your body’s simple way of letting you know that there is a price to pay for certain actions, for example, doing too much exercise too quickly. In fact, the risk of injuring yourself while engaging in sound exercise is very low. The danger of dying while exercising is extremely rare.

6.  I Get Enough Exercise at Work

Unfortunately, too many people equate being fatigued after work with having a similar effect on their body as exercising. Not true. Your work may be physically taxing, but it is not exercise.

7.  Exercise is Too Expensive

You don’t need to spend much money to exercise. Other than buying a good pair of shoes, your wallet does not have to withstand an assault to pay for your exercise regimen. Furthermore, relatively speaking, exercising is a lot less costly than the array of potential downsides to a sedentary lifestyle (e.g., higher healthcare costs, lower levels of productivity, etc.).

8.  Exercise is Too Physically Demanding

Certainly, exercising entails a greater physical challenge than the vast array of sitting-on-your-heinie tasks associated with a nonphysical activity lifestyle. On the other hand, exercise need not be unduly tough or hard. The key is to engage in an exercise regimen that is appropriate for your level of fitness. All too often, the real challenge you face is to conjure up enough energy to get up off the couch and get moving.

9.  I’m Too Old to Start Exercising

The innumerable benefits of exercising on a regular basis are within the reach of individuals of virtually all ages. In reality, you’re never too old to begin exercising. Depending upon your age (men over 45; women over 55), you may need to see your physician prior to engaging in a vigorous exercise program.

10.  I Don’t Believe in Exercise

A healthy dose of skepticism about the existence of some things (e.g., the Loch Ness monster, the Easter bunny, an honest politician, etc.) is appropriate. The value of exercise, however, should not be one of them. The benefits of exercise are extensive and well documented. If for any reason you question the merits of exercise, you need to invigorate your life with a 3-G’s strategy – get real, get up, and get moving.

James A. Peterson, Ph.D., FACSM, is a freelance writer and consultant in sports medicine. From 1990 until 1995, Dr. Peterson was director of sports medicine with StairMaster. Until that time, he was professor of physical education at the United States Military Academy.

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 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!