Half-Marathon Training and Injury Prevention

by Michael Silverman
Marathon 610x320

In preparation for the NYC Half, New York Road Runners hosted a live chat with physical therapist Michael Silverman on training and injury prevention tips. The following is an excerpt from the chat, with answers provided by Silverman.

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 physical therapist-patient relationship, or any other duty, between you and any member of HSS’s rehabilitation team.

After I run, my back (especially my right side) starts to hurt. Can you predict why?
Back issues after running can be caused by several different things. Weakness in the abs/glutes, over training, as well as improper form, can all be causes.

I’m kind of new to running. Anything specific I should be doing pre-run and post-run when it is cold out?
Dynamic warm-up before you run (high knees, butt kicks, side shuffles, etc.), followed by static stretching after you run are great ways to avoid injury and keep you going pain free.

I am down to bone on bone in one knee. If I get injections to replace cartilage will I be able to run? Would it be wiser to get a replacement even though I am young for it (early 40s)?
No one knows your body better than you. Conservative forms of therapy (injections, physical therapy, non-steroidal anti-inflammatory drugs) are always good to try to decrease symptoms. It’s worth a shot to try the injections. If they don’t work, at least you know you exhausted alternatives to having a total knee replacement.

Do you recommend seeing a doctor before running in a marathon as a first-timer? I’m very healthy and have never experienced severe problems when running, but I’ve been told I should look into getting my heart checked out.
I would speak to your primary care physician prior to running a marathon or training for one. They can look at everything that is imperative to keeping you safe on the course.

How often should I buy new sneakers?
I tell my runners to change shoes every 300-500 miles on average. Write the date you started running on your shoes to help give you an estimate of when you first started using them.

What are the chances that someone with a herniated disc can recover and run long distances? I’m working with a great doctor and PT. Just trying to manage my own expectations, which are currently very high.
Patients often will get back to distance running after a herniated disc. Keep up with your PT and MD, and stay the course. Just remember, rehab is not always linear. You may have your ups and downs, but stay positive.

How should I handle water consumption in cold weather? I find myself less thirsty during the winter and drink less while training, but want to be cognizant of how much I should be taking in.
It’s important to continue with water/fluid consumption even if it’s cold out. Runners still get dehydrated. I would recommend eight ounces every four miles just to stay on the cautious side. It’s very easy to overheat in the winter, because of all the extra layers of clothes.

I ran a marathon last year and have had minor issues with my knees since, unfortunately. Is it recommended to run with a knee brace? I can run without it, but I have another marathon coming up, and I’m afraid I’ll do more damage to my knee if I run without a brace.
A knee brace can help alleviate some minor aches and pains with running, but it may not prevent the knee pain that has been bothering you for the past year. To be safe, I would get your knees checked out to make sure they are structurally sound. As far as the brace and running a marathon, there are no issues with running with it on.

I’m a new runner. My right hamstring (but not my left) tends to always be really tight, no matter how much stretching I do before and after. Do I need to see a specialist or is there something I can do on my own?
Keep up with the stretching. As long as you are not symptomatic, it’s not imperative that you see a specialist. Tightness can occur unilaterally if there is a type of imbalance in your body which could possibly lead to injury. Keep an eye on it, but definitely keep up with the stretching.

What do you consider to be the best ways to cross-train for a half-marathon?
Two methods of cross training that I recommend to my patients are swimming and riding the bike. Both of these activities allow the muscles that weight bear to have a rest. In conjunction with those cardio activities, strength training is very important to keep your body strong for the demands of 13.1 miles.

I have a tight hip flexor that has caused some pain when I ran longer distances. How do you suggest I stretch this muscle? I’m beginning to train for a half-marathon in April.
The most common way I have patients stretch their hip flexors is in a half-kneeling position with a pillow under the knee. A dynamic way to do this is by doing butt kicks. I would recommend having a trainer/medical professional show you how to do this before trying on your own.

Michael Silverman, PT, MSPT, USATF-1, is a physical therapist at Hospital for Special Surgery’s James M. Benson Sports Rehabilitation Center, specializing in the rehabilitation of runners and other performance athletes. He has a special interest in running-form analysis, which he performs at the Tisch Performance Center at Hospital for Special Surgery. Mike is an avid runner and has participated in marathons and the Tough Mudder.

 

Topics: Featured, Rehabilitation and Fitness, Running
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The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

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Hospital for Special Surgery
April 22, 2014 at 5:34 pm

Did you know that Electromyography (EMG) is a form of electrodiagnostic testing that is used to study nerve and muscle function? Dr. Joseph Feinberg, Physiatrist, says: “There are two parts to EMG testing: a nerve conduction study and a needle exam for muscle testing. Both may result in some discomfort, but are usually well tolerated without the need for medication beforehand. EMG testing usually takes anywhere from 30 to 90 minutes depending on the condition being tested and findings of the study.” For more information on EMG testing, visit http://www.hss.edu/conditions_emg-testing-a-patient-guide.asp.

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