Tips On Maintaining Good Running Form

Over the past few weeks we have been writing all about running form. There is a lot to consider and after the recent blog posts it should become clear that running is a pretty complex movement.

There are a lot of variables to consider from posture, to heel strike, to cadence, it can all be a bit overwhelming to integrate.

So how can you start to implement changes without getting overwhelmed?

We know that maintaining good running form is essential for preventing injuries and improving performance. But like anything it takes time and conscious effort. Here are some tips you can use to help maintain good form during runs:

Tips On Maintaining Good Running Form

1. Make a list of priorities: Whether you have had a formal running gait analysis or are doing a self analysis its important to identify a list of things to work on. You should try to prioritize the most important variables first. For instance you may want to prioritize improving the position of your foot strike and overall posture prior to working on cadence.

2. Pick one variable to work on at a time: Focus entirely on that variable until you feel like you have made appreciable changes. By focusing on variable at a time you can avoid becoming overwhelmed and focus all your attention on reinforcing one thing.

3. Check in: Check in with your body periodically during your run and make any necessary adjustments to your form. This can help you maintain good form throughout your run. An easy way to do this is to set predictable times to check in with your form. If you listen to music do a mental check at the start of every new song. If you track your run do a mental check every 1/2 mile. Build in predictable times during your run where you consciously check in with your form. This will allow for more consistency, reinforcement, and carryover throughout the run.

4. Film yourself: A great way to notice change is by taking short clips of your running form. That way you can compare and analyze your progress over time. You can use the video to compare your form to what ideal form looks like and assess what areas still need work.

5. Practice: Remember, maintaining good running form takes practice. No one gets good at anything without a lot of practice. Change will happen over time with consistent effort. Stay focused on the long term changes and don’t get too bogged down with the day to day. Eventually you will optimize your form and you will have a whole new normal.

Have Any Questions? Let Us Know!

How to Improve Your Running Form: Tips for Runners

Whether you're a beginner runner or an experienced athlete, improving your running form can help you become a more efficient, injury-free runner. In the last blog we discussed where we think everyone should start when trying to improve running form.

In this post we discuss some other tips to help you improve your form and run more efficiently.

Posture

Good posture is essential for maintaining proper running form. When running, keep your shoulders relaxed and back, your chest open, and your head facing forward. This will help you maintain a neutral spine, which can reduce the risk of injury and improve your running efficiency.

When thinking of good running posture we really need to be thinking of it from the ground up. Good running posture consists of a person who is slightly leaned forward almost as if their body were falling forward slightly. This lean occurs through the ankle, in this way you are able to maintain a neutral spine.

Here is a great drill that we learned from an elite running coach that helps you find your optimal running position: Stand straight and engage your core while your spine is in a neutral position. Maintain the activation of your core as you raise both your arms overhead. Then lean forward through your ankles to the point just before you lose your balance or feel like you have to step forward. That point, right before you lose your balance is the position your body should be when running. This position puts your whole body at a slight angle to the ground emphasizing your forward momentum.

By maintaining a whole body lean you are able to translate your momentum forward, almost as if you are perpetually falling forward.

Foot Strike

The way your foot strikes the ground when running can impact your running form and increase your risk of injury. Landing on the midfoot or forefoot, rather than the heel, can help reduce impact forces and lower the risk of injury. Landing on the heel causes a much higher impact force as your body is essentially creating a breaking mechanism from the previous step. This is because heel striking occurs way out in front of your center of mass. As a result you end up slowing down then speeding up with every step you take. With a midfoot or forefoot strike this action doesn’t occur, or at least occurs much less. When running, try to land lightly on the balls of your feet, and avoid landing hard on your heels.

Cadence

Cadence refers to the number of steps a runner takes per minute. A higher cadence can help reduce impact forces and improve running efficiency. For the same reasons above a higher cadence likely means that your foot strike and loading is occurring closer underneath your center of mass. This helps reduce impact forces. Aim for a cadence of around 170-180 steps per minute. You can use a metronome or a running app that measures your cadence to help you improve your cadence.

