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#HURDLEMOMENT: A Physical Therapist's Take on Navigating Popular Running Injuries · Hurdle with Emily Abbate

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Speaker 1: Hey, hurdlers. Emily a Body here with another installment of
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Speaker 1: Hurdle Moment from Hurdle, a podcast that doctor everyone from
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Speaker 1: entrepreneurs to top CEOs and athletes about how they got
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Speaker 1: through tough times hurdles of sorts by leaning into wellness. Today,
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Speaker 1: I'm going to be diving into a little bit more
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Speaker 1: about the topic of injury. I got a lot of
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Speaker 1: really great feedback from you guys after I posted the
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Speaker 1: how to Deal with Injury Hurdle Moment, and I knew
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Speaker 1: that I needed to get a little bit deeper, so
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Speaker 1: I reached out to my friend Blake. He is a
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Speaker 1: physical therapist at Bespoke Treatments in Midtown. Let me tell
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Speaker 1: you the guys, they are the team there and they're outstanding,
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Speaker 1: highly recommended them. They have gotten me through hell and
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Speaker 1: back when it comes to really scary injuries that come
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Speaker 1: a little too close to raise base sometimes and I'm
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Speaker 1: so grateful for them. So I reached out to Blake
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Speaker 1: and we sat down and talked a little bit more
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Speaker 1: about the topic of injury. Before you get to more
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Speaker 1: on that, a quick shout out to a Hurdle Moment's
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1:20
Speaker 1: but then we came back and he had an open,
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Speaker 1: can get all of the details on their early morning
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Speaker 1: weekly workouts in the description to this episode. And now,
1:52
Speaker 1: as for what Leg and I get into today, it's
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Speaker 1: a lot about when you need to take a break,
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Speaker 1: when it's okay to push forward. He actually shed some
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Speaker 1: light on this idea that if you have an injury,
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Speaker 1: a lot of the time, the good news is that
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Speaker 1: you can keep running, you can keep doing activity, although
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Speaker 1: maybe not in the same capacity. That you started out
2:11
Speaker 1: your mission, like I said September, is all about running.
2:14
Speaker 1: It's all about marathon training for these hurdle moments leaning
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Speaker 1: up to a lot of these fall marathons. If you're running,
2:19
Speaker 1: if you have any questions you want answered, definitely reach
2:23
Speaker 1: out to me over DM or on email. It's at
2:25
Speaker 1: Emily a Body at Hurdle Podcasts and of course as
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Speaker 1: always Emily at hurdle dot Us. With that, let's get
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Speaker 1: to hurdling. All right, So injury, it sucks, it's no fun.
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Speaker 1: That's the worst. Have you ever been seriously injured?
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Speaker 2: Yeah?
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Speaker 3: Yeah, I've been taken away, I've been in a boot
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Speaker 3: head stress practures pretty much. We could go from the
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Speaker 3: toes all the way up to the low back. You
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Speaker 3: could probably name at least ten.
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Speaker 1: Yeah, let's give the hurdlers a little bit of context
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Speaker 1: on your personal running background, aside from now being a
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Speaker 1: physical therapist.
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Speaker 2: Sure.
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Speaker 3: Yeah, So I grew up playing pretty much every sport.
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Speaker 3: Soccer was kind of the main focus until I got
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Speaker 3: eighth grade and then middle school. Eighth grade I switched
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Speaker 3: more to running, and then by high school I was
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Speaker 3: running full time, so across country track a mile two mile,
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Speaker 3: I was on a four by eighteen. Then I went
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Speaker 3: to college Indiana University, ran track and cross country there,
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Speaker 3: came here to New York, and I took it a nice,
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Speaker 3: solid three year retirement, and then just within the last
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Speaker 3: couple of years, I've been getting back into the swing
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Speaker 3: of things.
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Speaker 1: How's it feel.
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Speaker 2: It's good, it's fun. It's fun to be in shape.
