Dr. Emily Carr: Why See A Physical Therapist Even If You’re Healthy?

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About This Episode:

In this week’s episode, Hillary Allen interviews Emily Carr, Doctor of Physical Therapy. Dr. Carr discusses the need for runners to implement strength training and talks about the common injuries she sees in runners. She stresses the importance of seeing a physical therapist even when you’re not injured to uncover the nuances of your body and identify ways you can increase performance and stay healthy.

Episode Highlights:

  • Strength Training is key to running performance and injury prevention
  • Exercises runners should add to their routine
  • Physical Therapy can help even when you’re not injured
  • Running alone is not enough to make your skeleton stronger

Guest Bio –Emily Carr PT, DPT :

Emily is a Doctor of Physical Therapy who comes to Colorado from Michigan. Emily completed her B.S. in Movement Science and her Doctorate in Physical Therapy at the University of Michigan. She now works with the great team at Revo Physiotherapy and Sports Performance in Boulder, Colorado. 

Emily is an avid soccer player and having played competitively her whole life, has had her fair share of injuries making her no stranger to the benefits of PT long before she decided to become one herself. From her experiences, Emily deeply understands the athlete’s mindset and the drive to achieve and maintain physical preparedness for the demands patients put on their bodies. Emily thoroughly enjoys working with athletes of all ages and abilities ranging from the weekend warriors and active elderly to high-level athletes. Emily’s special clinical interests include treatment of pregnant and postpartum athletes, runners, and soccer players of all levels and abilities. 

In her free time, Emily soaks up every opportunity she can to get outdoors. She enjoys mountain biking, skiing, playing soccer, and volunteering for a local canine rescue group! 

 

Read More About Emily Carr and Revo PT Boulder:

Website: https://www.revoptboulder.com/

Instagram: https://www.instagram.com/revoptandperformance

Facebook: https://www.facebook.com/RevoPTandSportsPerformance

Revo Blog, to hear more from Emily Carr: https://www.revoptboulder.com/blog

 

Listen to the episode on Apple PodcastsSpotifyStitcherGoogle Podcasts, or on your favorite podcast platform


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Episode Transcription:

Please note that this is an automated transcription and may contain errors. Please refer to the episode audio for clarification.

Hillary Allen (00:00):

Hello, and welcome to the train ride podcast. Today’s guests. We have Emily Carr. Emily is a doctor of physical therapy who graduated with both her undergraduate and doctoral degrees from the university of Michigan. Shortly after graduating, she moved to Colorado and currently resides and works in the Boulder Valley. She comes from a background as a competitive soccer player, which has influenced her treatment style and approach to the high level athletic population, which comprises most of her caseload. These days. She is fortunate enough to be treating at Rebo physical therapy in Boulder, Colorado. Big surprise. That’s how I met her and she specializes in the treatment of endurance athletes. She’s an avid hobbyist who will do pretty much anything. If it’s outdoors, that’s mountain biking, skiing, soccer, and running to name a few. When she is not at the clinic, you can find her searching and hoping for the perfect powder day, exploring new mountain biking trails throughout Colorado and hanging out with her exceptionally lazy rescue pup. Hi Emily.

Emily Carr (00:59):

Thanks for being here. Thank you so much. I’m really excited. This is my first podcast, so I feel very honored to be hanging out with you. I’m so excited.

Hillary Allen (01:08):

Um, so we’re basically, we’re sitting in, uh, in Rebo, so physical, uh, physiotherapy. I always, I just call it rebounds. So I mean, anyone who follows me on Instagram knows that I come here.

Emily Carr (01:19):

Oh, no. I feel like he was like the most tag person and it’s usual Rebo in here.

Hillary Allen (01:27):

So, um, so this is, this has become, I mean, I found these guys through, um, Matt Smith was my original PT. I found him through, um, my huge accident recovery. And so, I mean, I’ve dabbled in physiotherapy. Um, like I’ve seen the need for it kind of throughout my running career, but it wasn’t until, you know, but it was kind of like a typical runner. Like I would get injured and then I’d be like, okay, well I guess I should go to PT now. Like I literally can’t run. So for things to happen. And then like, literally I remember the last time that I went to, uh, like PT before the huge accident I had was, um, you know, this nagging like nerve pain that was caused by some like impingement in my hip. You know, I always say to, I mean, all the runners that I coach that pretty much almost every single running injury comes from hips or core imbalances with the exception,

Emily Carr (02:20):

Give me a little asterisk. There’s a little asterisk, definitely applicable to, you know, blunt force trauma.

Hillary Allen (02:29):

So, I mean, these guys just changed my life. I mean, they’ve become my extended family. I mean, when I was recovering from all those injuries, it was like a full-time job. And I was here like twice a day and, you know, they like, you know, leading technology, like blood flow restriction, um, like, you know, when I couldn’t wait there, um, they’re just amazing. So that started my kind of love affair with PT. And I’ve been an avid believer in like, I like believer cause a cult, but like yeah. A believer the process. And like, I come like, you know, now it’s just part of my routine.

