As a physical therapist who works with runners, there is one consistent area I find weakness even in very fit & strong runners – lateral (side) motions.

Running involves muscles to move you in a forward direction on flat ground, up hills, and down hills. The majority of strengthening most people focus on in legs is quads, hamstrings and calf muscles, which is helpful for running but not the only muscles a runner should focus on. While running is not done sideways, the muscles that function in side motions are important stabilizers to help keep you balanced and decrease the stress that occurs in lower back, hip, knee, foot and ankle.

As many runner head into their slower race time of year, it is a great time to begin to work on strengthening for the demands that running requires.

So continue to work on the strength needed to move you forward, but add in strengthening in the lateral motions. Some exercises to address this area are: sidelying clamshell, side stepping with theraband tied around ankles (keep feet parallel), side planks (adding in arm and leg lifts as you gain strength), side step ups or hops, jumping side to side, grapevine/carioca.

Also as you work on balance exercises make sure you keep your pelvis level and challenge your balance by being on unstable surfaces (ie. BOSU balls, foam, cushions, or pillow). So make a change to work your body in new directions!
​
Kristi Moore, MSPT
Alpine Physical Therapy, North
2965 Stockyard Rd.
Missoula, MT  59808
406-541-2606
www.AlpinePTmissoula.com

The Alpine tent was up and ready for action this past Saturday for Montana’s largest annual cross country meet, The Mountain West Cross Country Classic.  The event draws youth from all over the Northwest for a 3 mile run for High School athletes and a 1.3 mile run for Middle School athletes. The sun was out, the air was clear of smoke, making it a spectacular morning for such a great event.
​
Physical therapists Kristi Moore and Jamie Terry spent the morning taping, consulting on injuries, and triaging athletes to local Missoula Emergency Services. We were really fortunate to have support from Athletic Trainers Emily and Winter, Physician Assistant Kris Provo and Alpine Aide Maddie with the constant hustle in the medical tent. Trying to keep athletes doing what they do and injury free is a top priority here at Alpine, so it was an honor to spend the morning with these runners and see them excel.

Highlights from the morning, a huge upset in the female varsity run with Freshmen Anne Hill of Glacier upsetting Senior and reigning champ Makena Morley of Big Fork with a time of 16:39:64. In the JV race, local 9th Grader of Hellgate, Isaac Smith, came out on top with a time of 16:27:99. It will be really exciting to see what these two do over the next 3 years.
​
A big thank you to Michele Chalmers and the Mountain West Track Club for having us again this year. We love being a part of this community event and are looking forward to it again next year!

There are many of you who are winding down on you training season, and many who are training for fall races. In our day and age of technological gadgets we use watches, GPS devices, heart rate monitors, and many other devices. They can help you determine if you are in a zone, keeping pace, and going far enough for your training.

This can be helpful for beginning runners to know they are training appropriately for a new distance. They can help the seasoned runner know if they are maintaining a certain level or if they are improving. However, I have a challenge for you. Take one run per week (only one) and just go for a run. Listen to your breathing and how the run is feeling in your body.

If you feel good and want to push it go a little faster or a little further. If your body is recovering from your last run and is feeling like you need to slow down, do it. There has been much research done about perceived exertion and how accurate this can be in determining the level you are exercising at (compared to a heart rate monitor). I recently did this and remembered why I love to run. Enjoy being outdoors and exercising to help both your mental and physical being. I found it made me look forward to my next run.
​
As a Physical Therapist, many of the running injuries I see are from over training issues. If we occasionally take the time to listen our bodies will tell us what we are capable of doing and we may be able to avoid pushing into an injury. These technological advances have a purpose and can help you achieve your goals, but also listen to what your body is telling you. So go for a run and have fun!
​
Kristi Moore, MSPT
Alpine Physical Therapy, North
2965 Stockyard Rd.
Missoula, MT 59808
(406) 541-2606
www.AlpinePTmissoula.com

Running is different from walking because you are on only one leg at a time with each stride. With walking you gradually transfer weight from one leg to the other, not so with running. When you break down running to the most basic motion, it is jumping from one leg to the other over and over again.

