Dr. Christian Balldin on WOAI Radio – Avoid Muscle Strain During Holiday Travel

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TSAOG’s Dr. Christian Balldin was interviewed by Berit Mason with WOAI Radio on Tuesday, November 20th.

Don’t End up at Grandma’s House with a Muscle Strain

Believe it or not, traveling is tough on your muscles, which a lot of people will end up nursing along with a cocktail because they overpacked their luggage.

Experts say some 60,000 people end up at their doctors because of an accident related to lifting luggage.

San Antonio Orthopaedic Groups’ Christian Balldin, M.D., says he’s seen herniated discs from people lifting heavy suitcases.  

“Try to pick a size luggage that fits you. If you are not too strong or developed, don’t get the biggest luggage because that would be too much for you.”

He recommends buying light luggage with wheels and once you’ve lifted the thing… keep it close to your body.

One big cause of the luggage injuries…more people are cramming everything into one bag to avoid those airline baggage fees.

“A simple muscle strain or even a herniated disc can result if you are not using proper lifting techniques,” which means using the legs to lift and not the lower back and no reaching straight down from the waist but bending your legs.

One safety tip is to pack several smaller bags and not just one huge one.

“So when you are dragging it downstairs it can become unpredictable and jerk which can cause an injury,” he warns. And if you lose hold of the thing, it may fly at some unsuspecting stranger.

See the entire interview online: 

Dr. Christian Balldin is an orthopaedic surgeon, fellowship trained in sports medicine, with The San Antonio Orthopaedic Group.  He treats patients aged 3 years and up for all orthopaedic conditions with the exception of the spine.  His special interests include arthroscopic surgery and total joint replacement. To schedule an appointment with Dr. Balldin, call 210.281.9595.


Dr. David Schroder on Hip Revision Rates

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When Total Hip Replacement was first made possible, surgeons would delay surgery as long as possible. The reason was quite simple: we did not know how long the implants would last. It was not uncommon to wait until a patient was nearly wheelchair-bound with pain and disability before undertaking a hip replacement. Up until about 20 years ago, it was rare to see a hip replacement in any patient under the age of 65.

Today, the number of hip replacements performed in the US has exploded, with nearly 300,000 performed each year. Hip replacement has also become more common for patients in their 40s, 50s, and 60s. In a field where we now have follow-up data of up to 30 years, we can start to examine how well hip implants truly work and how long they can be expected to last.

A recent paper out of the Journal of Bone and Joint Surgery evaluated the risk of having to replace, or revise, a total hip implant that had been implanted in a patient. The authors compared patients 75 years and older at the time of the first hip replacement to those patients 65-75 years old.

The risk of a hip implant requiring revision was shown to be higher in younger patients and in male patients. This and other studies have shown that male patients, younger patients, patients with higher level of activity, and surgeons that perform less than 6 hip replacements per year all increase the risk of a patient needing a hip revision. Male patients, especially those who are younger tend to use the hip more and “wear” it out sooner, as do those patients with higher levels of activity. This is a manmade device with only so many cycles of use. In addition, surgeons who perform only a few total hip replacements a year are more likely to have subtle errors in technique such as implant angle of placement, which can lead to a need for revision.

As a hip replacement surgeon, I often see patients younger than 75 with severe osteoarthritis and patients who tend to be more active. In an effort to try to diminish the hip revision surgery rates, I will still have the patient delay hip replacement surgery as long as possible, altering their activity levels and prescribing effective nonsteroidal anti-inflammatory medication. If a hip replacement has to be done, the patient is better served by seeing a surgeon who performs a significant number of them (at least a dozen a year). The San Antonio Orthopaedic Group has several surgeons who operate at or above this level and complete the surgery in an efficient manner. Technology and materials are better as well, allowing better control of revision due of instability, or dislocation, and wear generated by the head of the hip on the socket. Finally, we try to match the implant and bearing type with the patient’s anatomy and their age, using more resilient bearings in all candidates.

