Here is the truth About Running Injuries: Prevention, Treatment, & More...
If you're like most people, you probably enjoy the health benefits and stress relief that comes with a good run. But did you know that running can also lead to injuries? In this podcast Lee Pattillo from Vitalee PT shares the most common running injuries, how to avoid them, and how to treat them if they do occur.
Here is the truth About Running Injuries: Prevention, Treatment, & More...
If you're like most people, you probably enjoy the health benefits and stress relief that comes with a good run. But did you know that running can also lead to injuries? In this podcast Lee Pattillo from Vitalee PT shares the most common running injuries, how to avoid them, and how to treat them if they do occur.
All right. We are here today with Lee with Vitalee PT and I'm Daphne, the owner of iDaph Events, and really excited to talk to you. I've been looking forward to this on the calendar for a while, Lee.
Lee Pattilo:Yeah, me too. Thank you for having me on.
Daphne Kirkwood:Yeah. I'm a runner and I've had a bazillion running injuries, unfortunately. And so just being able to talk to you I think is gonna be really beneficial for a lot of our participants and followers and people that are just curious about what in the world are they feeling? What is this nagging thing that's going on? So today, we're gonna talk about what some of the most common injuries are that you're seeing right now and we're really gonna stick to the runner right through this conversation. Isn't now? Yeah. Yeah. Cuz we, so this seems off topic. We could go all across the board, but we're gonna just do running because
Lee Pattilo:yeah, I like. On topic.
Daphne Kirkwood:Yeah. So we do, have triathlons and cycling events and we really have all abilities and different levels, but today we're just gonna stick to running and maybe we'll come back and talk about one of the other sports sometimes. Yeah. What are some things that you want, feel like you wanna talk about today? Just running stuff. Is there anything.
Lee Pattilo:I think running is good. Seems like the probably the crowd favorite on this podcast. Okay. Which I think is fitting so
Daphne Kirkwood:good. And I did ask some questions from folks to get some input on things that they would like to know. Oh, nice. Yeah. Now, so we'll get to those. The pressure is on or at the end of the podcast yeah. So first off, tell us a little bit about who is Lee and how in the world did you get in with, into this line of work and.
Lee Pattilo:Ooh, that's a very loaded question. That question's always probably changing. PT in general, Uhhuh, have a sports background, played sports and well played football in college. There's always injuries with that, rehab, that kind of stuff. Really just like working with people though. I remember being like 18 years old and what the heck do I want to do with my life? And I had a lot of good family members that were like, Hey, you're good with people. Do something. people and my mom was like, I think you would be interested in physical therapy. So I looked into that and then did a lot of working out running sport specific stuff and I was like, wow, that really fits a lot of the stuff that I really enjoy and I'm passionate about. That's really what got me into it. So it really feels like PT is sometimes not work because I get to do the stuff I really enjoy to do.
Daphne Kirkwood:And it's probably natural for you too,
Lee Pattilo:because Yeah, I think so. It feels pretty natural. Yeah. Yeah. I've my, my wife has been like, yeah, I don't really see you doing anything other than that, so that's probably a good sign,
Daphne Kirkwood:and when I met you, how was it a year, two years ago? I don't know. It's
Lee Pattilo:probably been a year and a half or so. Okay.
Daphne Kirkwood:Yeah, we met I was dealing with a running injury and you just seem to. Hop right in and be like, yep, I know exactly what that is. Which was really great because you definitely have this confidence about you that, you could me help mend it and get it figured out and fixed. So
Lee Pattilo:yeah, most most things I've. Most of the injuries I see, I have experienced something like that, or the same thing at some point in my life or career. And I always try to, I think, tailor my approach to what has worked for me and then like how has this felt and how does, how does this limit? So a lot of the training I've had plus personal experience I think has evolved into the way I practice. Yeah. Hopefully is a good thing,
Daphne Kirkwood:yeah. One of the other things and I've been to other physical therapists before in, in PT organizations and stuff. Yeah. One of the other things just really quick that I thought was cool about you is that you have the app that you can send the exercises and do the check-in and stuff, right?
Lee Pattilo:Yeah, the biggest, so that was I got into PT for all those reasons and I was really, honestly, this is I always hate sounding negative, but really my first year and a half in the profession, I was honestly disappointed with just the, I think the general way that we did it. And I really felt like a lot of the practice was See people really frequently, it seemed really fill the schedule, get people in, they're, you're trying to hit a number of quotas. So I was like, is this the way I want to do it or not? And basically I sat down and I was like, all right, the options are, do something different or go do it the way you think it should be done. And I've chosen the second option, and really my whole practice and philosophy and goal is to get people. In and out of pt really as quickly as possible in as few visits as we can, which that sounds really simple, but sometimes people are like, that's crazy because that's maybe cuts into your Yeah. Bottom dollar. But what I have seen is that it does the opposite. When you get people better and do the right thing quickly and don't waste people's time and money, you get other people because of that, Yeah, that's really the approach I've taken and it's. Trying to get people to learn and understand what to do on their own, where they're not reliant on coming into physical therapy consistently over and over again. And that's really how I practice for not just runners or athletes, but even, older adults or people that are post-op. The whole goal is we're building a plan that takes you from point A to point. getting you back to what you love to do.
