August 2021 COVID Update – COR continues to follow COVID safety protocols

What are the Most Prevalent Running-Related Musculoskeletal Injuries?

Running is a form of exercise that carries many benefits. Unfortunately, many athletes experience running-related musculoskeletal injuries. The vast majority of such injuries are caused by overuse and have a high recurrence rate. A recent systematic review determined that the knee and ankle are the most commonly injured sites. The running-related injuries that occur most frequently include Achilles tendinopathy, medial tibial stress syndrome (shin splints), patellofemoral pain syndrome, plantar fasciitis, and ankle sprains.

Achilles Tendinopathy

Managing Achilles tendinopathy can be challenging. Most patients see improvements after 3 to 12 months. In some cases, however, long-term symptoms can persist for years. Physical therapy can be effective for Achilles tendinopathy, especially if it includes a program with a heavy emphasis on exercise. The authors of a recent meta-analysis study recommend starting with an exercise program, such as physical therapy, since it is low-cost, accessible, and non-invasive.

Medial Tibial Stress Syndrome

Medial tibial stress syndrome, or shin splints, comes from inflammation of the tissue surrounding the tibia. This overuse injury often occurs from downhill running, running on hard surfaces, or including frequent starts and stops. Other factors include flat feet and obesity. In addition, female runners are more likely to develop shin splints than males. Treatment includes rest, ice, stretching, and orthotics. 

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome, or runner’s knee, causes stiffness and pain around the kneecap. It can cause difficulty with daily activities such as kneeling, squatting, and climbing stairs. Runner’s knee is often associated with repetitive stress on the patellofemoral joint (in the front of your knee). Likewise, misalignment of the femur and patella can aggravate the joint. PTs can instruct patients on specific exercises to improve range of motion and strength and help reduce pain.

Plantar fasciitis 

The plantar fascia is a tissue in the bottom of your foot. Collagen breakdown and micro tears of the plantar fascia can cause pain in the heel and bottom of the foot. Typically, cases resolve with physical therapy including manual therapy, stretching, taping, and orthotics.

FAQ: How can physical therapy treat running-related musculoskeletal injuries?

Physical therapists start with an injury assessment and create an individualized treatment plan. Physical therapy usually includes stretches, exercises, and manual therapy. PTs can also apply ice, heat, and other modalities as needed. Of course, prevention is the best medicine. PTs can help runners build strength and improve running form to avoid re-injury.

COR Running Program

Many running-related musculoskeletal injuries come from small loads over repetitive cycles. A personalized running analysis can guide runners on proper form to recover and avoid injuries in the future. The COR Running Program provides one-on-one assessment and support for runners. Call our office to make an appointment at 201-833-1333.

The Four S’s of Sports Performance: Strength, Stability, Speed, and Skill

A complete training program includes the following elements of sports performance: strength stability speed and skill. Sports performance is based on an athlete’s technical skills and physical capabilities. Elite athletes want to push their bodies to become faster and stronger. You can hone technical abilities and optimize fitness with targeted conditioning and training.


The adage “use it or lose it” applies to muscular strength. Muscle mass naturally decreases over time, so athletes must consistently work on all major muscle groups throughout the week. Plus, strength training does more than bulk you up. It is also important for building stronger bones, managing weight, and decreasing the risk of injury.


Stability refers to the body’s ability to rebound from a disturbance in equilibrium. In the most basic sense, it’s about shifting your center of gravity. For example, you can reposition your center of gravity when knocked off balance. In sports training, a lot of emphasis is put on core stability. While core stability is crucial, athletes also need joint stability, balance, and posture. 


Going fast requires many body systems working together. First, your sensory system perceives and processes the environment. Then, fast twitch muscles give a sudden burst of energy to accelerate. However, maintaining maximum speed results in the build-up of lactic acid. So, speed endurance training is important in order for an athlete to be able to maintain max speed for as long as possible while increasing their lactate threshold.


Each sport has specific skill sets, such as breath control, flip turns in swimming, or passing and shooting in basketball. Better technique means increased physical efficiency. You can do more with less energy over extended periods as your skills improve. Significantly, proper skill technique also reduces the risk of injury.