Arm Swing

The arms play an important role in running form, helping to maintain balance and generate forward momentum. Keep your arms relaxed, with a slight bend at the elbow, and swing them back and forth in a natural and relaxed motion. Your arms should be hanging directly under your shoulders and not held out away from your body. Avoid crossing your arms over your body, which can throw off your balance. If your arms cross your body or you have the tendency to hold them away from your body that may be a sign that you are trying to compensate for weakness in the hips and core.

Stride Length

Stride length refers to the distance between each step. A comfortable stride length that allows for efficient and fluid movement is important for maintaining good running form. Avoid overstriding, which can increase the risk of injury and wastes energy. Instead, aim for a comfortable stride length that allows for efficient movement.

Core Stability

A strong and stable core can help improve running form and reduce the risk of injury. Incorporate core strengthening exercises into your training routine, such as planks, resisted rotations, and dying bugs. A strong core can also help you maintain good posture while running.

Gradual Progressions

Improving your running form takes time and practice. Rather than trying to make too many changes at once, focus on one aspect of your form at a time. Gradually incorporate the tips mentioned above into your running routine, and allow your body to adjust to the changes.

Improving your running form is an ongoing process. By incorporating these tips into your running routine, you can become a more efficient, injury-free runner. Remember to listen to your body, and gradually make progressions towards better form. Happy running!

Having Trouble Running? Get In Touch Here:

One Change Every Runner Can Make To Optimize Form And Reduce Risk Of Injury

Running is one of the most popular forms of exercise. This is likely because there is very little barrier to engage in running aside from time and a pair of running shoes, though some people don’t even use the shoes.

There is no expensive equipment necessary just you and the road or trail. It provides a point of entry for almost any level of fitness and allows one to challenge oneself and progress over the entire lifespan.

As one of the simplest forms of exercise to engage in we often take it for granted that it is a pretty complex movement that requires reciprocation and coordination from all aspects of our body.

When we observe adult recreational runners we can see that there is an unlimited variation of running forms. Some running forms look very much like running and some seem to resemble an entirely different form of motion altogether.

Variability in running form is wide in adults which is actually in opposition to what we witness in children younger than 5.

Children younger than 5, or one’s that haven’t started spending the majority of their day sitting at school typically share a more homogenous running style. Very little vertical displacement, slight anterior body lean, mid foot strike occurring under the center of mass, full leg extension and kick back all tend to be hallmarks of this age group. This age group tend to resemble the running styles of professional track athletes much more closely than their recreational adult counterparts.

This all suggests, like many other mammals, that we have a pre-programmed neurological pattern of running that is typical throughout our species. Unfortunately this pre-programming gets hidden along the way by poor body habits, lack of routine exercise, too much time spent in a chair, too much time spent in heeled shoes and many other variables that plague modern society.

With that being said, the programming is still there, inside of us somewhere, if we can just clean up the the bad habits masking it we can unleash it to our benefit.

In doing so there seems to be one obvious place to start. But before we even begin to discuss the one change that every runner can make to improve their form, lets first talk about the benefits of improved running form.

The Benefits of Improving Your Running Form

Improving your running form can offer a variety of benefits that go beyond injury prevention.

Reduced Risk of Injuries

One of the most significant benefits of improving your running form is a reduced risk of injuries. Poor running form can place excessive stress on certain parts of the body, leading to injuries such as shin splints, knee pain, lateral hip pain, ITB syndrome, and Achilles tendonitis. By improving your running form, you can reduce the risk of these injuries and keep yourself healthy and injury-free.

Improved Running Efficiency

Improving your running form can also improve your running efficiency. This means you can run farther and faster with less effort. Good running form involves proper posture, a quick cadence, and a mid-foot strike. By improving your running form, you can reduce the energy you waste on unnecessary movements and focus on running more efficiently.

Better Balance and Stability

Good running form requires balance and stability, which can help you avoid falls and other accidents while running. When you have good balance and stability, you are less likely to stumble over obstacles or lose your footing on uneven terrain. Improving your running form can help you maintain balance and stability while running, making you a more confident and competent runner.

Increased Power and Speed

Improving your running form can also increase your power and speed. By focusing on proper posture, a quick cadence, and a mid-foot strike, you can engage your core and leg muscles more effectively. This can lead to increased power and speed, allowing you to run faster and with more force.

