Runner’s Issue 2009

Think back to the last pair of athletic shoes that you bought. What factors were considered when you decided to purchase them? Did you consider: Color? Brand? Price? Celebrity Endorsement? If these were the only factors that you considered, you may not be too satisfied with your purchase; or worse, you may have contributed to your own injury. Wearing shoes that fit properly and are designed for your foot type can help to prevent and alleviate many overuse conditions that are seen in the athletic and active population.

Generally, the job of the foot is to absorb the force of the body at foot contact and to provide forward propulsion just before the foot leaves the ground. Your foot type determines how well it can do both of these things. Most feet can be classified into one of three major groups. First, those with pes cavus feet, or feet with high arches, typically have a less flexible foot that is good at propulsion, but not as good at absorbing force at contact. Conversely, pes planus feet or feet with flat arches absorb force well, but are poor with propulsion. The third foot type is classified as normal,which falls somewhere in between a pes cavus or pes planus foot.

Shoe construction also falls into three major categories which match up to the three foot types. Cushioned shoes have the softest foot-bed and mid-sole, and the least amount of support across the inside portion of the shoe. This type of shoe is most appropriate for those with medium to high arches. The second type of shoe is called motion control. This shoe offers less cushioning, but more support along the inside of the shoe. This shoe is most appropriate for those with a low arch and whose foot rolls in towards the middle when walking or running. The final type of shoe is known as stability or neutral. This shoe has a mix of cushioning and support and is designed to optimize mechanics for those with a normal arch.

When choosing your next pair of shoes, before you consider color, brand, or price, consider the shoe type. In order to prevent injury and to get the most out of your shoes, make sure that your foot type matches up with the type of shoes that you intend to purchase. For more information on types of shoes visit a reputable shoe retailer or check out the resources from the manufacturer. Your physical therapist will also be able to direct you to the appropriate shoe choice based on your foot type and/or injury.

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JOI is proud to offer a professional Biomechanical Running Analysis

Running Technique Quiz �Do you have foot, ankle, knee or hip pain when running? �Do you feel like you are off balance during running? �Do your shoes wear unevenly? �Are you unable to tolerate the same mileage as before? �Do you feel like you land awkwardly? �Are you not running as fast as you would like?

If you answered YES to any of these, we can help! Call a clinician at JOI Rehabilitation today!

Article by: Drew Heideman, MPT, ATC If the Shoe Fits

Your outcome matters!

Choose JOI, the region’s leader in effective, healthyrehabilitation . JOI Rehabilitation

has eight convenient locations to

serve you.

��Beaches 436 Jacksonville Drive Jacksonville Beach, FL 32250P: 904.247.3324�F: 904.247.3926

��North12961 North Main Street Suite 201 & 202 Jacksonville, FL 32218 P: 904.757.2474�F: 904.757.5541

��Point Meadows (Gate Parkway & 9A) 7740 Point Meadows Drive Suite 1 & 2 Jacksonville, FL 32218 P: 904.564.9594�F: 904.564.9687

��Riverside 4339 Roosevelt Boulevard Suite 300 Jacksonville, FL 32210 P: 904.389.8570�F: 904.389.8599

��San Marco 1325 San Marco Boulevard Suite 102 Jacksonville, FL 32207 P: 904.858.7045�F: 904.858.7047

��South14985 Old St. Augustine Road, Suite 106 Jacksonville, FL 32258 P: 904.288.9491�F: 904.288.9698

��University 5737 Barnhill Drive Building B, Suite 204 Jacksonville, FL 32207 P: 904.733.9948�F: 904.733.9984

��Mandarin 12276 San Jose Blvd Suite 716 & 717 Jacksonville, FL 32223 P: 904.288.9604�F: 904.288.9643

How to Exercise Safely in the Hot Weather

Strrretch is brought to you in part by Bledsoe Brace Systems

As Floridians, we know a thing or two about hot weather. Exercising outdoors in the heat can be dangerous; during extreme heat waves it is best to move your routine indoors. But, for those of us that dread using a treadmill or want to be outside there are some ways you can exercise safely. Below are five steps to stay cool (and safe) on even the hottest of Florida days.

1. Drink before you are thirsty. When you begin to feel thirsty you are usually already dehydrated. Drink a few cups of water 1-2 hours before you head outdoors. Once you begin your workout you should have a drink every 20 minutes or so. Remember to drink water for aquatic sports as well; just because you are exercising in the water doesn't mean you are getting hydrated!

2. Don’t forget to eat. Sometime the heat curbs your appetite but it is never safe to exercise on an empty stomach. Even if you feel like it is too hot to eat, try foods like apples or carrots; they are naturally filled with water and will help keep you hydrated.

3. Wear sunscreen. Most doctors recommend SPF of 30 or higher and make sure to reapply often. Not only is a sunburn bad for your skin, but it can also increase your body temperature and put you at an increased risk for future workouts.

4. Avoid exercising when the sun is directly overhead. This usually means timing your workout for either early in the morning or late in the afternoon. Always look for paths that are shaded and try to avoid running or walking on pavement which will absorb the sun (and heat).

5. Wear light weight, loose fitting clothing. Light colors work best as they deflect the sun’s rays. Clothing made of 100% cotton or that have a “moisture wick” material that moves sweat off your body are the most ideal.

