Hydration 1101


Dehydration can be quite overbearing; whether you are a weekend warrior, or an advanced athlete. In this article we will offer you several tips and avenues on how to avoid dehydration as best as possible. According to the American College of Sports Medicine (ACSM), fluid and electrolyte needs are widely variable during physical exercise due to differences in metabolic rate, body mass, environmental conditions, heat acclimatization status, physical fitness, activity duration, and genetic variability (Casa, 2005, p. 115). There are many factors that affect hydration status before, during, and more importantly afterwards. Recovery is one of the most important processes that takes place and will be greatly hindered if proper hydration statues isn’t returned to normal promptly. Sweating is the bodies natural defense against overheating through the means of evaporation. The evaporation of sweat off of your skin is what helps heat radiate off your body. The down side is that you lose important electrolytes like sodium, magnesium, and potassium which are essential in a lot of processes in the body. You need to sip on water all day when training volumes are high and temps are even higher.

There are different methods to measuring your dehydration status, the two fundamental methods that we will talk about is weight management and urine monitoring. Recording your weight before and after will indicate whether or not you have lost a large amount of water. Weight loss greater than 1 percent can adversely affect performance, and weight loss of 3 percent of body weight or more after activity greatly increases the risk of heat illnesses such as heat cramps, heat exhaustion, or even heat stroke, which can be life threatening (Larkin, 2014).  Dehydration provokes changes in blood volume, which can affect cardiovascular, thermoregulatory, metabolic, and central nervous function that become increasingly greater as dehydration worsens (Larkin, 2014).  Essentially making any sport or exercise exertion levels tenfold as you become increasingly dehydrated. Hydration needs are very different on an individualistic basis so it is imperative that you find what works best for your body’s demands. There are many different recommendations for fluid consumption before during and after exercise or competitions. Individuals should drink approximately 20 to 24 oz of water or sports drink per pound of weight loss within two hours of exercise or athletic events (Binkley 2000).  Sipping on water or an electrolyte drink will help reduce your chance of  dehydration and help increase performance.

Hydration replacements such as Gatorade and PowerAde are great if your body does not have a problem processing all of the sugar and chemicals inside them. For some reason or another Gatorade and PowerAde will work for some and for others it destroys their Gastrointestinal Tract. (G.I.) For people with delicate G.I.’s have no fear there are plenty of options such as, Skratch, Gu Brew, Nuun, Nathan, Skoop, Coconut water, FLuid, UCan, Clif hydration and much more. Biggest take way is find what works and remember to carry out plan of action in preparation of your next training day or race. Another great reference for fluid replacement recommendations is by an organization called National Athletic Trainers Association (NATA)- http://www.nata.org/sites/default/files/FluidReplacementsForAthletes.pdf they have their own position statement on hydration as well.


Binkley, HM, Beckett, J, Casa, DJ, Kleiner, DM, and Plummer, PE. National Athletic Trainers’ Association Position Statement: Fluid Replacement for Athletes. Journal of Athletic Training 35(2):212-224, 2000. (Binkley 2000)

Casa, D., Clarkson, P., & Roberts, W. (2005). American College of Sports Medicine Roundtable on Hydration and Physical Activity: Consensus Statements. American College of Sports Medicine, (4), 115-127. Retrieved November 15, 2014. http://www.acsm.org/docs/publications/Roundtable%20on%20Hydration%20and%20Physical%20Activity.pdf (Casa, 2005, p. 115)

Larkin, S. (2014, May 1). Beat the Heat – Combat Dehydration. Retrieved August 5, 2014. http://www.nsca.com/Education/Articles/Hot-Topic–Beat-the-Heat—Combat-Dehydration/ (Larkin, 2014)


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Runner’s Knee

The Knee & Patellar Tendonitis

Knee Pathology


Patellar Tendinitis, also known as a tendinopathy/tendinosis is caused by excessive loading of the patellar knee extensor mechanism via overloading, jumping, and muscular imbalances. Found in a wide variety of sports this nuisance can be highly detrimental to your training and has the potential to threaten your mobility in the future. Follow along as we delve deeper into this pathology and find the solution to this troublesome joint. Below is a picture of a normal knee and some important landmarks to know. The knee joint is known as a hinge joint but it does more than flex and extend. The condyles of the Femur roll and glide against the Tibial plateau within the Menisci which makes this joint slightly more intricate than most would think. That is why imbalances are so hazardous to biomechanics, with the slightness dominance of one side dysfunctional mechanics can send its counter part out of whack grinding bone on bone.

