Tag Archives: form

My new book: bedtime story for the new royal baby?

It seems the Brits have been busy. A few weeks ago, a new Royal baby greeted the world, and it seems my collection of bedtime stories to Prince George was released just in time!

photo-14Anatomy for Runners has made quite an impact. Since its release almost one year ago, its been one of the top selling running books, and achieved significant accolades with runners, coaches, clinicians, and the industry. In fact the book has done so well, that it was picked up by a UK-based Lotus Publishing Group. The overseas edition, re-titled “Run Like an Athlete” is available now to anyone on the other side of the pond. I’m quite happy with this title – its actually hat I wanted to call the US book in the first place. It features all the same excellent content, although its been translated from English to well, English……

Yes…..The Queen’s prose is quite different from our countrymen’s linguistics. Going through the editing process with the publisher, I’m shocked at how much it was altered for the european audience: “Soccer mom = football mum” are among thousands of edits.

Note: this version of the book is best utilized with hot tea, crumpets, ascots, and a Hugh Grant movie playing in the background. 

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my copy arrives by none other than the Royal Mail

Do you sprain your ankles? if so read this!

Screen Shot 2013-06-25 at 3.31.53 AMThere’s a good chance that you heard a friend say ” I sprain my ankles all the time”….or maybe you are the one saying this! Why do some people sprain, and then keep spraining their ankles over and over? Well, we recently published a study examining just this. This study was first-authored by one of our former grad students, Lisa Chinn, PhD,  as part of her dissertation at the University of Virginia. While Lisa has moved on to a faculty position @ Kent State,  she spearheaded this project. So, I thought I’d play “7 Questions with Dr. Chinn.

I’ll briefly set the stage here. People with chronic ankle instability sprain, and keep spraining their ankles. There has been lots of attention paid to this area of research lately, because lots of sprains can cause lots of long term problems, and lead to lots of down time in training. Most of the research comparing the folks who keep spraining their ankles is done comparing walking and running barefoot. Yes, I know the barefoot movement is strong, but let’s face it – most people are wearing shoes, and despite what you’d like to think, barefoot gait is quite different than your gait in shoes (and it’s NOT just rearfoot vs forefoot folks….) Given the following, we thought that we’d examine the different ways people walk and run when they have healthy ankles, “single-sprain” ankles, or “chronic ankle instability” ankles.  This got slightly technical at times, but I tried to summarize things towards the end. Since about 30-60% of you will have this issue, let’s ask Dr Chinn some Q’s:

1. What is chronic ankle instability, and how does this differ from people who have only had one sprain?

Chronic ankle instability (CAI), interestingly enough, is a very difficult (sometimes frustrating) syndrome to define. There is an ongoing discussion for a common description of CAI; however as of now, there is not a universally accepted definition. Some researchers rely purely on subjective reporting of symptoms by patients, while others, require some type of mechanical dysfunction to be present at the ankle joint, while still others desire a history of multiple ankle sprains. And of course, there are some who use any combination of the three. The majority of researchers (myself included) will described CAI as the long-term feelings of your ankle giving way or weakness following an initial ankle sprain. This can occur as a result of a single ankle sprain or from an accumulation of multiple sprains. Many subjects/patients claim to “tweak” their ankles all the time. It is estimated that about 30-60% of individuals that sustain an initial lateral ankle sprain will develop CAI.

There is a group of individuals who sprain their ankle once and who do not go on to develop CAI; researchers are currently using the term “coper” to describe these individuals. Research is relatively new on this population. What about them results in a full recovery from their ankle sprain? Was the sprain different or was something regarding their rehabilitation different? Are there other characteristics of these individuals that reduce their feeling of instability? Or, have they changed their lifestyle to not put themselves at risk for “tweaking” their ankle? This is a very exciting area of research because, our goal as a clinician is to prevent CAI from occurring and since we probably won’t ever figure out how to actually prevent ankle sprains from happening; we would like to determine how to get all ankle sprainers to become copers.