As we accumulate data on the current generation of hip implants and manage the increased need, we as surgeons will continue to strive for improved longevity of your total hip replacement. As more patients receive this type of surgery, we will continue to see the need for revision surgery, but patients will better served by seeking out more experienced surgeons and improved implant technology.

Dr. David T Schroder is a board-certified orthopaedic surgeon, fellowship trained in total joint replacement, with The San Antonio Orthopaedic Group.  He treats patients aged 11 years and up for most orthopaedic conditions, with the exception of spinal surgery. His special interests include total joint replacement of the shoulder, hip, and knee.  To schedule an appointment with Dr. Schroder, call 210.281.9595.

TSAOG Welcomes Athletic Trainer John Carollo

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TSAOG is very pleased to announce that Athletic Trainer John Carollo has joined our team!

According to TSAOG Chief Operating Officer Chris Kean, “the addition of an athletic trainer will enhance our sports medicine program by supporting the San Antonio Talons’ and the San Antonio Scorpions’ needs in addition to the many local high school and college athletic teams for which we provide medical coverage.  John Carollo is a talented individual who has dedicated his career to supporting both professional and amateur athletes and helping them to achieve their maximum sports potential and we are excited to work with him.”

John Carollo has been working as an athletic trainer for 15 years.  He completed his undergraduate degree in Athletic Training at Texas State University in San Marcos, TX and went on to attain a master’s degree in Medical Management at Ohio State University.  In addition, he served 5 years in the US Navy as a Russian translator and is an Operation Desert Storm veteran.

John’s resume as an athletic trainer is impressive, including work with the following organizations:

  • 2012 Olympic Games in London
  • 2011 PanAm Games in Guadalajara
  • University of the Incarnate Word Football
  • Roosevelt High School (NEISD)
  • Baltimore Ravens
  • Cleveland Cavaliers
  • Florida Panthers
  • San Antonio Talons
  • San Antonio Rampage
  • US Olympic Committee
  • Kingdom of Bahrain Olympic Committee
  • USA Wrestling, Volleyball, Gymnastics, Taekwondo, Synchronized Swimming

John will be working closely with TSAOG’s Sports Medicine Institute to provide coverage for athletic organizations in and around San Antonio.  Dr. Christian Balldin, TSAOG’s newest sports medicine trained orthopaedic surgeon, had this to say: “The hiring of John Carollo allows our Sports Medicine Institute the opportunity to connect more effectively with local athletic trainers.  His extensive experience in high school football right here in San Antonio as well as in the London Olympics this past summer makes him a tremendous asset.  I am very much looking forward to working with John in developing easier access to specialty orthopaedic care within our Sports Medicine Institute thus allowing the athletes that need it better and more global care from the field and training room to the doctors’ office.”

We invite you to contact John Carollo directly with any questions you may have regarding sports coverage requests or sports injury management.  He can be reached at [email protected] or by phone at 210.683.5749.

Dr. David Schroder on Combatting Obesity in Patients Undergoing Total Knee Replacement

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As an orthopaedic surgeon who performs a significant number of total knee replacements, I have observed more frequent complications in those patients who live with obesity. Several studies have also spotlighted this trend. A recent report out of Europe pooled together data from multiple total knee replacement studies and determined that obese patients are nearly twice as likely to have a local infection after a total knee replacement, more than twice as likely to have a deep infection, and slightly more likely to require a surgical revision than those who are not obese.  Obese for the study was defined as those patients with a Body Mass Index (BMI) greater 30. An example of this BMI would be a 5’8” male who weighs 200lbs, but many obese patients have BMIs greater than 35, 40, or even 50.

We have known for years that obese patients can be very happy with their total knee replacement outcome and in some cases, even more satisfied than their non-obese counterparts. Unfortunately, patients with obesity do run a higher risk for infection and they tend to have complications associated with obesity, such as diabetes and coronary artery disease. As physicians, we owe it to our patients to try to optimize their surgical results.  As such, I strongly encourage weight loss for all of my patients, but particularly those contemplating a weight-bearing joint replacement.  Patients who lose weight and build muscle prior to joint replacement can expect a smoother recovery following surgery.

