So they’ll start training in June, July and train throughout the fall, compete, take very little time off, start indoor and then go to outdoor season. So looking at overall training, only training volume, but also the surfaces that you’re training on. In my experience, um, kids who’ve are training on more like hard services, concrete, asphalt, a knot, softer surfaces or trails. We’ll tend to have more bone stress injuries or sins with related symptoms.

Welcome to the PT Rebels Podcast. This is the place to learn how you can become a PT rebel and take charge of your own health and wellness. We will help you find answers to your questions about pain, injury, and the path towards healing in the most efficient and effective way possible.

I’m your host, Dr. Gina Fick.

On today’s podcast, we wanted to welcome three steadfast track and field athletes. Steadfast is a local track and field club who are participating in the Spokane Speed Games in Spokane, Washington this weekend, and we had the unique opportunity to be able to sit down with these young ladies. Just to get their perspective on track and field injuries, uh, as related to physical therapy and how that’s helped them in the past. I wanted just to do a q and a and see what their top questions would be for me. So it should be a fun time just sitting down with Steadfast Track Club and these young ladies. We have Liv Clark, Maddie Proctor, and Chloe Johnson with us today. So welcome ladies. Hello. Hi. Hi y’all. Welcome to the podcast. Super fun to have you on today. We’ll start with Maddie. Maddie has a lot of experience with physical therapy. A few injuries here and there. Maddie, what questions do you have for me today? I would say, what is the hardest injury that you’ve had to work with? That’s a really good question in terms of track and field. Injuries. I think one of the most difficult injuries that I’ve had to deal with involves a bone stress injury and also compartment syndrome. So this athlete had both, and I think it becomes really tricky trying to diagnose the injury right away just to determine like what is actually the pain generator? Is it a bone stress injury? Is it, uh, more complicated in terms of. Potential compartment syndrome. So I’ll go into a little bit more depth about what those things are. So bone stress injury is when your overall training load or volume exceeds your bone’s ability to withstand that bone stress. So if you’ve amped up your your training really quickly, maybe running on harder surfaces. Running faster, running at a higher intensity. You amp that up very quickly at the beginning of the season. For instance, start doing a lot of hill or speed training that can start a process of bone stress, but usually it starts with chin split feeling, and then that can progress to more of stress to the bone. Then things just escalate from there. So it’s really important right away to get assessed properly by a physical therapist so we can make sure that doesn’t get worse. But in this case, with the A athlete I’m referring to, she also had something called compartment syndrome. And you can have in your lower leg, for instance, there’s compartments between the fascia and the muscle where pressure can build up, and that starts to cause pressure on. Nerves or arteries in your lower leg, and that creates sensations of pain, tingling, numbness, tightness, and swelling in your lower legs. Sometimes that’s related to a bone stress surgery and sometimes it’s not. But that can be significantly, not only painful, that can also cause nerve damage to the point where you start to get like a foot drop condition, and that’s pretty serious and needs to be addressed quickly so that you don’t have more permanent nerve damage and lasting. Pain and dysfunction from that. So that’s just an example where if you don’t catch it early on, it can become a lot more significant and serious and really cause you a lot of problems down the road. I’ve seen athletes just have to stop running of it. Chloe has a question. Yeah. So is there a common injury that you treat a lot that’s easily preventable? And, and if so, what is it and what can we be doing to prevent it? I’d say shin splints would be, one was probably the most common track and field. Injury that we see. And so I think there’s a lot of factors you can address when you’re trying to preventions once. Number one is just having good training shoes. Number two is controlling your volume and being communicative with your coaches and athletic trainers and yourself. So not push through it. So if you start to feel something, say something. To your coaches, they can help you address your training load and volume. Sometimes it’s just multifactoral. We know with shin splints that we’re the most important muscles to train is the soleus muscle. So the soleus muscle is right below the gas strap muscles that helps you push off power off the ground with your knee flex. So when you plate or flexor push off the ground with your knee flex. The soleus muscle is primarily the muscle that allows you to propel forward with power. If you’re running uphill, for instance, that’s really