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Tips for Safe Running in the Summer Heat by Dave & Kristy Ochsendorf

“Injury Prevention”

By Dave Ochsendorf, MPT and Kristy Ochsendorf, DPT

Tips for Safe Running in the Summer Heat

 

It is a well-known fact that the heat and humidity in Florida can be brutal, and exercising in the heat can be very dangerous, especially to those who aren’t properly acclimated. Runners are used to pushing themselves to the limits and this can be hazardous in hot, humid conditions when combined with other risk factors.   A lack of acclimatization, certain medications and dietary supplements, low fitness level, viral illness, diarrhea, dehydration, sleep deprivation, and obesity have all been linked to exertional heat stroke (EHS). Here are some general recommendations to reduce your risk of heat-related illness.

 

1) Hydration Guidelines including water, sports drinks (and beer)

How much should I drink? This varies based on the individual and should be determined by fluid (sweat) loss.

Pre-hydration is very important.  Drink water often throughout the day and then consume an additional 12-16 ounces immediately before your run to “top off the tank.” Drink until your urine color is pale yellow to clear, as thirst is not a good indicator of your level of hydration.  If you are well-hydrated prior to exercise, you should be able to complete 30 minutes of running without additional water or sports drink.  After 30 minutes you should be consuming 5-12 oz of water (depending on your sweat rate) every 15 minutes.  After 60 minutes, electrolyte and carbohydrate stores may become depleted.  Supplementing with sports drink has been shown to improve performance and reduce the risk of hyponatremia (dangerously low levels of sodium) when running longer than 60 minutes.  Sports drinks which are 5-7% carbohydrate concentration are absorbed best (be wary of anything too sweet).

 

Re-Hydration should be based on fluid lost.  Weighing yourself before and after 30 or 60 minutes of running can yield your hourly sweat rate (subtract the number of oz consumed during your run from the total weight loss and know that 16 oz equals 1 lb) and the total amount of fluid lost.  If you lose 3 pounds during a run, you should be replenishing 48 oz of fluid.  Greater than 2% dehydration (calculated by comparing your weight pre and post-exercise) can have an adverse effect on performance and place you at increased risk for hyperthermia/heat illness.  Once you know your hourly sweat rate you can determine the number of ounces you should consume every 15 minutes during running.

 

Is beer a good recovery drink?  Yes and no.  Many runners view beer as a great way to replenish carbohydrates.  This is true, but remember that alcohol is also a diuretic, so remember to supplement with plenty of water.  Consider that caffeine is a diuretic as well.  There are studies that show caffeine can boost performance, but you must weigh these benefits against potential increases in fluid loss.

 

2) Modify your workouts according to the heat – in high heat or high humidity expect your normal times to be at least 15% less and don’t be afraid to slow your pace. Adjust your intensity and be wary of increased levels of fatigue, or dizziness, chills, cramping, disorientation or cessation of sweating.  If you experience these symptoms, stop exercising, find the shade, drink water and cool your body. 

The coolest time of day to run is sunrise.  Air temperatures remain high at the end of the day due to heat retention from the ground. 

Consider other options such as walk-run workouts or one weekly running session in the pool with a flotation device.

 

3) Clothing considerations – lightweight and light colored technical materials are best to reflect sunlight and wick away moisture.  Visors are better than hats to shield sun but not prevent heat loss from the head.

 

4) How to recognize and treat heat illness – if you follow the above guidelines you can significantly reduce your risk of heat illness, but you must monitor symptoms closely and use good judgment.  Don’t push yourself in the heat if you don’t feel right.

 

Heat Cramps – most commonly recognized as muscle cramping in the legs. Treatment includes rehydration with water and electrolytes, massage and prolonged stretch. Physical therapy patients are often surprised to learn that leg cramping at night is most often caused by dehydration and relieved by simply drinking more water!

