By: Holly Warner, PT, DPT

Training errors, along with certain running biomechanics, place us at risk for developing a running related injury. Excessive pelvic drop and hip adduction can contribute to an increased risk of developing gluteal tendinopathy or a gluteus medius/minimus muscle strain, especially when we also have exceeded our tissue’s load capacity through an abrupt increase in running mileage or intensity.

Gluteal tendinopathy is often the cause of lateral hip pain (pain on the outside of the hip) in runners. This type of injury often happens due to increased compressive loads placed on the gluteal tendons at the greater trochanter located on the outside of the hip. The compressive loads are often caused by excessive pelvic drop or hip adduction when running. 

Pain is often felt running, especially uphill, and also when lying on the affected side, climbing stairs, and with single leg activities. 

It is important to avoid stretching with this type of injury, such as IT band stretching. Stretching the lateral hip structures actually further increases compressive loading of the tendons and mimics the type of movement that is often the cause/mechanism of injury. Instead, the best way to treat this type of injury is to strengthen the hip abductor muscles (gluteus medius and minimus), starting initially with isometric exercises. Isometric exercises are exercises that cause a muscle to work/contract without moving the joint. Types of these exercises for the gluteus medius and minimus muscles might look something like this:


To learn more about lateral hip pain and for specifics on exercises to try, check out Sapphire Physical Therapy’s blog post on Addressing Lateral Hip Pain In Runners. Whatever your injury may be, Sapphire PT is ready to help!

Hydration vests let you go light and far!

Summer is fast approaching, and that means big summer adventures are right around the corner! Whether you’re looking to do a run around town or a day in the mountains, a hydration vest is an integral piece of gear for trail runners and hikers. If you’ve ever looked into buying one, you probably already know that there are tons of options and endless variations on what at first glance is a simple piece of gear. We want to help demystify the world of hydration vests for you. Running vests are an investment, and getting one that is the perfect match will make a world of difference!

What size/volume vest do I need?

Running vest volumes are generally measured in liters (the size of a Nalgene water bottle). Vests come in a variety of sizes, from 1-2 liters up to 15 liters or more. For most people, a vest in the 5-12 liter range is ideal. To gauge the size of the vest you need, think about the gear, food, and water that you’ll want to carry with you. About how many water bottles would all of that fit in? That’s how many liters you want to shoot for!

  Jeff’s philosophy: “I like to move light and fast and carry only the necessities, so I tend to opt for vests that are as small and light as possible. I’m partial to vests 8 liters and smaller, though I have some vests over 12 liters for really really big days or when I need a lot of clothes or water.” Jeff is a big fan of the Salomon Advanced Skin 5.

Vicky’s philosophy: “I always want to have enough room for my things and be able to pack an extra layer. I find a 12-liter vest works great. Plus, I can always run with it empty and it feels the same as a smaller vest. It’s a great ‘one pack to do it all’ size. You can make a vest smaller, but it’s tough to make on bigger!” Vicky recommends the Nathan Pinnacle 12 or The North Face Flight Training Pack 12.

How should a vest fit?

Snug around the shoulders with no space between you and the vest.

Vicky wearing the Salomon Advanced Skin 8 for a  comfortable fit in the front.

Vests come in both unisex and women’s specific fits. The sizing is generally similar to t-shirt sizing. The best thing you can do is try a bunch of vests on! All vests are cut different (even from the same brands), and you never know how one will fit your body. Unlike a backpack that just needs to fit your shoulders comfortably, you want the vest to hug and wrap your whole upper body snuggly.

You don’t want space between the shoulder straps and your shoulders. You also don’t want space between the sides of your pack and ribs/chest. A comfortable, snug fit will reduce bouncing and chafing. It’s especially important for women to try packs, as they fit different chest sizes very differently. A ladies’ favorite is the Salomon Advanced Skin 8, which has bottles designed to sit lower on ribcage rather than up by the sternum (Ashley says: “keeps the bottle off the girls!”).  It can take some experimenting with different vests and adjustments to get the fit dialed in just right! Other ladies specific vests include the Ultimate Direction Mountain Vesta 5 and the Nathan Women’s Pinnacle 4 and Pinnacle 12.

 Bladder or bottles?