2. Why did you choose this topic to research?

I am an Athletic Trainer by profession. While working with various sports, at various levels, and multiple age groups one injury I always encountered were ankle sprains. No matter who you are, there is a risk of suffering an ankle sprain. With my background in athletic training and my exposure to the injury, when I decided to go to the University of Virginia for my doctorate I decided that I wanted to focus my research on ankle sprains and ankle instability. Being at UVA gave me access to prominent ankle researchers and an unbelievable motion analysis laboratory which I took advantage of.

This particular study was developed as a progression from a previous study conducted at the lab. A couple of years prior to my arrival to UVA, Lindsay Drewes (now Lindsay Sauer) and Patrick McKeon, conducted a similar study in CAI subjects, however, their data was collected while subjects were barefoot (Drewes et al., 2009; Drewes, McKeon, Kerrigan, & Hertel, 2009). Their studies reported some interesting findings; however asking individuals to perform barefoot tasks is novel, so I wanted to replicate the study while subjects were shod (shod means in shoes), a more common/comfortable condition.

3. What did you find?

The short answer: we found that while shod, gait kinematics are different between those with and without CAI. (note: kinematics is a fancy word for range of motion)

Interestingly, unlike previous gait research on CAI subjects, we did not find kinematic differences just prior to, at, or immediately following initial contact. I think adding shoes to our methods has revealed altered kinematics that barefoot methods had not previously done. Our kinematic differences occurred towards terminal stance as well as during swing. One thing to note is; no one really understands when ankle sprains occur, it has been hypothesized that they may occur either at initial contact OR terminal stance (Konradsen & Voigt 2002). However the majority of research has only focused on initial contact. Our study actually evaluated the entire gait cycle finding difference at terminal stance is very new and original. Hopefully this will encourage more researchers to evaluate the later stages of gait in the future.

4. Given that the previous research was using people walking/running barefoot, what do you think adding shoes into the equation helps?

Adding shoes to the research has added a piece to the mysterious CAI puzzle. Before I discuss what shoes added, let me explain a little about the shoes we used. We were able to obtain multiple pairs (both men and women sizes) of Brook Defyance shoes. Collaborating closely with Brooks, we were able to remove various aspects of the shoe to enable us to place anatomical markers on a subject’s skin without disrupting the integrity of the shoe. Placing markers on the skin allowed us to better observe joint kinematics. Placing markers on top of shoes (which has been done in the past) only allows researchers to observe what the shoe is doing. Shoes may slip or move differently than the joint. Our goal was to see what each individual’s limb was doing, which with this custom shoe we were able to do.

So, getting back to your question, I believe incorporating shoes, specifically our custom shoes, has significantly contributed the CAI literature. Previous research has shown that there are kinematic differences and muscle activation differences between running barefoot and shod (Kerr et al 2009, De Wit et al 2000, Burkett et al 1985). If anyone has ever tried to go and run barefoot (outside or on a treadmill) without weeks of acclimation, your feet hurt and your gait naturally changes in order to adequately absorb forces. The majority of previous CAI literature asked their subjects to perform this novel task of running barefoot. Knowing that gait changes, we are unsure if their findings are due to the task or due to CAI or both. Allowing our subjects to wear shoes, we were able to capture a more natural gait stride. Secondly, plantar stimulation has been shown to affect CAI subjects differently than healthy controls. Placing shoes on our subjects may have provided some stimulation that barefoot gait does not. Plus, being an athletic trainer, I always want to try to mimic what athletes do and there are not many sports that train or compete barefoot.

5. Can you make any recommendations based on this study?

I think the most important recommendation I have for clinicians and athletes is not to shrug an ankle sprain off as “just” an ankle sprain. This study as well as the majority of CAI literature shows that individuals with CAI have both local and global alterations compared to healthy controls. We also know that CAI has been linked to osteoarthritis. This study specifically shows that gait changes can be observed. After suffering from an ankle sprain and those who have CAI should evaluate their rehabilitation and not hurry back to activity. Therapists can incorporate gait re-training exercises into rehabilitation.