important muscle to give you power. Also, with shin splints, one of the things we commonly see is there’s hip weakness involved. If the hip is weak, then the hip is dropping and causing the knee to collapse or mu the ankle and fed to collapse. That will put more stress on a muscle called the tibialis posterior muscle, which is in the lower leg, connects down into the foot, and if your hips are weak. Oftentimes you’ll experience symptoms down the chain and into your lower lay. I think that with, since splints, it’s really important to address overall training services. So for instance, some of our mid distance or distance runners will run cross country. So they’ll start training in June, July, and train throughout the fall, compete, take very little time off, start indoor and then go to outdoor season. So looking at overall training, only training volume, but also the surfaces that you’re trading on. In my experience, like, uh, kids who’ve are trading on more like hard surfaces, concrete, asphalt, a knot, softer surfaces or trails will tend to have more bone stress injuries or sins. One related symptoms, something that you can really easily address as two. And so that’s a hole that can go down that topping in terms of shoes, what types of shoes you should wear. Do you wear carbon fiber shoes? How shoes train in those? That’s a whole other topic, but shin splints is probably one of the most commonly preventable injuries, and I think it really ties back to running mechanics and overall strength and specific muscles that we’re targeting for strength. Lip has a question. Um, my question was when do we know to ice an injury versus use heat on it? A great question. I actually did a separate podcast about this, this summer, but ICE is not as commonly used now for treatment of injuries. What I tell patients is that if you’re having a lot of pain and need help with pain control, use ice, but we want the body’s natural mechanisms to activate and come into play if it’s a sore muscle, if it’s a tight calf, if it’s soreness after a workout. Generally use heat doesn’t have to be hot, but you use a mild form of heat, let your body recover. Do active recovery. Sometimes just motion mobility training. Just going through active recovery in mobility and stretch routine will also help to alleviate that sort of, we know the body responds well to increasing blood flow to that area. So generally we teach patients not to use ICE or NSAIDs like Advil. Motrin, that sort of thing. Unless you’re having an extreme amount of pain that can’t be controlled with other means. Actually, the guy who came up with a whole rice method of using ice acutely after injury actually came back and reversed his decision and said, oh no. Now we’re gonna take ice out of that, and focused more on letting your body’s natural tail responses play into that. So, good question. I wanted to know, what’s your relationship like with lactic? Acid because that’s something that’s big in our lives. Obviously we know that like temple days, we know that we’re gonna have to fight through lactic, and I know that lactic can cause obviously a lot of soreness. Um, what are your perspectives on like how we deal with a, running through lactic and b, like the fallout of going lactic? Yeah. One of the. Interesting thing is with lactate threshold type workouts is yes, they’re very tough, they leave you sore, but the purpose is to increase your lactate threshold so that when you’re running a 400, 800 mile, that you’re able to push harder and ultimately be faster. So I think it’s important to understand when LAC lactate builds up in your muscles, that actually triggers a CAS cascade response of. Increased protein synthesis, collagen census. So it’s actually doing good things within your body. Mm-hmm. But it leaves you right after very sore, hard to walk your legs lock up and you’re and wonder what in the world should happen. So just keep in mind that those workouts are actually for the good and doing a lot of good. And then you have to figure out like, how do I best handle that? So one thing that is really interesting that I have found to be helpful. Is a supplement called Beta Alanine. I don’t know if you guys have heard of that, but Beta Alanine, if you take that and let that build up in your bloodstream, it actually delays the buildup of lactate and allows you to push a little harder in your workouts and actually overall increase your overall performance in competitions. If we’re talking about lactate threshold workouts and you’re trying to recover from those tough workouts, I think doing things like. Epsom salt, bath, magnesium, uh, protein. Super important. You can take a collagen supplement of doing an active mobility or movement routine just to help flush some of that and, and just get moving. The movement tends to really help with that sort of. Also, if we’re talking about state track meat, that’s a different story. So if you have three days, two or three days of tough competition, what we’ll say is. You’re pushing yourself to that extreme. I do believe in an ice bath because we know that it helps to decrease delayed onset