Marathon Recovery

Posted by | Posted in Inspiration, Our Therapists, Running, Tips & Favorites | Posted on 13-11-2013

Last Sunday’s ING NYC Marathon has come and gone, but for most runners the journey isn’t over. Recovering from a marathon requires just as much mindfulness as training for one.  We spoke to 44th Street‘s Abby Karpinksi, PT DPT and 56th Street‘s Sarah Tabia, PT DPT for some tips to help you maintain a balanced and replenishing marathon recovery.

The Weeks After:  Rest, Flush, Massage, and Stretch

When 56th Street‘s Sarah Tabia, PT DPT crossed the finish line on November 3rd, she was gently guided by marathon volunteers to keep walking.  As she slowly made it a mile deeper into the park, heat sleeves and the ubiquitous mylar blanket were draped over her shivering body.  “They make you do this to flush out the lactic acid,” Sarah explained when we spoke to her about her recovery game plan earlier this week.  “They ask you to walk slowly and to keep your legs moving.  When the [volunteer] wrapped the warm blanket around me I remember looking up at her, just so vulnerable and cold and she put the hood over me and it was the best moment of my life.”

Rest
Running 26.2 miles certainly takes it’s toll on the body.  According to a study cited by Competitor.com, “both the ‘intensive training for, and the marathon itself, induce inflammation and muscle fiber necrosis that significantly impaired muscle power and durability.’”  This means that taking the time to rest and recover your muscles before returning to training full-time is absolutely necessary.

Sarah’s recovery game plan for the days immediately following the marathon made rest her first priority.  “First and foremost I did no running for at least a week.  People who love running typically want to get back to running as soon as possible, but I was in full recovery-mode all week.”

Flush
44th Street‘s Abby Karpinski, PT DPT, who along with 16th Street‘s Jason Kang, PT DPT and Lisa Yirce, PT DPT, volunteered at the marathon medical tents last Sunday, also recommends mixing in a little gentle cross-training (walking, biking, elliptical) to continue to flush out the lactic acid that has pooled into the muscles.

“10-20 minutes of light cardio or elliptical a few times a week is all you need during your recovery period.  I also tell my patients to get up every hour or so, especially if they return to a sedentary job immediately after the marathon.  Being idle is bad for your muscles so you’re going to want to move around regularly,” advises Abby.

Massage
Both Sarah and Abby also recommend a soft massage from a licensed massage therapist after a day or two of rest from the marathon.

Says Sarah, “I got a massage on the Tuesday after the race with Laura Mirabella and it was incredible.  I noticed that my walking was significantly better after that.  She worked on my legs and my lower back and that helped a lot, because before that I was actually limping.”

Make sure to let your massage therapist know you are recovering from a marathon.  Your massage therapist should avoid any deep tissue work, and will instead gently roll out your muscles to help you with your range of motion and soreness.

Stretch
Finally, Abby recommends constant gentle stretching to keep your muscles loose and from spasming.  For this, she highly recommends consulting a physical therapist first in order to learn proper form.  “While there’s no such thing as too much stretching, there is such a thing as over stretching.  If you stretch too far or pull too hard you’ll injure yourself,” cautions Abby.  “Daily stretching is vital, but make sure you’re being good to your body.  You’re asking a lot of it by running a marathon, so you need to be good to it in return.”

Run This City

Posted by | Posted in Inspiration, Running, Tips & Favorites | Posted on 01-11-2013

For the last two weeks SPEAR has been spotlighting our patients who are running this year’s ING NYC Marathon on November 3rd. Today’s installment features Vishal Desai, who sees Abby Karpinski, PT DPT at our 44th Street facility.  Vishal’s story of triumph over cancer and paying it forward via the American Cancer Society’s DetermiNation team is truly inspiring and we are honored to have been able to help him prepare for his first NYC Marathon.

