Pigeon holed into a particular running form. Some thoughts.

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We should not pigeon hole everyone into one of the major (often discussed) "running forms". Every person's running form has some unique parameters that work for them (and perhaps some components that do not work for them and lead to injury), and asking their body to do something else that you "deem" better for them because it looks right/better can at times lead to new issues or complications in resolving their complaints. Work with their system, their anatomy. Help them correct mechanical flaws related to their problems/complaints/injuries. Do not try to get everyone into one of the classically pristine and magazine cover running forms. As Allan on our FB page said, "gait correction requires work". And may we say this . . . . that prescribing corrective exercises does not mean they will spill over into their gait with positive changes. There must be teachable time that is hands on to help them blend over the corrective work into new gait patterns. This is a skill that takes a long time to learn and figure out, and each client is different and each client requires different cues and different exercises to tap into the desirable cues for them. This is why internet/youtube corrective exercise prescribed homework (ie. do this exercise to correct your iliotibial band syndrome) often does not work and sometimes creates new problems down the road. Why? . . . because there are holes missing when there is not a hands on exam to ensure the corrective work is the right work, and, just as importantly, it takes time and skill to show, demo, and translate how and why the homework will take over into a new gait pattern. Translation, corrective exercises do not guarantee a new gait pattern or new running form. There are so many bad examples we could use, "just going to the mechanic does not guarantee they will fix your car", "changing your tires does not necessarily make you a safer driver", "watching some youtube videos on learning to drive does not mean you actually know how to sit in a car and drive".

Medieval "Turn Shoes": How we used to walk.

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In the 1500's in Western Europe, shoes were different. People wore “turn shoes”, leather shoes that were made inside out then reversed for wear. This was likely the beginning of the use of molds to make shoes, carpenters up until the twentieth century would carve a wooden foot model of various sizes to model the process and standardize it.

These "Turn Shoes" were replaced by shoes with a frame construction as shoes changed to adapt to different environments, as streets changed.

The Turn shoes were basically a slip on or lace up thick leather sock. Thus, they were zero drop, soft, and provided much "feel" for the ground. Proprioception was obviously well appreciated.

We have spoken about the difference between heel strike and heel contact in walking. One can safely heel strike if barefoot on soft grass, but one cannot on the hard concrete or asphalt that we have covered much of our world with. Thus, if one were to wear "turn shoes" in our modern era, one would be forced to adapt to a heel contact or "heel kiss" on the ground, meaning, a more predominant forefoot loading style as described in this video.

What he describes, is largely not a choice, it was because they were in soft thin leather sock all day long, and even on wood or hard dirt packed floors and cart paths all day long, the heels would want some reprieve from heel "strike".

Screen Shot 2017-10-08 at 10.45.45 AM.png

Another way around this, to reduce heel strike, is to do it more naturally, by shortening the step and stride lengths a little, by keeping the body mass over the foot strike. "Chi Running" and "Chi walking" are based off of this principle. By moving the body mass forward with the foot, one has to naturally reduce heel strike. If one lags the body mass behind the foot however, the foot moves out in front, and heel strike begins to naturally (or shall we say, unnaturally) out in front, more heavily. This is not exactly desirable, for many reason.  Yet, since most of our shoes have some form of heel lift (a heel to forefoot drop), particular dress shoes (yes, even men's dress shoes, see photo), and even many modern day running shoes, the heel is essentially made more prominent (the heel rise essentially makes the brain think our heel (calcaneus) that much longer. This makes it easier, yet undesirable, to heel "strike" first. Oh what we have done for fashion !

He gets a few things wrong in the video, in terms of "ease" of walking, but largely it is decently done. One has to be careful if they perch the foot out in front like he does in the slower demonstration, in a plantarflexed ankle and foot, one can easily begin to lock up the knees. We often see this in teenagers in flip-flops.

-Shawn and Ivo, the gait guys

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Impact matters: How you put your foot on the ground matters.

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Impact matters. For years Ivo and I have been telling our clients this obvious fact. Over and over we hear the heavy heel strike of our barefoot clients on the floors of our office. We are constantly drawing their attention to this unnecessary impact load.  They hear it, feel it, and make immediate notable changes and realize that they are a big part of their own problem.  (Recently, an onslaught of Sever's "disease" cases have been coming into our office and the parents confirm a herd of elephants live on the upper floors of their homes, if you catch our drift. Impact matters.  Kids with heel growth plate issues should not be pounding their heels into the floors.)  We like to say, the heel can touch down first, that is ok, it is normal in walking gait, just please "kiss the floor" with the heel instead of driving nails.  But, to be fair, all those high heel EVA foam cushioned shoes have brought us to where we are, and minimalism is trending us out -- a little.  

