Rehab Options for the Off Season


By Karen Patterson

With the drop of temperatures and the promise of spring still months away, a simple walk to drop the trash at the curb can become a battle with the elements. Though the cold may occasionally put a damper on outdoor workout plans, the winter months bring an opportunity to heal tweaked muscles, sore joints and worn spirits.

To have an effective off-season, identifying injuries sustained during the race season is key. Whether it is an achy knee or a tender hamstring, seeking professional help to assess the injury is the first step to preparing your body for a new season of running.

“When somebody feels pain, should they get treatment? Usually the answer is yes,” says Dr. Paul Plaskett, a chiropractic physician at the Chicago Chiropractic and Sports Injury Center in Lincoln Park. “Winter is the time to look at mechanical issues that are affecting other things.”

Plaskett and his team focus on the biomechanics of movement: posture and how individuals adapt to previous injuries and balance, amongst other things.

“Running is a sport where you’re moving in one direction and trying to hold a specific symmetry,” Plaskett explains. “Something can easily become aggravated or inflamed if it’s worked too hard. We try to figure out some of the mechanical flaws.”

Dr. Timothy Jantz, a Crystal Lake-based podiatrist agrees that finding the source of the pain is key.

“We also look to see what precipitated the injury,” Jantz says. “Was it doing too much? Was it the wrong shoes? Often times [injuries] are a result of doing too much too soon.”

Once an injury is assessed, the rehabilitation process can begin. As no two runners have the same stride or style, no two therapy plans are identical. Jantz and Plaskett each recommend low-impact exercises just to stay in shape: pool running, a stationary bike and even yoga.

“The key really is getting a diagnosis and forming a rehab plan,” Jantz says. “I have so many patients that say, ‘I had this ankle or heel pain, took off the last four months, did some cycling and weight-lifting, and the problem came back.’ They never found the source of the pain.”

Plaskett and his team use progressive rehab—starting simple and working the body back up to full strength. Joint manipulation—adjusting and assisting the bone alignment—can help create better balance. Active Release Technique targets muscles with high tension and works to relieve that pressure.

“We’re looking to support optimal mechanics through rehab and chiropractic adjustments to create better symmetry so that people are less prone to injury down the road,” Plaskett says.

He compares the rehab process to the alignment on a car: you can rotate the tires all day long, but only when you get under the car to see the mechanics can the greater problem be assessed and corrected.

For those who have not necessarily suffered an injury but still are looking to maintain a high fitness level through the colder weather, cross training provides an easy solution. Dr. Chuck Cranny, the clinical manager of outpatient physical therapy at Rush Memorial Physical Therapy offers swimming as the most effective method to maintain a high-level of cardio.

“Say you’re dinged up with Achilles Tendinitis, a knee problem or a hip problem. You often shut everything down to begin rehab,” Cranny says. “With swimming, though, you can stay active.”

Cranny acknowledges that cross training, like rehabilitative therapy, is not “one size fits all,” adding that the key is for each person to find something that works to strengthen their body without further aggravating chronic problems.

“Some of these avid runners who can kick out 15 or 20 miles without thinking about it just hate swimming,” Cranny explains. “For people like that, there’s something available called an anti-gravity treadmill.”

First introduced in 2008, the AGT seals a runner’s legs in a bubble around the treadmill. The bubble is then inflated, raising the runner slightly off the running belt. Rather than pounding with 100 percent impact, runners have as little as 50 percent impact, allowing ankle, knee and hip joints a break while still providing the respiratory workout.

“Two years ago this was a pretty specialized piece of equipment, but now most private clinics have them,” Cranny says.

For those with a standard gym membership, or even just a yoga mat in the living room, plyometrics, climbing stairs, a rowing machine and even power walking offer the body rest from running’s demands. For those still looking for something more intense, cross country skiing is an easy, active option.

“If you want a good workout, cross country is the ultimate test,” Cranny says. “You start out thinking it’s too easy or that you won’t like it, and 15 minutes in you’re breathing hard.”

Jantz, Plaskett and Cranny all agree that the most important thing for someone who suffered any sort of injury in the course of training is to have the issue properly evaluated and begin a healing process.

“Winter is a great time to take care of that stuff,” Cranny says. “You can still do cross-training or other cardio without pressure of a looming race. It’s important to take care of the problem before it lingers into spring and affects any early races someone may want to compete in.”

Cranny adds that education is often important in avoiding injury. Whether it’s a seminar offered before a race or a consultation with a local doctor, learning the specific ins and outs will help a runner of any ability better protect himself or herself from injury.

Plaskett adds that adjusting footwear and understanding its role is also important.

“Shoes are a variable to help control and to help position you, but you want them to help maximize your potential, not do all the work,” Plaskett explains.

“All of these things—shoes, cross training and recognizing imbalances—are ways we try to help people retrain so that they go back to their activity in a better position than when they came to us.”