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Upper Middle Back Pain Causes That Go Deeper Than Muscle Knots: And why that matters

By: Dr. Stephanie Duffey, PT, DPT

Upper middle back pain is one of the most overlooked areas of spine health, often dismissed or temporarily managed with massage and stretching that never addresses the root cause. This post breaks down why that pain keeps coming back and what is actually driving it beneath the surface.

The thoracic spine sits between two of the most discussed pain regions in healthcare, and that middle position means it is frequently undertreated. From postural strain and core weakness to nervous system dysregulation and referral patterns from the neck, the causes go far deeper than a muscle knot.

Physical therapy is one of the most effective tools for identifying and treating the specific underlying cause of upper middle back pain. Understanding what is actually happening in your body is the first step toward lasting relief.

You’ve tried all the things…massage, stretching, heating pad, having your significant other rub your back at the end of the day. It helps for a day, maybe two. Then it’s back.

That upper middle back pain, tension, and muscle knot can really wreak havoc on your focus, concentration, comfort, and ability to get through the day.

If muscle tension were the whole story, it would’ve stayed gone. A massage or stretch session would have actually fixed the problem and you wouldn’t be reading this blog post.

It’s what is actually under the muscle tension and knots, the thing that is driving the tension, that is the key.

Once you can identify what is driving the tension, you can address it, and actually get lasting relief.

I am going to break it all down for you today and tell you everything you need to know.

Here’s what we are going to talk about in this blog post:

Why the upper middle back gets neglected
Common upper middle back pain causes
What helps upper middle back pain and what does not
How physical therapy helps upper middle back pain

Why the upper middle back gets neglected

In healthcare and on the internet, upper middle back pain (aka pain in the thoracic spine) often gets neglected. So much focus and attention is put on the neck and lower back, and the mid back becomes like the middle child of the spine.

Yes, there is a lot going on in the neck and back regions, and pain in these areas are very common. But so many people have come to me with upper middle back pain, confused and worried about what is actually going on and how they can feel better.

My honest opinion is that there aren’t a ton of high revenue-generating treatments for upper middle back pain, so less attention is given to it. It sucks, I know. That’s why I’m here to share the truth with you.

Upper middle back pain is very fixable with conservative care. There is hope and I’ve got you!

Common upper middle back pain causes

The spine is all connected, so it is worth talking about the neck, low back, and nervous system when addressing upper middle back pain causes. We will address all of it right now.

Common upper back pain causes are:

Postural strain

This one is usually pretty obvious for people. Almost everyone comes through our doors saying they think their posture is causing their pain. Sometimes this is the case! Optimizing posture, especially for desk workers, dentists, aestheticians, and nail technicians can go a very long way in improving upper middle back pain.

Spending lots of time in a forward head posture puts increased demand on the muscles of the neck and upper back to hold up the head and torso. This strain compounded over the hours spent in a forward position can really cause a lot of pain and tension. Yes, it can manifest as muscle knots, but the underlying reason is too much muscle demand (and potentially not enough strength). These muscles are working harder than they ever were intended to work.

Core and back muscle weakness

The core and back muscles are super important for supporting your body through movement and sustained postures every day. However, they work in different ways.

Think of the back muscles as marathoner muscles. They are designed to hold you upright all day, every day. Weakness in the back muscles that run up and down the spine can make you feel like it is hard to hold yourself upright, especially for long durations of time. Over time, this can cause pain anywhere in the spine, including the upper middle back.

In contrast, the core is a sprinter muscle. While it does help support upright posture, it is also designed to help you lift and move heavy loads. So if it seems like working out or heavy, repetitive activities (think gardening, mulching, heavy cleaning, lifting and carrying small children, etc) trigger your upper middle back pain, your core is probably not stabilizing you well.

When your core isn’t stabilizing you well, your body will find that stability elsewhere. The path of least resistance is the back and neck muscles. But remember, those are marathoner muscles…not sprinter muscles. If you try to make a marathoner into a sprinter, it’s not going to work well. The end result? Upper middle back pain, tension, and muscle knots.

