Foam Rolling 101 for Endurance Athletes

Have you ever been told you need to foam roll as part of your training program? If so, did you know why you were foam rolling or how you were supposed to go about doing it? Here is a quick Q&A guide to those interested in a simple and effective training tool.

What is foam rolling?

Foam rolling is a common form of self-myofascial release most often used by endurance athletes to help combat delayed onset muscle soreness (DOMS).

What are the benefits of foam rolling?

While foam rolling is most often used to treat muscle soreness and enhance recovery following intense bouts of exercise, foam rolling has also been shown to be an effective tool for improving joint range of motion at the hip, knee, and ankle without compromising muscle performance. Therefore, it can be beneficial when used either pre or post-workout. You will often see foam rolling utilized as a therapeutic tool used to treat Patellofemoral Pain Syndrome (i.e. runner’s knee), IT Band Syndrome, Achilles Tendintis, and Medial Tibial Stress Syndrome (i.e. shin splints).

What areas should I focus on?

Targeting sore areas of the muscles in the legs following a training session can be an effective way to enhance muscle recovery and reduce the negative effects of DOMS. Common regions to foam roll in the legs are the calves, hamstrings, gluteals, quadriceps, IT bands, and adductors. Here is a video of a sample foam rolling routine for runners:

What areas should I avoid?

In general, foam rolling is limited to soft tissue, as it is a self-myofascial release tool. Avoid rolling over bony prominences (bumps) or joint surfaces, as this is more likely to be aggravating as opposed to therapeutic.

How long should I foam roll each region?

Studies suggest that foam rolling an area for 30-60 seconds is sufficient to enhance joint flexibility and reduce muscle soreness. No need to roll much longer!

Other considerations...

Foam rolling is meant to be a tool utilized in conjunction with, not a substitute for, other evidence-based training principles. It will not eliminate your risk of getting injured if you are over-training or training inconsistently. As always, please consult your primary care provider or physical therapist if you have any questions or concerns before implementing a new wrinkle to your exercise routine, such as foam rolling. If you experience any progressive increase in pain or discomfort with foam rolling, stop and seek guidance from a healthcare provider or fitness professional.

-Grant Hennington, DPT

Preventing ACL Tears In Soccer Players

With the World Cup currently in full force, it is difficult for physical therapists everywhere to not think about ACL tears when soccer is at the forefront of our attention. ACL tears are alarmingly prevalent in soccer players, particularly in females. In fact, female soccer players are near the top of the charts when it comes to athletes most at risk of ACL tears. But what, if anything, can be done to prevent this? While the risk of ACL tears can never be eliminated, the evidence suggests the risk can be reduced via targeted injury-prevention programs. Injury-prevention programs designed for ACL health should focus on improving lower extremity biomechanics via functional strength and stability exercises, particularly targeting the quadriceps, gluteals, hamstrings, and core musculature. Here are some common therapeutic exercises to consider:

• The TRX Retro Floating Lunge is a great way to improve dynamic knee control while strengthening the quadriceps, hamstrings, and gluteals. Perform 3 sets of 10-20 repetitions per leg, every other day.

• Band-resisted side-stepping helps to strengthen the gluteus medius, a muscle critical in controlling excessive rotational forces at the knee, which can be implemented in ACL tears. Perform 3 sets of 10-20 steps each direction, every other day.

• Lateral bounding is a common plyomteric exercise that can help to improve dynamic knee control and hip stability, while also increasing power in the leg musculature. Perform 3 sets of 10 jumps in each direction, every other day.

• An agility ladder stepping series creates a functional opportunity to improve coordination and dynamic knee control, translating to more efficient footwork on the soccer field. Perform a routine similar to this every other day.

Programs to reduce the risk of ACL tears should incorporate training multiple days per week and contain workouts that are at least 20 minutes in duration. With any injury-prevention program, compliance is key, as you only will see a benefit if these exercises are performed with regularity. Finally, when considering any new training program, please consult with your physical therapist or sports medicine provider before moving forward. Play on!

-Grant Hennington, DPT

Promoting Improved Shoulder Health In Rock Climbers

Climbing season here in the Pacific Northwest is upon us and with that, more often than not, comes nagging climbing injuries. While traumatic injuries can occur from unexpected falls or hazardous rockfall, the majority of climbing injuries are related to overuse, with the shoulder joint being a common culprit. Common climbing injuries involving the shoulder include shoulder impingement syndrome, rotator cuff tendinopathy, rotator cuff tears, and labral tears. But can anything be done to prevent climbing injuries resulting from overuse? The short answer is yes, with a combination of strength, stability, and mobility exercises being ideal for reducing your risk of injury. Here are 5 therapeutic exercises to try:

1. The band-resisted wall crawl exercise helps to strengthen the rotator cuff, a group of muscles that help to stabilize the shoulder joint during overhead activity. Perform 3 sets of 5-10 repetitions every other day of the week.