Daphne Kirkwood:Yeah. Yeah. And the thing is, we're so busy, right? It's like we're juggling families and kids and sports and our own exercise and work and all the things, and it's like sometimes you just can't fit an hour PT session. To go somewhere, drive down, yeah. 26, heaven forbid, to get there, yeah. And it's yeah, I think that you have to think outside the box a little bit and yeah, so sometimes I think you do need to definitely come in and make sure that you're doing it correctly and that sort of thing, but it sounds like you've really come up with a way to make. more accessible and convenient for
Lee Pattilo:people, yeah that's definitely the goal. I The other thing is when you're talking about working with a runner like yourself, or even someone, maybe they're not a runner, they're cross the athlete or or person that's playing a lot of sports. If you're doing physical therapy the right way, their prognosis and recovery time should be a lot faster. So I'm okay, if I do the right stuff, this person should see some change in. two or three weeks. Versus I think the traditional model a lot of times is like, Hey, let's try PT a couple times a week or once a week for eight weeks. But yeah, really try to hone in on, hey, if this person, if we're doing the right stuff, we should see pretty quick changes and know if we're doing the right thing or not. Yeah. Cool. And yeah, I'm like, if someone told me to do PT three times a week, I'd be like, yeah, I don't really think I have time for that. Yeah. when am I gonna
Daphne Kirkwood:put that in? Yeah. Alright. At night, you just wanna sit and do nothing. Sometimes and it's
Lee Pattilo:like sometimes you need to do that. Yeah. Sometimes you need that recovery. It's important. Yeah.
Daphne Kirkwood:So like I said, I've had all the injur. I think all the injuries, I'm exaggerating of course, but I've had a lot of running injuries. And I remember specifically the first one that I got which was 20 years ago, I started running and just knew nothing about it. Just started running and then, ran every day and just, ran fast, ran hard, like just, whatever. I ha I didn't know anything about it and. I remember I got a groin pool, a severe groin pool was what it was called. And it was, I did way too much mileage too quickly. I was running fast and probably turned incorrectly, whatever. So when I had this injury, Lee, I was like, Why? What is this? I have not fallen. Yeah, What? What is going on here? I didn't even know you could get a running injury from just
Lee Pattilo:running. Yeah no tra, no Trump traumatic
Daphne Kirkwood:event. Yeah, like I didn't trip on a trail. I just was running and got this injury. Does that seem strange
Lee Pattilo:to you? Yeah it's funny because those are the cases that honestly are the most worrisome because you exactly what you said, you're es essentially I did not do anything that makes sense. Why this should feel this way. I do not understand. And then you can go the doctor Google route or think of all these different things that could be going on and it really, it freaks you out. But yeah, I mean it's really common. I hate, I really hate a strong word, but I don't like, The whole like overuse thing. I think in your example it was more so Hey, I didn't have the best training program or kind of thing to follow. It wasn't necessarily that. Maybe you were just like running too much more so the volume at certain times or under recovery, and I think it's, that plays adamant to, it's good that there's a lot of resources out there now that have programming and even a lot of the general apps and things like that have really good places to start. With the base from, but that's very common that people say that, Hey, I just started running, or this or this. And then they're like, why the heck is this going on?
Daphne Kirkwood:And what I found out through the years is it's because of the impact, right? It's different than other sports too, like cycling where you don't have that high impact. And so your lower extremities especially are just feeling. Bang. Yeah. So especially if you're a pavement runner, which that's what I am.
Lee Pattilo:Yeah, I think that that really goes into the philosophy where, If you have, like having not perfect or not the most adequate technique may not be a big deal. but if you're getting into that higher volume of mileage, the kind of the wear and tear without maybe the right running technique or best best form, that starts to really add up. Because not only is it, there's high impact, it's pretty much repetitive, the same. over and over again and what we know in fitness world or PT world, even if you're doing something that's low load, but very repetitive if something's even just off by a small margin, that adds up and over time, you're probably gonna end up with that out of the blue, the heck did this happen? That's a really common presentation of how did you get to this point of what we'll call injury?