Speaker 3 (03:03):

Yeah, absolutely. No, I feel super fortunate to be here and the Geyser I’ve, I’ve learned so much from them. Um, and I feel really lucky to be able to continue to learn from them and kind of advance my career in that way.

Hillary Allen (03:15):

Yeah. And then there’s a huge, um, like, uh, what’s the word I’m looking for? Uh, just mix of athletes that come in to repo. It’s not just runners. There’s a lot of cyclists,

Speaker 3 (03:27):

Lots of cyclists. Yeah. Lots of endurance athletes in general, but it’s an, a whole spectrum. So like I see, like I can see, like I’ve seen pediatric patients here. I’ve seen geriatric patients here and I really love that. And I think that’s something I really love about treating in Boulder is everybody has the same goal. They just want to be able to continue to be active. Um, and that looks different for everybody. Um, but it says set that spectrum of just like what is active to them and how can we keep them continuing to do that.

Hillary Allen (03:57):

Yeah. And so I guess this is my selfish ploy for not only the athletes that I coach, but I think just the running population in general, um, or endurance athlete population in general, like stressing the importance of, of physical therapy. And so I guess I don’t even want to specify for runners yet, but why do you think that strength training or, you know, physio is important? And, um, I guess like I can kind of use those, but there’s a difference there’s a subtle difference between like physical therapy or, you know, the strength.

Speaker 3 (04:30):

Yeah, absolutely. I think, um, for endurance athletes specifically, their sport is not enough alone to, um, meet the demands of their sports. So you can’t just run and expect running to be enough to drive the adaptations that you need to continue to be able to run however many miles you want per week at the level that you want to run. So I feel like it’s been a really slow realization in the running community. That strength is a really pivotal piece, um, to that component. And that’s where PT can come in and really tailor that. Um, so we’ve, uh, we work a ton with strength coaches as well, but I think PT is kind of the piece where we really dive into like the Bob mechanics and, um, like maybe a little subtleties or nuances with form and things like that. Let’s say like for a totally asymptomatic runner, we can pick up a little things that could potentially kind of lead to injury, um, down the road and really hone in on those, um, develop those out with a kind of a strength program and go from there. Um, and then like obviously with the symptomatic runner, that’s our bread and butter. So I would love to see more asymptomatic errors. So people coming in just from like a prevention standpoint, but, um, a lot of times it’s people are having issues kind of chronic type things that have crept up on them. Um, and that’s where I think we can make a huge difference. So, yeah.

Hillary Allen (05:53):

So I mean, I, honestly, when I first came, like I was afraid, especially cause now like the more I read and the more, um, especially for the trail running that I do Matt, my PT, like he, he has me, I mean, this, I just say him, cause he’s like, yeah, I just always associate him. But like everyone here at Rebo, like he prescribes me to do heavy lifting and I’m just like, Oh my God. First of all, my, my comment is like, whenever he does these things, it’s like, it’s like full body lifts. It’s not just legs. Um, the second was like my bird runner arms, like I can’t lift fast and he’s like,

Speaker 3 (06:27):

You roll your eyes at him every time when he’s like, you need to do a trial,

Hillary Allen (06:34):

But it’s so important

Speaker 3 (06:35):

Going back to like running alone is not enough to make your skeleton stronger. Yeah.

Hillary Allen (06:40):

So like, let’s talk about this because I was afraid that like lifting heavy I’d get like big and you know, like I’m like I’m past this idea of like, I think still some runners and, um, I have to be sensitive to this. Like someone is, are afraid. It’s like, you know, um, eh, like the VO two max, like the easiest way to build Bousfield two max would be super light, but I think that plays less to travel.

Speaker 3 (07:03):

I think so too. And I think, um, there’s still just this big misconception he gets shifting. I think, um, every time I think of like a strength, someone that’s adapted or adopted a strength training program and has done really well. I think of Allie Kieffer, she’s American. I know her and she was a huge advocate for CrossFit. She did it for a short time and just saw these huge gains in her performance. And, and she’s also a really awesome example too. Like you don’t have to be the leanest person out there to perform really well. Um, but she was a really big, uh, advocate for that strength training piece. And I think she was the first person or one of the first people to like really put it out there, like maybe five ish years ago. Um, so kind of building off of that, I think, um, going back to, running’s not enough to give you the stimulus that you need to do really well. Um, renders have super strong legs, but hips and core, typically a lot weaker. Um, we need to load the axial skeleton, meaning like the spine and the hips and pelvis a lot more than we do in just running. So that’s where that like external load is like a deadlift squat, things like that really comes in. And I think that’s why, um, we have a program for you so much too.

