Ohio State’s Sports Medicine Endurance Medicine team specializes in treating common injuries that affect endurance athletes.

Due to the repetitive nature of endurance sport activities, a slight misalignment can create inefficiency or pain, but when evaluated promptly and appropriate measures are taken, many injuries can be treated early, preventing time away from competition and/or activity. Our expert analysis programs are helping athletes correct their technique, improve biomechanics and prevent injuries.

How our specialists can help you

Whether you’re a runner, cyclist or swimmer (uninjured or injured), we’ll watch the way you move, particularly how these movements impact your joints. Select your sport below to view a few examples of what we assess and how improper or unbalanced movement can limit your ultimate race potential.

Runners

Runners

All runners should consider a running gait analysis. Not only will runners who are experiencing any type of pain benefit from the advice, but anyone looking to make improvements and prevent future injuries will find it valuable too.

Gait Analysis Overview

The evaluation includes a medical and training history, assessment of range of motion and strength and video analysis of your running form. We analyze this data and provide recommendations regarding running form modifications, types of footwear, exercises to prevent injury and training. 

The cost for those looking to prevent injury or improve performance is $100. Current patients or injured individuals who have a physician referral can bill the gait analysis through insurance. If you are unsure of your plan’s coverage, please contact us and our staff will verify coverage with your provider.

The Evaluation

Whether you’re uninjured or injured, we’ll watch the way you move, particularly how these movements impact your joints. Here are a few examples of what we assess and how improper or unbalanced movement can limit your ultimate race potential.

Flexibility/functional analysis
Identifies areas of muscle tightness, joint instability, movement pattern dysfunction and muscle strength to help us hone in on body segments during run analysis.

Stride length
Inappropriate stride is not only inefficient, but loads unnecessary stress on muscles and joints.

Foot strike
The dispersion of shock across your foot has an impact all the way up your body. All foot strike patterns have their own advantages and disadvantages. We can help suggest the best strike pattern that fits you.

Core stability/hip drop
Excessive hip adduction and femoral internal rotation may contribute to knee pain and Iliotibial (IT) band injury.

Foot & ankle pronation/supination
If your foot doesn’t optimally distribute the force of impact on the ground as you run, certain muscles may overcompensate, leading to pain and inflammation.

Leg stability
Knee flexion at foot strike reduces the vertical elevation of the body by lengthening the contraction of the quadriceps.

Arms
Too much movement may lead to lower body misalignment and/or back pain.

Return to Running After Injury

Returning to running after any time off, especially due to injury, can be challenging. By returning gradually, with a progressive addition of plyometric activity prior to running, you can reduce your risk of reinjury and get back to the sport you love as soon as possible.

While this guideline provides a general framework on how to return to running, you should always consult with your physician or physical therapist for your specific situation.
  • Initially, you should be able to walk with no pain and have minimal to no swelling.
  • Next, you can progress to a series of single and double leg jumps and multi-directional hops. Once you achieve 200-250 foot contacts with proper form and no presence of symptoms, you can begin running.
  • Running should include at least one rest day each week, a gradual increase of daily and weekly mileage (no more than 10 percent) and no return of pain or symptoms. Here is a basic progression:

 

Day 1

Day 2

Day 3

Day 4

Day 5

Day 6

Day 7

Total

 Week 1

 -

1

 -

1

 -

2

 -

 4

 Week 2

 -

2

 -

3

 -

3

 -

 8

 Week 3

 -

4

 -

4

 -

2

 -

 10

 Week 4

4

-

2

2

 -

4

-

12

 Week 5

4

-

3

3

-

4

-

14



Cyclists

Cyclists

Having pain when you cycle?
Want to improve your cycling performance?
Dissatisfied with the comfort of your bike?
Would you like to increase your safety while riding?
Looking to prevent injuries in the future?

We recommend you have a bike fit analysis.