Daphne Kirkwood:Yeah. As we put on races and you come to a lot of our events and set up and for me as a race director, I see how much. Time and energy and commitment people put into the goal of getting to the start line and then getting to the finish line at a race. There's so many sacrifices that people make along the way. And it can be so frustrating when you are on your way to that goal and then something comes up, like a running injury, right? And it sidelines you. And I think. That's one of the reasons I wanted to talk to you is just, a, to give people hope that you wouldn't get better. Because sometimes, things last for a long time. I've been dealing with a tendonitis issue for a long time. And I, I think that, maybe if we just talk about what some of those running injuries are and the prognosis of that, I think that might help. tell me a little bit about what some of those injuries are that you're seeing like over the last six months to a year
Lee Pattilo:especially. Okay. Yeah. I've actually not been seeing quite as much of a adductor growing, but that definitely is in there. The most common one that comes to mind, and you can, I can go back through my data, is we'll say anterior knee pain. So essentially knee hurts painful in the front. Diagnosis could include. Oz Gola jumper's knee, it's really commonly patella tendonitis. And essentially with that, you, a lot of times you're gonna see, similar to what you said, there may be this repetitive, thing you're doing with your training or maybe you're missing something, but essentially, Overtrain quad becomes injured strain that causes the muscle to actually get weak and that actually causes it to get tight, which actually causes the patella to then get tight in the pool on the insertion point in the tibia, which is right below the knee. And then that's when the brain says, Hey. this hurt and does not feel good. And really the big thing with that, and like with the injury you mentioned too, it's important to get in quickly. My rule for people is Hey, if you have this issue that flares up, give it like one to two days. Maybe just take some time to rest and recover. And if it goes away, hey, no big deal. Probably just a minor strain your body's saying. you pushed a little bit too much, you need to recover more. No big deal. If it hangs around really longer than that's where I would say go see medical professional or someone in your corner that you can trust with, like sports injury and then what we know from a prognosis standpoint, the quicker you start getting treatment or intervention for. you're gonna get over that injury faster. Specifically for tendon injuries, it's the chronicity of it where if you're hanging around with tendon pain for a long time, it actually makes it harder to get better because that muscle group, again, is weak and tight and it's just getting more and more atrophied. And what happens in healthy people, because you're so healthy and fit, you basically compensate with other muscle groups and you're like, this is fine. I can run and get away with it. No big deal. And this little snowball is slowly in the shadows building up and you get a problem down the road and you're like, wow, what, where did this come from? And where did it happen? And that's what I really see with people is, that's what's gonna change. The prognosis is. really your time from injury to your time of starting to get treatment for it and starting to get it to get it better. Yeah.
Daphne Kirkwood:So is the knee pain that you're talking about, is that runner's knee,
Lee Pattilo:what they call it? Yeah, that, that'd be the same diagnoses. The problem. Okay. The problem in western medicine sometimes we're, we give these all these cool names and it's cool. What does that mean? Who knows? Yeah. A lot of times they present pretty similar. Essentially, if you're getting, in this case what we're talking. Knee pain in the front, along the bony part of the kneecap, whether it's above or right below. Fits into that category. And if you look at really evidence-based physical therapy, what's the best course of action for it? It's actually strengthening the quad, which can sound weird because a lot of times people are thinking it got hurt from doing something active. it seems like it would make it worse to do more on it. Yes. But you're essentially doing more of what you should be doing is more of a type two kind of anaerobic stimulus for it, which is gonna be a little bit different than of your distance training regimen.
Daphne Kirkwood:We don't. I don't understand that
Lee Pattilo:terminology. trying, I'm trying to sound really smart. Type two So basically distance running, you're gonna be working types.
Daphne Kirkwood:You have all this lingo,
Lee Pattilo:we try to sound fancy. With distance running, you're doing more endurance based exercise. So what their data really shows. And what I think a lot of people know, cross-training is really important, where you're getting a different stimulus. So a lot of times to get an injury better or to prevent it, you want to do some cross-training basically for that muscle group. And in this case, for a distance runner, it's gonna be some type of. Resisted strength training. Load. And we won't go too much into physiology, but you do. You have type one, type two, muscle fiber. There's also a intermediate, but in running you're mostly using the type one. So there's some thought if you aren't getting as much anaerobic type two muscle fiber development, that system weakens. But really simply put, you just want to do. A different stimulus that strengthens the quad in a less repetitive, impactful way. To target the muscle group that you're gonna use when you run.
Daphne Kirkwood:So I had that injury a long time ago. and the person that I saw at the time told me to take up biking that I needed to bike bike. Get on my bike. Yeah. And build up my quads. So I did So got
Lee Pattilo:rid. Did it get better? Yes. nice. Yeah. Hey, score a one for us.
Daphne Kirkwood:Yeah. But there was other stuff involved too, but that was basically like, instead of just running. Ad cycling and to help build up those muscles. Yeah.
Lee Pattilo:I think the most common thing I see is people, their first thought is to stretch, like stretch. Which makes sense because at least from like a logical standpoint, cuz a lot of times with those types of injuries, it feels like there's tightness around it. And I think the important thing for you guys listening to realize is, Tightness a lot of times is more of a symptom and it's coming from somewhere else. And in, in this case, a lot of times it's the root cause of muscular weakness if you just stretch it or try to stretch it to get over it, you're gonna be treating the symptom. Whereas like in your case when you started biking, you started doing quad dominant strength training in a non painful environment or stimulus. that basically broke the cycle of the root cause where the muscle group was weak and causing the tightness. Yeah. So you wanna get to the root cause and a lot of times it is the muscle weakness, which can sound weird. Yeah.