6. What questions remain unanswered about the effects of CAI on athletes?

Oh so many! As any researcher will tell you, as we answer one question it seems like 10 more pop up. I touched upon this previously, but I think the three most important unanswered questions pertaining to CAI are, 1) What causes it? 2) Can we prevent it? and, 3) How do we best treat it? I know these are three very broad questions, but it’s what all CAI researchers are striving to determine.

7. Describe your new career/research interest for us?

Since leaving UVA about a year ago and starting here at Kent State University, my overall research focus has not changed; I still want to better understand CAI and determine how to prevent CAI. However, because I do not have access to a state-of-the-art motion analysis lab my methods are shifting a bit. Neuromuscular control, balance, and proprioception are, in my opinion, the keys to ankle sprain rehabilitation. I am implementing various interventions on individuals with CAI in hopes to determine the most effective way to treat this syndrome.

So…..for those of you wanting a simple summary. Here it is. People who keep spraining their ankles walk and run different from those who don’t sprain frequently. While some of you may say “who cares”  - this is pretty important stuff. You see, all the gait research out there says something pretty simple. Variability is good. Its good to have slightly different ways to move. This way, when you get into “interesting situations” (like when you plant your foot slightly wrong) you have a skill set in place to correct your ankle position and save your body from injury. But this study shows that the pattern of people with CAI is different. And since these people keep spraining, one could say this compensated pattern really isn’t working….and is likely a big contributing factor to their ongoing issues.

From the clinical side, its a good idea to improve the stability of your foot and ankle. Strong muscles inside the feet means less stress to the joint and better proprioception for faster stability, which both reduce injury risk. Want some more? Check out foot some specific foot strengthening exercises in my book, and on this video below (right about 3:22).

Lastly, I’d like to say thanks to Lisa for all her work on this project, and thanks to Brooks for supplying shoes, and helping to ensure that the modifications we made to the study shoes to get 3D markers on the foot did not alter the function of the shoe during walking and running. If you’d like to contact Dr Chinn for additional questions, feel free to contact her below.

Lisa Chinn, PhD, AT. Assistant Professor in Athletic Training, Kent State University, Room 266D MACC Annex,Kent, OH 44242  - lchinn@kent.edu

Triathletes: don’t let your cycling mess with your running!

What can a new research study tell you about running off-the-bike? Sometimes, research just tells us things that are somewhat interesting. And other times, like this one, research provides a very nice take home message of which we should all take note.

A few weeks ago, we published a study called “Sagital Plane Kinematics During the Transition Run in Triathletes.” Don’t let the fancy words throw you off. All you need to know is this: Cycling before your run makes it harder to maintain your posture. 

Now those of you who have seen me for an evaluation, read my Running Times article called “P is for Posture”, or read my book know that this is the un-sung skill that can make or break you as an athlete. Posture is the foundation around which the most powerful muscles in your body attach. If the position of those muscles is optimal, a number of things go really well…..most notably peaked performance, and a better stabilized chassis for a reduced risk of injury. If this optimal position is compromised, then you aren’t operating at your best.

So, if I told you ahead of time that doing “A” before “B” will produce complications that make “B” harder, you’d (hopefully) try to prepare ahead of time to minimize, or eliminate those complications. Right? …. Well, here’s what happens.

We had a group of triatheltes come into our lab and run. We measured a number of factors related to the way they ran to get a baseline. This same group of runners came back a second time, but before they ran, they cycled for 30 min at a just-easier-than-threshold effort. Their post-bike running data showed that they had more arch in the low back, a more anteriorly-tilted pelvis, a more flexed hip, and less hip extension.