muscle sardis. So if you have state track meet day one on Thursday, and then you have day two on Friday, guys, for instance, we’ll have people get into the big trash buckets of ice water for eight, seven or eight minutes because they’ll feel better the next day. Another cool thing that we sometimes use is. The ischemic preconditioning protocol on the blood flow restriction devices. Mm-hmm. So the BFR devices will do that IPC protocol and that will help with that response as well. And also promote a lot of healing factors that help decrease that delayed onset muscle source. Specialized BFR protocols not only help them feel better, but also enhance their performance into the next day or two years. What’s the most important way for an athlete to keep their body muscles healthy? I could just give you the basics right off the bat. I know your coach has probably told you this as well. Sleep. Go sleep. Mm-hmm. Mm-hmm. So if you can aim for eight to 10 hours of sleep, it doesn’t have to be consecutive. So like today we traveled. I mean, you guys are, you can already tell you’re starting to look a little tired. So if you can get a good dinner and get some good sleep, you probably not gonna sleep 10 hours tonight. I doubt it. But if you do, great. But if you don’t, then tomorrow, if you have time to take 30 minute, hour, little rest. That that rest will accumulating. That’s number one. Sleek. It’s a secret weapon of mine. Secret weapon hydration. Super important. Make sure you’re hydrating with electrolytes that will increase your overall blood volume and your body’s ability to keep your overall resting heart rate down, and it will help improve your performance as well. So hydration is really important. Also, nutrition. Everyone has some different nutritional needs, so just make sure that if you have any allergies or specific needs, even when you’re traveling, that you reach out to your coaches or parents if they’re there, and just help you get the nutrition that you need so that your energy levels are up. I think another top recovery secret would be protein intake. Make sure you’re getting adequate amounts of protein and good quality protein, and that can also be hard sometimes when you’re traveling. So packing snacks, protein bars, laying protein, protein is really essential for helping your body recover. There also are tools that you can use if you have them at your disposals, for instance, like Recovery Boost such as NormaTec or X Body. Uh, no Boost Art Pro Sternin, we use a lot in our clinic. You can use things such as TBD one help decrease inflammation. Those are some, some other recovery results that you can use, but I’d say number one, sleep, hydration, nutrition would be the most important things. I have a question. Going back to the bone stress injuries, what do you think an athlete should do if they believe they have something wrong with their bone? Yeah, that is a great question. I think number one, communicate that to coaches. Communicate to that, to your athletic trainers, your parents, so that everyone understands that you are having some pain there. A physical therapist or athletic trainer will be able to adequately assess. What’s going on and be able to guide you in the proper treatment. Or if there’s other imaging that we need to do to help out a more serious problem. Physical therapists in Colorado have the ability to write referrals for imaging. So we can start with the x-ray and then move into something, uh, like an MRI. If you feel like the x-ray didn’t give us enough clarity. If you get that early on, you’re able to prevent further lost time from SWR down the road. And we can usually treat that pretty quickly, especially if you’re with a physical therapist who has a pretty good understanding of bone stress injury. So number one is just communicate and then find a good provider who understands that and that could get you treatment right away. We figured. I have one more question. What do we do? If our high school trainers are not amazing and they tell us things that we don’t think are true, but they don’t want us to run and they want us to either get a second opinion or whatnot, what, how do you think a, a high schooler should navigate that kind of. Situation. Yeah, I think that’s probably the top question that I get almost every year, and it’s something, I’ve been a PT almost 25 years. It’s something I’ve been helping people navigate through for 25 years. Number one, I think there are so many good athletic trainers out there, and I think one of the issues is in the high school level, especially there to be one athletic trainer for a large five, a high school, and they literally. Have no time to do much other than throw some tape on there, give you a bag of ice. And they could be the best athletic trainer in the country, but they literally don’t have the time. Now, some just aren’t very good and there’s some P PTs that aren’t very good. That can be the case too, but I think it goes back to communication. So A, you feel like your athletic trainer isn’t giving you. The advice or the information that you need or is giving you advice that doesn’t really