learn to run. what we know and what we made up
DESCRIPTION
Learn to run presentation by Max Martin at Filex2013. Evidence behind shoe selection, footstrike patterns and injury.TRANSCRIPT
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!!
?
???
??
?
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
Lieberman et al 2010
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!
Lieberman et al 2010
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
There is more to it than just foot-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
There is more to it than just foot-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
Don’t run to get fit- get fit to run!source unknown
Even GREAT running is inherently damaging- ACCEPT IT!
Management Strategies:Supplementation
ProteinOmega 3sMagnesium
Foam Rolling/StretchingSpecific functional/corrective trainingRest weeks
Physical Capacity
Don’t run to get fit- get fit to run!source unknown
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
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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
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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.
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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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