Tag Archives: gait analysis

Does barefoot running really impact injury or performance? Evidence for the peanut gallery

Screen Shot 2014-05-16 at 2.34.30 AMOK…..most of you are going to have a field day with this blog post, so let’s just get it out there. Barefoot running came in a BIG way. And like most BIG things that come quickly, its fading at a rapid rate. A lot of people think barefoot runners are nuts, and begging for injury. And others think that the injury risk is the same as those who wear shoes, but the location of injury in the body will just move from one to another. Well, I’m not really a fan of speculation.

Some years ago, I put out a survey to barefoot runners with some simple questions. How much to you run barefoot? Why did you go down this path? Did barefoot running impact your injury risk or performance? Over 500  runners responded. Thank you interweb.

To be 100% forthcoming, the study is biased towards runners who have actually tried barefoot running (not minimal footwear, but true barefoot). Duh, you had to have experience running barefoot to answer the questions! Barefoot runners are a passionate bunch, but we made the default assumption that people tell the truth. And yes, its just a survey. But it provides an interesting slant. Instead of wondering if barefoot running works, why not just ask people who do it?

This study, “Barefoot Running: Evidence from the Field” was just published in the Journal of Sport and Health Science, and you can get a full download right here. And for those of you who just want the simple version, the abstract is below.

Now I’m not saying that all of you should ditch your shoes for 100% of your mileage. But this idea of barefoot running supports a very critical concept. Feet are capable of some pretty good work. Barefoot running, when done in the right volume and circumstances, can be a great training tool to help you build a better body. And no matter what side of the barefoot debate you stand on, putting better bodies into running is a concept we can all get behind.

Abstract

Background

Running is becoming an increasingly popular activity among Americans with over 50 million participants. Running shoe research and technology has continued to advance with no decrease in overall running injury rates. A growing group of runners are making the choice to try the minimal or barefoot running styles of the pre-modern running shoe era. There is some evidence of decreased forces and torques on the lower extremities with barefoot running, but no clear data regarding how this corresponds with injuries. The purpose of this survey study was to examine factors related to performance and injury in runners who have tried barefoot running.

Methods

The University of Virginia Center for Endurance Sport created a 10-question survey regarding barefoot running that was posted on a variety of running blogs and FaceBook pages. Percentages were calculated for each question across all surveys. Five hundred and nine participants responded with over 93% of them incorporating some type of barefoot running into their weekly mileage.

Results

A majority of the participants (53%) viewed barefoot running as a training tool to improve specific aspects of their running. However, close to half (46%) viewed barefoot training as a viable alternative to shoes for logging their miles. A large portion of runners initially tried barefoot running due to the promise of improved efficiency (60%), an attempt to get past injury (53%) and/or the recent media hype around the practice (52%).

A large majority (68%) of runners participating in the study experienced no new injuries after starting barefoot running. In fact, most respondents (69%) actually had their previous injuries go away after starting barefoot running. Runners responded that their previous knee (46%), foot (19%), ankle (17%), hip (14%), and low back (14%) injuries all proceeded to improve after starting barefoot running.

Conclusion

Prior studies have found that barefoot running often changes biomechanics compared to shod running with a hypothesized relationship of decreased injuries. This paper reports the result of a survey of 509 runners. The results suggest that a large percentage of this sample of runners experienced benefits or no serious harm from transitioning to barefoot or minimal shoe running.

Webinar of the month: Running Footwear

USA Triathlon selected my webinar “Running Footwear:  A critical look at what we know about footwear, and how to select the right shoes for your athlete.” as the February spotlight. This presentation is loaded with objective information and references to understand what shoes do (and don’t do) and help you see past the marketing hype to select the right tool for your runs.

Smarter runners make smarter decisions on footwear!

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Brain Camps and Tri-camp: education for you and yours this new year

Happy NY! and with a new year, hopefully comes new stuff to put in your brain. Some of the knowledge below will help with your patients (talking to you MD’s and PT’s) , some will help your clients (hey coach!), and some is for you the athlete ( yup – come spoil yourself in a complete winter triathlon immersion camp here in Bend, OR). Together, we’ll discuss research and concepts that guide our thought process and training, do hands on assessments, drills, and interventions to help us all do what we do better.

