I just stumbled upon an interview I did back in 2007 with Dr. Marc Bochner, who is board certified in sports injuries and Active Release Techniques (ART). It got lost in the shuffle when we transferred the blog over from Blogger to WordPress. I’m very happy to share it because we’re big proponents of ART but it also provides great insight into how to comprehensively prevent and treat running injuries.
Coach: Should you get ART only when you’re injured?
Dr. Bochner: ART can be used as part of a prevention program, where an athlete can be screened for areas of tightness or weakness that may eventually lead to injury. But most athletes, especially beginners, tend to seek treatment only once they are in pain/injured, which can be unfortunate.
Coach: What types of injuries react best to ART?
Dr. Bochner: Injuries which involve the development of restrictions in the soft-tissues are the most commonly treated. Luckily for runners, most of the overuse injuries are of this type. The whole lower extremity, from hip to foot, can be treated, as well as the “core” area of the lower back and pelvis.
Coach: What are the most important things a runner can do to prevent injuries?
Dr. Bochner: 1) Train properly! Start slowly. If you have not ran in a while or are a beginner set up a realistic program to get you ready for whatever race you are training for. Using a coach is a great idea- such as the Run Smart programs…
2) Get videotaped- if you have muscle imbalances or technique problems, the earlier you discover them the better. For example, if your ankle is not moving properly when running, it can be treated with ART, and then specific strength exercises and running technique advice can be prescribed to keep it moving properly.
3) Stay consistent with your training and your body will adapt over time to increased training levels with less chance of injury.
Coach: You talk a lot about core strength exercises…how many days a week should someone training for a marathon do strength work?
Dr. Bochner: Weight training, including the core, three times every 10 days is sufficient and more realistic than three times a week. Core exercises can be done more often, maybe as part of warm-up or cool-down drills with running. During the last 4-6 weeks before the marathon, decreasing the strength work to once a week may be necessary to prevent overtraining, especially for those doing their first marathon.
Coach: I’m going to mention two common injuries. Can you give a brief overview on how to effectively treat each?
Dr. Bochner: Before I give specifics on each injury, describing the general approach that they all have in common is useful. First, a diagnosis of which exact muscle, tendon, bone or combination of tissue is involved in the injury should be made. If the injury is acute, ice should be applied to control pain and swelling, and modalities such as electric stimulation or ultrasound can be used.
At the same time, removing the adhesions which are usually present and causing the pain, swelling, and stiffness should begin- that is where ART and other soft-tissue techniques are used. Next, initiating a specific stretching and strengthening program can help prevent reoccurrence. And finally, video analysis of running form should be used to discover other areas that may not be painful but need treatment and to give form advice.
Coach: ITB syndrome.
Dr. Bochner: When acute- apply ice at knee, stop running, and get to the immediate cause which is usually the adhesions described above by checking and treating all of these areas: ITB, v.lateralis, tensor fascia latae, gluteals, lateal hamstring, deep and superficial calf muscles. Then strengthen weak hip abductors, check cores strength/flexibility, and check if orthotics are needed for pronation/supination. Train smart!
Coach: Shin Splints.
Dr. Bochner: Again, ice massage if acute. The doctor should be making sure the injury isn’t already a compartment syndrome (an increase in pressure in the muscles which requires more rest from running than “shin slints” in addtion to treating the soft tissues) or a stress fracture (which will need complete rest for 4-12 weeks and use of an aircast). In all of these cases, ART should be used to release adhesions in the muscles. They are usually found along the tibia in the soleus muscle and/or tibialis posterior muscle for inner leg pain, in the tibialis anterior for front/outer leg pain, and in the peroneals for outer pain. The video analysis may show the runner not using the quads and hamstrings to push off and pull leg through and instead overusing the calves, which causes then to tighten. Strengthening the soleus muscle often helps.