Back Pain?

Back pain is no joke. Many adults and even children suffer from back pain, specifically lower in their backs. There are a whole host of things that contribute to back pain, some are life style choices and some are genetics. Back pain can remove you from daily life activities that are both fun and necessary. Runners are not immune. Running involves repetitive stress and impact for long periods of time, which obviously has the potential to cause some back pain or tightness at some point. Maintaining good running form, following some basic training rules and keeping the back muscles loose will save you from missed work, and more importantly missed running.
Maintaining proper running form and a strength training routine (see mine here)  focusing on the core muscles (including the lower back) is going to go a long way in preventing lower back pain. Running form can make you a more or less efficient runner and it can make you a more or less injury prone runner. What is proper form? First, you don’t want to make big changes to your running form at a time, pick one of these and do it until it becomes automatic and then move to another. If you notice any pain, which you shouldn’t, make sure you are doing it correctly. If any pain continues, reduce it to every other run until it’s comfortable and then increase to every run.
  1. Head up and shoulders back, not uncomfortably but might feel a little weird if you sit at a computer for a long time each day.
  2. Chest up. Imagine a string attached to your sternum about nipple height pulling up to the sun or moon. This is probably the most helpful with aligning your body.
  3. Be aware of your legs. they should be under your body when you land not way out in front, especially downhill otherwise every step is like putting on the breaks and causes major impact to go through your body improperly.
  4. Foot plan should be mid-foot or forefoot. If you are doing one or the other, don’t switch. Basically, you don’t want to heel plant see number 3 above.
  5. Arm swing. Hold a ninety degree angle at the elbow, hands loose, like you’re holding a potato chip. Don’t cross your arms past your mid-line, center of your torso. Your elbows should come up to your hip and swing back until your wrists are at your hip. They should go straight back and then straight forward, a little pull toward the center is okay, just don’t cross over.
Another important factor, is increasing your miles by the 10% rule and taking rest weeks every 4th week (reduce your miles by 20-25% for the week). Increasing your miles too quickly doesn’t give your body enough time to build the muscle to handle the next level of training. Training with big mile jumps leads to over use injuries. Rest weeks are equally as important because they give your body time to heal and get stronger. As we run we create micro tears in our muscles. This is good because they heal stronger and build more muscle. But if you don’t give it time do do that effectively, it will just do the best it can with what it has, which doesn’t work well long term for you.
Self massage on the back. Sure being able to afford regular massages by a professional would be awesome, but not all of us runners have sponsors, which means all our money goes to our shoes and socks… That leaves massaging to our significant others or more often ourselves. The least expensive and surprisingly very helpful are La Crosse balls. Buy two of them from Amazon or a local athletic store and tape them together. Keep the tape smooth and make sure they are secure. Place the taped balls between your back and the wall with the indentation in the middle over your spine. The balls will be on either side. Now slowly raise and lower yourself against the wall. Keep your hips neutral (great squat workout too). Stop on knots for a few 20-30 seconds to see if you can get them to release. Keep going for 2 minutes or longer if you’d like.
A wonderful tool for total body massage (no they don’t pay me) is the Body Wrench, find it here. It’s a bit pricey, but remember it’s an investment in your body and it’s 100% money back guaranteed. You can use it for strength training as well (a 2-fer). It comes with a storage bag and an instruction manual. There are instructional videos online, found here.
Running forever, means we are going to do what we need to do to prevent and fix injuries and pain.

Foam Rolling?