Everyone has slight differences in strength or flexibility between our legs, but significant differences are amplified with running. To help you decrease the subtle differences between sides it is important to do single leg exercises and stretch the muscles that are tight.

For balance: The first place to start is just balance on one leg. Check to see if you can stand the same amount of time on each leg and how difficult it is. If this is easy start to add arm or opposite leg movements.

For strengthening: do single leg squats or single leg press, single leg calf raises, and single leg bridges (make sure to keep you pelvis level).

For dynamic strength/drills: do bounding (long strides hopping from one leg to the other), side shuffle with quick feet (almost a slight hop from one foot to the other going sideways – both directions), and high knee skipping. These are just a few ideas of ways to start working on individual leg strength.

For flexibility: It is a good idea to stretch the major leg muscles (hamstrings, quads, hip flexors, calf, and gluts).

AFTER a run, if you find that one side is significantly tighter than the other make sure to stretch that muscle group. Get balanced and keep running!
​
Kristi Moore, MSPT
Alpine Physical Therapy, North
2965 Stockyard Rd.
Missoula, MT 59808
406-541-2606
www.AlpinePTmissoula.com

For the 8th consecutive year,  Alpine Physical Therapy will be the exclusive physical therapy sponsor of the Missoula Marathon.  This prestigious sponsorship puts us face-to-face with runners of all skill levels, giving us opportunities to provide consultation to all participants and to present numerous training seminars for area marathoners.

Our team of 14 therapists provides both pre- and post-race massages for all Missoula Marathoners. In addition, we offer free injury consultations both before and after the race.

We offer a unique service for all runners called The Runner’s Clinic, which is overseen by expert physical therapist, Kristi Moore, MSPT. Kristi is our sport biomechanics expert associated with high-mileage running.

Participants entering The Runner’s Clinic undergo 2-D video analysis of their stride, along with a comprehensive body and movement examination.  Integrating the 2-D video analysis with the clinical exam provides an exacting assessment for identifying running faults that can contribute to injury and impact performance.  The results of the examination form the basis of specific corrective exercises that you’ll begin learning and doing on day one!  For more information on The Runner’s Clinic, be sure to visit our website by clicking here.

Gaining knowledge about your injury and what you can do to resolve it puts you ahead of the pack. We invite you to peruse The Runner’s Clinic section of our website for information on various injuries common to runners.  Gather additional information by clicking on the Patient Resources section of our website for news and information on these and other conditions runners face.

We have three locations in Missoula.

• Alpine Physical Therapy, North
  We are located at 2965 Stockyard Road in the North Reserve Business Center, just behind Carino’s.  406-541-2606.

• Alpine Physical Therapy, South
  We are located in the Peak Health & Wellness Center South on the corner of Highway 93 South and Blue Mountain Road.  406-251-2323.

• Alpine Physical Therapy, Downtown
  We are also located in the Peak Health & Wellness Center Downtown at 150 E. Spruce, Ste A.  406-549-0064.

​All participants of the Missoula Marathon are provided free injury consultations with one of our physical therapists. Call to schedule a free injury consultation or to schedule for The Runner’s Clinic.

Special thanks for this article to Alpine super star, Antara Quinones, DPT.

********

IASTM is short for Instrument Assisted Soft Tissue Mobilization and just might be the answer if you have been dealing with nagging, recurrent muscle or “soft tissue restrictions”. Ideally layers of muscle and fascia glide over one another as move through a range or contract muscle tissue.

Runner’s often end up with injuries that restrict that normal tissue mobility. This lack of mobility often causes pain and inability to run with proper form. Common examples include iliotibial band syndrome (ITB), plantar fasciitis, achilles tendinitis, chronic tight calf muscles. and hamstring strains.