Enhanced Endurance

Finally, improving your running form can enhance your endurance. When you have good running form, you are more efficient, which means you can run longer without getting tired. Good running form also helps you use the muscles to their intended mechanical advantage making them work more optimally and efficiently.

How To Improve Running Form

There is one place to start when improving your running form. That is working on improving the relationship between the position of your stance leg to your body’s center of mass when the stance leg gets fully loaded.

The most efficient form of running happens when the stance leg gets loaded directly under the center of mass.

That means that the initial contact or foot strike should occur just slightly ahead of the center of mass. As the body moves forward over the leg, the leg will begin to accept the full weight of the body. If acceptance of the full weight occurs directly under the center of mass less energy will be lost and ground reaction forces will become more vertical resulting in less shearing forces or strain to your body.

Drills To Improve Loading And Foot Strike

The two drills that are staples at improving foot strike position are the A Skip and B Skip. These two drills focus on the foot landing and loading directly under the COM. The B skip differs slightly in that it exaggerates the activation of the hamstring just prior to foot strike.

To implement these drills walk out about 10 yards of space and practice, first starting slowly and then increasing the speed as you feel comfortable. At no time should you sacrifice form and precision for speed.

Do a few rounds of each drill prior to your run. This way you will have already primed your body to load under your center of mass prior to your run. The run then becomes a reinforcement after the drills.

For a demonstration on how to properly perform an A Skip and B Skip check out these short but great videos staring two local track legends, Navy Director of Track and Field/Cross Country Jamie Cook and Olympian/wide receiver Devon Allen:

A Skips

B Skips

The Science Of Making Long Lasting Changes

Can you remember back to when you first started riding a bike? Or when you first learned to throw a ball? Better yet, maybe you have tried taking up a new sport recently?

Learning something new can be a fun and exciting time. It can also be a frustrating time . The desire to be good is usually meet with the reality that practice makes perfect.

The initial stages of playing a new sport is usually never a pretty sight and often requires a lot of concentration.

As a parent of young children I’m able to witness this first hand. Watching my son learn to throw a ball or ride his bike has given me the opportunity to see the progression of motor learning and neuroplasticity again first hand.

Playing “catch” with my son early in his throwing career was really more an act of chasing the ball all over the yard rather than catching. But with time he has been getting more and more accurate and his form is starting to resemble something fairly textbook.

His improved accuracy and efficiency is a direct result of motor learning and neuroplasticity.

We all know practice makes perfect, but what are the actual mechanisms of practice that make us better?

Motor Learning & Neuroplasticity

Motor learning and neuroplasticity are what’s going on behind the scenes when we practice. When we practice a new or old skill we strengthen the synaptic connections within the nervous system.

With time and practice something as complex and difficult as throwing a ball can become automatic. Some people can even get so good at it that they can throw 100mph and be accurate within an inch of where they are aiming. These strong synaptic connections are what we talk about as having a good “mind-muscle connection.”

Particular synaptic connections are always fairly task specific however. This means that depending on our history and what activities we have been exposed to, it may be easier or harder to perform a different or new task.

For example, someone who is a professional baseball player will probably be pretty good at throwing a football too. Not as good as a professional quarterback, but certainly better than a cornhole player. That’s because the overhand motion of throwing a football and baseball are more similar than the under hand motion of throwing a cornhole bag.

This works the same with any activity we do. If an activity is similar we can pull from our motor memory and we will be more likely to succeed. If it’s something completely different we will likely be challenged. Along with the initial challenge, it will also take a lot longer to get proficient at this new activity.

The Mind-Muscle Connection Works Both Ways

The strengthening of synaptic connections are mostly indiscriminate. We will strengthen the connections that we consciously or subconsciously reinforce.

We will strengthen synaptic connections that we tell our brains based on the choices we make, the habits we have, or the routine patterns that our bodies move in.

Not all strong synaptic connections are good for us though. Do you have a bad habit that you just can’t break? Well it’s hard to break because those synaptic connections associated with the bad habit have been reinforced for so long.

Having trouble eating healthier? Your fighting against long standing synaptic connections.

Having pain? We all cultivate default movement patterns in our bodies. Pain that starts to appear without any apparent cause or reason can usually be associated with suboptimal movement patterns. Often getting out of pain means strengthening a new mind-muscle connection so that you can move more optimally and efficiently.