Here in this study, they "aimed to determine if a quantifiable relationship exists between the peak sound amplitude and peak vertical ground reaction force (vGRF) and vertical loading rate during running."

They used the same queuing in the study that we use in our offices, participants were verbally instructed to run quietly compared to their normal running. What is interesting is that "simple linear regressions revealed no significant relationships between impact sound and peak vGRF in the normal and quiet conditions and vertical loading rate in the normal condition." But, read carefully. There is a subtlety in this study, there were changes when the runners were queued to run more quietly, consciously.  This was different compared to those who just unconsciously ran quieter. 

"During the normal running condition, 15.4% of participants utilized a non-rearfoot strike technique compared to 76.9% in the quiet condition, which was corroborated by an increased ankle plantarflexion angle at initial contact. "

"This study demonstrated that quieter impact sound is not directly associated with a lower peak vGRF or vertical loading rate. However, given the instructions to run quietly, participants effectively reduced peak impact sound, peak vGRF and vertical loading rate."

J Sports Sci. 2016 Sep 3:1-7. [Epub ahead of print]

Running quietly reduces ground reaction force and vertical loading rate and alters foot strike technique.

Phan X1,2, Grisbrook TL1, Wernli K1,3, Stearne SM1, Davey P1, Ng L1.

Do novice runners really have weak hips and poor running form ?

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Folks are ramping up mileage here in Chicago-land for the October marathon. Lots of first timers trying to fill the bucket list, and lots of hip and knee stuff coming into the office. This older article reminded us of the paramount need to slowly build up safe durability. So many folks just follow the ledgers, "This week is 16 miles, 2 more than last sunday, this will keep you on track to get to your taper week". We get all that. But this recipe doesn't work for everyone. Some bodies are so weak and out of shape that their recipe is drastically different than the "average joe or jane". Many need their marathon program time frame doubled so they can build their durability. Yes, novice runners often have functionally unstable/weak hips (amongst other things), and some have bad running form, and many have BOTH ! We remind folks that 26 miles is something to endure for most, and that means preparation, probably preparation before the running training started. So it is about educating them for next time, if there is a next time for them ! Don't forget, running is a sagittal game, one is moving forward. The frontal and axial (rotational) stability is often neglected, and here lies the hole in the bucket that leads to unjuries. Even if you are half way there to your marathon date and doing fine, it is never too soon to start frontal and axial plane durability work, just in case the 18 miler is just beyond what you can endure to protect those joints.

http://www.physiospot.com/research/do-novice-runners-have-weak-hips-and-bad-running-form/

 

 

 

 

Forefoot strike running: Do you have enough calf muscle endurance to do it without a cost ?

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Below you will find an article on footwear and running. Rice et al concluded that 

“ When running in a standard shoe, peak resultant and component instantaneous loadrates were similar between footstrike patterns. However, loadrates were lower when running in minimal shoes with a FFS (forefoot strike), compared with running in standard shoes with either foot strike. Therefore, it appears that footwear alters the loadrates during running, even with similar foot strike patterns.

They concluded that footwear alters the load rates during running. No brain surgery here. But that is not the point I want to discuss today. Foot strike matters. Shoes matter. And pairing the foot type and your strike patterns of mental choice, or out of natural choice, is critical. For example, you are not likely (hopefully) to choose a HOKA shoe if you are a forefoot striker. The problem is, novice runners are not likely to have a clue about this, especially if they are fashonistas about their reasoning behind shoe purchases. Most serious runners do not care about the look/color of the shoe. This is serious business to them and they know it is just a 2-3 months in the shoe, depending on their mileage. But, pairing the foot type, foot strike pattern and shoe anatomy is a bit of a science and an art. I will just mention our National Shoe Fit Certification program here if you want to get deeper into that science and art. (Beware, this is not a course for the feint of heart.)

