Injury Xchange Vol. 1: Lower Extremity Injury Prevention

This week, it’s my pleasure to introduce you to our good friend Mike Ryan, PT, ATC, PES. Mike is the Head Athletic Trainer/Physical Therapist for the NFL’s Jacksonville Jaguars and the founder of, an incredible resource for free sports medicine dedicated to keeping mature athletes healthy and active. Outside from his professional life, Mike’s also a dedicated athlete and fellow mudder. The 25-year NFL veteran is a 6-time Ironman triathlon finisher with a personal best of 10 hours & 36 minutes at the age of 46!

The Injury Xchange

Here’s the best part… through our newest feature – the Injury Xchange – Mike will share his expertise with the Mud Run Maniac community, providing exclusive articles on sports medicine, injury prevention, rehab, nutrition and more! How cool is that? So, without further adieu, I bring you the first edition of the Injury Xchange with Mike Ryan: Lower Extremity Injury Prevention.

Thanks Mike! Cheers!


Mike Ryan Fitness
Mike Ryan, Head Athletic Trainer of the NFL’s Jacksonville Jaguars, evaluating a player.

Lower Extremity Injury Prevention

Training for a mud run is not easy and staying injury-free is a high priority for racers young and old.  Too many of us have been forced to limit our workouts and race schedule because of a preventable injury.

A combination of injury prevention techniques, proper gear and smart training will significantly reduce your chances of being injured.

Let me share with you simple sports medicine tips to keep you injury-free in 2012 to help you take on those mud runs and adventure races healthy and strong!

Avoiding Lower Extremity Injuries

Sprained ankles, hamstring strains and Achilles tendon injuries are considered to be the “Big 3” when it comes to lower extremity injuries for mud runners. A combination of injury prevention techniques, proper gear and smart training will significantly reduce your chances of being injured.

I’d like to share with you sports medicine tips to help you avoid lower extremity injuries to keep you healthy and ready to play in the mud.

  • Rolling Away Your Pain – Consistently using a firm roller for your quads, IT bands, hamstrings and calves is a very simple and effective way to increase soft-tissue mobility and decrease pain.  Using the roller both before and after every workout and race is one of my secrets.  The roller is not always comfortable so toughen up and trust in it’s benefits.
  • Preventing Ankle Sprains – Include easy barefoot agility drills on grass/sand, side shuffles, figure 8’s, and on-hands-and-feet crawling into your weekly workout routine.  Performing these exercises 1-2 times per week is a great way to strengthen the muscles, ligaments and tendons associated with your ankles.
  • Ice is Your Friend – If you want to keep the small aches from becoming big pain, you need to implement cryotherapy or ice therapy into your daily routine.  The use of an ice bag, an ice massage or the granddaddy of cold therapy, the ice bucket, should become a common habit following all of your workouts/races.  A typical ten (10) minute treatment time is all you need to reduce lower extremity swelling and supercharge your recovery.
  • Preventing Muscle Strains – Adding simple lower extremity flexibility exercises, yoga/pilates and massage therapy to your routine will help keep your quads, hamstrings and calves healthy.  Elevating your legs while pumping your ankle after your hard workouts is a simple way to accelerate the recovery of your legs.
  • Smart Mud Run Supplies – Calf-high compression socks, high-top water-friendly shoes with extra ankle stabilizing straps and performance compression shorts are supplies of the smart athlete interested in avoiding injuries.

Mike Ryan FitnessAbout Mike Ryan:

Mike Ryan, PT, ATC, PES is currently the Head Athletic Trainer/Physical Therapist for the Jacksonville Jaguars of the National Football League.  The 25-year NFL veteran is a 6-time Ironman triathlon finisher with a personal best of 10 hours & 36 minutes at the age of 46.

Mike is the President of the Professional Football Athletic Trainers Society’s Research & Educational Foundation and a member of numerous NFL and youth sports medicine committees.  An established international lecturer and fitness enthusiast, Mike Ryan founded to share his sports medicine expertise with athletes, young and old.

Mike takes great pride in reinforce his personal mission statement: To Enhance the Health of Others.

Got a Question? Ask Mike!

Need help with a sports injury, nutrition or rehab? Wanna talk sports medicine? Ask Mike in the comments below. While you’re at it, go ahead and spread the word about the Injury Xchange by hitting one of those share buttons! Thanks!

