Training for an endurance event such as a triathlon or a marathon can be challenging and rewarding, but can often result in injury. There are multiple reasons injury can occur: progressing training too quickly, not allowing enough rest between workouts, muscle imbalance or poor footwear.  A common injury that runners and triathletes experience is shin splints, or tibial stress syndrome.

Tibial stress syndrome is somewhat of a catch-all term for injuries in the front of the lower leg.  Pain can occur along the inside or outside border of the shin bone (tibia) and usually increases with intensity or duration.  Pain often resolves with rest.  However, after a tough workout, aching can persist at rest.  The muscle along the bone is often tender to the touch and can swell.

One cause of this pain can be irritation (either acute or chronic) of the muscles around the shin bone.  If the problem is strictly muscular, it can often be resolved with stretching, appropriate strengthening, modalities such as heat or ice, and massage. Another possibility could be stress fractures along the shaft of the tibial bone.  They are tiny, hairline fractures that sometimes can039#t even been seen with an x-ray.  Similar treatment can be applied but only after long rest periods and wearing a boot or splint. Additionally, a cause can be tightness in the fascia, or outer covering of the muscle, called compartment syndrome.  Symptoms are similar but should be monitored to ensure that the condition is not worsening, in which numbness and weakness can occur.  This condition can be treated conservatively with stretching and massage but surgery could be indicated depending on severity. Check out the video below for a sample stretch that you can do:

As previously mentioned, shin splints can indicate various injuries and it is important to know what the issue is. If pain continues for more than 1-2 weeks then a physical therapist can evaluate and help determine the cause.  From there, the PT can guide you through an appropriate treatment plan, help adjust your footwear, or refer you for further testing in order to safely address the issue and get you back on your feet.  Once it is appropriate to get back into training, it may be beneficial to do so with a group such as Team Philly Race Training. Team Philly consists of trained professionals who help runners at all levels train for various distances, in a safe and controlled manner.  A group may help you reach your goals and avoid re-injury.

Contributed by: Emily Baith, PT, DPT, ART

Erica Gerlach, PT,MPT, Cert. MDT, ART, Clinic manager of Excel's Northeast Philadelphia location, became certified in Active Release Technique (ART) for the shoulder, arm, wrist and fingers this past February and is already reporting outstanding results!

She tells us that within as little as one visit, she has seen improvements in
shoulder flexibility that allows the individual to perform functional overhead activities. She has also seen reduction in elbow pain when the person is performing activities that involve using the wrist and hand.

Erica recently worked with a patient who had been dealing with shoulder pain and limited motion overhead for several years, with minimal relief from previous physical therapy treatment. Within four visits and use of Active Release Technique, the patient was able to reach overhead to touch the back of his head with improved mobility and little to no pain!  This was his major reason for attending therapy and his goal was achieved in a short time.

“It is because of this that I love incorporating this manual treatment in my patients program and of course they love the quick results as well”, says Erica. Here is a quick demonstration and explanation from Erica on the benefits of Active Release Technique:

Active Release Technique® (or ART®) is a patented manual therapy technique that corrects soft tissue restrictions that lead to pain and decreased mobility. Combined with traditional rehabilitation activities, this technique is producing extraordinary functional outcomes with patients.

Patients with repetitive use injuries, frozen shoulder, tendinopathy, carpal tunnel syndrome, plantar fasciitis, rotator cuff pathology, restricted joint motion and sprains/strains are examples of diagnoses that respond well to ART®. Usually a patient will see significant results within just a few visits. ART® is not only the treatment of choice for high performance athletes and workers’ compensation managers, but also for top sports medicine physicians in the tri-state area.

Excel Physical Therapy & Fitness has more certified ART® providers than any physical therapy practice on the East Coast. Each of our eight locations has at least one certified ART® therapist. Click here for a list of Certified ART providers near you.

Valerie Brill, PT, OSC, ART, physical therapist and clinic manager at our Villanova location was featured on 6ABC Healthcheck on Thursday, August 12th. Valerie talked about the increasing wave of gadget injuries in children and teens. She is currently treating 18-year-old Beau Whitman, who is an athlete and video game enthusiast.

Valerie says when Beau injured his shoulder while pole vaulting, his constant poor posture made the injury worse. She says new technology is sparking a rising trend of poor posture. In the past he says he'd play video games 2 to 4 hours per day; all the while slouching.

“Kids today, if you watch them, the majority of them are laying on their bed and watching this,” Brill said, “Or they're sitting slouched over a computer screen. The concern is they're so young, so what's going to happen in college, adulthood?”

Brill says poor posture makes people more susceptible to injuries because their back and core muscles become weak. She's helping Beau to improve his posture.

To prevent problems, Brill says parents should limit video game time to 30 minutes a day. While on the computer, kids should sit at a table in a good work position and take breaks.

Click here to read the rest of the article and video including another common tech injury called “Blackberry Thumb“.

Jane Fagan

Staff Physical Therapist, Jenkintown

Jane Fagan, DPT, Cert. MDThas continued to carry a strong caseload while taking on the responsibility of more direct supervision of the staff and Jenkintown clinic. She always provides excellent treatment, customer service, and has the patient039#s interest at heart. She has also done community work this past month at the Jenkintown running store. Keep up the good work Jane!

Team Philly Race Training is the premiere race training program in the Philadelphia area to prepare for either the Philadelphia Marathon or Half Marathon (Nov 21^st).  This community running program is affiliated/endorsed by the marathon and the City of Philadelphia and run by local fitness and wellness businesses: Philadelphia Runner, Fusion Cross-training and Excel Physical Therapy.

The 16 week training program just launched last Sunday and we already have an inspiring story from one of our young runners. It is very touching and a glimpse into how Excel is helping people. Read Kelli's story and you'll see why this training program is not only inspiring, but rewarding.

I'm sure that everyone has a beautiful story of what drives them to hit the pavement, and here is mine…

~ Kelli Powell, Team Philly Race Training Member

Whether you are training for a Marathon, Triathlon, or any kind of endurance exercise – training can be very challenging.  On average, athletes deal with different types of injuries, and most occur from the overuse of joints or muscles.  Physical training causes stress on the tissues surrounding joints, bones, tendons, and muscles, which can be a very difficult and painful thing to deal with.  The body is sometimes unable to keep up with the repair of the damage created from overuse, and this is when the injury occurs.  Because the tissue surrounding muscles and bones begins to deteriorate from overuse, this can cause pain and weakness, including inflammation around the injured component.  The most common ways to relieve pain and swelling is resting, icing the injured spot, relaxation, and of course, a physical therapy regimen.  We039#ve detailed before some injuries, such as Hamstring strain,  today we are going to talk about: Runners Knee.

One of the most common injuries that occurs amongst runners (and cyclists) is runner's knee, or Chondromalacia Patella. Usually, the patella, also known as the kneecap, moves smoothly over the femur, but this is not the case when an athlete has runner's knee.  The cartilage under the knee becomes rough or soft, which causes the patella to roughly rub over the femur creating friction and pain.  Strengthening the quadriceps will help prevent the injury from happening.  A physical therapy regimen will include strengthening the muscles and increasing flexibility in the hamstrings and quads.

As mentioned above, rest, relaxation, massage, and ice therapy are useful in preventing and treating various injuries. However, some injuries require a licensed professional's help in curing the ailment.  If the pain continues for more than a week, contact a physical therapist, who can play a key role in one's recovery.  If the symptoms are not treated, one could end up developing a more chronic condition which can prevent you from competing in the long term.