Stiffness in the spine

The thoracic spine is an area of the spine that can get stiff over time. It inherently is more stiff than the neck and low back because of the ribcage. But with chronic forward posture and core or back muscle weakness, these joints can become more stiff.

Motion is lotion here! Doing mobility and strength drills to actively move the mid back can make a big improvement in upper middle back pain.

Carrying high amounts of stress

Carrying high amounts of stress and overwhelm, especially over months or years, can manifest as muscle tension and knots. The most common areas to hold stress in the body are the neck, shoulders, and jaw as well as the hips and low back. What is right in between these areas? You got it, the middle back. Stress can absolutely be held here. Plus, the mid back will feel the effects of tension, strain, and tightness in the parts of the spine above and below.

Additionally, chronic stress puts your nervous system in a heightened state. In this heightened state, your nervous system is trying really hard to protect you. One of the ways your nervous system protects your body is through stiffening the muscles. This is a protective mechanism that works well if you’ve broken a bone or sustained trauma, however it does not work well when you’re trying to live your daily life.

Referral from the neck

One of the most common causes of upper middle back pain that I see is a referral from the neck. This is called a Cloward’s referral. If there is irritation in the neck, usually at the disc level, it refers pain to the upper middle back and inner part of the shoulder blades.

So many times, clients have come to me with knots in the muscles right along the shoulder blades. All they’ve been doing is addressing those knots. But what actually works for them is focusing treatment on the neck. Once we do this, they get immediate relief.

Unfortunately, this Cloward’s referral is very often missed in traditional medical exams. At Empower Physio and Wellness we know to screen for this pattern and recognize it quickly so that you can feel better in the most efficient way possible.

Other

A less common cause, but one worth mentioning, is referred pain from the organs. I’ve seen a few cases where we helped upper middle back pain a bit, but couldn’t get it to totally go away. If your pain is tied to eating, is worse at night, or really doesn’t follow any pattern, it is worth exploring if this pain is referred from an organ like the gallbladder, liver, stomach, or heart.

What helps upper middle back pain and what does not

It is very important to address the underlying upper middle back pain causes in order to experience lasting relief. Simply stretching or massaging tight muscles only scratches the surface and keeps you on the frustrating cycle of pain.

While the things that will work best for you are highly individualized, here are common strategies that help our clients with upper middle back pain.

Posture optimization

Optimizing your workplace setup can really go a long way in improving spine pain. For all the details on this, check out our blog Posture, Neck Pain, and Headaches: How Physical Therapy Can Break the Cycle.

Remember that your best posture is your next posture…it’s a posture that is always changing. Our bodies are made to move, so even the most “perfect” posture will only last for so long. Aim to get up and move every 45-60 minutes throughout your workday.

Strengthening the core and back muscles

Solid muscle strength is so important for literally everything in life. Having a good exercise routine where you strength train two to four days a week can really improve spine pain.

Whether you have a strength routine already or not, here are some of our favorite exercises:

Core breathing– This is a foundational breathing and core activation drill that is great for both beginners and experienced lifters alike.
Chin tuck swimmer– This is a great drill to specifically target upper back strength.
Dead bug– This is a great beginner to intermediate core strengthening drill.
Bear plank– This is a great intermediate to advanced core and upper back strengthening drill.

Improving thoracic spine mobility

There are two parts that are important for improving mobility and also keeping this mobility. First, start with this open book drill. It will target stiff areas of the spine and get those joints moving better. Then follow it up with a side plank thread the needle to build strength through the mobility you just gained from the open book.

Nervous system regulation techniques

Productively processing stress is a great way to reduce pain from muscle tension, especially in the spine. We love using breathing to help regulate the nervous system and get you in a coherent state to productively process stress. Try this Quick Coherence® Technique from the HeartMath Institute, then spend 5-10 minutes journaling or brain dumping your stress onto paper. This is a super powerful combination of techniques!

