ELY- Physical Therapist Toni Dauwalter knows a lot about running. And during her 40 years working as a physical therapist, she has learned how to treat runners and their injuries. Last Tuesday, Dauwalter, who works at the Ely-Bloomenson Community Hospital, held a free “Marathon Prep Class,” aimed at those already training for the Ely marathon and half marathon races on Sept. 23.
The three main things that lead to injuries to runners are over-use or overloading one’s body, lack of mobility/flexibility, and increasing volume of running too quickly, she said.
Strength training is essential, she said, and runners should focus on training from their knees to glutes, as well as their core.
“Your glutes are hugely important,” she said, noting that stronger glute muscles take pressure off other smaller muscles that are more prone to injury. Adding too much training volume without adding strength training is the cause of many injuries she treats for runners, she said. Runners should aim to strength train two times a week during their “running season” and three times a week the rest of the year.
“Running should have seasons, you need to have times of the year with low running volume,” she said. “You can do things like ski or bike in the shoulder season. You need a level of rest to be ready to train for a marathon.”
Mobility and flexibility are important for several reasons, and preserving flexibility in younger runners is essential because it is harder to increase flexibility as one gets older. She recommended foam rolling the larger leg muscles regularly. And while stretching before running is no longer recommended (dynamic warmups, which mimic the muscles used in running are now preferred), she said stretching should remain part of one’s weekly routine.
“Your body needs to be balanced,” she said. “You need to have your hamstrings and quads balanced. If you’ve always had tight hamstrings, you are not going to change that.”
The biggest problems she sees runners getting into regard volume. Doing too much (mileage and speed-wise), too soon, gets runners into trouble.
“How much can you do without getting into trouble?” she said. “There isn’t a rule.”
While there is no limit to the number of training regimens being offered in books, apps, and other sources these days, Dauwalter advises that there’s no one-size fits all program.
She said a new runner might benefit by consulting with a physical therapist to adapt a ready-made plan. She said reviewing a training plan with a physical therapist can help tailor a plan to one’s specific goals and current fitness level.
“It takes discipline to train for a long race,” she said. “This is what makes an athlete.”
A physical therapist can also do a running gait analysis. Dauwalter offered participants in the session a quick version of such an analysis, watching a runner on a treadmill and observing their gait, cadence, posture, and arm positioning. With regular clients they can also do analysis of running gait outdoors, on a more natural running terrain.
What to do when something hurts
A new pain that doesn’t resolve itself in a week or so probably merits a trip to a physical therapist, according to Dauwalter. This often, but not always, requires a referral from one’s primary care physician, she said. When working with runners, her priority is getting that person back on their training schedule as quickly as possible, as safely as possible. For a runner with a good solid training base, taking a few weeks off, even in the months or weeks before a race, won’t hurt a person’s overall fitness and ability to race. Often a physical therapist can recommend another aerobic activity to pursue while an injury is healing, such as biking.
“Our goal is to get you to the start line,” she said.
Dauwalter spent some time talking about running shoes, something all runners do like to talk about.
“If a shoe works for you, just stick with it,” she said. “There is always a new trend out there, from barefoot running to those thick-soled Hokas.”
The most important thing is to not choose a shoe for its looks.
“The shoe should feel comfortable right away,” she said.
She recommended first getting fitted at a shoe store that specializes in running.
“You can trust the staff there,” she said. “Be sure to try on several kinds.”
Every running shoe brand has styles made for different types of feet, some need more lateral support, some need more cushioning, some need different drops (the height different between the heel and toe). There are also different running shoes for miles spent on paved roads versus trails, as well as specialized shoes for racing.
“The same style shoe can change over time,” she said. Dauwalter said she has been running in the same model of Nikes for 30 years. “The shoes do change a little, but my body has gotten used to it.”
Once a runner knows what type of support, cushioning, and drop they can explore other brands and styles similar to what they are currently using.
Running shoes do wear out, and Dauwalter recommends having two pairs to train in.
“If you are trading off between two pairs of shoes, they do seem to last longer,” she said.
Runners should start checking shoes for wear after about 200 miles. How long shoes last can vary for each runner, but she recommended that shoes get replaced at least once a year. Runners who spend most of their miles off-road may wear their shoes out more quickly. Signs of wear include worn soles, worn uppers, too much bend in the sole (toe end tipping up), and shoes that feel noticeably less cushiony. To ensure running shoes last as long as possible, they should only be worn while running. “Retired” running shoes are still great for regular use.
Race day nutrition was also discussed.
“You need more than water when doing a half or full marathon,” she said. “You need to eat well before the race also.”
What types of running nutrition is best is different for every runner, and runners need to figure out what types of carbohydrates, needed to replenish energy stores during a race, work best for them.
“You need to practice it,” she said. “And that goes for everything else on race day. Never try something new during a race.”
Several attendees were hospital employees, not yet seasoned runners, who will be part of a hospital relay team, portaging a canoe, three miles each participant, along the course.
Dauwalter recommended starting to simply walk with the canoe and be sure to train on hills which match the course. Strength training for one’s core and upper body will also be essential, she said. If not, she said, “this probably isn’t going to be good for you.”