But just like learning a new activity it may take time to change your old movement patterns.

The message here is that it takes conscious effort to cultivate and strengthen new synaptic connections. With routine effort it takes an average of 4-6 weeks. Depending on how long standing the old pattern is however, it could take upwards of 10 months.

Regardless of age or ability everyone can make new connections though. There are studies that even show neuroplasticity in people with dementia and those who have suffered a severe stroke.

No matter how long it takes to form a new habit or movement pattern, once that becomes the dominant synaptic connection it will stay that way for as long as you reinforce it.

So be consistent with your effort and look towards the future with the work you’re doing in the present.

Neuroplasticity & Pain

Learning occurs at every level. Pain is no exception. Through neuroplasticity we can learn to be in pain, but we can also unlearn pain. That’s a whole other topic though and one you can read more about here

Have any questions about this blog post or looking to start building some new synaptic connections of your own? Contact us, we are glad to help!

References:

Chang Y. Reorganization and plastic changes of the human brain associated with skill learning and expertise. Front Hum Neurosci. 2014 Feb 4;8:35. doi: 10.3389/fnhum.2014.00035. PMID: 24550812; PMCID: PMC3912552.

Dayan E, Cohen LG. Neuroplasticity subserving motor skill learning. Neuron. 2011 Nov 3;72(3):443-54. doi: 10.1016/j.neuron.2011.10.008. PMID: 22078504; PMCID: PMC3217208.

Shaffer J. Neuroplasticity and Clinical Practice: Building Brain Power for Health. Front Psychol. 2016 Jul 26;7:1118. doi: 10.3389/fpsyg.2016.01118. PMID: 27507957; PMCID: PMC4960264.

What Actually Happens When You Have a Sprain?

Imagine you’re playing basketball; you jump up for a lay up and as you watch the ball fly towards the hoop, your foot lands awkwardly on the court and you twist you ankle inwards. Ouch!

A lot of us have experienced a similar situation that resulted in a sprained ankle.

Have you ever wondered what a sprain actually is or what goes on in your body after it happens?

A sprain is a stretch or tear that happens in a ligament. A ligament is fibrous connective tissue between two bones. On the outside of our ankle, we have several main ligaments including the anterior talofibular ligament, the posterior talofibular ligament, and the calcaneofibular ligament.

Luckily our bodies are masters at healing and are able to get us back up and moving relatively quickly. How quickly depends on the degree of sprain, which can be graded as mild (Grade 1), moderate (Grade 2), and severe (Grade 3).

A Grade 1 tear includes mild stretching and slight tearing of the ligament.

A Grade 2 tear includes partial tearing of the ligament with an increase in joint motion.

A Grade 3 tear includes a full tear of the ligament with an increase in the joint motion.

So you’ve had a sprain…. where does our body go from there?

There are 3 phases of tissue healing that our bodies go through to repair the ligament:

1. Inflammatory: A blood clot is formed and inflammatory agents are released. An initial scar is created (0-14 days)

2. Proliferative: Immature collagen production starts to fill in (week 2-4)

3. Remodeling (week 3-26): Scar matures and forms dense connective tissue, the initial weaker collagen is replaced by another stronger form

What can you do during this process?

You can do all the basics to help your body heal. The simple things like getting adequate hydration, nutrition, sleep, and rest.

Depending on the degree of sprain, and how long it’s been since it happened, gentle motion and walking are encouraged.

For detailed instructions from there, you should seek help from your local PT :o)

Go Solo Interview With GOfit

I was recently interviewed by Go Solo, a web based editorial and education platform that supports entrepreneurs and small businesses. They wanted me to share my experiences starting a small physical therapy practice.

You can find the interview here.

The interview had me reflecting on why Cara and I decided to start GOfit in the first place.

When we started working as physical therapists we soon recognized that the traditional model of physical therapy was broken. It leads to profession wide burn-out, compassion fatigue, and diminishing patient outcomes.

We knew we couldn’t make an entire 30+ year career the way we were working. We believed in the power of physical therapy and we knew there had to be a better way.

For us it’s never been about money. We want to survive of course, but its never been about maximizing profits. I know that’s blasphemy for a business owner to say, but it’s true.