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Speaker 3: It's it's not fun getting in shape, but it's a
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Speaker 3: lot of fun when you're in the group of things.
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Speaker 3: And it's a great way to meet people too. I mean,
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Speaker 3: that was one of the big biggest reasons I jumped
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Speaker 3: back into running, was being able to meet people be
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Speaker 3: part of that community again.
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Speaker 1: One hundred percent. Okay, so let's talk about running injuries.
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Speaker 1: Running is tough. We know this. So it's like, I
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Speaker 1: feel as though I'm constantly hovering on this line of
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Speaker 1: like doing all the things and not doing enough things.
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Speaker 1: And when I'm not doing enough that's really more so
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Speaker 1: I find when I'm getting injured, when I'm not warming up,
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Speaker 1: when i'm not pooling down, when I'm thinking that I
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Speaker 1: can run like once or twice during the week and
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Speaker 1: then go kill a long run just because of time constraints. Yeah,
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Speaker 1: is that something you see often?
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Speaker 2: Totally.
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Speaker 3: Yeah, it's all running is always kind of this delicate
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Speaker 3: balance between doing too much or doing too little. I
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Speaker 3: think what I've learned over the last you know, fifteen
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Speaker 3: years of running is a nice way to kind of
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Speaker 3: optimize my time, because time is always an issue for
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Speaker 3: everybody in the working professional world, especially when you're trying
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Speaker 3: to juggle work in life and marathon training all at once.
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Speaker 3: So figuring out what's the best, what's the most efficient
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Speaker 3: way to optimize your training so you're not spending you know,
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Speaker 3: thirty minutes on a warm up, thirty minutes on.
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Speaker 2: A cool down and then you have to go out
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Speaker 2: for an hour run.
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Speaker 3: Right, Sometimes it's just being it's all about kind of
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Speaker 3: figuring out what's the most important for that day and
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Speaker 3: then knocking out of the park.
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Speaker 1: Okay, so obviously there are different types of injuries, but
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Speaker 1: on broad scale, talk to me about like when dull
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Speaker 1: pain versus regular pain versus extreme pain, Like when should
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Speaker 1: someone actually go seek out some help.
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Speaker 3: Yeah, so running injuries, they're gonna happen. The aches and
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Speaker 3: pains are just sort of part of being a runner.
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Speaker 3: You know, you're constantly sort of trying to progress through
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Speaker 3: training program, whether.
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Speaker 2: That's with speed or with volume.
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Speaker 3: You're always changing these variables trying to squeez out a
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Speaker 3: little bit of fitness. So anytime you throw a new
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Speaker 3: variable into your training plan, you're gonna have a little
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Speaker 3: bit of an ac and pain, or.
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Speaker 2: At least you can expect it. It's not not an
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Speaker 2: uncommon thing.
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Speaker 3: So eggs and pains are normal with running, and they
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Speaker 3: have generally happen and last for about one to three days,
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Speaker 3: and I'd consider that a normal pain. So something that
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Speaker 3: lasts for up to three days usually gets better with
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Speaker 3: time and isn't anywhere over like a two to four
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Speaker 3: at a ten pain level, it can be, there can
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Speaker 3: be some sharpness to it.
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Speaker 2: It's just one of those things.
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Speaker 3: You kind of need to proceed with caution and kind
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Speaker 3: of monitor your symptoms daily.
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Speaker 2: Was to better than yesterday? Was today worse than yesterday?
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Speaker 3: What do I need to change to kind of reduce
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Speaker 3: the stress to this area? And then there's abnormal pain
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Speaker 3: when I consider those things that last for longer than
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Speaker 3: a week, things that are over like a five or
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Speaker 3: six out of ten pain, things that are causing you
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Speaker 3: to compensate or change the way that you're running, those
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Speaker 3: are things that are abnormal and that at that point
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Speaker 3: you might want to consider seeking a medical consult. It's
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Speaker 3: not something that you want to that kind of linger
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Speaker 3: for too too long. On the opposite side of that,
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Speaker 3: there's rest, which is almost always what people revert to.