Jan 16-17th
I’m headed back home to New Orleans to teach at the USA Triathlon Certification Course. If you are seeking to get certified as a Level 1 coach, or if you are a current USAT LEvel 1 coach and looking to get your Youth Coaching certification, follow this link for details. As a bonus, I’ll be offering a course on thursday the 16th on “Bike Fit for Performance” – of note, you can register for the Bike Fit talk even if you aren’t planning on going to the full Triathlon certification course. Click here for registration info on both.

Jan 25-26
Calling all Physicians, Therapists, and Athletic Trainers: Join us for the Health Running Course in beautiful and sunny Laguna Niguel, CA. Check out the link for an action packed weekend of peer-reviewed clinical knowledge and hands-on sessions designed to help you help your patients. At the end of the day, run along the cliffs and go for a surf. Not a bad place to be in January!

Jan 31st – Feb 2
Athletes, this one is for you. the REP Lab is hosting its first annual Winter Triathlon Skills Camp. We’ll talk shop, you’ll talk to professional triathletes, you’ll outline off-season conditioning plans and strength routines, do swimming form clinics, performance bike fits, and a 3D instrumented runing gait analysis. That’s right – a complete soup-to-nuts guided plan. Bring your 2014 goals, your gear, and a notepad, because we designed this camp to build a better you and a better season. NOW is the time of the year to make things better  – don’t wait until 2 weeks before your first race! More info in the link.

March 7th -8th
Clinicians, this is not to be missed. Join us at the longest running, running-speciifc CME course out there: UVA Running MedicineThis 11th annual event will be a dual focus on foot and ankle mechanics as well as strength and power development for endurance runners, field athletes, and sprinters. We are very excited to have Dr. Brad DeWeese as our keynote presenter this year. As of today- there are a few spots left for the Saturday hands-on lab, so register soon if you’d like to join us (the lab will sell out). Note: this isn’t a simple link – click here, then click on “live conferences” and then scroll down until you see “UVA Running Medicine” – you can download the brochure and register from there.

A lot of time and energy goes into each of these events to ensure that you have the best experience possible –  Hope to see you soon!

 

Running around from USATF Nationals to USATF Nationals

Last week, I had the privilege of jumping on a plane and traveling to speak at the USA Track and Field National Conference in Indianapolis. It was a great melding of the minds, with the focus on “rebuilding” the athlete pool. I was asked to speak about injury and trying to reduce injury. My talk was titled: “Solving the mystery of running: practices for sustaining an injury free career.” Given that over half of runners get hurt every year, its a pretty important concept to take a step back and try to STOP this madness. In this presentation we talked about how and why mobility, stability, strength, and power are all unique traits that runners must have, and how these attributes directly transfer to gait. And most importantly, how to improve deficits you’ll find in your runners. So after a day of great discussion, meetings, and networking,  I jumped on a plane back home to Bend, OR.

USATF Nationals to NationalsAnd nationals followed me back home!- This weekend is the USATF National Cross Country Club Championships.  About a thousand runners are converging here in Bend to see which XC Club can take the cake. Local stud, Max King, has organized a challenging course for Saturday. On Friday, I’ll be hosting an all-star athlete panel Q&A featuring: Lauren Fleshman, Besty Flood, Mario Mendosa, Stephanie Howe, and Max King. If anyone wants to ask the best what makes them the best, and gain some scientific insight as to why and how these concepts may make sense for you, come on by – we’ll see you at 4 PM PST at the event expo.  And on Saturday (raceday!), we’ll see you starting at 9 AM for the community run. The REP Lab tents  will have fire pits, hot chocolate, a propane heater, and most importantly – we’ll be hosting a holiday cookie swap!  -that’s right – bake some cookies, trade em out, and eat up. And yes, yours truly will be awarding bragging rights for the best cookie at nationals. Sugar cookies are cute, but don’t stand a chance. To all the potential bakers out there, I’ll give you a hint – don’t bother bringing an entry without chocolate if you really do want to win. And while you are munching, you’ll be cheering as MC’s Jesse Thomas and Matt Lieto calling the races from 10 until 2. And rumor has it there are some after-parties happening ’round town……come see us at the tent and we’ll give you the scoop.