Often, those with bad knee arthritis have will have difficulty with any exercise to lose weight. Many patients will claim they will lose weight after the knee gets replaced but research shows otherwise. (If anything, these patients tend to gain more weight with the new joint in place.) If water therapy is possible, it too may serve as an alternative exercise regimen. When exercise is too painful or the patient seems otherwise unwilling to exercise, we attempt to at least modify diet. Patients are not encouraged to rapidly diet, but we will set modest weight loss goals to be attained over time.

No one is claiming that weight loss is easy, but I believe that if more people were educated about the difference a little weight loss makes to your joints, they would better understand why it is so strongly encouraged by orthopaedic surgeons. For example, did you know that for each pound of weight you lose, 6-8 lbs of force will be taken off of your knees? A ten pound weight loss over 6 months means you’ve removed 60-80 pounds of force from your knees!  Until we get it under control, America’s obesity epidemic is going to continue to strain the knees of Americans and the success rate of the valuable procedure of total knee replacement.

Dr. David T Schroder is a board-certified orthopaedic surgeon, fellowship trained in total joint replacement, with The San Antonio Orthopaedic Group.  He treats patients aged 11 years and up for most orthopaedic conditions, with the exception of spinal surgery.  He has a special interest in total knee replacement.  To schedule an appointment with Dr. Schroder, please call 210.281.9595.

To see the study that Dr. Schroder is referencing, click here.

Dr. Christian Balldin on Collarbone Fractures

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The clavicle, also known as the collarbone, is a frequently injured bone (up to 10% of all adult fractures).  Most of the time it is fractured (broken) when someone falls onto the outside part of their shoulder and the force is transmitted to the weakest part of the bone (which is the middle section).  Common causes of collarbone injury include:

  • Football tackles, with the opposing player tackling an individual who then falls with the extra weight onto the shoulder
  • Falls while riding a bike
  • Falls onto the shoulder while skiing
  • Direct trauma such as getting hit with a lacrosse stick, a hockey stick, baseball or heavy object.

The collarbone can fracture in a variety of locations including the part closest to the chest wall, the middle portion, or the part closest to the outside shoulder.  We can often treat clavicle fractures without surgery but in certain cases they do better with an operation.  These cases include:

  • Open fractures (aka compound fractures where the bone penetrates the skin and is exposed to the outside and is no longer sterile)
  • Comminuted fractures (where the bone is broken into many pieces)
  • Shortened fractures greater than 2 cm
  • Grossly displaced fractures (where the ends of the bones are far apart)

Some collarbone fractures encompass more than one of the situations listed above.  The less common fractures of the clavicle (those closer to the shoulder area) are more prone to not healing and need to be monitored closely.  Many different ways exist to fix these broken clavicles.  There are intramedullary devices that are placed into the canal of the clavicle.  They do not seem to work very well in cases where there are multiple fracture fragments (pieces of bone).  The most common way to surgically repair a clavicle fracture is to use a metal plate with metal screws.  The vast majority of time the hardware remains in place and does not need to come out. However, there are instances when it is recommended to remove the hardware.

Treating a clavicle fracture non-operatively can be the treatment of choice for many fractures.  However, there are some complications seen with this such as:

  • Nonunion (the bone does not heal), with rates reported as high as 24%
  • Symptomatic malunions (the bone does not heal correctly and is symptomatic), with rates reported as high as 10%
  • Decreased shoulder function due to abnormal biomechanics of  a now non-anatomic clavicle

As with any operation there are risks to surgically correct a clavicle fracture as well.  Examples are:

  • Infection
  • Symptomatic hardware (the plate and screws are easily felt and painful) which can be more common in women as they wear the purse over the clavicle and it can be irritable to the underlying skin/tissue between the plate and the purse
  • Risks of anesthesia

All of the possible risks have a low chance of occurring but something to be aware of when discussing the treatment options with your orthopaedic surgeon. 

Dr. Christian Balldin is an orthopaedic surgeon, fellowship trained in sports medicine, with The San Antonio Orthopaedic Group.  He treats patients aged 3 years and up for all orthopaedic conditions with the exception of the spine.  To learn more about Dr. Balldin, visit his web page here.  To schedule an appointment with Dr. Balldin, call 210.281.9595.

TSAOG Customer Survey Highlights – October 2012

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Any time our physicians have something to say about an issue facing TSAOG or our community, we ask them to BLOG about it.  Starting today, when our patients have something nice to say about TSAOG, we’re also going to BRAG about it.

Please enjoy some of the highlights from our October Customer Survey:

  • Dr. Burkhart has done everything he could to help me, and his staff has been helpful. The staff has shown genuine concern and I feel they are there to give their patients excellent nursing care.”

  • “My physician had given me my life back with the care provided. I was 8-9/10 on pain scale when I had first seen him…I am now 90% improved and getting better everyday. He is a blessing.” (Dr. Hennessy)

  • “Patient portal to fill out all my forms via typing the night before was AWESOME! Insurance information automation was also very nice. I really liked your streamlined e-check in process.”

  • “Having been in medical ofc mgmt and billing, I am pretty picky about the way offices are run. I have no complaints about the treatment my husband and I have rec’d from both Kaiser and Jacobs. They are both my kind of doctors. Also, x-ray was excellent.”

  • “The San Antonio Orthopeadic group has been a wonderful experience. Doctor Brenman has been one of the most professional, patient, and knowledgeable Doctor that I have had the opportunity to be involved with.” 

  • Dr. Ochoa was very good & thorough.”

  • Dr. Balldin was very professional and answered all my questions to my satisfaction. His nurse Amanda was also very helpful in every situation in which I dealt with her. She is polite and professional.”

  • “I feel blessed to have such a wonderful doctor who did a complete hip replacement on me. I have no pain, I can walk, and he explains everything in detail. Excellent doctor!” (Dr. Ursone)

  • “Doctors take their time talking to me. I also like the different locations for physical therapy.”

  • Dr. Valdez is kind & is a good listener. He makes me believe he cares about me.”

  • “I don’t think any other doctor’s group in town can match it. Best doctors and great staff. Whats not to like. Could not be more pleased.”

  • “My friend recommended Dr. Viroslav because he is a wonderful Dr., skilled & patient.”

  • “So happy for the south side location. Dr. Bell was great!”

  • “The dedicated, knowledgable, caring and professional attitude by your Dr. UrsoneDr. ConnorPA’s Miller, nurses, and Imaging Technicians and Doctors.”

  • “Was happy n very satisfied with Dr. Drukker his bed side manner, politeness n quickness to see n tend to my finger ,been a long time seen by such patient care with care. Did not think existed anymore .thank you DrD.”

  • Dr. Galindo and his staff are WONDERFUL.”

  • Dr. Frank Garcia was remarkable. He zeroed in on the problem, set up the appropriate tests and his grasp of my problem which will require surgery was thoroughly explained and several specialist were given to me right on the spot. I feel confident my problem can be successfully addressed.”

  • “Thank you for the on time appointment and the excellent physician and assistant.” (Dr. Gonzalez)

  • Dr. Jacobs is the most personable physician I’ve dealt with with my knee problem. He answers all my questions. And he really enjoys working with his patients–a true professional.”

  • “I wouldn’t change a thing. I was completely satisfied with my over all care. The staff was very professional and Dr was very attentive. Thank you.” (Dr. Marx)

  • “I feel very much at home…the staff make it a point to ask how I am doing even if they are not currently part of my treatment team.” (Dr. Pace)

  • “Very little wait, staff and Dr Rowland wonderful.”