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Speaker 3: And it makes total sense that if a body part
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Speaker 3: is being injured or hurts, and you know, hurts to run,
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Speaker 3: let's just take like two weeks totally off. And the
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Speaker 3: problem with resting is that while you're resting, and this
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Speaker 3: is most often what happens is the total rest without
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Speaker 3: any sort of supplementation through strength or cross training, is
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Speaker 3: that it's just a full kind of bed rest or
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Speaker 3: no running or exercising. And then what happens when you
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Speaker 3: do that is as you've rested that two weeks, you
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Speaker 3: might be out of pain, at least in the short term,
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Speaker 3: but as soon as you get back to running, the
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Speaker 3: tissue that you've been rehabbing and resting is in a
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Speaker 3: weaker state than it was before. It's it's atrophy, whether
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Speaker 3: it's bone, whether it's tendon or muscle, they all sort
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Speaker 3: of respond in the same same manner, and so when
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Speaker 3: you go back to running, in that weekend state, You've
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Speaker 3: just had a heightened increase for future injuries. So you're
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Speaker 3: kind of in this negative cycle of you know, injury,
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Speaker 3: I'm going to rest it, I'm weaker now, and then
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Speaker 3: I get back to running and I injure myself again
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Speaker 3: and just kind of just this downward spiral.
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Speaker 1: So let's talk about then, some of the most popular
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Speaker 1: or commonly seen running injuries, because I mean, right out
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Speaker 1: the top of my head, I think about runners knee,
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Speaker 1: I think about Shin's blends, I think about probably pureformist syndrome.
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Speaker 1: So what do you got for me?
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Speaker 2: Totally?
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Speaker 3: Yeah, I'll the above those are all really important areas
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Speaker 3: that we use for running. So you know, the runner's
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Speaker 3: knee tendinopathies are a big one. Tendonitis, whether it's in
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Speaker 3: the achilles or the hip, it band is sort of
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Speaker 3: treated as a tendonitis as well.
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Speaker 2: The yeah, runners needs a big one. Calf complex injuries,
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Speaker 2: whether it's a strain or or tenonitis, that's another big one. Pureformist.
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Speaker 3: All of these generally are are overuse injuries or you've
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Speaker 3: done too much too soon, too quickly, whether that's you've
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Speaker 3: you've ramped up your intensity too much, or you've ramped
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Speaker 3: up your volume too much, or maybe you added hills
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Speaker 3: that weren't part of your training plan a week ago,
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Speaker 3: and a lot of them can be prevented by by
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Speaker 3: building up strength. Right, So, if you know you're prone
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Speaker 3: to pureformist syndrome, or you know you're prone to knee
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Speaker 3: runner's knee, there's definitely strengthening and capacity you can build
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Speaker 3: in these areas, whether it's the hip orne or calf
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Speaker 3: uh to keep those injuries at bay and protect yourself
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Speaker 3: from from developing them in the first place.
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Speaker 1: So you stand by something called the guests and check method. Yeah,
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Speaker 1: so talk to me about that, sure.
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Speaker 2: Yeah.
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Speaker 3: So, like for specifically, like a returning to run sort
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Speaker 3: of plan, it's it's there's no cookie cutter, there's no
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Speaker 3: like calculated formula that you can use. So when somebody's
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Speaker 3: injured and they're not able to run to their full capacity,
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Speaker 3: that load needs to be managed somehow. Right, So you're
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Speaker 3: not able to run at one hundred percent like you
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Speaker 3: used to, we might need to considered cross training, we
9:09
Speaker 3: might need to consider a run walk program.
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Speaker 2: We needed to.