 The age-old question sure to rile up any trail runner. There is no right answer, but there may be a right answer for you! Most all packs are compatible with both hydration bladders and up-front bottles. Pros of up-front bottle are that you can see exactly how much you’ve drank and can have two different types of drinks. They are also easier and quicker to refill at aid stations or streams. Bladders carry water weight more efficiently on your back and can more easily carry large amounts of water. However, it is hard to tell how much you’ve drank and they are a bit more cumbersome to refill. Most vests come with bottles, but the Nathan Pinnacle 12 comes with a bladder ready to go!

Ashley carrying two bottles, Bridgett with one bottle and a bladder, while Chuck has just a bladder

How to try on a vest

Put a vest on and grab some snack and goodies! Can you reach the pockets you need to reach while running? Are you able to adjust the vest for a good fit while it’s filled with snacks? How easy is it to get on and off? If you’re carrying bear spray in a water bottle pocket, can you get it out easy? Think about how you’ll be using the vest while running and try to simulate that in the store. Chances are if something bothers you in the store, it will bother you on the trails! This is a great time to test things out before making an investment in a running vest. And maybe most importantly, make sure your giant smartphone will fit in one of the pockets!

What features am I looking for?

The North Face Flight 12L pack has a giant pouch in the back great for big days on the trails!

There are all sorts of bells and whistles on hydration vests. Focus on the ones important to what you’ll be doing and how you’ll be traveling. If you plan on carrying trekking poles, check to make sure the vest you get has trekking pole attachments. We all carry our phone, so be sure to test it out in a few pockets to make sure you can fit it in an easy to access spot. If you might need to carry extra clothes or gear, check for bungee straps on the back. Take a peak at the adjustments to make sure the vest can adjust to fit you in both a summer t-shirt and winter layers.

Other considerations

In Montana, we’re often running or hiking in grizzly country. Hydration vests are perfect for carrying bear spray in an accessible place! 

Need to carry bear spray? One of your bottle pockets is the perfect spot!

Out for a long mountain run? Try out a BeFree water filter to turn any water you find into clean, potable water! 

Jeff’s take on BeFree filters: “I carry substantially less water now that I have a BeFree filter. I check to see how much water is on a route, then just refill my bottle at stream crossings and don’t worry about carrying liters and liters of water for a big route. It’s been a total game changer!!”

Never run out of clean water with a BeFree filter!

Despite the rain and snow, it was all smiles at the Hootenanny! Photo: Seth Orme

Alex Levan celebrating his 50k finish. Photo: Seth Orme

Patty Creek Junction keeping the base area lively! Photo: Seth Orme

It seems like once a year, Missoula gets a day where it rains ALL day. This past Sunday was that day. Not to be deterred, Hootenanny 50k and Relay participants came out in force to run through rain, snow and mud. The sun may have been hiding behind dense clouds, but the smiles and laughs from hundreds of runners warmed up the chilly day. Volunteers brought energy to both aid stations and kept fires going to take the edge off the cold. Not to mention they pumped all the runners full of tasty food! At the base area, volunteers, spectators, and runners were treated to live music from Patty Creek Junction to keep the excitement high. Thanks to all who came out and persevered through some tough weather! Congrats everyone and thank you volunteers!

50k Race

The 50k consisted of three approximately 10-mile loops, with the first loop having an additional mini-loop to get the total distance to a full 31 miles. The course was slightly different from the 2020 course, but times were expected to be very similar. The 50k started at 7am under cloudy, but not yet rainy, skies. Many runners got through most of one lap without getting too too wet. Laps two and three were wet for everyone. Rain poured down in the base area, while big fat snowflakes flew up high. Trail runners are tough cookies though, and smiled their way through the chilly slip n slide of a course. Congrats to all!


Erin Clark coming in for a first place finish in the women’s 50k. Photo: Seth Orme

Even with a muddy course on a chilly day, the women’s race went out hot. After the first lap, it was clear that multiple women had the potential to better Evie Tate’s 2020 course record of 4:49:26. Coming off her win at the Sentinel Hill Climb, Erin Clark powered through to a new course record at the Hootenanny 50k. Clark ran an incredibly speedy 4:12:06, besting Tate’s 2020 record by a whopping 37 minutes. Keep an eye out for Clark at next month’s Western States 100 Mile Endurance Run! Also under course record were Imogen Ainsworth (2nd place, 4:30:21), Christi Richards (3rd place, 4:46:05), and Reagan Colyer (4th place, 4:46:50). Master’s winner was Renate Bush (8th place overall, 6:04:18). The women’s race saw 34 starters with 28 finishers.