Vishal Desai

Why do you run?
My reasons are twofold. When I first started, I was looking for a way to get into better health, and for a way to give back to charity. I survived cancer when I was a teenager and I received assistance from the American Cancer Society. I figured I would try to run the NYC Half Marathon in 2012, and thought the perfect way to do it was by training and fundraising with the American Cancer Society’s DetermiNation team. I loved every minute of running with the team and I’ve been running ever since. I’ve been able to complete 7 half-marathons and 1 marathon.

How long have you been running marathons?
I did my first marathon in Philadelphia last year when the NYC Marathon was cancelled due to Superstorm Sandy, and thanks to Abby and SPEAR, I’m getting ready to finally run the NYC Marathon this coming weekend!


Which physical therapist do you see at SPEAR and what treatments have you been doing for training?

After having to stop training early in the summer due to shin splints and foot pain, I began seeing Abby Karpinski. I’ve learned quite a few strengthening, stretching and balance exercises. Abby helped me realize that I was pounding the ground and compounding my problems with my running style. After a few weeks of working together, and with a fair bit of ice, I was able to start running lighter, and reduce my pain. I was able to get back to training in September and now I’m ready to run my race!


Do you have any words of wisdom or training tips for anyone thinking about doing their first marathon?

The biggest thing is to take the race and training seriously. Stay disciplined, make sure you stretch and get time on your feet so you become mentally ready for 26.2. And if you can, try to find a team to run with. Nothing to keep you going like a little peer pressure.

Run This City

Posted by | Posted in Inspiration, Running, Tips & Favorites | Posted on 28-10-2013

For the next two weeks SPEAR is spotlighting our patients who are running this year’s ING NYC Marathon on November 3rd.  Today’s installment features husband and wife runners Adam and Elizabeth Brill, both patients of Jason Kang, PT DPT at our 16th Street facility.

Adam and Elizabeth Brill

Why do you run?
Adam: Running makes me feel free. Just a pair of sneakers and I’m on my way. It’s my favorite way to explore new places. I also run because I love food, and there’s nothing more satisfying than cooking and eating a meal with your lungs still burning from a hard workout. Running is a great way to stay in shape and learn about yourself and your surroundings.

Elizabeth: I was never that into sports – and definitely not into running – but I started running when we moved to New York six years ago. It was a great way to get to know the City and spend more time outside. (I also didn’t have to pay for a gym membership.) I kept running because I loved it. I was training for my first half marathon when we got engaged – Adam designed these “bride” sneakers for me with our wedding date – by far the best running gear/pair of shoes I’ve ever owned!

How long have you been running marathons?
Adam: The 2013 race will be the fourth race I’ve trained for, and the third one I’ve run. I finished NYC in 2008, Chicago in 2009, and then got “Sandy’d” in 2012. I think I’ll always wear that asterisk.

Elizabeth: This will be the second marathon that I’ve trained for, but the first one I’ll actually get to run because of Hurricane Sandy. Since I started training for the 2012 race last spring, I’ve run more than 1,300 miles or roughly the distance from New York to Florida.

Which physical therapist do you see at SPEAR and what treatments have you been doing for training?
Adam: I work with Jason, and he’s been an integral part of my training. My IT band has been a trouble spot for me throughout the years, but with Jason’s help, I’m able to run with more confidence. We do exercises to strengthen and stretch my glutes, quads and hamstrings as well as massage to loosen my IT band.

Elizabeth: I also work with Jason, and the experience has helped me improve both physically and mentally. I first started coming to SPEAR to get some knots in my legs worked out. At my first appointment, Jason put me in front of the mirror and asked me to do a one-legged squat. Looking at my reflection, I was shocked by how little strength and control I had to keep my knee from caving inwards. I thought I was doing enough by covering the long distances, practicing on hills and doing interval work, but Jason showed me how to train smarter. Since that first appointment, I’ve worked on strengthening my glutes and quads, stretching out my hamstrings and have also had Jason work on the knots in my muscles. I know that I am physically stronger than I was this time last year, and that gives me the confidence to be mentally stronger, too. Jason and the SPEAR team have been all-around fantastic, and I know I’m as prepared as I can be to face whatever the marathon throws my way.