Daphne Kirkwood:What else? So what's the next one?
Lee Pattilo:What's the prob probably sticking with the knee. This is one that always gets me when I ramp up my running volume, or even if I. Or backpack more specifically, but lateral knee pain. So we're going to the outer part of the knee outside part. Common diagnoses is gonna be, Hey, you have it Bend Syndrome, and essentially when you run, you're gonna get this kind of dule achy pain Yeah. Outta part of the knee in that bony area. When I have experienced it, I normally don't feel it as much with running. It's more so when my running volume goes up and then I'm doing squatting and other things, and I'm getting into deeper squats and I start getting this stabbing knee. in my outer part of the knee. And normally my, now my mind goes to, oh, my hip abductors are probably, something's happened there not doing enough stuff. And essentially go the strengthening route there. But the going on my own example similar story, I think I was training for the Blue Ridge relay, which is what's the common term for that? Like a Nordic, not Nord. Relay essentially where you go like 24 hours and you take turns and you sleep in a van and it's supposed to be a lot of fun, but it ends up being a little bit miserable, But I was training for that and this was actually when I was in physical therapy school pretty early on, Uhhuh and I got this lateral knee pain and just like your story, I was like, what the heck? Where did this come from? No traumatic. Issuer injury and I saw a couple PTs for it. That I think probably went more of the biomechanics, looking at more like structural things. And essentially it got better when I started doing hip abductor, closed chain, single leg strength training, which was weird because in my mind I was doing a lot of running and CrossFit at the time and I was like, I'm doing a lot of strength training. Yeah. It's weird that I need to do more, but I needed. A specific stimulus that was similar to running, which is single leg, most of running, you're spending either in the air if you're running correctly or you're in single leg. So if you have weakness in your hip abductors, which is this nice muscle group on the out outer part of your hip you may be having a problem there If you're essentially, excuse me, if you're essentially getting lateral knee pain, which is a weird one because the pain is in. in the knee, but a lot of times the issue is actually coming from somewhere above in the hip.
Daphne Kirkwood:Okay. Potentially. So like when I've had it band issues as well, so when I've gone to get massages, they always just rake on that. Yeah. Massage, is that good for it or is that.
Lee Pattilo:Yeah. That's not, it's not a, it's not a bad treatment at all. Going back to, and this really fits into my story as well, going back to that kind of physiology where if you have that muscle tightness or that trigger point that really tells you there's a muscle weakness there. A tight muscle is a weak muscle. So like in the past when I was struggling with it, I was doing that kind of. And it would get a little better and it would still be the cycle of like little better, worse, little better worse. And it was really adding the specific strengthening that broke the chain. But to the massage therapist credit, or a PTs credit that's gonna do soft tissue massage or something like even dry needling. sometimes you need that hands-on intervention to get you out of the pain threshold. So in that case, like if you're having so much knee pain, you can't do. Strength training or running, you may need the massage or the dry needling treatment acutely just to get you out of it. Where then you can strengthen the muscle group back. Or a foam roller, right? Or foam roller. Yeah, you can go that route too. I would just caution you if you're only doing the foam roller or the massage, or the acupuncture or the dry needling. you're really just treating the symptoms and you're probably gonna be in that cycle for a long time where it's gets better, gets worse, gets better. And sometimes that's where you know, you will see a PT plan of care take eight to 12 weeks because you're focusing on that kind of stuff, rather than working towards the strength training stuff, which essentially you can do on your own as well. And that gets you hopefully better. Yeah.
Daphne Kirkwood:All right. So we've talked about the niece. Top two were knees. What's the next one? What's the next injury?
Lee Pattilo:Actually recently been a lot of medial inner arch foot issues. So this could be, I, you've prob you've probably noticing I'm calling most of the problems like foot pain or knee pain because it's much more. Simple than to give it, like a diagnosis, like plantar fasciitis or something like that, or Achilles tendonitis. But yeah, I would say most recently, the biggest one I'm seeing is we'll just say running related foot pain, whether it be on the inner arch or the heel. And that one's gonna, that one's gonna be a little bit tough. Treatment wise, because it's can be hard to stay off your feet and not yeah, aggravate. But the treatment a lot of times is gonna look similar where it's basically find where it's coming from, hopefully from a muscle group. Treat the muscle group again, it may be soft tissue work, it may be dry needling, it may be something as simple as, Hey Daphne, start foam rolling this muscle group. Get pain level down, and then start strengthening the muscle group that. It is contributing to the problem the other side. If someone's having foot issues, I'm normally, typically more likely to look at maybe running mechanics at that point, or screening the hip just to see if there's something else playing in. Sometimes it's not always a strength imbalance. Sometimes people end up in that scenario because there is something technical, going wrong. But yeah, I'd. Yeah. The big next group is gonna be foot pain, whether your plantar fasciitis or posterier tib tendon pain or Achilles tendonitis. Neuro. I've had one of them, or, yeah, that's the, that if someone has anoma, that's probably one of the hardest ones because you're dealing with something. Less truly muscular, which is always more
Daphne Kirkwood:challenging. Yeah. everybody what a neuro is in case
Lee Pattilo:they don't. It's essentially where you're getting a nodule in. Part of, we're just gonna say the nervous system or peripheral nerve and like especially the foot, it's really common between, can't remember exactly which toes. Maybe it's the first and second or third and yeah, third and fourth sounds more accurate. I haven't seen a lot of neuros lately, which is, But yeah, very painful. You're getting a lot of times nerve symptoms and as a PT, when people present with just like classic traditional muscle pain, I'm like, heck yeah, we can fix that. That's super easy. Whenever they start presenting with something nerve or more mechanical or structural, that's where. it gets a lot more challenging. Yeah. Prognosis. Not
as
Daphne Kirkwood:good. Yeah. I got my neuro because I would run during my lunch break and then I would go and put on my fancy tight closed shoes. Yeah. Shoes, and so once I, once we figured that out, I stopped wearing that type of shoe. And got my foot all fixed up.