make sense. I think it’s important to talk to your coach. Mm-hmm. I think it’s important to talk to your parents, um, so that they understand that yes, you did try to go through your athletic trainer Yeah. Didn’t really get anywhere. Yeah. And you’re not really sure what to do, but you know that. It doesn’t really make sense what they told you just to ice it and keep running and run through it. Yeah, which could be off the type of the case. So if you do have the resources to be able to have an As or a physical therapist that can assess that outside of your school, I think that’s the best place to start. And as physical therapist, we generally just wanna help our patients find a physical therapist who’s willing to assess and help you and communicate with your athletic trainer. Because sometimes that’s much easier for that physical therapist to get in touch with their athletic trainer and get through to them and collaborate on what they see, versus you trying to communicate that with your athletic trainer mm-hmm. Than with your coaches. And sometimes the, the waters just get really muddied. I think it’s so important to learn to be your own advocate because most of you guys are gonna run at the collegiate level. And so at the high school level, it’s so important to learn that you have to speak up and say something. If there’s something wrong with your body, you guys have been doing this long enough and you’re elite enough to know that’s not right. Mm-hmm. And so it’s fine to be respectful and you wanna be respectful to your athletic trainer, but also respectfully disagree. And you don’t have to even respectfully disagree to their face, but just in your mind, go, okay, and now that’s not right. I need to talk to my coaches and then seek the help that you need. Most of the time, if you can access your athletic trainer, maybe on times that where it’s not as busy in the training, that can be helpful too, because then they have more time to listen and spend with you. Mm-hmm. I think that even at the collegiate level, at the D one level, some of the schools that you would think have the. Best athletic trainers available. This is still an issue, so just know that this could be something that arises at every level. Being your own advocate is the number one thing that you can do, and knowing that if your athletic trainers don’t have the answers, find someone that does, especially when it comes to something like a injury that could be season ending. If you have a mild hamstring tear and they say, oh yeah, you can run tomorrow, and you know, that doesn’t make a lot of sense that you need proper treatment. Speak up and say something and say, I, I can’t. This is something I can’t run through. And if you have a coach who’s professional enough to listen and caring enough to listen, they’re not gonna have you push through that. If you don’t, then you may have to find a different situation, and that’s why you see a lot of athletes transfer doing sort things like that. Now, to help avoid that, I think one thing that you can do is ask a lot of questions when you go on your collegiate visits. Yeah, ask your future teammate. What resources they have and really dig in a little further and you’ll get a feel from the team. Even if it’s like vague responses, you’ll get a feel like how many girls had to sit out this season for a bone stress injury? Eight. Okay, that’s not so good. If you have a situation where you’re hearing really high injury levels or eyes rolling when you ask the question or. Stuff like that, that it is probably a red flag I should look forward to. Yeah, that was something that I was very diligent about when I was going through my recruiting process was definitely I would ask, is there a common injury in your program? ’cause I know that there’s programs out there that bone stress reactions are super common, and so I would ask that. And then if there wasn’t a common injury, I said, what does it look like to be an athlete in your program and return from an injury? What does that. Process looked like and the responses that were like, we worked very closely with the athletic trainer. I liked those, like the people who the coaches and athletic trainers collaborated, but then the coaches who were like, well, we have a very basic return to play or return to run program. Those ones that are like, oh, I don’t really know. ’cause if it’s not personalized, I feel like it’s not gonna be the best. Exactly. Yeah. That’s great advice for everyone. Thank you, Chloe. Yeah, of course. I have some questions for you guys. I’m gonna ask you really quick. I’m gonna flip it around. Then you guys have to go get ready for dinner. Yes, you guys, I highly respect you guys and you know that I’ve been watching you for swimming for a long time, and I wanna know track and field is a very difficult sport. Steadfast is elite. It’s in elite club. You’re in the elite group. You guys work extremely hard. What drives you and motivates you to do this every day, and how do you keep focused on your goals? I would say for myself, coming from soccer, which was just a super emotionally draining sport, I feel