I began my exam by performing some routine orthopedic tests to rule out sciatica and low back nerve impingement.  Results were negative.  I then performed a seated Piriformis Syndrome stretch test.  Bingo!  Positive.  I never would have guessed.  I had her lay on her stomach and I palpated the hip region where the Piriformis muscle resides.  Ouch!  It was exquisitely tender and there was a noticeable “speed bump”/muscle spasm that when pressed recreated her symptoms.

I explained the condition to her and reviewed the proper treatment protocol.  After providing her with information and pictures regarding her condition we decided to begin treatment immediately.  Following the treatment session she immediately felt some relief she has not felt in 10 months.  She asked why no one else had ever found that before.  I explained that “you can not find something if you do not know what you are looking for”. 

Piriformis Syndrome is classified a ‘Syndrome” because it has multiple symptoms  and causes.  Because no one had diagnosed her condition accurately she had been receiving treatment and therapy directed at the wrong region.  Piriformis Syndrome is easy to diagnose and treat if you know what you are looking for.  Piriformis Syndrome is common to runners I explained.  Because I have been treating runners for 12 years and see this condition many times per week I have grown adept at recognizing it immediately and have researched the best possible treatments to get rid of it.

It is all too often that I see patient’s who have seen well intentioned doctors and therapists who unfortunately have little experience with runners and running injuries.  This results in a typcial situation where the runners has to deal with a painful injury that inhibits them from doing the thing they love….running.  Most of the time I can get the patient back to running within 2 weeks.  It’s unfortunate that they do not find our running injury clinic sooner.

Dr. Runco is a US Navy Veteran, a Doctor of Chiropractic, the owner of the San Diego Running Institute and the Clinical Director of the San Diego Running Institute Sports Injury Clinic which has been in private practice since 2000. As an endurance athlete, he has competed in various 50+ mile races and various marathons and similar races around the region. He also teaches continuing education at various local colleges, and continues to extend his generosity and expertise to both Charitable Organizations and established Running Clubs and Groups around the Southern California Region. Dr. Runco specializes in Running Injuries, Shoes & Equipment and Endurance Training and continues to help athletes complete their goals both injury free and well-equipped. For more information, visit http://www.sdri.net or http://www.whateverybodyneeds.net

Dr. Runco is a US Navy Veteran, a Doctor of Chiropractic, the owner of the San Diego Running Institute and the Clinical Director of the San Diego Running Institute Sports Injury Clinic which has been in private practice since 2000. As an endurance athlete, he has competed in various 50+ mile races and various marathons and similar races around the region. He also teaches continuing education at various local colleges, and continues to extend his generosity and expertise to both Charitable Organizations and established Running Clubs and Groups around the Southern California Region. Dr. Runco specializes in Running Injuries, Shoes & Equipment and Endurance Training and continues to help athletes complete their goals both injury free and well-equipped. For more information, visit http://www.sdri.net or http://www.whateverybodyneeds.net

Start your run at the Mast Blvd. entrance to Mission Trails Park at the equestrian center. This is also the start of the Dirt Devil Racing’s Stairway to Heaven 15K in August and the Xterra 15K in February. Head out West towards the grasslands until you get to the 4 way intersection. Go North (right) out and under the 52 freeway. You will run into Spring Canyon as you pass beneath the 52 freeway. Follow the canyon until you get about 1.9 miles. Make sure to take the single track trail that runs right along the hills on your left. At mile 1.9 look for the slot canyon on your left guarded by 3 rusty bullet ridden barrels. Make a left (West) into the slot canyon and follow the single track all the way to the back of the canyon. The trail will bend to your right and take you up the ridgeline to the top of a jeep road. This jeep road provides access all the way to Miramar Naval Airbase. When you get to the top of the jeep road look for the single track trail directly across and slightly to your right. It is hard to see but it’s there. Go directly across the jeep road and start your Westward descent down the other side of the canyon. The switchbacks will eventually give way to nice flat single track trail. As you course through the canyon you will eventually bend to your left (North) heading back towards the 52 freeway. The trail will take you back under the freeway where you will pass a trailhead sign and double track on your right. Continue past this and hook to your left. You will see a double track heading uphill in front of you and a rocky entrance to your right. Go north into the rocky entrance of Oak Canyon. Follow the rocky trail and listen for the waterfall on your right. The fall is slightly off the trail and requires you to do a little bouldering. Take time to play at the falls, have a snack and then continue into Oak Canyon. The trail will take you to a “T” intersection. To your right (West) is the infamous Hill of Torment which will take you up towards North and South Fortuna Mountain. Go left instead and stay on the single track trail that bears right and across a wood footbridge. Continue through rocky but scenic Oak Canyon. You will cross another wooden bridge and have a wooden fence on your left. Follow this trail towards until you cross another wooden bridge and head towards Historic Mission Dam. You will eventually cross the bridge over the dam and now have the San Diego River on your left. There is a water fountain and Port-o-Potty here if you need to stop. Run past the dam and up onto Father Junipero Road and go left on the pavement for about ¼ mile. Look for the entrance on your left and head down the concrete path over the stone bridge and back onto the trail dead ahead. The trail will take you back up into the grasslands. Once in the grasslands continue straight, you will see the 52 freeway in front of you. Look for the 4 corner intersection from the beginning of the run and make a right heading back to your car.