  • “I like the courteous and friendly service. I also like being given all treatment options so I can make my own decisions for treatment.” (Dr. Schroder)

  • Dr Taber is the greatest!”

  • “Staff was very nice and made me feel Welcomed.-Everyone cared about the Injection I was going to receive in my right knee.” (Dr. Tolin)

  • Dr.Woodbury is very nice, made me feel very comfortable.”

  • Mrs. Miller and PA Miller are the two most dedicated, professional and caring health care providers my wife and I ever had the good fortune to obtain services from. By total coincidence, PA Miller and his wife provided Imaging Services and Othopedic Services to my wife and I during other than normal duty hours on two successive nights. I can’t say enough about the Millers dedicated and outstanding health care thru all phases of urgent care services. My wife and I have traveled all over the world for the past 50 years or so and the outstanding services by the Millers was indeed refreshing.” (Note: PA Davis Miller is our lead PA at the OrthoNow Urgent Care Clinic at the Orthopaedic Institute.  His wife, Leticia Miller, is our ultrasound technician at the same office.)

We encourage you to review and rate your experience with TSAOG.  The next time you visit us, please take the time to fill out our customer survey and you may see one of your comments online the next month!

Dr. Christian Balldin on WOAI Radio – High School Athletes Ignoring Concussion Symptoms

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Dr. Christian Balldin of TSAOG spoke with Jim Forsyth on WOAI radio this week to discuss a new study, which states that despite increased media coverage of concussions, many high school athletes choose not to report concussion symptoms for fear of being excluded from play.  See the whole story below.

Thursday, November 1, 2012

Many High School Athletes Still Ignoring Concussion Symptoms
Study shows desire to play trumps health concerns

Jim Forsyth

Despite new emphasis being placed on avoiding concussions, and new UIL rules requiring specific precautions be taken if a concussion is taken, a new survey shows one third of high school football players are still ignoring or covering up concussion symptoms.

The reasons:  they are afraid that coming forward will result in being excluded from the team, or that they will be considered to be ‘soft’ or a ‘crybaby’ by coaches and fellow players.

“Parents as well as athletic trainers and coaches all need to be aware of the repercussions of concussions, and especially of a second concussion very soon after an initial injury,” Dr. Christian Balldin, orthopaedic surgeon with the San Antonio Orthopaedic Group.

Researchers found that 32% of high school football players said they had clearly concussion-like symptoms, like headaches, confusion, or vomiting, but did not seek medical attention.

The National Football League has been working to raise concussion awareness, and new UIL rules stipulate that teenaged players who are suffering from concussion symptoms be removed from play and cannot return until they have been cleared by a doctor.

But Dr. Balldin says the key is for coaches and trainers to make sure young players are aware that getting a concussion will not mean the end of their season.

“Most concussions won’t keep you out for the entire season,” he said.  “But they need to be monitored not only by the parent and coaches, but also by a neuro-psychologist.”

The NFL is being accused in a class action lawsuit with allowing players to continue to play with multiple concussions, leading to dementia and other long term health problems.

“Some of the signs are simply headaches and dizziness,” said Balldin, who is team physician for Our Lady of the Lake University’s athletics program.

See the article online at WOAI:

Dr. Christian Balldin is an orthopaedic surgeon, fellowship trained in sports medicine, with The San Antonio Orthopaedic Group.  He treats patients aged 3 years and up for all orthopaedic conditions with the exception of the spine.  His special interests include sports-related injuries and hip arthroscopyTo schedule an appointment with Dr. Balldin, call 210.281.9595.

Dr. Christian Balldin on Knee Dislocation

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WARNING: Video Contains Images of Graphic Injury


Marcus Lattimore sustains a knee dislocation in this past weekend’s game.  
Video courtesy of ESPN.

The term knee dislocation is not to be taken lightly.  The clinical definition of a knee dislocation is injury to three of the four major ligaments surrounding the knee.  The four major ligaments are the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL) and the fibular collateral ligament (FCL) occasionally called the lateral collateral ligament.  Of course there are many more stabilizing structures of the knee including the separate bundles of the individual ligaments and the structures in the postero-medial and postero-lateral corners (PLC/PMC). 

