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Do you want to incorporate strength training into your routine? hqdefaultThe use of specific exercises to gain strength and decrease weakness can greatly support your running endeavors and help avoid injuries. Add these four exercises into your training program at least twice per week, and after a month of consistency, see if you feel stronger, faster, and more durable.



One Leg Squat


Do you find one side of your body to fatigue more quickly than the other? Stay focused on this strength training routine, and see if you are able to even out the imbalances.

ashley perrott_familytri_smallOne of the most challenging parts of getting fit is staying healthy and injury free.  Dr. Ashley Perrott  is an Ironman finisher, busy mom, and family medicine physician at Novant Health Salem Family Medicine in Winston-Salem, North Carolina. (See photo, left, of Ashley with her parents and brother Brett Miller, our Director of Business Development, at the start of Ironman Florida, which the whole family completed together!) Dr. Perrott is answering some of the most-common questions our users have on staying on track.

One of the biggest mistakes runners and athletes make is that they rush back from injury, and don't give their bodies adequate opportunities to heal, repair, and gradually build back to the level of activity they did before the injury.  This prolongues the healing process, and in some cases, it can cause chronic pain and discomfort. Some athletes, trying to stubbornly run through the pain, end up altering their gait patterns to compensate for the discomfort, and end up with new injuries.

While each injury is as unique as each athlete, most strains, sprains, and soft-tissue injuries follow predictable patterns of recovery and healing. If you have any pain or discomfort that persists or worsens as you exercise, and continues even with two to three days of rest, be sure to see a medical professional to get guidance on the nature of the injury, and the collaborate on a plan for rehabilitation and return to running and other sports you do on a regular basis. 

Below are the typical stages of injury.  Respect each stage, take time to complete it and give your body the opportunity to properly heal so you can come back strong. Remember: you only get ONE chance to recover from an injury.  Don't rush it and end up chronically injured. Here are the general stages you can expect to go through on your road to recovery.
Phase 1: Protection/Acute Inflammation
With a soft-tissue injury, such as a pulled muscle or a twisted ankle, initially the pain, bleeding, and swelling continues through the first two to four days after the initial injury, depending on what type of injury it is. To help reduce discomfort, try over-the-counter NSAIDs and RICE (rest, ice, compression, elevation).  Ice the injured area for 10 minutes at a time to decrease the blood flow to the injury, which will decrease the inflammation and pain. Talk with a medical professional about what sorts of precautions—if any—you’ll need to take with daily activities, like walking, taking stairs, etc., and what types of exercise you can do to keep up your cardiovascular health (and sanity!) while you recover.
Phase 2: Transition
This is when repair of the injured tissues gets underway. This can last up to six weeks. During this time, the body is generating new soft tissue to replace what has been damaged. It’s important to avoid NSAIDs at this stage, as studies have shown that this can interfere with the healing process.  To facilitate healing during this time, talk with your doctor about the types of range-of-motion and gentle stretching exercises you can do without interfering with recovery. Inflammatory response and pain should dissipate during this phase.  If chronic or acute pain continues, consult your doctor.
Phase 3: Remodeling
At this stage, new soft tissue stretches and strengthens, but it may not be sufficiently strong enough to return to your normal volume and intensity of activity. Talk with your doctor about what kinds of activities you can safely do to keep up your cardiovascular fitness without interfering with the healing process. 
Phase 4: The Functional Phase.
This phase typically begins about two weeks after the injury, and can it can last up to six months, depending on the severity of the injury, and the success of the previous stages. This is the time that you can start returning to your regular level of activity. At this stage, you can start to work on returning to the sport—without risking re-injury as long as you have clearance from your doctor. Work on increasing strength, endurance, speed, agility, and flexibility under the guidance of a medical professional. Stop if you have any sensations of pain or strain.

ashley perrott tri mediumOne of the most challenging parts of getting fit is staying healthy and injury free.  Dr. Ashley Perrott  is an Ironman finisher, busy mom, and family medicine physician at Novant Health Salem Family Medicine in Winston-Salem, North Carolina. (See photo, left, of Ashley with her parents and brother Brett Miller, our Director of Business Development, at the start of Ironman Florida, which the whole family completed together!) Dr. Perrott is answering some of the most-common questions our users have on staying on track. 

How do you know which aches and pains you can keep exercising through, and which ones should send you running to a doctor?


Joint pains are more concerning than muscle pains in general.  Muscle soreness can be expected for 1-2 days after a more intense workout or more intense week of training.  This soreness should improve daily.  Recovery with rest or light workouts after an intense workout can help muscle soreness and stiffness.  Muscle injury lasts longer than this, and may prevent the ability to complete a light workout or even regular activity.  Rest will generally help this pain and soreness.  Any pain that gets worse with activity should prompt the athlete to reduce speed/intensity to avoid injury.  Muscle pain or weakness that persists despite rest is a reason to see your MD.

Joint or bone pain, swelling, or redness may represent more significant injury.  Certainly a specific episode of injury (rolling ankle, falling, tripping) that causes deformity should prompt an evaluation at the MD in some fashion.  Joint pain is worse with pressure on that joint even at rest.  Patients may complain of pain with standing, sitting, or laying down.  Instability is another concerning sign/symptom.  if a joint “gives out” or “catches” with activity it’s something that we would like to see.

In general an increase of more than 10% mileage or intensity per week can be associated with more injury.   