Lee Pattilo:But yeah. Are you a big fan of the wide tow? Yes, same. I've been, even just recently, I've been working a lot of hours and on my feet a lot and I'm like, Ugh, I have some non wide tow box shoes and I'm about to go all wide toe box because of thatchy.
Daphne Kirkwood:Yeah. When you feel that little electricity zing when you step down
Lee Pattilo:that'll make you switch shoes on it. Toes. It's
Daphne Kirkwood:no. Yeah, this isn't gonna work. Okay. Alright, so we talked about Achilles heel pain. What's the next.
Lee Pattilo:Those are, those are the big ones. Then I would come back and go more with the adductor injury. And I've had, it's always interesting, especially with females, and this is where it's good. I'm not a pelvic floor specialist, but there are PTs, great PTs out there that specialize in that. Yeah. And it's not uncommon for people, whether they're runners or not, to have abductor or grow. Injury and it truly be that, or it could be something pelvic floor related, which is common. In runners too. But to be simple, that's gonna be Yeah. That inner upper leg kind of hip. Especially after having, making Yeah, exactly. That's there's definitely some things that have changed and gone on, which is necessary, but it definitely it definitely can have a big impact.
Daphne Kirkwood:Yep. Big. Awesome. So if somebody's feeling some of these things, I would recommend personally, don't go to YouTube and look up videos, how to take yourself, because I knew I
Lee Pattilo:liked you for a reason. I did
Daphne Kirkwood:that recently, and I must tell you that I couldn't walk that night because I didn't put the tape. I thought I knew what I was doing, but I didn't really know what I was doing. I love tape. I don't know, it's just like this weird thing. I feel like it's a little security blanket, yeah. If I have a little nagging thing, I'm like, I'll just throw some tape on that. Some K tape. Yeah. But you need to know how to put it on because there is an art to it. And there's different types of tape and all that. So you do that too, right? Like you can take Yeah. Take people.
Lee Pattilo:Yeah. There some PTs. Take specialty. Courses in that. I haven't done any like specialty courses with that. But essentially if you, if if you're someone that knows your anatomy and you have a at background, you can normally do pretty good work with tape too. But yeah, sometimes the doctor Googles and Doctor YouTubes are not always the, I know, the best route to go. Sometimes they weren't great, but sometimes they don't. flipping a coin. I Sometimes you go to. PT or doctor or whoever, and you may get mixed reviews. It really just depends. I think it's important to have trustworthy pt, chiro orthopedist Do, I mean someone that speaks the language and that you trust their opinion. I think in the physical therapy world, the, we'll say the money's really in the evaluation. If something's going on, you really want to know where's the problem coming from and then like we've discussed some of the strategies to help fix it Or even watch YouTube and get some information and then take that to your trusted provider and see if that's, you're already on the right track. Or is that maybe not the best idea? Because everyone is very everybody is different, which is good. Yeah. Keeps
Daphne Kirkwood:things interesting. And I know too, when I've had injuries. you just get fed up with it and you get impatient. Like you just wanna be running tomorrow, right? Yeah. So you wanna get fixed really fast and back on the road and all of those things. And it's, for me, I'm super proactive when it comes to that stuff. But sometimes, like you said, people wait and wait and they. Get checked out and get help, what advice do you have for people that you know are just on the fence about coming to pt?