We wanted to create a sustainable business model and lifestyle that would ultimately let us be the best version of ourselves and in turn give our patients the best version of ourselves. We wanted to give our patients the time and attention to be heard and cared for. We wanted to create something where everyone wins. That was our mission starting out and that is what we intend to keep doing.

What Is The Ideal Squat Form?

Look anywhere over the internet and you’ll find anyone and everyone espousing an ideal squat form so well that can seem utterly convincing.

But is it really that simple? Is there really only one perfect way to squat that every single person should be trying to replicate?

How can one specific way of squatting really fit every single body type out there?

These are tough questions and I don’t think the answer lies in a one-size-fits-all answer.

There are too many body types out there; narrow hips, wide hips, heavy, thin, tall, short, short torso and long legs, long toro and short legs, the list goes on too long for there to only be one ideal way to squat.

The geometry of the head of the femur varies between people and this factor alone can cause squat form variations.

Here is a better idea: Instead of saying there is only one ideal way to squat…

Let’s say there are ideal principles that we should apply to each individual that will then dictate their very own ideal squat form.

So what should be our guiding principles?

1.) Everyone should be able to keep their core engaged and their spine in neutral throughout the entire squat.

• This includes the bottom position of the squat. It is not normal for someone to posteriorly pelvic tilt their pelvis at the end range of squat. This is commonly called a “butt wink” and it is not ok to have your spine move like that under load.

2.) Everyone should feel balanced during the entire squat while avoiding the sensation of falling or leaning in any direction.

• The squat you do without weight on your back should look pretty much the same as when their is weight on your back. The weight of the bar should never be keeping you from falling over.

3.) No one should experience pinching in their hips

• Pinching can be a sign that the hips need to rotate outwards or the stance needs to be wider.

4.) Everyone should be able to keep the weight they are lifting, regardless if the weight in their hands or on their backs, directly over their center of gravity.

5.) No matter the amount of rotation in the hips, everyone should be able to keep their knees in the same plane (pointing in the same direction) as their hips and ankles, throughout the entire movement.

In theory this list can cover a wide range of squat set ups (think wide stance vs. narrow stance) while all being considered “ideal.”

Nowhere on this list is it stated that feet should be a certain width apart or rotated at a certain angle. That’s because a one-size-fits-all squat form is unrealistic.

Some of the strongest athletes on the planet are a testament to this. Spend time watching elite Olympic weightlifters or powerlifters and you will see the variability in stance width and rotation of the hips. However they are all able to maintain a neutral and engaged core and stay balanced throughout the lift.

If you are having pain or difficulty with squatting let us know and we can surely help you out!

Do You Have An Ankle Sprain Or Want To Prevent One?

Ankle sprains are quite common. I bet many of you reading this have had an ankle sprain.

I remember when I sprained my ankle…. I was playing an intense game of racquetball. I jumped up in the air to hit a high ball, really extending my arm upwards. Then I came down, landing on the outside of my ankle as my foot rolled under me. Ouch!

Let’s just say that being a physical therapist now, I certainly would have treated my ankle sprain differently back then.

So, do you always have to go to physical therapy after an ankle sprain?

I would argue yes. Even with a low-grade ankle sprain it is advantageous to go to physical therapy to help get you back on your feet ASAP and minimize any impairment.

If you had a moderate or severe ankle sprain, then physical therapy is certainly recommended to improve recovery and prevent any potential long lasting functional impairments.

A simple ankle sprain left untreated can sometimes turn into recurrent ankle sprains and chronic ankle instability. Next thing you know you can start feeling like you have “weak ankles” and start second guessing doing the activities you love.

So even with a relatively benign ankle sprain it can be a good idea to go to physical therapy. Some research estimates that 29% of ankle sprains in high school students can become recurrent or lead to chronic ankle instability (Holland).

What are some risk factors that predispose people to ankle sprains?

1. Previous injury: Although conflicting research is available there are several research studies that indicate that people with a history of a lateral ankle sprain are more likely to have another (and we would tend to say this is what we see clinically).

