​My 11 yr old received a cookbook, How to Cook, for her birthday this August, and it has been a game changer.  So far she has actually cooked dinner with minimal help one night a week in September, it's like a miracle!  This meal turned out really good, and can easily be adapted with lots of different ingredients to use what you have or what you like best.  

Ingredients:
1 14-oz package of firm or extra-firm tofu
3-4 tablespoons olive oil, separated
2 tablespoons soy sauce
1 garlic clove, minced
1 tablespoon sherry vinegar
4 eggs
4-6 small heads of baby bok choi, rinsed and sliced in half
1-2 carrots
1 red pepper, sliced
4 packages of instant ramen

Instructions:
**Feel free to use any veggies you have on hand, sauteing up a few sliced mushrooms, broccoli, or zucchini would be a nice addition or substitution to any of the ingredients above. 

Make the tofu:  This step can take anywhere between 15 min to 6 hours, depending on what time you have.  The longer you drain the tofu and marinade it, the more flavor it will have in the end.  But a quick squeeze and marinade also works in a pinch!  Pat the tofu dry, then wrap it in cheese cloth or a few paper towels.  Place it between two plates and place a moderately heavy thing on top, careful it may slide as this sits.  Let this arrangement sit for 15-60 minutes.  By "squeezing" out some of the liquid in the tofu it is able to take on more flavor from the marinade and also bakes up to be nice and crispy.  Slice the tofu into 6 rectangles.  Wisk together 2 tablespoons of the olive oil, the soy sauce, garlic and vinegar.  Place this in a bowl or plastic bag with the tofu.  Let sit for at least 10 min or up to several hours, even overnight in the fridge.  Preheat the oven to 325 degrees.  Place the tofu on a baking dish and roast it until the tofu has a firm texture and has a light brown color flipping half way, about 40 minutes.  Set aside on a plate.

Soft boil the egg:  Fill a medium bowl with enough water to submerge your eggs.  Place some ice in the water, and set aside.   Place the eggs in a medium pot and cover with water by about 2 inches.  Set over high heat and bring the water to a boil.  As soon as it comes to a boil, cover it and remove it from the heat, let it sit for 6 minutes.  Then place your eggs carefully into the ice bath, let them sit for 5 minutes.  Gently peel the shells, slice in half.

Sauté your veggies: Heat up 1 tablespoon of olive oil in a medium pan.  When your oil is hot sear the bok choi for about 2-3 minutes or until it chars a bit.  Put this on a plate.  Then add another tablespoon of oil and sauté the red pepper until just crisp tender.  

Shave the carrots: Wash and peel the carrots.  Then using your peeler, shave the carrot into long ribbons.  

Cook the ramen according to the package then serve, adding the tofu and veggies to the bowls of ramen.

Enjoy!

Don't want to take the time to flip all those pancakes? Here's a one bowl, one pan breakfast that cooks up easy with ingredients you probably have already in your cupboard  Feel free to use frozen berries, and any fruit would work great.

Ingredients:

4 tablespoons butter
6 eggs
1 cup milk
1 cup flour
1/2 teaspoon salt
pinch of cinnamon
1 teaspoon vanilla
1 1/2 cup blueberries
optional toppings: whipped cream, maple syrup, powdered sugar, yogurt, bananas, etc.

Instructions:

Combine the eggs, mild, flour, salt, cinnamon, and vanilla in a blender. Pulse until evenly combined and smooth.  Let batter rest for 15 minutes at room temperature.  Or leave overnight in the fridge.

Preheat oven to 425 degrees when you are ready to make the Dutch baby.

Place the butter, cut into pats, in a 14 inch cast iron pan or a 9x13 inch baking dish.  Spread out the fruit with the butter.  Place this in the oven for 2 minutes, or until the butter melts.

Pour the batter over the melted butter and berries, then return immediately to the oven.  Bake for 22-25 minutes or until the edges have puffed up and started to turn a golden brown.

Cut and serve immediately, using any desired toppings.

​

Here's a healthy option when you get a huge head of lettuce at the farmers market, and you're looking for something tasty other than salad.  This recipe is pretty quick to whip up, if you skip the marinating of the chicken.  Our family used chicken here, but you can sub tofu for a vegetarian dish as well.