Hillary Allen (08:19):

Um, and also some things that like, I, which I appreciate, um, like I’ll just, I mean, it’s a form of core. I do these on my own, but like pushups or, you know, like in rows and, Oh my gosh, like banded pull-ups cause like I need the banter, but yeah, like, you know, every time I’m just like, Oh my gosh, like, do I really need to be doing this as a runner? And I’m like, but I think, I think it’s awesome. And I’ve known a difference. I mean, in certainly in my recovery, like I think, I, I mean, obviously I, I attributed a lot to revoke because if I wasn’t, I mean, obviously I was super devoted. Like I mentioned, it was like a full-time I was in at Riva like twice a day doing things. Um, and a lot of it, it really wasn’t that much.

Hillary Allen (09:01):

A lot of it was, you know, I couldn’t walk for three months, so like I had to get creative and so did Matt too, but there’s plenty of stuff that we could do totally. And, um, of course I wasn’t lifting heavy thin, but then, you know, we progressed and, um, I just noticed a shift that I was just, I felt like stronger, more stable. I was able to withstand more training load like running. And at that time I found cycling too. Um, I don’t know if you can, um, talk to that point with this kind of a curve ball, but like, um, I mean I’ve incorporated cycling, but I like how that benefits it’s different muscle groups to me for running. Yeah.

Speaker 3 (09:38):

Yeah. I think everyone’s different with how they like to cross train or like adding strength training. Yeah. Um, I know people that purely just run, but they are really good and careful about their volume week to week. Um, and that’s a lot on the coaches. Um, but that’s where I come in and I really stress the importance of here. If you’re going to be running these high volumes, you need to make, like, you need to incorporate that strength training to make sure that your skeleton can withstand all that impact. Um, and so that’s where like the threshold for these runners to, for string train, a lot of them haven’t strength trained before, but they’re such high level athletes. The threshold for seeing an improvement is a lot lower in terms of that strength train. So I say like two days a week in the gym, like, let’s give you just a couple of things and you can see such a big difference.

Speaker 3 (10:27):

Um, I, I just think like the, if people can commit to that, um, the gains are so big there. And I think, um, going back to, like, you were talking about a little bit about performance, um, when I’m having trouble pitching a patient like a runner, like you need to strength, train. I bring up the performance piece too. So not only is running restraint training, a great tool for injury reduction or risk of injury. Um, it’s also great for performance. So there’s tons of research on the improvements of strength correlating with running economy and things like that. So he brought up VO two max and your body becomes more efficient at, um, consuming that oxygen and the stronger you get. So there’s a lot to be said there.

Hillary Allen (11:12):

Oh yeah. And I mean, and also just, I think if, if there’s like some sort of an imbalance, like your body’s pretty good at adapting, like I definitely have, you know, experienced that. Like, I mean, every person is different. I feel like my body still has, it’s like, you know, right side versus left side, one side is tighter than the other, you know, and it’s continued to work on, but like, your body’s very smart. So if you can kind of like try to work in unison with it, I feel like you can get a lot, like a lot out of it.

Speaker 3 (11:39):

Great. So we’re on those imbalances to, um, bringing up like where PT can come in and all of this I’ve talked to them about strength, but also looking at like biomechanics, we can really hone in on side to side differences and those like subtle compensations can really develop into other things. That’s where we really come in, kind of, um, identify those and then work on like the motor control, the muscle activation to kind of prevent or improve upon those and prevent further injury to, that’s kind of another big piece of the puzzle, um, where we come in for endurance athletes.

Hillary Allen (12:12):

Yeah. And I mean, I love that because I feel like I’ve seen that for cyclists a lot. It’s like, it’s something because for runners it’s so simple, like we just have shoes and so we can go out and run, but for a cyclist, they can come in because they have to get a bike fit. So they have to like, cause if, I mean, I get a bike fit and I’m not like a pro cyclist, but like I run my bike quite a bit. And so with that repetitive motion, you can tell if something’s a little bit off. Totally. And so they, it was so funny, like when I was able to run again, um, I remember coming in and they, and re revoke, put, like, they put like these little sensors, like kind of on my, my ankle, my knee, my hip, I think the, my, like the center of my chest.

Hillary Allen (12:48):

Yeah. And then they had me do single leg squats and, um, kind of like some, I don’t know, some double leg squats and like measured how my hip drop. Um, I also did this on the treadmills. They’re seeing kind of my trunk lean and you know, where am I, if my knees are falling in, which is indicative of like weak glute meat or something like this. And I remember that like the first time that I was doing this pre, like just the very beginning of the strength work, my knee, my knees were like collapsing in and I’m a very strong runner. So I was like, Oh, this couldn’t happen to me. Like, I’ve got strong legs, like, come on. I’m not like a wave of a runner. I’m like, you know, like, I’m like, you know, I felt like I was like pretty strong, but, um, it’s just, I mean, running is pretty, um, brutal, like to end like to the body.