Runaway bride? Elizabeth's "Bride" running shoes, designed for her by then-fiancé Adam.

Do you have any words of wisdom or training tips for anyone thinking about doing their first marathon?
Adam: Go for it. If you’ve thought about doing one, chances are you’re the type of person who has the tenacity and commitment to realize your goal. Before I started training for my first race, I had never run more than five or six miles. You learn a lot about yourself, and it’s a great sport. And as race day approaches, don’t over think it. Trust your training!

Elizabeth: It is an amazing experience – and you should do it! Be committed but have fun. Listen to and take care of your body. Ask for help before you need it. Eat dessert. It’s OK to get nervous, but don’t let yourself or anyone else talk you into thinking that you can’t do it. You will be astonished by what you can achieve.

Run This City

Posted by | Posted in Inspiration, Running, Success Stories, Tips & Favorites | Posted on 22-10-2013

For the next two weeks SPEAR is spotlighting our patients who are running this year’s ING NYC Marathon on November 3rd.  Our first installment features Danielle Harris, a patient of Cathy Campbell, PT DPT at 44th street and Zarina Mustapha, who sees Sarah Tabia, PT DPT at 56th Street.  Zarina is also the author of Run Raw, a running blog documenting her marathon training.

Danielle Harris

Why do you run?
As an athlete growing up, sports has always been a big part of my life. When the team sports ended, running became my main source of cardio and the one consistent hobby I have and love. Not only does running keep me sane, but it is the one thing I can do on my own. It’s truly therapeutic for me; just me and the pavement every time I run.

How long have you been running marathons?
I started running marathons about 4 years ago. It started with one 5K race, then two, then a 10K, then a half marathon. Once I did my first half marathon, NYC, I wanted to do another, which then led me to the big 26.2.

Which physical therapist do you see at SPEAR and what treatments have you been doing for training?
I’ve been seeing Cathy Campbell for the past 3 years and I don’t know what I’d do without her! Depending on what week of training I’m at and how I’m feeling, I do a number of different exercises and treatments. For the marathon it’s been a lot of dynamic stretching, various TRX exercises and cable workouts.

Do you have any words of wisdom or training tips for anyone thinking about doing their first marathon?
If you’re thinking about doing a marathon, go for it! And for the best inspiration, head out on Sunday, November 3rd and watch! That’s what sparked my interest two years ago, when I was on the sidelines cheering on my best friend. I had a few doubts before signing up, but figured, why not? Not only is it a check off the bucket list, but it’s also one remarkable achievement. In the beginning of my training program, I thought, “How am I ever going to get through this?” But like all things, practice makes perfect and in time and through routine, you get the hang of it. I am super excited for November 3rd! If all goes well, I’ll be signing up for my second marathon- Chicago!

Zarina Mustapha

Why do you run?
I began running a few years ago to lower the negative numbers on my health chart. But then, running evolved into a vehicle of self-discovery. I don’t run with music, so I have ample time for introspection and mindfulness of my own state as well as the terrain and the environment that I have the good fortune to run on. Running affords me the freedom to explore my own limits, to experiment on my strengths and accept my weaknesses. It gives me the equilibrium of elation, solitude, and peace, alongside with pain, fatigue, and fear–the rare luxury that keeps me calm and helps me persevere.

How long have you been running marathons?
NYC Marathon will be my first marathon. The 2012 NYCM would have been the first, but it didn’t happen. I trained for the New Jersey Marathon in April, but I was derailed by two cervical disc herniations. So, technically, I’ve been training for two years for this singular marathon.

Which physical therapist do you see at SPEAR and what treatments have you been doing for training?
Sarah Tabia is my PT who helped me with my neck injury in April/May, and also with posterior tibialis tendonitis on my right leg for this training cycle. Sarah conducted an evaluation and identified that my problem wasn’t exclusively on the lower leg, but the hips and core. There was a marked difference in strength between my right and left legs and hips. It didn’t help that I’m also extra bendy.