Ingredients:
1-1 1/2 lbs diced chicken (you can use breasts or boneless thighs)
1 large egg white
1 tablespoon and 2 teaspoons cornstarch (divided)
2 tablespoon rice wine or dry sherry (divided)
2 tablespoons oyster sauce
1 tablespoon hoisin sauce
1 tablespoon soy sauce
1 teaspoon toasted sesame oil
4 tablespoons peanut oil
3 cloves garlic, minced
1 teaspoon minced ginger
4 scallions (2 minced and 2 cut into 1-inch pieces)
salt
1/4 teaspoon sugar
1/2 lb mushrooms, stemmed and diced
12-14 large lettuce leaves.  (Bib or Butter lettuce is preferred)
Soy sauce, chili paste for serving

Instructions:  (total time about 1 hour with marinating step)
Prepare the chicken: Wisk the egg white with 1 tablespoon rice wine and 1 tablespoon of cornstarch in a small bowl.  Add the chicken and toss to coat.  Cover and refrigerate for at least 30 minutes.

While the chicken is chilling, make the sauce:  Wisk 1/3 cup water, the oyster,  hoisin and soy sauces, 1 tablespoon rice wine, and the sesame oil in a bowl or small mason jar.  Then add 2 teaspoons of cornstarch, mix until dissolved.

Make the stir-fry:  Heat 2 tablespoons of peanut oil (you can sub vegetable oil in a pinch, but the peanut oil will give it a nice flavor) in a large skillet over medium high heat.  Add the chicken and cook, stirring for 2-3 minutes or until cooked.  Remove the chicken with a slotted spoon and place on a plate.  Add the remaining 2 tablespoons of peanut oil, then stir in the garlic, ginger, and minced scallions.  Add the sugar and 1/2 teaspoon salt, stir-fry for 30 seconds.  Then add the mushrooms and scallion pieces and stir-fry for about 2 more minutes.  Return the chicken to the pan and then add the sauce.  Cook for 1 minute.  

Serve with lettuce for wraps.  Enjoy!
​

By Brace Hayden, DPT and Miya Ensley

If you are interested in learning more about the causal factors and differential
diagnostics for Medial Tibial Stress Syndrome (MTSS) or “Shin Splints” please read the first of this two part article “Running with Medial Tibial Stress Syndrome - What is Causing My Shin Pain?”

Treatment Options for Shin Splints

As this article was compiled by a PT, we can only stress the benefits of getting yourself in for a proper professional and structured PT assessment.  This will give you the most personalized treatment plan for optimal healing and expedited return-to-run results.

However, the DIY options include:

• Pausing high impact training (ie. running) or ramp down your training until MTSS symptoms improve.
• While taking a hiatus from run training or reducing your run volume, don’t throw out your metaphorical running baby with the bathwater and lose your fitness by stopping all physical activities. You can increase your odds of a faster healing process by diversifying your workouts and cross-training. Consider pool running, kick-boarding drills in the pool, biking on road/gravel/trails, or hiking/walking with ski/trek poles.
• Ice cup massage your shin(s) to reduce acute inflammation or hot pack them to improve blood flow. There is debate in the current sports medicine literature as to which is best, so a little self-experimentation is recommended to see what helps your system more.
• Always try to do a light warm-up jog for 5-10 minutes and then perform run-specific dynamic mobility exercises as a pre-run / cross-training workout to reduce future injuries. See these two prior RWM articles on some selected exercises and benefits of performing some pre-run stretches.
• Post-run sustained stretches (hold each for 5 to 30 seconds, back off/relax muscle, and repeat stretch 5 times). Like cooking, some people spend hours preparing a meal, others pop a frozen burrito in the microwave.  Customizing the duration of a recovery stretching routine is largely an individual’s preference based on time availability and what works best for their body.  Most importantly, just do it. Some people find adding tooled assistants (ie. foam-rolling or percussive massage guns) can add value to the routine. The bottom line is, performing a stretching routine after a run has a lot of supportive evidence on keeping muscles more flexible, less sore and reduce occurrence of injuries.
• “Toe-ga exercises” and more: Here are a few popular PT-recommended foot/ankle drills links to improve your leg strength, mobility, and MTSS-rehabilitating exercises. Dosing (repetitions, sets, times per day/week) of each can generally be started with 2-3 sets of 10-30 repetitions depending on respective fatigue and relative fitness. 
  • Ankle alphabets
  • Split lunge on BOSU
  • Eccentric tibialis ankle pull ups with loop band and weight
  • Heel-walking drill
• Wrapping and taping: Wrapping the shin musculature with a compression wrap prior to exercising can reduce some of the stress response and shin pain. There are a multitude of available taping techniques (Kinesio Tape, McConnell, etc) for supporting / binding the medial arch and lower leg musculature some athletes have found helpful.

