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

Category: Newsletter

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.

4 Ways to Qualify for the NYC Marathon

Qualify for the NYC Marathon

The New York City Marathon is one of the biggest running events in the world. Unfortunately, it’s also one of the hardest ones to qualify for. Many runners see it as a personal challenge to run in this event. There are several different ways to qualify for the NYC marathon, such as qualifying based on time or entering through New York Road Runners.

Qualifying by Time

Competitive runners of all ages and genders can qualify for the NYC marathon based on the time they take to run other qualifying races including half marathons and marathons. The New York Road Runners (NYRR) website lists qualifying charts for full and half marathons for men, women, and non-binary based on age groups. For example, men ages 18-34 have a qualifying time of 2:53 for the full marathon and 1:21 for half. On the other hand, women over 80 need to come in at least 6:35 for a full marathon or 2:50 for a half marathon.

Road Runners Club 9+1

Local runners have the opportunity to also gain entry through the 9+1 program. Each year, the Road Runners Club hosts over 30 opportunities designed to enable runners to earn their spot. NYRR members need to compete in at least nine qualifying races and volunteer at one event for guaranteed access. 

Lottery Drawing

The NYC marathon accepts rolling applications year-round. Then they hold random drawings every two months. There are three drawing pools for local, national, and international applicants. Having different pools allows coordinators to ensure the geographic diversity of runners. The chances vary from year to year, depending on how many runners apply for the lottery. For example, in 2020, applicants had a 2.3% chance of winning the drawing. 


Runners can also gain entry through charity and international partners. Participating charities offer some spots in exchange for fundraising a certain amount. In addition, the global Travel Partners Program guarantees entry for those living outside of the US with the purchase of the Travel Package of flights and hotel stays in the New York area. International runners can buy the package from an official International Tour Operator.

Preparing for the Marathon

Training for a marathon takes dedication and top physical fitness. Our COR Running Program features personalized biometric feedback from a professional physical therapist. We’ll work with you to design an individualized training program based on your specific needs. Schedule a consultation online today.

What is The Effect of Aerobic and Anaerobic Fitness on Sports Performance?

aerobic and anaerobic fitness

Athletes need high levels of aerobic and anaerobic fitness to achieve maximum sports performance. Both types of exercise benefit the body, but they use energy differently. For example, aerobic metabolism uses oxygen to produce ATP energy for the cells and boosts cardiovascular health. On the other hand, anaerobic metabolism is a non-oxidative process that results in lactic acid. As a result, an athlete who uses both types of training achieves greater benefits. 

How Does Aerobic Capacity Affect Performance? 

Peak oxygen uptake, also called maximum oxygen volume (VO2max), is a good indicator of aerobic fitness. An athlete with higher peak oxygen uptake can use oxygen more effectively and generate more ATP energy. Aerobic, oxygen-dependent, metabolism supplies most of the ATP energy used in sustained cardio exercises such as jogging and cycling. Increasing aerobic capacity enhances an athlete’s cardiovascular fitness. Better blood flow brings more oxygen and nutrients to muscles, improving flexibility, endurance, and overall sports performance

How Does Anaerobic Fitness Affect Performance?

Anaerobic exercises include intense physical activity for short bursts such as sprinting, high-intensity interval training (HIIT), and resistance training. When athletes perform these muscular activities, the body uses energy already stored in the muscles. Anaerobic metabolism makes much less ATP and causes lactic acid build-up instead. As a result, anaerobic training improves muscle endurance by increasing tolerance for lactic acid and strengthening fast-twitch muscles.

What is the Relationship Between Aerobic and Anaerobic Fitness?

Some sports involve short sprints and sustained movements, such as soccer and basketball. With such activities, the body switches between anaerobic and aerobic metabolism. Research shows that a combination of aerobic and anaerobic training may improve endurance more than one alone. For example, distance runners who also use resistance training tend to have better overall running economy.

These two types of metabolism affect each other in mutually beneficial ways. For example, anaerobic exercise can positively impact an athlete’s aerobic capacity. Likewise, aerobic capacity helps muscles recover after anaerobic workouts such as HIIT training. 