Anatomical Knee Labeled

How much is too much?

 Whether its overuse, too much too soon, or muscular imbalances the outcome is usually the same. Excess friction and inflammation resulting in micro tears can eventually turn into tendinopathies and in severe cases tendon tears. The main function of tendons is to provide structural support between muscles and bones. During movement however, their job duties increase exponentially: absorbing impact, stretching, gliding and bending. When athletes push their bodies to limits that they are not functionally fit to carryout such as basic movement patterns at high velocities they sustain injury. Below is an example of an inflamed knee with the pain represented in the color red radiating out from the source.


Other probable causes of patallar tendinopathies include but are not limited to ankle mobility, Quadriceps dominance, poor patellar tracking, Plica syndrome, bursitis, hip weaknesses and much more. So before you self diagnosis yourself and consider yourself down and out be sure to have the right people take a look at you and get the right diagnosis.

How to fix it and keep it away

Patellar Tracking

One exercise I found that works well with patellar tracking is leg extensions. This is just one of many exercises you can do to help strengthen the VMO. The VMO is a group of muscles that insert next to the knee and that are located on the inside of the leg by the knee cap. However with recent findings this would be considered an old way of fixing the cliche’d knee pain but I still think this exercises is important. You can’t do one exercise and expect it to work. One exercise doesn’t fix all.

IMG_2944  IMG_2945 IMG_2946 IMG_2944

Contract straight leg at the knee and proceed to lift off ground. hold for a second and then put it back down. repeat this 5-10 times and if this approach is too easy hold for 2-5 seconds. You can vary this too by pointing your toes up or having them slightly circumducted “slightly rotated out,” as seen in the picture.

VMO Strengthener ( Contract quad, lift leg, Helps with patellar tracking.) Avoids Runners knee, Osgood Slaughter, and Patellar tendinopathy, and more. Pertaining to the above pictures.

Quad hip flexor stretch

Below is one of the most paramount stretches one could do to help release tension in the quad that is most responsible for Petellar Tendonitis. If you put enough time into this stretch, good things will happen and the tightness will subside.

3x1min each side and work on deep breathing to help relax muslces.

Hip Flexor rectus femoris stretch

Patellar Tracking exercise

The below link is a great demonstration of terminal knee extensions. This is a great exercise to do everyday and it only takes a couple of minutes. The VMO is a tough muscle area to strengthen as a runner so doing this type of exercise will help with patellar tracking and overall strengthening.


Hip strengthening and stretching

Soft TissueTennis Ball Glute MedX Band Walks

Pigeon pose to the Modified Pigeon


The Pigeon Pose is a great yoga pose /stretch to start with and progress to the modified Pigeon Pose.  With every exhale you should be able to reach a deeper stretch in your hips while leaning your upper body forward. 2-3 reps of 30-60 seconds is a great amount to start with. A lot of the knee pain stems from tight hip muscles which is why I highly recommend this stretch.

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Interventions for Female High School Runners in Hot and Humid Climates

Interventions for Female High School Runners in Hot and Humid Climates

By: Benjamin Pignatone CSCS, USAW, USATF, RRCA

With the rise of high-level female athletes comes a special set of medical and orthopedic issues. Environmental factors play a huge role in all sports taking place outside. Using a hierarchy of evidence to navigate through various reviews and appraised topics, looking at educational interventions for female athletes who develop the female athlete triad in hot and humid climates? Identifying evidence with large sample sizes, generalizablity, and internal validity will ensure the highest level of evidence appraised.

Looking at The Female Athlete Triad a study using 93 female endurance runners between the ages of 13-18 used an eating disorder questionnaire to correlate weight concern, appearance, and dietary restraint with the development of the female athlete triad and ultimately negative bone health effects. There is a high affinity between the lack of educative intervention for female athletes in hot climates and the risk of them developing the female athlete triad. Most female athletes go through some sort of dietary restraint which ultimately negatively effects their bone mass, hydration state, and causes multiple physiologic imbalances within their bodies. The eating disorder questionnaire is considered to be the gold standard for assessing eating disorders because of the instrument’s internal consistency. The eating disorder questionnaire is a valid tool in narrowing down individuals who suffer from eating disorders and hydration issues. It should be implemented as an educative intervention for female runners in hot and humid climates.