So, we did a series of hips, quads, and core strengthening exercises, with deep tissue massages on the calf muscles, and ice and e-stim. I started out with two sessions a week, and as I got better, once a week. She also showed me a few extra stretching routines for me to do before and after my workouts. I did some of the exercises on my own, off-session, as a supplement [to my training].

The PT sessions with Sarah have improved my running form significantly. My leg swings are more even now, and with little support of KT tape, I can run longer distances at a much slower pace with less pain.

Do you have any words of wisdom or training tips for anyone thinking about doing their first marathon?
Train smart, run hard, eat right, think well. Running should be a joy to be enjoyed.
Get a solid training plan, and stick with it. Listen to legendary coach Alberto Salazar’s golden rules (http://www.outsideonline.com/fitness/running/Alberto-Salazars-Ten-Golden-Rules.html).

Born to Run?

Posted by | Posted in Running, Tips & Favorites | Posted on 08-10-2013

When Christopher McDougall‘s book “Born to Run” was published in 2009, it set off a booming trend in minimalist running, sending thousands of runners previously beholden to clunky “support” shoes on the streets with barely-there sneakers, most recognizably Vibram’s 5-finger shoes.

Since then the debate over which shoe is more effective for runners- shoes that offer maximum bio-mechanical support vs shoes that simulate “barefoot” running- has been raging between professional and casual runners alike.

According to Runner’s World, the pendulum is beginning to swing toward more traditional running shoes, due in part to the sheer number of brands and products now available to runners (too many choices often leads to information overload and consumer burnout).  As Runner’s World quotes Peter Larson, author of the popular minimalist shoe blog Runblogger.com, “I think we may have reached the end of people’s infatuation with them.  The fit is so hard to get right. The toe pockets, you either love those or hate those when you run in them. I think a lot of them are sitting in people’s closets.”

Walk NYC Podiatry‘s Dr. Amnon Barnea cautions against framing the issue as the search for the definitive “better” shoe, and instead suggests that consumers rely on medical evidence tempered with personal data to inform their shoe-buying decisions.  In other words, when the commercials tell you to consult your physician before making any major changes to your workouts- especially if you suffer from bio-mechnical foot issues- they mean it!

As Dr. Barnea explains, the consumer market is currently flooded with products that fall under either end of the spectrum.  How could they all be good for you?  Buying the correct shoe for you is an individual endeavor that should be predominantly informed by your current foot bio-mechanics and your future goals for running.

Consider your surfaces:  Since NYC is mostly concrete, remember that you’re running on mostly hard surfaces.  If you’re running for longer distances on hard surfaces, you might want to explore shoes that offer more support and protection against debris.  Minimalist/barefoot running shoes maybe be better for your feet if used on shorter distances and softer surfaces (like grass, sand, boardwalks, or dirt trails).

Mix it up:  If you’re torn between using minimalist shoes and traditional running shoes, try mixing up your routine.  1/3rd of the time, use barefoot running shoes.  The rest of the time stick to traditional running shoes, or shoes that offer more bio-mechanical support.  Vice versa also works if you’re addicted to your running shoes, but bottom line:  MIX IT UP!  Varying the support level on your feet will prevent them from relying on a specific set of muscles/connective tissue over another.

Seriously, consult your physician: Having a physical therapist evaluate your feet yields indispensable information that you can use to set healthy, achievable goals for your running.  Choosing your running shoe is simply dealing with the symptoms of underlying bio-mechanical problems.  Teaming up with your physical therapist to understand and treat your underlying bio-mechanical problems is the most effective way to truly improve your form.

Dr. Barnea says that the jury is still out on the debate between minimalist vs. maximum control shoes.  In 3-5 years we will be able to collect more data to reach more substantial conclusions.  Until then, be mindful of the needs of your feet, and of course, trust your friendly neighborhood medical professionals!