Maggie McKay (Host): Have you ever wanted to start running, but don't know where to begin? This is part one of our conversation with Physical Therapist, Chad Boehm, on running, training, how to avoid injuries and more. Welcome to To Your Health, a podcast from Jefferson Healthcare. I'm your host, Maggie McKay. Thank you so much for being here, Chad.

Chad Boehm, DPT, CSCS: Thank you for having me. Great to be here.

Host: So let's get right into it. The Roadie Run is coming up in Port Townsend. And for people who would like to run in the race or just get started in running in general, what advice do you have?

Chad Boehm, DPT, CSCS: If somebody was coming to me and just said, like, this is my first run ever, I'd like to start running; first and foremost, we want to ensure they're safe. A lot of times what we think about is like kind of cardiovascular like physiologically safe and mechanically safe and usually what that means is if they've had like a history of any kind of heart disease or lung disease or any of those systems that pump oxygen and blood around your body, blood pressure issues, you know, definitely, definitely visit with your doctor first to make sure you're, you're safe to do so.

And then like mechanically safe. A lot of times, if you're pretty active already, you know, do quite a bit of walking and maybe a little jogging here and there, you're probably safe to just kind of start running, an hour a week or something. But if you're concerned, like you have some nagging injuries, a history of injury, you know, definitely try and consult with some kind of movement expert, usually a physical therapist for like a technique assessment, to assess any kind of like weaknesses you might have that might impact your training, because that's the number one goal, right, to get to the start line healthy, feeling good and healthy. And, in addition to that, what I might say is when you actually do start running, definitely keep track, you know, keep a journal, keep a log of how many miles did I do? Or how much time did I do? That can be really, really invaluable in progressing and kind of avoiding overtraining.

And even if you do get injured or you do feel a little overtrained, you can kind of look back on it and say, oh, maybe I did this, maybe I did too much that week, or maybe I changed something I shouldn't have changed. Or, that's kind of bare bones of if somebody wants to start, that's kind of where I start with them and so.

Host: And if someone wants to run a 5K or a 10K, how long beforehand should they start training? They should work up to it slowly, right?

Chad Boehm, DPT, CSCS: Right. And, if you're coming in and like no running experience whatsoever, for a 5K, six weeks, eight weeks, you know, maybe 10 weeks, something like that. Usually where I start, cause like I do a little coaching on the side, and for those types of clients, I usually start with like run walk, you might spend one week or maybe two weeks doing a certain fraction of running and walking.

And then the section of running gets a little bit longer and the section of walking gets a little bit shorter until eventually you're doing, the whole an equivalent distance or an equivalent time, and, like I said, depending on the person's activity history and the person's tolerance to running, you know, that might take a little bit longer, but as a minimum, if you're coming in totally cold, yeah, maybe about six weeks.

If you're already in shape a little bit, like say, if you're doing a little bit of walking, a little bit of running, you can probably shorten that up a little bit. And it depends a little bit on the distance too, if you want to do, because like 5K, you know, you can get in shape for that a little bit easier or a little bit faster than a 10K, you know, six miles.

That's, that's a bit of a chunk for a lot of people. And so there you're looking a bit longer, like maybe 10 weeks, 12 weeks, if you are coming in totally cold, but, yeah, you definitely want to work into it gradually.

Host: Just last week, Chad, I work out a lot, but it doesn't include running. It includes, it's bootcamping, it includes like jogging. So anyway, I was walking around the park and I looked at my watch and I had to be somewhere and I'm like, oh my God. So I started running, even though I used to run, but I haven't in a long time.

I have when I was finished then that night and the next day, my back hurt so bad and I thought, well, that wasn't smart. It did not dawn on me that even though I'm in good shape and I work out a lot, that running is different. It just uses different parts of your body. So you work with a lot of runners in your practice. What kinds of injuries do you see people running into?

Chad Boehm, DPT, CSCS: So the most common, like by far, most common injuries for runners are going to be patellofemoral pain, otherwise known as like runner's knee, or like a hip pain or a IT band pain, and luckily, most of those are like fairly easy to treat. The main issue is with like itises, you know, any kind of inflammation of a tendon, or insertion.

Those, again, they're fairly easy to treat. A lot of it's just kind of activity modification, usually stretching, strengthening of a particular area. But they do hang out for a while. So, usually if somebody starts feeling like a nagging, you know, something coming on, it's important to consult early before it gets to a point where it's severely impacting your training cause that's, you know, sometimes that's kind of the nice thing, but one of the frustrating things about runners sometimes is there's a determined personality.

So a lot of times they'll just kind of like run through it until it becomes an issue. And when really it's better to just like sacrifice a little bit of time away from running and focus on rehabbing or recovery to kind of get it, keep it at bay. But that's like the most, most common knee, hip, sometimes back. And so yeah, when it starts coming on, definitely consult with somebody to get it kind of taken care of early.

Host: Should you stretch before and after?

Chad Boehm, DPT, CSCS: So the recent research doesn't say like to not stretch, but it's more in favor of kind of like a dynamic warmup. So usually for most people, what that means is, you know, spending in the first, maybe three minutes or five minutes, just kind of walking, getting the blood pumping a little bit.

