Monday, February 23, 2015

Hospital for Special Surgery Chat Transcript

The United NYC Half is coming up on March 15, and while training for that I followed this helpful Facebook chat conducted today by physical therapist Mike Silverman of the Hospital for Special Surgery. Here is an edited transcript of that chat, which I think will be beneficial to all runners. I recommend following @HSpecialSurgery on Twitter like I do. - Mark

  • Martin Larrosa My problem is that sometimes while going for a long run i get this sharp pain right next to my knee id say almost where he knee bends and it worsens as rhe runs go on. Ive been told that it could be IT band issues but not really sure. Any exercises or recommendations?
    Like · Reply · 5 hrs
    • United Airlines NYC Half The standard IT band treatment involves massage, foam rolling, and then check your shoes (are they up to date?), try running on softer issues. If it's the outer part of the knee, it does sound like an IT band issue. A specialist like those from Hospital for Special Surgery should be able to help you get a diagnosis and care.
      Like · 5 hrs
    • Martin Larrosa Yeah the shoes are new and and pretty comfortable. Ill have to do more foam rolling and maybe schedule an appointment
  • Bolivar Paul Norona What you recommend to eat the night before and what we should eat or drink for breakfast?
    Like · Reply · 5 hrs
    • Hospital for Special Surgery Bolivar, that's a tough question to give you the specifics for. What I generally tell my running patients is to practice what they are going to eat on race day during their long runs. I personally, eat a bowl of pasta with a few slices of pizza the night before and a bagel with cream cheese for bfast. That works for me, it doesn't necessarily mean it works for everyone.
      Like · 2 · 5 hrs
    • Bolivar Paul Norona Thank you. Just one more question, about to keep us hydrated. Will be enough with the water/Gatorade that the race provided or we should bring additional stuff with us (like gel, gums, etc)?
      Like · 5 hrs
    • United Airlines NYC Half Bolivar Paul Norona great question! There is water and Gatorade at or near every mile marker and PowerGels between mile 7 and 8. See the map -
  • Lauren Seldon Mathews I've had bad IT band pains from my hip to knees while training. Any tips?
    • Hospital for Special Surgery Lauren, sorry to hear about your ITB pain. The best piece of advice I can offer for ITB pain is to foam roll (may want to start with a lighter color that is less firm) and then work on strengthening your hip abductors
      Like · 2 · 6 hrs
    • Linda Hemerik Lauren, I suffered from IT band injury just recently and started wearing the Protect IT strap, which has a little cushion that presses down on the IT band and prevents the friction when running. It is a miracle worker. Still do all the foam rolling and exercises though.
      Like · 1 · 6 hrs
    • Heather Lassen If I can chime in... I started using a foam roll (because I happened to notice my gym has them) and it helps a TON for my achy hips & knees
  • Jess Podell I've noticed my running shoes are slowly breaking down. How often should I be replacing them and what is the best way to break in new shoes before the big day?
    Like · Reply · 1 · 6 hrs
    • Hospital for Special Surgery the general rule of thumb is every 300-500 miles. For breaking them in, you don't want to go out and run your typical run, it's best to walk around town or even doing your cross training in them to break them in properly. The same way you would with a dress pair of shoes.
      Like · 6 hrs
  • Heather Lassen What is the minimum long-run (miles wise) to accomplish prior to race day? Realistically I will probably only be able to safely get up to 10ish miles. If I can do that without stopping, will adrenaline get me through the rest on the day of??
    Also, what should the last week & day look like from an activity and diet perspective?
    Thank you!
    Like · Reply · 6 hrs · Edited
    • Hospital for Special Surgery Heather, great question. There is no set minimum, I have had runners who have only run 5 miles and others that do 15 before a 1/2 marathon. I think 10 is fine, just know that you need to go out slow, despite the adrenaline. You want to make sure you have some energy left in the tank at the end of the race. As far as the week before, you do want to decrease the typical mileage, maybe only 2 runs that week, with the last run 2-3 days prior to the race. Diet the night before, don't change anything or introduce foods that you normally would not have eaten. You don't want any GI issues on race day.
      Like · 1 · 6 hrs
    • Heather Lassen Heavier on carbs?
      Like · 6 hrs
    • Hospital for Special Surgery Yes, I would increase your carb intake. If you really want to get specific, working with a sports dietitian is a great tool for fueling, they can map your your entire training season, race week, race day and also recovery.
  • Chris Oliver I ran my last real long (10 miles) run yesterday before the race. This is my first Half. Around mile 9 my knees started to feel some pain. I do light strength training once or twice during the week. Anything I should focus on in the next three weeks? I'm nervous about injuring myself before I finish. Strength training? Rest? Both?
    Like · Reply · 6 hrs
    • Hospital for Special Surgery Chris, congrats on finishing the 10 miles. If you feel the pain coming on during a run like that, it's not a bad idea to walk for a few minutes, stretch and see if that relieves the tension. Ice after the run also helps. I would stay on the conservative approach leading up to the run, rest, ice, stretch, maybe some biking to take the load of the joints. Still run, but use pain as your guide.
      Like · 6 hrs
    • Chris Oliver Would you suggest a stationary bike over a treadmill? I had planned on running light 3-4 miles with possibly one more long-ish (6-7 miles) run next weekend.
      Like · 6 hrs
