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How Sports Chiropractors Prevent Injury in Runners

By Sabrina Grotewold Active.com If you think chiropractors simply "crack" backs, you're not alone. Scott Duke, D.C., owner of Duke Chiropractic in New York City, is accustomed to hearing this misconception. "Sports chiropractors who are trained in muscle work, such as Active Release Technique (ART) and Graston, are probably the best manual therapists for preventing injury and optimizing performance," says Duke. "That's why theres always a sports chiropractor on Olympic and professional sports teams." For runners, chiropractic can be used for injury prevention because it emphasizes proper alignment of the spine and pelvis. The most common running-related injuries Duke sees in his patients, which range from recreational runners to Olympians and New York City Marathon winners, are plantar fasciitis, Achilles tendonitis, IT Band Syndrome, patella (knee) tracking problems and hip bursitis. More: 4 Running Setbacks and How to Handle Them Duke's rst step in treating these injuries: Search for misalignment. "Malalignment of the spine can cause unnecessary tension on one particular body part versus an equal distribution of pressure," he says. "I can't take care of anyone's chronic IT band problem without making sure their pelvis is in as perfect alignment as it can be. Otherwise, itll continue to wear, tear, and put strain on that one particular body part."

What Causes Improper Alignment?

Major causes of improper alignment include running in the same direction on the same course every day; running often slanted surfaces, such as a beach; and not replacing shoes every few hundred miles. Fix these training errors that cause misalignment with a few simple tweaks: Vary your running surfacepavement, track, asphalt, grass, dirt, wood chipsa few times a week, and youll naturally run on different courses. Run as close to the water as possible when on the beach, as the sand tends to be more at there. Buy two of the same type of running shoes, and switch between the pairs. "There's a lot that contributes to improper spine or pelvic alignment, and sometimes it has nothing to do with running," says Duke. "It has to do with a day job, where you sit in one particular position all
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day and then go for a run. The muscles are in a state of tightness on one side and are lengthened on the other, and then you go for a run and your pelvis shifts." Switch positions and seats, if possible, every 30 minutes during the day. Varied posture remains the best posture, according to Duke, so cross your left leg, then a half-hour later, cross your right leg; sit on top of your ankle, sit straight, and even slouch. Try sitting on a stability ballit challenges your abdominal muscles and allows you to rock your pelvis, which lubricates your joints. Switch between a chair and stability ball, stand, and take short walk breaks if you work in an ofce. "One position for various amounts of time is disastrous for the spine," says Duke. Whether you run in the morning soon after rising, or in the afternoon/evening after sitting all day at work, a proper warm-up also helps prevent injury. More: How to Detect a Running Injury

Warm-up and Stretches to Prevent Injury

After years and years of treating patients for the majority of the same injuries, and recognizing patterns such as not warming up and/or stretching properly, Duke developed an app, called W.E. Run, that demonstrates warm-up and stretching exercises. "You need to warm up the hip in circular patterns, and you need to warm up the spine in rotary movements," says Duke. "You need to wake up the outer buttock muscles, called the glute medius, in order to keep your pelvis stable when you go for a run. Those are the essentials." The best injury-preventing warm-up for runners includes exercises that support the spine, get you locomotive, lubricate the joints, "and break up the intra-articular adhesions that get stuck in the joint and prevent it from uid mobility," says Duke. Your hip socket is a great exampleyou need to warm up your hips so they can move as freely as possible to respond to slips, quick changes in stride and uneven terrain. More: 4 Dynamic Warm-up Exercises for Runners Duke's warm-up takes two minutes to complete; do 10 or so reps of each exercise and move to the next. Start each exercise in a standing position. Diagonal leg swings: Hold on to the wall or a chair for balance. Extend your left leg straight to the side and swing it from side to side in front of your body. Repeat on right leg. Hip gyros: Hold on to the wall or a chair for balance. Raise the left leg and, keeping the knee bent, circle the leg inward for 10, then outward for 10. Repeat on the other leg. Side lunges: Start with feet together. Lunge to the left, keeping your right leg straight and extended and your left knee bent. Let your weight shift a bit back to keep pressure off your knee. Repeat, and then complete on right leg. "This wakes up the glute medius, which helps

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keep your pelvis level while running," says Duke. Pelvic rocks: Rock the pelvis from front to back and side to side. "This lubricates the joints of your lower back," says Duke. Backstroke arm swings: Swing your straightened arms behind you in a backstroke swimming motion. "There's a slight rotation that occurs in the shoulders when running," says Duke. Thoracic twists: Twist your torso to the left, twist to the right, and repeat. This movement activates your rib cage. Move dynamically before running to prepare the body, and stretch after to ward off injury. "You never want to stretch before the run because it de-activates the muscles you want active to propel you forward," says Duke. "But it's hazardous not to stretch. Do it after you run, but it doesn't have to be immediately afteryou can do it later in the day." Stretch the following muscle groups: hamstrings, calves, quadriceps, hip exors, quadratus lumborum ("hip hikers"), piriformis and low back, and make sure to do so every day that you run. Stretch for about 30 seconds on each side for each exercise. A complete stretching routine should take about ve minutes. Combined, the warm-up and stretches occupy seven minutesnot a lot of time compared to the hours you could spend on injury rehabilitation. More: 5 Injury-Prevention Stretches for Runners Sign up for your next race.

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