Lee Pattilo:Definitely do your research ahead of time. I'll, I have people that have asked me like how do you know, how do you find a good physical therapist? And it can be challenging because there is always the business side in healthcare where there are places that, it just depends where you go, essentially. But I would say what you do is go online, read about it, look at reviews. I, the easiest thing to do is call somewhere and just be very general and vague and just simply, how many times a week do people normally do physical therapy? Don't tell oth, don't tell'em anything other than that. Just, that's the simple question. And if they're like everyone does three times a week for six or eight weeks, you probably want to call a different place. Cuz you're more going into a cookie cutter. Exactly. Exactly. Yeah. Or if you ask, the other thing is to ask if you're gonna always be one-on-one with your physical therapist. There are a lot of places, depending on insurance business model, you may not be. And then for that question, first question, Hey, how many times a week do people typically do get your answer and then ask, am I always one-on-one with my physical therapist? And if they say, anything other than Yes, you'd probably not your top choice unless you're
Daphne Kirkwood:totally agree with
Lee Pattilo:that. Yeah yeah. Not to say those places are terrible, but there's good, there's great PTs everywhere. It's really I think it's really the system. You have to be careful about this system you're choosing that you go to. It's the
Daphne Kirkwood:business model, and I think if you want the attention that you deserve, you know it. Pay to do a little research.
Lee Pattilo:Yeah, do some. Yeah, I think it's always good. I'm I'm really, I'm odd and really weird and love talking about health insurance and copays and monetary things, but sometimes you can go to a out of network cash base, self-pay physical therapist and actually, they may charge a lot more than your insurance cover. but you may actually get better faster and do less visits. And in the long run it saves you a lot of Yeah, time and money. I There's always, I always look at it, I grew up in this area and I've always, I don't know if weird, but I'm always wondering about the financial stuff, which I think is healthcare providers. You have to I think you honestly have to, because again, you're talking about making PT accessible or not, and for some people, Even with health insurance, you go to physical therapy, you've not met your deductible or you don't have good Yeah. Insurance. If you're paying$90 a session or even 70, and they're saying, Hey, you need to do eight to 12 visits, that wouldn't be affordable for me. I'd be like, yeah, I think I'll go to YouTube. Yeah. See what
Daphne Kirkwood:happens. Assume because they have PT coverage with insurance that's the best deal. Financially, but it's not necessarily,
Lee Pattilo:yeah, not necessarily depends,
Daphne Kirkwood:it's definitely, you're hooked into this set number of things, like you said, and this is the cost. And if you run the numbers and you come and see you three times versus, 14
Lee Pattilo:Yeah. Yeah. Really in, in my business model essentially we're trying to. Trying to offer the best quality care possible. But there's always the thing where trying to compete with insurance and trying to give people the best price for the, for their quality, where it's hopefully you don't have to worry about, all right, insurance is this place is this. But yeah, anytime. The biggest thing is find who's gonna get you better quickly, and there's a clear defined plan. You're here, this is how we get to here. This is our timeframe, and ask a lot of questions. Yeah. Okay. Like hard questions put people on the spot.
Daphne Kirkwood:Yeah. That's good advice. I know we've been talking for a bit and we did have some questions that came in that I just wanna ask. We don't have to spend a ton of time on'em, but I thought they were good ones. All right. Pressures on. What's the best thing to do for sore muscles? I don't have a bathtub, which means I can't soak in Epsom salts.
Lee Pattilo:Oh. If you're getting sore, that's good. You're doing good stuff. I would say. Sleep is very important for recovery. I think that's very underutilized. And talk about, I really don't believe in hardcore you're over-training. I more so believe in under recovery, which is probably a cliche to say, but on days you're really sore, do a light workout, but do it more so just to get the heart rate up and get blood flow pumping. You're not trying to push. And do something really
Daphne Kirkwood:strenuous of running, maybe try swimming or biking. Yeah
Lee Pattilo:cross train. Hit, yeah, hit a yoga session mobility session. Even at that point, something that's more relaxed, almost even meditative. Yeah, I like, I'm a big fan, not that it always has worked or proven in research, but the nothing beats getting in the Davidson River. Now and then.
Daphne Kirkwood:I didn't think about that. That's a great suggestion.
Lee Pattilo:Yeah. I like the cold one. Yeah. If if that works for you, there's, I don't have solid research that just says, Hey, go do that. There's not a ton that says, that's clearly defined to, IM improve recovery and performance. It may only be like a percentage point or two, but it's really finding. Yeah. Makes you feel better. It's, specific. Yeah.
Daphne Kirkwood:Okay. All right, next question. Is there a specific timeframe after an injury to hold off on running? Or do you just start back when it feels better? Like how do you know it's okay?
Lee Pattilo:Oh, that's a great question. I try to guide my clients, patients, runners whatever you want to call them, with almost more being intuitive, where essentially, Let's say you can run, let's say you have knee pain. Hey, when you normally run at the five minute mark, you're getting knee pain, okay? We need to basically stop the exacerbation of symptoms, so we're gonna pull your running down less than five minutes. Do. Some interventions probably give you some strength training stuff. And essentially if you can still run for a minute to four minutes, it's good to continue your running. And then basically from there it's let's reintroduce you to that stimulus and if you can essentially run with even just we'll say mild or very dull symptoms below four outta 10, probably fine as long as you're not continuing to run and those symptoms are worsening or. day after next day, your symptoms have come back. I think the simple answer is you can keep running. Up to the point of symptom exacerbation, but you should also be kind cognizant not to over. Over push. Hope that answers that. Yeah.