And if you can’t make it to Bend this weekend, Make sure to check out the Runner’s World Google Hangout with Oiselle’s Project Little Wing. The REP Lab is proud that these elite women  call our clinic home for their performance and injury prevention needs.

So this weekend: listen to the experts, eat cookies, and run…..that about sums it up!

Why is stability important for long term athletic success?

Success as an athletes depends on an intact joint, strong muscular support, and specific control from our brain to use the right amount of force for the job. But what happens when our joint is chronically damaged? Is your career over? Let’s take a detailed look at how the body adapts, and even improves with stability training.

Warning: I shot this quickly between patients…..there is some fast talking going on at times…….

Treadmill Running: What’s different? What’s the same?

Well, its that time of year again. The sun sinks below the horizon early, and with that my phone rings with reporters wanting to know what tips they should give to their readers about running successfully on a treadmill. Rather than risking this info getting watered down, I figured I’d give you the straight scoop.

  • Fact vs Fiction: A lot of coaches preach the message “you push yourself over the ground outside, and your pull yourself overground on a treadmill”…..this is 100% false. If you look at the fancy stuff we measure called “ground reactions forces” you’ll see very very similar patterns when running on either surface. The overall mechanics are very much the same.
  • Think about it as a different surface, not a different way to run: despite the fact that the treadmill is very similar to running over ground, there are some differences, and some are actually what qualify as “statistically significant.” But if you look at the clinical impact this has, and if you deal with this type of data every day like I do, the differences are really small. There is a difference in body mechanics running on grass, trail, asphalt, and concrete. But again, these differences are small. As long as you slowly adapt your mileage to treadmill, you’ll be OK. No one runs 100% of their miles on trail and then jumps 100% onto the road. This goes for transitioning miles to the treadmill. Allow a few weeks to transition your mileage over, and your body will adapt to these slight changes.
  • Run correctly on your treadmill: Here’s the most important one. Everyone has a friend who ran on their treadmill and then got hurt. Or maybe it was you. They “blame it on the treadmill” – what happened? First, you need time to acclimate (re-read previous paragraph).  But most importantly, its not running on the treadmill that’s typically the issue. More often than not its running differently on the treadmill. Example. If running outside, you are free to make small fluctuations in speed. On the treadmill, the belt speed is held constant. So if you decide to try to slow down 1%, you can’t. As you get tired, your speed changes, but your cadence slows, which forces a longer stride than you are used to. Your body’s soft tissues are in a completely different position (longer) than you’ve trained them in your previous miles. This longer position can create strains on soft tissues and increase the lever arm on your joints and cause pain. But this really isn’t a treadmill issue – its a running form issue.
  • To incline or not to incline? We often hear to increase the incline on the treadmill to 1-2% to make up for the lack of wind resistance. Here’s the deal. Raising the incline slightly increases the physiological stress level compared to flat, and it doesn’t really change the loads much on the body. In fact, running with a slight incline is actually a bit “safer” for the body since it makes it tougher to over-stride. So no harm here.

What’s a safe way to run on the treadmill?

  1. gradually increase the % of miles you are doing on the treadmill
  2. run the same. Be honest with youself. Are you really running 6:45’s on the road? or are you really running 7:15’s? Aim to keep paces realistic. And aim to keep your stride pretty close to what you typically do. An easy way to do this is by counting your cadence (number of foot contacts per minute). Next time you are running 7 min pace, count your strides. If you are consistently hitting 88 per minute (single side), then aim to maintain the same cadence on the treadmill at 7 min pace. This way you avoid overstriding and the stresses it can place on your body.
  3. Novices: don’t go crazy on speed work. Doing intervals makes you tired. Running faster than 800 meter pace on the treadmill can make it much more likely that you’ll run with compensated form.  In general, I recommend tempo intervals on the treadmill, but speedwork is best done outside. If you must do speedwork on the treadmill, make sure your cadence is similar to what you’d maintain outside.

For those of you who like the fine print, feel free to read more below. And of note, all the information in this article pertains to steady state distance running. Sprint training on treadmills is a different concept entirely. My UVA lab group wrote one, and Irene Davis’ team wrote another. No matter on treadmill or outside – enjoy your run!

