Category Archives for Injuries

Stress Fractures

Here's are some excerpts from a great article on stress fractures from the American Orthopedic Society of Sports Medicine.

What is a stress fracture?

Each day, the body produces new bone to replace the bone that is broken down by the stress of everyday living. Usually, this process is balanced, with the body replacing the amount of bone lost. However, this balance may become upset with excessive physical training. The body, due to several factors, may not produce sufficient bone. As a result, microcracks, called “stress fractures,” can occur in the bone.

Learn more about diagnosis, treatment, & prevention by downloading the complete publication.

Muscle Cramps

written by Kerry Gustafson

It's summer.  It's getting hot.  Whether you are training, racing, or recreating, everyone is going to succumb to muscle cramping at some point.  

The question is:

Are all leg muscle cramps the same?  Should we treat them all the same?

The answer is, No

There are two different types of leg muscle cramps.

Type 1, or single muscle cramping, is due to electrolyte imbalance, dehydration, and depletion.

Type 2, is skeletal muscle overload and fatigue.  It can also could be a deficit in strength or flexibility from a prior injury.

​Cramping is often reported following calf or hamstring strains.

What You Can Do About It

​Prevent Type II race-associated cramping by: protecting any recent muscle-tendon injury (due to strain or cramps) and allowing time for full regeneration.

Then use stretches and strengthening exercises to improve imbalances in strength, flexibility, and activation of surrounding muscles.

If leg muscle cramping continues to plague your training and races, it's time to seek outside expertise and consult a sports medicine clinician.

Additional strategies to preventing cramps:

  • 1
    Take a longer and more gentle warm-up.
  • 2
    Shorten your exercise segment, rest for 3-5 mintues between segments, and gradually increase the number of segments.
  • 3
    Slow down the pace of your workout--especially from the beginning.
  • 4
    Shorten the length of the workout on a hot/humid day.
  • 5
    Break your workout into two segments.
  • 6
    Look at any other exercise that could be causing the cramps.
  • 7
    Take a buffered salt tablet at the beginning of your exercise.
  • 8
    Runners: Shorten your stride-especially on hills, and take more frequent walk breaks.

Aqua Jogging

written by Kerry Gustafson

In the beginning, the AquaJogger® was conceived in Eugene, Oregon USA as a way to take the impact out of running for world class runners like Mary Decker. Mary’s coach, Dick Brown, in addition to training elite runners, was also working with Dr. Bruce Becker (Washington State University) in designing water rehabilitation programs for pre and post surgery patients. Unhappy with the various flotation vests and water ski belts available, Dick began to search for something better.

In 1987 a collaboration between Dick Brown, Dianne Bedortha, a water exercise specialist and Lew Thorne, the president of Excel Sports Science, resulted in a flotation belt design now known as the AquaJogger® Classic. This unique and affordable flotation device soon captured the attention of athletes, fitness instructors and medical professionals around the world and "AquaJogging" was born.

The AquaJogger® is a tool that provides access to the many benefits of deep water exercise. Gravity loads the body causing stress through impact and compression on the joints, bones and muscles. Running and exercise in deep water eliminates the affects of gravity and frees the body to cross train in an effective and safe way.

Aqua running offers benefits to both healthy and injured individuals. In both untrained and post-operative individuals, aqua running offers:

  • Increased strength
  • Increased VO2 Max
  • A non or partial-weight bearing component
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    Improved neuromuscular control and proprioception
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    Decreased heart rate (10-12 beats per minute) and increased RPE due to resistance of upper extremities and lower extremities against water Increased venous return resulting in decreased edema

The benefits of aqua running in trained individuals and athletes include:

  • VO2 Max values similar to land-based training (within 3.8 ml/kg/min) 
  • with improved running economy, core strength, and proprioception
  • Improved strength, respiratory function, and endurance 
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    Decreased compressive loading of the spine
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    Active rest from running without effects of detraining

Further evidence of the value of aqua running include:

Bushman et al demonstrated that distance runners on a 4-week program of aquatic only training maintained running performance, VO2 Max, maximum heart rate, and lactate threshold. Bushman et al noted no difference in 5K time after 4 weeks of deep water running only w Wilber et al report that 32 recreational distance runners maintained a 2-mile run performance after only 6 weeks of deep water running only.

