Physiotherapy Toronto Blog 

iRun is Canada's #1 Running Community & Magazine, available in print, online, and across social media.  iRun educates, informs, and inspires runners across Canada, helping them reach their goals and celebrating the community. Be sure to follow @irunnation and visit irun.ca

Coach's Corner with The Running Physio, Lauren Roberts, is a regular column in iRun magazine.  Here, Lauren offers everything you need for fall finish lines. 

Got a question you want Lauren to answer Email ben@irun.ca to be featured! Check out Lauren's Q&As from the latest Issue of iRun:

What risk does training too much in the summer pose for a fall race and how best can we go about finding our training sweet spot?

A. Lauren Roberts: Summer training can be so much fun! Social run groups are at their peak and brunch patios are bustling. The biggest problem tends to be inadequate fueling and hydration. Many people will complain of having a sensitive stomach or experience the dreaded “Runner’s Trots.” While this definitely is an issue, it’s important to know that the smooth muscles of our gut can actually adapt over time. I recommend ensuring a good carb-rich meal the night before a long run, and fueling with a carbohydrate of choice every 40-50 minutes during training. Start with something easily tolerated and in small amounts, and then gradually work up to 70-90 grams-per-hour.

Is there a rule of thumb for the average amount of weekly kilometres necessary for half marathon training? How about the marathon?

A: Absolutely. Half marathon training requires weekly mileage no lower than 15K-per-week to start and reaching 40-50K-per-week at peak. To marathon train properly, you should already be comfortably running around 50K-per-week at base. Peak should be no less than 70 kilometres-per-week. More mileage has been associated with speedier times, but mileage over 65K-per-week is also associated with greater risk of injury, which is why marathons are no joke and should be approached with respect and patience.

How might things like meditation help runners, and how could someone unfamiliar with that learn how to start?

A: Great question. In my opinion, running is its own type of moving meditation. A lot of people who get into distance running have their own personal reasons for it—and often anxious people find a certain “release” with running. The ability to find a place in your mind that can view all emotions and feelings in a neutral, curious, and non-judgemental way will prove useful in a race. A strong runner won’t get bogged down by any one feeling at any one time, and can mentally and physically remain present in the moment and at the same time have a macro, big-picture perspective of the race as a whole.

Does every runner need shoes with a carbon plate?

A: NO!! In fact, if you have history or are currently dealing with shin splints or foot and ankle issues (tibialis posterior, Achilles tendonopathy or plantar fasciitis), you should most definitely not be in a carbon plated shoe. As well, the energy return gains are more evident at faster speeds. Research has confidently concluded that at speeds much less than 16 kilometres-per-hour (~4:45-4:50-per-kilometre) there’s no real improvement compared to a non-speed shoe. Go and get a Running Analysis by one of our certified Runner’s Program practitioners at Athlete’s Care first!

What have you learned over time to produce faster race times and what have you learned is a surefire way to screw everything up?

A: LR: Faster race times are a perfect balance between pushing and pulling. We all know “recovery” is important, but the things that actually impact good recovery are often not front of mind. It’s been found that runners who scored lower mental health questionnaires for anxiety or depression are more likely to be injured. And, high mileage runners (70+ km per week) who sleep less than 9 hours per night have shown the same. So yes, foam rolling and massage guns can feel good, but things like life stress and sleep have to also be in shape for you to perform your best. Neglecting the basics will absolutely ensure a poor performance. 

Can you talk a little about running and aging? Is there a point past which it's impossible to PB?

A: I recently treated a 73-year-old triathlete. Are his times slower than 20 years ago? Yes. Is he still winning his age group? Yes. Moreover, race times aside, we know that things like meniscus thickness (the cartilage in your knees) and bone density tend to be better in long-time runners; the opposite of what many people think. Loading your skeleton repeatedly over time doesn’t “wear it out”—it strengthens it. There are also many stories of women who have come back after having babies and are even faster than beforehand. In my opinion it’s because moms are superheroes of time management, but I’m probably a little bit biased!

Of course every body is different but, as a rule of thumb, past 50, does running 100K weeks produce diminishing returns or does that strengthen everybody?

A: In general, running more does equate to better race times, but not improved strength. More time spent running will decrease the catabolic work of strength training. As I mentioned, we do know pretty clearly that over 65K-per-week increases the likelihood of injury, but interestingly enough older runners tend to experience less injury. It’s possible that many runners have just stopped running at this point because of injury which would skew these results, but it’s also possible that athletes running for so much of their life have just become extremely resilient to injury.

What’s one stretch we should do everyday and one stretch we should never, ever, ever do again?