A prospective cohort study examined the relationship of the female athlete triad among a sample size of 163 female athletes. Daily injury reports and an eating questionnaire was used to collect data throughout the study. Measurements of bone mass density before and after were taken by a dual energy  x-ray absorptiometry scan that measured bone mineral density, lean tissue mass, and adipose tissue. The generalizability of this study’s findings implicate the importance of proper dieting and hydration for general maintenance of the female athlete and furthermore avoiding musculoskeletal injuries during their time as an athlete. Throughout the study’s design and data collection a high internal validity is clearly noticeable. Highly trained staff administered the Athletic Health Care System Daily Injury Report form the first day of practice up until the cessation of competition. Injured athletes reported higher mean scores for all questionnaire subscales which taken into account injured athletes had lower bone mineral density which was correlated to eating disorder and amenorrhea.  The sample size was large enough to examine analysis of the triad factors and other important characteristics concurrently. It would seem prudent that through an educative intervention modality, female athletes would benefit significantly and avoid further musculoskeletal injuries, dehydration, amenorrhea, and other dysfunctions linked to the female triad in harsh climates. Preparticipation screenings should be initiated for all athletes especially female who wish to participate in sports. Using the results from these important screenings will help athletic trainers delineate and prevent unnecessary injuries from happening and possibly diminish any future injuries from ever occurring.

It is important that information about the female athlete triad  should not be kept a secret. Looking at the literature it is clearly evident that most female runners are unaware to what is going on inside of their bodies. Through an educative intervention; dehydration and the female athlete triad can be reduced if not completely eliminated among female high school athletes in hot and humid climates. There is not a high cost for developing an educative intervention according to the literature. Regular maintenance such as daily nutrition log books and questionnaires should be administered more frequently in an effort to relinquish this ongoing nuisance for the female athletic population.


Eden, A.(2011). The Female Athlete Triad, Journal of Pediatrics for Parents. 27,21-22.

Retrieved from Proquest, http://proquest.umi.com/pqdweb?ind ex=5&did=24236 197 91& Src hMode=5&  Fmt=6&retrieveGroup=0&VInst=PRO D&VType=PQ D&RQT=309 &VName =PQD&TS=1330442189&clientId=8631

Study Design: Expert Opinion

DeSouza, M.,  Metzger, D. (1991). Reproductive Dysfunction in Amenorrheic

Athletes and Anorexic Patients: a Review. Medicine and Science in Sports Exercise, 22, 575–582. Retrieved from PubMed, http://www.ncbi.nlm.nih.gov/pubmed/1943636

Study Design : A Review

Donaldson, M. (2003). The Female Athlete Triad: A Growing Concern, Journal of Orthopedic Nursing 22,322-324. Retrieved from Proquest, http://proquest.umi.co m/pqdweb?index =4 &di d=119  9555171&SrchMode=2&sid= 19&Fmt=6&VI nst=PROD&VType=P QD&RQ T= 309 &VName=PQD&TS=1331521164&clientId=8631

Study Design: Critically-Appraised Topic (Article Synopses)

Ducher,G., Turner, A., Kukuljan,S., Pantano, K., Carlson, J., Williams N.,Souza M.(2011). Obstacles in the Optimization of Bone Health Outcomes in the Female Athlete Triad, Journal of Sports Medicine. 41,587-607. Retrieved from Proquest, http://proquest.umi.com/pqdweb?Index =0&did=2378756341&SrchMode=2&sid=19&Fmt=6&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1331521164&clientId=8631

Study Design: Systematic Review

Holly, B. (2007). The Female Adolescent Athlete. Journal of Pediatric Annals.36,719-726. Retrieved from Proquest, http://proquest.umi.com/pqdweb?index=2&did =1401791241&SrchMo de =2&sid=19&Fmt=6&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=133152 1164&clientId=8631

Study Design: Critically-Appraised Topic

Loucks, A. (1990). Effects of Exercise Training on the Menstrual Cycle: Existence and Mechanisms. Medicine and Science in Sports Exercise,3,275-280. Retrieved from PubMed, http://www.ncbi.nlm.nih.gov/pubmed/2199748

Study Design: Review

Mazerolle, S., McDermott, B., Burns, B.(2009). Female Athlete Triad Leading to a Distal Femoral Shaft Stress Fracture in a Collegiate Cross-Country Runner, Journal of Athletic Training & Sports Health Care. 1,85-92. Retrieved from Proquest, http://proquest.umi.com/p qdweb?in dex=0&did=1664359171&SrchMo de=1&sid=1&Fmt =3&VInst= PROD&VTy pe =PQD&RQT=309&VName=PQD&TS=1331520543&clientId=8631