Mike Ryan Fitness

Meet the Author


Mike Ryan, PT, ATC, PES is the Head Athletic Trainer/Physical Therapist for the Jacksonville Jaguars of the NFL and a 6 time Ironman triathlete. Mike is the founder of, a free sports medicine resource dedicated to keeping mature athletes healthy & active.

8 comments… add one
  • Stevo of Townsville, QLD, Australia Mar 12, 2012, 6:06 am

    Many thanks guys!
    Your efforts in helping pass info and lessons learnt is much appreciated.

    • Mud Run Maniac Mud Run Maniac Mar 12, 2012, 6:59 am

      Thanks Steve! And be sure to post a comment for Mike for any sports medicine needs!

  • Dennis Mar 12, 2012, 7:52 am

    5 weeks ago I suffered from what I think is an irritated IT Band. My knee started to feel tight and painful right above the outside of the joint about 5 miles into a run. I reconfirmed my diagnosis a few days later by running on a treadmill until the area felt tight and painful again (.5 miles) and then rolling out the area and running again for another .5 miles without pain. I have greatly reduced my running, even cutting it out for a couple of weeks. I am back up to 3 miles before I feel a light pain/ tightness. I perform strengthening and stretching on the area 5 days a week. Is there anything I can do to speed recovery or do I just need more time? I have 5 weeks until my Tough Mudder event and would like to be able to run 7-10 miles pain free before then.

    • MikeRyan MikeRyan Mar 13, 2012, 5:33 pm

      Sorry about the ITB Syndrome. I had a few run-ins with that injury and it’s not much fun. You may have some quad tendon involvement seeing how well it responded during the runs.
      Your Sports Medicine Plan:
      1. Get busy with the roller on your quads, lateral thigh and calves 3x/wk.
      2. Stop running for at least 4 days.
      3. Become a flexibility freak: quads/ITB/hamstrings/hip flexors/calves are the big 5 that you need to focus on.
      4. Get a biomechanical eval by a sharp sports medicine specialist if symptoms continue to see if a leg length, unilateral hip tightness or glut (butt muscle) weakness is the underlying reason for the symptoms.
      5. Conservative quad strength work that is completely pain-free and never going deep er than 80 degrees of knee flexion.
      6. Ice, ice and more ice.
      Progress slowly into your running on level surface b/c you never want this injury to come into your running life. Trust me on that one.
      Get healthy & fast soon. MDR

  • Joe Sutich Mar 12, 2012, 10:25 pm


    In training for Go Ruck Challenge and using weighted vest. I’ve been going along pretty well no injuries until about 2 weeks ago I started to get a pain in the top of my right knee cap after doing some box jumps. The pain has been about a 5 on a scale 1-10. Most of the pain is when going down or up stairs. I’ve continued to run and workout.
    Should I take a break and wait to heal? Any exercises that you suggest to strengthen the knee? I want to continue my workouts. Thanks for any advice.

    • MikeRyan MikeRyan Mar 13, 2012, 4:46 pm

      Hi Joe,
      You probably have quadriceps tendonitis: inflammation where the quad muscle anchors into the patella or kneecap. It’s common with jumpers if your quad fatigues and/or becomes too tight.
      Your plan: stop running for 4 days, stick with easy biking with the seat position high, get busy with the quad roller, and become a felxibility freak focussing on knee flexion in a painfree range of motion (ROM) hammies and hip flexors.
      Personally, I would avoid jumps with the heavy vest for at least a month.
      Always remember that ice is your best friend so make sure you reintroduce yourself to HER at least 3x/day.
      Your’ll feel 85% better within 14 days.

  • John H Mar 16, 2012, 9:03 am

    Hello Mike,
    Wanted to ask best practices for continuing to train for an obstacle race while nursing a torn quad. The tear isn’t bad at all, but it’s not healing as well as my PT and Clinical Massage Therapist would like. They’ve asked that I lay off of my routine for at least a week. (“Normal” routine is 6 mi bike, 2+ mi run, 2+ mi fast walk) I don’t want to keep an injury so I’ll be good… But… 😉

    My question is this, with so much endurance built up, will the week really make a difference in what I’ve built up, and how can I safely focus on strength and endurance while letting my leg heal properly?

    Thanks in advance,

    • MikeRyan MikeRyan Mar 17, 2012, 8:34 pm

      Hi John 
      You won’t lose much fitness if u stay busy on the bike and pool.  As for the quad. Your PT and MT are right, you need a week off from your running.
      Strength work will need to be no great than 70% intensity with leg extensions to avoid RSI jury.
      Be patient and ice like a polar bear and this will be a thing of the past by early April.

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