What is Therapeutic Exercise?
Unlike a regular exercise program, which focuses on improving your general strength, aerobic endurance and general fitness, therapeutic exercise is more specific. Based on the findings from your physical therapy evaluation, therapeutic exercise usually focuses on:
- Fixing any muscular imbalance
- Progressively loading a muscle and tendon to help regenerate soft tissue restrictions and treat tendinitis through soft tissue remodeling
- Enhancing deep core stability and learning how to incorporate core stability into your functional everyday activities
- Improving muscle length and joint range of motion
- Specific exercises to enhance joint stability and overall mobility
Whether you have suffered an injury, experienced an illness or feel you have lost your physical abilities, therapeutic exercise can treat and prevent impairment and disability while improving your overall fitness.
Testing Running Injuries:
The ultimate special test for runners is RUNNING. The key to effectively treating and preventing running injuries is determining the cause of injury rather than treating the effect or symptoms alone.
There is quite a bit of research out there examining the different characteristics of running form and how it may affect your likelihood of injury. These include but are not limited to:
- Footstrike (how your front foot hits the ground with each step)
- Step rate (how many steps you’re taking during your run)
- Hip adduction (how much your leg falls toward midline with each step)
- Loading rates
In a comprehensive physical therapy evaluation, Dr. Trinh will perform a formal running analysis using what is termed “The Four S’s of Running Analysis:”
- Step rate
As a clinician, there is much information that can be obtained from simply listening to one run, particularly:
- Do you run quietly or are you stomping the ground?
- Do your feet sound similar or is there asymmetry?
- Does the sound change as a result of different shoe types?
One simple tip to decrease likelihood of injury is actually to just “quiet your feet down.” What this does is reduce the ground reaction force you are placing on your body.
When running, do you tend to land on the balls of your feet or your heels? Perhaps you land flat-footed? Are both feet landing the same way?
I have found that not one type of foot strike is necessarily better than another, though each type of foot strike can serve a certain purpose for injury treatment and prevention.
For example, training a forefoot strike may be effective for those who have dealt with pain more along the front of the leg, such as shin splints (tibial stress syndrome), anterior compartment syndrome, anterior knee pain.
On the other hand, if you’re a runner dealing with an achilles tendinopathy or recovering from a calf strain, a heel or rearfoot strike during running has been shown to decrease loading on the achilles tendon.
Running is merely a series of rhythmical single leg hops. Research has shown that by increasing your step rate by as little as 5-10 percent above preferred while keeping your velocity constant, you can reduce shock absorption at the knees and ankles by up to 20%.
What this means is that by increasing the number of steps while keeping your running velocity constant, you may be able to reduce the amount of force you are applying into the ground, thereby decreasing body breakdown. There are actually apps that you can use to measure your step rate or cadence. One of my favorites is “RunCadence.”
Your speed is the amount of ground you are able to cover in a given time. When you run faster, you must actually push on the ground more forcefully. Oftentimes, your body is able to withstand high forces but requires more progressive loading to work up to faster speeds without injury.
If you come in for a running analysis, expect:
- A treadmill running analysis (unless you’re unable due to current injury) where Dr. Trinh will examine your running biomechanics in a multi-angle video recording and provide you with an edited youtube clip for your record
- We will have a discussion of your running gait, footwear considerations
Once Dr. Trinh identifies compensatory movement patterns, she can prescribe the correct strength and mobility exercises.