IASTM is a technique physical therapists use to break up the adhesions between the tissue layers and bring blood flow to the area. The treatment is often intense at the time but is quick and highly effective if followed with good stretching and correction of faulty movement patterns.

Want to try it out? Alpine’s Physical Therapists will be performing post-race massages after the Missoula Marathon and we will have our IASTM tools available if you want to try this technique out.

Look for the MASSAGE signs at Caras Park from 8:00 am to 1:00 pm. All massages are 15 minutes for $20. Sign up when you register for the race or at our booth upon completing your run.
​
For more information, visit our clinic web page on this topic by clicking here.

In the few days or week leading up to a race, avoid doing new things for your body because you just don’t know how your body will respond. Make the day before a long race a lazy day with minimal prolonged standing and walking. Be extra nice to your knees and feet. If you’re thinking about using tape on race day, make sure you have already tested running with it on.

Morning of the race – eat what your body knows. Warm-up! Run in the shoes you trained in. Run in the clothes you trained in. You don’t want any surprises on race day! BODY GLIDE (nipples, bra line, waist band, inner thighs, under heart rate monitor if you wear one) Don’t overdress – to help get it right you should be a bit cool before you start your warm-up. A few pieces of toilet paper in your pocket might come in handy. Water and Electrolytes are equally important.

Schedule a massage for after, NOT before the race. Believe in yourself and your training. Visualize yourself crossing the finish line. You’ve finished! Jump in the River!

Pre-race injuries: Here’s a guide to help you determine whether to run or not to run.

Quality of Pain
PAUSE: Mostly ache
GO FOR IT: Dull ache, tight, sometimes sharp
JUST SAY NO: Sharp, stabbing, sometimes sharp searing

Intensity of the Pain
PAUSE:  Moderate
GO FOR IT:  Mild
JUST SAY NO: Severe

Tolerance to Running
PAUSE: Worsens with mileage
GO FOR IT: Stays the same or improves with mileage
JUST SAY NO: Worsens and increased mileage causes swelling

Effect on Stride or Form
PAUSE: Mild change
GO FOR IT: No change
JUST SAY NO: Altered stride or form

Stage of Injury
PAUSE: Sub-acute
GO FOR IT: Chronic
JUST SAY NO: Acute
​
If you have other questions, need an injury consultation (free to Missoula Marathon runners), or need more information, call our clinics at 406-251-2323.

Special thanks to running specialist and Alpine physical therapist, Kristi Moore, MSPT, for this informative article.

*************

Lately I have been asked by many people about stretching, particularly in relation to running. My answer is “yes,” but it needs to be done correctly and at the right time.

There has been recent research about the effects of static stretching prior to runs and whether it decreases your ability to run as fast as if you did not stretch. The answer is true because with static stretching you are lengthening a muscle, then to run fast you need a quick response from that muscle to shorten (contract) to move you fast.

There are ways to loosen up muscles prior to a run that can be more effective without negatively affecting your running speed. Dynamic flexibility or drills help to move your joints and muscles through a larger range of motion but utilize movement to loosen muscles versus a static stretch.

As for static stretching with longer holds, do it, but do it after your runs and on days you are not running. You may wonder why to do them at all? The answer is that your muscles tighten up with running and daily life, and the shortening of your muscles is not always equal on both sides. This creates an imbalance in your body when either one side (right to left ) or front to back of your body has asymmetrical pulling across your joints.

In the big picture if you have an area that is always tight it may affect your form with running or other activity and lead to an injury. The key to static stretching is using correct form and being active to keep good form while holding the stretch for a full 30 seconds.
You also need to stretch a muscle from both it’s attachments (origin and insertion) to be effective at lengthening it. This should be done after your runs or other activities. For runners the areas that commonly get tight are: hamstrings, quadriceps, calf muscles ( gastroc and soleus), and hip muscles (gluts, hip flexors, etc).