You can also take our Nervous System Quiz to see how much your nervous system is contributing to your pain. You’ll receive our free 3-week Empowered Nervous System Recalibration Method after you take the quiz! It is an amazing resource to support your nervous system in an accessible, genuine way.

Improving neck mobility

The most effective way to improve upper middle back pain that is referred from the neck (aka a Cloward’s referral) is with these two drills: chin tucks and neck rotation SNAG. Do these drills two to three times per day in the beginning, then just once a day or every other day for maintenance.

How physical therapy helps upper middle back pain

Like I mentioned, addressing the specific underlying cause of your upper middle back pain will allow for the most efficient recovery. The best way to do this is to have an expert on your team!

Physical therapists are specifically trained to identify the root cause of pain and efficiently help you fix it. We are the experts so you don’t have to be.

We first determine the primary underlying cause(s) of your upper middle back pain, whether it be postural strain, muscle weakness, mobility problems, nervous system dysregulation, or a referral from another part of the body.

Then we can curate a customized plan for you to feel better as quickly and efficiently as possible. This can include any combination of manual techniques, dry needling, cupping, mobility drills, lifestyle modification, strength training, and nervous system regulation techniques.

Feeling better is not only possible, it is extremely attainable! Nothing is broken, you just need the right support.

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Bottom’s Up! How Much Water You Actually Need To Be Drinking

Domain:
Mechanics

Dr. Stephanie Duffey • Jun 15, 2020

With summer upon us and the outside temp heating up, I thought I’d pop in with this blog post all about drinking water! Do keep in mind that it’s important to stay hydrated all year long (not just during the warmer summer months). Here, I’ll break down everything you need to know—from the important role water plays in keeping you healthy, to tips for meeting your daily intake needs.

What’s the deal with water anyways?

As crazy as it sounds, did you know that up to 60% of the adult human body is made up of water!? Check out this break down of the water percentages in your body:

Brain and heart = 73% water
Lungs = 83% water
Skin = 64% water
Muscles and kidneys = 79% water
Bones = 31% water

So why does all this matter?

Water not only helps your body stay hydrated, but it also keeps your muscles and joints lubricated for maximum efficiency. Water is beneficial to other systems too because it:

Regulates our internal body temperature by sweating and respiration
Helps transport oxygen all over the body for a healthy heart
Assists in flushing waste and preventing constipation
Acts as a shock absorber for the brain and spinal cord
Forms saliva and aids in digestion

How much water should I actually be drinking?

Now, to answer the question you’ve all been waiting for! How much water should you be consuming on a daily basis? The amount varies per person but the easiest way to think about it is to aim for half your weight in ounces of water.

So let’s say you weigh 150lbs. Your water intake should be right around 75oz. Another factor to pay attention to is activity level. If you exercise often and sweat a lot, you’ll want to consume even more water to replenish yourself. You can perform a sweat test before and after exercise to see how much you’ve lost through perspiration. For every pound you lose, that’s an extra pint of water you need to drink.

Tips for getting your H20:

Sip your water throughout the day rather than chugging it all at once and always keep a bottle with you (Hint: If you’re thirsty you’re already dehydrated).
Use water as your main source of hydration (Drinks that are high in sugar or caffeine can actually dehydrate you).
Check the color of your urine (It should be pale and clear rather than dark and odorous).
Try infusing fruit into your water for a fun and refreshing flavor.
Incorporate liquid-based fruits like grapes and watermelon into your diet (these provide hydration too!)

I hope you found this post to be helpful. Questions or comments? I’d love to chat with you!

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8 Tips For Tight Hamstrings

Stephanie Duffey • Jul 06, 2020

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As a physical therapist, I hear complaints all the time related to tight hamstrings. In fact, the hamstrings get a bad rap for always being the problem muscle, but if we take a closer look, you’ll find that your hamstring tightness may just be a symptom of another issue. Here, I’ll break down my top 8 tips for relieving tight hamstrings and preventing future pain in this muscle group.