Preventing Medial Tibial Stress Syndrome

• Make sure you wear the correct running shoes for your foot type. If you're unsure, visit a local running store that offers professional fitting and analysis.
• Have two pairs of (reasonably recently purchased) running shoes with good cushioning and alternate wearing them can vary the stresses on your feet / legs.
• If you enjoy running on roads or paved roadside paths that have a significant camber to aid rain run off, run out and back on the same side of the road (if traffic / safety allows). Similarly, consider alternating directions if you are doing long-distance track workouts.
• Strength train two to three times a week. Long-distance running requires a solid routine of weekly strength and conditioning workouts to maintain healthy joints and supportive musculature. Some runners can get away with just running, but the best evidence leans on a balanced (strength, cardio, stretching, sleep, nutrition, etc) routine. See the “Toe-ga exercises” section above for a few suggested starters.  Visit with a PT for a more personalized plan.
• Perform pre and post-run stretches. Especially if you are prone to developing sore shins, take the extra time to stretch the muscles of your calf and anterior shin once you’ve warmed up.
• When returning to your running routine, a good rule of healing is to gradually increase your mileage by no more than 10 percent of total distance / mileage each week.
• Choose your return-to-run surfaces and incline angles wisely. Hills and hard surfaces (ie. concrete) can increase impact loads on tendon bone connection causing the aforementioned increased potential for inflammation on the legs. Softer surfaces (ie. grass, trail, or the synthetic rubber track) and lower angle profile runs are recommended until MTSS pain has resolved. Reinstating hills and hard-pack surfaces gradually after injuries is helpful.
• Nutritional recommendations for reducing inflammation, healing and improving bone density are summarized nicely in these two articles on healing and bone health and healthy dietary tips on reducing inflammation.
• Improve your running stride and cadence. New evidence on shortening your stride and optimizing the rate your feet strike the ground each minute can reduce injury risk and improve gait efficiency. Getting an appointment with a PT trained in running assessment is one helpful route or measuring and progressing your cadence to 170-180 steps per minute has been deemed optimal. The benefits of shortening your running stride length and increasing the frequency are summarized nicely in this systematic review article.
• Orthotics and supportive insoles may be helpful for some foot types or people suffering from shin splints. People with particularly flattened arches or recurring MTSS issues, may find either off the shelf or custom fit corrective orthotics beneficial for reducing stresses on the lower leg. Supportive insoles may also improve alignment and stability of the legs and feet, thus improving the strain potentials of the musculature affecting shin splints.

References
Bhusari, N., & Deshmukh, M. (2023, January 18). Shin splint: a review. Cureus, 15(1). 10.7759/cureus.33905

Budde, K. B. (2018). Physical therapy guide to shin splints (medial tibial stress syndrome). Choose PT. https://www.choosept.com/guide/physical-therapy-guide-shin-splints-medial-tibial-stress-syndrome-

MacLean, K. (2023, November 16). 9 healthy eating tips that can help reduce inflammation. UC Davis Health. https://health.ucdavis.edu/blog/good-food/9-healthy-eating-tips-that-can-help-reduce-inflammation/2023/11

McCrann, P. (2018, September 1). Choosing the correct running cadence. Endurance Nation. https://www.endurancenation.us/run/choosing-the-correct-running-cadence/

McNamara, W., Longworth, T., Sunwoo, J. Y., Rizvi, S. M., Knee, C. J., & Cole, B. F. (2023). Treatment of medial tibial stress syndrome using an investigational lower leg brace. A pilot for a randomised controlled trial. BMJ. 10.1136/bmjinnov-2022-001054

Schubert, A. G., Kempf, J., & Heiderscheit, B. C. (2014). Influence of stride frequency and length on running mechanics: a systematic review. Sports Heatlh, 6(3), 210-217. 10.1177/1941738113508544

Shin splints | medial tibial stress syndrome (exercises, rehab, strengthening). (2021, October 3). YouTube. https://www.youtube.com/watch?v=_OyNx5VMzzc

Shin splints: symptoms, causes & treatments. (2023, June 14). Cleveland Clinic.
https://my.clevelandclinic.org/health/diseases/17467-shin-splints

Vasudevan, J. (n.d.). Shin Splints: Causes, Symptoms, Treatment and Prevention. Runner's World. Retrieved June 24, 2024, from https://www.runnersworld.com/health-injuries/a19595626/shin-splints/

Winters, M., Eskes, M., Weir, A., Moen, M. H., Backx, F. J., & Bakker, E. W. (2013). Treatment of medial tibial stress syndrome: a systematic review. sports medicine, 43(12), 1315-1333. 10.1007/s40279-013-0087-0

Apparently this rice bowl has, at one time, gone viral on social media.  I think I missed that, but I can see why...it's easy, yummy and versatile.  I even sent left overs to school with my kids as make your own sushi rolls!  This is a recipe that you can be creative with for toppings, make your favorites and mix your own bowls.  This recipe will feed about two people.  It makes extra Sriracha mayo, but I would make more of everything else if you have more people!

Ingredients:
4 oz salmon
1 tsp avocado oil
salt to taste
1 cup brown rice (cooked according to package)
2 tbsps  mayonnaise
1 1/2 tsp Sriracha
2 tsp tamari or soy sauce
1 1/2 tsp mirin
1/2 tsp freshly grated ginger
1/4 crushed red pepper
1/4 tsp salt
1/2 cup chopped cucumber
1 chopped avocado
1/4 cup kimchi, optional
one small head of broccoli
12 4 inch sheets of nori (roasted seaweed)

Instructions:
Prepare your rice per the package instructions, we use an Instapot, but a rice cooker is super easy too.  As the rice is cooking you can prepare the rest of the meal.

Preheat your oven to 400 degrees F.  Line a small baking sheet with foil and place the salmon on this pan.  Drizzle with oil and season with a little salt.  Bake until the salmon flakes easily with a fork, about 8-10 minutes.

Cut up the broccoli into bite-sized pieces and in a small pot with a vegetable steamer basket, steam for 3 minutes.  Set aside.

Mix up the sauces, mixing the mayonnaise and Sriracha in a small bowl.  Wisk together the tamari, mirin, ginger, red pepper and sale in another small bowl.  Set these aside.

Chop up your cucumber and avocado.

Divide the rice in bowls, top with salmon, and any other toppings you prefer.  Drizzle with the Sriracha mayo and the tamari.  Serve with the nori and enjoy!

By Brace Hayden, DPT and Miya Ensley

​Medial tibial stress syndrome (MTSS) has replaced the more alarming and antiquated term “Shin Splints” as the more helpful and broader regional pain diagnosis in the lower leg that can occur on either or both of the inner (medial) or the outer (anterior) part of the shin.  Many sore runners have joined the time-honored MTSS Club when they ramp up their mileage too quickly, or drastically alter their training routine (ie. by vigorously up-training plyometric exercises, track drills or increasing volume of hill workouts).

There are many working theories in sports medicine about what is going on when the tibia is stressed to the point of causing this painful and limiting condition. These theories include:

• Microtears and inflammation in the tibialis anterior muscle’s tendon (effectively a tendinitis) along its insertion to the shin/tibia (the muscle that helps lift and evert the foot, as well as decelerate the body during the running stride)
• An irritation of the tibia’s periosteum or a “periostitis” (the fibrous sheath that helps supply nutrition and blood to the bone, repair injured bone and contribute it’s to growth)  
• Combination of both uncomfortable theories

Differential Diagnosis of Medial Tibial Stress Syndrome: 
Pain in your lower leg doesn’t always fit the criteria for an MTSS diagnosis. There are two other similar unpleasant running ailments that can be confused as shin splints: 

• Compartment syndrome has a similar pain presentation along the outside of the shin, but typically has more swelling/pressure, nervy sensations and eventually progressive ankle weakness if untreated. Getting a proper medical diagnosis sooner than later is important, as compressed nerve injuries take a lot longer to heal. 
• Stress Fractures of the tibia can also present as shin pain when the repetitive impact of running causes partial fractures in the bone. These bone injuries can also be more sinister than shin splints, so getting a proper diagnosis from a medical provider (PT, MD, RN… not Dr. Google) is helpful and warranted. 
  • The typical pain of MTSS usually spans north and south along the tibia, whereas a stress fracture tends to be more point tender. 
  • Another differential point lies in their time of day presentation. MTSS tends to feel worse with the initial steps in the morning, as the muscles and connective tissue tighten up while resting. Stress fractures tend to feel better first thing in the morning as the bone has been unweighted throughout the night. 
  • Lastly, MTSS is typically more sore when you flex shin muscles, effectively lifting your toes toward your shin. Stress fractures conversely are usually not painful with resisted ankle flexion. 

Known Knowns That Can Contribute to Medial Tibial Stress Syndrome

• Too much, too fast: the aforementioned training error of increasing mileage or load too aggressively. 
• Hyperpronation: excessive rotation of the midtarsal (midfoot ankle bones) inward and downward, effectively collapsing the foot’s middle arch. Miles of running with 2.5-3x your body weight pounding through each over-pronated step could contribute to excess MTSS. 
• Sub-optimal pre/post-run stretching: stiff musculature in the lower leg can further stress on the connection area of the tibialis muscle on the tibia creating a higher potential for injuries.
• Worn-out shoes: this is not an exact science, as many people joyfully complete marathons barefoot. However, some aches and pains that accrue with higher mileage training can be improved with a new pair of supportive running shoes. 
• Imbalanced leg loading:  Uneven loading on one leg (ie. only running on the right side of a cambered road or only running around the track in one direction).
• Leg muscle strength deficits: an imbalance of pull between your calf muscles and the shin muscles can unevenly load, stress and cause running injuries.  See this prior RWM article on the importance of strength training your calves.

* Tune in next week for Part 2: Running with Medial Tibial Stress Syndrome - What do about Splintering Shins!

Alpine PT believes that our services and Physical Therapy in general are a very worthwhile investment in your health.  But we understand that costs can be a burden and that insurance benefits can be confusing.  It is with this understanding that we have decided to transition toward a deposit due at the time of service.  We encourage people to check into their Physical Therapy benefits prior to beginning a course of PT.  We believe that understanding the estimated cost of each visit will prevent surprise bills after your treatment is over.  As always we feel communication is key!  We pride ourselves on trying to work with and understand where our clients are coming from, both in their physical health and their financial health.  So please feel free to ask questions and discuss with your PT any concerns you may have about your treatment.  As we describe below, there are lots of ways to help you reach your goals.  

Why do I have to pay if I have insurance?  
A: Your insurance benefits are dependent on your plan and may include a deductible that has not been met, a coinsurance, or a co-pay that is the patient's responsibility to pay. You are responsible to pay some amount at each visit. By paying toward the total balance at each visit, your final bill will be much lower. 
More info: Until your deductible is met, you will be responsible for the full amount of each visit. Ultimately this amount is determined by your insurance company. Once the deductible is met, the amount you pay at each visit will decrease significantly. With some insurances, once the deductible is met you pay nothing, for other insurances you will have a coinsurance to pay once your deductible is met. Check your benefits to understand more. 

How do you determine the amount I need to pay toward each visit if I have insurance? 
A: The deposit toward your visit is based on the average amount that gets passed to the patient after insurance processing plus considerations including a) if the deductible has been met and b) your co-pay or coinsurance associated with your plan.
 
What if I can’t afford that amount? Consider other options that currently include:

1. Adjusting frequency and duration of visits - focus on a plan of care with self-efficacy at the center
2. Cash pay plans (although this is not always better if they might meet their deductible this year as we will not bill insurance retroactively)
3. Direct Primary Care plans, such as the one at Cost Care, that include 5 visits/year with only a $40 copay
4. 10 Pack for $1600
5. We will work with people on an individual basis to set up payment plans, only if necessary. Experience has taught us they don’t often get paid. The billing team will work one on one in these cases.
6. Currently PhysioTrekk is $95/standard visit (~40 min), $129/premium visit (~55 min). (works great for something that requires less than a handful of visits, patients that are good managing their own care but not ideal for post-op, conditions that require frequent follow-up or individuals that need more managed care)

What if I end up paying more than I am billed? 
A: Once your PT course of care is complete, and your final claim has been processed through your insurance, any remaining credit on your account will be reimbursed to you from Alpine. 

Why is the cash pay rate lower than the insurance rate? 
A: We offer a discounted rate on our billed charges to patients who opt to self pay at the time of service because we cut out the administrative costs associated with insurance billing. 
More info: Theoretically, this discount is available to insurance companies, but they don’t pay at the time of service. 