Daphne Kirkwood:So my my tendonitis after about a mile of running just goes numb in that area. Yeah, it's great.
Lee Pattilo:Plus low baby
Daphne Kirkwood:It's the one I stopped and I'm like, oh. Yeah, Yeah. So I think sometimes it's like you don't really know until you're done
Lee Pattilo:necessarily. Yeah. That's a tough one. I It really depends on the scenario, but it's really guiding your return to running with symptom management, I think is the simple. Yeah. That may not be the best answer, but
Daphne Kirkwood:yeah. All right. Next one. Somebody who has battled with planter fasciitis. Is that the right way to say that? Fasciitis. Fasciitis. You can say it however you want tips and exercises for that.
Lee Pattilo:I'm gonna, I'll give the, I was p there's always the, it depends answer. Again, you want to break pain cycle the stimulus. A lot of the research shows like night splint, bracing, if it's truly plantar fasciitis is good. Sometimes changing footwear or shoewear plantar fascia pain or that presentation of pain can be truly coming from the plantar fascia or foot, we'll say intrinsic. Stabilizing little muscles in the arch of the foot. It could also be referring from your gastro soleus muscle group above or even somewhat coming from the Achilles. So in that case, it's really figuring out which muscle group is it coming from. and then basically trying to get the muscles relaxed and then really, the general answer's gonna be building them back up. True. Yeah. Strength. With strength. The biggest thing I really, my kind of thing with almost everything is if you have pain and muscle tightness or issues, you probably have a muscle weakness and imbalance somewhere. Okay. It's just a matter of finding where it is.
Daphne Kirkwood:And you helped do that, right? You helped figure out what that. Muscle imbalance is where it's ho hopefully.
Lee Pattilo:Yeah. Yeah. Yeah, I should,
Daphne Kirkwood:yeah. All right. How about running in cold weather, like trying to get your muscles warmed up and ready to go like any. any suggestions on just, keeping those muscles warm and stuff when it's super duper cold and you're running?
Lee Pattilo:Yeah, I definitely a really good active warmup. Maybe even an active dynamic warmup. Not necessarily, and I'll preface that and say active dynamic warmup is gonna be, you're doing like running, almost like running specific drills or functional compound movements. Not necessarily static stretching, but maybe do that in a warm. And then transit and get really warmed up and transition to outside. What you wear is important too. Yeah, and I think the, the hardest thing with running your upper extremities get cold because you're mostly using your leg, so your blood flow. By default, it's gonna go to those muscle groups. I, I think like wearing stuff on your hands and those extremities in the upper body that aren't gonna be as, as warm, definitely keeping, your head is where your warm air escapes from. So definitely prioritizing. I know when I run in the cold, I don't like to get all, if you're bundled up and restricted in your upper body, that's really challenging. Definitely go with good headwear because that's easy to take off, get rid of, or on top of that, it's a lot of, lot less weight for what it's accomplishing. I think a cool side note, not necessarily answering this question, but they've done research on, I think it was. I think it was runners, but they had runners basically train, some of them trained in a moderate temperature environment and some of them trained in a really hot temperature environment and then they competed in a more of a cold temperature environment. And basically the runners that trained in the heat did even better in the cold because essentially when you're training in the heat, Your blood supply is in battle for getting blood flow to the muscle groups, getting it to the skin to cool down. So even if you're doing like a winter run, if you can train in the heat or go somewhere hot and train hot. Yeah, exactly. Then that's actually gonna be, that's actually gonna be beneficial from a performance. That's great standpoint. That's good to
know.
Daphne Kirkwood:I like that. Good side. Good side note, that's a little tidbit. I like that Intel. Hope everybody heard that. Alright. And then the last question, if you start to feel some pain running. should you push through it? Should you stop immediately? think this sort of ties back into what you were saying before, but any advice on that? If you just all of a sudden feel something?
Lee Pattilo:I think it's identifying the stimulus of pain or sensation. So is it more like, Sharp, stabbing, high intensity above. We'll say five out of 10 if that's the case. I would say yes, stop. If you're getting more dull kind of ache below five out of 10, you're probably getting more muscle feedback. That's probably saying Hey Lee, hey Daphne, we're tired. Now please slow down if you're getting that type of pain. Yeah. Totally fine to push through if it's the sharp stabby back off.
Daphne Kirkwood:Yeah. And all of our races, we always have, water stations and medical crew and stuff like that, it's just, Trust me, it is not worth pushing through something that's a stabbing 10 because it will take months and months
Lee Pattilo:live. Live to run another
Daphne Kirkwood:day to get it back to where it needs to be. So you can run again. I know. Come
Lee Pattilo:back stronger if you do the right stuff. Yeah. Yeah. Your performance will probably be better.