Hillary Allen (13:35):

And so it’s like these little things. And I mean, when I’m talking about like hip drops, this is like from the axes of, you know, like if you draw a straight line across your spine, when one foot hits the ground, you can see the other, um, like side either drop or go up, like drop basically to compensate it. And that degree should not be more than 5%. And I remember one of mine, like, even if it’s like five or six, like, I think one of my was like 9%. Um, that can cause significant issues over time.

Speaker 3 (14:03):

That’s huge. If you think about how highly repetitive running is, if you have that torque going through the joint, that’s not meant to be going there. Um, and especially talking about like ultra runners, right? Like that’s an incredible amount of, um, force going through a joint was, let’s just use the knee joint for example. Cause that’s where most people see the most dysfunction. Um, yeah. I always look, yeah, look upstream. It’s um, typically it’s not the knee joints coming up from more approximately the hip and core. Um, but that repetitive nature of running. And if you don’t have biomechanics really dialed in, that’s when things go awry and, um, it takes a lot of strength to be able to do that properly. In most runners, I find, um, they don’t either have the strength or range of motion or the motor control to be able to really execute just something as simple as a single, like squat really with good mechanics,

Hillary Allen (14:56):

Dude. Yeah. I mean, it’s hard, it’s super hard.

Speaker 3 (15:00):

Um, but it’s nice to have those objective things to work towards and show our athletes, um, because that’s, what’s going to be like, make the difference, um, in the longevity of their running.

Hillary Allen (15:12):

Yeah. And so, um, man, I mean, I remember Matt saying that to me, he’s like, he’ll, you have to be able to, you know, perfect a single leg squat before, you know, you can do this. And of course every one of them looks different. Like, uh, one of the recruit injuries that I had was, um, ankles. And so my dorsiflexion on one side is like pretty limited compared to the other. I mean, it’s getting better, I hope, but, um, but, uh, that would limit my range of motion for like a proper squat. So for me, it’s like even more important than my hips are super strong to build that. And so this is like a good segue into kind of like, what are the like common ailments or like specific things that you see with runners? I feel like it’s a myth that they’re like, Oh, running is bad for your knees. It’s just like, I don’t think so. I think it’s just like, well, let’s like work on your [inaudible], but you gotta have like strong bundle, but we’re going to trademark it.

Speaker 3 (16:12):

So, um, big things like the crux of what we do as it PTs for runners is like bone stress injuries and any like tendonitis stuff. Um, if you’re going to be a good PT for runners, you have to be really good at managing those. Um, so I’d say right now my caseload of my renters, I have probably 50% are bone stress injuries or bone stress reactions. Um, and

Hillary Allen (16:34):

From like blunt force trauma or no.

Speaker 3 (16:37):

Um, so like think like a stress fracture, so repetitive, um, stresses to the bone over time. Um, and there’s a lot of men there. They can be really tough to treat cause there’s so much going on that go into, um, uh, those patients

Hillary Allen (16:52):

I was about to say, cause like, I think there’s a common misperception, um, that stress fractures are due to the pounding nature of running and, and like

Speaker 3 (17:06):

That certainly contribute. But I go back to like biomechanics, I go back to like, even like bigger picture stuff. Like what is their recovery routine look like? Are they getting the other fueling properly?

Hillary Allen (17:17):

Yeah. A lot of the athletes that I work with, like for like, if that happens, it’s usually a combination of such it’s like biomechanics are out and they’re probably not eating enough because bone strength is so impaired is like nutrition is so pivotal and so important in that. And then also like with your bones, like they’re so cool. I used to teach anatomy and physiology and um, it’s so cool to see like you in a bone, it’s not just like this like pure white, like, like it’s a living organism and like it creates layers upon layers based on your stress patterns in your gait, certain areas of the bone will actually become more calcified and become stronger. And so if you think about that, if you have kind of a gate that’s off. Yep.

Speaker 3 (17:59):

Yeah. And it’s like Wolff’s law, your bones will add up to the stresses that are applied upon them, but that kind of, there’s a threshold for that.

Emily Carr (18:07):

So, and that’s where people, a lot

Speaker 3 (18:08):

Of like kind of toe that line and that’s when, um, bone stress injuries occur. So I’d say that’s a big chunk of my caseload pretty regularly with, um, runners, um, especially adolescent runners, just because there’s a lot going on there. Of course. Um, I have, I’ve had a couple of masters runners as well. So I also look at age has a big role in that too. Um, what is happening, um, at the hormonal and metabolic levels too, that could be contributing to that. Um, so I almost always, when I’m treating a bone stress injury, I, if I’d say adolescent, I’m talking to their parents, I’m getting them really involved. I usually refer out to a registered dietician. I just find that they’re a wealth of resource and a wonderful resource in just the wealth of knowledge, because I know my limitations. And usually there is a fueling, um, like a mishap tear.