FAQ: Which sports need strength, stability, speed, and skill?

Fast-paced athletics need a combination of technical ability and physical fitness. So, improving strength, speed, and skills helps in any sport. Activities that need optimal physical performance include: 

  • Basketball
  • Football
  • Soccer
  • Track and field 
  • Swimming
  • Skating and hockey
  • Martial arts
  • Cycling

Sports Performance: Strength, Stability, Speed, and Skill

Successful elite athletes train these components of sports performance: strength, stability, speed, and skill. The first step is identifying your current level in each area and developing a growth plan. Next, we’ll work with you through our Elite Athlete Performance Plan to identify specific goals and design an individual training program. Schedule a consultation online today.

Six Situations Treated with Women’s Health Physical Therapy

It goes without saying that female bodies are different from males. Women have unique bone structures, hormones, and bodily stressors. So, it takes a specifically trained professional in women’s health physical therapy to evaluate and understand how female physiology impacts overall wellness. For example, a physical therapist (PT) can teach you how to strengthen pelvic floor muscles and eliminate vaginal pain. Likewise, physical therapy can treat incontinence, prolapse, pelvic pain, diastasis recti, and more.

1. Urinary Incontinence 

Urinary incontinence (UI) can impact women of all ages, from teens to post-menopausal women. For example, high-impact sports, such as gymnastics and track, often lead to urinary incontinence in adolescent female athletes. UI also occurs later in life. For example, many women experience urinary leakage following childbirth and after menopause. Fortunately, you can counteract UI with pelvic floor physical therapy.

2. Organ Prolapse 

The pelvic floor muscles support pelvic organs such as the bladder and uterus. If these muscles become weak, or there is laxity in the supporting structures, the organs can drop down, bulge, or prolapse into the vagina. Fortunately, prolapse is very treatable. A PT can teach you exercises to strengthen the pelvic floor. Early treatment can prevent invasive surgery down the road. 

3. Pelvic and Vaginal Pain 

Women can have many different types of pelvic pain. Some discomfort is associated with menstruation, infections, or pregnancy. However, other causes are musculoskeletal. For example, vaginal muscle spasms can lead to painful penetration. Pelvic floor physical therapy offers individualized treatment plans designed to eliminate pelvic pain. 

4. Diastasis Recti Abdominis

Many women experience stretching of the abdominal muscles during pregnancy. This stretching may lead to what is called diastasis recti abdominis: the separation of the external abdominal (stomach) muscles. This is because the connective tissue between them stretches as the left and right sides separate. Fortunately, strengthening and stabilizing your core muscles before, during, and after pregnancy can help! 

5. Lower Back Pain

Pregnancy puts a lot of strain on the lower back. Before childbirth, the hormone relaxin softens the joints and ligaments. However, additional weight can aggravate the joints. For example, sacroiliac (SI) joint dysfunction causes pain in the lower back and buttocks. Physical therapy treatment can help strengthen the surrounding muscles and support the SI joint.

6. Postpartum Scar Restrictions  

Cesarean and vaginal deliveries can leave behind scars. Following a c-section, some people experience discomfort along the scar tissue. Likewise, many women have tenderness from scar tissue left by episiotomies or natural tears. Therapy for postpartum scars involves soft tissue massage, scar mobilization, stretching, and strengthening of the surrounding muscles. 

FAQ: What does a women’s health physical therapist do?

Women’s health PTs use evidence-based treatment for musculoskeletal disorders affecting women. They can help you eliminate pain and return to your everyday quality of life. For example, pelvic floor physical therapy improves the stability of the pelvis. Treatment usually involves muscle exercises, massage, and patient education.

Getting Treatment

Women’s health physical therapy is a first-line treatment for these conditions and is far less invasive than surgery. Our women’s health expert, Dr. Rachel Feldman, has extensive experience treating female-specific dysfunctions. Don’t live with pain and discomfort. Schedule an appointment online today.

