Mailbag 005

Posted on October 22, 2009 by CoachJay

This question was sent to me via RunningTimes regarding the General Strength series I produced for them this summer.

I just finished a great 6 months of training involving 2 half marathons and a marathon. I was injury free for the whole time. After my marathon though I suffered knee pain on the front part of my legs, slightly below my knee-caps and to either side. The area was tender to touch and to walk on immediately after the race and the day afterward. I feel this could be avoided with strength training. I am a little nervous to start training again as I don’t want to irritate my knees any further. But at the same time I don’t want to lose what I have gained over the spring and summer. If I were to follow all my runs with the Myrtl routine and pedestal exercises as demonstrated by Coach Jay (in his general strength exercises video under training tab), would this be sufficient enough to strengthen my legs to prevent injury or should I try to find weight lifting exercises on top of the general strength exercises?

Obviously the first thing this runner needs to do is to see a doctor, chiropractor, physical therapist, etc. to get a diagnosis of the problem. Also, the fact that the runner finished two half marathons without this pain yet experienced it after the marathon might be a function of training. I’m starting to be a big believer in the one LONG run, or run-walk-run, each week for the first time marathoner as those who spend almost as much time on their feet in one training session each week as they’ll spend racing tend not only race well but have fewer post race injuries (Thanks to Jonas Holdeman for sharing not only this insight but his training plans for mid pack marathoners). Also, we don’t know how big of a human this runner is and given the nature of the injury/issue I wonder if this is a big man, well over 6 feet, who may also be packing a few extra pounds. The human body

But after those two obvious issues – that this person needs to get a professional evaluation and needs to re-evaluation their marathon training – there is little doubt that some sort of extra/ancillary work should be done if this runner is to better handle the demands of training and racing in the future.

I’m sure some of you would advocate lots of eccentric work and I encourage those thoughts/comments below; I’ve never done a lot of eccentric work, though my friend/collaborator Mike Smith uses this as part of his prophylactic/preventive work (note: if you have time this PDF is a great introduction to Mike’s approach to training).

Okay, that’s enough for now. I’ll be writing regularly in the coming weeks.

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  • Matt

    OT, but speaking of Running Times, I just went to the mailbox, and who do I see but Sara! Look forward to the story.

  • Ross11

    I could have sent in this letter about 3 years ago. Having been through it and eventually getting back on the road, here would be things I'd recommend:

    - DO NOT run through it. I tried this, it doesn't help – it just makes your running shorter and more painful. Your body is telling you something is wrong. As Jay advises, seek help. I do highly recommend keeping fitness up via eliptical, swimming, etc. as simply not running or exercising at all is a bummer.

    - Have a gait analysis done. My pain was actually due to multiple issues. One of them was that I was a heel-striker. Becoming a mid-foot striker made a big difference in my ability to run more than a half marathon pain-free.

    - See a PT. They can pretty quick assess where you are weak and/or tight and help you make a plan to stengthen in your weak areas. Having a plan, you can assess whether you are making progress or not according to the plan. For me, my hips were weak. The PT gave me a rubber cord that attached to both ankles and had me do basketball-style side-to-side drills. This workout was tough. I would highly recommend this for all runners. It was a big help to me, and not an area I would have strengthened by running alone given it was a side-to-side movement.

    - Be cautious on chiropractic help. I also went to a chiropractor, and the changes they make to try to help you are pretty significant physiologically. I still have weakness in my ankle based on the chiropractor trying to improve my foot flexibility. They can certainly be part of the solution, but recognize that there is risk.

    - Accept that rest is often part of the process to getting back on the road. This is tough, but even with rest you can move your fitness forward in other ways.

    The good news is there is hope, as I just finished a marathon pain free last weekend in KC.

    Finally, thanks to Jay for his videos. The pre-hab alphabet spelling balance work completely got rid of my plantar fasciitis (the plantar fasciitis I got by switching from heel to mid-foot striking) in about a month. It had been a year-long battle, so it is surprising how an exercise so simple can reap benefits. Moral of the story, Jay knows what he is talking about.

  • karlstutelbergpt

    Congrats to Sara Vaughn on her Running Times cover and positive article! Congrats to you Coach Jay for keeping her healthy and helping her achieve her goals.

  • jxmolina

    In Building a Better Runner, Coach Smith goes through a series of eccentric exercises such as “reverse step ups” and others.

    In the preventive area of these DVD's there are a lot of movements that I consider “pre-habilitative”. I usually incorporate these workouts with my athletes from the midpoint of the pre-season on. We also use these movements as recovery after hard races.

    I have found these routines work very well!

  • Matt

    Speaking of strength exercises and the latest RT, I saw this quote on p. 21 that summarized what I'd always thought: “By strengthening the core and hips, I could handle more training, and was stronger and more powerful as a runner.”

