Marathon Preparation Utilizing Therapeutic Exercise and Stretching

by Carl Gustafson PT AT CSCS

Sports and PT Associates

Marathon Defined: Long distance race 26 miles 385 feet,

A Difficult Undertaking,

A test of endurance

Encarta World

Overtraining :a lack of Recovery to training NSCA ?? or Micheli, Children’s Hospital found that Dancers who

danced greater than 12 hours per week were significantly more prone to injury

Gustafson, SPTA with Boston Skating Club found a significantly greater chance of injury with skating greater than 20 hours per week.

Under conditioned: Lack of Physical Conditioning NSCA? Are the injuries you sustain while

training due to lack of overall conditioning?

Empirically when do the Wheels fall off the bus??

Novice Runners about 6 miles

10 k Runners 10-12 miles

Experienced marathoners usually due to running >than 3 Marathons per year

Micro vs. Macro Trauma Micro trauma small repetitive traumas

resulting in tissue breakdown NSCA

More Prevalent during Marathon Training

Macro trauma 1 large event or trauma resulting in injury NSCA

Training in Boston over the Winter BEWARE!

Strain vs. Sprain Strain Micro tears in muscle due to overload NSCA

Sprain Tears in ligaments due to overload or overstretching NSCA

Tendinitis/Tedinosis Intrinsic Tendinitis Acute Inflammation of

tendon due to lack of flexibility Witvrouw

Extrinsic Tendinitis Acute Inflammation of the tendon due to external friction ( Shoe wear, Skate bite) NSCA

Tendinosis A tendinitis that has lasted through the acute stage NSCA

Stress Fractures

Need to see MD, PA or NP for Diagnostic Tests to determine if present

A stress fracture is a small crack in a bone. Stress fractures often develop from overuse, such as from high-impact sports like distance running or basketball AAOS

Gastroc-Soleous Strain /Achilles tendinitis Acute gastroc Soleous Strain due to

muscular overload NSCA

Acute Achilles Tendinitis due to lack of flexibility and Strength NSCA

Acute Extrinsic Tendinitis due to foot wear and or orthotics /heel cups in shoes NSCA

Gastoc Soleous/ Achilles rehab Short Term raise heel via Heel lift or Higher Heel

counter in shoes, Don’t stretch for 7-14 days but do progressive plantar Flexion gradually to full weight bearing. Then once full strength apply stretch.

Illiotibial Band Tendinitis Due to Lack of flexibility , strength and or friction NATA

Illiotibial band rehab Stretch Illiotibial Band

(Long Tendon Not as impressive a stretch) and Rectus Femoris stretch

Apply stress to tendon via and step ups which progress to lunges

Patella Tendinitis Due to Lack of Flexibility of Patella

Tendon Witvrouw

Patella Tendinitis Rehab Stretch Rectus Femoris,Quad

and Hamstrings

Apply Stress to tendon via knee extensions and step ups which progress to lunges

Low back pain Strain to Lumbar muscles and

compression to facet joints from being in prolonged lordotic positions NSCA

Rehab exercises for Low back pain Reduce spasm and

joint compression through directional appropriate exercises Donnelson

Stretch Rectus Femoris, piriformis and hamstrings

General Muscle Achiness DOMS Delayed Muscle Onset

Soreness NSCA

Low Resistance Aerobic Training Bike or Elliptical NSCA

Cross Training If Injured utilize Cross training to continue to raise

aerobic endurance without the pounding and compression of the street. NATA

Utilize Treadmill, Elliptical or Pool

Modalities Therapeutic Agents to Stimulate

Circulation and Decrease Swelling APTA

Acute Inflammation from large influx in Running

Utilize Ice Electrical Stimulation and Pumping massage APTA

Train Smart ! The Human Race

Running a Race

To Race for a Cure

Everyone is a Winner

THANK YOU !!