2. Sex: Females have an increased risk

3. Age: Every 5 year increase from 15-40 years old was found to increase the odds of sustaining a lateral ankle sprain in elite football and basketball players (Pourgharib)

4. Those with generalized hypermobility demonstrate an increased risk

5. Limited or asymmetrical range of motion in both ankles: More specifically, limited motion moving the door upwards (called dorsiflexion)

6. Decreased hip strength: specifically of hip abductors and hip extensors

7. Poor performance on single leg clinical tests: This includes single leg balance and squatting tasks

8. Activity: higher risk with court sports and during the second half of games (soccer, Gaelic football, American football, rugby, futsal) (de Noronha)

What can you do to reduce your risk?

1. Work on balance training (Bellows). Often times “weak ankles” aren’t actually weak. Meaning they are just as strong as any other set of ankles out there. What they really are is uncoordinated and that’s why they feel weak in certain positions.

   Balance training is the best way to improve ankle coordination. Start with the simple exercises below and then progressively increase the challenge. To do this try to replicate the positions that you would be in when playing your sport. This will have a greater carryover to the activities that you love doing.

2. Perform unilateral(single leg) functional strength training. Working on single leg squats, lunges, side lunges, and single leg jumps into multiple planes are a great way to improve coordination and control in activities that replicate sport. The key when training is to focus on strict form to ensure that this carries over to the court or field.

3. Improve your conditioning. There is a reason that more injury occurs in the second half of a game. Because people are tired. And when people get tired and lazy they start to lose good form and coordination. Improving your conditioning will allow you to better tolerate the length of activity and reduce your risk for injury.

4. For those with increased risk factors as noted above: using taping techniques or ankle bracing when participating in high-risk activities may be of benefit (Leppanen)

So what comes next if you sustain an ankle sprain?

Physical therapy, naturally!

Recommended treatments include:

1. In the initial stages, progressive weight-bearing is important and bracing and taping may be necessary. Immobilization should only be used in severe cases and for 10 days maximum.

2. Exercise: A tailored exercise program is important to address each person’s deficits individually. Balance training, neuromuscular re-education, and postural re-education are recommended. (Martin)

3. Sport and occupation-specific training to help introduce specific movements and postures that you need to do on a regular basis

4. Hands on treatment: Manual therapy to help reduce pain and increase range of motion

Here are some very simple and basic balance exercises that you can do to help prevent an ankle injury. (Of course, we can make them much harder if necessary depending on your skill level!)

1. Balance on a single leg while reaching the other leg forwards, sideways and backwards to tap an object outside of your base of support. The further you have to reach, the harder the exercise is

2. Balance with your feet together eyes closed. Try to hold for 30 seconds. Too easy? Try it again with one foot in front of the other.

3. Balance on a single leg while doing upper extremity exercises like rows with a tough resistance band

Holland B, Needle AR, Battista RA, West ST, Christiana RW. Physical activity levels among rural adolescents with a history of ankle sprain and chronic ankle instability. PLoS One. 2019;14:e0216243. https://doi.org/10.1371/journal.pone.0216243

Pourgharib Shahi MH, Selk Chaffari M, Mansournia MA, Halabchi F. Risk factors influencing the incidence of ankle sprain among elite football and basketball players: a prospective study. Foot Ankle Sec. 2020:1938640020921251. https://doi.org/10.1177/1938640020921251

de Noronha M, Lay EK, McPhee MR, Mnatzaganian G, Nunes GS. Ankle sprain has higher occurrence during the latter parts of matches: systematic review with meta-analysis. J Sport Rehabil. 2019;28:373-380. http://doi.org/10.1123/jsr.2017-0279

Bellows R, Wong CK. The effect of bracing and balance training on ankle sprain incidence among athletes: a systematic review with meta-analysis. Ing J Sports Phys Ther. 2018;13:379-388

Leppanen M, Aaltonen S, Parkkari J, Heinonen A, Kujala UM. Interventions to prevent sports related injuries: a systematic review and meta-analysis of randomized controlled trials. Sports Med. 2014;44:473-486. https://doi.org/10.1007/s40279-013-0136-8

Martin RL, Davenport TE, Fraser JJ, Sawdon-Bea J, et al. Ankle stability and movement coordination impairments: lateral ankle ligament sprains revision 2021. J Orthop Sports Phys Ther. 2021;51(4):CPG1-CPG80.http?//doi:10.2519/jospt.2021.0302

You Should Be Prioritizing Sleep, Here's Why

We write about a lot of different topics on this blog. Topics that you might not expect from a physical therapy practice. Thats because having a healthy body is more than just exercise. Having a healthy body is a lifestyle choice. The intention of this blog isn’t to start a lifestyle revolution (although I could definitely get into that), it’s to give you every advantage to living your best life.

