Is the Injury On One Side of the Body or Both?

When you've sustained a running-related injury --not the traumatic event kind (like an ankle sprain), but the kind that just 'appears' for no obvious reason-- is it typically on one side of the body or both sides?

I ask because, if you stop to think about it, probably 9 times out of 10 it's only one side that is injured.

Yet, how do most folks explain their symptoms?

- Bad shoes

- New training variable (hills, speed, distance, terrain...)

- Weakness / not enough strength training

- Tightness / not enough stretching / yoga

- Didn't rest enough / poor recovery

- Forgot to foam roll / meditate / psyche up before running

- Slept weird

- Wore the wrong color socks (might this be it?!)

I'm sure you can think of a few more!

Thing is, we run with both legs. Both feet are wearing the shoes, running the hills, the speed, the distance, yet the injury is only on one side. I think we need another explanation. Do you agree?

In my experience, biomechanics is likely where the answer lies.

Remember, we need access to all joint movements if we wish to enjoy maximally efficient running. If a joint cannot access its normal range of motion, your clever body will still find a way to get you from point A to point B. It will rely more on the joints to which you DO have access.

Could there be a benefit to injury?

As frustrating as injury is, you can thank that annoying injury for alerting you to the fact that there is a problem somewhere. But, don't be fooled into thinking the symptomatic spot is the root problem.

Problems and symptoms are very different. The symptom is where it hurts. You'll have a lot of awareness there, obviously. The 'problem,’ however, is likely to be a movement in which you lack awareness because you are unable to access it. If you've never rotated your pelvis well, how would you know what a 'well rotating pelvis' feels like?

The solution, then, is to first become aware of this inaccessible movement and then to experience it on a regular basis so that it feels natural again. (Hint: I can help you with this!) So, indeed, injury is an invitation to become more aware and improve.

Why would you be missing access to a movement??

We all have unique histories and experiences - some of which have caused us to delete certain movements as safe options.

- Sprains, falls, impacts, surgeries, pregnancy, accidents, broken bones, whiplashes, concussions, (the list is endless) are all "structural" examples of reasons why you may have deleted a movement.

- Powerful emotional experiences and high stress levels can cause us to subconsciously hold tension in our body.

- Learned behaviors like holding a certain posture (much love, all you dance/ballet friends) or following movement rules ("keep your shoulders down and back" or "never allow your knee to push beyond your toes") actually limit our movement potential.

Now that we've ruled out causative factors like what time you went to the bathroom in the middle of the night, forgetting to do your mini-band glute strength routine, and others, I hope this discussion has increased your awareness to the possibilities that exist around one-sided injuries. Each little part of the body must play its role, no more and no less.

In the next post we'll discuss exactly why strength training, which is presented as a common solution to overcome many running injuries, is unlikely to address the *root cause.*

For now, if you're wondering if inefficient biomechanics may be contributing to your current situation, please don't hesitate to contact me!

Footstrike – Should You Worry About It?

Are you a heel striker? Most likely. Perhaps you connect with the ground with the entire foot at once (mid-foot)? Or maybe you're one of the few that land with the ball of the foot first (forefoot)?

Does it even matter?

Yes and no. It depends. Hopefully by now you know there are no absolutes with this stuff. (Run the other way if someone preaches one way for everyone) Here are two things to think about regarding footstrike. As you consider these points, keep in mind that everyone is different and arrives at a running with their own unique set of history, movement patterns, skill, strength, endurance, etc.

Land With Your Foot Beneath The Body

Regardless of exactly which part of your foot hits the ground first, you need to position your leg in such a way that it will absorb impact efficiently AND not slow you down. For teaching purposes I'll typically cue someone to simply put their foot down “earlier”. Sprinters think of stepping “over and down” and I like that for distance runners, too, with less emphasis on “over” and more on “down”.

A quick way to determine if you're overstriding is to have someone take a picture of your stride. Notice the angle of your shin as your foot makes initial contact with the ground. The closer that shin is to vertical, the better the body can tolerate load and dissipate force throughout your body. A locked out knee is not a good shock absorber!