Heat Exhaustion – common signs and symptoms include low blood pressure, elevated heart and respiratory rate, sweaty, pale and ashen, dizziness, headache, weakness, irritability, nausea, vomiting, diarrhea.  Treatment should include moving the individual to a shaded or air-conditioned area, remove excess clothing, elevate legs, provide oral fluids, and monitor vital signs closely.

Heat Stroke – signs and symptoms depend on the degree and duration of hyperthermia and range from disorientation, confusion, dizziness, irrational or unusual behavior, inappropriate comments, irritability, headache, to inability to walk, loss of balance and muscle function resulting in collapse, profound fatigue, hyperventilation, vomiting, diarrhea, delirium, seizures, or coma.  Recommended treatment is rapid body cooling through cold water or ice water immersion, ice packs or ice towels to the head, neck, axilla (underarm) and groin, and activating emergency medical services.

 

5) Acclimatization - Ten to 14 days of light, progressive training in the heat is recommended by the American College of Sports Medicine to improve acclimatization and reduce the risk of heat illness.

For additional information and recommendations please visit the following links:

 

References:

http://www.acsm.org/access-public-information/position-stands

http://www.runnersworld.com/hydration

http://www.runnersworld.com/heat

 

Dave and Kristy are avid runners, MTC members, and owners of Siesta Key Sports and Physical Therapy.  The orthopedic section of their physical therapy education included extensive instruction in foot and ankle biomechanics, and they have worked with many runners in their 10 years of practice.

A New Arrival!

September is Pain Awareness Month!

In honor of National Pain Awareness Month we would like to offer some information regarding a tool that is used with many of our patients. We have found that a vast array of problem areas can be treated with the foam roller.

Everyone can benefit from using the foam roller whether you are elderly and needing posture assistance, a busy Mom who suffers from neck pain or an athlete experiencing pain and or soreness in the lower extremities.

We have included below a very popular hand out that we give many of our patients and patrons when they purchase a foam roller or are needing some guidance on how to use theirs.

 

Foot & Ankle Pain

Tips for Foot and Ankle Pain

By Dave Ochsendorf, MPT and Kristy Ochsendorf, DPT

In this latest article we will provide some helpful tips for strengthening your foot, ankle and lower leg muscles.  These muscles are faced with the challenge of stabilizing and controlling the impact and advancement of our lower limbs as we run.  On long runs, or on uneven surfaces, this can be very demanding and may lead to overworked or inflamed tendons, muscles or ligaments.   Performing routine exercises that simulate these demands is an effective way to prevent and treat many common overuse injuries.  Specific balance, “eccentric”, and light plyometric exercises are typically the most appropriate for runners.  An eccentric muscle contraction is one in which the muscle is lengthening, sometimes referred to as the “negative”.  Some examples would include exercises in which you lower your body slowly such as single leg squats or lunges.  These movements also challenge your balance at the same time.  It is advised to perform these exercises after running so that your muscles aren’t exhausted prior to your run.  The pictures below illustrate the proper technique.  To effectively supplement your running, try to complete a higher number of repetitions (3 sets of 15-20 reps) or longer duration holds when balancing (3-5 bouts of 30-60 seconds) to build endurance.  Exercises should be continued until the lower extremity muscles are thoroughly fatigued, without causing pain.  Figure 1 demonstrates balancing on one leg.  For more of a challenge attempt with your eyes closed, or while rotating your head or body side to side.  In Figure 2, bend the knee slightly and extend the opposite leg to the front, the back and the side.  Figure 3 shows a single leg heel raise for calf strengthening.  Normal strength would be 20 repetitions.  Perform the heel raise with your knee slightly bent to strengthen your soleus, the other primary calf muscle.  Another excellent calf exercise (to be performed after running) is walking on your toes until fatigued.  Figures 4 and 5 demonstrate more advanced balance exercises that incorporate an eccentric strengthening component as well.  It is important to perform these exercises to tolerance and not while experiencing pain.

Look for us at the races and feel free to contact us directly with specific questions or for recommendations on exercise progressions or plyometrics.

