Tips for Post-Race Recovery, University of Utah Health Care

About the Runner's Clinic

Runner on the treadmill
Running #FTW:
10 Awesome Facts
About Running

Helping you run injury free

Using the latest technology including force plate treadmills, wireless EMG, and slow motion video capture to analyze your running mechanics, we identify your optimal form for reducing running specific injuries and improve your running efficiency. Our clinicians practice evidence-based research to analyze individual runners and provide solutions for acute or chronic running injuries.

The clinic was founded and is directed by Laura LaMarche, DPT. 

Contact Us

University Orthopaedic Center
(801) 587-7005

South Jordan Health Center
(801) 213-4500

Please contact your insurance company prior to making your appointment to verify your coverage and referral requirements regarding physical therapy benefits.

As part of the clinic, we offer the following services:

  • Detailed review of running history and injury
  • Comprehensive one and a half hour evaluation
  • Musculoskeletal exam including strength and flexibility
  • Assessment of back, hips, knees, ankles and feet
  • Video analysis of running mechanics
  • Customized program for injury treatment and recovery
  • Therapeutic exercises to address impairments
  • Shoes and orthotic recommendations
  • Training program modifications

RICE Method: First Injury Treatment Steps

For all injuries aggravated by running, always start treatment using the RICE Method:

REST - Cut back on daily activities, including running.

ICE - Apply ice to your injury for 20 minutes at least 4 times daily.

COMPRESSION - Use elastic wraps, compression socks, air casts, etc. to reduce swelling and inflammation.

ELEVATION - Elevate the injured area above your heart level to decrease swelling and inflammation.

Note: In order for the RICE method to be effective, all injuries should be treated immediately, and the four steps should be continued for at least 48 hours. If symptoms persists, it may be time to see your doctor or health care provider.

Injury Prevention for Common Conditions

Achilles Tendonitis

The Achilles tendon is a very thick, strong structure that can absorb and transfer a lot of force. With this in mind, running imposes a large amount of force onto the body (and the Achilles tendon). The body’s ability to accept this force improves with time as it responses to a gradual training load volume increase.

Many times Achilles tendon pain will come from increasing mileage too fast or adding in speed workouts, which the current strength of the tendon cannot tolerate. Another increase in demand to the Achilles tendon will occur if the runner changes to a more minimalist shoe with a reduced ramp or drop. Ramp is a measurement of how much drop the shoe creates in the sole from the heel to the toes. With the movement of minimalist running, the ramp is decreased from as much as 14mm to as little as 0mm, dropping the heel down closer to the level of the toes. A lower ramp shoe will increase strain to the Achilles tendon. Changing shoes to a significantly lower ramp while still training at the same volume may increase the load on the Achilles tendon too fast. In the Running Clinic, through the support of instrument assisted soft tissue mobilization, we can strengthen the tissue of the tendon. We also work to develop a safe progression of increased volume to reduce the likelihood of tendonitis.

Two things to try at home for Achilles tendon pain

1. Eccentric heel raises:

  • Stand on a step with both balls of the feet on the step and the heel off the step.
  • Raise all the way up into a heel raise with both feet.
  • Take the non-painful foot off the step and slowly lower the heel all the way down on just the affected side.
  • Do on both sides if the pain is on both Achilles tendons.
  • Do three sets of 15 reps daily.

2. Soleus calf stretch:

  • Stand with one leg on a stair with just the ball of the foot.
  • Let the heel drop down slightly.
  • Bend your knee forward, stretching the lower calf region.
  • Hold for 30 seconds.
  • Repeat two times.

Calf Muscle Pull

The calves are important muscles to produce power when your foot is pushing off the ground before it begins to swing. The calves also work to control your shinbone from falling forward while you are loading it with your weight. Typically, the calf will become strained during the push-off phase of running. The butt muscles and hamstrings work together with the calf during this phase of running. If these muscles are weak or there timing of contraction is delayed/impaired, then calf will become overloaded and more prone to becoming strained.