Speaker 3 (19:01):

Um, there’s something going on to, um, different areas in the body, depending on the, where the stress fractures is, can be really indicative of. Is it like an under fueling problem there too? Really? So usually I say girl or like pelvic stress fracture, a lot of times that can, um, clue into certain mineral deficiencies. So the body’s actually pulling minerals from the bones in that area, kind of the more core areas. Um, and then like lower extremity, kind of your typical, like a tibial stress fracture that tells me a little bit more like bio mechanics. That’s what I’m thinking. I’m not thinking right away, potentially got fueling issue. I’m thinking more biomechanics, but certainly that feeling can also contribute.

Hillary Allen (19:39):

What about a femoral stress fracture or something

Speaker 3 (19:41):

Like that could go either way. Yeah. So I would look at time on the biomechanics for that too. Yeah. But I think anything closer to your axial skeleton, meaning like your low back your spine, um, I almost kinda jumped to maybe a little bit more, um, potential for that under feeling or a mineral or a vitamin deficiency. Wow.

Hillary Allen (20:03):

Yeah. See, and then, so how does, I mean, cause my, I mean, whoops, I go straight to like, so my mom actually, she has asked you Penia, so not osteoporosis, but like the precursor, the precursor. And this was actually because she spent time in the peace Corps in Nepal and her diet was like, she wasn’t getting enough nutrients that she needed. And actually she didn’t have a menstrual cycle for like two years. And that was in your early, you know, early twenties. And so he moves as TMI, but I don’t really care. I’m an athlete. It’s fine. I talk about my period to my coach

Emily Carr (20:37):

All the time. And he’s a man role

Speaker 3 (20:43):

In how you perform as an athlete.

Hillary Allen (20:44):

Yeah. And so like me, is it like as a developing teenager, like I was so active that my menstrual cycle was never the same. Like I would go from like with like three months and you know, maybe like then I’d have a period and then maybe not six months and actually during my injury recovery, because my bones were healing so much actually did not have a menstrual cycle for nearly a year. And I was kind of, um, like I know that this stuff is important. And so like, um, I, I know it’s like one ways to combat that obviously is making sure you’re eating enough, but strength training. And that was something that was super pivotal, pivotal for me to kind of get my body reset. And um, yeah, I mean, I don’t, I mean maybe I think it just signals different hormones, um, to recruit to your skull system to

Speaker 3 (21:34):

Exactly like all your muscles attached to bones. Right. So you need to pull on those bones to make them stronger. And how do we pull on those bounds? It’s going to be resistance training. Exactly. So that’s another, um, there’s just so many reasons, but bone health is a huge reason why resistance training is so pivotal for string, uh, for runners.

Hillary Allen (21:54):

And so then I guess like kind of at the along the same line, you mentioned tendonitis, like, so like, like no tissue stuff. So that can also could

Emily Carr (22:03):

We’re string training lead to tendonitis. Maybe not, no, I wouldn’t

Speaker 3 (22:08):

And jumped to that, but I think again, I go back to biomechanics. I know I like to sound like a broken record right now, but um, I like to see like how are runners running to really know what tissues are they loading? Are they overloading? Um, a lot of times people are overloading their calf complex and not using their hips hips enough,

Emily Carr (22:28):

Especially for view over the last of elevation,

Speaker 3 (22:30):

Loosen up things like that. Um, so when I see the Achilles tendonitis patient tendinopathy or tendinosis, whatever you want to call it, um, I’m looking at glue strength, a ton. Are you over, are you trying to propel yourself with your calves versus your glutes on those uphills? Things like that

Hillary Allen (22:46):

And see, actually I think that’s interesting, like a runnable uphill, maybe it’s easier like you get into the calf kind of thing. Like the little, yeah. But I think I love the steep train and so I can feel myself and empower hiking that it’s more of like the quads and the glutes. Yeah.

Speaker 3 (23:00):

And it shouldn’t be, it really should be the calves give enough work as it is. They don’t need more. So, um, that’s where the glutes come in. They’re the biggest muscle in the body and then you should be really using them. So, and that’s how you’re going to propel your center of mass. They’re closest to the center of mass. So thinking about too, just like a mechanical advantage, you really want to use them to push off.

Hillary Allen (23:20):

So, and I’m a big fan of, uh, the posterior chain strengthening.

Emily Carr (23:25):

Yes, yes. Yeah. But why is that? I mean, it’s all on the hip. Um, I think it doesn’t Matt says to me every single time I go into more pots and I’m like, Oh my gosh, the hip hinge,

Speaker 3 (23:40):

I go to bed at night and I just hear him change in the back of my head. Oh my gosh. Yeah.

Hillary Allen (23:46):

So, so pleased that’s one takeaway. Okay. Yes, exactly. Hip hinge and coming to rebuild to actually find out what that is because yeah. It’s actually really important for the form. Um, but yeah, so, I mean, is there any other stuff you can tell us about like specific PT for runners or like how you treat people when they come in? I think that’s another huge thing is like, there is, um, and I hope to have like a, another podcast on this too, about the topic of like buy-in, but like there’s a lot of like to get, I think a lot for runners like to get to the PT things have to be pretty bad because I hit rock bottom. Like it was easier for me to like come back and commit, but I feel like that first step. And so when you’re talking to someone like how do you get them to kind of buy into it?

