Jarod Carter found his passion for the movement and care of the human body from his early days as an athlete in high school and throughout his time as a springboard diver on the University of Texas at Austin’s swimming and diving team. After graduating from UT with a bachelor’s in kinesiology, Carter went on to the University of St. Augustine to earn his doctorate in physical therapy. He opened his own practice a little over 10 years ago and continues to serve the Austin community, ensuring that every patient receives the attention they deserve.
Carter sat down with the AFM team to talk about common injuries and preventions for runners and hikers.
Q: What issues do you often see arise in runners?
A: With running, there are quite a few very common injuries—from a variety of different types of knee pain to different types of heel and ankle issues, like plantar fasciitis and Achilles tendonitis, which are probably the two most common ones down there. Then, there are those types of pain and injury in the hip and back region, which are slightly less common but certainly happen enough to be called a “common” injury.
All of these can come from a variety of things and be called a variety of things. With knee pain, common issues include patellar tendonitis, IT band syndrome, ligament strains and damage or tearing of the meniscus. In your hip, it’s not uncommon to aggravate the labrum—this piece of cartilage in the hip joint—and plenty of our runners end up with issues surrounding that particular tissue. Luckily, all of these common injuries are mostly treatable without surgery.
Q: How do you treat someone with one of these ailments?
A: It all comes down to figuring out each individual, understanding their specific puzzle. It’s very rare that any one injury or pain has developed because of one single thing. That’s why I think it’s so important for individuals to find practitioners that actually have the time to look at them from head to toe—practitioners that aren’t having to rush through three to five patients an hour and can therefore only have time to look at the knee. You want to have time to think, “Well, what’s going on above or below that might be contributing to the pain they’re experiencing?” So, for each individual, that puzzle can look very different.
As a licensed health care provider specializing in pain and injuries, that’s where you have to take them through a thorough evaluation. That’s when you take those pieces of the puzzle, and you plan to address each one of those, because leaving out or missing just one of those pieces can be enough to allow for that pain to become a chronic problem and the person never really being able to get back to hiking or running in the way that they want to.
The treatment of the puzzle pieces involves using a variety of tools and techniques to resolve any tightness, weaknesses or movement dysfunctions like bad running/walking form. With running, there are specific issues when it comes to running shoewear. You have to make sure it’s a “good fit,” both literally on that person but also for that person’s running form and body type. A shoe that’s perfect for one runner might be a disaster for another, which is similar with hiking shoes and boots. So, it has to be specific to the individual from head to toe in evaluation and treatment.
Q: Are the issues for runners the same for hikers?
A: There is definitely some crossover, but with hikers, we tend to see a higher number of foot-related issues and one type of knee issue. The knee issue is patellar tendonitis and is especially seen in hikers that are doing a lot of elevation change. If it’s the type of hike where they’re just going out for a stroll in the Greenbelt, then it’s not much of an issue. However, for hikers that are into that aggressive elevation change, they’re really loading that tendon going up and down, even more so than you get in running.
With running, we see plenty of knee pain, but it’s less common to have patellar tendonitis than it is to have, say, IT band syndrome. We do see, now and again, meniscus tear issues when hikers lose footing. Those who are out doing an easier stroll are more likely to see plantar fasciitis, or foot pain. If the hiker is doing aggressive elevation changes, back and hip pain or injury also become more common.
Q: What are some ways to avoid or alleviate that kind of issue in hikers?
A: A lot of people don’t know this, but issues like tightness in the hip flexors will often manifest as pain or issues of the lower back, but everyone is then looking at their back when the problem is actually in the front.
This is also a common issue for cyclers. If they experience back pain but haven’t addressed their hip flexors, they need to look at that first.
In both cases, just loosening and working on those tissues of the hip flexors can in and of itself be enough to get rid of the pain. Though this may be the case, tightness isn’t the only issue, and occasionally lack of strength plays a role. If someone is consistently hiking with decent elevation changes, that should be enough to strengthen the flexors adequately. If they are hiking inconsistently, then they will want to incorporate some strengthening in between to be prepared for the challenge of a hike with large elevation changes.
Q: What are some ways one can prevent those common running issues?
A: Strengthening of specific hip muscles—having strong muscles in the hip can help to address and resolve what I consider the most common reasons for a variety of different kinds of running-related issues. There’s a specific weakness that we see a lot in runners, and it can lead to a wide variety of injuries in the foot, in the back and in the hip.
In this video, I’ve laid out some simple techniques to show AFM readers how to self-evaluate to see if they are dealing with this specific issue. If they are, the video shows three exercises they can do to help resolve the issue or prevent it from causing pain or injury on your runs. It may not fix it all the way—but it’s a start to resolving some very common, injury-producing issues in runners.
Jarod Carter PT, DPT, MTC is a Doctor of Physical Therapy and the founder of Carter Physiotherapy, where active people in Austin go to quickly recover from injury so they can keep playing their sport, exercising and enjoying life. Offering specialized, hands-on manual therapy as well as online telehealth treatment options, all sessions are one-on-one with a Doctor of Physical Therapy and designed to get you maximal results as quickly as possible. Carter is also the author of two books and has helped thousands of healthcare providers around the world to create private practices offering the highest level of treatment and care. Jarod provides monthly resources and discounts specifically for Austin Fit Magazine readers here: www.CarterPT.com/AFM