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poor position = poor performance

For those of you wondering if this is good or bad, I’ll give you both the simple and more in-depth version. Running off the bike makes you look more like the person on the left than the person on the right.

optimal posture = optimal performance

optimal posture = optimal performance

For those of you who want to know why, and get more in depth –>  read my article in Running Times, and then read Ch 6 and 8 in Anatomy for Runners, especially the “3 non-negotibles” on p.183, and the test on p. 196.

I simply cannot downplay the significance postural alignment. If you screw this up, you’ll screw up your run. And given that 70% of injuries in triathlon occur in the run, this is yet one more contributing factor.

Cycling doesn’t “hurt us”  - then why do we see postural shifts occur in triathlon? You are bent over in a forward position. Some tissues get bound up. Others get lengthened.  And we only did this for a 30 min ride.  What happens if you force this constrianed position for 5 hrs, and then go run? We don’t know for sure (because we didn’t test this) but if I was a betting man, I think we’d see the same patterns, but somewhat worse.  To be fair, we only looked at their running data for the first 14 min of the run. Maybe posture improves after this 14 min. Maybe it stays the same. Maybe it gets worse. We didn’t test it. But no one wants two slow or injury-prone miles out of T2. And due to the fact that central fatigue typically makes our posture worse, I’d think this is something we should all pay attention to.

So here’s your chance to beat the odds, and be “smarter” than the average. Here’s your mission for today:

  1. Find correct posture standing right now (see above references)
  2. Hold correct posture walking around your office or house.
  3. Go for a run, maintain correct posture (and if you fall into the “back seat” stop and fix it!)
  4. Go for a brick workout, and pay special attention to your postural alignment off the bike. If you focus on this in training, it will be easy to correct on race day. You should be able to run any pace – from an easy run to 400′s on the track – without compromising your posture alignment. 

I’d like to thank our former grad student and first author, Nicole Rendos, for taking the lead on this study. And if you are looking for more ways to tune-up your triathlon training, come see us this August for our REP Triathlon Camp!

TONIGHT: Beyond Pink: Strong Women, Strong Athlete

There's no "one look" for every woman, and no "one body" for every athlete

There’s no “one look” for every woman, and no “one body” for every athlete

Ladies – tonight its all about you!

Sports Illustrated ran a photo series years ago that is one of the most powerful collection athleticism.  Athletes come in all shapes and sizes, and one of them is YOUR size. And that’s the point of tonight’s talk. As the kick off to the REP Lecture series tonight in Bend, we are going to discuss “the unique needs of a woman.”

We’ll take a look beyond the marketing drivel and discuss what really is unique about your needs in pursuit of your goals. Come grab a seat and a beer, and find some tips that take you to the next level.  Hope to see you 7:00 tonight at Rebound Westside!

The Bat-signal has been lit: time for a PARTY!

 

Want to see what we are up to @ Rebound? Come grab a beer, some eats, and join us for our open house this Thursday! (superhero dress optional)

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“black box” training = grey answers

The black box training model that most of us follow is pretty much like a blender.

Its time for breakfast, and you want a smoothie. You scrummage through the kitchen and try to find anything resembling fresh or frozen fruit. The blender is loaded up, and spinning loudly as the morning sun crests through the window. You take a sip……its good. But why isn’t as good as the smoothie you made a few days prior. What specific things made the other smoothie better?

Most of us put as much forward thinking into smoothies as we put into our training plan. We throw a bunch of training hours in, and based on our success, we arrive at conclusions. Well, what really happened? Some of you may have gotten faster. But could you have gone faster yet? Some of you may have plateaued…..why? And a few of you may have even gotten slower…..a lot of people really want to know the answer to this!

Wouldn’t it be nice to know more than just “effort in = race performance out?” What if you could actually see inside the black box?