 Some people might do like a knees to chest or like pulling the heel to the butt, you know, type of a stretch beforehand, which can be definitely helpful and it's good for pretty much anybody along the lifespan. But I will say it is maybe like a little bit more important for older individuals coming into running a little bit later in life.

The tissue just isn't quite as pliable as it used to be, you know, when you're 20 or something, 20 or 30. So, definitely beforehand is good. And personally, I am a strong advocate of definitely after. It's kind of like, if you can do it before, do it before, but definitely do it after. And so when the muscle's nice and warm and pliable, stretching, foam rolling, some people, if you have like a percussive massager, you know, something like that is excellent. It's an excellent recovery tool after a run. So yeah, definitely. That tissue pliability is big.

Host: Injuries you mentioned before, how can people work through those challenges? I mean, ice, heat, come see you. What do they do?

Chad Boehm, DPT, CSCS: Right? So, at the bare minimum, like, to start with, stretching, ice, and activity modification are probably the three biggest things. So, like I said, reducing the time spent training a little bit, maybe reduce it by, usually I say about 8%, 10%, something like that, see if it makes a difference.

If it's acting up after a run, definitely ice, definitely stretch. Try that out for about a week, maybe two weeks. If it's just not moving and not getting any better, definitely trying to get in with a physical therapist to figure out like, why isn't this getting better, you know? And so, yeah, usually the old acronym RICE, rest, ice, compress, elevate, you know, you don't need to do all of those, but definitely icing, stretching, and activity modification.

Host: Cause sometimes you hear ice, heat, ice, heat back and forth, so you're just saying, avoid the heat, just keep the ice on it. Cause what does that reduce the swelling?

Chad Boehm, DPT, CSCS: Right, it helps kind of get the inflammation down a bit, actually constricts some of the blood vessels, which kind of squeeze out some of the fluid that would otherwise be kind of hanging out there and taking up space and becoming painful. You can, you know, like I mentioned earlier, at the beginning of a run, like a dynamic warmup, a really easy kind of walk. That can be effective in keeping some of those, like, itises at bay, otherwise you can do some, like, uh, hot pack beforehand as well.

 Usually we kind of categorize those things into either, like, an active warm up or a passive warm up. So a passive warm up would be, like, a hot pack. So maybe, like, you know, hot pack before, cold pack after. Or just, like, just kind of walking and a little dynamic stretching usually is pretty effective in warming it up enough.

Host: Let's say somebody starts running and pretty quick into it, they feel discomfort or pain. Should they just stop or run through it like you were saying some people do?

Chad Boehm, DPT, CSCS: So usually I follow like a 10 minute rule. So for most kind of small like kind of nagging injuries, it should kind of clear up after about 10 minutes. Or in other words, if you, it's almost like a stoplight rule where if you start an activity and that injury or that kind of pain or nagging injury thing; if it gets better, or even stays the same, that's kind of like a green light, you know, yellow light. Continue, but kind of be cautious. If it is getting worse, then just forget it, stop, go home. Give yourself the first eight to 10 minutes, and if it isn't changing or it's getting worse, just stop. Plus then you, you still get 10 or 20 minutes of running in. So it's not like a complete loss, but you give yourself more time to recover and yeah, just go home, stretch, ice.

Host: Just feels like a complete loss.

But what complete loss would be, would be if you kept running and injured yourself more, and then couldn't run for much longer down the road. So is it better to run on grass or around a track on that kind of astroturf or cement? I mean, a lot of people, all they have is cement. So is that worse for your bones and your back and everything?

Chad Boehm, DPT, CSCS: Interestingly enough, it doesn't seem to matter very much. More recent studies suggest that if you run on harder surfaces, the foot and the lower extremity, essentially, so if you run on a hard surface, they kind of make themselves a little bit softer to absorb some of that force. If you run on softer surfaces or uneven surfaces, they kind of stiffen themselves up a little bit to accommodate that softness.

And so in the end, the ground reaction force or the force your body feels coming up from the ground is like about the same, regardless of the surface. Personally, I tend to try and get like a fairly even split of road versus trail, and primarily, not necessarily as an injury prevention thing, but just to kind of like mix it up, you know, mentally it can be a little bit more pleasureable to, you know, run in the woods one or two days a week, or especially in Port Townsend, we're pretty lucky that we have a pretty extensive trail system. So, I mean, if you ran six miles, you could do maybe about three, two or three of them on trail also. In terms of like injury prevention, doesn't really make like a whole, like a lot of difference, but in terms of like enjoyability of training, it can make a pretty big difference.

Host: The trails sound ideal. Well, I can't wait to talk to you again in part two of our conversation coming up in the near future. Thank you so much for sharing your expertise and giving us some good, solid advice on how to start training to run a 5K, 10K, or just to run in general.

Chad Boehm, DPT, CSCS: Yeah. My pleasure. Thank you for having me.

Host: Again, that's Chad Boehm. To get more tips, go to jeffersonhealthcare.org. That's jeffersonhealthcare.org. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thanks for listening. This is To Your Health, presented by Jefferson HealthCare.