Why do my knees always hurt when I run downhill, shouldn’t it be easier on my body than running on flat ground?
- Trevor from Hastings
While much easier on the cardiovascular system, running downhill can cause a lot of wear and tear on the muscles and tissues surrounding your knees due to eccentric loading. Eccentric loading is just a complex word for when an outside force tries to lengthen and stretch the muscle and to control that stretch the muscle contracts. Every time your foot strikes the ground while running, especially downhill, your quadriceps and gluteal muscles have to work extra hard to contract and stabilize your knees. If your quads and glutes are not strong enough, most of the strain will be placed on the knees, which is why knee pain, such as ITB syndrome and runners knee, is very common in runners who do not run downhill often.
You can help prevent or minimize knee pain by:
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Pilates has become known for creating more strength, improving coordination, and speeding recovery.
But like any specialized system of exercise, not every teacher brings the same depth of knowledge and knack for technique to the task. When evaluating different instructors and studios, here's what you should consider:
Training in body mechanics: Ideally, you would do well to find a Pilates teacher who has extensive experience in understanding physiology, anatomy, movement, and exercise science. For example, seeking out a physical therapist who can guide you through Pilates sessions would give you a more personalized plan, geared toward your goals, level of fitness, and injury history.
Listening skills: There are some classes, like dance sessions or kickboxing, where you can jump in, have fun, and work up a sweat. But Pilates is all about precision, not a calorie scorch. In order to get the best results, you need a teacher who will listen to your aims — injury prevention vs. performance boost — and tailor your movements accordingly.
Certification and experience: Anyone can take a quickie course (sometimes even online) and then claim to be a Pilates teacher. That's why it's particularly important to talk to teachers about their training and background, especially if you'll be working with equipment. Like any type of exercise, it's possible to become injured if training isn't done properly, so making the effort to check into a teacher's background is essential.
Personality and rapport: Someone could be the most talented Pilates teacher in the world, but if you dread having to go to sessions, you're more likely to skip them altogether. Much like other types of teachers, forging a personal connection can help you work together and focus on your goals.
In general, it helps to find a teacher that makes you feel not only results-driven, but also safe. Try out a session or two before committing to a long-term practice with that teacher, and eventually you'll find a Pilates relationship that clicks.
Gluteal Amnesia, though sounds silly, affects a large percent of the American population. If you suffer from back, hip, knee or shoulder pain you could be one of the many who lack proper gluteal activation.
Why does gluteal amnesia occur
Gluteal Amnesia is when your body forgets how to activate the gluteal muscles properly. The average adult is sedentary for 64% of the time they are awake due to the overwhelming majority of adults working a desk job that require almost no physical activity. Because of this sedentary lifestyle, our muscles are not working as much as they should be, in particular our gluteal muscles. This is detrimental to the whole body because the glutes are the strongest and largest muscle in the body. Excessive sitting lengthens the gluteal muscles and tightens the hip flexors which leads to decreased stabilizing function and overall gluteal weakness. Beyond excessive sitting, gluteal amnesia can also occur because of the overworking of your quadriceps, a previous injury, poor core strength, improper body mechanics and poor posture such as an anterior pelvic tilt.
How gluteal amnesia contributes to injury
There are a number of injuries that are caused by weak gluteal muscles, here are the three most common:
Hamstring strains: The over activation of the hamstring occurs because the glute is not firing properly during hip extension. This puts too much pressure on the hamstring causing a strain.
Low back pain: The gluteus maximus plays a crucial role in the stabilization of the pelvis and spine. Weak glutes cause your lower back muscles to pick up the slack. Because your glutes are not doing some of the work, your back will suffer.
Knee pain: Glute weakness creates excessive rotation of the femur which puts too much pressure on the knee. Knee injury examples due to weak glutes: Iliotibial band syndrome and ACL injuries.
Symptoms of gluteal amnesia
Correcting gluteal amnesia
In order to correct gluteal amnesia, you need to retrain your gluteal muscles to activate properly. One way to reverse gluteal amnesia is to warm up your glutes prior to your workout. Before your workout do 5-10 minutes of glute specific exercise such as gluteal bridges, clamshell exercise and donkey kicks. This will activate and wake up your glutes so they are ready to be used during your workout. Self-myofasical release can also help with gluteal activation. Use a lacrosse ball or foam roller to help loosen your over activated muscles i.e. hamstrings, hip flexors and lower back muscles. This will allow for your glutes to activate more easily.