We love to hate the foam roller. After a full round of strength training posts, I believe it is a good time to post about the benefits of the foam roller and how to do it correctly. I didn’t learn to love and value my foam roller until I had to walk backward down hills during the last five miles of a mountain marathon. Not pleasant. Since then, I have be come a huge advocate of foam rolling because I know it works. I know it keeps me running. If I slack off for a week, I can tell. My muscles start get tight and I start having some tension in the typical area’s in my quads and calves. And I know, if I don’t get serious with the rolling again, I’ll be wishing I had.
Rolling helps prevent injuries by keeping your muscles loose. Tight muscles do not move the way they are supposed to and then they get pulled, torn, or they cause injury to a supportive tendons/muscles that gets incorporated to help the tight ones than is typically would with a healthy muscle. Our muscles build up lactic acid which can make them sore, especially for new runners or runner conquering more distance. Rolling breaks this up and allows your body to flush out what it doesn’t use. Your muscles will eventually learn to burn the lactic acid as a form of fuel and you don’t get sore anymore (I know you don’t believe me, but as ultrarunners who have been running 100s a while if they get sore…). Tight muscles prevent us from using the most efficient running form we can because we don’t have the range of motion and we rely more heavily on support muscles. Running efficiently means more speed, more endurance, and less injury. Every runner wants those things, or at least the last one.
Can’t I just stretch to make sure I maintain mobility and range of motion? In my experience, no, Foam Rolling is the answer. Runners hear a lot about stretching and there is research saying stretching is helpful, pointless, or harmful to runners. Stretching done right, can be helpful (I’ve posted about yoga and it’s benefits to runners). But stretching done wrong can be very very bad for runners. Cold muscles should not be stretched. Muscles should not be stretched past the point of tension (not pain). If you do want to stretch, make sure your muscles are sufficiently warm, after a run is best. If you stretch without them being warm, you can tear them or strain them. How to stretch and which positions are best can be complicated. Foam rolling on the other hand is easy. I like easy.
Yes foam rolling is one more thing to consume your time. The thing with foam rolling is, you really can’t make an excuse not to, because you can do it and watch TV, talk on the phone, supervise children, help with homework, and play with the dogs. The one thing I don’t recommend is eating and foam rolling. It can be messy. The amount of time you spend rolling is going to depend on your body and the amount of running you do. I run 90 miles a week and do strength training on the days I don’t run, which means I’m pretty dedicated to my foam roller and we spend a lovely time together each evening.
For other runners, daily rolling isn’t going to be necessary. At a minimum runners should be rolling on days they run. It doesn’t have to be right after running, although that would likely  be best. I don’t have time to do it right after a run, because I have to get to work. I roll in the evenings before I go to bed.
How to foam roll:
  1. Purchase a foam roller. I like the foam rollers that are not actually foam. They are a hollow plastic tube about 18 inches long (45cm) and five inches (12.5cm) in diameter. They have contoured cushioning on the outside surface. You can use just a regular foam roller, which many gyms have if you want to try before you buy. You can try them at running stores too. The plastic tube ones are more durable.
  2. Find some floor space, light carpeting will be okay, but you don’t want super cushy.
  3. For the ITBand, place the roller on the floor and lay on the foam roller on the outside of your leg beginning at the him. Support yourself with your arms; you can put the other leg down if you need too. Slowly roll down to your knee and then back up. It’s important to go slow. Stop on any knots (bumps) you feel and rest here for 20 to 30 seconds.
  4. Continue rolling that muscle for 1-2 minutes and then switch.
You can choose to roll just the muscles you typically have problems with, or you can roll all the muscles of the leg. I recommend all the muscles of the leg because they all work together and if you are having a problem with one, it could really be a problem with a different one that is merely impacting the one that is causing you concern. You can also choose to roll only when you are having tightness or tension in your muscles or you can choose to roll on a regular basis. I recommend rolling regularly because you will prevent issues from coming up. It also takes less time if you roll regularly than if you have to roll multiple times a day to fix something.
Runners roll routine. Roll for 1-2 minutes on each of the following muscles:
Glutes (butt)
Quads (make sure you get all three during the time you roll this group)
Rolling can make a world of difference. I know it has for me. I even take the roller to races with me and on vacation.