Recommendations for aqua running in trained individuals:

Tartaruga et al report that distance runners replacing 30% of their training with deep water running demonstrated no change in maximal O2 uptake, ventilatory threshold, maximal expiratory volume, running economy, maximal heart rate, stride frequency, length, and time. Martel et al demonstrated an increase in vertical jump of volleyball players with aquatic plyometric training, and an 11% improvement in jumping performance on land.  Robinson et all demonstrated that aquatic plyometrics resulted in the same benefits as land-based plyometrics with less muscle soreness.

  • Intensity must be similar to land-based training 2-3 days per week
  • Durations of 50-90 minutes (90-100% VO2 for 30 minutes, 70-75% for 60 minutes) with deep water running for distance running training
  • Shallow water training for vertical jump training
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    Water shoes/socks are recommended for shallow water running and jumping


  • Increased enjoyment of running 
  • Faster running times
  • Decreased injury risk 
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    Achievement of goals



  • 10 minutes easy pool running
  • 10×1’ at hard effort with 1’ active recovery
  • 10×30” at sprint effort with 30” active recovery 
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    5-10 minutes easy warm-down


  • 10-15 minutes easy pool running
  • 1’, 2’, 3’, 4’, 5’, 4’ 3’, 2’, 1’ at hard effort except the 5’ session which is at tempo effort 
  • Each interval has 1’ of active recovery
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    5-10’ easy warm-down


  • Warm up 10-15 minutes
  • 1’, 2’, 3’, 4’, 5’, 4’ 3’, 2’, 1’ at hard effort except the 5’ session which is at tempo effort 
  • Cool Down 10-20 minutes


  • Warm up 20-30 minutes.
  • 3 minutes hard, 2 minutes recovery
  • Repeat this 5-minute interval 6 times.
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    5 minutes recovery “jog”
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    3 minutes hard, 2 minutes recovery. Repeat this 5-minute interval 6 times. 
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    Cool down 15-20 minutes.

Shin Splints

written by Kerry Gustafson

As cooler autumn weather arrives, it seems to be the perfect time to head out on the trails for a long run. Whether you are running to simply run or you are preparing your legs for turns down Baker in just a few months, nothing puts a damper on those plans like the striking pain of shin splints.

Posteromedial tibia stress syndrome, known to most as ‘shin splints,’ is caused by repeated stress and inflammation of the muscles, tendons and bone tissue around the tibia – where the muscle attaches to the bone. It is very common in runners and jumpers and dancers with a 13-17% occurrence rate. 

KEY POINT: It is important to know the difference from a stress fracture

  • stress fractures are usually a specific point of pain over the bone and can keep you up/awaken you at night,
  • shin splints are more of a stretched pain lingering down the entire shin. In the beginning symptoms may subside after activity has stopped. Over time the pain can become continuous.

The most common factors leading to this over-use injury are:  

  • 1
    improper shoe wear
  • 2
    muscle imbalance
  • 3
    lack of stretching 
  • 4
    non-gradual training  

There are times when the pain does not subside from basic treatment and rest. We may want to make sure you do not have a stress fracture – this can be caused by stress and overuse of the area. An MRI may be suggested to help diagnose a more consistent pain.

Although treatment for both shin splints and stress fractures can heal with a combination of rest, non-steroidal anti-inflammatory drugs, ice, stretching, physical therapy, and modifications in training; it is always best to avoid this painful diagnosis all-together. For runners, shoes need to be switched out every 300-500 miles, or every 4-8 months.

With simple modifications such as properly fitting footwear, cross training and slowly building your fitness level, you may avoid this pain creeping into your legs.