This is a great run and as many opportunities for adding more miles.

You can download a map of Mission Trails Regional Park at www.mtrp.org

See Interactive Map of Route Here

8 Mile Mission Trails Waterfall Run

Peanut Butter

For years, runners have made peanut butter a staple in their daily diet. Whether it be in a sandwich, on a banana or just plain, peanut butter provides runners both carbohydrates and protein, essential nutrients for endurance training. Peanut butter is also high in fiber, helping runners feel full for longer. Want a great pre-run snack? Try smearing some peanut butter on whole wheat bread.

Almonds

Almonds are high in vitamin E, a vital antioxidant for runners. The vitamin E can help to stave off achy muscles while the high fiber content can also help your tummy feel full. Almonds are great as a snack or sprinkled on a salad for added protein and calories.

Sweet Potatoes

While these spuds are naturally high in carbohydrates, they are also high in vitamins A and C, potassium, magnesium and iron. With potassium and magnesium being essential electrolytes, sweet potatoes can also help with hydration and cramping. And at only 100 calories per small potato, they can be a great snack either baked, boiled or microwaved. Here at SDRI, there is always a potato cooking in our kitchen, we just can’t get enough of this nutritious spud!

Oranges

You see oranges at every race, usually at aid stations and the finish line. The reason? This juicy fruit is high in vitamin C, which can help your bones absorb calcium and reduce muscle soreness by helping with recovery. Oranges also can help with iron absorption, an essential nutrient that helps with fatigue and low energy.

Bananas

Another fruit that is popular at races and sporting events alike. Bananas are high in potassium, an essential electrolyte that helps with hydration. Also, high in carbohydrates, bananas are considered to be safe foods since they tend to be easier on the stomach for some runners.

Whole grain pasta and bread

This ones a no-brainer, pastas and breads are very high in carbohydrates, a staple for every endurance athlete. In addition, whole grain pastas and breads are higher in fiber too, leaving you feeling fuller, longer. Opt for the whole grain instead of the more processed, refined sugar types. Whole grain has more of the nutrients, giving your body what it needs.

While we here at SDRI are by no means nutritionists, we do have quite a bit of experience with different foods during endurance training. After trying various diets, supplements and food plans, all of the staff here at SDRI can agree these foods are definitely top of the list. And  since all of these foods are easy to find at any local grocery store, incorporating them into your diet is extremely easy. So next time you’re aimlessly wandering the aisles at the supermarket, throw in some of the above foods in to your basket. While no food is going to magically make you a better runner, having the right nutrients for endurance training can help with your performance and recovery.

Next weekend is the Inaugural Wildhorse Trail Half Marathon.  This event is part of a Trail Half Series put on by my company, Dirt Devil Racing.  This race is going to be awesome.  I am hoping it does not rain but either way it is going to be fun.  The issue with rain is it may turn it into a mud run.  No worries, we won’t charge any extra for the mud!  Even with rain most of the trail will be fine.  There is one section though…..the mud can get kinda sticky.  Runners will have to make their way through the mud and over a foot bridge.  They will also have to come back through the mud a second time.  This will definitely be interesting.  Hopefully we can get a camera crew up there.

The Wildhorse Trail Half Marathon is the first in a series of trail half marathons.  The second is on April 22 and is called the Foxy Trail Half Marathon followed by June’s Cougar Trail Half Marathon (watch out for those women 35+) and will culminate in the October extravaganza called the Raptor Ridge Trail Half Marathon.  All of these races have great swag, awesome trails, cool medals and shirts and post race parties that rock.  The big Half Marathons like Carlsbad are fine but you need to check out smaller events like theses trail half marathons.  They are limited to 300 runners and have such a great feel to them.  Easy parking, beautiful trails, great aid stations, nice medals and prizes along with affordable entry fees.  Next time you are looking for a race consider doing one of these.

Dr. Runco is a US Navy Veteran, a Doctor of Chiropractic, the owner of the San Diego Running Institute and the Clinical Director of the San Diego Running Institute Sports Injury Clinic which has been in private practice since 2000. As an endurance athlete, he has competed in various 50+ mile races and various marathons and similar races around the region. He also teaches continuing education at various local colleges, and continues to extend his generosity and expertise to both Charitable Organizations and established Running Clubs and Groups around the Southern California Region. Dr. Runco specializes in Running Injuries, Shoes & Equipment and Endurance Training and continues to help athletes complete their goals both injury free and well-equipped. For more information, visit http://www.sdri.net or http://www.whateverybodyneeds.net

It’s flat. I mean really flat. There are a couple of little hills around the upper Otay Lake but nothing my strong legs can’t power through. If you’ve ever done any of our other races, this is by far the flattest, fastest one. Heck, if you’ve done our Stairway to Heaven at Mission Trails with the Steps of Fortuna, this race is a cake walk compared to that one.

There are plenty of wildlife to encounter. While out running a couple of weeks ago, Em and I came across a pack of about 5-6 coyotes while out on the trail close to the Olympic Training Center. We see a lot of coyotes, rabbits, snakes (only in the summer usually) and actually some deer as well. Oh, and plenty of ducks too. (Which I love to chase and actually sometimes catch!)

It is cold in the morning! Em and I usually run about race time (6:30 – 7:00) and it can get down right chilly right by the lake. I wouldn’t really know of course because I have a beautiful, thick fur coat to warm me up. But Emily usually has to bundle up with gloves and a beanie.The temperature can be in the 30s and 40s so be sure to dress accordingly!

There’s mud! Now, it definitely won’t be a mud run but there are a few sections that have some serious sticky stuff. And if we get rain this weekend like all you humans are saying, then it will be even mudier. I of course don’t have a problem with mud because my paws are already strong and get a great grip with the wet stuff. But if you’re wearing shoes, just be careful. I’ve seen Em almost go down a couple of times in the mud, even when she has slowed down (she sure can be a little clumsy sometimes…)

Here at SDRI we are really excited about this new race. Em and I will be at an aid station so be sure to give me a good pet as you run by and good luck! See you on the trail!

Spring time is a great time of year in San Diego to get out and get those longer runs in, especially now that the days are starting to get longer. This time of year also initiates a common trend in the clinic of the most seen chronic use injuries.

The IT band is a band of tissue, more properly identified as fascia that originates on the outside of the hip (from the gluteal muscles at the back and the tensor fascia lata muscle at the front) and inserts at the patella and tibia. With contraction of these muscles, the tension of the band increases. The function of the band is to coordinate with the thigh and gluteal muscles to provide stability to the outside of the knee joint.

Symptoms of ITBS

o       Sharp pain on the outside of the knee, especially when running. Most athletes are unable to run through the ITB pain, however, it is sometimes possible. The most common description of the pain is “a hot knife stabbing into the side of the knee”.

o       The pain goes away as soon as the athlete ceases running, but returns on the next run.

o       The pain usually starts on longer distance runs (those at or exceeding 10 miles).

o       Tenderness may be elicited when pressure is applied to the insertion point of the IT band.

It is the repetitive bending and straightening of the knee coupled with biomechanical abnormalities, or external factors which initiate and prolong IT Band syndrome. IT band syndrome can have many causes and can be specific to the runner. Causes of IT band syndrome can go unnoticed for large periods of time unless the athlete increases mileage. Those athletes maintaining weekly mileage where the longest run does not exceed the duration necessary to induce the symptoms of IT Band syndrome will likely never know they are prone to this syndrome. There is a critical threshold, and that threshold is personal to each athlete.