Bike Fitting Overview

Our program includes a medical history and functional screening, dynamic bike fit performed on a trainer, biomechanical measurements of fit and appropriate adjustments and recommendations on ways to treat or prevent injuries.

The cost for those looking to prevent injury or improve performance is $100. Current patients or injured individuals who have a physician referral can bill the bike fit analysis through insurance. If you are unsure of your plan’s coverage, please contact us and our staff will verify coverage with your provider.

The Evaluation

Whether you’re uninjured or injured, we’ll watch the way you move, particularly how these movements impact your joints. Here are a few examples of what we assess and how improper or unbalanced movement can limit your ultimate race potential.

Flexibility/functional analysis
Identifies segmental movement dysfunction and helps relate areas of impairment with areas of pain (for example, hip flexor muscle tightness can cause back pain with cycling).

Saddle height
A saddle too low increases pressure on knees, increasing risk for patellar tendinitis or generalized knee pain.

A saddle too high increases the risk of saddle sores and Achilles tendinitis from pointing your ankles/toes too long.

Forward reach distance
Improper reach can increase shoulder pain or cause hip joint pain from your hands being too close or too far away from your hips.

Cadence
Aim for between 90 and 110 revolutions per minute for efficiency and to decrease stress on joints and muscles.

Core stability
Helps support the trunk with prolonged upper extremity weight bearing and can decrease risk of low back pain and saddle sores (by decreasing hip rocking while seated).

Foot position
Proper cleat position can help decrease risk of Achilles tendinitis, knee pain, IT Band pain, and can improve efficiency.

Shoulder position
Proper shoulder position helps to decrease neck pain caused by upper trapezius muscle tightness and reduce numbness in the arms and hands.

Swimmers

Swimmers

Swimmers should consider a video swim stroke analysis for multiple reasons. If you have pain with swimming, slow motion video feedback and swim stroke advice can correct common errors that lead to pain. In addition, performance and confidence can improve with proper timing and form that can be learned with corrective exercises and drills.

Swim Stroke Analysis Overview

Our swim stroke evaluation includes a medical and training history, assessment of functional range of motion and strength, and a video analysis of swimming form with feedback from your physical therapist. Recommendations based on your analysis will be provided, including ways to treat or prevent injuries in and out of the water.

The cost for those looking to prevent injury or improve performance is $100. Current patients or injured individuals who have a physician referral can bill the swim analysis through insurance. If you are unsure of your plan’s coverage, please contact us and our staff will verify coverage with your provider.

The Evaluation

Whether you’re uninjured or injured, we’ll watch the way you move, particularly how these movements impact your joints. Here are a few examples of what we assess and how improper or unbalanced movement can limit your ultimate race potential.

Hand placement
Correct entry into the water prevents excessive internal rotation of the shoulder which can increase shoulder pain and pinching of the rotator cuff muscles.

Body roll
Using larger muscles in the core to power the stroke provides better arm recovery and injury prevention, and increases efficiency with swimming.

Catch and pull through
By working to develop a high elbow catch technique, plus good swimming posture, excessive shoulder load can be avoided.

Position relative to water surface
Proper swim posture can eliminate low back pain and increase the functional use of the core.

Kick technique
Anterior knee pain can be common with repetitive flutter kick, breaststroke kick and flip turns. We can analyze your stroke to ensure proper alignment.

When does pain from endurance training need rest or medical management?

Chart showing endurance pain levels

Normal

Pain subsides after a few hours of rest

  • Continue to train
  • Begin using ice and NSAIDs, especially if pain reaches a 3 or above on a scale of 1 to 10
  • Mention pain to coach

Chart showing endurance pain levels

Heads Up

Pain continues 4-8 hours after resting

  • Consider “relative rest” – decrease training volume, longer warm-up and slower speeds
  • Handle with coach

Chart showing endurance pain levels

Rehabilitation

Pain continues into the next day after training

  • Consider removing from training
  • Three-day trial of absolute rest
  • Refer to sports medicine physician and rehabilitation

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