like there’s a much better coaches in track and field as well. You can tell they care about you. They may not be the best coach, but they’re very good people and they’ll care about you and your journey and lead you to a better place. I think just striving to be the best that I can personally be. While helping those around me is probably what keeps me motivated. Yeah. Yeah. And I’ve been running for a very long time. I started running. Seriously when I was to fifth grade, and so I’ve been with the sport for a long time, but I’ve changed my mindset a lot throughout the sport. I had a very negative experience with a coach, and navigating that is very hard to do, but I’ve learned so much about myself and who I am as an athlete because of it. Once I found Coach Marcus, my entire world changed and I show up for him and I show up for my teammates when I feel like I can’t show up for myself. Because having someone like Marcus and a coach that believes in you more than sometimes you believe in yourself is, I dunno, it’s an amazing experience and it makes you wanna keep doing it. For sure. Agree. Yeah, I agree with what Chloe said, like when you have somebody who genuinely cares about you and your success, but on a personal level it makes you wanna strive to be the. Best you can possibly be, not even for yourself, but for them and for those around you. And something that helps me is having all the support around me. Like my teammates just going through the same thing. It’s not the exact same thing ’cause we’re not the same person, but we experience the same things. We just wanna be. The best you can possibly be. And you wanna show up and show out, not for yourself, but for your team. Mm-hmm. And steadfast creates that perfectly. It’s an environment, especially this past year, we, we’ve had like complete 180 in our culture. And I think our culture is something that I’m super proud to be a part of because we lift each other up, we realize a teammate has a bad day, but I’m also gonna be a number one fan when a teammate prs and, and we have that for each other. I think culture and environment and a coach is what drives us. Absolutely. So. I think you hit the nail on the head with a culture, and I think that’s something that Marcus and Casey both create, and that’s why I’m really proud to know them. I’m proud to partner with them and proud that our son runs for them as well. So, final question. How do you feel like that culture and the lessons that you learned are going to help you in college and lay your own life? So for me, it guided my recruiting process a lot because I’ve been with a coach that I know I don’t vibe with. We don’t see eye to eye, and so I looked for those red flags and it really helped me find a coach that I fell in love with. But then also when I went on my visits, I noticed how the girls interact with each other. A big thing for me was how they interact with food. I wanted to make sure that they were not embarrassed to order a big meal when we went out to eat. And so that was a big thing for me. And it was also how they talked about the coach and how they talked about each other. I stayed in the dorms with the girls and that was an awesome experience. ’cause I got to see firsthand, okay, this is what the culture is like, and I felt like I was on the team and the school I ended up choosing is the one that I felt like even if I were to be injured, I would still feel like I would be a part of this team and be. Successful. Yeah. In that way or not? I completely agree. Some people might say that I took the safe option for my school because I have a lot of teammates that I already know there. But I think that really helped lead to my decision because I know that the culture’s gonna be good. And when I went on my visit, I fit in right away. Everybody was so kind and welcoming and we had a lot of fun together, and the coach continually stayed in touch. The end asked me how it’s doing and how track was going, how school’s going work. Not just, Hey, are you gonna come to my school? Yeah. So I feel like that the pressure of not being forced to go there and more of like them wanting me really helped because it just shows they’re a loving, welcoming family of a team. Liv, how do you feel like as an athlete on steadfast, what life last learned had been learned up to this point that Coach Marcus and Coach Casey have instilled in you? That just helps you in the day to day? Okay. Uplift each other genuinely. Be there for each other, uplift each other, love each other. Don’t be a jerk, don’t talk behind their back. All this kind of stuff. The stuff that normally happens in high school, they’ve taught me to be the best version of myself. Uplift each other no matter what. Thank you girls so much. Thank you. An honor to know each and every one of you, and we’re super excited for this weekend and to see how everyone does and it’s just really fun to see you outside of. Colorado and seeing you have fun on this trip and V more together. Thank you for sharing your questions and your experiences with your club track team. I think this will be really encouraging for a lot of people.