References:

Riley PO, Dicharry J, Franz J, Della Croce U, Wilder RP, Kerrigan DC. A kinematics and kinetic comparison of overground and treadmill running.Med Sci Sports Exerc. 2008 Jun;40(6):1093-100

Fellin, R.E.,  Manal, K, Davis, I. Comparison of Lower Extremity Kinematic Curves During Overground and Treadmill Running. J Appl Biomech. 2010 November; 26(4): 407–414.

 

Island Power: a case study in athlete development for Ironman World Championships

“Hello- this is Jay can I help you?” After a short sigh, I get a panicked summary of the past several months. A constant battle with shin splints and stress fractures. Not able to run. Rest isn’t helping. Oh and their biggest race of the season – IM Kona- is in 7 weeks. I wasn’t startled. I asked her what her goals were for race day and she said top 10 and a PR in the run. Fast forward through 7 weeks of targeted rehab,strength, and form work. Longest run up to Kona was only 9 miles. Results? She ran a 3:04 and got 10th.

How? It’s actually really simple. For years the triathlete mindset has been that strength and cross training is “something else” to fit in on top of your swim, bike, and run volume. Well, research and successful splits on race day are blowing this myth wide open. The truth? To perform at your limit, its essential to benchmark, and target, your mobility, stability, strength, and power. Instead of just improving your fitness, you can improve you. We didn’t just think outside the box, we threw the box away and re-engineered Linsey’s training in new way to meet her goal. A better you is a faster you.

100% focus during the race, 100% smiles after

100% focus during the race, 100% smiles after

When I saw Linsey 1:40 down with 1.5 miles to go, I knew she could pull through and make a move from 11th to 10th. She had strength and form nailed down solid. Not only did she make the pass, but she made it with over 20 seconds to spare. And I should note that she also maxed out on several of her strength exercises the same week as Ironman. Strong runners = fast (and happy) runners!

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beautiful form, beautiful race course!

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here’s how you start the day in Kona

20131015-032221.jpgMy first, and likely only pic, in Triathlete. Doesn’t this pic look a bit like the “which one of these is not like the other one” song from Sesame Street? Yours truly hasn’t seen 6% body fat in a while…..From left to right: me, Linsey Corbin, Matt Lieto, Chris Lieto, and Elliot Bassett.

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flower power

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Linsey has beer, and it needs transport 1 mile down the road to Bike check on friday…..these are the type of circumstances at which I’m best. Taking resistance training to a whole new level. Ice cold Corbin’s! Get your Ice cold Corbins here!

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some folks will be happiest after IM is over!

Linsey Corbin’s Lucky 13: kudos from the field

I work with many athletes – and to be honest, I get just as much personal satisfaction seeing a person complete their first 10K as I do helping an elite earn a spot on the podium.  I’m always humbled and honored when athletes seek out my help, and even more humbled when they put out some nice footage such like this as a way of saying thanks.  I’m really just trying to do my job!

Well, professional triathlete Linsey Corbin is also trying to do her job with a stellar performance in Kona 2 weeks from today. Check out Day 2 on linseylucky13.com to learn what Linsey and I have been working on together.

The Tipping Point: how does aerodynamics impact cycling?

Cycling is a balance act – you want to produce as much power as possible to make your bike move forward, while maintaining comfort, aerodynamics, handling, and safety. But quite often, we loose sight of the big picture in search of the “fastest looking position.” The most common question I get from time trialists and triathletes is, “Can you make me more aero?” Let’s tackle this issue head on using an example, and some science.

TippingPointPicSeveral years ago, I did a fit on a medical resident; we’ll call him Bill. He was three years into his cycling career and was doing quite well at the district and state level. He came and saw me for a bike fit on his time trial bike. His goals were to podium at state and place top 10 at nationals, and also to eliminate his low back pain on the bike. I’ll spare you the details, but after his fitting, his back pain was 100% gone, he won state, and placed 4th at nationals in the 40K time trial. The next year, he stood on the podium at nationals. Bill was very happy.

Right after nationals, Bill graduated and began making more income and sought out the advice of a wind tunnel to squeak out a performance advantage. The folks in the wind tunnel were able to produce a 28% improvement in his drag coefficiency. This is a very, very large improvement in aerodynamics! Bill left and was excited to see how this new position would play out over the season.