Dave and Kristy are avid runners, MTC members, and owners of Siesta Key Sports and Physical Therapy.  The orthopedic section of their physical therapy education included extensive instruction in foot and ankle biomechanics and they have worked with many runners in their 10 years of practice.

Recipes We LOVE!

Runners World Magazine Recipes we LOVE!

Runner's World Recipe:

Chicken with Quinoa Tabbouleh

Marathoner and chef Charlie Trotter shares his recipe for a high-carb, high-protein postrun meal. By Charlie Trotter Image by Yunhee KimFrom the September 2008 issue of Runner's World

Chicken with Quinoa Tabboule

Quinoa is a whole grain that's rich in carbohydrates and is as easily prepared as rice. One cup of raw quinoa is equivalent to about three cups cooked.

4 boneless, skinless chicken breast halves, grilled and thinly sliced

For the Quinoa Tabbouleh
3 cups cooked quinoa, at room temperature
1/2 cup cucumber, diced with skin on
1/4 cup red bell pepper, diced
2 tablespoons fresh flat-leaf parsley, chopped
2 teaspoons fresh mint, chopped
2 tablespoons olive oil
1 tablespoon freshly squeezed lemon juice
2 tablespoons red onion, minced
1 1/2 tablespoons sherry vinegar
1/2 teaspoon Kosher salt
1/8 teaspoon freshly ground black pepper

For the Parsley Vinaigrette
2 tablespoons freshly squeezed lemon juice
1 1/2 tablespoons water
1 tablespoon olive oil
2 1/2 tablespoons flat-leaf parsley, finely chopped
Kosher salt and freshly ground black pepper

Tabbouleh In a large bowl, combine the quinoa, cucumber, bell pepper, parsley, mint, olive oil, lemon juice, red onion, and vinegar. Toss to mix. Season with salt and pepper.

Vinaigrette Whisk together the lemon juice and water. Whisk in the olive oil, and then stir in the parsley. Season with salt and pepper.

Plate It Divide the quinoa into four dishes or containers and top with the chicken. Drizzle with the vinaigrette. Serves four.

Calories Per Serving: 410
Carbs: 32 g
Protein: 33 g
Fat: 16 g

Charlie Trotter's, 816 West Armitage, Chicago; charlietrotters.com

Siesta Key Sports & Physical Therapy's 2012 Summer Newsletter is here!

Recipes We Love!

Publix Lemon Thyme Chicken with Sautéed Squash Ribbons

Total time: 30 minutes   Servings: 4

Ingredients                                                                                                                                                

     ¾ Ib. boneless, skinless chicken breasts

½ tsp. kosher salt

¼ tsp.  Pepper

1 TBS canola oil

2 BS lemon juice

¾ cup white wine

1 (14-oz) can reduced sodium chicken broth

8-10 whole sprigs fresh oregano

1 TBS cornstarch

2 TBS water

Steps

1.       Preheat large sauté pan on medium-high 2-3 minutes. Season chicken with salt and pepper (wash hands). Place oil in pan and then add chicken; cook 2-3 minutes on each side or until lightly browned.

2.       Stir in lemon juice, wine, broth, thyme, and oregano; cover. Cook and stir 8-10 minutes, turning chicken occasionally, or until 165 degrees F. Remove chicken, thyme, ad oregano from pan.

3.       Combine cornstarch and water until smooth; pour into pan and bring to a boil. Cook and stir 2-3 minutes or until thickened. Slice chicken, top with sauce, and serve.

Calories (per ¼ recipe) 300cal; FAT 3g CHO 110mg; SODIUM 140mg; CARB 4g; FIBER 1g; PROTINE 1g; VITA A 15%; VITA C 6%; CALC 2%; IRON 8%

Sautéed Squash Ribbons

Ingredients

            1-2 medium zucchini

2-3 medium yellow squash

½ tsp. minced garlic

1 TBS butter

1/2 tsp. kosher salt

1/8 tsp. pepper

Steps

1.       Cut zucchini and squash thinly, using vegetable peeler, down length of squash until reaching seeds. Rotate squash and continue cutting ribbons until only seeds remain.

