Seeing as how the marathon is just next monday I thought today’s post should be about the most common problems I’m seeing in the office with runners.  At this point, the longest run of their training is over, and they’ve been able to see how their bodies are going to hold up for the majority of the race.  The most prevalent injury I’m seeing after this long run isn’t really an injury at all, it’s an annoyance for most people.  It’s described as a “pinching” or “jamming” in the hip joint.  Symptoms include slight pain in the front of the hip or side of the hip, restricted motion when bringing knees to the chest, or just a feeling of something not being right in the hip itself.

This problem can be just an annoyance or it can lead to enough pain where someone has to actually stop their run.  What happens is this.  Mile after mile the head of the femur, which normally glides and rotates inside the hip joint, gets compressed into the hip joint.  This causes abnormal motion inside the hip and is described as a “stuck” or “jammed” or “pinched” feeling deep inside the hip joint.  This may be hard to visualize but if you’re a runner who’s had this happen you know exactly what I’m talking about.  It’s as if you lost normal range of motion in your hip joint but you can’t remember injuring it.  This causes people to just get frustrated and stop running for a while until it hopefully subsides.

The quickest fix for this hip issue is an adjustment to the femoral head itself.  Basically the femoral head needs to be loosened away from the hip joint.  It’s the most common adjustment I’ve been performing the past few weeks for the athletes I see.  It’s typically very quick and the results are seen very rapidly after the adjustment.  If you’re a runner and have experienced this common hip problem and you’re worried about running in Monday’s Boston Marathon then you should call your chiropractor as soon as you can, because it may be a quick fix.  Good luck to everyone running on Monday!

If you live in Boston you have inevitably noticed the summer weather we’re experiencing in March… and you may have been so excited that you threw on your sneakers and bolted out of the office to get a quick walk/run in.  You can’t walk down a single street in Boston without seeing people out and about.  But along with this new found activity level Boston is experiencing comes an inevitable question… when to stretch?  Before… after… does it really matter?  Lets take a look at the physiology of stretching.

The hamstring stretch is probably the most popular stretch of all time… so lets take a look at what happens when you bend forward to touch your toes.  Immediately your hamstring contracts, which may sound counterintuitive.  If I’m stretching then why is my muscle contracting?  Well the reason lies in protection.  If you bent forward and your hamstring did not have this reflex of contracting your hamstring would tear in half… every time you bent forward.  So your body came up with a way to prevent this from happening and it works the same for every muscle.  When a muscle is first stretched it will automatically contract and tighten up to prevent a tear…it’s called the stretch reflex.  This reflex will last from 30 seconds to 1 minute.  This is why after a minute of stretching you start to feel like you’re actually making progress… it also explains why 20 second stretches do nothing.

So the longer you hold the stretch the further your muscle fibers will separate or expand if you will.  The muscle will expand up until a certain point, and then the body will hit its breaking point where it knows it can’t go any further without rupture.  Now if you stand back up from your hamstring stretch and walk around you feel different, like you’re walking a bit differently than before… and you actually are.  This is because the muscle fibers have opened up and now you’re actually using muscle fibers that you don’t normally use.  You’ve woken up dormant fibers that haven’t been used for days, months and in some cases years.

Now back to the original question… when should we stretch?  One of the worst things I’ve seen in practice is a sprinter who stretched his hamstring for 10 minutes before his big race because he thought they needed more time since it was a “big race”…then 2 seconds into his race the hamstring ripped in half.  This happened because he stretched his hamstrings so far that “dormant” muscle fibers “woke up” and started to work.  Then he put these muscle fibers through something they’d never experienced (a sprint) and since they weren’t ready for this activity they gave out and tore in half.  If he had just warmed up normally this probably wouldn’t have happened.

So the answer to the original question is that we should all be stretching after exercise, not really before.  However, I say that with an asterisk next to it because we shouldn’t just throw on our shoes and head out for a run without warming up.  The body has to be warm so that it has proper blood flow to all our muscles and joints.  So some light wamup exercises such as body weight squats or jumping from side to side should always be performed before exercise.  Just something that mimics the activity you’re about to perform to get things moving.

Once you’ve finished your run or  your workout then you should head straight into stretches.  And these should be held for 3 minutes each… 3 minutes… not 30 seconds.  You have to shut off your stretch reflex which takes 30 seconds to a minute, so doing 30 second holds isn’t going to help anyone.  Also, when the body is warmed up, like after a run, the stretch reflex doesn’t last as long, so you don’t have to hold the stretch quite as long.

The take home here is to warm up before you exercise but don’t stretch much before… stretch after your workout and hold the stretch for 3 minutes each.  Do that and you’ll stay injury free for one of the hottest springs we’ve ever had here in Boston!

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