Can I find out how much my total PT care will cost? 
A: In some cases we can, but it is only an estimate based on the number of visits we think you will need. 
More info:  It is best to meet with your physical therapist for your initial evaluation first, then they can take all of your health factors into consideration to provide an estimate of the number of visits you will need. If you are cash-pay, this is a bit easier since the cash pay rate is set. If you are using insurance and have a deductible or coinsurance it is trickier and will be less accurate.

Why do you charge so much for a PT visit?
A: In the US healthcare costs are only subsidized if you qualify for Medicare, Medicaid or VA benefits. Instead healthcare is provided by private businesses that have to set prices according to costs of doing business. For Physical Therapy this includes doctorate level providers who are highly trained experts in their field. At Alpine, we provide one-on-one care with your physical therapist for the full treatment session, which typically lasts between 50-60 minutes.
More info: The cost for a PT visit depends on the length of the visit, how much time is spent with the physical therapist rather than with an assistant, and the location of the PT clinic (both geographic location in the US and if it is a hospital vs private clinic). 

If I pay cash can I submit the bill to my insurance on my own? 
A: Typically, yes.  The process to do this is set by your insurance company.

Sheet pan dinners are a good go to for my family.  Especially during the busy spring sports season, they are a great option to get a home cooked meal on the table in less than an hour.  You can even make the sauce and marinate the fish and veggies in advance, leaving only the short cooking time after a weeknight round of extra curricular carpooling!  This fish recipe is a classic Mediterranean meal all on it's own, but you can easily beef this dinner up by making brown rice or barley to have with the veggies and extra sauce.  As for fish selection, Halibut is delicious, but any other white fish such as cod, haddock or red snapper will be good as well.    Enjoy!

Ingredients:
Zest of 2 lemons
Juice of 2 lemons (or about 1/2 cup)
1 cup olive oil
1 1/2 tablespoon minced garlic
2 teaspoons dill weed
1 teaspoon salt and more to taste
1/2 teaspoon black pepper
1 teaspoon dried oregano
1/2 teaspoon ground coriander
1 lb fresh green beans
1 lb cherry tomatoes
1 large yellow onion, sliced
1 1/2 lb halibut fillets

Instructions:
Preheat the oven to 425 degrees.

In a large mixing bowl, whisk the sauce ingredients together.  Add in the green beans, tomatoes and onions, toss to coat.   With a slotted spoon transfer the veggies to a large baking sheet, and spread them out.  

Toss the halibut in the remaining sauce and place next to the veggies on your baking sheet.  Pour the remaining sauce over the fish and veggies.

Bake for 15 minutes.  Then transfer the sheet to the top oven rack and broil on high for another 3 minutes, watching carefully!  The cherry tomatoes should begin to pop.   Remove from the oven and serve.

​I have fond memories of potato pancakes growing up, smothered in applesauce or sour cream.  Lately, I have come to really enjoy sweet potatoes, so the marriage of the two in this recipe caught my eye.  The lemon-tahini sauce is a bit more of a time-consuming preparation than the plain old sour cream or applesauce. We have topping options in my household, as my kids prefer the simpler toppings, but the creamy punch of the L-T sauce makes for an excellent dish. 

 Ingredients: 
3/4 cup plain yogurt
2 tablespoons tahini
2 tablespoons lemon juice
1 garlic clove, finely grated
1/2 teaspoon black pepper
2 1/2 teaspoons salt, divided
1 lb sweet potatoes, peeled and grated
1 lb Yukon Gold potatoes, peeled and grated
1 1/2 tablespoons olive oil
2 medium leeks, white and light green parts thinly sliced
2 large eggs, beaten
1/4 cup flour
1/2 teaspoon ground cumin
1/2 teaspoon ground turmeric
1/2 teaspoon ground ginger
oil for frying (vegetable is best)

Instructions:
Make the sauce: Whisk together the yogurt, tahini, lemon juice, garlic, pepper and 1/2 tsp of salt into a small bowl and set aside.

In a large colander (over a bowl or the sink) add the shredded potatoes and 2 tsp salt.  Toss to combine and let stand for at least 10 minutes.  Squeeze out the excess liquid, then transfer to a large bowl.

In a large skillet, heat 1 tablespoon over medium.  Add the leaks and a pinch of salt.  Cook, stirring occasionally, until the leeks are soft and starting to brown, about 5 minutes.  Add the leeks, eggs, flour, cumin, turmeric, and ginger to the potato mixture and stir until evenly combined.

