Learn to run. What we know and what we made up.

http://www.slideshare.net/informmax

What we know and what we made up!

We are runners!!

We have glutes!!Achilles tendon/ITB/peroneus longusLongitudinal archNuchal ligament

Bramble & Lieberman 2004

HOMOGENEITY

Variance?

ENVIRONMENT!

•Forward head and shoulders

•++Thoracic kyphosis

•Ineffective core

•Deconditioned glutes and

lower leg muscles

•INJURY?

Running Requirements

SkillPhysical capacity

InjuryCapacity

Vs Demand

50% injured annually!!Fields et al 2010

40%+ injuries are to the knee!!Taunton et al 2002

Skill: The non-negotiables•A stable head

•Open shoulders/chest

•Slight forward lean (50)

•Elbows (to 900)- not crossing midline

•Smooth symmetrical trunk rotation

•Tri-planar alignment at pelvis- neutral lumbar spine

•Stable hips (no catwalk models!!) that extend 100

•Frontal plane knee alignment

•Feet and knees aligned

•Feet not crossing the midline

•SYMMETRY!!

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???

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www.theperfectrunner.com

Building a body to run- Physical Capacity

What we know.....Weak hips = More injuriesStrong hips = Less injuries(Fredericson et al 2000, Cowan 2006 , Niemuth et al 2005, Noehren et al 2007, Noehren 2012, Snyder et al 2009)

Can you do a single-legged squat?

Commonly used in literature as a determinant of hip muscle strength (gl mx/md)

Describes much more than just this!

Skill- Good Running?

Learn to walk!

Skill- Good Running?

A Paradigm.....

Pose Tech Corp

The Forefoot Strike

Show me the evidence!!Analysis of shod elite runners who participated in a 1/2 marathon (Hasegawa et al. 2007):75% of the runners were heel strikers, 24% were midfoot strikers, and 1% were forefoot strikers

Retrospective study comparing 52 cross-country runners (Daoud et al 2012): Heel-strike runners twice as likely to experience repetitive stress injuries compared to the forefoot strikers.

The Forefoot Strike

Show me the evidence!!

Retrospective descriptive epidemiology survey (Goss & Gross 2012)

2,509 runners (1,254 male, 1,255 female, aged 18 to 50)

Online survey assessed running tendencies, footstrike patterns, shoe preferences, and injury history.

Significant association between shoe selection and foot-strike.

Traditionally shod runners 3.41x more likely to report injuries than experienced minimalist shoe wearers.

Thank you!

What we know and what we made up!

The Forefoot Strike

Show me the evidence!!10 participants with anterior compartment syndrome (surgery rec.). Deibal et al (2012)

6 week heel-strike to forefoot strike adaptation program.

All participants improved pain and disability scores.

All participants avoided surgery

All maintained improvement and running style at 1yr follow-up

The Forefoot Strike

Why varying foot patterns?Ground hardness and shoe build seem to affect Foot strike patterns (Goss & Gross 2012)

40 RFS asked to run BF on a hard surface and a soft surface. (Grubera et al 2012)

20% used MF/FF on softer surface

65% used a MF/FF on harder surface

The Forefoot Strike

Why would this be?Heel strikers produce an ‘impact transient force’ (Lieberman et al 2010, Cavanagh 1980).

Forefoot strikers produce peak collision forces equal if not greater than Heel strikers (Lieberman et al 2010)

Lieberman et al 2010

The Forefoot Strike


How is the force accepted by the body?Rearfoot strike displays greater deceleration at the kneeForefoot strike displays greater deceleration at the anklePaquettea et al 2013; Hamilla et al 2010; Williams et al 2012

The Forefoot Strike – training required!

Forefoot strikers:Land on a more compliant section of the footCan utilise greater range of dorsi-flexion to dissipate force/create elastic recoilPaquetta 2013: greater rate of loading in FFS (gastrocs) – train this!Hamilla 2012: runners can change foot-strike pattern

But associated re-organisation of control – train this too!


The Forefoot Strike

There is more to it than just foot-strike!

Goss and Gross (2012) show that FFS have shorter stride length with greater frequency, and less vertical displacement.

Running speed is stride length x stride frequency

Example: 2 runners running 200m in 1min (12km/h)

• Runner 1: Stride length 1.43m= Frequency 140spm

• Runner 2: Stride length 1.11m= Frequency 180spm

Which is better?

The Forefoot Strike


Which is better?Heiderscheit et al 2011

5% increase to preferred (172.6± 8.8) cadence =

• Decreased knee power absorption (20% reduction)

• Decreased knee flexion angle

• Decreased COM vertical excursion

• Decreased braking impulse

The Forefoot Strike


Which is better?10% increase to preferred (172.6± 8.8) cadence =

• Decreased knee power absorption (34% reduction)

• Decreased knee flexion angle (related to ITBs)

• Decreased COM vertical excursion

• Decreased braking impulse

• Decreased hip power absorption

• Decreased hip adduction angle

• Decreased hip internal rotation moments

Heiderscheit et al 2011

The Forefoot Strike

Athletic Performance benefits?

Hayes & Caplan 2012181 runners across twenty two 800m and 1500m seeded races in UK.

FF and MF strikers had significantly shorter ground contact times (GCT)

than HS

They also had significantly quicker average race speeds than HS!

Strong correlations between GCT and race speeds

GCT in first laps were significantly shorter than in last laps – fatigue!

The Forefoot Strike

Should I barefoot run?Differences in running gait between experienced barefoot and shod runners include:

decreased stride length increase stride frequencyIncreased ROM at the ankle (with increased PFlx loading), Decreased ROM knee and hip (with decreased loading)a more plantar-flexed foot at foot-strike

No credible-scientific studies have proven barefoot running reduces injury risk

Jenkins and Cauthon 2011.