Daphne Kirkwood:Exactly. So what else? That's the questions we had. What do you, what else do you wanna share with. I know you had put some literature and some
Lee Pattilo:Oh yeah. I think I think we've talked about it a lot. If you're probably tired of me saying get it stronger, do some strange training. But even from a performance standpoint, I shared this article with you. They took elite distance and mid-distance runners that were not doing strength training. And essentially had them do two to three times a week squats, polymetric. I thought it was really fascinating sprint interval work. And essentially what they found was that actually improved running economy would be the fancy word, but it essentially improved their running performance. And what's really cool about that is happening in highly trained elite runners. So if you're kind of. couch to 5K or kind of a recreational runner looking to boost your performance and you've not done strength training before. If you prioritize, two to three times a week of that, you're probably gonna see pretty, pretty substantial benefits to your running and in theory. maybe prevent injuries and things like that. Yeah.
Daphne Kirkwood:Or if you're just a cardio endurance junkie and you don't like going to the gym Yeah. then, if you make that a priority, yeah. It does make a difference. It really does. Like I, I've been doing it religiously since this past summer. I was hit or miss before for me with strength training, but even when I run. I'll feel, I'm like, my legs feel strong, yeah. And I always thought my legs would be strong cuz I run. But adding that extra strength
Lee Pattilo:element, different stimulus. Yeah. Yeah. I think it's important to find what you enjoy. I don't like. I will run a 10 k Getting above that, I'm that just sounds torturous. Like my running regimen, I love to go do like sprint intervals. I'm weird and have like track spikes and like to do sprints and that kinda stuff. Yeah. You thing. Yeah. But as a distance runner, if you like you, if you're a distance runner, you like running. Yeah. If you just even mix in sprint work and speed work like that. Fast running, you're gonna get a strength stimulus from that, so you don't have to go to the gym. I think sometimes the gym can be, yeah. Can be boring for some people.
Daphne Kirkwood:Now I just a question because I'm curious. One time when I had an injury, I went to a pt I, no, I think he was a sports medicine doctor actually, and he told me I just needed to stop.
Lee Pattilo:Probably not the answer you were looking for.
Daphne Kirkwood:You don't tell people that, do you, Lee?
Lee Pattilo:No. No. No, of course not. Definitely. No. No. I
Daphne Kirkwood:think runner that you need to stop running.
Lee Pattilo:Yeah. I, if that's your thing, you can't, it's like telling a fish not to swim. It's not, you're not gonna get a good outcome with that. There, there's gonna be scenarios where it's yeah, maybe you should. Time off and do some other stuff, or in a very extreme scenario, sure. Stop running. But I, yeah, I can't really say in the years I've been doing this, I've just bluntly told someone like, you can't do this. I think a lot of being able to do something or not comes down to the person. Yeah, whether you want to do it or not, you can, be creative and figure out ways to.
Daphne Kirkwood:Yeah. Yeah. For me it was doing different exercises, not just running, so adding and biking, swimming, yoga. Yeah. That, that helps, and it's man, if I could just run every day, I would, but my body doesn't put up with that. And I would say a lot of people's bodies don't, yeah. So I think it's that trick of cross-training that really helps you to be able. to do the things that you love to do for a long period of time, yeah.
Lee Pattilo:That's what's cool with I think triathlons too. It's essentially a cross-training event. Yeah. It's very endurance, but yeah.
Daphne Kirkwood:Great. That's wonderful information. I think you covered some really good stuff. And how do people find you if they wanna. Talk to you or connect with you. What's the best way to, to do that, Lee? If you
Lee Pattilo:go this, it's, it may be hard to spell my website, vitally pt.com, essentially vital. V I T A L E P t.com. Information on there phone numbers on there, email is on there. Have people ask questions. Again, as you should, before you go to pt, I have. Try to make it really easy. Streamline, you can self schedule online. Pulls up the calendar Oh, that's to the button. Send you intake. Yeah. So try to keep it as easy as possible. But yeah, all my information is is online. I'll be setting up at the, when is Astral Marathon? March. The date is,
Daphne Kirkwood:March 18th, 18th marathon in half. And if you hear this after that, you're at quite a few other events throughout the year that we put on too. At the finish line or at our expos, you can stop in and visit with Lee. And
Lee Pattilo:yeah. I would say too I get people sometimes that call me, that have PT or I'll get people that are like, Hey, I wanna go to physical therapy. My copay is$20. I see you don't. Insurance and your rate is a little bit more than that. I get people that ask that sometimes and I'm happy to say, Hey, try, try this clinic if you want to use your insurance. I don't just bluntly turn people away. Yeah. Yeah. Try to get people in the right spot, I think yeah. As for our profession, it's cool if you hopefully do PT and get good. Yeah,
Daphne Kirkwood:that's the goal, right?
Lee Pattilo:That's the goal. That's the goal, baby. All
Daphne Kirkwood:right. Awesome. Thank you Lee. I appreciate you on all this wealth of information you provided. And we'll see you soon.
Lee Pattilo:I appreciate it. Thank you for having me on. Thanks. Thank you.