Speaker 3 (24:31):

I think if someone is skeptical and like, let’s say they’re not injured, I just go right back to that performance piece. Um, this is how you can make some serious gains if you’re not, um, strict training initially. Um, when it comes to just PT in general, I can spot, I don’t think I’ve ever seen a perfect running pattern. Like I think there is something almost everyone can improve. That being said, I try not to change a whole lot. So, um, talking about like things like foot strike, um, there’s, it’s so hotly debated in the PT world and the running world and, um, it’s really inconclusive on like what’s best there’s pros and cons to every type of foot strike rate. Um,

Hillary Allen (25:12):

Yeah. So like heel versus toe versus like midfoot.

Speaker 3 (25:17):

Yeah, exactly. Um, and I think I always look approximately, so I look more towards like, what’s the trunk doing? What’s the hips doing things like that. And I find that can cleanup a lot of if we’re having issues downstream that can clean up a lot of things. Um, so even if someone’s not symptomatic, like I want to watch them run and try to convince them, like, there’s still some things you could probably work on. Like, let’s get your glutes going a little bit more. Like, that’s like the number one thing I see is people don’t use their glutes enough. Everyone runs really upright. Um, so when you’re in this like upright position, it’s a lot harder to engage those glutes. So if you can get feel just for a Trump thing, you’re going to have a better cadence. You’re gonna have a better foot strike. You’re gonna be able to absorb a lot more through the hips and then use those hips to propel yourself. So it’s kinda all, um, interrelated.

Hillary Allen (26:04):

Yeah. And I think, I mean, runners, I think at least Hill runners can definitely, um, visualize that. I think a lot more. I mean, I say this to some of my athletes, like when we’re doing Hill repeats, especially like VO two max style ones are 10 by one minute pass. Oh my God. They suck. But, um, but a way to kind of like, feel like you’re going faster and actually I think does it two things actually lean forward into the Hill and like swing your arms. Like, I feel like that helps you kind of like get into what you feel like, not that you’re going to like fall over, but like you’re leaning into the Hill.

Speaker 3 (26:37):

It feels really exaggerated when you first started working on it, but it makes such a big difference. And I think going to your point of like, why is it important for me to lift up her body? Like, think about that, like that contract ladder, like propulsion that you need to really get those arms going. Um, and like fatigue, resistance for those muscles too. Like, you don’t want your arms to like kind of bonk out before your legs. Right? Like you don’t really need those arms in those moments when you’re pushing up pills. So that’s another piece of the puzzle.

Hillary Allen (27:05):

And, and so, and also running like, um, it’s kind of more style like in Europe, like when they’re super steep and really long climbs people use like trekking poles and so in long distance ultra running, that’s a huge thing. And again, it’s like, I mean, yeah, there’s certain times that you can feel it. I mean, you don’t want to arms tickets.

Speaker 3 (27:23):

Exactly. Exactly. You want to like, be able to maintain that.

Hillary Allen (27:27):

Yeah. That’s actually a good, a good, um, way for you to like boost your VO two max as you’re like using your own body.

Speaker 3 (27:32):

Right. More bang for your buck and triceps check. Yeah. That’s awesome.

Hillary Allen (27:41):

Yeah. And so, I mean, but yeah, so I mean, obviously there’s the performance thing that you can talk about for like a buy-in, but, um, and, but I mean, also for me, it’s like, how do you keep a runner, a strength training even after they’re injured? Cause I feel like that’s also typical. It’s like most runners are like, Oh, well I am now I’m better. Like I’m going to go running. And it’s something that happened to me too. I was like, Oh, like I just want to run now. So like, I don’t have, I don’t need yeah. Or I don’t have time for the gym, but like maybe it was just the nature of my industry industry injuries that kept me a little bit more, um, you know, attached to [inaudible].

Speaker 3 (28:18):

I think you’re, you’re kind of an exception, but I think obviously falling off a cliff is, um, is one thing, but most people, their injuries are multifactorial. So there’s other things that lead up to it. Um, and I don’t find that those are just resolved right away so we can get somebody symptomatic. I sure as hell want to get them. Um, I want to get them through that prevention piece too, but that’s where a lot of people kind of falter. And I think that is something I’m working on as a clinician too, is like selling that like you like for you to continue running at the rate that you do for the next decade, you need to be doing XYZ and that’s something, um, I think runners are very headstrong and that’s why they’re, they’re good at running. But, um, I think that is something that, um, they need to take ownership of and then I need to really educate them on why this is important.

Speaker 3 (29:15):

Yeah. Um, so that’s something I try really hard to do, um, in all my positions, but especially when I’m treating, um, endurance athletes, it just doesn’t, it doesn’t just go away when you’ve had one issue. Um, and I think most of the people I see, like they start to realize that as we’re working together and developing that like therapeutic Alliance, um, they, they learned to trust me as a clinician and then knowing that like, there’s other things that are contributing to this, it’s not just this like one ankle sprain or it’s not just this out like lateral knee pain that I have. There’s other bigger picture things that we can address. Yeah.