How to Start Running: A PT’s Guide for Beginners

Running is an excellent exercise for maintaining health and wellbeing. Whether you have marathon ambitions or want to improve your health, knowing how to start running gets you on the right foot. Keep in mind that every runner is unique. We all have our own goals, skills, and fitness levels. So, be kind to yourself when just starting — don’t hold yourself to someone else’s standards. 

FAQ: How do I start running if I’m a new runner?

Consistency and planning are critical for new runners. When you decide to start, create a training plan you can stick with. Bear in mind that your body needs time to adjust to any new activity. So, build planned rest days into your schedule. Many people benefit from using a walk/run program that eases them into running. There are many pre-designed programs and apps that can help you start running. If you have any cardiac history, check with your primary care doctor and/or cardiologist to make sure that running is a safe exercise for you.

Training Frequency and Intensity 

When creating a personalized running regimen, consider the frequency and intensity that feels right for your fitness level. Frequency is how often you exercise, and intensity is how hard you run. For example, beginners may benefit from a walk/run program that can also incorporate jogging into their training program. In addition, it’s vital to build cross-training into your schedule. For example, you can always work on strength training and conditioning on days you’re not running. 

Injury Prevention

New runners unfortunately tend to get injured more easily, and we see a lot of preventable running injuries in the clinic. So, injury prevention is crucial to a successful running career. One straightforward injury prevention technique is to start slow. Increase your weekly distance slowly because pushing yourself too hard could quickly end your running journey. Likewise, listen to your body. If aches and pains hinder progress, it’s okay to return to your previous mileage. In addition, repetition can lead to injury, so strive for variety in your training. For example, change up your daily distance or run on various surfaces. Make sure that you include another form of exercise in your weekly exercise regimens, such as yoga, biking, swimming, or strength training. Running is a great exercise, but only using running as exercise can increase your risk of injury.

Importance of Individualization 

No two runners are the same. What works for one person may not work for you. If you decide to use a pre-designed running program, you can modify the plan to fit your needs. If you’re wondering how to start running, we suggest creating an individualized program tailored to your specific goals and needs. 

The COR Running Program offers a personalized consultation with a physical therapist to put you on the path to success. Our unique biomechanical analysis process gives invaluable insight into your gait and cadence. Running is a fun way to exercise and stay healthy. So, we’d love to help you get started on your running journey. Schedule a consultation online today

The Dangers of Overtraining are Real

Dedicated athletes train hard and push their limits. But there’s a fine line between a strenuous training load and an overreaching one. So, it’s important to understand the symptoms and dangers of overtraining syndrome. Amature and elite athletes alike run the risk of health complications and injury from overtraining. In addition, if you don’t get enough rest and recovery, you can see a decline in performance.

What is Overtraining Syndrome?

Essentially, overtraining syndrome is your body’s response to excessive physical activity without proper rest and recovery. As a result, a combination of neurological, hormonal, and biological factors leads to fatigue and lower sports performance. The loss of performance could last for several weeks or months.  

Symptoms of Overtraining 

The main symptom of overtraining syndrome is performance loss. Athletes may notice a decrease in strength and conditioning despite increasing their training regimen. Other symptoms include:

  • Fatigue
  • Disrupted sleep 
  • Mood swings
  • Behavior changes
  • Decreased urination
  • Increased infection risk

Overtraining Factors 

Numerous factors can trigger overtraining, and no single element is the sole cause. For example, we know that athletes who neglect their nutrition, sleep, and recovery are at risk for overtraining syndrome. In addition, there is a long list of behavioral, external, and internal factors, but experts lack a clear understanding of the root cause.

Behavioral Factors

  • Poor nutrition
  • Bad sleeping habits
  • Inadequate rest and recovery
  • Prolonged or monotonous exercise
  • Increased training load

External Factors

  • Life stressors
  • High Altitude
  • Distrusted sleep
  • Too many competitions
  • Heat-related injury

Internal Factors

  • Previous illness
  • Overworked muscles
  • Low muscle glycogen
  • Reduced glutamine 
  • Increased oxidative stress 
  • Hormonal changes
  • Decreased serotonin levels
  • Low sympathetic nervous activation

FAQ: When should I rest from sports training? 