  • jschools

    I just want to make a testimonial to the general strength training. I have been coaching high school cross country for 20 years. I have half heartedly incorporated general strength training into my workouts before this year. After getting the DVD, subscribing to Coach Jay's newletter, watching all of the videos online, and reading posts by all of the other coaches…I decided to make the full commitment to strength training. I incorporated Lunge Matrix into my warm up routines, Med Ball workouts, strength circuits, and most importantly Myrtl at the end of each workout. I could not be more happier with the results! My number one kid won the individual district championhsip! My number two runner finished 11th qualifying him for the Pennsylvania State XC Championships, my number three finished 16th, just missing qualifying for States. Other members on the team improved their times on district course from earlier in the year by up to two minutes! I credit the strength routines that were incorporated into their training! Thank you Coach Jay and all the other awesome coaches that post on this website!

  • Shane

    I got into a discussion with a coach about the importance of strength/flexiblity to overcome knee problems/ shins splins and other common high school training injuries. He thinks its finding the correct shoes but i think fixing the underlying problems first with circuits like yours. Is there any book, article to point us into a direction to conclude our discussion.

  • jschools

    Well, I could be completely off base with this opinion, but it is my belief that shoes are the quick fix for injuries. I have a runner that wears flip flop/sandals are summer long. He trained very hard and had no injuries. School starts and now he is wearing shoes…and injuries start to show up. My thinking is that wearing flip flops/sandals actually strengthen his legs and when he went to wearing shoes, those muscles weakened. Thus creating the injuries. Just a thought!

  • micubano

    Coach I just completed my first half marathon and now getting ready to finish my first marathon. My question to you is can a person who is built like me(200 6'1 8% body fat) ever think about placing in the top 20? I clearly saw the faces of those runners that were on their way back towards the finish line and I can see it in their faces. However, why can't i? Am I limiting myself physically? I love to run in fact I am finding that I love it more than weight training.

    TC

  • http://coachjayjohnson.com CoachJay

    Thanks for the kind words, yet you're obviously not giving your self enough credit for their success. The GS work simply sets a kid up to property train, to properly develop their aerobic system by training.

    …but I love hearing that the LM and Myrtl are mainstays of your program. Very cool.

    Hope the state meet went well.

  • http://coachjayjohnson.com CoachJay

    yes, you're right on.

    I still like the term “preventive” but “pre-hab” is arguably a better term because more people use it. Either way, you're trying to strengthen in such a way that you prevent running injuries. Simple concept, but tough to fully address in a practice setting.

  • http://coachjayjohnson.com CoachJay

    Both are great approaches and both should help. It's a chicken and the egg type question but one thing I can attest to is that for the common running injuries you can't go wrong with doing two or three things at once – strengthening for posterior tibialis, some work for IT band and Tensor Fascia latae. If you want to see an video of this email me and I'll do a separate post on it.

  • http://coachjayjohnson.com CoachJay

    Chris Solinsky is a big guy (see photo) and a world class runner. Stay lean and be mindful of slowing building your volume and intensity. Good luck!

    http://www.caribtrack.com/USATF_2009/K_teg.jpg

  • Robert_trachtenberg

    Hi there; which pre-hab video is it? i am totally struggling with plantar fasciitis, and it's not resolving despite some down time, ice, golf-ball and ART. please let me know!!!

    thanks so much,
    Rob

  • Rossbielak

    Jay has videos for running, which include “prehab”. You can buy them from him, just send him an email and I'm sure he could help you. The exercise that worked for me from Jay's videos was pretty simple. Before trying the videos, I tried the boot, rest, ice, stretching, all sorts of things for about a year. What I came to realize now is that those are soothing remedies, but not ones that go to the heart of the matter – making your foot actually stronger so that it can handle the stress of running. The alphabet spelling exercise from Jay's prehab is this: Take off your shoes…bare feet. Lift one leg out in front so that you are standing on one foot, the foot that has the plantar is the one on the ground . Close your eyes. You may struggle with balance. This is good. You are strengthening the bottom of your foot. Do not lean on anything, the exercise is all about the foot on the ground getting stronger. Then once you have your balance, try to spell the alphabet with the foot that is in the air. The bigger the letters, the harder it is. If it is too hard, then do the exercise with your eyes open, which is easier. You must spell the entire alphabet without letting the foot touch the ground. Do this exercise twice a day, it can take a while because I would start over if I lost my balance, and then everytime that you are just standing around during the day and can lift your foot a little in the air to do an abbreviated exercise, do it. I am just one data point, but I could tell there was some improvement after about two weeks..and my plantar was 90+% gone after a month. The last 10 % took about another month. After I stopped doing the exercises, it was about a year before I started feel a little plantar twinge return, but doing the exercises again fixed it. I hope this helps. Good luck!

  • Robert Trachtenberg

    this is great, and thanks for all the tips and the exercises. i did send Jay a note, though i am sure he's hugely busy! will get the videos and will try the alphabet exercise right now! Its almost resolved, but that last little bit is hanging on and i don't want to run and rip it again. thanks much, and glad that it worked for you. PF is a huge pain….never had it before and I'm used to little twinges that resolve with some ART in a day or two….yuck…thanks again and happy running!

    Rob