Presentation by by Mike Potter, Evie Burnet and Tina Keasey at the May 7 annual meeting of the Williamsburg, VA Colonial Road Runners.

1. Core Strength andCore Strength and
Stability: Why Should IStability: Why Should I
Care? PRPCare? PRP New TreatmentNew Treatment
Option?Option?
Evie Burnet, DPT, PhDEvie Burnet, DPT, PhD
Michael Potter, MDMichael Potter, MD
TinaTina KeaseyKeasey, ATC, CSCS, ATC, CSCS

2. Running InjuriesRunning Injuries
Topics:Topics:
–– Importance of Core Strength andImportance of Core Strength and
stabilitystability
–– Relationship to common running injuriesRelationship to common running injuries
–– Injury preventionInjury prevention
–– Therapy and strength training specificsTherapy and strength training specifics
PRP new treatment?PRP new treatment?

3. Running InjuriesRunning Injuries
Weak core and poor stability canWeak core and poor stability can
lead tolead to
–– Runners knee or patellofemoralRunners knee or patellofemoral
syndromesyndrome
–– Iliotibial band syndromeIliotibial band syndrome
–– Stress fractures in tibia or femurStress fractures in tibia or femur
–– And many more injuriesAnd many more injuries

4. Running InjuriesRunning Injuries
27 to 70% of runners injured per27 to 70% of runners injured per
yearyear (Niemuth 2005; Davis 2005; Wen 1998; Jacobs 1986; Lysholm 1987)(Niemuth 2005; Davis 2005; Wen 1998; Jacobs 1986; Lysholm 1987)
–– Females > malesFemales > males (Rauh 2000)(Rauh 2000)
Majority are overuse injuriesMajority are overuse injuries (Macera 1989)(Macera 1989)
Traced to training errors, anatomicTraced to training errors, anatomic
or biomechanical factorsor biomechanical factors
–– Increased focus on biomechanics of theIncreased focus on biomechanics of the
hip and pelviship and pelvis

5. Ground ContactGround Contact
Stance phaseStance phase
Vertical ground reaction force (vGRF)Vertical ground reaction force (vGRF)
2 to 5 times body weight2 to 5 times body weight (Cavanagh 1990)(Cavanagh 1990)
–– Altered mechanics = higher vGRFAltered mechanics = higher vGRF
–– Linked to lower extremity (LE) injuryLinked to lower extremity (LE) injury
and increased metabolic costsand increased metabolic costs (Ferber 2003; Taylor(Ferber 2003; Taylor
1980l Farley 1992)1980l Farley 1992)
Importance of core strength/stabilityImportance of core strength/stability

6. Core Strength/StabilityCore Strength/Stability
Coordinated activation of muscles toCoordinated activation of muscles to
produce muscle strength and enduranceproduce muscle strength and endurance
resulting in proper alignment and stabilityresulting in proper alignment and stability
Abdomen, pelvis, and low backAbdomen, pelvis, and low back
Primary musclesPrimary muscles
–– Transverse abdominusTransverse abdominus
–– ObliquesObliques
–– Quadratus lumborumQuadratus lumborum
–– Hip musculatureHip musculature

7. MusclesMuscles

8. MusclesMuscles

9. Why Are Runners Targets?Why Are Runners Targets?
What is the purpose of running?What is the purpose of running?
–– To run as quickly as possible from oneTo run as quickly as possible from one
point to the nextpoint to the next……straight linestraight line
–– So, little to no rotation or sidewaysSo, little to no rotation or sideways
movementsmovements
Without cross training (coreWithout cross training (core
strengthening) core stabilizers arestrengthening) core stabilizers are
weakweak

10. Clinical ExampleClinical Example

11. SnapshotSnapshot

12. Why Should I Care?Why Should I Care?
INJURY!!!INJURY!!!
Poor performancePoor performance
–– Metabolic inefficiencyMetabolic inefficiency

13. What Should I Do?What Should I Do?
Injury preventionInjury prevention
–– Cross training (core strength/stability)Cross training (core strength/stability)
–– Running analysisRunning analysis

14. PRPPRP
A newA new ““experimentalexperimental”” procedureprocedure
Very common in EuropeVery common in Europe
Early studies and results are promisingEarly studies and results are promising
Used to treat overuse injuries that haveUsed to treat overuse injuries that have
failed traditional treatmentfailed traditional treatment

15. PRPPRP
What is it?What is it?
–– Draw the patients bloodDraw the patients blood
–– Centrifuge bloodCentrifuge blood
–– Separate the platelet/growth factor richSeparate the platelet/growth factor rich
layerlayer
–– Inject into injured or abnormal tissueInject into injured or abnormal tissue
–– Accelarates the repair/healing responseAccelarates the repair/healing response

16. PRPPRP

17. PRPPRP
transforming growth factor betatransforming growth factor beta
(TGF(TGF--b)b)
plateletplatelet--derived growth factorderived growth factor
(PDGF)(PDGF)
insulininsulin--like growth factor (IGF)like growth factor (IGF)
vascular endothelial growth factorsvascular endothelial growth factors
(VEGF)(VEGF)
epidermal growth factor (EGF)epidermal growth factor (EGF)
fibroblast growth factorfibroblast growth factor--2 (FGF2 (FGF--2)2)

18. THE ENDTHE END
QUESTIONS?QUESTIONS?
I’m sorry, Mr. Gronewald, but running
red lights does not count as an
exercise program.