Cover your skillet with oil and heat over medium until shimmering.  Working in batches, spoon batter for each fritter into the skillet and flatten with a spatula.  Cook until golden and getting crisp, 2-5 minutes per side.  Transfer the fritters when done to a paper towel over a plate to drain the oil.  Add more oil to the skillet between batches if needed.

Serve with lemon-tahini sauce, apple sauce, plain yogurt or sour cream.

​Enjoy!

​

By Jess Kehoe, DPT

Missoula is full of runners.  We are blessed to have ample trail systems which, nearly anywhere you live, can be accessed nearby.  We have big hills to run up and down and miles of pavement to pound if that’s your preference.  We’ve got professionals and near professionals in our midst, and those of us just in it for the regular daily jog, with their dog or friends.  No matter the category you fall into, runners are always looking for ways to stay on their feet, and avoid the common injuries.  That brings us to the point of this blog, the benefits of a weight training program for runners.  

There is evidence coming out of the Montana Running Lab here at the University of Montana, that there are several positive benefits to getting stronger.  Some of these that can directly impact running are increased bone mass, stiffer tendons and more resilient joints.  Another recent systematic review(1) looking at non-running based injury prevention programs has shown that the most effective requires more than 6 weeks of consistency, and are more effective with professional guidance.  This makes some intuitive sense since it takes 6 weeks to begin making changes in your muscle tissues with a weight training program, so staying consistent for the long haul will give you the most benefit.  Also it appears that having a professional guide might make it more likely that you are consistent and that you are working to your full potential.  

Maybe you are new to this idea, or maybe you have been lifting for years.  Maybe you have been struggling with a chronic injury or just interested in trying to improve your strength.  In any case, the PTs here at Alpine think that adding a strength training program to your routine is a worthwhile investment.  Adding exercises like the back squat, single leg Romanian deadlift, planks, calf raises and plyometrics to name a few can challenge your muscles and tendons to increase strength and resiliency for running.

To avoid feeling like your lifting training causes fatigue for running, we have a few suggestions.  First, lifting twice per week is enough.  If you have been consistent with lifting for several months, and your running is ramping up, there is even evidence(2) that maintaining only one weight training session per week can help retain strength benefits.  Second, the number of exercises doesn’t have to be many, you can keep it to 4 or 5, and only 3-4 sets per session.  If you feel this causes fatigue in your running, reduce a set but keep the weight heavy.  Also, don’t work until complete exhaustion, allow 2-3 more reps in the tank for each set and take a 2-3 minute break between exercises to avoid circuit training.  Thirdly, if you are trying to lift and run on the same day, run first.  This way you can adjust your lifting if you are feeling fatigued, instead of tired legs from the lift affecting your run.

For many weight lifting programs you will see reference to a 1RM which stands for one repetition max, or the weight you could lift for only one attempt.  The guidance coming out of the Montana Running Lab is that the best range to work in is 70-80% of your 1RM.  There are some apps out there that will calculate your 1RM such as this one.  However, if you don’t work out at a gym, or don’t feel the need to be quite so scientific about it, you can also use the following general advice.  Muscles will strengthen due to the overload principle, complete 3-4 sets of 6-8 reps at a weight that makes it feel that you cannot do many more.  If you don’t have complete weight sets available to you then the next best option is to use a challenging weight, and complete as many reps for 2-3 sets that causes fatigue, or again gets you to where you cannot do many more with good form.  For instance at home I only have a 20# dumbbell, so I might do 2 sets of 15 Bulgarian split squats with this weight, but if I’m in the gym I’ll go heavier and complete the 3-4 sets of only 6-8 reps.

Always remember that you shouldn’t experience pain during your lifting or running and ignoring pain for too long can make it worse.  If you need guidance for starting a new program, or getting help to reduce an injury contact Alpine PT and we can help get you on your way.



References:  
1.  Wu H, Brooke-Wavell K, Fong DTP, Paquette MR, Blagrove RC. Do Exercise-Based Prevention Programs Reduce Injury in Endurance Runners? A Systematic Review and Meta-Analysis. Sports Med. 2024 Jan 23. doi: 10.1007/s40279-024-01993-7. Epub ahead of print. PMID: 38261240.
2.  Steele, James, et al. “Long-term Time-course of Strength Adaptation to Minimal Dose Resistance Training: Retrospective Longitudinal Growth Modelling of a Large Cohort Through Training Records.” SportRxiv, 27 Jan. 2021. Web.

​