2. The bird dog exercise helps to build stability of the shoulder joint complex, while also isometrically strengthening the rotator cuff, helping you better perform moves involving mantling. Perform 3 sets of 10 repetitions every other day of the week.

3. The open book exercise helps to increase the mobility of the thoracic spine while also improving the flexibility of the pectoral muscles, helping to create a more efficient overhead reach. Perform 1 set of 10 repetitions each direction, up to 7 days per week.

4. The chest opener stretch, performed on a foam roll, helps improve posture by stretching out the pectoral muscles, which are chronically tight in rock climbers. Perform 1 set of a 3 minute hold, up to 7 days per week.

5. Thoracic spine mobilization over a foam roll is a great way to improve thoracic extension, helping with more efficient overhead reach in climbers. Perform 1 set of 60 seconds, up to 7 days per week.

With any and all of these exercises, the motion should be gentle and pain-free. Fight the temptation to do more than recommended, as you will not get better twice as fast if you do twice as many repetitions, sets, and/or days per week. It should be noted that not only will these exercises help reduce your risk of injury, but they will also give you a bump in performance, allowing you to climb more challenging routes for longer periods of time. The exercises should be performed for a minimum of 8 weeks in order to experience significant changes in strength, stability, and mobility. Climb on!

-Grant Hennington, DPT

Training For Backpacking Season

As temperatures rise and snow levels melt, many of you have visions of epic backpacking trips in the mountains this summer. But how do you train for the rigors of dozens of miles of trails with thousands of feet of elevation gain and a heavy load on your back? When considering a training program for backpacking season, it is important to take in to consideration both injury prevention and performance. Over 200,000 individuals are treated in emergency departments each year for injuries related to outdoor recreational activities. Common injuries sustained while hiking or backpacking include ankle sprains, patellofemoral pain syndrome, and low back pain. Training plans should incorporate the following principles in order to reduce the risk of these conditions:

• Programs to minimize the risk of initial or recurrent ankle sprains should focus on muscle control, balance, and proprioceptive deficits. Perform this single leg balance progression 3-4 days per week of ankle sprains.

• Programs to minimize the risk of anterior knee pain (a.k.a. patellofemoral pain syndrome) should focus on improving gluteal and quadriceps strength, ankle mobility, and foot stability. Perform single leg squats and band-resisted side-stepping 3-4 days per week to reduce your risk of patellofemoral pain syndrome.

• Programs to minimize the risk of low back pain should focus on improving hip mobility, trunk stability, and core strength. Perform a hip stretching routine or trunk stability exercise 3-4 days per week in order to reduce your risk of low back pain.

With all of these in mind to reduce your risk of specific and common backpacking injuries, it is also important to maintain adequate fitness levels in preparation for your backpacking trip. Your training program should be specific to the physical demands you will encounter on your backpacking trip. While running on a treadmill will improve your cardiovascular endurance, there is no substitute to carrying a heavy backpack for miles on a trail with significant elevation gain, should you be planning a backpacking trip in the mountains. Finally, be sure to carve out adequate time to prepare for your adventure, as it takes 8 weeks of consistent training in order to improve strength, flexibility, and stability. Happy trails!

-Grant Hennington, DPT

How To Safely Increase Your Running Mileage

If you are in the midst of training for a marathon or half marathon, or thinking about running one in the future, you will inevitably be faced with the task of increasing your weekly running mileage in preparation for race day. Currently, there are many commercial training programs readily available online, with varying degrees of progression, at various costs to the consumer. But how do you evaluate a training program and select the right one for you? An important consideration is how much should you be increasing your running mileage each week. Research suggests increasing your running mileage no more than 10% per week in order to minimize your risk of injury, while still improving performance. Anything more and you are significantly increasing your injury risk. Contrary to popular belief, the leading cause of running-related injury is overuse or improper training progression, not running form, shoe selection, or running on pavement.  Too much, too soon, and/or too fast can lead to situations where tissue breakdown exceeds the ability of the tissue to regenerate. This is the primary mechanism of an overuse injury. Common overuse injuries seen in runner's include patellofemoral pain syndrome (runner's knee), median tibial stress syndrome (shin splints), Achilles tendinopathy, and plantar fasciitis. So if you are experiencing any nagging aches and pains while running, assess your training program and see how much your running mileage is increasing each week.

-Grant Hennington, DPT