Complete Running Strength

Adding strength training for your body overall is obviously going to help you as a runner. Strength training should be done for 30-60 minutes three days a week. You can do them after your run or on days you don’t run. I recommend the latter. If you can’t go through all of them during the time you have available (this whole program is about 1.5 hours), do some one day and then the others the next. You can even break it up into three shorter sessions and just rotate through them.
You don’t necessarily need a gym membership to do these exercises because they use a few free weights, which you can get at any sports store and many general stores. Most of them are inexpensive as well. For runners using free weights, body weight, and plyometrics are going to help you the most. Machines may seem ideal because they are easy and they will help you build strength. The issue is they are stationary and running is not stationary. You are working to strengthen patterns of movement.
Here is a list of the equipment you need to complete this comprehensive strength workout: Kettle bell, swiss ball, medicine ball, resistance band (loop) and dumbbells.
Many of the exercises we’ve looked at work more than one section of the body making this easier than it looks if you’ve read all of the prior blogs. I’ve compiled the list here for easy access . Please feel free to use this and share it with others. If you can’t remember how to do them, I’ve linked the post with the instructions. I’ve put them in supersets to make it less overwhelming. I string them together so you can move between them easily. To perform a superset complete all three rounds of the exercises in the set and then move to the next superset. Complete 10-20 repetitions of each exercise in each set. If it gives you a time then, do it for that duration three times. Try to move from exercise to exercise as quickly as possible.
Superset One
Tri-cep press
Bicep curls
Fire hydrants
Donkey kicks
Eccentric calf raises (double and single leg)
Squats sumo and narrow legged
Superset Two: 
Renegade rows
Shoulder press
Planks side and front
Leg lowers (with or without medicine ball)
Kettle bell swings
Bird dogs
Back extensions
Monopoly game
Chair on toes
Toe tug
Superset Three
Twisting crunch,
Modified bicycle,
Window wipers
Box jumps
Jane Fondas,
Piston squats
Split squat,
Side squat,
Farmer’s walk on toes
I highly recommend doing the complete program. It’s going to get you a more rounded and balanced body. However, I’m a realist. If you can only do one part, focus on your core. Here are the links to the core posts, abs, hips ,  and thighs.
We all want to become faster, stronger, and more efficient runners. And even if there are a few who don’t want those things, you still want to be able to run for the rest of your life. The best way to make sure you are able to continue running is to reduce the risk of injury and one of the most effective ways to reduce your risk of injury is through strength training.
We’ve been making our way down the body considering how each muscle group helps us become faster, stronger and more efficient runners through strength training and as we’ve looked at each section something that has become a theme is injury prevention. Injury prevention is something all runners can get behind regardless of your distance or where you fall in the pack.
We’re all going to get slower as we age and it becomes more difficult to build muscle mass, not that we want a lot of mass as runners, but an area where we can continue to get better and balance out what we lose in strength is efficiency.

Feet and Running

Similar to our ankles, we don’t think much about strengthening our feet. It’s crazy that we spend so much of our life on our feet and they rarely get an aware thought, unless they are hurting and then we complain about them to no end. When was the last time you thought, “Good job feet! you worked hard today. You’re going to get some extra attention tonight.” Ummm never.
Runners have all kinds of problems with their feet: pronation, supination, flat feet, high arches, plantar faciitis,  blisters, black toe nails. We spend $12.00 or more for one  pair of socks because we love our feet so much and don’t even talk about how much our shoes cost. And yet, we don’t train our feet. Many don’t even actually wash their feet…
You can have incredibly strong legs, core and upper body, but it wont make up for weak feet. Over pronation or supination will misalign your entire leg and hip. If your arch collapses your knee comes in and your quad tries to compensate by pulling it out. This will lead to many different injuries and a very inefficient running form, aka wasted energy. Complete three sets with 10-15 repetitions of each of these, unless it gives a time and then do three sets of that time. If you aren’t able to do the full set that’s fine just back off to where you are and move forward again.
  1. Monopoly game.
  2. Chair on toes 20-60 seconds.
  3. Toe tug.
How to do it:
  1. Monopoly Game: put ten small objects on the floor like marbles, legos, or monopoly pieces.  Put a small cup near by. Use your toes to pick up each piece one at a time and place them in the cup.
  2. Chair on your toes: Stand with your feet about shoulder width apart. Hold your arms out straight in front of you. Rise up on your toes as high as you can and bend at the knees lowering yourself like you’re in a chair. Try to stay up as high as you can on your toes.
  3. Toe tug:  Toe Tug: wrap a exercise band around a heavy object and then around your toes while you’re sitting on the floor facing the object.  The band should be anchored straight in front of you.
As your feet become stronger, you may want to get re-fitted for running shoes. When I first began running, I wore a motion control shoe, but now I wear a neutral shoe. Why? because my feet are much stronger. Having strong feet can also change the size of shoe you wear. We talk about having a strong base or foundation when we are increasing our miles during training and a strong foundation begins with our feet.