Hillary Allen (29:55):

And so, I mean, I think I don’t want to like, you know, just like give people like, okay, they do these things and like this’ll help. But like, but I mean, I think like you said, like every person is different and I think it’s important to kind of see where your biomechanics lie and even if you are injured or certainly if you’re injured, but even if you’re not to kind of see that preventative stuff. But like for me, some staples that, um, have been in my strength training plan have been, you know, squats or deadlifts and, you know, that can be amended based on, you know, like for me, my range of motion in my ankles and things like this, like, um, like, um, you know, types of deadlifts, I, for me, it’s like trap bar versus like a straight Romanian deadlift. Um, I feel like I’m a gym rat now say all those terms, but yeah, you guys can look these up.

Hillary Allen (30:48):

This is like, um, Trefor deadlifts are really cool. It makes you feel very strong. Um, but yeah, and so something, and then something for me that’s always like that I’m always, um, like fighting against is how tight my calves can be, because that can cause different issues. Um, for me, not only in my range of motion in my ankles, but I feel like strength, training and PT, it’s like, it’s, it’s definitely the actual act of lifting heavy weights or some sort of weights or working on that imbalance if you have it. Um, I would, yeah, I think most people do have it, um, have some sort of imbalance and that’s normal, but exactly. And I, but I think it’s also just the, the recovery aspect too. Like, um, you know, I, I use Rebo just as much as coming, like to lift weights as I do to do recovery and stretch and do little like ankle mobility things and, you know, dry need to lean. Yeah,

Speaker 3 (31:42):

Absolutely. You know, I think runners really just like to run, but that, other than like, we talked a lot about spring training, but the recovery piece is equally as important because that’s where PTs come in quite a bit. So you mentioned the dry needling. Um,

Hillary Allen (31:55):

Yeah. What is it let’s, let’s talk about that for a second. What does journey building sure.

Speaker 3 (31:59):

Is it use of an acupuncture needle into like a quote unquote dysfunctional muscle? So, um, there’s a couple of different like indications where it for, for you, um, we’re need your casks cause they’re super tight. Um, insertion of that needle causes changes at the chemical level to help that muscle release. Um, we can use that like certain trigger points. So let’s say you have like a not near muscle, um, putting the needle in that area, um, can help release that muscle tissue. If you think about, if you have a big knot that’s muscle tissue, it’s banded up, um, muscles need to shorten to contract. If you have this bandit bunch of tissue, those that’s tissue, that’s not contracting properly, so it’s not doing its job essentially. So for you, like you’ve, I, when I needled you on Friday, like you had a couple of really big muscle knots in there that’s contractual, the tissue is not able to contract because it’s over shortened. So, um, that’s where dry needling can come in as well. Um, it’s an awesome, awesome tool for both like, um, from a therapeutic standpoint, but also from a recovery standpoint for more performance athletes. Um, and then things like, like foam rolling and ankle mobilizations and, um, lacrosse ball to those trigger points, those tender spots, it’s all really another important piece of the puzzle. So, um, I, that’s another thing I’m harping on a lot of my patients about stretching

Hillary Allen (33:25):

Some I don’t at all then like, you know, and I mean, I would say that I think it is beneficial solidly. Like I know endurance athletes, they, they don’t need to be as flexible because like there is some benefit of having a little bit more like kind of less like more muscle tension, um, as opposed to like a, maybe a sprinter, like a fast 5k, 15 meter, 1500 meter runner, like they need like full muscle, like extension and contraction. Yeah. So

Speaker 3 (33:53):

I think, um, yeah, I believe the, um, stretching it wasn’t something that I stressed as much until I started working here a lot of high alert, higher level athletes. Um, and I dunno if I have a good answer for why, but, um, one of the big things we stress here is two to two and a half minutes for every muscle group. So if you’re going to be stretching and you’re doing anything less than that, like two to two and a half minutes, it kind of wasting your time. That’s what research shows you need to do to actually make a clinically significant difference in the length of the tissue. So, um, longer holds, I think people just set a timer because it feels like forever, cause it is forever two and a half minutes feels so long when you’re actually doing it, but that’s what I need to do. Yes. I know. So I think with like one of the biggest, um, like, like say faults I see, um, with running is lack of hip extension. So a lot of times that could be a glute strength issue who max strength issue is that hip flection tightness. So kind of decipher in that. Um, and I have a lot of people just do long like hip flexor, quad stretch hold, um, to address that. But that’s another thing that we pick up on quite a bit is, um, that’s a big piece of puzzle as well.