Study Design: A Case Study Review

Otis, C., Drinkwater, B., Johnson, M., Loucks, A., Wilmore, J. (1997). The female athlete triad: American College of Sports Medicine position. Medicine and Science in Sports Exercise,29, 1-9. Retrieved from http://journals.lww.com/acsm-msse/Abstract/1997/ 05000/ACSM_Pos ition_Stand The_Female_Athlete_Triad.37.aspx

Study Design: Critically-Appraised Topic (Article Synopses)

Raugh, M., Nichols, J., Barrack, M.(2010).Relationships Among Injury and Disordered Eating, Menstrual Dysfunction, and Low Bone Mineral Density in High School Athletes: A Prospective Study, Journal of Athletic Training.45,243-252. Retrieved from Proquest, http://proquest.umi.co m/pqdweb?index=1&did=2041517761&SrchMode=2&sid=19&Fmt=6&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1331521164&clientId=8631

Study Design: Cohort Study

Torrw, D., Snell, J.(2005). Use of Preparticipation Physical Exam in Screening for the Female Athlete Triad Among High School Athletes, The Journal of School Nursing.21,340-345.Retrieved from Proquest, http://proquest.umi.com/pqdweb?index=3&did=937733321& SrchMode=2&sid=19&Fmt=6&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1331521164&clientId=8631

Study Design: Critically-Appraised Topic (Article Synopses)

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In recent years there has been an ongoing battle between what is the most beneficial form of stretching. Dynamic Stretching or Static Stretching. Below I am performing multiple static stretches along with some assisted stretches with my stretching rope. Whether you believe in cold stretching, warm stretching, AIS, PNF, passive, or active. The bottom line is you need to experiment with all of them and find what works for you. Individualism plays a crucial role in programming and improvements among athletes.

You should devote 1-2 mins total per stretch in my opinion. I am constantly bombarded with why does it take so long? Stretching and recovery days need to be treated like workout days. You devote countless of hours to training, why don’t we devote just as much time to recovering?

Below in no particular order are various stretches and exercises for the most efficient rehabilitation and recovery days. I hope you get as much out of them as I continue to. Thank you for reading. If you have any questions or comments please do not hesitate to contact me.

Thanks again!

Here is a downloadable Stretch sheet that is a must for all athletes. And essential to a Pain Free / injury free athletic lifestyle.

Stretch Sheet

Calf Stretch “Gastrocnemieus”


-if you are unable to keep both hips on floor drop your leg from 90 degrees to 110
and try it from a lesser intense stretch position.


Groin Stretch with rope. Gradually lift leg to roughly 90 degrees and then proceed to abduct “lower” your leg to your desired level of discomfort.


Above view of the I.T. Band Stretch   ( Try to keep the hip of the leg that is being stretched on the floor.)


Hamstring Stretch with rope ( contract quad of the leg being stretched a couple times during the stretch)


Rear foot elevated “hip flexor, quad stretch and much more” One of the most powerful stretches among all of these stretches. Get those hips forward, be light on your front foot, breathe, and make sure the leg being stretched isn’t pointed to one side. Try to make sure there is a straight line of pull from your knee to the ankle inline with the hip.


Quad Stretch


Prone Quad Assisted Stretch


Superior View of Assisted Quad Variation Stretch



Piriformis Variation with rope ” In cases where patients have poor mobility or flexibility, this would be applicable.”


Hamstring Assisted


Hamstring Variation


Bent knee variation. Stretches the Hamstrings differently.



Frog Pose in the Back position. Great for working on external rotators of the hip i.e Piriformis Obturator Externus and Internus to name a few.


Frog Pose in the forward position.


Front View of Frog Pose.

Butterfly Stretch for the Groin muscles.



Long Lunge stretch. Be sure to do this on a soft surface. The knee that supports the majority of your weight should be behind your butt. Meaning that pressure from your body weight is not directly on the patella (knee cap). Majority of your body weight should be slightly above the knee cap. You can vary this stretch by moving your front foot farther away from your body or moving your front foot closer to your body.

The following eight pictures are for your hip flexors. There are a couple variations here; one stretch you have ground contact with one of your knees, and in the other variations you do not have any knee ground contact. Notice, it is important to breath and walk your hands forward on both. It is also important to reach over head for the other half of this stretch. IMG_2925








This is a safe alternative for stretching your quadriceps, There is no need to lay down, that could potentially put too much strain on your knee. Rule of thumb is to try and align your torso with the quad being stretched. Lowering yourself down to that depth usually elicits a strong enough stretch. In hyper-mobile, and extremely flexible people, laying down may be okay. However I do not recommend it.