Ankles and Running

It seems pretty obvious that having strong ankles would be beneficial to runners, but never in my life as a runner (or before) have I heard one runner say to another runner:
“What’d you do at the gym today?”
You laugh but it’s true. And yet we rely heavily on our ankles to make sure we stay upright and moving forward. Our ankles have to be both flexible and strong. We need them to be able to bend and move with the variations of trails and other surfaces, and to hold strong stabilizing our feet and lower leg on these precarious surfaces too. Ankles, like many of the other muscle groups we’ve covered, play a role in our efficiency as runners because of how they can impact our form. Their position on the body makes them important because they are going to throw things off from your feet all the way up.
An ankle injury will take you out of running completely and it can take a long time of physical therapy to come back from. While in physical therapy you’ll work on strength, mobility, and proprioception, so why not work on those things before and protect our ankles from the beginning. Complete three sets with 10-15 repetitions of each of these, unless it gives a time and then do three sets of that time. If you aren’t able to do the full set that’s fine just back off to where you are and move forward again.
  1. Drunk Flamingo 30-60 seconds.
  2. Four Directional hop.
  3. Ankle Rotations with toes tucked in and weight bearing.
  4. ABC’s.
How to do:
  1. Drunk Flamingo: stand on one leg with your eyes open. Once you can do it with your eyes open, stand on an unstable surface like a pillow or mini-trampoline, a bosu trainer. When you’re good at that, close your eyes.
  2. Four directional hop: stand on one leg and hop forward then back to center, hop back then back to center, hop left then back to center, hop right and then back to center.
  3. Ankle rotation: hold your foot up off the ground and rotate your ankle one way and then the other. Pull your toes toward you and then place your heal on the ground and spread your toes while you rotate.
  4. ABC’s Stand on one leg, hold the other one in the air about 6-10 inches off the ground and write the ABC’s with your toes.
We don’t think too much about our ankles, but strong ankles is going to help prevent injuries all the way up to your head.

Calves and Running

All runners have strong legs right? well yes, but some times they type of running you do impacts the amount of development you see in your leg muscles. The calf muscle is one area where this is most pronounced. Sprinters use explosive speed to get ahead of their competitors, leading to larger calf muscles  Long distance runners don’t use that explosive power as much and their calves tend to be lean and toned. Trail runners tend to fall in the middle because of the mountains they climb.
Our calf is composed of two muscles the inner and outer. These muscles extend and flex to control our foot movement as we land and push off. They absorb a lot of impact and put a spring in our step.  Our calf is attached to the Achilles tendon, which as we all know, can be a problematic and temperamental little tendon. Calf strain/pulls are one of the most common injuries runners experience. Usually the place that it injured is where the calf muscles are inserted into the achilles tendon. Having weak or tight calf muscles can lead to ruptures, strains, and tears in this favorite tendon. Your calf also helps stabilize your ankle and your knee. As this wasn’t enough for the calf to do, it also helps with blood flow. When it flexes it pushes blood back to the heart, when it relaxes blood flows back into the calf to be propelled up with the next flexation.
Before we get into the nitty gritty of how we can strengthen our calves, we’re going to lean about two stretches for the calf because of the potential injury to the achilles if this is neglected. To stretch the calf properly, you need to stretch both the inner and outer muscle. Stretch ONE: Stand at your arm’s length from a wall(facing the wall) and step back with one foot. Put your hands on the wall and lean your chest toward the wall, keeping the leg that’s extended straight. Hold for 30-40 seconds and do the other side. Do both sides twice. Stretch TWO:  Stay in the same position, but move the back leg forward about 6 inches and bend your knees (the back more than the font). Keep your heel on the floor. Hold for 30 seconds and then do the other side. Do both sides twice. Whenever you are stretching, stop before it is painful. You should feel tightness but not pain. You can tear your muscles and even rupture them if you use too much force. Stretching your calf muscles everyday is a good idea, especially if you can take the five minutes after a run and do it. For all my Yoga runners, down dog is a great way to stretch your calves.
Regardless of which body part you are trying to strengthen, as a runner, you don’t want bulk. It slows you down. Because of this, we train with lighter weights or body weight and higher repetitions.  Complete three sets with 10-15 repetitions of each of these, unless it gives a time and then do three sets of that time. If you aren’t able to do the full set that’s fine just back off to where you are and move forward again. We all start somewhere.
  1. Farmer’s Walk on toes sixty seconds.
  2. Eccentric Calf Raise
  3. Jump squats (make sure your muscles are warm before doing any plyometric aka explosive exercises)
How to do:
  1. Farmers walk: hold a pair of dumbbells straight down at your sides. Rise up on your toes and walk forward while standing tall. This is the one exception to using light weight. You want to have pretty heavy weight here.
  2. Eccentric calf raise: stand on a step with your heels hanging over. Rise up on your toes and then slowly(ten second count) sink down until your heels are below the step.
  3. Jump squat: stand tall with your feet a little more than shoulder width apart. Toes should be turned out a bit. Hold your arms out in front of you, squat down, pushing your butt back while keeping your upper body tall. Try to lower your but below the knees if you can, but don’t skip this if you can’t. Now explode up as high as you can and land softly.
Your calves are pretty important when it comes to running, but they don’t have to look big to be strong.