    • Hospital for Special Surgery I would start with the bike and then progress to running. Outside over the treadmill, if possible, just so you are simulating all the factors you'll have do deal with on race day.
  • Sharon Ryan While running I feel pain in my right glute and somewhat on my right hamstring. Left side is pain free. Only happens while running . What can I do to relieve that pain ?
    Like · Reply · 4 hrs
  • Eileen Donoghue Nervous that i haven't ran more than 10 yet. Hoping that I taper enough, right around the corner! 😬 the last half i did not taper appropriately i ended up with tendinitis and bursitis of the ankle.
    Like · Reply · 5 hrs
    • Hospital for Special Surgery Eileen, with the race less then 3 weeks away, now would be the time to start to taper. You want to finish strong, without pain and most importantly, enjoy the race. Nothing better then that straight away through TImes Square
  • Adrienne Dubitsky-Norris I am a 66 year old female, diagnosed with a torn meniscus and some arthritis. Never had pain till meniscus tore. Have run 2 marathons and 13 half. Run/walk. I have been getting physical therapy and see no difference. Just wondering what success rate is for surgery at my age. Live in nj and will go to HSS for opinion. Some doctors at HSS will not see me because there is minimal arthritis present. I can go for hours with no pain and then the meniscus must slip and then I'll have discomfort till it shifts again.
    Like · Reply · 5 hrs
    • Hospital for Special Surgery Adrienne, sorry to hear about the meniscus injury. I do think you should get an opinion from an MD regarding your injury. It's difficult to give you an objective success rate on the surgery, but I do know that many patients who have had a knee scope where they fix the tear of the meniscus tend to get back to running successfully without pain. I would keep going with the PT, at the very least, you a strengthening the muscles around the knee joint and if you do go under the knife, you'[ll be that much stronger post surgery. When you call HSS, use the physician referral service, 877-606-1555 They should be able to point you in the right direction.
  • Cleo Rallis Soreness outside my foot . I being tapping and running w compression socks! What else to do ? Txs !
    Like · Reply · 6 hrs
    • Hospital for Special Surgery Cleo, you may need to get a more thorough work up to find the cause of the pain; changing shoes, running analysis to see what your mechanics are like or an PT/MD evaluation
  • Adam Kolodny I have been training for the 1/2 since January, I have had 4 long runs over the last 4 weekends, 9, 10 ,11, and 12 miles. Is that now enough of the long runs and should I now start to taper off a bit., and what then would you suggest as a weekly mileage and long run.I ran the race last year.
    Like · Reply · 5 hrs
    • Hospital for Special Surgery Adam, sounds like you've done a very good job training for the 1/2. I think 12 is definetly sufficient for your long runs. I do think you can begin to taper now. In terms of weekly mileage, that's unique to the individual and to the program. However, if I'm running 25 miles per week on average leading up, I generally cut to ~15 first week, ~12 second week and then just 2 runs or so leading up to race week, 5 and 3 miles or so.
      Like · 5 hrs
    • Adam Kolodny Thanks that is in line with what I was thinking too. how about intensity during the taper. I have been doing speed work (sprints) and tempo runs as part of my weekly runs. I ran 1:53 last year and I am really looking to break the 1:50 mark, even if only by a second
  • Linda Hemerik dealing with calf strain at the moment. The tightness feels like a knot in the calf. How long should I refrain from running?
    Like · Reply · 6 hrs
  • Lina Joy Your thoughts on running marathon with piriformis. I haven't run in 2 weeks and am feeling bummed out with this potentially being a prolonged injury. I am now seeing a physical therapist and cross training in the meantime but what i would like to know is if this specific sciatic injury is permanent and what precautions can I take to prevent furthermore damage.
    Like · Reply · 6 hrs
    • Hospital for Special Surgery Lina, sorry to hear about your injury. Piriformis syndrome can be tricky, sometimes it's purely coming from the muscles, other times it's referred from the low back and other times it's a combo of a variety of factors. I would keep working with your PT, but in my expereince, the injury is not permanent. Keeping the muscle loose by foam rolling, and keep the muscles of the gluts strength will help you prevent those symptoms from coming back and getting worse; keep listening to your PT and you should be better soon and back to running.
  • Mariana Cab I just ran my first half marathon this past Sunday and (not surprisingly) I'm feeling extremely sore. Additionally, my right leg is experiencing some sharp shin splint like pains (that started in January). What's the best way to recover but maintain fitness for the half and help to build up strength in my right leg?
    Like · Reply · 6 hrs
    • Hospital for Special Surgery Congrats on your first 1/2 marathon. Soreness is totally normal right now. I would do some light biking and wait ~5 days or so to resume running. Ice and ibuprofin help too. As far as the shin pain, you may want to get that checked out by an MD to make sure it's nothing serious but for exercise; a program consisting of strengthening the quads, hamstrings, calves, gluts and abdominals would put you in a good position to stay on the pavement longer and faster.
  • Colby Brin What's the deal with stretching? Some people say it's not necessary at all. Some say it's only nec after a run. Others say it can't hurt, so you might as well...What's the straight truth?
    Like · Reply · 5 hrs
    • Hospital for Special Surgery Colby, great ? And a very common ? as well. There are several schools of thought, the one that our Sports Rehab Center at HSS prescribes to is to do a dynamic warm up prior to your run and post run doing your static stretching.

No comments: