5 Things Every Runner (and Athlete) Should Have

The running population, myself included, puts an inordinate amount of time and energy into designing our ideal workout program.  This may be periodized with a specific race in mind or varied with a few key races built into a training cycle.  We assess, re-assess, and often times over-analyze whether the amount of mileage planned is too much or too little and whether the paces for workouts are realistic.  We spend money on training shoes, racing shoes, running gear, and travel to destination races.

However, we often de-emphasize or neglect the aspects outside of the actual running that can help us get the most out of our training plan and race preparation.  Below I have listed what I consider the top 5 things every runner should have or consider outside of their actual running plan.

1.  Injury Fund:  Running by nature is a repetitive activity. If you perform the sport long enough, an overuse injury should be expected.  The sport is also addictive.  We use it as a stress relief, a means to stay healthy, an avenue to fulfill our competitive drive, and a way to explore.  When we admit that something doesn’t feel right or is actually painful, we automatically assume that a prescription of rest is on the horizon.  This assumption prevents many runners from seeking help because they worry their training cycle will be interrupted.

However, our fears could be alleviated and a properly estimated time to recovery given, if we had an accurate clinical assessment/diagnosis from the beginning.  Delay to diagnosis will significantly affect the treatment outcome and healing time-frame.  Seek qualified advice from an orthopedist, physiatrist, physical therapist, or certified sports chiropractor that is knowledgeable and versed in your sports’ training demands.  Imaging (Xray, MRI, CT, diagnostic ultrasound, etc) can play a key role in assisting with the injury management plan (5).  If imaging is recommended, make sure it is justified and is being ordered to confirm a clinical suspicion.  For an overview on certain running injuris where early imaging is the preferred course of action, please review to Dr. Bergman and Dr. Fredericson’s post on the topic:  MRI finds runners’ overuse injuries.

2. Walking Boot – I know, I know, it’s the scarlet letter for an athlete.  Wearing a walking boot is like begging people to ask the question “What happened to you?”.  But, the walking boot can be a key recovery weapon for your arsenal.  Keep it for rainy days, when the long run didn’t go as well as you would’ve liked because your foot started tightening up or you felt a “weird twinge” in your achilles during your last 400m repeat.  Having a walking boot on hand can also be a saving grace when you start feeling a hot spot on the top of your foot or inside part of your shin before it turns into a full-blown stress response.  Additionally, after receiving aggressive soft tissue therapy, a partial weight-bearing walking boot for 24-48 hours during normal daily activities can help take the pressure off the lower leg musculature for more efficient recovery as it creates an evenly distributed foot loading pattern. (9)

3. Post-run mobility routine – I’ll preface this by saying I’m not a big fan of static stretching, yoga, or foam rollers (I’ll get out a post soon as to why).  With that being said, I am a big fan of dynamic stretching and/or joint capsule mobility exercises.

With running being a ballistic, repetitive, and unstable form of exercise, it’s natural for muscle tension to build and joint stiffness to occur as a result.  Our body is a system of levers (muscles) with pivot points or hinges (joints) that allow us to move.  Increasing the speed of that movement requires balanced efficiency within joints.  They need to have both the freedom to glide while being dynamically supported.  Maintaining capsular mobility without compromising stability is important to ensure normal muscle firing in the tissues that support the joint so that excessive strain isn’t being placed on the levers guiding the movement. (8)

The hip in particular is the centerpiece of the movement symphony.  It guides the angles and loading patterns for the joints below and absorbs much of the force for the joints above.  Synchrony and efficiency can go a long way in reducing injury risk and increasing running economy.  (3,7,12,13)  For a simple 5 min example of some dynamic hip mobility exercises, view a simple routine I give patients:  hip mobility routine.  These exercises would be performed 8 reps each side in slow controlled motions after workouts.

4 . Access to a Swimming Pool –  This one relates to the concept of the post-run mobility routine, but has a twist.  Walking in the shallow end of the pool for 10min a couple times a week after workouts or long runs can help create joint movement in a less than 100% weight-bearing environment.  This creates similar benefits to dynamic stretching routines, where imbibition takes place (a pumping of the joint to help clear old fluid and bring in new fluid that keeps the joint lubricated and pliable).  Additionally, there is a pressure gradient that forms helping to move lymph fluid.