However, I just wanted to approach a theoretical topic today, playing off of the “Forefoot strike” methodology mentioned in the article today.  I see this often in my practice, I know Ivo does as well. The issue can be one of insufficient endurance and top end strength (top end ankle plantar flexion) of the posterior mechanism, the gastrocsoleus-achilles complex. If your calf complex starts to fatigue and you are forefoot striker, the heel will begin to drop, and sometimes abruptly right after forefoot load. The posterior compartment is a great spring loading mechanism and can be used effectively in many runners, the question is, if you fatigue your’s beyond what is safe and effective are you going to pay a price ? This heel drop can put a sudden unexpected and possibly excessive load into the posterior compartment and achilles. This act will move you into more relative dorsiflexion, this will also likely start abrupt loading the calf-achilles eccentrically. IF you have not trained this compartment for eccentric loads, your achilles may begin to call you out angrily. Can you control the heel decent sufficiently to use the stored energy efficiently and effectively? Or will you be a casualty?  This drop if uncontrolled or excessive may also start to cause some heel counter slippage at the back of the shoe, friction is never a good thing between skin and shoe. This may cause some insertional tendonitis or achilles proper hypertrophy or adaptive thickening. This may cause some knee extension when the knee should not be extending. This may cause some pelvis drop, a lateral foot weight bear shift and supination tendencies, some patellofemoral compression, anterior meniscofemoral compression/impingement, altered arm swing etc.  You catch my drift. Simply put, an endurance challenged posterior compartment, one that may not express its problem until the latter miles, is something to be aware of. 

Imagine being a forefoot striker and 6 miles into a run your calf starts to fatigue. That forefoot strike now becomes a potential liability. We like, when possible, a mid foot strike. This avoids heel strike, avoids the problems above, and is still a highly effective running strike pattern. Think about this, if you are a forefoot striker and yet you still feel your heel touch down each step after the forefoot load, you may be experiencing some of the things I mentioned above on a low level. And, you momentarily moved backwards when you are trying to run forwards. Why not just make a subtle change towards mid foot strike, when that heel touches down after your forefoot strike, you are essentially there anyways. Think about it.

Shawn Allen, one of The Gait Guys

Footwear Matters: Influence of Footwear and Foot Strike on Loadrates During Running. Medicine & Science in Sports & Exercise:
Rice, Hannah M.; Jamison, Steve T.; Davis, Irene S.

http://journals.lww.com/acsm-msse/Abstract/publishahead/Footwear_Matters___Influence_of_Footwear_and_Foot.97456.aspx

Podcast 46: Georges St. Pierre, Regenokine & Compensation Patterns,

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Podcast 46 is live !
Topics: Diffuse Axonal Shear in the nervous system, the new procedure Regenokine, the neurologic status of UFC fighter Georges St. Pierre, PCP thearpy, the new generation of slow running children, posture, compensation patterns, pre-race Tylenol effects/dangers, tibialis posterior tendonitis, shoe selection and so much more !  If you have not listened to one of our podcasts, this one will surely give you a good taste of what you are missing !

A. Link to our server:

http://thegaitguys.libsyn.com/podcast-46-slow-kids-regenokine-compensation-patterns-monty-python

B. iTunes link:

https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138

C. Gait Guys online /download store (National Shoe Fit Certification and more !) :

http://store.payloadz.com/results/results.aspx?m=80204

D. other web based Gait Guys lectures:

www.onlinece.com   type in Dr. Waerlop or Dr. Allen,  ”Biomechanics”

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* Today’s show notes:

Neuroscience Pieces:
1.  Future of computing 
 
2. We have been talking about body part replacements like bionics etc……but this could be the stone in the road to this progress
 

REGENOKINE: THE UNPROVEN TREATMENT THAT PROFESSIONAL ATHLETES ARE FLYING TO GERMANY FOR

5. Gait Factoid, posture matters
This week you did another post on running faster and about  "lifting the head to engage extensors"……  here was an article in the news on posture
- can you give the listeners a neat neuro tidbit on posture and the brain ?
6. Ivo: What is your take on leaving obvious problems and compensations alone or fixing them ?      
7 . National Shoe Fit Program
8 . Tylenol Boosts Performance in Hot Conditions
 9. from a blog reader:
Hello Gait Guys,
What would you look to do with a 20 year-old competitive 5k runner (me) with chronic posterior tibialis problems?
- a short background: surgery two years ago on left talo-navicular joint osteochondral defect, since then mileage has been extremely limited (now it begins to fatigue painfully on 30 minute runs). 
Both sides affected, or sometimes one or the other. Arch of right foot got so painful last summer I was on crutches and could not walk/stand without supportive shoes. Currently the left side is most troubling and I can see no pattern!
Many thanks for the fantastic blog
Joy
10. Facebook reader:

  • I thought I’d go the experts on this one. I just took a myofacsical release class and the instructor said the most efficient running gait is by using your psoas. So, forward lean until you are about to fall forward and then contract psoas to lift the leg just enough to catch up with the body. He said this is how all the Kenyans run… makes sense kind of.. but???

11. Disclaimer: