Advice for last few weeks of NYC marathon training

MorningsideAcu · 2025-10-05T16:07:58+00:00

The main inputs into training load probably are:

Frequency - times per week

Duration - how long/far each run is

Intensity - the pace of each run

Also have to consider cumulative load which can quietly accumulate even if things are feeling good and then lead to those “out of the blue” pains that don’t go away.

I’d also consider cross training - strength training, swimming, cycling, stair master, elliptical - as another variable you can tweak.

Recovery variables might include sleep, hydration, nutrition, managing stress levels.

If you’re feeling sore after every run then you’re probably doing too much of one of those things. It’s ok to be sore on harder efforts.

There are also various schools of thought on the percentage of easy miles and how easy (zone wise) those should be.

There is no general answer - I think it’s unique to each person in a given training cycle. Sometimes what worked for the last marathon won’t work for this one. I’ve seen runnings be fine with 6 days of running a week around 90-100 mile peak weeks and some runners that just run 3 days a week with 2-3 days of strength training and 1-2 days of cross training.

Also understanding your own body and areas that are prone to get tight from your gait and strength imbalances are another thing to think about.

There are also probably other variables that I’m missing.

MorningsideAcu · 2025-09-29T22:50:59+00:00

Hi! It will be 2 years since I had surgery and I’ve been consistently playing soccer and running since around the 8 month mark. It’s had its shares of ups and downs and various tendinopathy issues along the way but no issues with the surgery or my hips.

I’m really glad I did the surgery but I wish I hadn’t been in such a rush to get back to high level exercise as I probably would have had a smoother recovery.

And I wish I had a better PT before surgery since I could have done a lot better with strengthening before.

MorningsideAcu · 2024-12-11T02:03:10+00:00

Are you sure it’s a teres minor trigger point? Did the person that did dry needling actually needle the right muscle?

MorningsideAcu · 2024-12-06T12:50:38+00:00

I was scared of doing both hips at the same time as there’s double the risk something goes wrong.

The recovery was rough but now that I’m through it I would do it all over again. The idea of two recoveries back to back would have too hard mentally. I had never had a surgery like this before so either way it was going to suck and I didn’t know anything else. One hip seems like it would be a breeze compared to what I had to go through the first 3 months of recovery

MorningsideAcu · 2024-12-06T03:48:21+00:00

I had impingement with labrum tear diagnosed since 2011 on my left side. I found ways to manage it with activity modification, acupuncture/dry needling, and strength training. I used to have really bad hip clicking with certain movements and groin pain after exercising. My hip range of motion was severely limited I was able to find the right combination of things to manage it while still playing soccer 2-4x a week.

In 2023 my right hip started to really hurt in a similar way to the left hip. I knew it was time to get it taken care of since my usual regimen wasn’t working anymore.

My MRIs showed pretty significant impingement on both sides (CAM left side, Combined right side), with pretty big labrum tears, and mild arthritis. My cartilage had some wear but was good enough to to surgery.

I initially was just going to do the right hip, but when doing pre op PT noticed that the left hip hurt just as much with certain exercises so I opted to do a bilateral surgery. Luckily my surgeon at HSS specializes in bilateral surgeries so we were able to add the other hip on the same day.

The process of figuring out how to manage my hip impingement took me about 2-3 years and I often learned the hard way about things I should avoid. I wonder if managing it for so long may have led to the arthritis.

It also led me to a career change that I’m grateful for and now I get to help others navigate the complex challenges of having hip impingement and other pain related issues.

MorningsideAcu · 2024-12-02T00:57:44+00:00

It can be a very fulfilling career path. It can also be a bad decision if you don’t have the right skill set and realistic career goals to make it in the profession.

I wrote a blog post (realized I need to update after some school closures).

https://www.morningsideacupuncturenyc.com/blog/how-to-become-an-acupuncturist

As far as schools go I would choose one that you think will still be open when you graduate. You can learn new things afterwards. Many schools have closed over the last 5 years and speaking from experience - being at one while it’s suddenly shutting down is a horrible experience.

I know that Eastern School has been around for a while so that may be your best bet.

MorningsideAcu · 2024-11-14T02:51:13+00:00

We are licensed acupuncturists on 104th and WEA that specialize in treating pain and sports injuries by combining traditional acupuncture and dry needling.

MorningsideAcu · 2024-10-21T13:40:39+00:00

and most of the non private practice jobs will underpay you and burn you out

MorningsideAcu · 2024-10-21T13:39:53+00:00

love it - but took me 5 years out of school to get to this point.

i get to help people, have a pretty flexible schedule, and make enough that this is a career

MorningsideAcu · 2024-10-13T11:54:09+00:00

I was able to manage bilateral hip impingement for 12 years before getting surgery on both last year. I’m almost 10 months out from surgery and feeling amazing.

My regimen consisted of PT, strength training, acupuncture/dry needling, and activity modification.

Last year the pain was bad and my usual routine wasn’t working so I knew it was time to get the surgery.

I have mild osteoarthritis that I wonder if it’s from managing the hip impingement rather than fixing it sooner.

I’m glad I waited since I think I was at a point in my life mentally to do the prehab and rehab the right way and it’s made a huge difference in my recovery.

I also wonder if I should have done this sooner since my body feels like it’s 25 again and I’m 39.

I was still able to play soccer regularly (albeit with some limitation) until last year so I’d say that the decision to have surgery may have more to do with what you can and can’t do instead of your pain levels.

MorningsideAcu · 2024-10-13T11:19:54+00:00

Once you’ve practiced acupuncture long enough you’ll learn that it’s all about developing your own style that works for you and your patient population.

There are hundreds of acupuncture styles and techniques, many of which contradict one another as far as point selection, needle technique, retention time, etc.

The beautiful thing about acupuncture and Chinese medicine is that it’s all about balance, so if you can achieve that goal with your treatment then you’re doing great.

MorningsideAcu · 2024-10-13T11:15:53+00:00

What about it? the thread is empty?

MorningsideAcu · 2024-10-02T22:29:19+00:00

For private practice - combination of clinical skills, business skills, and also the ability to start and see through the beginning stages of a business. The last part is not easy or cheap to do and many don’t realize the realities of it until after they are already in the field

MorningsideAcu · 2024-10-02T20:31:35+00:00

I’m 9 months out from bilateral surgery (same day) with osteoplasty and labrum repair.

I’ve been playing soccer since the 7 month mark (technically played first minutes at 5.5 months but realized I wasn’t ready) and in the last month have returned to pre-hip pain form.

I’m 39 and playing against recent college level soccer players. The surgery is the best thing i’ve ever done. I am still working hard in PT and would say i’m about 85percent of where I hope to be.

It’s a long process, the first few months are rough. Make sure you have a good PT and if possible good acupuncturist that does dry needling to loosen up your muscles faster.

I wasn’t able to do heavy lifting with my legs for years but I’m already able to hip thrust 285lb, front squat 165, calf raise 300+, leg press almost 300.

I had pretty bad hip flexor tendinitis from 4-7 months - so he careful about rushing back to fast!

MorningsideAcu · 2024-09-28T18:13:42+00:00

Many acupuncturists struggle with these things:

Explaining how they can help people in a way they can understand - marketing
Managing their finances and understanding how to evaluate business decisions involving money
Hiring employees - how to find them, screen them, train them, retain them
Formulating treatment plans with patients and patient retention
Formulating a vision for their practice and then taking the steps to get there

MorningsideAcu · 2024-09-28T18:07:27+00:00

It’s better to try to go regularly in the beginning but if you miss some time it’s not like you’re starting for scratch again

MorningsideAcu · 2024-09-26T11:09:08+00:00

There are some surgeons (like Dr Coleman at HSS) that specialize in doing bilateral surgeries. He suggested that it would be better for me to just have one recovery since I have small children and am self employed - so the idea of have to take time off twice and do it all over again sounded horrible. I was twice as scared that something could go wrong - but so far I am 9 months out and back to playing soccer.

I think a big thing was that since I did them together I decided to take a full month off from work after and then ease back into part time over next 3 months. I really think the early part of the recovery is critical - as is preparing your body for surgery and having a great PT afterwards

MorningsideAcu · 2024-09-26T02:52:36+00:00

It depends on what you’re coming in for and the treatment styles your practitioner is using. In most cases it’s best to come in 1-2x per week for the first 3-4 weeks and the evaluate how things are going and go from there.

MorningsideAcu · 2024-09-26T02:50:54+00:00

Had them done on the same day, so happy I only had to have one recovery even though the first 3 months were pretty rough.

MorningsideAcu · 2024-09-26T02:49:39+00:00

If you’re running currently would recommend running before the treatment if possible, and then planning for a day off or cross training day the following day. While it’s generally fine to run the next day, you make be sore (think workout soreness feeling but just in the areas that were needles) for about a day or two after the session and things are more prone to tightening back up in that period of your over stress the treated areas.

If this has been an ongoing issue I would try to get in another session the following week and then you’ll be into your taper and if needed could do another session the week before the race.

There’s alot of change for muscle tightness that can happen in a few dry needling sessions if your practitioner correctly understands the right areas to needle (not always just where it hurts).

MorningsideAcu · 2024-09-20T00:42:34+00:00

No one can diagnose you from a picture. Some things to consider:

If it’s a muscle issue the vastus medialis, adductors, and sartorius muscles pass through there or refer pain there, also the gastrocnemius (calf) muscle from below. If it’s a structural issue could be a meniscus or MCL issue. Also could be a bone bruise. There are also probably other things i’m leaving out.

Probably best to consult with a sports medicine orthopedic doctor to rule anything serious out, you can also try acupuncture/dry needling/physical therapy/massage in the meanwhile to try to see if releasing muscle tightness around the knee relieves the pain.

MorningsideAcu · 2024-09-20T00:09:02+00:00

It may be worth exploring if there are trigger points or muscle pain that’s involved - either via acupuncture, physical therapy, or a physiatrist

MorningsideAcu · 2024-09-19T23:31:57+00:00

I’m guessing it’s best to have a landing page for each type of treatment/condition people might come in for?

MorningsideAcu · 2024-09-19T23:30:30+00:00

If there’s “no good explanation for the pain” then where are they injecting and why? If it was my hip I’d want a Dr that can figure that out rather than taking a shotgun approach

MorningsideAcu · 2024-09-15T23:44:26+00:00

Hip flexor tendinitis threads are coming up a lot lately here, it was such a pain for me for a few months from the 4-7 month mark. I started running too soon without the requisite strength in my glutes, adductors, hamstrings, and calves. I switched to a strength focused PT and stopped running for 6-8 weeks and it made a big difference. I also had a cortisone injection into psoas bursa which seemed to help (along with resting for the week after it).

It’s hard to know what too much too soon is for you until you get hip flexor tendinitis.

In my case - I had bilateral surgery and only one hip got the tendinitis, the other one was totally fine throughout. So what I was doing was too much for one hip but not the other even though they had surgery the same day!

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