For example, if you are standing  at a depth of 4.5 feet of water, you are creating a pressure gradient equivalent to 77 mmHg at your calf (approx. 3.5 feet below the surface), which is over 2x’s greater than standard graduated compression socks or sleeves (which are usually around 22-32 mmHg).  Now add motion to that pressure gradient by walking and you create an efficient way to clear excess inflammation post-workout without blocking the adaptive response.

In contrast, ice bathing post-exercise can block the adaptive response of the workout by creating excessive vasoconstriction (a tightening of the blood vessels) in the tissue preventing the inflammatory response, key component for tissue adaptation (read more about this from an earlier post here), from occurring while also delaying fluid clearance.  The big negative here is time.  I understand that it’s tough to get to the gym, change, get wet, change again, and get home.  But, adding this component in 1-2 x’s per week, especially in the evenings following hard workouts or long runs, can help reduce your injury risk by providing an efficient means of soft tissue recovery and lymphatic fluid clearance. (1,2,4,6)

5. Ancillary Strength Routines – Strength work is important for every runner.  The high school aged and younger competitive runner will develop proper balance, coordination, mobility, stability, and core endurance by incorporating a properly designed “strength” program to teach them how to move efficiently.  The experienced and older athletes will maintain aspects of power, speed, tissue elasticity, and joint control by utilizing strength work to support their adrenal system and and promote recruitment of both local and global stabilizer muscles. (7,8,10)  But, in both cases, the program must be progressive and timed depending on the goal of the workout stimulus and the phase of training.  For a simple and generalized strength training progression, read this post from Coach Jay Johnson on the topic: progression of strength training for runners.

These 5 components can carry significant weight when trying to optimize your training and recovery.  We place a ton of emphasis on getting the most out of our performances and dwell on the ones that don’t go as well as we like.  Rather than being stubborn or neglectful of these components, be attentive and do the little things that will enhance and possibly salvage your training cycle.


  1. Bleakley, Chris M., and Gareth W. Davison. “What is the biochemical and physiological rationale for using Cold Water Immersion in Sports Recovery? A Systematic Review.” British Journal of Sports Medicine (2009): bjsm-2009.
  2. Dorit Tidhar, B. P. T., Jacqueline Drouin, and Avi Shimony. “Aqua lymphatic therapy in managing lower extremity lymphedema.” Journal of Supportive Oncology 5 (2007): 179-183.
  3. Heinert, Becky L., et al. “Hip abductor weakness and lower extremity kinematics during running.” Journal of Sport Rehabilitation 17.3 (2008): 243.
  4. Jakeman, J. R., R. Macrae, and R. Eston. “A single 10-min bout of cold-water immersion therapy after strenuous plyometric exercise has no beneficial effect on recovery from the symptoms of exercise-induced muscle damage.”Ergonomics 52.4 (2009): 456-460.
  5. Johansson, Christer, et al. “Stress fractures of the femoral neck in athletes The consequence of a delay in diagnosis.” The American journal of sports medicine18.5 (1990): 524-528.
  6. Leeder, Jonathan, et al. “Cold water immersion and recovery from strenuous exercise: a meta-analysis.” British Journal of Sports Medicine (2011): bjsports-2011.
  7. Leetun, Darin T., et al. “Core stability measures as risk factors for lower extremity injury in athletes.” Medicine & Science in Sports & Exercise 36.6 (2004): 926-934.
  8. Mann, Douglas P., and Margaret T. Jones. “Guidelines to the implementation of a dynamic stretching program.” Strength & Conditioning Journal 21.6 (1999): 53.
  9. North, Kylee, et al. “The effect of partial weight bearing in a walking boot on plantar pressure distribution and center of pressure.” Gait & posture 36.3 (2012): 646-649.
  10. Nadler, Scott F., et al. “Hip muscle imbalance and low back pain in athletes: influence of core strengthening.” Medicine & Science in Sports & Exercise 34.1 (2002): 9-16.
  11. Peiffer, Jeremiah J., et al. “Effect of cold water immersion after exercise in the heat on muscle function, body temperatures, and vessel diameter.” Journal of Science and Medicine in Sport 12.1 (2009): 91-96.
  12. Powers, Christopher M. “The influence of abnormal hip mechanics on knee injury: a biomechanical perspective.” Journal of Orthopaedic & Sports Physical Therapy 40.2 (2010): 42-51.
  13. Souza, Richard B., and Christopher M. Powers. “Predictors of hip internal rotation during running an Evaluation of hip strength and femoral structure in women with and without patellofemoral pain.” The American journal of Sports Medicine 37.3 (2009): 579-587.