Thigh Strength and Running

 If you’ve been following this series of posts about why strength training is important to runners and how to do it, you know that strengthening your core muscles is really important. And if you have to choose one area, because of your limited time or whatever, chose your core muscle group, especially your hips.
Given that, my ultimate recommendation is to strengthen your entire body with running specific exercises. Using stationary machines may get you stronger, but they are not the most beneficial for runners. Using body weight and light weights while moving really focuses on all the muscles you use to run. Running, after all, is not a stationary movement. These exercises are not meant to increase the size of your muscles. You don’t have to be big to be strong. Size only adds weight and slows you down.
What do your thighs do when you run and why is it important to make sure they are strong? Your thighs (and hamstrings) get you up and down hills. They also make sure your knee cap tracks as it should. A knee that does not track properly is painful and can put a complete stop to your running. I’m going to touch on your hamstrings a little here as well because your thighs, aka quadriceps, and hamstrings work together to move your leg forward and back. Many runners have weak hamstrings. An imbalance between hamstrings and quads can lead to over use injuries, muscle strains, and tendon inflammation. All bad. As you strengthen your quads, make sure you are also strengthening your hamstrings.
Quadriceps push you up hills and take most of the impact when you run down hill stabilizing you with each foot step. Your hamstrings and glutes should be working in conjunction with your quads to push you up the hill and stabilize on the down hills. If you have weak hamstrings and glutes, make sure you are focusing on them while you climb and descend, think engage the glutes and feel them flex and push. This is called proprioception or knowing where and what your body is doing. If you read the last post on hips, you can alternate between your hip awareness and your hamstring/glute awareness. For exercises that strengthen your hamstrings see Tuesdays post here.
When runners come to me with sore knees and shins after a long run or race, I always ask how much down hill there was. People think that downhill running is easier than uphill and it is mentally and aerobically easier for most. The issue is the impact to your quads. If you don’t train your quads to absorb that impact, you’re going to hurt, and you’re going to end up injured.
Your quads consist of four major muscles on the front of the leg, one pretty much straight down the front, one that attaches to the inside of your knee, one that attaches to the outside of your knee, and the last one hides underneath the first one is said. Do the following exercises three to four days a week. Complete three sets of 10-20 repetitions. You don’t need a lot of weight because we are not trying to get bigger.
  1. Split leg squat.
  2. Narrow leg squat.
  3. Chair.
  4. Kettle bell squat.
  5. Side squat
How to:
  1. Spit leg squat. From a standing position step forward and lower down until your knees are at ninety degree angles (both front and back so make sure your stance is not too wide or narrow). Hold at the bottom for 2-3 seconds. Come back up and repeat. Don’t alternate. Just stay in that position until the set is finished. Keep your knees straight forward.
  2. Narrow leg squat. From a standing position, place your feet about six inches apart (you can put your hands into fists side by side to measure). Raise your arms straight out and lower down as far as you can. Keep your knees straight forward and behind your toes.
  3. Chair: Same position as the narrow leg squat. The difference is hold at the bottom for 30-60 seconds.
  4. Kettle bell squat. From a standing position, step out so your feet are about the length of your leg apart. Turn your feet out a bit, forty-five degrees-ish.  Hold a kettle bell below your chin and squat down until your thighs are parallel with the floor. Keep your back neutral not bending forward over your legs.To add some arms to this you can lower the kettle bell as you stand and raise it as you squat down.
  5. Side squat. From a standing position. Step out with one leg and two to three feet. Squat down with the one leg keeping the other straight. Repeat on the other side. You can add a kettle bell to this one too.
Balanced strength in all four quads will prevent improper tracking of your knee cap. An important concept to come way with, for this whole series really, is that our muscles don’t work alone and we need to keep them balanced.