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Speaker 3: Decrease the load into your total system so that your
9:15
Speaker 3: body has the ability to recover and adapt to the
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Speaker 3: stresses and rehab exercises that you're doing. So a lot
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Speaker 3: of the clients I have now are more of that
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Speaker 3: return to run sort of client where we're not just
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Speaker 3: coaching for performance, but we're really kind of guiding through
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Speaker 3: an injury. And so that requires a lot of guests
9:32
Speaker 3: in check, where it's a lot of the next day, like, hey,
9:34
Speaker 3: how'd you feel in the run yesterday? Because usually it's
9:36
Speaker 3: that next morning where you can kind of gauge if
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Speaker 3: the day before was enough stress or too little stress.
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Speaker 3: And so especially with those clients, it's a constant guess
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Speaker 3: and check. You're constantly modifying things, changing certain variables, whether
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Speaker 3: it shoe wear or intensity or some of the exercises
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Speaker 3: you're doing to specifically load.
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Speaker 2: These areas.
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Speaker 3: A lot of times with like more of a performance
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Speaker 3: I path that you can get away with like setting
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Speaker 3: a week plan ahead of time and saying, okay, I'll
10:03
Speaker 3: speak with you in a week. But with the with
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Speaker 3: the injury type stuff, so much can happen within a week.
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Speaker 3: You know, you can can be feeling great one day
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Speaker 3: and then the next day you know you don't feel
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Speaker 3: so great, and so it's a conversation that you need
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Speaker 3: to have with a person figuring out what the day
10:18
Speaker 3: before did we do that might have triggered.
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Speaker 2: These sort of symptoms.
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Speaker 1: I think what people struggle with also is just this
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Speaker 1: idea of cross training not being what was on the
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Speaker 1: original plan. I think often, you know, with an injury,
10:29
Speaker 1: whether it is maybe like a strained hamstring or which
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Speaker 1: is just a nightmare, or something again like shin splints,
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Speaker 1: where cross training is recommended, getting in the pool just
10:39
Speaker 1: feels so different than hitting or run. So for the
10:41
Speaker 1: people that have been advised or been offered that type
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Speaker 1: of advice, what do you say to them?
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Speaker 3: Yeah, No, I think cross training has a ton of
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Speaker 3: really great benefit and sometimes it's necessary even when you
10:51
Speaker 3: are healthy. It's a nice way to get a little
10:52
Speaker 3: bit extra volume without loading your body too much and
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Speaker 3: breaching that barrier. At the same time, it's terribly boring,
10:59
Speaker 3: you know, to sit on a try mill or a
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Speaker 3: bike or elliptical for an hour, because that's another thing.
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Speaker 3: You can sit on these devices for, you know, one
11:06
Speaker 3: and a half time to what you'd normally be running,
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Speaker 3: because you're not loading your body to the degree that
11:10
Speaker 3: you would be if you were out there pounding your
11:11
Speaker 3: feet all the time. So to get a good aerobic benefit,
11:14
Speaker 3: you might need to go for a little bit longer
11:16
Speaker 3: on some of these cross daring machines, but it's a
11:19
Speaker 3: great way to still get stressed into the body. That's
11:22
Speaker 3: one of the that's one of the things we just
11:23
Speaker 3: kind of talked about was rest. Rest is almost never
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Speaker 3: the answer, right. We should never just kind of be
11:27
Speaker 3: sitting and waiting out this injury to go down. Crosstrating
11:30
Speaker 3: is an important piece, and what I always tell people
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Speaker 3: is try and make it as specific to running as possible.
11:36
Speaker 3: So elliptical in my mind, is kind of one of
11:40
Speaker 3: those things where you're still on your feet.
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Speaker 2: It's a still more reciprocal bipedal motion.
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Speaker 3: You know, you're you're working the legs in a similar fashion,
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Speaker 3: at least more similar to running than you would be
11:49
Speaker 3: say like swimming. Right, So swimming is a total anti
11:52
Speaker 3: gravity motion. Even aqua jogging, it's it's anti gravity. It's similar,
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Speaker 3: like you're turning the legs over, but it's not quite
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Speaker 3: the same. So I usually trying to get people on
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Speaker 3: the elliptical if I can, that's usually my go to.
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Speaker 3: That's usually the one that people don't like the least,
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Speaker 3: but yeah, I think it's that one of the best.
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Speaker 1: Okay, So then the question arises, when do you draw
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Speaker 1: the line between deciding Okay, I can manage this and
12:18
Speaker 1: pushed forward versus I need to abort.
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Speaker 3: It's totally person dependent, right, depends on the injury, depends
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Speaker 3: on the person's training age, you know, how long and
12:28
Speaker 3: how much experience they have with running. It depends on
12:31
Speaker 3: the severity of symptoms. So in general, with tenanopathies, what
12:36
Speaker 3: tendonitis sort of symptoms that have been longer than just
12:39
Speaker 3: that tendonitis acute phase, things that are kind of going
12:42
Speaker 3: more into the week. Plus, uh, those those teninopathy issues,
12:46
Speaker 3: we're pushing a lot more.
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Speaker 2: Than we used to. In the P two world.
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Speaker 3: Used to be just kind of you know, ice stretch,
12:53
Speaker 3: you know, roll, those sorts of things. But what we
12:56
Speaker 3: know about tendons is that they respond really well to loading,
12:59
Speaker 3: and so you need to kind of strike that balance
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Speaker 3: between loading too much and irritating the tendon and loading
13:05
Speaker 3: too little where the tendon's not getting stronger. Really similar
13:08
Speaker 3: to a muscle where if you were to do one
13:10
Speaker 3: hundred bicep curls, your arm would be sore, but you
13:13
Speaker 3: know you're going to get stronger, the muscle's going to
13:15
Speaker 3: grow really similar with the tendon. You're going to get
13:17
Speaker 3: some of that growth and some of that positive benefit
13:20
Speaker 3: and adaptation from a loading program. Again, it's just it's
13:23
Speaker 3: something that can't be done too much, but it's also
13:25
Speaker 3: something you don't want to do too little of, So
13:27
Speaker 3: resting is no good, and then continuing to run or
13:31
Speaker 3: push things might not be too good either. That said,
13:34
Speaker 3: with some of the tendinopathy issues, it's I totally give
13:37
Speaker 3: people the okay to run, knowing that running itself is
13:40
Speaker 3: a positive stress.
13:41
Speaker 2: So you consider running.
13:42
Speaker 3: Apply metric exercise right, and you're bounding from one leg
13:45
Speaker 3: to the next, and in some ways it's the best
13:48
Speaker 3: exercise for running as long as it's dosed appropriately. So
13:51
Speaker 3: as long as the tendinopathy is mild enough and they're
13:55
Speaker 3: not experiencing any more than like a five sometimes six
13:58
Speaker 3: out of ten pain, then I said tended up is
14:01
Speaker 3: one of those things that you can sort of train through.
14:04
Speaker 2: Generally as a general states general, Yeah.
14:08
Speaker 3: But it's totally person dependent and case dependent, and you
14:11
Speaker 3: need to make sure that all that's backed up with
14:12
Speaker 3: the appropriate strength program as well, because that's that's what's
14:16
Speaker 3: laying the foundation for a lot of this uh, that's
14:18
Speaker 3: what's going to allow you to run in the future.
14:20
Speaker 1: I know last year I was dealing with a little
14:23
Speaker 1: bit of ham string stress, and all of the work
14:26
Speaker 1: that I did was completely contingent on just strengthening, whether
14:29
Speaker 1: it was single like deadlifts or squats or just some
14:32
Speaker 1: things to kind of add some strength to that area.
14:35
Speaker 1: And within you know, two and a half weeks of
14:37
Speaker 1: consistent strength program, which is something that I should be
14:39
Speaker 1: doing all the time, I felt a dramatic difference in
14:43
Speaker 1: how it was handling my running.
14:44
Speaker 3: It's a little counterintuitive, right, because you've just strained this
14:47
Speaker 3: muscle by exercising it too hard, So why would the
14:50
Speaker 3: why would the remedy.
14:52
Speaker 2: Be to put more exercise into it? Right?