Boulder Running Clinics – August 3rd

Boulder Running Clinics

On August 3rd, 2013, Boulder Running Clinics will be hosting their inaugural running clinic on the campus of University of Colorado – Boulder.  This summer’s clinic will be geared toward high school coaches with future clinics geared toward marathon running, nutrition, bio-mechanics, etc.  I am excited to be a part of this first clinic and will be given the opportunity to lecture on two important topics

  • The Science of Training the “Core” with Practical Applications for Distance Running

During this lecture, I will try to present what the current research states and how to safely and effectively implement routines into your training.

  • Endurance Training with an Injury Prevention Mindset

In this second lecture, I will be presenting on common running injuries and aspects to focus on when structuring ancillary strength routines during workouts in an effort to minimize injury risk.

Also lecturing at this clinic is Coach Jay Johnson and Dr. Jeff Messer, whose topics include: periodization, program design, the science behind endurance training, and implementing training philosophies of elite coaches.  It will be exciting to work with these outstanding coaches and hear them speak.

The cost of this clinic is only $100 with those signing up before July 15th receiving a pair of Nike shoes.  Please check out Boulder Running Clinics for more information and registration assistance.

The Alter-G: Re-inventing Training and Rehabilitation

Recently, we added the Alter-G treadmill to our clinic, the first of its kind that is open to the public in the Boulder/Denver metro area.  The decision to add this piece of equipment was a relatively easy one to make.  By incorporating differential air pressure technology to decrease the amount of weight on the lower extremities, the Alter-G allows patients to safely return to full weight-bearing running and walking quicker during the rehab process while reducing the amount of impact on the body.  Already used by many professional/collegiate sport programs and Olympic-level athletes, the Alter-G has quickly become a valuable training tool to safely progress running volumes and intensities allowing athletes to train harder and recover faster.  Whether recovering from a stress fracture, rehabbing after surgery, improving your neurological efficiency, training for a marathon, or transitioning to minimalist running, the Alter-G is fast becoming an essential part of modern endurance and rehabilitation training.  These units have recently been featured in many news publications including: Triathlete Magazine, Running Times, Runner’s World, Competitor Magazine, New York Times, Active.com, Denver Post, CBS New York, NBC New York, and Livestrong.com.  The ability to train safely, rehab quickly, and recover faster utilizing this unit is a nice luxury to have, especially with the winter weather fast approaching.  To inquire about testing out the Alter-G for free at our clinic or for additional questions, call us at 303-442-0355 or email Dr. Hansen at r.t.hansen@gmail.com.

Incorporating a Dynamic Warm-up into your Workout Routine

*Originally written for the Boulder Triathlon Club as part of their monthly newsletter

Over the past few years, research has shown the adverse effects of static stretching prior to working out.  We grew up thinking and being told flexibility was a good thing, and the best way to attain that was by putting our bodies through a stretching routine before we exercised.  However, flexibility is relative to your biomechanics and activity preference.  If you were a gymnast or kung fu master, you would rely heavily on having flexible and pliable tissue to torque your body in a wide variety of positions.  However, as endurance athletes, we need to have some tension through our tissue to create joint stability, as well as elastic momentum to propel us forward (like the recoil of a stretched rubberband).  Too much or imbalanced tension is obviously an issue that can create strain on the muscle/tendon/ligament, but too little tension or too much flexibility can create instability of the joint.

Now, where does static stretching fall into the realm of proper joint mobility and right amount of flexibility without compromising the stability?  Personally, I think in most situations you can do without static stretching as it tends to fatigue the tissue.  But, if you feel the need to incorporate some aspect of this component into your training program, the best time would be after your easy sessions. The problem with static stretching (meaning holding a stretch for a period of 30seconds to a minute) is that it can reduce eccentric (lengthening) strength and peak force of the muscles for up to 60 minutes following the stretch; you need some tension in your muscles to optimize the elastic component of the tissue during the workout, and by placing a static stretch on tissue that is not already engaged or prepared for that component, the body’s muscle spindles will reflexively activate to resist the stretch.  So, the body can actually become tighter as a protective mechanism when static stretching is performed. Therefore easier effort days would be, in my opinion, the only time to do some sort of static stretching, following your workout, as these days recovery and flexibility should be the goal, not muscle tension for performance optimization.  Prior to workouts (regardless of intensity and duration) and before/after harder and longer effort days, a dynamic routine should be implemented to properly engage and activate the tissue while minimizing the effect the stretch reflex can have.

What do I mean by a dynamic warm-up?  I typically recommend a series of lunges called the lunge matrix (from Coach Jay Johnson, developed by physical therapist Gary Gray) followed by a series of leg swings prior to any exercise.  A lunge, although inherently a strength exercise, is a terrific stimulus to activate all the muscle of the leg prior to working out.  Additionally, drills such as skipping, bounding, body squats, side walking, backwards walking/running, mountain climbers, and karaokes are all examples of dynamic exercises to get the legs prepared for the demands of your workouts.

Strength Training for Distance runners (Poll)

Today, I had a great converstation with Coach Jay Johnson about what type of strength training (if any) is appropriate for distance runners. As we spoke, we covered a wide range of topics and various opinions from different coaches, athletes, researchers, and trainers. It made me realize that the thought behind incorporating this type of work differs depending on who you ask, regardless of what current research might state. So I thought I’d throw this poll out there to see what opinions we might get back. Additionally, I’d like to open this up as a discussion with the type of workouts you currently do (if any) outside of running and why? The more comments, the better the discussion, so please leave your input.

Adding a Hip Mobility Routine as part of the Cool-Down

It’s been a while since my last blog post and part of that is because I have been consumed with the fall cross country season. This year was my first as the head coach of the Peak to Peak cross country team in Lafayette, Co. It was a pretty exciting season that saw the boy’s team qualify for the state meet placing 12th overall (after finishing second in our region, they were 5th last year) with a ridiculous 25 second pack time, as well as one girl (who had never run cross country before) qualify individually and place 53rd overall. One of the biggest aspects of our training this season was the addition of a number of ancillary routines pre and post-workout with each having a specific purpose or goal. One of those routines is what I called the hip mobility progression. I picked this up from Coach Jay Johnson (he calls it the cannonball cooldown)and modified it for the purpose of making it a mobility routine. The reason I modified his original routine was some of the exercises in the original routine I would consider strength work (which we do in some of the other routines) rather than strictly mobility and because there would be instances when time becomes an issue, so I try to limit each routine to under 5 minutes to make sure we can get in the desired work. The routine that our team does is 20 reps on each leg in the following order: iron cross, scorpions, active straight leg raise, groiners, and hurdle rolls (or hurdle seat exchange from the video). Why do we do this? I look at this routine as a series of exercises to open up the hip capsule while creating dynamic flexibility in the surrounding tissues. Depending on the exercise being performed, there is a certain level of eccentric loading taking place on the hip flexors, hamstring, adductors, quads, and lumbar paraspinals. Additionally, the various exercises help prevent the hip capsule from getting impinged (that can occur during running) while avoiding over-stretching (that can happen during a static stretch where the surrounding muscles are relaxed, reducing their protective control over the joint). We would do this routine about 3 x’s/ week, typically after harder workouts or long runs, as a way to flush the tissue out. As I told Jay, of all the routines that we do, this is the one that I feel had the greatest effect in helping to keep the kids healthy throughout the season. It should also be noted, that I have given this routine to patients in practice who have experienced anterior hip impingement, excessive hamstring tightness, Psoas or Quad overactivity, and TFL/Glut Med/ITB tightness.