Sometimes athletes can push themselves too hard. Depending on your level of training, take a rest day every three to five days. Or more frequently if you’re starting. Likewise, it’s vital to rest at least 6 hours between workouts and limit each bout to under 2 hours. You should also rest from exercise following illness or injury, after heat stroke, and during stressful life events. 

Avoiding the Dangers of Overtraining  

They say prevention is the best medicine. Athletes who maintain balanced nutrition, rest, and exercise will likely prevent complications from overtraining. For example, an experienced runner knows to taper before a marathon. Essential prevention tips are:

  • Adjust volume and intensity 
  • Eat enough calories 
  • Drink enough water
  • Get enough sleep
  • Rest and recover

These tips represent a holistic approach to their overall health, including balanced nutrition, sleep, and recovery. With proper guidance and direction, you can avoid the dangers of overtraining. 

At Churchill Orthopedic Rehabilitation, we work with athletes to develop goal-driven plans that achieve optimal results. Schedule a free consultation today.

Physical Therapy Treatments for Pelvic Floor Dysfunction Following Childbirth

Women have a high risk of developing pelvic floor dysfunction following childbirth. These are complex disorders of the ligaments and muscles that support the pelvic organs. Often, postpartum patients experience weak pelvic muscle tone, leading to further complications. Fortunately, physical therapy can help patients recover faster and improve health outcomes. 

Pelvic Floor Dysfunction Following Childbirth 

Disabling pelvic floor dysfunction negatively impacts the social, emotional, and physical aspects of patients’ lives. Family duties associated with raising a newborn compound these adverse effects, causing extra stress and ailments for many new mothers. Often, these patients experience pain, numbness, or pressure in the pelvis. For some, the pain causes difficulty in walking and performing activities of daily living. In addition, if left untreated, pelvic floor dysfunction can progress to organ prolapse, unitary incontinence, and sexual dysfunction. So, patients need pelvic floor physical therapy which supports recovery through manual manipulation and exercises for stretching, conditioning, and relaxing pelvic floor muscles. 

Physical Therapy Following Caesarean Sections

Many women in the US give birth via C-section. According to the CDC, over 31% of deliveries in 2020 were Cesarean. Despite their common use, these are complex surgeries with complications such as diastasis recti, postoperative pain, and pelvic floor dysfunction. In addition, Cesarean deliveries cause prolonged pressure in the abdomen and excessive stretching of the pelvic organs, ligaments, and muscles. Fortunately, physical therapy treatment can help the pelvic floor recover after abdominal delivery. According to a report published in the Journal of Physical Education and Sport, c-section patients who received physical therapy showed statistically significant improvements compared to those who recovered independently. 

Physical Therapy Following Vaginal Birth

During vaginal delivery, the pelvic floor lowers and expands. Stretching of the perineum can lead to tears, a substantial risk factor for pelvic floor dysfunction. A recent systematic review suggests that pre- and postpartum pelvic floor muscle training improves patients’ quality of life. In addition, it helps reduce the risk of more severe complications. For example, Kegel training strengthens muscle tone and reduces pelvic floor disorder symptoms.

FAQ: How long is pelvic floor recovery after childbirth? 

With proper treatment, most women recover within six months. However, actual rehabilitation times depend on several factors, such as severity and treatment. Early intervention leads to faster recovery and a rapid return to a full and healthy life. 

Postpartum Pelvic Floor Care

Postpartum care is about ensuring the well-being of the mother and newborn. And the pelvic floor needs special care because it changes significantly during pregnancy, labor, and delivery. Likewise, a patient’s musculoskeletal system is vulnerable after giving birth. Regardless of the delivery method, physical therapy is essential to a postpartum treatment plan. Therefore, OBGYNs are wise to prescribe pelvic floor physical therapy starting on the first day of recovery. 

Churchill Orthopedic Rehabilitation offers a robust women’s health program for treating pelvic floor dysfunction following childbirth. To refer a patient, call our office at 201-833-1333.