When knee dislocation is suspected, emergent evaluation by a physician is a must.  There can be an injury to the nerves and blood vessels to the lower leg necessitating emergent surgical intervention.  The energy required to cause a knee dislocation is very high and often times there are other associated injuries. An example would be a motor vehicle accident with direct forceful blow to the knee or significant twisting event.  They can also be present in sports such as football or speeding down the hill and hitting a tree while skiing.  An example of a knee dislocation happened this past weekend during the University of South Carolina vs University of Tennessee football game when highly regarded NFL prospect Marcus Lattimore sustained a knee dislocation.  

Many of these ligament injuries are diagnosed using the clinical exam.  However, x-rays are a must and a magnetic resonance imaging (MRI) study is needed as well.  The x-rays provide information regarding the status of the bone in regards to any fractures, the position of the bones, and overall bone quality.  An MRI on the other hand provides much greater detail in regards to the soft tissue structures such as the cartilage surfaces on the bones, the medial and lateral menisci, and the ligament and muscle condition surrounding the knee. 

At times, the MRI will show that the MCL or FCL is intact and without an abnormality but clinically during the exam there is laxity to these ligaments.  This is especially so in chronic cases.  Stress x-rays with a manual force provided to the knee will then give objective evidence to any increased laxity as you compare the normal side to the injured side.  These types of techniques can be of utmost importance to determine injuries to these areas of the knee.

Unfortunately, knee dislocations the vast majority of the time require surgical intervention.  The type of reconstructive surgery required would depend on the severity and type of knee dislocation as well as associated knee injuries.  Anatomical reconstruction would be the goal in most cases.  The subtle injuries to the posterolateral corner can often be missed if a careful clinical and diagnostic workup is not performed which would set any reconstructive surgery of other ligaments up for failure if not recognized and dealt with.  These injuries can be devastating and not only end the career of an athlete but if there are injuries to the blood vessels at the time of the injury they can at times even lead to loss of the limb.  Thus, these injuries should be taken very seriously.

Dr. Christian Balldin is an orthopaedic surgeon, fellowship trained in sports medicine, with The San Antonio Orthopaedic Group.  He treats patients aged 3 years and up for all orthopaedic conditions with the exception of the spine.  To learn more about Dr. Balldin, visit his web page here.  To schedule an appointment with Dr. Balldin, call 210.281.9595.

Dr. Philip Jacobs Serves as Medical Director at AT&T Championship Golf Tournament

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This weekend marks the 28th Annual AT&T Championship Golf Tournament in San Antonio. The tournament begins today and runs through Sunday, October 28th at the TPC Canyons Course at the JW Marriott.

TSAOG’s own Dr. Philip M Jacobs has served as Medical Director for the tournament for 16 consecutive years so, if you’re headed out to the tournament this weekend, keep an eye out for him!  Providing professional orthopaedic care for pro and amateur athletes alike is one more way TSAOG makes your health our mission!

Dr. Philip M. Jacobs is no longer a member of The San Antonio Orthopaedic Group, effective 9/30/2016. To schedule an appointment with a different sports medicine specialist, please call 210.281.9595.

Dr. Frank Garcia on Training for a Marathon

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If you look into the origin of a marathon, you would likely think twice about participating.  The modern marathon commemorates the run of the soldier Pheidippides from a battlefield at the site of the town of Marathon, Greece, to Athens in 490 B.C., bringing news of a Greek victory over the Persians. Legend has it that Pheidippides delivered the momentous message “Niki!” (“victory”), then collapsed and died, setting a precedent for dramatic conclusions to the marathon.  However, considering in the modern day that there are over 500 marathons held throughout the world each year, a marathon (26.2 miles, approximately 25,000 steps) is an achievable goal.  Unfortunately, a significant number of runners sustain some form of injury.