Providing High Octane Fuel for the Body and a New Twist on a Breakfast Staple

My wife and I have recently begun following a modified paleolithic diet, excluding a lot of gluten/wheat, incorporating minimal dairy and raw sugars, and eating mostly organic fruits/veggies and organic grass-fed or free-range meats. In doing so, we have noticed a tremendous improvement in a number of health-related aspects (such as daily energy, quality of sleep, mood, recovery after exercise, etc). Our reasons for choosing this way of eating came after reading literature on the types of toxins that are included in processed foods and the nutritional value (or lack thereof) that is found in commerically grown and raised produce and meats. We agreed that our bodies react based on the fuel we give it. So we might as well put our bodies in the best position to perform well.

However, following such a diet comes with its share of challenges. First off, it is by and large more costly and time consuming to eat this way. For example, a dozen commercially raised eggs costs around $1.99, where as organic free-range eggs may cost around $3.50. But, the saying “you pay for what you get” rings true. The omega 3 (essential fatty acids with anti-inflammatory capabilities) to omega 6 (unsaturated fatty acids that in excess can increase the risk of a number of diseases or conditions such as heart attacks, stroke, diabetes, and cancer) ratio is one example of this. The ideal ratio of omega 3 to omega 6 has been suggested to be between 1:1 and 1:4. According to the book, The Omega Diet by Artemis P. Simopoulos, MD and Jo Robinson, this is right in the range that organic free-range eggs fall (about 1:1 to 1:3), where as commercially rasied eggs have a ratio as high a 1:20. The same can be said for organic grass-fed beef, whose ratio is around 1:5, where as commercially raised beef is around 1:20. Also, the number and types of products that contain some form of wheat or gluten is staggering. Gluten may be present in commercially made soups, tomato sauces, salad dressings, meatballs, prepared hamburger patties, yogurts, cheeses, etc. Why are we choosing gluten-free? Wheat and gluten are not necessarily bad for you, especially if you don’t have a gluten intolerance like those affected by Celiac Disease. We, however, choose to opt-for gluten free foods or fruits and veggies as our sources of carbohydrates because of the effect wheat/gluten may have on your immune system. In a 2007 study in the American Journal of Industrial Medicine, workers exposed to wheat flour had an elevated levels of IgG and IgA (serum antibodies that help protect against invading pathogens) indicating that a systemic immune response was being triggered. In a 2005 study in the Bioscience, Biotechnology and Biochemistry Journal, wheat gluten was given to a group of healthy individuals over a 6 day period and their immune system response was measured. Following the 6 days, natural killer T-cell levels were significantly increased in each of the individuals in the test group. So although we aren’t intolerant of gluten, we choose to opt for non-gluten containing foods to optimize the performance of our immune systems.

It is difficult though trying to maintain this type of diet while keeping some variety in the types of meals we eat when so many foods and recipes (esepcially when going to a restaurant) contain ingredients that we try to avoid. So I thought I’d share a recipe that we tried this past week that was both delicious and followed a lot of the self-imposed dietary restrictions we now abide by. Hope you try it out and enjoy it as much as we do. Additionally, if you have any recipes that follow a more gluten-free / paleolithic way of eating, please share those as well as we are always looking to expand our cooking repertoire.

Sweet Potato Waffles:

Prep Time: 10 min (not including boiling the sweet potato)

Cook Time: 5 min

Serves 6


  • 1 cup boiled then cooled mashed sweet potato (we skin ours and slice it first to help it cook faster)
  • 1 1/4 lowfat (preferrably organic) buttermilk
  • 1 egg (we use organic free-range as stated above)
  • 1 tbsp canola oil
  • 2 cups gluten-free pancake mix (we use Pamela’s brand)
  • 1/4 cup raw cane sugar
  • 1/2 tsp. cinnamon
  • we sprinkle unsweetened coconut and diced strawberries on to

Cooking Instructions

  • Preheat Waffle Iron
  • In a medium bowl, combine sweet potato, buttermilk, egg, and oil
  • In a separate bowl, whisk pancake mix, sugar, cinnamon, then stir in sweet potato mixture into dry ingredients. Batter will be fairly thick.
  • Coat waffle iron with nonstick cooking spray or spoon 1/2 to 3/4 cup batter into waffle iron and cook until crisp
  • Enjoy!