First developed to build strength among prisoners of WWI internment camps, Pilates has evolved over the past 75 years as a way to strengthen core muscles, improve coordination, and shorten injury recovery time.
But couldn't that be said about other types of practices? For example, yoga claims to have all those results as well, and so do martial arts like Capoeira and judo. But Pilates is unique among other fitness-related practices for several reasons:
Small movements, big results: Particularly in martial arts, big movements tend to be the norm, such as kicking and striking. Even in yoga, a flow practice can have a student sweeping from standing to plank pose in just a few seconds. But Pilates is highly focused on deliberate, controlled movements that are seemingly easy — but just wait until you've done a few sessions. Those small tweaks can add up to major improvements in flexibility and body awareness. The emphasis here is on precision, breathing, and mental presence. That benefits the entire body and mind, not just the muscles that were worked in a particular session.
Specialized equipment: Pilates does have an option of doing mat classes, done on a mat that's similar to yoga. But more advanced studios will have apparatus like the Reformer, the Cadillac, Wunda Chair, and other pieces of equipment that can look odd to the uninitiated. Comprised of straps, springs, and padded areas, these devices help you to adjust your level of movement, so you can progress from absolute beginner on up to higher levels. What all equipment has in common is a continued focus on core muscles and expending effort from there.
Although Pilates has much in common with other types of exercises that emphasize a mind-body connection for maximum results, the system is distinctive when it comes to building proper form and alignment.
As part of Pilates, there are many pieces of equipment designed to help people get in and out of movements more easily, and adjust according to their experience, injury, and fitness levels.
But even with all that said, it's easy to mistake the Reformer — considered the top choice for many Pilates teachers and students — as some type of Medieval relic.
Vaguely resembling a rack from a bad movie that's set in the Middle Ages, the Reformer comes in several variations, with different types of attachments, but all resemble a strange twin bed that's only partially padded.
Evolution of the form
Since the founder of the practice, Joseph Pilates, developed the system for those in World War II internment camps, it's been said that the Reformer gets its look from the small beds prisoners had. With many growing weaker by the day, Pilates modified the beds with springs and straps to allow them to do strength-building exercises without additional effort.
Since then, the equipment has been refined and scaled down, so that it's now more like a funky sled than a weird bed. Straps allow you to slide from one end to the other, all while concentrating on specific muscles and consistent breathing.
Ultimate in versatility
There's good reason that the Reformer is so popular for Pilates. Exercises can be done sitting, standing, lying down, or kneeling. By being able to use components like the footbar and shoulder blocks, you can train several parts of the body in a short timeframe.
Also helpful, the Reformer is geared toward letting you work at multiple levels. So, you can still do exercises effectively even if you're injured or a beginner. No matter what level you work at, the equipment will allow you to build strength, focus, and coordination.
The best way to use the Reformer is under the expert guidance of a qualified instructor who can assess which exercises are right for your goals.
Pilates is a beneficial method for recovering from injury, optimizing performance, and preventing physical ills. But there’s a way to maximize results even more: combining the technique with physical therapy.
Rest is an essential part of training, but can sometimes be the hardest part in your running journey. Many athletes do not realize that rest and recovery actually improves performance, which is why tapering is an important part of training for a marathon or any type of competition.
Tapering can be a challenge for many athletes. After weeks of hard training, slowing down before a race is a mental game. Reducing the miles and adding more rest time builds glycogen stores which helps the muscles heal. Tapering also reduces damage to the muscles, increases strength and even improves the nervous system which leads to more efficient running.
Some athletes make the mistake of thinking since they are reducing the miles, they need to increase the intensity of those shorter runs. This is harmful because your muscles are not used to short high intensity workouts and it will fatigue your muscles. It is also important to remember that you may not feel great during the beginning of your taper. Many athletes feel sluggish and winded on workouts they thought should be easy, some also feel phantom pains. This is a common part of tapering and resisting the temptation to resume regular workouts can be a challenge. This feeling does not last forever though, most athletes begin to feel back to normal one or two days before the race.
It is important to find a balance that works for you because everyone’s tapering length is different. Some runners taper only a week before a race and others taper 3 weeks before. Experiment to find what works for you, and your body will thank you.
