Tag Archives: gait

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!

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!

20131015-032001.jpg

beautiful form, beautiful race course!

20131015-032058.jpg

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.

20131015-032306.jpg

flower power

20131015-032327.jpg

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!

20131015-032356.jpg

some folks will be happiest after IM is over!

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. 

photo-13

my copy arrives by none other than the Royal Mail

Total success under the stars: In the Highcountry

Last night, you as a community:

Filled a garbage can full of food (kudos to whoever brought the red beans and rice) for Neighborhood Impact

photo-11

Raised money for Central Oregon Running Klub (CORK) Youth Development: 100% of the ticket sales went straight to a great cause

photo 2-4

Watched the YogaSlackers put on amazing show of athletic skill and balance, and come up out of your seats and joined in the fun (note: the 4 people you see on the ground in this photo are trained skilled professionals, the 4 people laying, hanging, and sitting on the trained professionals’ feet are not, and were pulling off these tricks within 5 min!)

photo 1-4

Watch as Joel Wolpert’s camera depicts the soul of Anton Krupicka trekking, running, and climbing all over our world. If you weren’t able to join us last night, you can check out the In the Highcountry here.

photo 1-5

Lastly – I’d like to thank our gracious sponsors for making this evening possible:  Deschutes Brewery, FootZone, Fleetfeet, and the REP Biomechanics Lab @ Rebound Physical Therapy.

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

The running shoe industry has been taken by storm: TP Striders

Revolution, not evolution.  The latest innovation for your feet is not from the behemoth with swoosh. Its not from the company who brought you “those funny toe shoes.” Instead, this latest venture was announced last night on prime time television.

Its innovative “dual-purpose outsole” has a unique feature to help you out of a certain situation that always seems to come on about 1 mile into your run. Run prepared! If you’d like learn more, check out the video below.