Screen Shot 2013-02-12 at 1.13.38 AMWhen athletes come to me for an analysis, my goal is to find their limiters. Everyone has them, but not everyone knows how to find them. Over the past decade, I’ve blurred the lines between sports medicine, lab analysis, and performance training. And I’ve done it by being specific. I take a hard look at the state of your body, and a hard look at your sport performance. My lab has fancy tools like force platforms and instrumented treadmills, and a real knack for understanding how these values actually impact your sport’s performance. I can see into your body in ways that no “trained eye” could ever hope to capture.  Specific measures = specific answers. I call it “opening the box.” It works. 

Over the next few posts, we are going to go through some examples on how this approach has helped others in the past. But if you want to know how it helps you, and want to look inside your own box, give me a call!

Think backwards to go forwards

So its the second week of the new year. Did your 19 New Year’s resolutions you had planned make it through week #1? This time of year, we all get caught in a trap: “Im going to do more base training, more speed work, more intervals, more weights, sleep more, eat healthier….the list goes on and on. While it would be great to have the luxury of time to make us all into training animals, we have this thing called life that gets in the way sometimes. And then a lot of us become discouraged when things don’t work out the way we planned, and we don’t achieve “more” of everything we set out to. Instead of doing “more” in 2013, let’s ask a simple question to help you do “better” in 2013.

Hard questions = best answers

When I work with a patient or athlete, I always discuss THEIR goals for the upcoming season. There really isn’t any right answer here – it may be to make the Olympic Trials, simply to PR at your half marathon, or just be able to get to the point where you can train consistently – your goals are your goals. My job is just to help you achieve them. After you tell me your goals, I ask one simple, but humbling question:  “what’s the biggest thing that stood in the way of your goals the past season?”

Ouch. This is typically the point where eyes roll back in your head. Every day you hit snooze and didn’t get up to train is flashing before your eyes. Why you didn’t dig deep for a finishing kick in your last race becomes more painful now than it did when you got passed with 50 feet to go. However, this question is not meant to punish you, its to get the the root of the problem. You don’t drive to grandma’s house aimlessly, you have directions and a plan to get to your destination. Training is the same thing.

Think backwards form your previous season. What went well? What were the defining workouts for you? Were you rested properly going into big races? How was your pacing? Did you do a good job of timing your weight sessions in relation to the rest of your workweek? Was your total volume of training time realistic with everything else you have going on in life? Did you pick the right races? Did you start oyur intinse training at the right time of the season? Wish you would have done more basework in the off season? Wish you would have taken more time off in the off-season to avoid burnout? What things stand out that didn’t go well? Were your goals too ambitious given your current life situation? If so, can other things be altered to allow you to train appropriately? Did you have fun?

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Note: this image is for figurative purposes only. If you see a lion in the mirror, you should probably run away.

This simple question can help you identify important things that often get lost in the shuffle. If you want to improve as an athlete, you need to train. Period. But your training should be focused for you, and “more” training is rarely the answer. Everyone wants to have some voice come along and say “just do this and you’ll achieve what you desire” Well, if you are honest with yourself, you’ll find that voice is you. With your limiters in front of you, you can now focus on specific ways to attack it. Looking backwards helps define where we need to move forward in 2013.

Christmas gifts for the athlete you love (or yourself!)

So we are officially past one of the coolest days ever (12-12-12) and now 11 days away from when the man in the red suit flops down your chimney to bring joy to all the good little boys and girls. Those of you much better than I are likely done your Christmas shopping. But if you are like me, and still haven’t picked out any presents for your wife (or other person you care about), I’d like to offer a few suggestions. If someone you love is looking for an edge, wants to improve their skills, and is looking to blow their inner athlete wide open – then look no further……

#1 – Rocker Board.
20121214-101308.jpgYou’ll notice a common theme here. All of the tools (toys) listed here are designed to help you improve balance and proprioception. These skills carry over in spades to all your athletic persuits: running, cycling, skiing, surfing, climbing, kiteboarding, football, basketball, tennis,  and possibly even bowling. Rocker boards are a great tool to teach you how to stabilize your foot and ankle. Hard unstable surfaces provide an optimal training environment to improve you. You should look for a board that only rocks in one direction (thus the name rocker board). Many folks also make boards that wobble and spin in all directions (called wobble boards). Both have their place, but when it comes to training the foot and lower leg, I’m a big fan of the former. These are sold in many places. If you are looking for suggestions, I typically direct people over to sportssmith.net because they have the cheapest one I’ve found: $29.99.