There are hundreds of different types of equipment to analyze your golf swing, along with pricey clubs that guarantee an improved swing and less injuries. However these devices can only solve part of the problem. Think about it, you could have the nicest looking car there is, but without the correct internal parts it is useless, this goes for golf or any sport.
Whether your goal is to improve your golf game or prevent injury, it is essential to understand how important proper body mechanics, mobility and flexibility are in golf. No matter how much proper swinging form can be taught, reaching your optimal performance will be an upward battle without mobility, flexibility and strength in the right areas. It is fairly easy to see what is outwardly wrong with a swing, but the real question is why? For example, maybe you have a hard time achieving a full backswing or often lose distance off the tee. Part of your problem could be poor technique, but it is more likely to do with tight hip flexors. Tight hip flexors limit trunk rotation, which then leads to other parts of the body compensating, such as the shoulders, elbows, wrists, hamstrings and lower back–often resulting in injury.
Before jumping to correct your swing technique take a step back to find out if there is an underlying physical limitation keeping you from the golf game of your dreams. A physical therapist will be able to identify these areas of weakness and immobility, and offer a personalized solution to get your body working properly to greatly improve your game.
2 stretches for improved golf mobility:
A-Frame Stretch: Helps improve hip mobility
Place your feet shoulder width apart. Slightly bend your knees and hinge forward and place your arm across your knees. With your other arm, rotate your trunk and your arm until your arm is pointing to the sky. Hold this position for 20-30 seconds. Repeat several times with both arms.
Split Stance Windmill: Helps improve T-spine mobility and hip rotation
Stand in a lunge and lean slightly forward with most of your weight in your front foot. Put both of your arms out wide, parallel to the ground. If your right leg is in front, turn the trunk of your body to the right so your left arm is in front of your body and your right arm is pointing up and behind you, and your chest is facing to the right of you. Hold this position for 10 seconds and repeat 6 times on each side.
Don't be a Charles Barkley and let the experts at Viverant help improve your golf game.
Dear PT Pete,
The past few times I have went out on a run I get shin splints. What are shin splints and what are some ways to heal them?
- Sheri from Independence
Shin Splints are one of the most common injuries to plague runners and athletes alike. There are few active individuals who have not experienced the dreaded pain associated with shin splints. So lets dive into what they are and how you can recover from them.
The medical known term for shin splints is medial tibial stress syndrome, which is an inflammation of the muscles, tendons and bone tissue around your tibia. In more severe cases, the inflamed connective tissues can actually separate from the tibia causing intense pain and a slow healing process. Pain is typically along the inner border of the tibia, where the muscles attach to bone. Shin splints often occur in athletes who have recently intensified or changed their training routines because the muscles, tendons and bone tissue become overworked by the increase in activity. Other reasons for shin splints are a change in the type of running surface, such as a treadmill to the street, or running in inadequately supported shoes.
Remember, it is important to determine what caused your shin splints in order to find the right healing method for you.
Methods for treating shin splints:
As a way to build strength, balance, and coordination, Pilates has won a worldwide following for its simple-yet-powerful movements.
People rely on Pilates techniques — developed nearly a century ago — to recover from injury, enhance performance, and improve overall wellbeing. Most notably, some of the basics can be helpful for any type of training. Here are the three Cs that are at the core of the practice:
Control: When he first developed this system of exercise, Joseph Pilates called it "contrology." (Not very catchy, obviously.) That's because every movement is done with complete control, often at a slow pace so it's easier to feel muscles engage.
Concentration: These deliberate movements help to fire up different muscle groups, but control is also mental — as you transition from one position to another, having conscious awareness of how your body is moving is crucial. This engagement lingers long after Pilates sessions, since that type of concentration can help in sports or even everyday life. The more control you have over how your body is operating, the less chance you'll have of injury.
Centering: Often, Pilates is used as a synonym for "core work" but that's not quite right. Although the abdominal muscles get significant benefits from Pilates sessions, a major principle for the practice is centering, not just doing crunches. Pilates believed that the center of the torso — from the lower ribs to the pubic bone — can be considered the powerhouse of the body. All movements originate from this area, so directing effort toward that center, and having movement come from there, give each exercise better flow and intention.
With these in mind, any Pilates session can yield better results. Whether working on specialized equipment or doing exercises on a mat, these Cs can help you make the most of any Pilates-focused time.
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