Strength Training and Conditioning for Peak Performance in Elite Athletes

Strength Training and Conditioning for Peak Performance

When someone starts sports, they get faster and stronger with practice. However, they eventually reach a plateau and have to do more to see the same gains. That’s why elite athletes use highly specialized programs for strength training and conditioning for peak performance. Practice isn’t enough; they need to focus on technique and target muscle groups to reach peak performance. 

How do you train like an elite athlete?

Training is more than just following an exercise routine. It’s a process that prepares elite athletes to achieve peak performance. Multiple factors go into one person’s training—age, gender, size, shape, past injuries, etc. Therefore, you can’t just copy someone else’s plan and expect the same results. A good training plan is unique and designed to meet each person’s needs. 

Frequency, Volume, and Intensity

Consider frequency, volume, and intensity when designing an individualized training plan. First, frequency is how often you’ll train each week. Next, volume represents the amount of work, such as the number of sets and repetitions. Then, intensity is the workout’s difficulty. For example, a higher weight or resistance is more intense than a lower weight.

Individuality and Specificity 

Everyone responds differently to training. For example, imagine you see an ad for an online program. However, you don’t see the same gains when you try it. So, was the program a fraud? Maybe, or maybe not. You are not the person in the ad. So, your body responds differently to the regimen. 

Elite athletes train with specificity and individuality. They adapt exercises to meet their metabolic demands. Likewise, they prepare for a specific activity or goal. For example, a swimmer may focus on the lats and back because these muscle groups are the main driver in the water. 

Strength Training and Conditioning for Peak Performance 

Strength training and conditioning for peak performance puts a lot of demands on the body. And the results are worth it. Achieving peak sports performance means following an individualized program that targets the specific muscle groups you need. At Churchill Orthopedic Rehabilitation, each Elite Athlete Performance Plan is designed for individual gains. Work with us to achieve your goals. Schedule an appointment online. 

The Effects of Running on Major Health Indicators

effects of running on major health indicators

Many Americans live very sedentary lives, leading to adverse health outcomes. In fact, inactivity is a significant risk factor for mortality. So, clinicians want to get people moving and often promote running to improve health. It’s important to properly understand the effects of running on major health indicators so that we can get the most benefit out of running.

What are the effects of running on the body?

Inactive adults can use running to improve their health. According to a meta-analysis published in Sports Medicine, runners see improvements in several prominent health indicators such as body composition, cardiorespiratory fitness, and blood serum indicators. Plus, the more runners train, the bigger gains they typically see.  

Body Composition 

Over time, endurance running increases lipid metabolism, which reduces body fat. In fact, the meta-analysis found that after a year of training, runners lost 2.7% body fat and 3.3 kilograms of body mass on average. In addition, men tended to lose more than women for both measures. However, the article found no statistically significant change in lean body mass and BMI. Therefore, the reduction of body fat percentage and the consistent lean body mass contribute to a decrease in body mass.

Cardiorespiratory Health

Regular exercise increases blood volume and cardiac output, which, in turn, delivers more oxygen around the body. So, running improves both resting heart rate and maximal oxygen uptake (VO2max). However, these improvements tend to affect males more than females. Still, the more you train, the greater the gains in both resting heart rate and VO2max that you tend to see.

Blood Serum Indicators

Research shows that running programs reduce triglycerides, the most common form of fat in the bloodstream. So, a reduction in body fat contributes to lower triglyceride levels. In addition, running increases high-density lipoprotein (good) cholesterol in the blood. However, there’s no evidence of it reducing low-density lipoprotein (bad) cholesterol.

The Effects of Running on Major Health Indicators

Health care practitioners can use this information to advise patients. Running can one of many effective ways to address high body fat and elevated triglycerides. When people know the effects of running on major health indicators, they are more likely to incorporate this activity into their routine. 

The COR Running Program offers individualized feedback to any runner — from beginner to elite athlete. Call our office to refer a patient at 201-833-1333.

Before starting any running program, you should talk to your primary health care provider about the safety of running.