Hip extension range of motion is another important factor in the ability for the butt to contract correctly. If the hip cannot move past the body during the push off phase, it reduces the ability for the butt to contract, in turn over loading the calf again. In the Running Clinic we use slow motion capture cameras to see when running mechanics are impaired. We also have the ability to see when a muscle is contracting during the running cycle to make sure muscles are working at the right time.

Two things to try at home for calf muscle pain

1.Calf stretches:

  • Stand with hands against a wall and one leg behind you.
  • While keeping the heel of the back leg pressured into the ground, push hips forward till a stretch is felt in the back of the lower leg.
  • Hold 30 seconds.
  • Repeat two times on both sides.

2. Bench hamstrings:

  • Lie on your back with your heels on the seat of a chair or bench. Your hips and knees should be bent to 90 degrees (knees right over hips).
  • Push your hips into the air until your hips are in a plank with your knees and hips.
  • Squeeze your glutes at the top; then roll back down.
  • Work up to three sets of 20 reps.

Groin Pull and Hip Flexor Injury

Hip flexor injuries result in anterior (back) hip pain and may spread to the upper quad/thigh area. Typically the pain is felt while running when the leg is extended behind and as you swing your leg forward. After straining the hip flexor, pain may also happen with lifting your thigh (getting out of a car), or from rising up from a seated position. Many runners are tight in the hip flexor muscles, and sitting for long hours reduces flexibility in the anterior hip region. Typical causes for a hip flexor strain are large increases in running volume, running hills, and increases in speed workouts. Tempo runs and interval work increase the demand on hip motion and increase the demand of the hip flexor muscles, resulting in injury if the demand is too much for the present fitness level.

Groin pull can be very similar in nature to a hip flexor strain, with the location of pain being more on the inside of the thigh towards the groin region. If pain persists longer than a typical muscle strain, see your physician to rule out other possibilities, like a hernia.

Two things to try for anterior hip or groin pain

1. Prone planks:

  • Come into a plank position either on your elbows and toes or elbows and knees.
  • Make sure you engage your core to stabilize a neutral spine, and squeeze glutes together.
  • Progressively add hold time as you get stronger, up to two x 90 seconds.

2. Once your hip is pain free:

  • Begin hip flexor strengthening.
  • Tie two loops at either end of a Theraband.
  • Secure one end to a stable pole (or behind a shut door) and place the other end around your ankle.
  • With the resistance pulling from behind you, swing your leg forward with a straight leg using your upper thigh to flex your leg forward.
  • Slowly bring your leg back to the starting position. As always, engage your core to keep your trunk stable.
  • Start with two sets of 10, slowly progressing reps to 20. • Do this exercise four to five times per week.

Hamstring Strain

The hamstring is a group of three muscles on the back of the thigh that work to pull the leg back and also slow down the leg before it makes contact with the ground again. The hamstring group works with the buttocks muscles during both parts of the running cycle. If the buttocks muscles are weak it can overload the hamstrings causing strain or inflammation. In addition if the hamstrings are weak or not contracting at the correct time this can cause strain or inflammation.

The hamstrings have low blood supply and require increased time over other muscles to heal. Sprinting has a higher rate of hamstrings strains due to the large increase in hamstring muscle demand. In the Runner’s Clinic we utilize tools (sEMG) to see when the muscles are contracting during running, allowing us to identify the source of the problem. We also use these same tools to find the perfect exercises specifically for you to gain the most muscle strength and control.

Two things to try at home for hamstrings strain

1. Clamshells:

  • Lie on one side with your hips and knees bent 45 degrees, legs stacked. Keep your feet together and your top hip just forward of your bottom hip.
  • Raise your upper knee as high as you can without moving your pelvis.
  • Pause, then return to the starting position.
  • Do 20 reps per side.
  • Repeat two times.
  • Add in resistance band around both knees as you get stronger.