A: Stop touching your toes to stretch your hamstrings! This is 75% low back flexion and 25% hamstring length. Please do some form of bridging every day to keep your glutes strong and your hip flexors long! I know I know…this is an exercise and not a stretch…but that’s just how it goes!

Lastly, for everyone embarking on their fall training, what's a last word of wisdom from you to all of us?

A: Plan your big picture! Don’t choose your runs day-to-day depending on how you feel; have an overarching plan to get you slowly and successfully to the distances you’ll need to be at on an appropriate timeline. And: do not wait to seek help for an injury!! Our clinicians love when someone comes in just with a small niggle. It means we can get on top of it before the compensations start to layer on. Our clinicians at Athlete’s Care all over Ontario are specifically trained in working with running injuries so don’t hesitate to book in.

Combined Decongestive Therapy ⭐️is the gold standard for managing lymphedema—a chronic condition that causes swelling—typically in the arms or legs—due to a buildup of lymphatic fluid. This happens when the lymphatic system (which helps remove waste and fluid from tissues) is damaged or blocked, preventing lymph fluid from draining properly.

Common causes of lymphedema include:
• Post-operative
• Post-radiation
• Post-traumatic
• Post-infection/ inflammation
• Chronic venous insufficiency
• Malignant disorders
• Obesity

While lymphedema can’t be cured, it can be effectively managed with Combined Decongestive Therapy (CDT) which may include:

• Manual Lymphatic Drainage (MLD)
• Compression therapy
• Exercise and movement therapy
• Skin care to reduce the risk of infection

RMT, Becky Yin, has completed the final level of Vodder training and is now a certified Combined Decongestive Therapist (CDT). Click the link to book an appointment with Becky at Athlete's Care Leaside or Athlete's Care at York Mills & Leslie.

For Our Mothers and to-be-Mothers on Mother’s day: The scoop on exercising during pregnancy

As we approach this day of celebrating Mothers internationally, we return to the fundamental rule of the caregiver: take care of oneself before taking care of others. And that process of caring for yourself first, begins during pregnancy. It will directly benefit the generation to come.

Today, we will delve into maternal self-care through movement. 

In 2019, a systematic research review emerged which inspired the creation of the Fit Pregnancy & Postpartum program at Athlete’s Care. It was titled, “The Canadian Guidelines for Physical Activity in Pregnancy.”  Here’s what we now know about physical activity during pregnancy:

1. It is not associated with miscarriage, stillbirth, neonatal death, preterm birth, preterm/prelabour rupture of membranes, neonatal hypoglycemia, low birth weight, birth defects, induction of labour, or birth complications.

2. Exercise should be thought of as a first-line treatment for reducing the risk of pregnancy complications, and improving the physical and mental health of pregnant persons.

3. Due to fatigue/discomforts associated with pregnancy, there may be periods when following the guidelines is not possible. During these periods, women are advised and encouraged to do what they are able, and return to the recommendations when they feel well. Listening to your body is key.

The 6 Guidelines are listed below:

1. All women without contraindication should be physically active throughout pregnancy. This includes those who were previously not active, those diagnosed with gestational diabetes, and those who are considered overweight or obese. 

2. It is recommended for pregnant persons to reach 150 minutes of moderate-intensity physical activity each week to achieve clinically meaningful health benefits and reductions in pregnancy complications. This even includes activity such as brisk walking, yoga/pilates, and rehab exercises. 

3. Exercises should be performed a minimum of three days per week; however, daily activity is recommended.

4. More benefits can be seen by incorporating a variety of aerobic and resistance training activities. Including yoga and/or gentle stretching may also prove beneficial.

5. Daily pelvic floor muscle training is encouraged to reduce the risk of urinary incontinence. Learning proper technique is recommended to gain optimal benefits.

6. Pregnant women who are light-headed, nauseous or generally feel unwell when exercising while flat on their back, can avoid this position while exercising. 

There you have it, the guidelines for exercising in pregnancy to maximize benefits during this period. Pregnancy is no longer considered a “fragile state” (for most). 

At Athlete’s Care we want to support your exercise goals in pregnancy. This is how the Fit Pregnancy & Postpartum program was born! It is a combined pelvic floor physiotherapy and perinatal chiropractic management strategy, to keep you comfortable, informed, prepared, and with the ability to maximize physical activity throughout pregnancy. 

Right now and until May 31st, we are offering free 15-minute consultations, to determine if you would be a good candidate for the program. If you are pregnant, or postpartum, and want to learn more, please call 416-691-6661 to book your free consult, and click here for more info!

We wish you a very happy Mother’s Day!