Which brings us to the topic of sleep.

Sleep is important in regulating almost every system in the body.

From the cardiovascular system, to the endocrine system, the nervous system, and of course the musculoskeletal system, sleep could be considered the great regulator.

Getting good sleep does more than just make you feel awake and refreshed. Trust us, there is a lot going on behind the scenes.

In a previous blog post we talked briefly about the benefits of a good night’s rest. In this blog post we are going to dive a little deeper.

Why You Should Take Sleep Seriously

Chronic sleep deprivation is listed by the World Health Organization as a carcinogen. Re-read that last sentence and think about that for a second, chronic sleep deprivation is in the same category as smoking. Smoking! And I’ll be willing to bet that sleep is the first thing to get sacrificed when your schedule gets busy.

I know what your thinking: ‘Oh chronic sleep deprivation must mean only getting a couple hours a night.’ Not true, chronic sleep deprivation is defined as getting less sleep than the recommended 7 to 9 hours a night. Constantly cutting your night short by a half hour could have profound effects on your health over your lifetime.

We are not just talking about insomnia here. People with insomnia have trouble sleeping and thus don’t get a lot of sleep. We are talking about people who have no problem sleeping but because of behaviors, lifestyle, or obligations are choosing to get less sleep.

I know what else your thinking: ‘Oh I’m one of those people who only needs 6 hours of sleep.’ Sure, those people do exist but it’s really rare, like winning the lottery rare or getting struck by lightening rare. Odds are you’re not one of those people and your morning coffee shouldn’t convince you otherwise.

What Are The Consequences Of Bad Sleep

Aside from the obvious symptoms like poor energy, inability to concentrate, slowed thinking, poor memory, stress, anxiety, and irritability, there are other less obvious consequences to chronic sleep deprivation.

Chronic sleep deprivation makes it difficulty to regulate the cardiovascular and endocrine system resulting in an increased risk of coronary artery disease, heart attack, stroke, and diabetes.

People who get less sleep have greater difficulty maintaining a healthy weight and maintaining normal hormonal levels.

People who get less sleep have weakened immune systems and are much more likely to experience mental health conditions like depression, anxiety, and bipolar disorder.

People who sleep less are at much higher risk of developing pain and having their pain worsen.

How Can Sleep Affect Pain?

There are really two parts to this answer. First, as we discussed in another blog post, pain is triggered by your brain’s perception of threat to the body. From what you read above, it should be pretty clear now that lack of sleep is a threat to your body. It threatens your mind and your body. If you are putting your body under constant threat from lack of sleep you will be more likely to experience pain. In an under slept state your body’s alarm is primed to go off.

Sleep is the time when our muscles, ligaments, bones, and articular cartilage recover and repair from the day. This brings us to the second part of the answer. If you are not allowing your body the time it needs to recover from the day’s activity then you will begin operating at a deficit, where you’re breaking down at a faster rate than you are repairing. Operating at a deficit like this could put you at higher risk for injury.

We are not saying that sleep is the cure to all pain and maladies. There are people who get great sleep and will still experience problems at times. But you really want to give yourself the best opportunity to live the healthiest life possible to perform, and recover at your greatest ability. With all other factors being equal you are not only going to recover better and faster from an injury or illness, you will be better at preventing injury or illness just by giving yourself the gift of better and longer sleep.

Tips For Getting Better Sleep

• Routine: Establish a consistent bed time and try as hard as possible not to stray from it. Your body thrives on routine and if you can build a routine that matches your circadian rhythms you will see your sleep quality skyrocket.

• Sleep hygiene: Turn off your TV, your devices, and anything that emits blue light at least an hour before bed. Put the house lights down low and start to unwind.

• Stretch before bed: Gentle stretching before bed can be a great way to start to peel the tension off your body from that busy day and get into a relaxed mood.

• Meditate: Practice 10 minutes of mindfulness meditation by just focusing on the slow flow of your breath. If you’re strapped for time, try to combine your stretching and mindfulness practice by focusing on your breath as you relax into different stretches.