Hips and Running

    Running is a whole body exercise and because of this, you need to strengthen your entire body.  If you don’t do any other strength training, do hip strengthening. Your hips drive you forward. There is a bunch of research out there that supports the importance of hip strength in preventing injuries in runners. Additionally, the fastest and surest way to improve your efficiency and speed is by doing hip strengthening. Why is hip strength so important? Your hips are a part of your core muscle group which is where all of your movements, upstream and downstream, originate from.
Weak hips are actually fairly common among runners of all distances. And of course the farther you run the more likely you are to end up with an injury related to your weak hips. Your hips help stabilize your pelvis as you run. When I say hips, the muscles I’m including are: hip flexors, the outside and inside of your upper leg, your glutes, and your hamstrings. Hip flexors and hamstrings work together to move your leg back and forth. The inner and outer upper leg muscles make sure those leg swings are aligned properly with the rest of your body.  Runners hip flexors and hamstrings tend to be tight exacerbating the problem of the weak hips.
So what does weak hips cause? ITBand syndrome, runners knee, shin splints, bursitis, plantar fasciitis, and low back pain. As it turns out, hip strength alone is only one part of this equation. Don’t throw up your hands thinking, “this is too much!” just yet because this part is easy and doesn’t require work outside of your running. It’s a matter of being aware, aka proprioception; it’s knowing where your body is in space in relation to the other parts of your body. Sounds complicated. It’s not. It’s a matter of knowing what it feels like for your hips to be in the right position and then making sure they are while you are running. Your spine and hips should be in a neutral balanced position. To keep your hips in a neutral balanced position, think of your pelvis as a bowl. As you run, don’t let your bowl spill out the front, tipping too far forward, or the back, tipping too far back. During your training runs check in with your hips and spine asking yourself, are they were they are supposed to be. You can even do this throughout the day as you move around. Obviously, if they are not, correct them. Pretty soon this will become your form and you won’t have to think about it.
Alright so back to strengthening those hips. Whenever you are doing strength exercises you should focus on the body part you are using and use slow controlled movements. Using proper form during the exercise is more important than pushing your body to exhaustion. Perform these exercises three to four times a week. You want to do three sets of 10-20 repetitions.
  1. Bridges
  2. Jane Fonda’s
  3. inner thigh lift
  4. lunges
  5. piston squats
How to:
  1. Bridges: lay on your back with your arms down at your sides. Raise your hips as high as you can and hold for 2-3 seconds. You can progress to doing them with one leg, then two legs on a swiss ball, then single leg on the swiss ball.
  2. Jane Fonda’s: Lay on your side and lift the leg on top as high as you can. Hold your leg at the top for 2-3 seconds. Remember this should be a slow controlled movement. Don’t throw your leg up there because you could pull a groin.
  3. Inner thigh lift: stay on your side. Bend your upper leg and place your foot on the floor at your hips or knee. Lift your lower leg. Hold at the top for 2-3 second.
  4. Lunges: From a standing position, step forward and lower down until your front knee is bent at a 90 degree angle. Your knee should not be in front of your toes. Hold for 2-3 seconds and then do the other leg. You should be moving forward.
  5. Piston Squats. From a standing position, hold your arms out in front of you 90 degrees with your torso. Hold one leg up keeping it straight. Your foot should be 6-8 inches off the floor to start with. Bend your other leg, keeping your knee behind your toes. This one is difficult, so don’t be surprised if you can’t lower your self very far. Keep working at it.
Your hips are the key to injury prevention and improving your running in both speed and efficiency and what runner doesn’t want those three things?