The Forefoot Strike

Should I barefoot run?Mechanics of FFS and BFs similar to each other, and different to RFS

Habitual heel-strikers still heel-strike barefoot

Transient forces greatest in barefoot heel strikers

Greater loading of metatarsalsWilliams 2012; Goss and Gross 2012

Are you equipped?!

Building a body to forefoot strike

Can you do single-legged calf raises?

Can you comfortably hop on one leg- with good joint alignment?

Physical Capacity

Don’t run to get fit- get fit to run!source unknown

Can you/r client:Stabilise pelvis?Extend and rotate Tx spine?Activate glutes?Do SL squats?Do SL calf raises?Hop on one foot?

Are there chronic tightnesses?

Physical Capacity


Even GREAT running is inherently damaging- ACCEPT IT!

Management Strategies:Supplementation

ProteinOmega 3sMagnesium

Foam Rolling/StretchingSpecific functional/corrective trainingRest weeks

Physical Capacity


Increase km’s gradually (5% p/wk)Set conservative goals and update when appropriateThere is a skill to itBe patient- you’ll have it for life!

In summary!

Heel Strike

FFS & BF (similar biomechs)

Forefoot Strike(but not necessarily BF)

Knee forcesstride lengthstride frequencyinjuries (knees, hips, shins)

Plantar flexionrate of forcestride lengthstride rate

athl. Performance

injury rates (?) (plantar flexors and connective tissues, metatarsals).

Different control requirements

In summary!

Tailor to the individual!

Consider Capacity vs Technique(skill) approach.

THANK YOU!!

http://www.slideshare.net/informmax

Bramble DM, Lieberman DE. Endurance running and the evolution of Homo. Nature. 2004;432:345–52.

Cavanagh PR, Lafortune MA. Ground reaction forces in distance running. J Biomech. 1980;13:397–406.

Cowan, S. (2006). The role of gluteus medius in patellofemoral pain. Journal of Science and Medicine in Sport , 6.

Daoud AI, Geissler GJ, Wang F, Saretsky J, Daoud YA, Lieberman DE. (2012) Foot Strike and Injury Rates in Endurance Runners: A Retrospective Study. MEDICINE & SCIENCE IN SPORTS & EXERCISE. Vol. 44, No. 7, pp. 1325–1334

Diebal AR, Gregory R, Alitz C, Gerber JP. (2012). Forefoot running improves pain and disability associated with chronic exertional compartment syndrome. Am J Sports Med. 2012 May;40(5):1060-7

Federicson, M., Cookingham, C. L., Chaudhari, A. M., Dowdell, B. C., Oestriecher, N., & Sahrmann, S. A. (2000). Hip abductor weakness in distance runners with iliotibial band syndrome. Clinical Journal of Sports Medicine , 10, 169-175.

Fields KB, Sykes JC, Walker KM, Jackson JC. (2010). Prevention of running injuries. Curr Sports Med Rep. 2010 May-Jun;9(3):176-82

Goss DL & Gross MT (2012). Relationships among self-reported shoe type, footstrike pattern, and injury incidence. US Army Med Dep J. 2012 Oct-Dec:25-30

Grubera AH, Silvernaila JF, Brueggemannb P, Rohrc E & Hamilla J. (2012). Footfall patterns during barefoot running on harder and softer surfaces. Footwear Science, Volume 5, Issue 1, 39-44

Hamilla J, GruberaAH, Derrick TR, (2010). Lower extremity joint stiffness characteristics during running with different footfall pattern. European Journal of Sport Science. 113(3), 599-609.

Hasegawa H, Yamauchi T, Kraemer WJ. (2007). Foot strike patterns of runners at the 15-km point during an elite-level half marathon. J Strength Cond Res. 2007 Aug;21(3):888-93.

Hayes P & Caplan N, (2012). Foot strike patterns and ground contact times during high-calibre middle-distance races. Med Sci Sports Exerc. 2012 Jul;44(7):1335-43.

Heiderscheit BC.(2011). Gait retraining for runners: in search of the ideal. J Orthop Sports Phys Ther. 2011 Dec;41(12):909-10

Jenkins DW, Cauthon DJ (2011). Barefoot running claims and controversies: a review of the literature. J Am Podiatr Med Assoc. 2011 May-Jun;101(3):231-46.

Lieberman DE, Venkadesan M, Werbel WA, Daoud AI, D'Andrea S, Davis IS. Mang'eni RO, Pitsiladis Y. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature. 2010;463(7280):531 5.‐

Niemuth, P. E., Johnson, R. J., Myers, M. J., & Thieman, T. J. (2005). hip muscle weakness and overuse injuries in recreational runners. Clinical Journal of Sports Medicine , 15, 14-21.

Noehren, B., Davis, I., & Hamill, J. (2007). ASB Clinical biomechanics award winner 2006: Prospective study of the biomechanical facotrs associated with iliotibial band syndrome. Clinical Biomechanics , 22, 951-956.

Paquette MR, Songning Z, Baumgartnera LD. (2013). Acute effects of barefoot, minimal shoes and running shoes on lower limb mechanics in rear and forefootstrike runners. Footwear Science. 5(1). 9-18

Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A prospective study of running injuries: the Vancouver Sun Run ‘‘In Training’’ clinics. Br J Sports Med. 2003; 37:239–44.

Williams, DSB, Green DH, Wurzinger B. (2012). Changes in lower extremity movement and power absorption during forefoot striking and barefoot running. Int J Sports Ther. 7(5): 525-532

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Learn to run. What we know and what we made up.

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Transcript of Learn to run. What we know and what we made up.