Article By: Sonya Thigpen, ATC

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Iliotibial Band Friction SyndromArticle By: Craig Torp, PTA

Iliotibial Band Friction Syndrome (ITBFS) is an inflammatory non-traumatic overuse injury of the knee predominately affecting long-distance runners. ITBFS may be caused by a multitude of factors, including training errors, worn out running shoes and/or lower leg misalignments. Knee pain usually occurs at a particular point in each training run, and is more pronounced shortly after the foot contacts the ground surface. Attempting to run through the pain will intensify the symptoms, eventually causing the athlete to shorten his or her stride or slow to a walk.

�Diagnosing ITBFS: Your therapist or physician can diagnose by using the modified Ober’s test. With the patient lying on the non-injured side, the practitioner raises the upper hip and thigh into slight abduction, extends the hip and thigh, and allows the leg to drop into adduction while stabilizing the pelvis and thigh. The test is positive for ITBFS if the thigh does not descend to or beyond 10 degrees.

�Symptoms: Sharp pain on the outer aspect of the knee that can radiate into the outer thigh and/or calf.

�Physical Therapy: A home exercise program on a foam roller can be taught for myofascial release. Combination ultrasound and muscle stimulation therapy will help restore normal muscle tone along with stretching and strengthening exercises. Iontophoresis with dexamethasone along with ice can also be used to decrease inflammation.

�Runners Home Program: A 15-to-20 minute flexibility routine with a resistance band, stretching of the hamstrings, quadriceps and IT band. Apply a cold pack to lateral aspect of the knee for 20 minutes.

Rope IT Band Stretch

Place a rope around your foot and pull straight up and across your body until you feel a good stretch down the side of your thigh.

Hold for 10-15 seconds Repeat 5 times

We are pleased to incorporate the Graston® Technique which uses stainless steel instruments to help your JOI clinician mobilize your soft tissue while performing rehabilitative exercises. We use these instruments to detect and amplify soft tissue restrictions and dysfunction, and to enhance our ability to decrease your treatment time and increase your functional outcome.

We often use this technique twice per week to treat Tendinitis, Tenosyno-vitis, Epicondylitis, Plantar Fasciitis, Ligament Sprains, Muscle Strains, Carpal Tunnel Syndrome, Edema Reduction, Scar Tissue Adhesions, andother injuries involving soft tissue. If you have any questions regarding this type of treatment, please call any of our locations and schedule an appointment, or visit us at

www.JOIonline.net

Corner

2009 Tips From the Clinicians at JOI

Tip #1 Do You Need Orthotics? Orthotics are custom-made biomechanical inserts that are placed in a shoe to either support or cushion the arch to decrease forces up the lower extremity. There are several types that are appropriate for different types of feet and people.

FOOT TYPE I – Requires a Shock-Absorbing Orthotic Pes Cavus (High Arch) – Rigid Foot FOOT TYPE II – Requires a Rigid/Supportive Orthotic Pes Planus (Flat Foot is the most common) – Flexible Foot

JOI offers customized orthotics fittings following a 30-minute evaluation from a trained therapist. Call a location near you for more info.

Article by: Matt Paulus, MS, ATC, LAT

Tip #2Tips for Injury Prevention

VOLUME Give yourself time! Running volume should increase at a slow pace over the course of 10-15 weeks to prepare your body for running 15K.

STRETCHING Maintaining good lower body flexibility is essential to injury prevention. Stretch following your training runs when your muscles are warmed up.

PAIN Listen to your body! Expect some soreness in the first few weeks of training, but sharp pains need to be addressed by a professional.

CROSS TRAIN Mix in a different kind of workout to your training program on off days. Ride a bike, swim, play basketball or another physical activity. This will build complementary muscle groups and give your running muscles a break.

REST You need one to two days off per week to give your body time to recover. FORM Your upper body should be as relaxed as possible with a feeling of being pulled along by a string attached to

your belly button. Your feet should hit without crossing over the midline of your body.

Tip #3Stretching and Hydration PEARLS

For every pound of weight lost during exercise, a 20-ounce electrolyte “sports” drink should be consumed.

Eating should be modified to fit exercise goals leading up to a race. Runners should perform a full body stretch routine

that hits all lower and upper body muscles utilized during running. Lower body stretches should include at the minimum: quadriceps,

hamstrings, IT Band, and calf (both gastrocnemius and soleus). Stretching should be performed pre- and post-workout

to ensure maximum flexibility and prevention of injuries. A short warm-up should be completed prior to pre-workout stretching. Your routine should include stationary “static” stretches, as well as active

“dynamic” exercises.

Drew Heideman, MPT, ATC

We are pleased to incorporate the Graston® Technique which uses stainless steel instruments to help your JOI clinician mobilize your soft tissue while performing rehabilitative exercises. We use these instruments to detect and amplify soft tissue restrictions and dysfunction, and to enhance our ability to decrease your treatment time and increase your functional outcome.

We often use this technique twice per week to treat Tendinitis,Tenosynovitis, Epicondylitis, Plantar Fasciitis, Ligament Sprains,

Muscle Strains, Carpal Tunnel Syndrome, Edema, Scar TissueAdhesions, and other injuries involving soft tissue.

If you have any questions regarding this type of treatment, please call any of our locations and schedule an appointment, or visit us at

www.JOIonline.net