Ask The Expert: Marathon Training Injuries
New York Road Runners hosted a live Facebook chat with physical therapist Mickey Levinson on injury prevention and race recovery for runners training for the ING NYC Marathon. The following is an excerpt from the chat, with answers provided by Mickey.
The information provided in this chat is for informational and educational purposes, and doesn’t constitute medical or health advice for any individual problem. Please consult with your health care providers for any health problem and/or prior to starting any new exercise regimen and/or medication or changing or discontinuing any medication you have been prescribed. This chat is not intended to create a physician-patient relationship, or any other duty, between you and any member of HSS’ medical team.
Q: What’s the best way to deal with plantar fasciitis?
A: The best way to deal with plantar fasciitis is to maintain all over strength and maintain flexibility by stretching. Make sure you have proper footwear, and definitely don’t try to run through pain. If it persists, a night splint can maintain the length of the plantar fascia, so you will have less pain in the morning. You may want to have your running analyzed. At times orthotics are helpful, depending upon the alignment of your foot and ankle, but I wouldn’t begin with orthotics.
Q: I have some tightness in the front of my left hip that I’ve noticed in the past couple of weeks. I noticed it’s actually worse during the week when I’m sitting 8 hours a day at my desk for work. Any recommendations/suggestions? I do stretch a lot after runs and try to move throughout the day and stretch a bit when I can.
A: Try to avoid extended period of sitting. Certain muscle groups are selectively tightened when we sit down. When you are stretching, make sure that you’ve performed an active warm up first to improve your core temperature. This will make your stretching more effective.
Q: What are the best preventive measures for shin splints?
A: Shin splints are a general term that can refer to different conditions. A good rule of thumb is to maintain good flexibility of your hip, knee, and ankle, maintain good hip strength, core strength, hip and ankle strength. Maintain proper footwear. Running shoes should be replaced every 250-500 miles. If they persist, it may be helpful to have your running analyzed.
Q: Is weight/strength training important? And if so what areas should I focus on?
A: Yes, strength training of the entire leg and core is very important for runners, because runners tend to lose strength in certain muscle groups as they begin to run more, and cross-train less.
Q: I completed my first marathon in March and felt great. Mid May, however, during the beginning of my NYC marathon training I started experiencing pain in my right hamstring. I rested for 5 days, but am still feeling a little pain. How do I proceed so that I do not hurt myself again?
A: It sounds like your hamstring has healed yet. Hamstrings don’t heal that quickly. I would cross train for a while and continue to build up your hamstring’s strength and flexibility. If pain persists, consult with a physician.
Q: What are your tips for healing a strained calf muscle?
A: The best way to heal a strained calf muscle is by icing it and restoring flexibility and strength to all of the calf musculature after your symptoms have subsided.
Q: Are ice baths after long runs worth the pain?
A: Yes, ice baths after long runs are very good, and so is just icing in general.
Michael Levinson, Physical Therapist and Certified Strength and Conditioning Specialist, is a Clinical Supervisor at the James M. Benson Sports Rehabilitation Center at Hospital for Special Surgery. Michael is on the faculty of Columbia University School of Physical Therapy. He has published numerous chapters and articles on Sports Medicine Rehabilitation, and has lectured extensively on various subjects regarding the shoulder, elbow, knee and ankle. Michael served as physical therapist for the New York Mets Baseball Club from 1994 to 2000 and from 2005 to the present. He has been a consultant to numerous youth, high school, collegiate and professional athletes.