14:54
Speaker 3: But as long as it's dost appropriately and you're not
14:56
Speaker 3: breaching that capacity that your hamspring.
14:58
Speaker 2: Can handle, it's going to bond.
15:00
Speaker 3: Well, that's that's essentially what happens when when you exercise
15:03
Speaker 3: to that limit, is you're you have these micro tears
15:05
Speaker 3: of their muscle fiber, and then the body responds by
15:08
Speaker 3: building that backed on.
15:09
Speaker 2: So same thing with a hamstring tear.
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Speaker 1: I think you're kind of a knight in shining armor
15:12
Speaker 1: by telling people that in most cases they can keep
15:15
Speaker 1: running totally.
15:17
Speaker 2: Yeah. Yeah, that's why I like, I want to get
15:20
Speaker 2: on the phone with people.
15:21
Speaker 3: I want to like have people into the office as
15:22
Speaker 3: soon as like they have something, because almost always there's
15:25
Speaker 3: a training modification that can be made, or there's uh,
15:28
Speaker 3: you know, a slight modification to their training that they
15:31
Speaker 3: can do, they'll keep them running. So almost never in
15:34
Speaker 3: the answer is okay, you need to stop, like let's
15:36
Speaker 3: get change the boot. Sometimes that's the case, but almost
15:39
Speaker 3: always like keep running. We just need we might need
15:42
Speaker 3: to rethink about how you're doing it.
15:44
Speaker 1: Any other last minute advice for upcoming marathonors, Oh gosh,
15:50
Speaker 1: a word of wisdom for departing Yeah, no, manage.
15:53
Speaker 2: Your loads appropriately. You know.
15:55
Speaker 3: Strength, I can't cannot overemphasize strength. You know, it should
15:58
Speaker 3: be at the cornerstone of not only a performance strategy,
16:02
Speaker 3: but also you rehab strategy too. If there's not some
16:06
Speaker 3: sort of strength component, then I think you're missing a big,
16:08
Speaker 3: big pace.
16:09
Speaker 1: How often would you say that a runner should be
16:11
Speaker 1: strength training during the week.
16:12
Speaker 3: Yeah, so with strength training, if I'm working with a
16:15
Speaker 3: more performance type athlete, I'll do like two days and
16:17
Speaker 3: more of this like maintenance, core tissue capacity building, strengthen
16:21
Speaker 3: durance type training, and then I'll try and get them
16:24
Speaker 3: in the gym twice a week for more of a
16:26
Speaker 3: performance cyclift, more of those heavier Olympic deadlift style lifts,
16:31
Speaker 3: more creative towards power output, neural drive, things like that.
16:35
Speaker 3: So more the recreational runner, I would consider like three
16:37
Speaker 3: to five to be a good thing to am more
16:39
Speaker 3: of that core building tissue capacity. That's what's going to
16:42
Speaker 3: help protect you against injury.
16:48
Speaker 1: So yeah, as you guys can see Blake, it's got
16:50
Speaker 1: a lot of really great expert insight into what to
16:53
Speaker 1: do when you're injured. And I can't say enough good
16:56
Speaker 1: things about him or Bespoke Treatments in Midtown. Definitely check
16:59
Speaker 1: those guys out you need anything, and you are New
17:01
Speaker 1: York City based otherwise, Like I said in my first
17:05
Speaker 1: hurdle moment about injury, I know it's tough and it
17:08
Speaker 1: can be frustrating, but know that there are resources out
17:11
Speaker 1: there for you to get better. There is a light
17:13
Speaker 1: at the end of the tunnel and all this stuff.
17:16
Speaker 1: The tough stuff, the good stuff. It all happens to
17:20
Speaker 1: teach us something. You know, the drill at Emilay Body
17:23
Speaker 1: at Hurdle Podcast. Share this one with a friend, won't you.
17:26
Speaker 1: It'll make my day. Another hurdle conquered. Catch you guys
17:30
Speaker 1: next time.