2.       Preheat large sauté pan on medium-high 2-3 minutes. Place butter in pan and then add garlic; cook and stir 2-3 minutes or until softened.

3.       Add squash ribbons, salt, and pepper; cook and stir 3-4 minutes or just until tender. Serve

 CALORIES (per ¼ recipe) 40kcal; FAT 3g; CHO 10mg; SODIUM 140mg; CARB 4g; FIBER 1g; PROTEIN 1g, VITA A 15%, VITA C 8%; CALC 2% IRON 2%

Below is the link to the recipe found at Publix. Enjoy!

http://sundaydinners.publix.com/recipes/lemon-thyme-chicken-saut%C3%A9ed-squash-ribbons

Improve Your Swing

GOLF POSTURE

Several key physical characteristics are important to have an efficient and repeatable golf swing. Golfers must be able to maintain consistent spine and joint angles from their set up position through impact.  Most golfers are aware that a lack of spinal mobility, or shoulder or hip tightness, can have an adverse effect on their golf swing, but many don't realize the importance of "core stability".  The core musculature refers to important stabilizing muscles around the thorax, lower back, and abdomen, as well as the gluteals.  Our injured golfers often demonstrate adequate flexibility, but perform poorly on basic golf fitness and strength tests because of core weakness. To maintain proper alignment throughout the golf swing, the upper body must be able to rotate around a stable base.  Once we train a golfer to engage their abdominals and gluteal muscles, they often report a dramatic improvement in their swing.  A Golf Fitness Screen can quickly detect if you have any of these deficits, and with the right exercises you can take immediate steps to improve your game.

Make a comment on this blog to win a one on one Golf Fitness Screening with Dave Ochsendorf, a TPI Certified Golf Fitness Instructor!

Working up to Run a 5K

I have been training to run a 5K. My husband was a college athlete and has started to run with me. As I huff and puff he runs cool and breezy, barely breathing. I am at least two steps behind him the whole way and my irritation grows as he has a casual conversation about his day. I can only gasp short "yes" or "no" answers.
Yesterday I had a great day. Yesterday I was so happy I had my husband with me. Finally I was able to run a 5K distance without stopping. With my husband Bryan pacing me and keeping me moving forward I had someone there at the end to say, "good job" and give me a hug.
Some stretches that Dave and Kristy have given to me that have really helped with any aches and pains I was having are below:

SKPT Halloween Celebration

Dave Ochsendorf as Captain Hook

We had a Happy Halloween here at              Siesta Key Physical Therapy!

Little princesses, ghosts, goblins, kittens and even Scooby Doo (and dad as Shaggy) came by. We had about 200 trick or treaters and went to get candy twice! The kids were so adorable and all looked fabulous.

One of our favorite patients, Bobbie Donlon came by to welcome the kids and see the costumes.
We had a great time meeting the families and even had a special treat for the parents- a drawing for a free 830Laser Treatment!

 

The March Hare from Alice and Wonderland and dad stopped by to hand out goodie bags and candy to the kids. Being on Siesta Key and participating in the annual Safe Treats makes us thankful to be a part of such a unique and diverse community!   

Our big winner of the FREE 830Laser Treatment goes to....................... 

Leanne Platfoot!

Congratulations Leanne and thank you for coming out Halloween and helping us celebrate!

Maezie, Traci (adiminstrative assistant)
and Bryan Kegerreis



Kristy and Dave Ochsendorf
owners of Siesta Key Physical Therapy
with baby Jessie

We would also like to thank all of the families that came out to Siesta Key to celebrate a safe Halloween and stopped in Siesta Key Physical Therapy to see us and share their wonderful costumes.



RUN For FUN!