Intrinsic factors (unchangeable or less easily changed) to the athlete can impact the development of ITBS. These factors cannot be easily (or at all) changed. Some people are predisposed to having tight IT bands. Tight IT Bands, excessively high and rigid arches or excessively low (flat) and flexible arches, a large quadriceps angle, and leg length inequality are some intrinsic factors that can impact the development of ITBS.

Extrinsic factors (easily changeable) include sudden, increased mileage, intensity, or duration, excessive hill work (hill repeats), running on crowned (cantered) surfaces, and improper footwear. If you are experiencing symptoms on both legs, come see someone at SDRI for an evaluation to make sure you’re in the appropriate running shoes that are specific to your body type.

What else could it be? IT band syndrome shares similar symptoms with other injuries such as popliteal tendonitis, fibular nerve entrapment, and injuries pertaining to the lateral meniscus. It is absolutely necessary to find proper treatment and to figure out the exact cause for pain. Treatment for each injury can be different. Seeking experienced help will reduce time spent dealing with the injury and speed recovery.

Dr. Runco has been treating patients in his Chiropractic clinic for 12 years. In those 12 years. He sees chronic use injuries multiple times per day and has tried and true methods to rehabilitate injuries and get you back out running as quickly as possible.

You can access the upper Lake by parking on Otay Lakes Road and running up the paved road until you are above the dam. Follow the fire road around the lake until you cross a small footbridge. Once over the bridge you can fork either left or right. Go to the right along the grassy footpath until you reach a double track trail. Hang a right and follow that down to the lake and loop back the way you came. When you get back to the grassy footpath go right around the ridge then back the way you came for a nice easy 3 mile run.

If you want to do more mileage there is plenty of opportunity at the upper lake. The area is full of single and double track in addition to lots of hills if you want them. You can also hook up the upper and lower lakes for a much longer run. On the lower lake at mile 3.2 when starting from the boat launch there is a concrete drainage tunnel with graffiti all over it. Go through the drainage tunnel. Once through go left up the embankment then right on the paved road. Once at the top follow the fire road around the lake until you cross the footbridge. You can follow the same directions mentioned earlier or explore a new trail.

Upper Otay Lakes Trail Run- Map

See Interactive Map of Route Here

Upper Otay Lakes Run

• IDEAL Heel: This heel structure shifts the ground contact point 3cm forward. This means that the runner lands with more ground clearance right under the middle of the heel. This is designed to reduce stress on the ankle, knee and hip joints, enhancing the overall performance with a more efficient gait cycle.
• Toe Flex: the PureProject shoes are around 25-30 percent more flexible when compared to a traditional shoe. Omega Grooves and strategic removal of the midsole encourages shoes to flex naturally with the foot. The big toe is isolated with the purpose of creating better alignment during toe-off. This design allows the foot to flex more naturally.
• NAV BAND: This is an elastic band around the arch designed for a better fit and more comfortable arch support.
• ANATOMICAL LAST:  is shaped more like a foot, with the longest part of the shoe being at the big toe and tapering downward.
• BioMoGo DNA: this new technology is a combination of Brooks’ BioMoGo foam and the relatively new DNA. This blend gives the midsole adaptive cushioning.

These components work together to provide an inherently stable shoe. In addition to IDEAL technologies, PureProject footwear is constructed with a lower profile, a 4 mm heel to toe drop, and a wider base which contributes the stability of the shoe.

We just recently brought the Pureflow into our inventory. The PureFlow has a little more cushion than the PureConnect, weighing 8.7oz/7.5oz in men/women’s shoes as opposed to the PureConnect which weighs in at 7.2 oz. As with all of the PureProject line, the PureFlow has a 4mm heel to toe drop and is relatively flat.  I was very surprised when I tried this shoe on. It was much cushier than I was expecting with noticeable arch support. The shape was comfortable and fit my foot nicely. I am no stranger to minimal/barefoot running and I love being able to feel and be able to react to the ground when I run. However it is nice to have a more substantial shoe on my longer runs. The PureFlow is a nice balance between a barefoot shoe and traditional running shoes.  I was very happy with the feel of the shoe and am looking forward to testing out the PureProject line more thoroughly!