Hillary Allen (35:06):

I think actually, so Rebo has, and I was using this when I was traveling a lot, um, like for races, I mean obviously Mike, Matt, he would write me a string program. So, but if I didn’t have like access to a gym, you know, I could still, I still had things that I could do. It doesn’t necessarily always have to be, um, super heavy if I didn’t have access to a gym, but on their website they have like a YouTube channel and the, you guys post a lot of good things and also on Instagram, it’s Riva sports and performance. Um, that’s I think the hashtag revolt. Yeah. We have a sports and performance. Um, R E V O N um, yeah, you guys post a lot of good information there for like, just like, you know, little, like little, little things.

Speaker 3 (35:45):

Yeah. We’re always working on content. I actually have to look up our hash or what our tag is, Rebo. Let’s see Rebo, PT, and performance. There we go. I should know that

Hillary Allen (35:56):

We do. I know I’m tagging them all the time. We both few team performance. There we go. Um, but yeah, so I mean, if there’s anything you want to add, we we’ve covered a heck of a lot, but

Speaker 3 (36:07):

I mean like string train for runners is a beast of a topic. We can go down a lot of rabbit holes here. Um, I think, um,

Hillary Allen (36:15):

I mean a basic routine. Do you think that that’s something besides, I mean obviously would encourage people to come in and get their, um, their specific

Speaker 3 (36:23):

Yeah, yeah, absolutely. I think if someone is asymptomatic any, any listeners that are just looking to add something into their routine, like one to two times a week, I can promise you’ll see a difference. Um, I think like a heavy front squat, uh, or I’m sorry, have you like squatted all with a barbell trap bar deadlift hip thrust? I would like add in like a heavy, lower body movement with a barbell. Um, I would do a S like a single leg strength circuit. So let’s say like single leg RDL, single leg squat, um, single like calf raise, and then I’d finish it off with like some hip and core accessory work. So like side plank, variations, fire hydrant, skaters, sidesteps, like all that. Um, and that’s kind of how I’d format. That’s how I format, um, quite a bit for my runners that are kind of working into a strength program.

Speaker 3 (37:17):

One other thing I really like to, um, emphasize for runners who are getting into a program where they’re kind of higher level runners, like running quite a bit of mileage per week, make your hard days really hard. So, and I know, you know this. Yeah. So, um, you want to make sure your arrestees are true rest days. So on the days that you have a hard track workout or a hard Hill workout or whatever it may be, that’s the day I’d want them in the gym doing some strength training as well, make that day all out that way, your rest days arrestees. So they know that better than anybody.

Hillary Allen (37:51):

Yeah. Those days become like an 8:00 PM bedtime nine. And I mean, yeah. And then you eat a lot of food too, but no, I mean, yeah, that’s something my coach that he, I mean, he would come here to repo as well. He’s since moved, but, um, you know, he’s always harped on that for me. That’s something I have on for my athletes as well. So it’s like make your hard days hard. And I mean, it can, I mean, definitely. I mean, I think it’s worth it. I mean, even if it feels like you need to get that extra motivation. Yeah. Um, but so I think my final question for you would be if you had one piece of advice for, um, for runners, uh, and strength training, what would it be? Oh gosh. I mean, at least my piece I’ll help you out here. Cause my piece would be like, don’t wait for it to tell it’s too late. Right. Like for me, I mean, I thought I was re like relying on my kind of strong muscular frame. Um, but you know, and that’s something that saved my life during the accident, but again, like, you know, Rebo and, and, and discovering these guys and discovering an awesome place to, to like do strength training is something that, I mean, I wish I would have found too.

Speaker 3 (39:02):

We’re really fortunate. Yeah. Revoke is a special place and I wish everyone had access to something like this. But, um, let’s see if I were to say one thing, like if I’m having a really hard time convincing someone, I need to strength, train. Uh, I think of, so this is kind of off the wall, but there’s this strength coach, his name’s Mark Rippetoe and think like he’s like eighties, power lifter, think like Arnold Schwartzenegger ESC and he has this awesome quote and it’s a stronger, people are harder to kill and more useful in general.

Hillary Allen (39:37):

That’s like what?

Speaker 3 (39:38):

I come to every time. Like, it’s like, you can’t like, look at the performance fees or the injury prevention piece. Like you’re going to be harder to kill us. You couldn’t run or you can string train. So that’s what I come back to.

Hillary Allen (39:52):

We’re going

Speaker 3 (39:52):

To like put that like on a bumper sticker or something.

Hillary Allen (39:55):

Oh my God. That’s amazing. I love it. That’s what I come back to you. So all right guys. Yeah. Come on runners. Like let’s not. Yeah, I think so. I think so. Like, you know, if you’re not run or bird arms, like if anything else it’s like, you know, like, let me stop. Let’s stop those jokes. You can run for a far ways, but I know

Speaker 3 (40:14):

A little weird saying that in front of some that fell off a hundred foot cliff,

Hillary Allen (40:17):

You know what though? But it applies to harder to kill. Oh man. So I’ll leave everyone with that. Well, on that note, thanks so much for joining us today. It was awesome. Thank you.


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