Happy stretching! And for more information visit the section for runners on our clinic website by clicking here.
​
Kristi Moore, MSPT
Alpine Physical Therapy, North
2965 Stockyard Rd.
Missoula, MT 59808
(406) 541-2606
www.AlpinePTmissoula.com

​Thanks to Alpine’s running specialists, Kristi Moore, MSPT, for this informative post.

************

It is the time of year when runners begin to look at the upcoming race season and decide what races they will participate in for the year. For many it will be setting a goal for a longer distance race. For others it will be just to finish their first 5K race.

Whether you are just beginning to run or are a seasoned runner, it is important to plan enough ahead of time to train appropriately for the races you are planning to do. A good plan will be 12-16 weeks in length with gradual increases. What does gradual mean? For the new runner, think 10% increase every 3-4 runs. For someone who is consistently running, it can be a little quicker, but you should still make sure it is a gradual increase.

The majority of running injuries are due to training errors, and the biggest error is increasing your mileage too quickly. There are a multitude of training plans out there, and I believe it is a good idea to follow one, especially if you are new to running. Our bodies can adjust to incremental increases in running with less risk of injury. You should expect to feel soreness as you get into or back into running, but not pain or soreness that lasts more than a day.

Another way to help prevent injury as you begin to train for your races is to add some variety to your runs. There is a saying that “variety is the spice of life.” This can help you avoid injury and also improve your running times. The most common ways to change your runs are to do faster runs (i.e. tempo runs or track workouts) that may be shorter in distance. Then do slower longer runs once per week. Also changing where your run can help you get stronger and avoid boredom. This could mean adding in hills or hill repeats on one run per week, or switching to the trails for some of your runs.

When you plan to have different lengths and types of runs, you can let how you are feeling dictate the type of run you do. This can be important for injury prevention. There may be days where you can push through, but listen to your body and know it is ok to mix up your runs. Most importantly have fun in your training!

For more information, visit our web page designed for runners by clicking here.
​
Kristi Moore, MSPT
Alpine Physical Therapy, North
2965 Stockyard Rd.
Missoula, MT  59808
(406) 541-2606
www.AlpinePTmissoula.com

Can running on a treadmill take the place of running outside when the smoke is bad?  The levels of smoke in the air fluctuate from day to day.  If you are training for a specific event it may be hard to decide whether it is better to turn indoors to a treadmill or keep running outside.  There is not a single answer to this question, but following are some suggestions.

AirNow.gov recommends that people should not run outside when the visibility is less than five miles due to smoke.  If you have heart or lung conditions this may be different.  The AirNow website  provides  air quality information and maps to help you determine if it is ok to be doing a more exertional type of activity outside.

If you have determined  to do some of your workouts on a treadmill, the question then arises about how to get a similar running workout on a treadmill as the one you would get outside.  There has been research suggesting you can get a similar workout with some adjustments to the treadmill settings.  You should know that your running gait will be different, just like it is different when you run on asphalt vs. trail.  The treadmill should be set up 1% on incline to mimic running on level ground outdoors.   You may also want to vary your speed throughout your run slightly.

When we run outside we are adjusting our pace frequently due to the changes in terrain.  On a treadmill you could just set a pace and stay exactly the same throughout.  The overall calories burned tends to be less on a treadmill than outdoors due to increased muscle recruitment outdoors (hamstrings and glutes are used to pull you forward, on a treadmill the belt moves your forward).  Also in general people tend to run faster, and longer when running outdoors compared to running on a treadmill.  So if you want to attain a specific goal with a treadmill workout you may need to run a little longer to get the amount you need.

Good luck in all the future training endeavors. Here’s to clear skies and more smoke-free days that will let us enjoy the great Missoula fall running weather!
​
Kristi Moore, MSPT
Alpine Physical Therapy, North
2965 Stockyard Rd.
Missoula, MT 59808
(406) 541-2606
www.AlpinePTmissoula.com