Tag Archives: injury

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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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…….

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.

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.

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

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

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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!)

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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.

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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.

“In the Highcountry” film premier – this Tuesday night @ Rebound!

High-Country-vimeo-Thumb-smPNW premier of “In the Highcountry” is this tuesday night @ Rebound Westside. We’ll be outside under the stars – Show up at 7:30 to hang out with your friends, sip free beer courtesy of Deschutes Brewery, chow popcorn, watch an acrobatics show with the YogaSlackers, and the highlight of the night….the film and a conversation with the film maker  - Joel Wolpert. cost is $5 plus a can of food. All food goes to those locally in need, and ALL PROCEEDS go to CORK youth developmental running probrams here in Bend!

In the High Country is an impressionistic mountain running film: a visual essay about a life in the mountains. It looks at running from a new perspective, both visually and in the style of running. This kind of movement blurs the lines between running and climbing, between human and mountain.

One way to learn our place in the world is through millions of accumulated steps: on gravel roads, glacial creeks, and over high mountain summits. Each stride imprints the terrain more deeply in the mind. The importance of any specific event falls away in the face of an ever-building accumulation of understanding.

In the High Country is the result of a year-long collaboration between filmmaker Joel Wolpert and mountain-runner Anton Krupicka. The film follows Krupicka’s evolution in running from his roots in Niobrara, Nebraska, to the Roost, his pickup truck home, and the miles in between; from itinerant shenanagins to speed soloing on the Flatirons.

special thanks to our local sponsors for making this night possible:
REP Biomechanics Lab – Deschutes Brewery – FootZone – Fleetfeet

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.

Ground-breaking news: runners who are faster than you have longer strides

This year, I got to present along an all-star cast at the USATF SPEED Summit in NJ. Basically, the goal is to breakdown the elements of coaching based on science, and then use this science to bolster what we do on track. Smarter plan = better results. Or maybe I should say smarter people help us develop better plans? This is the conference I was most looking forward to this year, and it did not disappoint.

So let’s get past the sarcasm in the title, and go straight to the big picture: if you run slow, you take short strides and your turn over isn’t that quick. The only way to run faster is to increase your turnover and your stride length. So it shouldn’t be a surprise when you hear that faster runners have a longer stride length than slower runners. But now we get into an interesting question…..is stride length the cause or the effect? Or more specifically, why do some runners appear to bound effortlessly over the ground?

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They are stronger. About 80% of the cost of running comes from holding your body up against gravity. If you have strength reserves, it’s easy to combat gravity and float from step to step.  This extra strength enables more “hang-time” which translates to a longer stride length with less effort. Take home here? Get stronger.

How can you develop running specific strength? You can run. Collegiate and sponsored athletes get two workouts a day, and are racking up big miles. You know what else they do? They lift weights to develop strength reserves. Its highly likely that you don’t have the time and energy to rack up monster miles each week. But take a look at your week. Can you examine your training program and budget 30 min 2x’s a week for some strength work? If the answer is no, take a look back at the Achievement Triangle post…..and ask yourself where you’d like to be.  And if you are over 40, this is not optional. Get strong to get faster.

Want more? Check out this reference: Weyand