1. Don’t be a sloucher.

Poor posture can be a huge contributing factor for hamstring tightness. When you arch your back, you’re actually putting more strain on your hamstrings to help hold you in that position. Instead, focus on stacking your ribs over your pelvis. Your hamstrings will thank you!

2. Be a belly breather.

Being a belly breather goes hand in hand with keeping good posture. When you stand properly, your diaphragm works more effectively, enabling you to breathe better while creating stability and activation through the core.

3. Keep your core strong.

When you stay mindful of your posture and breathe through your belly, you’re activating your core. In addition to following tips 1 and 2, it’s also important to specifically target the core as a muscle group. Tight hamstrings could be compensating for a weak core, so make core part of your weekly training routine. Here are some of my favorite exercises to work those abs (Plus bonus side effect: You’ll look great in your swimsuit!)

4. Keep your glutes strong.

Remember in tip 3 when I said that your hamstrings could be compensating for a weak core? The same is true with your glutes. The more you train the glutes and core, the better off your hamstrings will be. So share the love with other muscles groups. Download my Runner’s Prehab Guide for some of my favorite moves for strong glutes. (These are great exercises even if you don’t run!)

5. Don’t be a “sitter.”

This one’s for all my peeps with desk jobs. When you sit all day, you put your hamstrings in a shorter, tightened position. Take advantage of this quarantine and break up your day by going for short walks so you don’t get stiff. It’s also a great way to take a mental break!

6. Remember the hammies in your strength routine.

Fun fact, tight muscles do NOT always equal strong muscles. If your hamstrings are tight, it could actually be a sign that you need to strengthen them. Try some of these moves for strong hamstrings.

7. Practice dynamic stretching before a workout

You’ve probably heard this before but it’s incredibly important to move while you stretch to prevent cramping and better protect your muscles. Try walking hips swings or some of these exercises to set yourself up for success before your workout.

8. Foam roll after a workout.

One of the best ways to release knots and trigger points is foam rolling. It’s an awesome recovery for your muscles after a run or workout and provides a deep release while preventing muscle tension and pain. Do your muscles a favor and show them some love after you make them work! Here’s my favorite foam roller.

Need help treating your tight hamstrings? Let’s chat!

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Need New Running Shoes? Read This Post About Pronation First

By: Dr. Stephanie Duffey • Feb 17, 2020

Wearing a Running Shoes — Westerville, OH — Empower Physio & Wellness

If you’re a serious runner, you probably go through shoes pretty quickly (I know I do!) Or if it’s been a while since you’ve replaced your shoes (over 300-500 miles) it’s probably time to consider a new pair. But before you do, READ THIS POST! I’ll share my tips for identifying the right type of shoe for you based on the level of pronation in your feet.

WHAT IS PRONATION?

Let me start by saying, pronation is NOT a bad thing–it’s normal and it occurs when your foot absorbs shock as it makes contact with a surface. Pronation is essentially the natural process your arch follows from a lifted position, to a flattened position when you’re walking or running. When selecting the proper running shoe, you’ll want to pay close attention to your gait, which can show a pattern of neutral pronation, over-pronation, or supination (under-pronation).

OVER-PRONATION

Causes: Excessive, or over-pronation is when you pronate too much, too quickly, or stay in pronation for too long. This could happen naturally if you have flatter feet.

Symptoms: You could be experiencing tendinitis, shin splints, runner’s knee, or plantar fasciitis.

Shoe Recommendations: You’ll need a pronation control or stability shoe. The inner part of the shoe should have a thicker material to support you. You may consider brands like Brooks and 361. You can also try an insert for additional support (I like Powersteps), however don’t just jump to inserts right away. When your running or walking shoe is properly selected, it should give you enough support.

UNDER-PRONATION

Causes: Under-pronation, or supination occurs when you have a more rigid foot that isn’t absorbing shock as well as it could be. This could happen naturally if you have a higher arch.