Have a question about staying healthy and injury free? Contact Us. 

calfIn this edition of Ask the Practitioner, we again connect with Mark Fadil, Clinic Director at the Sports Medicine Institute (SMI) of Palo Alto.  SMI is one of Northern California's leading orthopedic and deep tissue massage resources, assisting both world class and recreational athletes since 1996.  

RC: Tight and/or sore calves are one of the most common ailments for new and experienced runners alike.  What exactly is happening when one feels like his or her calves are tight and they have become sore to run on? 

MF: Sore/tight calves are a very common problem with runners.  Generally someone may experience sore calves when running for the first time, coming back from time off, during a period of increased speed work or during a period of increased mileage.  In each one of these circumstances the calf muscles are adapting to the stress from the increase in activity.

RC: When treating runners with sore calves, what are the most commonly reported practices that have potentially led to the problem? 

MF: There is normally some sort of change that precedes sore/tight calves.  In addition to the changes I already mentioned it can come from a change in running shoes (usually a shoe with a lower heel such as a racing flat will put more stress on the calf), a change in running surface or increased hill running.

RC: What techniques do you and your staff employ to address this problem and what can runners to do maintain the work at home? 

MF: I usually focus on three things: massage, stretching and functional strengthening.  Massage can be done by a professional therapist or at home using a foam roller or "the stick."  This can be done on a daily basis for 5 - 10 minutes.  Stretching should focus on both the upper calf (gastrocnemius) using a straight knee calf stretch and the lower calf (soleus and Achilles) using a bent knee calf stretch.  I recommend stretching after massage as well as an additional 2-3 times a day.  Each stretch should be held for at least 30 seconds.  Functional strengthening is one of the most important pieces in preventing sore/tight calves from occuring in the first place.  A great way to incorporate functional strengthening is doing heel drops off the edge of a stair.  These should initially be done on a daily basis and eventually shifted to two to three times per week for maintenance.

There can always be other issues that contribute to calf soreness/tightness.  But this should provide a good overview of the more common causes and effective treatments for most cases.



Rikke Johansen, D.C., is the founder of Health Logic and has 18 years of experience in practice as a doctor of chiropractic medicine.

Dr. Johansen is a Certified Chiropractic Sports Physician (CCSP), a Certified Strength and Conditioning Specialist (CSCS), and has completed the educational requirements to qualify her as a Diplomate of the American Chiropractic Board of Sports Physicians (DACBSP) and as a Diplomate of the American Chiropractic Board of Radiologists (DACBR). She is also a USA Triathlon Level I certified triathlon coach and a USA Cycling Level II certified cycling coach.

rc:  What are the types of physical complaints Graston technique is effective in addressing?
RJ: The most common complaints in my practice (we see a high percentage of endurance athletes) where patients specifically come in or are sent by their medical doctors to get Graston are: Plantar Fasciitis, Iliotibial Band Tendonosis, and Achilles Tendonitis. Another common issue is post surgical scar tissue, i.e. after shoulder or knee surgery. The chronic high hamstring tear is also effectively addressed with Graston.

rc: What makes Graston different than other popular techniques, such as manual deep tissue sports massage and Active Release Technique?
RJ: It is important to  remember that all techniques are only as good as the overall assessment of the athlete as well as proper diagnosis of the kinetic chain and faulty bio-mechanics. A knee problem is rarely an isolated knee problem.  It is important to correct muscle weaknesses, range of motion challenges, etc. We certainly use a combination of myofascial techniques, but with the Graston instruments we are able to more specifically locate adhesions, get a sense of severity and create the localized controlled 'trauma' that will aide in normalizing the tissues.

rc: What does Graston feel like and how effective is it?
RJ: Everybody has different pain thresholds, and different body areas are more sensitive. Graston can be slightly painful, but more often in a 'good' way. It is often described as a rolling pin, when done on the back with a large instrument. Some people describe the smaller treatment edges as metal brushes. The technique is modified to each individuals comfort level and pain is not necessary to get results.  As to effectiveness, generally we take care of 85-90% of chronic conditions, such as those mentioned above, in 4-6 visits.

Ask the Practitioner: Back Pain

Written by Dena Evans September 17, 2012

Dr. Waite holds a B.S. in Exercise Science from Creighton University and a Doctorate in Chiropractic Medicine from Palmer College.  She has treated the knees of professional cyclists, the hands of musicians, the backs of police officers, the shoulders of golfers, and the feet of marathon runners.  Dr. Waite is a certified Active Release Techniques (ART) and Graston Technique provider, and specializes in the treatment of all manner of soft tissue and repetitive strain injuries.  

rc: Many recreational athletes struggle with periodic back pain.  What
are a few of the most common problems you see as people seek treatment
in your office?

AW: Low Back Pain due to Psoas (long muscle along the lumbar region) tightness, Paraspinal Lumbar tightness (knots in the low back in muscles adjacent to the spine), and Sacroiliac joint pain due to ankle instability
rc: What are some common situational factors the average person can
avoid to in order to reduce the chance of developing periodic back

AW:  Common causes of low back pain include sitting for long periods of time and continuing to use your running shoes beyond 300 to 400 miles.  Since running is a repetitive motion exercise which can lead to repetitive strain injuries, don't put off making an appointment for myofascial release such as Active Release Technique.  Make sure you stay hydrated and don't over train!

rc: What can you do at home to encourage maintenance of a healthy back?

AW:  Simple things we can do include maintaining a daily stretch routine, getting up and moving around every 20 minutes if you have a desk job, going to a Pilates or Yoga class once a week, using your foam roller on the hamstrings, adductors, quads, and IT bands, and making sure you cross train as an increase in overall strength and core strength will give you a more efficient stride.

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