Jeff Mogavero headed towards a win in the 50k. Photo: Seth Orme

The men’s race shared a similar success to the women’s race, with fast times clocked by many. The top three men came through lap one with less than one minute separating them. Jeff Mogavero pulled ahead on lap two and held on for lap three, establishing a new course record in 3:56:04. He was not the only dip under Jesse Potter’s 2020 course record of 4:42:40. Loren Davis (2nd place, 4:08:55) and Hunter MacHus (3rd place, 4:17:00) both came in under the record, as did the next three finishers (including Potter, who bettered his time by 6 minutes). Master’s winner was Ethan Richards (4th place overall, 4:25:05). The men’s race saw 52 starters with 41 finishers.

Women’s relay winners Local Bacon Toasted Hazelnuts Mozzarella Maple Chipotle Driz with big smiles at the finish. Photo: Seth Orme


The relay took place on the same course as the 50k, with three runners each running one loop of the course. The race started at 8am, just in time for everyone lucky enough to run the first (and longest loop) to get caught in the meat of the snow/rain storm. The trails were freshly muddied by the 50k runners on their first lap and the relayers rejoiced in the sloppy mudfest. Runners stormed the course with tons of energy, excitement, and awesome team names. It was a tight race between the women’s champs and the co-ed champs. Despite covering over 30 miles, co-ed team winner Go Biga or Go Home ran 4:14:56 to narrowly edge out women’s winners Local Bacon Toasted Hazelnuts Mozzarella Maple Chipotle Driz in 4:15:49. That’s one minute!! The Sweaty Singlets placed first for men, covering the 50k course in 3:35:35. Perhaps next year there should be a winner for best team name?!

Relayers partying their way to the finish! Photo: Seth Orme

Full results available from Competitive Timing here.

Photos from Seth Orme available for FREE download on Facebook and from Seth’s website.

Thanks to our sponsors!

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Photo: Votography Images

By: John Fiore, PT, owner of Sapphire Physical Therapy

The function of the foot

There are many simple yet highly effective exercises to aid in foot function

The human foot is an evolutionary marvel. The human foot contains twenty-six bones, thirty-three joints, and one-hundred ligaments, muscles, and tendons. Humans have the unique ability to walk on two legs (bipedal walking), due in part to the ingenious balance of mobility, shock absorption, and propulsion found in our feet. Our ancestors climbed trees and traveled on all four extremities. As humans diverged from our primate ancestors, our toes shortened for push-off, our heel (calcaneus) mass increased for foot strike, and our mid-foot arch developed for shock absorption and recoil.

Why focus on foot function?

Most of us keep our feet covered in socks and shoes and rarely considering the important role our feet play in our daily lives and recreational activities. I have seen many feet in twenty-eight years of physical therapy practice, and I am confident that there is no such thing as the perfect foot. The take home message of this article is the importance of regularly addressing foot joint mobility, strength, and balance to allow your unique feet to function properly for a lifetime.

John Fiore helping a runner after the Snowbowl 15k. Photo: Votography Images

Foot stress increases when the ankle joints are stiff. When the lower leg and foot musculature (intrinsic muscles on the bottom of the foot) are weak, foot and ankle strain increases. In addition, foot and ankle joint impact increases when our foot is not capable of effectively absorbing and transferring impact force associated with landing, especially during running and jumping activities.

Next steps

While it is true that more impressive exercises exist (squats, lunges, deadlifts, planks), there are few exercises as important for living, working, playing, running, or jumping without pain than foot-specific exercises. I recommend being proactive in regard to your foot health, especially if you have recreational or competitive goals in 2021. Make an appointment with one of our physical therapists for a consultation, individualized exercise program, and training recommendations. Sapphire PT specializes in foot and ankle treatment. Our services range from preventative, to post-operative, to custom foot orthotics fabricated on-site for your unique foot issues.