Symptoms: You may be experiencing general joint aches and pains.

Shoe Recommendations: You’ll need a nice, cushiony shoe that’s shock-absorbent. You could explore New Balance, Hoka, and Mizuno shoe brands.

OTHER TIPS

No matter what level of pronation you have, I recommend going to a shoe store where they watch you walk or run on a treadmill to see how your foot looks and feels in a shoe. Make sure you’re comfortable. When you find a shoe that you like, stick with it, but I’ll caution you to pay attention to the shoe production quality over time. Often, companies will switch up the production and this can definitely make a difference.

This post should help you find a running shoe that’s right for you! Need help identifying your foot type and what type of shoe would be best for you? Let’s chat!

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The Pain Threshold: When Do I Slow Down, Stop, or Keep Going?

Domain:
Mechanics

By: Dr. Stephanie Duffey • Dec 04, 2019

As a physical therapist, I’m often asked the question, “How do I know when I need to slow down, stop, or keep going?” It’s a valid question, and one that many people struggle to identify. It’s challenging to interpret what you’re feeling in your body, when you can push harder, and when you need to scale back. So, to keep things simple, I came up with a little something I like to call the stoplight method. Let’s break it down.

Green Light: When you’re operating at the green light level, you’re able to exercise with no aches and pains and you may even be looking for ways to intensify your workouts. If you’re a runner, you’d be able to maintain the current pace or distance that you’re following with no discomfort. This is where you want to be (but I know this isn’t always possible or realistic).

What to do: Maintain what you’re doing, or experiment with advancing to the next level. For runners, this means working toward a faster pace or increasing your mileage.

Yellow Light: Signs to look for if you’re approaching the yellow light include light soreness or achiness that persists for more than 24 hours after your run, a small limp when running (but not when walking), and slight swelling of your joints after a run.

What to do: Slow down a bit—this is your body telling you to back-off. Take a rest day and re-evaluate how you’re feeling. Try to recognize patterns. For example, maybe your knees start to hurt when it’s time to get new running shoes, so take a trip to the shoe store! Listen to your body and take action if there’s a behavior you need to change to feel better and enhance your performance.

Red Light: If you’re approaching the red light, you’re experiencing very sharp pain that stops you in your tracks. The pain is debilitating and you are unable to walk without a limp. You may be experiencing intense swelling in your joints and intense discomfort that doesn’t subside after 24 hours.

What to do: It’s time to consult an expert. You may be at risk of a stress fracture or other serious injury. While it’s challenging to seek help and cease physical activity, it’s important to be seen by an expert early, so your injury doesn’t intensify. You may also be able to recover more quickly if you get help for the problem earlier rather than later.

I hope my simple stoplight method helps you identify how to deal with the pain you may be experiencing in your body and the action steps you need to take to feel better.

Need help from an expert? Let’s chat!

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Plantar Fasciitis: What the Heel?

By: Dr. Stephanie Duffey • Mar 02, 2020

If you’re dealing with plantar fasciitis, you know how stubborn and tricky this ailment can be! In this post, I’ll break down the root causes and share my tips for managing the discomfort and eliminating the problem for good.

WHAT IS PLANTAR FASCIITIS?

You have a thick band of tissue called the plantar fascia, which stretches from the bottom part of the heel to the toes. This tissue is designed to give your foot extra stability, but sometimes it can get irritated. You may notice sharp and intense heel pain in one or both of your feet when you get up in the morning, or when you stand up and walk after sitting for a while. These are common signs that you may be experiencing plantar fasciitis.

WHAT’S THE CAUSE?

The pain you’re experiencing is the result of irritation in the plantar fascia. But what’s causing this irritation? Likely, you have other areas in your body that are too tight, too loose, or too weak. This could be another area in the foot, leg, or even the core. Finding out why you’re experiencing this discomfort is the most challenging part and allows me as a physical therapist to play detective. It’s always my goal to get at the root cause of the issue to keep people out of pain long-term.