Hurdler stretch.  This stretch can put a great deal of internal stretch on your hip’s joint capsule. So if you are doing this for the first time, rule of thumb is to point your knee almost in the same direction as the straight leg and with time you will be able to bring the knee away from mid-line ( your other leg).



Pigeon Pose Variation- Careful with this stretch because this way of doing this stretch will apply a great deal of stress to some of your ligaments in your knee like the LCL, ACL, PCL… So it is important to build up from a standard pigeon pose.
















Standing Double Hamstring and Erector Spinae Muscle stretch


Side View Double Hamstring Stretch


Double Hamstring Stretch


Figure 4 Hamstring stretch ” reach with both hands, gradually tuck chin”


Plantar Stretch “Great for Plantar Fasciitis”


Shin Splint Stretch Different Angle


Shin Splint Anterior Tibialis


Ankle Dorsiflexion Enhancement


Soleus “notice the bend in the knee”


Gastrocnemius “Calves”


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August 20, 2013 · 11:25 pm

Foam Rolling Series

Foam Rolling & The Benefits of Self-MyoFascial Release



There are multiple facets of recovery modalities used in the industry of sports performance and health today. Briefly I will discuss just a handful of reasons of the benefits gained by using a foam roller.

The most widely understood concept of using the foam roller is that it speeds up recovery.  Shrink wrapped tightly around all of our muscles is known as fascia. From joint to joint this connective tissue stretches throughout our body in a basket like woven pattern running from head to toe. When we exercise these tissues expand and contract. Studies have proven that the better circulation you have to the muscles the faster they will repair and recover.

Foam Rollers

There are many different densities,  shapes, and sizes of foam rollers in today’s society. First off I would like to touch on the density aspect. In the pictures below I am using a blue foam roller that is of softer quality opposed to a black foam roller or PVC cored foam rollers. It is important to begin with a lighter density foam roller so that you do not inhibit recovery by bruising yourself. Usually the white or blue foam rollers are easier to manage. There are more aggressive foam rollers such as PVC centered cores, ridged surfaced rollers, and even larger 3D-pattern foam rollers i.e Y Roller by Pro-Tec.

How To

You can start out using the foam roller on a soft surface or mat eventually moving to a harder surface. The softer the surface is the less intense the pressure will be. Start out by supporting your body with your hands and gradually move to using one leg instead of two i.e. calf exercise. For greatest results you should foam roll the entire length of the muscle. The best way to tackle the foam roller is a slow and steady roll. It is like a deep tissue massage so for the first few times it will hurt a little. Make approximately 5-10 passes on all sides of the muscles in total.

Upper Back


Shoulder Blade / Rotators


Upper Back and Shoulder Blades






Piriformis / TFL




Modified I.T. Band


I.T. Band when performing the exercise below be sure to have feet elevated.


Calves lateral middle medial FYI ( Relax feet keep toes pointed away)


Hamstrings ( Sit on edge of one side of the foam roller)


Both Legs Quads


Single Leg Quads ( Rest body one one side of foam roller)


Shins Tibialis Anterior






Upper Middle and Lower Trapezius


VMO Quad


Tennis Ball Hip


Quad Variation


Tennis Ball Glute Medius


Peroneals of Calf


Modified Glute Medius


Advanced Calf


Tennis Ball Arch


Posterior Tibials & Medial Gastrocnemius


Foam rolling in my opinion is one of the best recovery aides for every athlete regardless the sport. I am a firm believer in trying things out first hand so I invite you to try out some of the exercises for yourself and you be the judge.

Thanks for reading and if you have any questions or comments please do not hesitate to ask.

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August 19, 2013 · 2:48 pm

Off To The Races! State Bound!


Track Stars!

April has come and went! We are now down to the State Finals!!! In case you missed the action here is what you missed. We are currently the District and Regional 3A champs for the 4x800m Relay Team for the men and women. We have a couple girls who made it out in the mile and 2mile. On the guys side we have 1 boy in the 800 and 1 in the mile. There have been so many ups and downs this season it is hard to say what will happen at the finals. The FHSAA Finals are in Jacksonville, May 2nd and 3rd. A couple of sites to also check out to that will have live results and live streaming is www.fl.milesplit.us and www.distancepreps.com theses are fabulous sites to use to help follow along.


Here are the results from the Regional meet.


Here are the results from the District meet.


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April 30, 2013 · 3:25 pm