Sports Performance Training

When working with elite athletes, providers are always looking for ways to maximize performance. One way to do that is by maximizing aerobic and anaerobic fitness. An experienced physical therapist can work one-on-one with patients to develop an individualized training plan. Churchill Orthopedic Rehabilitation has the experience and know-how to take sports performance to the next level. To refer a patient, call our office at 201-833-1333.

How Fear of Movement Impacts Sports Performance

Fear of Movement Impacts Sports Performance

The old adage says if you fall off a horse, get right back on. But it isn’t always easy for recovering athletes to return to the game. Fear of movement impacts sports performance more than people may realize. When patients are afraid of re-injury, they compromise their athletic conditioning and rehabilitation. Thus, a person-centered approach considers psychological and physiological factors when treating injured athletes. 

What is the Fear of Movement? 

The fear of movement (kinesiophobia) is when an athlete is afraid of re-injury. This fear leads to avoidance and escape behaviors which negatively impact sports performance. Kinesiophobia was first defined by Kori et al. in 1990 as “an excessive, irrational, and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or re-injury.”

Two Paths: Avoidance and Confrontation 

There are two paths an athlete can take following a painful injury—avoiding pain or confronting pain.


It is natural to want to stay away from pain. Fear-avoidance, however, is a maladaptive response to injury. When the fear outweighs the risk, it negatively impacts recovery and performance. Research published in Clinical Orthopaedics found that “an increase in athletes’ fear-avoidance was associated with a decrease in physical function.” Therefore, the authors suggest that clinical interventions take the impact of fear-avoidance into account when treating injured athletes. 


Fear of movement is a barrier to recovery. As clinicians, we need to encourage recovering athletes to get back in the game and be as physically active as their condition allows. Start by educating the patient to explain the cause of the pain. Cognitive Behavioral Therapy (CBT), alongside Physical Therapy, can help them face their fears and return to normal functioning. 

Measuring Fear of Movement

Clinicians use various scales to measure athletes’ emotions about returning to sports and identify psychological barriers to recovery.

  • Athlete Fear Avoidance Questionnaire (AFAQ) is a 10-question self-assessment that rates thoughts and feelings about injury on a scale from 1 to 5. 
  • Injury-Psychological Readiness to Return to Sport Questionnaire (I-PRRS) is a self-report on athletes’ confidence on a scale of 0-100
  • Re-Injury Anxiety Inventory (RIAI) covers 28 statements about anxiety about returning to sports.
  • Emotional Responses of Athletes to Injury Questionnaire (ERAIQ) evaluates fears about returning to sports. 
  • Return to Sport after Serious Injury Questionnaire (RSSSIQ) measures how fear of re-injury has interfered with sports performance after returning. 
  • Tampa Scale for Kinesiophobia (TSK) includes statements rated on a 5-point scale (0 to 4) related to fear of injury.

Fear of Movement Impacts Sports Performance 

Fear of movement impacts sports performance and rehabilitation outcomes. A person-centered approach to physical therapy recognizes that there is more to healing than physical recovery; athletes need to feel safe as well. At Churchill Orthopedic Rehabilitation, we consider the whole person. We work with patients one-on-one to determine an optimal treatment plan that meets their physical and emotional needs. To refer a patient, call our office at (201)-833-1333.

Combating Achilles Tendonitis in Runners

Achilles Tendonitis in Runners

We often see Achilles tendonitis in runners at our clinic. Elite male distance runners have a 52% risk of developing it in their lifetime. If left untreated, Achilles tendonitis can lead to significant pain and limit your ability to run.

What is Achilles Tendonitis?

Achilles tendonitis (or tendinopathy) is an overuse injury. It results from repetitive micro-tears in the long tendon that connects the heel bone to the calf muscle. This degradation causes swelling, inflammation, and pain in the back of the leg above the heel. 

Treating Achilles Tendonitis in Runners

There are several ways to treat Achilles tendonitis. For mild cases, the pain may respond to self-care options. If not, physical therapy can help with stretches and exercises to improve strength and mobility. There are also more invasive medical procedures for severe cases.   

At-Home Care

Runners can start by treating their pain at home with the RICE method—rest, ice, compression, and elevation. It’s always good to wear supportive shoes and avoid walking barefoot. Seek medical attention if the pain doesn’t disappear in a day or two.

Physical Therapy for Achilles Tendonitis 

A physical therapist will start by assessing your individual needs. Then they will identify possible factors that lead to injury and come up with management strategies. Gentle exercise and range-of-motion treatments can help you reduce pain and regain function. Next, your PT will work with you to develop a recovery plan to get you up and running safely. 

Other Medical Interventions

One medical option is an injection that breaks up scar tissue on the tendon. Surgery is the last resort when all other treatments fail. Talk to your health care provider to determine the right treatment plan. 

How to Prevent Achilles Tendonitis

Many runners will experience Achilles tendonitis in their lifetime. And it’s crucial to take steps to reduce the risk. One of the most common factors leading to Achilles tendonitis is a sudden increase in training, so you should try increasing duration and intensity gradually. Follow these tips when running to maintain a healthy Achilles tendon.

  • Wear supportive shoes
  • Stretch daily 
  • Increase training slowly
  • Get adequate rest
  • Cross-train

Can I run with Achilles tendonitis?

Achilles tendonitis is an overuse injury, and exercise can worsen the symptoms. But that doesn’t mean you have to stop running altogether. Instead, in mild and moderate cases, you can take precautions to reduce the risk of exacerbating the injury:

Warm up with a dynamic warm up before running.
Set a moderate pace and stop if you experience significant pain. 
Follow each run with stretches, icing, and proper rest.

When to See a Doctor for Achilles Tendonitis 

Achilles tendonitis in runners is a severe problem. However, prevention, treatment, and maintenance will help you stay on your feet. See your medical provider if at-home remedies don’t alleviate pain in a few days. At Churchill Orthopedic Rehabilitation, our running program provides individualized support and feedback to help runners prevent and recover from injury. Schedule an appointment online today.

Management and Prevention of Bone Stress Injuries in Runners

Bone Stress Injuries in Runners

Runners are constantly putting strain on their bodies. When the bones cannot withstand the repetitive loading, runners may develop bone stress injuries. These common injuries occur at a rate of 20% annually, with higher instances in females. Biological and biomechanical factors are at play. When runners are experiencing pain due to an injury, they require a thorough evaluation from a healthcare provider that includes their medical history and a physical examination, and they may be referred for imaging such as an X-ray or MRI. Timely evaluation is crucial for runners, as delayed diagnosis and treatment of bone stress injuries can lead to further injuries such as stress fracture and complete fracture. 

What causes bone stress injuries in runners?

bility to resist the load. Running creates repetitive loading that can cause micro-damage to the skeleton. BSI results when this damage accumulates faster than it heals.

Managing Bone Stress Injuries in Runners

The primary treatment goal for runners experiencing bone stress injuries is to return them to their pre-injury functioning and running in the shortest time possible. However, we don’t want to risk further tissue damage or recurrence. Thus, runners with BSI need management strategies to reduce load-bearing in the future. Three steps for managing BSI in runners are identifying risk factors, activity modification, and physical conditioning. 

1. Identifying Risk Factors

Identifying risk factors is the first step to managing BSI. Look at training factors such as frequency, duration, and intensity of running, as well as changes such as new shoes, different running surfaces, and new physical activities outside of running. Dietary considerations such as calcium or vitamin D deficiencies are also risk factors for BSI, so runners may benefit from working with providers such as nutritionists to optimize diet.

2. Activity Modification

The next step in managing a BSI is to work on activity modification, which may involve temporarily decreasing the frequencing, duration, and intensity of running to give the body time to rest and heal. During initial recovery, the goal is to be pain-free during activities of daily living. In cases of more severe or significant BSIs, patients may need to temporarily use assistive devices such as canes, crutches, or braces.

3. Physical Conditioning

During rehabilitation, the injured runner can gradually reintroduce physical activities for maintenance. Patients should begin low-impact cross-training such as cycling, swimming, or antigravity treadmill training as soon as possible. Conditioning is an essential step towards a return to running, as it helps the body build muscular strength and endurance required for a high-impact activity such as running.

Prevention of Bone Stress Injuries

Bone stress injuries can have recurrence rates higher than 20%. So, once a patient has fully recovered, it is essential to have an injury-prevention plan in place. Each runner will need an individualized training plan to maintain gains while preventing injury. Increasing bone-loading cycles too quickly can lead to re-injury. When developing prevention measures, runners need to consider the impact that shoes, shoe inserts, and running surfaces can have on their running mechanics. Harder surfaces such as asphalt create a higher risk of BSI than soft surfaces like grass or rubber.

Nutrition also plays a role in bone injury prevention. For example, calcium increases the rigidity of bones, and vitamin D promotes calcium absorption. A study published in Physical Medicine and Rehabilitation found young female runners with high calcium and vitamin D consumption had significantly more bone mass density than those with lower dietary consumption. 

Developing a Training Program

Proper training is the key to preventing bone stress injuries in runners. When athletes increase training too quickly, they raise their risk of injury. Still, there is no “one-size-fits-all” algorithm for developing a running program. Considerations include multiple, complex factors such as training frequency, duration, and intensity as well as running surface, shoes, technique, and so on. At Churchill Orthopedic Rehabilitation, our individualized runner’s program provides one-on-one support to get athletes back on their feet with optimal recovery and maintenance. To make an appointment, call our office at 201-833-1333.

Vulvar Pain: Causes, Factors, and Treatment

Vulvar Pain

Do you experience burning or soreness outside the vagina? You’re not alone. Vulvar pain can happen to women of all ages. It’s most common in young women and again around menopause. The pain can come and go for months at a time. Don’t ignore these symptoms. Seek medical treatment right away.

What causes the vulva to hurt?

The vulva is a sensitive area, so many different conditions cause inflammation and pain. For example, yeast or bacterial infections lead to itching and burning. Sexually transmitted diseases such as herpes also create pelvic pain. Chronic pain with no underlying cause may be a condition called Vulvodynia. 


Vulvodynia is chronic, unexplained pain around the vaginal opening that lasts for three months or more. It may feel like burning, aching, stinging, or rawness. You may feel pain all over the vulva or just in one place. The discomfort may be constant or only crop up at certain times. For example, sexual activity or tampon insertion sometimes triggers pain at the vestibule. Vulvodynia has adverse effects on women’s sexual relationships and quality of life. Fortunately, treatment is available.

Vulvar Pain Factors

While environmental factors such as infections cause pain in the vulva, genetics are also at play. Certain risks for developing chronic pain are hereditary. So, if your mom experienced it, you are also more likely to develop it as well. Likewise, psychological stress is associated with pain sensitivity. For example, women with Vulvodynia are four times more likely to have anxiety. Hormonal changes and quality of sleep also play a role. 

Pelvic Floor Muscles

Hyperactivity of the pelvic floor muscles is an indicator of Vulvodynia. Overactive muscle contractions create inflammation and sensitivity around the vulva. Too much muscle tone will decrease the blood flow and oxygen to the area, leading to lactic acid build-up. Improving the condition of pelvic floor muscles goes a long way in relieving pain

Vulvar Pain Treatment 

One of the best treatments for Vulvodynia is pelvic floor physical therapy. The therapist provides a comprehensive approach to pelvic health through manual therapy and education. In addition, your PT may recommend home exercises or vaginal dilators to stretch the vagina. Your doctor can also prescribe a topical cream to relieve pain. Many women find relief from physiological stressors through Cognitive Behavioral Therapy and relationship counseling. Surgery is a very last resort when no other treatments work. 

Seeking Treatment

Vulvar pain is an underdiagnosed issue that affects many women. Most patients improve with treatment, but complex underlying factors mean each person needs an individualized treatment plan. The first step is talking to your gynecologist or healthcare provider.

At Churchill Orthopedic Rehabilitation, our women’s health expert can assess your pain and work with you to determine the best course of action. You don’t have to live with chronic pain—schedule an appointment online today.