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Have you ever gone out for an easy run and looked down at your watch only to wonder why your heart rate is so high when you feel like you are barely moving? You might be trying to stay in Zone 2, but no matter how slowly you run, your heart rate keeps climbing and climbing. What about when you’re running with a friend who can carry on an entire conversation while you’re struggling to get a a word out. Why does running sometimes feel so hard when you’re going so slow? The fir

Knee pain is the number one most common injury among runners and has been for years. There are many kinds of knee injuries that runners can have. Most knee injuries are due to changes in training load, adding too much intensity or duration at once or even due to a change in surface. Several years ago I had a terrible flare up of IT band pain. I lived in Boston and was training for a spring marathon and we had a late snow. I had a long run scheduled and didn't want to move it

I have been running for a majority of my life, but started long distance races about twenty five years ago. At which time, most people didn't bring a phone running, track their runs, or even wear a running watch. Strength training wasn't a thing, carb loading was a must, drinking coffee at the starting line was common and grabbing a banana and or a bagel was plenty after a run. I loved it. I never knew my heart rate variability, my recovery score or my ground contact time. S

When you got injured did you treat your injury or just ignore it? Did you look up what you should do on social media, chat GPT, Claude or ask a friend what to do? Did you go to PT for a couple sessions then decide you were good enough then move on? Did you make it all the way through treatment until the pain was gone then stop? When you get injured there is more to getting better than rest or even making then pain stop. Of course I no longer want you to be in pain - but as a

I have heard some version of this from runners for years: “It hurts when you run? Just stop running.” There are absolutely times when I tell a runner they cannot run. A suspected bone stress injury is an obvious example. High-impact activity may need to stop while the athlete is appropriately evaluated, followed by progressive loading and a gradual return to running.¹ But for many running injuries, “just stop running” isn't a treatment plan. As a physical therapist, I want to

As you know by now, if you have been reading my blog - there are a lot of things that can contribute to a running injury: training history, previous injuries, strength, recovery, nutrition, sleep, biomechanics, and what changed before the pain started. Sex is another piece of that picture. For a long time, sports medicine research was heavily weighted toward male athletes. We now have better data showing that although male and female runners may have similar overall rates of

Living and running in Atlanta, avoiding hills is almost impossible. I frequently have runners tell me that “Hills hurt.” Sometimes my clients have stopped running hills completely because they assume hills are bad for their knees, Achilles, calves, hamstrings—or whatever happens to be bothering them. But hills aren't inherently bad. They are just a different training stimulus. Just like adding mileage or speed work, adding hills changes what we are asking the body to do. If

You made an appointment with a physical therapist because your knee hurts when you run. Then I start asking about your sleep, what you ate yesterday, your training schedule, stress at work, previous injuries, shoes, menstrual cycle, and whether you've ever had anemia. You may be thinking: Are we eventually going to talk about my knee? Yes. But first, I need to know more about you. When I evaluate a running injury, the conversation we have before I start testing strength, mobi

When a runner comes into my clinic, one of the first questions I ask is pretty obvious: “Where does it hurt?” Where you feel pain gives me a place to start. Anterior knee pain makes me think about different structures than pain behind the ankle. Groin pain creates a different list than lateral hip pain. But after years of evaluating and treating runners, I can tell you that where you hurt is only the beginning of the story. Running injuries commonly involve the knee, ankle/fo

Does your running form actually need fixing? Learn when gait retraining can help runners with pain and injury—and when changing your stride may be unnecessary.

I just got back from The Running School New York- a running camp in the Catskils where I gave a lecture on Low Energy Availability (LEA) and Relative Energy Deficiency in Sport (REDs). After the lecture, I was blown away by how many athletes came up to talk with me. I spent more than an hour answering questions, and I know that many of those runners walked away wondering, “Could this be happening to me?” This is the second time I have given this lecture at a running camp this

Walking into a specialty running store can be overwhelming. There are dozens of shoes on the wall, every brand has its own terminology, and many shoes look remarkably similar despite feeling completely different when you put them on. BUT if your local running stores are anything like mine they want to help and love that you are there. Ask questions, try things on and have fun. You don't need to know everything about running shoes before you walk through the door. However, hav

“I am a runner.” It is such a simple statement, but for many of us it means SO much more than the fact that we like to run. Running becomes part of how we see ourselves. We wake up early to run. Our friends are runners. Our vacations somehow turn into race weekends. We structure our schedules around training. We spend way too much money on shoes. We follow other runners on social media and talk about running with people who actually want to hear about our long run. And slowly

Every once in a while, I read something on social media that makes me stop scrolling. Last week was one of those times. Someone forwarded me an Instagram post that read, "Hot take: The lighter you are, the faster you are." Normally, I don't comment on posts I disagree with. Maybe it's because I don't enjoy conflict. Maybe it's because there are simply too many opinions on the internet to chase down. But this one genuinely made me angry because it was so irresponsible. Over th

I took this of some of our ATC elites at the One Mile invitational in Boston when we were there this April. (Luciano Fiore, Luke Houser, Clay Pender, Sean Dolan) This past weekend I was glued to the TV watching the USATF Outdoor Championships. There were several of our ATC athletes competing so I was not only engaged, but also yelling at the TV. One of our athletes, Sean Dolan was interviewed after advancing through his preliminary race in the men's 800 meters. Early in the i

Last year at running camp, we (my colleague Elizabeth and I) spent hours watching videos, writing out gait analysis and explaining what we saw to hundreds of middle school and high school runners. By the end of the week, we realized something, not only were we completely exhausted, but we were saying the same things over and over again. "Lean from your ankle, not your hips" "Keep your arms from crossing your body. Your elbows should go back" "Don't reach so far out in front o

It sounds like strange advice until you spend a few hours in a self-defense class designed specifically for female runners. Recently my clinic, Precision Performance & Physical Therapy hosted a women's self-defense class, taught by my friend and black belt in Karate, Heather Wright. I hate that we even had to have this class, but it is the reality of the world we live in and its important for women to support women. While we did practice some punching and escapes, the biggest

Can you keep running as you get older? Absolutely. Research consistently shows that runners can maintain high levels of fitness, performance, and health well into their 60s, 70s, and beyond. AND you are never too old to go out and walk or even run. While aging affects muscle mass, recovery, running economy, and aerobic capacity, many of the changes we associate with "getting old" are actually related to inactivity, loss of strength, inadequate recovery, and poor training habi

I wish I could tell runners that every bone stress injury follows the same timeline. It would certainly make things easier. The reality is that a return-to-running program for a tibial bone stress injury may look very different than a return-to-running program for a navicular stress fracture. Add in factors such as energy availability, hormonal health, breastfeeding, strength deficits, or a history of recurrent bone stress injuries, and the picture becomes even more individua

One of the most common questions I get as a running physical therapist is, "What shoe should I wear?" Although my patients don't like it, the answer is almost always the same: it depends. The shoe itself is a tool. Like any tool, its job is to help you accomplish a specific task. Some shoes are built for daily mileage, some are designed for racing, some are intended for trails, and others are designed to provide a different running experience altogether. Footwear companies us