• Morning sunshine: Get direct sun exposure when you first wake up. Getting 10-20 minutes of direct sun exposure in the morning is a great reset to your circadian rhythms.

More Resources:

American Academy of Sleep Medicine

National Sleep Foundation

Is Shoulder Pain Holding You Back?

Resistance training (aka strength training) for you shoulder may be key…. but not only for the reason you think!

How many of us have been sidelined by shoulder pain?

Did the pain hold you back from throwing a ball, exercising, picking up a heavy piece of luggage, reaching into a high cabinet, or washing your car?

One possible source of shoulder pain is rotator cuff-related shoulder pain (RCRSP). This category not only includes pain from things like rotator cuff tendonitis and tendon tears, but also from other sources in the shoulder like bursitis.

In their recent article Powell, J. and Lewis J. highlight that with RCRSP there are often multiple structures within the shoulder that can contribute to a person experiencing pain, versus just one primary structure.

So, what exactly is the rotator cuff and what does it do?

The rotator cuff is comprised of four muscles that assist in stabilizing the ball and socket of the shoulder at rest and during movements. The four rotator cuff muscles include the supraspinatus, subscapularis, infraspinatus, and teres minor.

These four muscles work synchronously whenever we do a movement with our shoulder, keeping the ball firmly in the socket of the shoulder.

What is a bursa?

A bursa is a fluid filled sac that acts as a cushion between two structures to help reduce friction. There are a number of places throughout the body that need this kind of help and as a result we have tons of bursa throughout our bodies.

In your shoulder an example of this is the bursa between your acromion (a bone) and your supraspinatus tendon. The bursa here helps the supraspinatus tendon from rubbing on the under surface of the acromion during arm movements.

Now that we know what some of the structures in the shoulder are, what Can we do about shoulder pain?

Recent clinical practice guidelines recommend non-surgical management and education as the main treatment method for RCRSP (Powell and Lewis) (Vandvik, Lahdeoja, Ardern, et al.).

This is great news because we know our body has the amazing ability to heal itself.

One form of Non-Surgical management for shoulder pain is resisted exercise, or strength training.

There are so many ways in which strength training can benefit your shoulder including improving muscle mass and strength, improving muscle coordination and timing, and improving mechanics at the shoulder.

But resisted exercise can do so much more:

Strength training helps to reduce pain itself, improve confidence, influence systemic inflammatory chemicals, improve quality of life, and changes the way we think about pain (Powell and Lewis).

Who knew strength training could have so many benefits?

Here are some simple exercises for the shoulder that you can try yourself:

1. Serratus slide: First place a looped band around your wrists. Then, pull your wrists apart so that they are shoulder-width apart. Your elbows should also be shoulder width. Keep your elbows bent at a 90 degree angle during the entire exercise. You should be pressing the band outwards, pressing the wrists away from each other and holding this same distance during the entire exercise. Start with your wrists at the level of your elbows. Slowly move your arms so that your wrists are now at the level of your shoulders. Then lower your arms back down to the starting position. Repeat 15-20 times, 2-3 sets.

2. Rows: Anchor a resistance band to a stable object. Hold one side of the band in each hand. Pull the arms back with the elbows leading and slightly squeeze your shoulder blades together. Do not allow your elbows to go very far past your body. Then slowly return to the starting position. Repeat 15-20 times, 2-3 sets.

3. Y’s: Lying on your stomach with your arm hanging off of a bed, lift your arm up on a diagonal with your thumb pointing towards the ceiling. Think about your shoulder blade moving down and back towards your opposite back pocket. Repeat 15-20 times, 2-3 sets.

These three exercises are great exercises for improving muscle strength, timing, and coordination of the entire shoulder girdle.

Powell JK and Lewis JS. Rotator Cuff-Related Shoulder pain: Is it Time to Reframe the Advice, “ You Need to Strengthen Your Shoulder”? J Orthop Sports Ther 2021, 51:4, 156-158.

Vandvik P O, Lähdeoja T, Ardern C, Buchbinder R, Moro J, Brox J I et al. Subacromial decompression surgery for adults with shoulder pain: a clinical practice guideline BMJ 2019; 364 :l294 doi:10.1136/bmj.l294