WHAT CAN YOU DO?

Other than identifying what caused the irritation in the first place, here are some of my other tips for managing plantar fasciitis:

Get a frozen plastic water bottle, freeze it, and roll your foot on it using moderate pressure a few times a day. This loosens the tissue and the ice cuts inflammation. You can also use a tennis or lacrosse ball.
Stretch your calves with the knee straight and then bent, or use a foam roller. Tightness and trigger points in the calf can be a contributing factor and refer pain to the heel so it’s extra important to stretch this area.
Stretch the plantar fascia by crossing the ankle over your knee and pulling your toes backward. This is a great way to loosen up the bottom of your foot
Get a supportive, pronation-control shoe. Plantar fasciitis pain can come from excessive or quick pronation. Find a shoe that works for you and use inserts as a secondary supplement.
Try a night splint or sock that pulls the toes up to give a long duration stretch while you sleep. This can be uncomfortable so I recommend you build your way up. Start with a few hours and gradually work up to the whole night. It usually takes about 3 months to get the full benefit.

If you’re suffering from plantar fasciitis, my biggest piece of advice is to do something ASAP. The longer it’s irritated, the longer it takes to treat and calm down. Need help from an expert? Let’s chat!

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8 Steps to Relieve and Prevent Back Pain

By: Dr. Stephanie Duffey • Mar 02, 2020

Experts estimate that up to 80% of the population will experience back pain at some time in their lives. While common among many people, back pain is NOT the norm and there are many steps you can take to relieve and prevent it from occurring. Today, I’ll break down 8 steps that I’ve implemented into my own life to help reduce back pain.

Watch how you lift. Whether you’re lifting a squirming child or weights, be sure to lift with your legs, not your back. The quads and glutes are waaayyy stronger than your small back muscles, so be mindful.
Take a posture check. How you sit (or stand) during the day is really important. Desk jobs in particular bring you forward and cause you to slump. Think of it this way: For every degree your head comes forward, your spine muscles have to work exponentially harder. Not sure what your posture looks like? Have a co-worker take a surprise picture of you sitting at your desk to get a good glimpse of your posture during the day.
Use a lumbar roll, especially if you work at a desk or drive frequently. A lumbar roll is a squishy pillow that you can place behind your low back to create additional support. It also helps your posture when you’re seated. Here’s the one I use from Amazon.
Take a stress test. What repetitive motions do you do frequently exhibit throughout the day that cause aggravation? Maybe it’s reaching for something, picking up an infant, or some other movement. Make a tally of what’s causing irritation in your back on a daily basis.
Strengthen your core correctly. By activating ALL the core muscles (not just the six-pack in the front) you take strain off your back. While strengthening your core isn’t the only way to resolve back pain, it certainly is a game-changer.
Move your body. Incorporating movement into your daily routine can significantly reduce back pain. The next time you miss your workout, notice how you feel. Chances are, you’ll feel much better when the muscles are loose from working out.
Stretch your hips, mid and upper back. Practice mobility work so you can move through these areas and you aren’t relying only on the mobility of your back alone.
Use good pillow support when you’re sleeping. If you’re a belly-sleeper, you may try placing a pillow under your hips. You should also consider training yourself not to be a stomach-sleeper to take some of the pressure off of your back. If you’re a side-sleeper, put a pillow between your knees to keep your legs stacked. This helps take the twist out of the low back). Back sleepers should try placing a pillow under the knees for additional support.

It’s never too early to start taking preventative measures to protect your back and it’s never too late to start living a pain free life! If you’re experiencing back pain and need help from a professional, let’s chat!

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Nutrition Tips for Runners Who Want to Feel Good, Run Fast, and Recover Effectively

By: Dr. Stephanie Duffey • Apr 21, 2020

Sweet Dish — Westerville, OH — Empower Physio & Wellness

As we gear up for the spring and summer, many of you are probably excited to capitalize on the warmer weather and increase your mileage. One of the best things you can do to feel great during your runs and promote effective recovery is to fuel your body with quality food. So, if you want to run better, recover faster, and feel AMAZING overall, I’m here to share my well-researched nutrition tips.

