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Running Resiliency: Injury management for all runners

Overview
 
This two day practical course is a thorough and extremely practic best-practice management of the injured runner. The course emphasis is on the manipulation of load and stress management in our injured patients and integrates running biomechanical principles within the biopsychosocial framework.  
 
Participants will learn:
  1. the common running injury risk factors and means of modifying those risk factors.
  2. The biomechanics of running, how those biomechanicsrelate to injury and how those biomechanics can be changed will be taught.
  3. Participants will become very comfortable and proficient in performing a treadmill analysis of a runner’s technique. Both video examples of treadmill analyses and in person treadmill analyses will occur throughout the course.
  4. A best evidence guide to exercise prescription for pain relief, increasing load tolerance, injury management and performance will be taught and participants will become comfortable adapting exercise programs for the individual needs of their patients.
  5. How to keep a runner running when in pain and learning when a runner must rest
  6. Building physical and psychological resiliency in your patients through appropriate education
 
Bottom line, you will be comfortable performing a thorough analyses of the all the factors contributing to stressors on a runner, gait analyses (with potential modifications) and exercise prescription for both performance and injury management. You will be comfortable changing an injured runner’s training program to keep them running and will gain proficiency in designing training programs that also function as rehabilitation programs.

 

Running Resiliency Outline
 
Day 1:
A. Course Overview (9.00 - 11.00 hours)
  1. What does a resilient runner look like?
  2. What is the opposite of a resilient runner
  3. Components of best treatment
    1. Load management
    2. Symptom/Stress modification
    3. Exercise Prescription
    4. Cognitive Restructuring
 
B. Running Biomechanics, Injury Risk and Treatment Implications (11.00 - 13.00 hours)
This section will follow a similar template for each body region. A description of the basic kinematics and kinetics of the body region during the phases of running will occur, followed by an exploration of the potential injury risk factors and an overview of how those risk factors can be addressed. When appropriate suggestions for performance will be made. Below is an example of the Foot, Ankle and Shank.
  1. Foot, Ankle and Shank
    1. Foot strike kinematics, kinetics and muscle function
    2. Influence of anatomical variations on function
    3. Potential variables related to injury
    4. Potential variables related to efficiency
    5. Influence of shoes on injury risk and efficiency
 
  1. Knee
    1. Foot strike kinematics, kinetics and muscle function
    2. Influence of anatomical variations on function
    3. Potential variables related to injury
    4. Potential variables related to efficiency
 
  1. Hip
    1. Foot strike kinematics, kinetics and muscle function
    2. Influence of anatomical variations on function
    3. Potential variables related to injury
    4. Potential variables related to efficiency
 
  1. Trunk and Arms
    1. Foot strike kinematics, kinetics and muscle function
    2. Influence of anatomical variations on function
    3. Potential variables related to injury
    4. Potential variables related to efficiency
 
C. Load Management and Training Variables (14.00 - 17.00 hours)
This important section will introduce to the participant to the various training program and components of traditional running programs. An evaluation of the relationship between all loads (mechanical and psychosocial) and injury risk will be explored. Injury case studies will be shown to demonstrate how training variables can be manipulated to address common running injuries.
 
Training
PT’s should look at an athletes training log/plan - in brief this can highlight what leads to injury, overtraining, burnout, poor performance and the contrary. This also enables the PT to get to know their athlete more with regards to attitudes/beliefs around training.
If the athlete has a coach it offers more opportunities to gather more information regarding training and the athlete themselves.
Frequency, Duration, Intensity, Consistency - Note an athletes chronic load and acute loading. Examples of whats good and whats not: basically a consistent training load to maintain chronic load (week in week out), some intensity but the majority of training aerobic. Demonstrate injury risks.
Rest periods and holidays.
Environment - runners attitude to different terrain and excellent opportunity for a PT to promote resiliency by
Training groups / partners - reasons why they train with others: Positive: social, motivation, fun. Negative: Being pushed too far beyond current capacity or not enough, competing in training - the runner who competes to win in training because it is easier to do in a race - often injuries become a ‘get out of racing card’.
Supplemental training they do - Why are they doing it? Is it for the right reasons: Including Weights, Plyo, Drills, Yoga, Stretching, Pilates.
 
Other Stressors
Social, Family, Work, Other commitments, hobbies - how does an athlete fit running into the rest of their life.
 
Rest Recovery
Basically what can restore an athletes homeostasis from a sympathetic/training state to a parasympathetic / resting state - sleep, rest, nutrition, whatever relaxes an athlete
 
Equipment
Running shoes - Advice I give is light weight and some cushioning. Supportive/Heavy cushion/Minimalist not necessary though salient point is what ever you wear make sure it feels good and allow for adaptation when changing footwear.
Compression wear / tape - I don’t endorse either (perils of decreasing resilience) but when it might be OK (no harm if an athlete just likes to use them).
 
Competition
How often do they compete.
Preparation
Attitude and beliefs surrounding racing.
 
Examples
I’ll give an example of what an elite athlete’s training plan would look like and a good and poor example of an amateur athletes plan.
Examples of how to adjust an athletes training plan with regards to injury: e.g. decreasing intensity/duration but maintaining frequency/aerobic training to maintain run condition.
 
Day 2: 
D. Running Analyses and Re-education (9.00 - 10.30 hours)
  1. How to perform a treadmill running analysis will be taught
  2. The rationale behind symptom modification, associative learning and stress shifting as a temporary desensitizer will be explored
  3. The literature on running re-education will be reviewed
 
E. Comprehensive Capacity - Exercise Prescription for the Injured Runner (10.30 - 12.00 hours)
  1. The limited role of exercise prescription and minimal effective dose for common injuries will be reviewed
  2. Special emphasis on tendinopathy loading will be reviewed
  3. The case for simple exercise loading for common running related injuries will be made
 
F. Cognitive Restructuring (12.00- 13.00 hours)
  1. How to make the shift in your athletes from dependency to an internal locus of control
  2. The role of expectations and beliefs on fragility and running injury sensitivity
 
G. Performance and Special Topics (14.00- 15.00 hours)
  1. The role of plyometrics
  2. The role of strength training and efficiency
  3. The role of stiffness and flexibility
  4. Can gait retraining influence efficiency
  5. The importance of just running for performance
 
H. The simplified Assessment (15.00 - 16.30 hours)
  1. Ruling out the sinister and serious
  2. A debunking of the majority of orthopaedic testing
  3. Expose or Protect? Decision making on when to load to adapt or when to advocate relative rest 

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