Well, things didn’t play out so well. Bill called after several months of riding in his new position. His back pain returned. He hadn’t made the podium in a single time trial all season. And he wasn’t able to hit the same power output on his new time trial position that he could easily hit on his road bike. Guess what we did? We adjusted his fit exactly back to where it was when we last worked together. Bill made the podium in his next race, and the next, and the next, and won nationals. Bill was happy again.

What happened? Bill hit the tipping point. Sure, he was more aerodynamic, but aerodynamics don’t make you ride fast; producing power does. Let’s back this up with some data:

  • The chief obstacle you have below 11 mph is the rolling resistance of your tires. At slow speeds, nothing matters more than tires and pressure.
  • When your average speed is above 25 mph we should begin to have talks on aerodynamics, and when your average speed is above 27 mph we really need to address aerodynamics. But for most riders, you’ll gain more speed by producing more power over your entire race distance rather than aiming to adopt a sleek, aerodynamic position.
  • Comfort matters. For most competitive cyclists, it’s likely you’re signing up events that 40K or longer. Those of you doing Ironman distance events are spending 5+ hours on the bike. Don’t try to replicate the overly aggressive position of a Tour de France time trailer (whose TT is quite short) just because you think it looks cool. You’ll end up so uncomfortable in your aerobars that you won’t be able to stay in them for long.
  • Power comes from your hips, not your knees. If I told you that you had a muscle in your body that had the best leverage of any other muscle, and was more resistant to fatigue, wouldn’t you want to tap into that muscle? You do have that muscle; it’s called your gluteus maximus. Strong quads are nice, but a proper position on the bike optimizes your glut to drive the pedals.

To get aerodynamic, most riders opt for a low, forward position to get their trunk down and out of the wind. This creates two issues. First, it compromises power by shifting emphasis from muscles in your hips (very fatigue resistant) to your knees (fatigue quicker). Poor compromise. Second, I’ve personally been in the wind tunnel with athletes and it is possible to get excellent drag numbers while maintaining a very powerful pedal stroke. This gets complex and very individualized, but good bike fitters can not only help you look better to the wind, but look better to the clock

 

 

Bike Fit: yes, its worth it. But don’t take my word for it.

Screen Shot 2013-09-10 at 3.28.42 AMBike fit is critical. Why? cycling is a pretty constrained motion, and you go through a LOT of repetitions. Even the forces on the body are much lower than running, the volume on the bike can still add up to a lot of wear and tear.

So can it make you faster? Optimizing the position of your engine (you!) over your machine (your bike) does in fact pay off. The research is pretty much all over the place on bike fit. Doing well controlled studies is pretty hard to do for cycling, because people are just different. But when you really nail down what’s different, and work to not just improve the “Fit” but also improve the rider on the bike, big things start happening.  In light of this, I thought I’d offer some feedback from a few of my clients over the past year.

“after years of low back pain on the bike, nothing hurts! – thanks!”
Chris Eatough – Professional Mountain Biker, Six-time World 24hr Solo Mountain Bike Champion, Five time US 24hr Solo Champion

“wow – this is going to be fast! – thanks!”
Ben King – Professional Road Cyclist, US National Champion

“Thank man! Had a solid ride yesterday with the new position! Best power output so far by a ways”
Jesse Thomas – professional triathlete, multiple-time Wildflower champion

“Basically, I feel like a kid in Maine again: Lower seat, cleats further back, putting down the power, and trying to ruin corners. Its really fun”
Adam Craig – professional mountain biker: US Olympian, US Champion in XC, Super D, and Cyclocross, Single Speed World Champion

“Loving my bike fit – fast and comfy”
Carl Decker – professional mountain biker, multiple time Downieville All-mountain Champion, US Super D champion, US Road Champion, Single Speed World champion

“Loved, loved, LOVED it! Bike felt so good – Thank you!!!”
Serena Bishop Gordon – 2013 NUE Series Champion, 2nd place US Mountain Bike Marathon Nationals

“The juice is back – nothing hurts and feeling strong!”
Matt Lieto – professional triathlete, commentator, author, fastest bike split IM Whistler 

I don’t work magic, but I do my best to help you achieve your goals. Give me a call if I can help you out with yours.