As you read through these tips, please be aware that this guidance is mainly for endurance athletes or folks running longer distances (between 45 minutes-1 hour). If you’re running for 30 minutes or less, the timing and precision of what you consume is a little more flexible.

Before we get into the details of what and when you should eat for optimal performance, it’s important to understand the three types of fuel your body expends.

TYPES OF FUEL

1. Blood glucose is sugar found in your bloodstream and it’s the first source of energy your body burns because it’s highly accessible.

2. Glycogen is glucose in storage form and your body uses it when you’ve already tapped in to all of your blood glucose.

3. Fat takes the longest to break down and is the last source of fuel your body uses.

Now that you understand how the body accesses what it stores, we can get into the fun stuff: The food groups!

FOOD GROUPS

1. Carbs give you immediate energy and are used right away (so if you’re a high-endurance athlete, just say no to Keto). 60-65% of your diet should consist of high-quality carbs, but be sure they’re low in fiber so you don’t activate your digestive system. Additionally, know the difference between simple and complex carbs. Simple carbs (found in sports drinks, chews and gels) give you the immediate energy you need right before a workout. Complex carbs (think bread and pasta) take a little longer to break down so eat these a few hours before your run.

2. b provides endurance energy and (despite popular belief) is actually a good thing. If you’ve been buying low fat versions of food at the store, this is a public service announcement to stop doing that! Low fat items strip out fat and replace it with sugar. Instead, focus on quality and get a mix of saturated, polyunsaturated and monounsaturated fats.

Examples: Saturated fat

Butter, coconut oil, red meat

Examples: Polyunsaturated fat:

Seeds, fish

Examples: Monounsaturated fat:

Avocado, nuts

3. Protein is not used to give you energy during long runs. Instead, it’s critical to recovery. When you lift or run, your muscles tear and reform as stronger muscles. The more intense your workout is, the more micro-tears in your muscles. Aim for 20 grams of protein between 20-40 minutes after a workout to rebuild your muscles and 60-65 grams of protein broken up throughout the day.

Examples:

Fish, chicken, beans, eggs, protein powder, quinoa and barley

TIMING (AKA: WHAT TO EAT BEFORE, DURING AND AFTER A RUN)

Before

Before a run, fuel up on simple carbs low in fiber 30-60 minutes prior. You can also eat a big meal containing carbs the night before a morning run.

Some of my faves:

Toast with peanut butter and jelly
Banana and peanut butter sandwich
Oatmeal and fruit
Pretzels and hummus
Whole grain waffles and syrup
1 cup of low fiber cereal with milk
Granola bar

During

Unless you’re running for a duration longer than 60 minutes, you don’t need to fuel up during your run. If you’re an endurance athlete running a marathon, you’ll want to consume approximately 15-30g of carbs every hour. But you need to figure out what works for you PRIOR to race day so there are no surprises.

Some of my faves:

Gels: honestly, I prefer chews over gels so I don’t have a go-to gel
Chews: Clif Bloks, Shaklee energy chews
Sports drinks: Shaklee hydrate, Nuun (skip the Gatorade and other drinks with high fructose corn syrup!)

After

Be sure you eat carbs and protein immediately after you finish your run, ideally within 30-40 minutes. If you wait, you significantly reduce the glycogen that gets put back into muscle storage. This can limit your endurance on your next run…no good. Glycogen stores in muscle are super important for distance running!

Some of my faves:

Shaklee protein shake with fruit (banana with chocolate protein is my go-to because of the potassium in bananas)
Chocolate milk
Fruit and cottage cheese
Trail mix
Energy bar with a good mix of carbs and protein

If you’re looking for some great recipes for runners, be sure to check out Run Fast. Cook Fast. Eat Slow. I’ve been loving this cookbook!

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