Make Sure Your Foot Is Relaxed Before Impact

Toes pointed, calf tensed, braced for impact. THIS is the most common error I encounter during my comprehensive running assessment when I'm working with someone who's attempted to “change their stride”. Prancing = no bueno.

If your calf is already tensed before it hits the ground, you'll have a few issues.

First, you can't take advantage of the natural stretch reflex of your achilles' tendon. You've got to allow the tendon to relax and lengthen fully so that it can then recoil and provide you with some 'free' power.

Second, since you aren't taking advantage of that stretch reflex, you are relying on the calf muscle to contract incredibly forcefully in order to prevent the heel from hitting the ground. This is very inefficient!

Third, since you've got limited stretch reflex and lots of muscle tension going on, you'll also wonder why your calves are incredible SORE. I'm betting that's starting to make some sense now ;-)

Changing your footstrike is a delicate act.

It's just one aspect of the puzzle and I'd say that there are bigger fish to fry in terms of improving your running form. If you're not doing things correctly you can easily get hurt.

Work on Cadence First

Before worrying about changing your footstrike, try optimizing your cadence. Your footstrike will change subtly but you may not even notice that. You may, however, notice that your knee hip, or back pain does feel better!

Identify your current running cadence (how many strides per minute you take) by counting your steps for 20 seconds and multiplying by 3.

The average person should be in the 170-180 range. If you're lower than that (and you're not 6'6”), try adding 5% to your number and work on making that feel normal. This will take a few weeks and can be best implemented by doing increasingly longer intervals at the faster cadence.

Start with only 100m and add on only if you can maintain your form and match your stride to the beat. You can use a metronome app on your smartphone or check out jog.fm to find music that has the right tempo for you. This song has a beats per minute of 180!

http://www.youtube.com/watch?v=gEmJ-VWPDM4

First, You Need To Move Well - Pt. 1

A new client came in the other day and was interested in running better.  But when we talked it became clear that before we could help him run better, he had to regain “running eligibility”.  He was constantly caught in an injury cycle and was desperate for a solution.  He was frustrated that, just as his fitness was close to an all-time high, knee pain threatened his every stride. Hold on.  Running eligibility?  Huh?

Yup, you gotta earn the right to run.

But we're Born To Run!

Yeah, you WERE.  But you aren't anymore.  Thanks to that desk job.  Thanks to that car.  Thanks to that special occasion meal every couple of days.

The bottom line is that you've likely lost your basic ability to move PROPERLY.  When you try to run, you are equally likely to be running on one compensatory movement after another.  How do you think that's going to play out?

Well, if you run at the typically recommended 180 strides per minute, you're going to accumulate a lot of strides → impact → tissue stress.

In fact, here's a formula that reliably predicts injury risk:

Injury = [Number of Repetitions X Force] / [Range of Motion Amplitude X Relaxation]

Basically, in running, we have a lot of repetitions and a lot of force (2.4-2.6 times bodyweight).  At the same time, we have very little range of motion and, since everyone wants to train for a marathon these days, very little relaxation!

So the formula predicts that we are playing with fire by choosing to run.  Crap.

But wait... “I love to run and I'm not gonna stop!”

So, ok, I finally have some good news.  You don't have to stop running.  You just have to understand one basic fact.

Your ability to move properly makes it possible to train for running.

Remember how the ball coach used to preach fundamentals, fundamentals, fundamentals?  Well, we need to have basic human movement fundamentals down pat before we, uh, train for a marathon!

I educated my new client about movement, took him through the Functional Movement Screen (FMS) process and identified his weakest link.  We were now on the road to recovery.  Turns out he needed help re-learning hip separation.  I gave him drills that improved his hip mobility within a few minutes.

He must practice these simple, proven movement drills in the morning, before running, and at night.  This is what it will take to make lasting improvement in his movement quality.  In fact, one of them is soooo simple: breathing properly.  More on this later...

In the next installment, we'll discuss why focusing on mobility before stability is critical when reprogramming movement habits.