Runners Rehab

When a runner is faced with an injury, one of the most devastating things is an inability to keep running and maintain the training. Usually in this case a complete rest from running activities is advised by physical therapists. However, a complete rest from running is not a good idea for quick runners rehab. To make your body move right as soon as possible let’s look at the most effective cross-training options: water running, spinning, and Alter-G treadmill. These methods will improve your recovery and will keep you in touch with the training process without having a long unmotivated break.

Water Running

A woman at water running session at NYDNRehab

Running in the pool can be useful for those who cannot run because of injury but still want to train. It is probably the safest cross-training option for lots of runners’ injuries. Because there is no impact on the body in the pool, running can be maintained in the water with as much time as running on a hard surface. Resistance provided by the water reduces the risks of aggravating trauma.
Tips and tricks for water running:

  • In the pool your turnover will be slow but try to simulate your normal running style, do not ‘paddle’. Try to let the bottoms of your feet kick the water behind you and let your legs push you forward. Take short, quick steps, because a fast cadence intensifies the workout
  • Remember that in the water your heart rate will be at least about 10% lower than when running on land with same intensity. Also, keep in mind that water is more resistant than air and your pace will decrease accordingly. Perceived exertion to gauge your effort in the water
  • If you are a beginner water runner, you may apply an aqua jogging belt or get rid of it if you want to increase the routine
  • In addition to exercises in a deep end of the pool, you may use the shallow end to train without the risk of unnecessary impact by performing a few sets of basic drills
  • Also, keep staying attentive because you might enjoy the water running so much that you would not want to stop exercising!


A woman performs spinning exercise

The next best cross-training option for improving runners rehab is a spin class. The training in a spin class is lot more effective at replicating running routines than interruptive road cycling.

Try to find a spin bike for specific sessions rather than a bike trainer because the resistance can easily be controlled and you can get out of the saddle to replicate a running motion when doing intervals.

Since there is no impact on the body in spinning it allows going further without fear of been re-injured. Spinning accelerates the recovery and maintaining fitness by literally mixing up interval workouts and tempo “runs” on the bike every other day.

Spinning workouts has to be about 150% longer lasting than the regular running workouts to achieve an equivalent effort. While spinning try to use a heart-rate monitor and make sure that your heart rate is in the limits of a proper cardio zone. Usually your heart rate would be about 15 RPM lower than when running.

Alter-G Treadmill

A woman is running in AlterG antigravity treadmill

Alter-G anti-gravity treadmill is one of the most innovative machines in the history of physical therapy. This anti-gravity devise lovers the body weight up to 90%, which gives an opportunity for a runner to bypass the injury by allowing replicating regular running workouts at a fraction of a body weight.

Lowering the body weight up to 90-93% limits the pounding on the legs, accelerating quicker recovery at the same time still receiving the fitness benefit. More often Alter-G course starts from lower percentage of your body weight, increasing the weight gradually until normal.

The Alter-G helps not only in case of trauma, but also is a good recovery device, especially between the long roads, like marathon or half-marathon. The key idea about it is the better you rehab, the better you will run.

For most runners, access to Alter-G antigravity treadmill is limited, but at Dynamic Neuromuscular Rehabilitation in NYC, it could be rented out if you want to salvage your hard-earned fitness and return to running on land as quickly as possible.

Cross Training for Runners

There is a lot of buzz in the media about the importance of cross training for runners. Running is a unidirectional physical activity which creates muscle imbalances in majority of runners. A runner with perfect mechanics and perfect technique is an exception to the rule. Therefore, we agree that cross training is a good idea as long as this cross training is running and patient specific. When the runner is injured and he has decreased or stopped running it’s important that the cross training for runners is specific to runners deficiency. The biomechanical assesmen or computerized gait analysis may be of value. Frontal plane deficits, poor balance and proprioception, muscle imbalance and sticky feet are very common among runners.

DNR being a full gait and motion analysis lab we have developed specific programs which fit different types of runners. Every program is individualized based on biomechanical profile, running style, foot type, and injury relationship.

At DNR we don’t look at necessary mileage decrease as down time. Our technology and expertise can turn this down time into improvement of running efficiency.

Should You Invest In A Gait Analysis?

In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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