#2: Surfing in your living room – meet the Si-Board.

20121214-101324.jpgSo you’ve mastered basic balance skills, and are looking to quite possibly have as much fun as possible while under your roof? Look no further than the Si-Board. Sure the Indo Board is cool, but this thing is in a class by itself. I have one and absolutely love it. Its so much fun! Its not one of those things you’ll say “oh I have to make time to work on my balance……” Its so engaging that you may find yourself taking time away from other things! Your feet and hip stabilizers will get a workout like nothing else. They are pretty $$$$. I bought the DIY creator kit for cheap, and in 45 min was “surfing” in my living room.  In my mind, if you are an athlete, you should have one of these. Period.

#3: Surfing down the pavement –> Longboard.

20121214-101339.jpgPresents are all about fun right? Buying a long board was one of the best decisions I made. Its not like hucking off the loading docks like we all did when we were 12. This is all about the flow. It’s great to carve slalom turns down the hill – almost as much fun as skiing or snowboarding. And once you learn to “pump it” you can fly. I can roll miles down the road without pushing at all. I guess some people might say its a great workout, but its so much fun I’d do it even if balance skills didn’t translate into other sports. What board to get? wow – there are hundreds of options out there. Personally, I’ve got a Original Pintail 40. I bought it because it has springs instead of bushings. This makes it easy to rail turns at low speed and a bit tougher to control at high speeds, but lets’ face it: Most of us aren’t looking to hit 50 mph down a mountain while slamming a RedBull.  Only warning I’d offer is this: you may find yourself longboarding more and doing your typical sport a bit less!

#4: a book? Maybe a book called Anatomy for Runners! Its by far the cheapest thing on this list, and quite possibly the most valuable. I’ve spent many years of my life teaching. I’ve taught at UVA and continue to teach around the US. You’ll be surprised what people are capable of when you give them the knowledge to succeed. That was the goal behind my book. Its a way to give you information to help you hit your goals this season and beyond. Sure its slanted towards runners, but about 80% of the information in there applies to other endurance and strength and power sports as well.

If you are looking at the equipment above and thinking “that’s a bit high level for me-  no way”……let’s put something out there. Blowing past your comfort zone is the only way you’ll ever make jumps to the next level in your performance. And yes, I’ve put “old folks” on these with tons of success. Sure you should be careful when you are learning, but I will caution you that liberal use of #2 and 3 above just might result in fun!

Disclaimer for the people who think I’m funding my retirement with these recommendations. I personally bought the Si-board starter kit and my Original Longboard (in fact I bought a second one too!), and my clinic purchased the rocker board form Sports Smith. These folks have no idea that I am writing this, and I’m getting absolutely nothing in return.

Well, with the legal mumbo jumbo out of the way, Happy Shopping, and Happy Holidaze!!!

And if you’d like to re-live a little Christmas story from last year, check out how Climate change is impacting reindeer training. 

How should your foot land when you run?

Foot strike: your cross country coach from 1972 told you to always roll through from heel to toe. the barefoot zealots tell us we should always land on the forefoot. And several other schools of though tell us something else: to land on our midfoot.

Measuring all this stuff in the biomechanics lab has taught me a lot. Foot strike is but one of many variables that are worth looking at, but not the only one worth looking at. Additionally, people often strike different than they think they do. Lastly, Pete Larson found that there isn’t much of a difference in foot strike patterns and running times.

Foot strike is more of an effect of many things related to your form, rather than the overiding factor that governs your form. And if you’d like to see more, check out what Pete Larson and I said to Competitor Magazine.