2. Bench hamstrings

  • Lie on your back with your heels on the seat of a chair or bench. Your hips and knees should be bent to 90 degrees (knees right over hips).
  • Push your hips into the air until your hips are in a plank with your knees and hips.
  • Squeeze your glutes at the top.
  • Roll back down.
  • Work up to three sets of 20 reps.

Iliotibial Band Syndrome

The Iliotibial band, or IT band as it is more commonly known, runs from the outside of the hip to the outside of the knee, attaching onto the tibia. This band crosses both the hip and the knee, and its primary function is to stabilize the knee. The IT band is a thick strand of connective tissue that encloses a small muscle called the tensor fascia latae (TFL) that anchors this muscle into the iliac crest, as well as most of the tendon from the gluteus maximus.

IT band syndrome has been linked to weak gluteal muscle strength, which is important for stability of the pelvis and lower leg. If the gluteal muscles are not working while the leg is on the ground, then the alignment of the pelvis and the knee become impaired putting more tension onto the IT band. Over time the impaired alignment continues to put increased strain on the IT band causing it to become irritated.

Strengthening of the muscles around the hip, butt, and abdominals are important to help improve the alignment. Also, working on your body’s awareness of its alignment so that the muscles contract at the right time is a very useful tool to produce long-term changes. In the Runner’s Clinic we utilize slow motion capture cameras, along with a force-plated treadmill to help improve body alignment.

Two things to try at home for lateral knee pain

1. Foam roller release:

  • Place the foam roller perpendicular to your body.
  • Lie on the foam roller with your lateral thigh on the roller (this leg is straight), your other foot flat on the ground in front of you (knee bent), and both hands on the ground for support.
  • Roll up and down from just above your knee to just below your hip. Make sure you get both the quad/anterior side and the hamstring/posterior side of the ITB.
  • Do this for five minutes daily.

2. Lateral walking with resistance band:

  • Loop the resistance band around both ankles.
  • Walk to one side for 15–20 steps and then back to your starting position while keeping your feet pointing forward, a slight bend in both the hips and knees, and your back stable.
  • Repeat two to three times.

Patellofemoral Pain Syndrome (Runners Knee)

The kneecap is an important structure to effectively stabilize the knee while running. It is shaped to fit within the grooves of the thighbone, so when it moves up or down there is good surface area distribution. If the butt muscles, hip muscles, abdominals, or quads are weak and lack the ability to control the pelvis and lower leg, the knee cap will shift to the inside or the outside of the knee joint. This will increase pinpoint pressures on the underside of the kneecap causing pain over time.

This pain is very sharp and typically will quickly reduce a runner’s ability to enjoy running. It’s important to focus on strengthening weak muscles that help to control leg alignment. Another important factor is improving body awareness so that the muscles contract better when they are supposed. In the Runner’s Clinic we use slow motion capture cameras to see when running mechanics are impaired. We also have the ability to see when a muscle is contracting during the running cycle, to make sure muscles are working at the right time.

Two things to try at home for anterior knee pain

1. Quad and hip flexor stretch:

  • Using a chair with a padded seat, place one foot on the back of the chair and the knee on the padded seat. The other leg will be on the side of the chair slightly in front.
  • Stand up tall and tuck your butt under.
  • Slowly push your hip forward until you feel an anterior hip and quad stretch down the leg on the chair.
  • Repeat two times for 30 seconds on each side.

2. Glute squats with resistance band around knees:

  • Place a tighter resistance loop around both knees, preferably above the knees.
  • Squat down starting with bending at your hips like you are sitting down into a chair far behind you. Make sure you keep your knees in alignment with your ankles and hips by pushing into the band, but keeping your feet flat on the ground.
  • Repeat 20 times, adding three to four sets as you get stronger.
  • Stop if pain increases to your knees or lower back.

Lower Back Pain

Low back pain during running can occur for multiple reasons. Abdominal strength and proper posture while running is an important skill to be able to maintain throughout the running cycle. If the abdominals are not being used while running, it can increase back extension (arching of the lower back), forcing the ligaments or joints of the spine to take the load causing pain.

Hip range of motion is another important factor in good running form. Right when the toe is about to push off the ground is a critical phase of running where hip motion is important. If you don’t have good hip extension, then it will force the back into extension to make up for the motion. Over time this can cause back pain. One thing to think about while running is having a tall spine with consistent tension in the abdominals. In the Runner’s Clinic we specifically focus on mobility and strengthening that will help to improve the body’s ability to keep a neutral spine while running.

Two things to try at home for lower back pain associated with running

1. Prone planks:

  • Come into a plank position either on your elbows and toes, or elbows and knees. Make sure you engage your core to stabilize a neutral spine and squeeze glutesl together.
  • Progressively add hold time as you get stronger, up to two x 90 seconds.

2. Hip flexor stretch:

  • In a half kneeling position, keep a tall spine and tuck your butt under.
  • Slowly push your targeted side hip forward till a stretch is felt to the front of your hip and upper quad.
  • Do two per side for 30 seconds each.

Piriformis Syndrome/Gluteal Pain

The piriformis is a muscle within the buttocks that stretches from the sacrum to the outside of the hip on the femur. This muscle helps to stabilize the pelvis, as well as rotate and extend the leg out and back. The muscle can become overused by muscle weakness within the bigger muscles of the buttocks (gluteus maximus) or from instability of the pelvis due to lack of abdominal strength.

When this muscle becomes overused, it can become tight and tender. Not only will this cause pain in the buttocks, but it can also restrict the movement of the sciatic nerve traveling down the leg causing radiating leg pain. Mobility and strengthening specifically address individual impairments and is important for each individual with piriformis syndrome. In addition, running form can be an important component to analyze and address, which the Runner’s Clinic does with slow motion capture analysis.

Two things to try at home for piriformis/ gluteal pain

1. Piriformis stretch:

  • Lie on your back with both feet flat on the floor and knees bent.
  • Put the ankle of the right leg over the knee of the left leg.
  • Pull the left thigh in towards your chest and hold the stretch, which will be felt in the glutes of the right side.
  • Hold 30 seconds.
  • Repeat two times for each side.

2. Fire hydrants:

  • Start in a quadruped position (on hands and knees) with back flat and parallel to the ground.
  • Keeping your pelvis level, raise one knee out to the side (and slightly back) trying to get the knee parallel with your hip.
  • Then lower the knee to the starting position. Keep your back and pelvis flat and neutral the whole time.
  • Do two to three sets of 15, progressing the reps as you get stronger.

Plantar Fasciitis

Plantar fasciitis is a common injury that affects runners in the arch of their foot, or, more commonly, in the heel. Pain in the bottom of the heel after sitting is characteristic, especially with the first few steps getting up in the morning. The plantar fascia tissue can get aggravated with large increases in activity and with increased activity in poorly supportive shoes, sandals, or barefoot. This injury is often associated with tight calves, calcaneal bone spurs, micro tears where the tissue in the foot attaches to the heel, and increased weight gain.

Many runners with acute injury may benefit from taping or temporary orthotics to help support and offload the arch. In the Runner’s Clinic we will help to improve cadence and work on running mechanics to decrease the force in the foot as the runner strikes the ground.

Try these two things for plantar fascia pain

1. Soleus calf stretch:

  • Stand with one leg on a stair with just the ball of the foot, letting the heel drop down slightly.
  • Bend your knee forward, stretching the lower calf region.
  • Hold for 30 seconds.
  • Repeat two times.

2. Single leg, heel raises:

  • Stand on one leg either on flat ground or with the ball of the foot on a stair.
  • Slowly raise the heel up as far as you can go while keeping your knee straight.
  • Slowly lower back down.
  • Start with two sets of 15 and work up to three x 15 per side.

Shin Splints

Shin splints can occur in two different locations on the lower leg, in the front of the shinbone and on the inside of the shinbone. Even though the problem can occur at two different locations, the most common cause of this problem is typically ramping up volume too quickly or a slow cadence (cadence is the number of steps a person takes per minute). When a person has a cadence that is slower than 160–170, typically they have a longer stride length and land with a straighter, more rigid leg. Landing with a straight leg is not as effective at absorbing impact forces, increasing demand into the muscles and bones of the lower leg.

Increasing cadence by five to 10 percent reduces the loading rate and impact forces on the body, especially the knee and hip joints. In the Runner’s Clinic we use a force-plated treadmill to analyze loading impacts and cadence. It is important to note that increasing your self-selected cadence by more than 10 percent at any one time will increase a runner’s energy demands, so it needs to be increased slowly over time.

Two things to try at home for shin pain

1. Single leg heel raises:

  • Stand on one leg either on flat ground or with the ball of the foot on a stair.
  • Slowly raise the heel up as far as you can go while keeping your knee straight.
  • Slowly lower back down.
  • Start with two sets of 15 and work up to three x 15 per side.

2. Increase your cadence while running by five to 10 percent:

  • Count your self-selected (normal) cadence by counting how many times one foot lands on the ground for 30 seconds.
  • Multiply this by number by four. This is your cadence (or steps per minute) at that speed.
  • Without increasing your speed, try increasing your cadence by no more than 10 percent by using a metronome or a metronome app on your phone to get the targeted stepping rate.
run fit

Advanced Run Fit Class

This is a race training class designed for half-marathon distances and longer to improve your overall running strength. We will cover running form, strength training, running drills, and run-strong workouts. The class will also include educational lectures on Monday where you will learn about appropriate training, shoe wear, nutrition and supplements, and other current running topics.

When:

2015 Run Fit Class
Feb 23–April 8, 6:30–8:00 pm

This year we will offer two classes:

  1. Beginner's
  2. Advanced

Both will have a lecture series covering running injuries, nutrition, supplements, training principles, and more.

Where:

University Orthopaedic Center, 590 Wakara Way

Cost:

$200

Who:

Classes are taught by running experts from the UOC Runner's Clinic, including physical therapists, personal trainers, and exercise specialists.

Register

Begins in late Oct/early Nov

Phone: (801) 587-2222

Questions? Email

marathon runners

Runner's Workshop

Injury Prevention & Nutrition

Come discover how to keep yourself healthy while running at a free workshop. Learn to prevent injuries and how to fuel and sustain your body for the upcoming SOJO marathon, half marathon, and 5K on October 18.

DateLocation
Thursday, September 25
6:30 pm–7:30 pm
South Jordan Health Center
Daybreak Conference Room A
5126 W. Daybreak Parkway (11400 S.)
South Jordan, UT 84095
Map

Register
Or call (801) 213-8803 to register.

University of Utah Health Care is the presenting sponsor and medical provider for the SOJO Marathon.

Logo for the South Jordan Marathon

Laura A. LaMarche, DPT

Laura LaMarche, DPT graduated with a Doctor of Physical Therapy degree from the University of Utah in 2010. Prior to becoming a physical therapist, Laura had a career as a botanist and wild land fire fighter. Advanced training since graduation includes biomechanics of gait and running analysis. She developed a... Read More

Specialties:

Physical Therapy

Locations:

A location has not yet been added by this physician.

Jason Larry Miller, DPT

Jason Miller, D.P.T., is a licensed physical therapist. He received his bachelor’s degree in exercise and sports science from the University of Utah and his Doctor of Physical Therapy Degree from Idaho State University. His professional interests include running and other sports injuries, spinal disorders, manua... Read More

Specialties:

Physical Therapy

Locations:

South Jordan Health Center (801) 213-4500

Specialties:

Physical Therapy

Locations:

A location has not yet been added by this physician.

University Orthopaedic Center 590 Wakara Way
Salt Lake City, UT 84108
Map
801-587-7109
South Jordan Health Center 5126 W. Daybreak Parkway
South Jordan, UT 84095
Map
801-213-4500
clinics & locations