Through the use of a training plan, proper equipment, and discipline the modern marathon is well within grasp of the average, motivated person, while minimizing the risk of injury in the process.

Technology can be a significant help in training.  The use of a heart rate monitor is recommended by most experienced coaches.  It is common for inexperienced runners to use “how they feel” or “rate of perceived exertion (RPE).”  RPE can be a good guideline for the experienced athlete, but most newcomers tend to underrate their RPE, sometimes with disastrous consequences.  Still, a large majority of athletes still use a combination of RPE and the heart rate monitor.  Heart rate monitors, when used correctly, will allow you to better train in the proper zone which not only helps to improve your fitness, but also reduces the risks of an overuse injury.  This, in combination with a proper training plan, is the most effective way to achieve your goal.

Another tool that is important to helping you achieve your marathon goals is choosing proper running shoes.  It seems simple enough, but more often than not, people run in improper footwear.  Training places significant stresses on the body and improper footwear can increase your risk of injury. Consider the fact that while running, patella tendon forces have been calculated at 5 to 7 times your body weight and patella femoral forces at up to 10 times your body weight.  Wearing “good-looking shoes” won’t make you faster, so it’s imperative that you spend the time to have a gait evaluation by a qualified person.  This can typically be done by employees (which are typically runners/athletes themselves) in reputable running and fitness stores.

If you are new to marathon training, it is an absolute must to have a proper plan along with adequate time to train. Without it, you are more prone to overtraining, increasing the risk of injury.  The best training plans use what is called “periodization.”  Joe Friel, a well-known author and coach of professional athletes for over 30 years, describes periodization as a widely accepted training approach in which you manage your resources – time and energy – to achieve your goals.  It is often broken down into various periods including prep, base, build, peak and race phases. 

The primary purposes of each phase are as follows:

  • Prep – Preparing for training which can include cross training, weight lifting etc.
  • Base – Developing basic abilities with a focus on technique and duration, not speed.
  • Build – Developing advanced abilities with an emphasis on intensity.
  • Peak – This is of short duration, typically referred to as “tapering.”
  • Race – Rest and preparation for your race.

All phases include a steady build up of intensity and duration and you should always have a recovery week prior to moving on to the next phase.  The recovery week is expected to be EASY!  Active recovery tends to improve a person’s economy greater than doing a rest week where no exercise is done by allowing the body to flush out excessive waste products from muscles.

You must also set realistic expectations based on your training goals and the time you are willing to dedicate to running.  Risks of injury are significantly higher with less training time, especially if you have little or no base fitness.  For this reason, running groups or a personal coach can often help you in keeping on task and keeping your fitness goals in check.

Lastly, I want to touch briefly on overuse injury.  As I’ve mentioned, training for long distance races poses significant risks for injury, particularly as you start to build intensity.  Newcomers and seasoned athletes alike are at risk.  What often differentiates them is what is done when an injury occurs.  Inexperienced athletes are more likely to work through an injury rather than rest and allow the injury to heal.  An experienced athlete is more likely to rest until fully recovered.    Obviously, as race day gets closer, resting an injury becomes much more of a mental challenge because the athlete feels pressured into achieving their set goals.  Regardless, injury recovery is important to minimize the risk of an acute injury becoming a chronic and long-term problem. In summary, injuries occur when athletes exercise too often, too hard, too much, or too soon after an injury.

Training for a marathon can be a daunting task.  However with the proper training plan, tools and time, completing a marathon is an achievable goal. In 2011, there were approximately 520,000 runners who went the distance in the US. That would place you in an elite group of less than one-one thousandth of the population of the US!

Dr. Frank J. Garcia is a board-certified orthopaedic surgeon with The San Antonio Orthopaedic Group.  He treats patients aged 14 years and up for all orthopaedic conditions.  To schedule an appointment with Dr. Garcia, please call 210.281.9595.  To learn more about Dr. Garcia, visit his web page here


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