Bill's Beer Run

I have never been a big runner, maybe in college when nothing got sore and I had endless amounts of energy. Since I am working at Siesta Key Physical Therapy I thought maybe it would be a good idea to get off the couch and try to run in a race. Dave and Kristy participate in many races and they seem to have a great time. Sunday morning I decided to go out to Bill's Beer Run  and realized that I have been missing out on all of the fun! I now see how exercising whether its running, taking a class or walking in the evening with your dog can be good for your social life as well as your health.
I have not been to a race here in Sarasota and on Sunday I realized how many people participate in these awesome events. Bill's Beer Run, a 5K race also had a 1 mile fun run, but either way everyone was having fun. Families were dressed up in their Halloween garb, music was playing and the coffee (and then beer) was flowing. I had fun and I was just there to take some photos and cheer Dave and Kristy on!

Dave, Kristy and Jessie

 I have started training for a 5K run with the help of Dave and Kristy. Siesta Key Physical Therapy will be participating in the Sandy Claus Beach Run in December. I plan on being in better shape, able to RUN the whole race and I will proudly be sporting a Santa hat ready for a fun day. For a weekly update on my progress visit us on our Facebook page. See you at the races!!

“Injury Prevention”

By Dave Ochsendorf, MPT and Kristy Ochsendorf, DPT

Tips to Prevent and Manage Knee Pain

Pain in the front of the knee is very common in runners.  A frequent finding when evaluating this condition is tightness in the quadriceps muscle group.  The quadriceps is made up of 4 muscles on the front of the thigh, which join into one common tendon and attach to the knee cap (patella).  When this muscle is excessively tight it creates increased tension in the tissues above or below, or on either side of your patella.  Additionally, it increases compressive forces on the back of the patella every time your knee bends which can lead to discomfort or “grinding” (crepitus) with activities such as stair-climbing or rising from sitting.  Prolonged compressive forces could potentially contribute to early arthritis, or increase pre-existing arthritis pain.  Normal quadriceps flexibility for a runner would be illustrated by the ability to easily pull your heel up to your buttock with your hand on the same side (see figure below).  Two common quadriceps stretches are pictured below and should be performed before and after your runs, three times each, for a duration of 30 seconds each time.  Performing these stretches throughout the day provides additional benefit. 

Excessive tightness in the calf or hamstring muscles can make it difficult to fully straighten the knee when running, which also creates more pressure on the patella.  Effective stretches for these muscles are pictured below. 

Other common causes of pain in the knee with running include weakness in the quadriceps or hip musculature, tightness in the hip joint or musculature, misalignment of the hips and/or knees, or abnormal foot and ankle biomechanics such as excessive pronation.  These issues can be a little more complex and may require a thorough evaluation and exercise prescription by a qualified medical professional.  Supplemental strengthening for the knees and hips will be covered in next month’s column which addresses prevention of hip pain.

Just remember, consistent quadriceps stretching can be extremely beneficial in treating or preventing knee pain to keep you running later in life! 

                                                              

Do You Experience Back Pain?

Here are some helpful hints:

Use ICE or a cold pack on the painful area when symptoms frist occur to manage inflamation. HEAT can be used for muscle spasms and stiffness after the first few days.
Practice good Body Mechanics: Avoid bending, twisting, and lifting.
Relative Rest/Activity Modification: Continue your normal activities as you are able to without pain.
Exercises to reduce low back pain are not complicated and can be done at home with a program designed by a physical therapist for your specific needs.
Consult with your physician or physical therapist if symptoms persist.

Summer Senior Exercise Classes

Free Senior Exercise Class

Our Free Senior Exercise Classes began on June 2nd and has been an amazing experience! We have held them every Thursday morning at 9:00 a.m. and the response has been TREMENDOUS.

The class has grown so much in size that we have had to purchase more equipment to accommodate all of the participants.
The focus has been on improving flexibility, posture and strength.

Siesta Key Physical Therapy has enjoyed welcoming people who have just recently moved to the area and are looking for an outlet to meet people as well as get into shape!

Dave instructing the group on stretching techniques they
can do at work or at home.