Tag Archives: Running injury barefoot minimalist

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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Anatomy for Runners: Top 9 Thought Provoking Books of 2013

Its always nice to get a shout out. Steve Magness is one of the “better thinkers” in the world of running, coaching, and athlete performance, and I respect his opinion highly. Apparently, Steve is nice enough to respect mine as well, and named Anatomy for Runners as one if his “Top 9 Though Provoking Books of 2013″ – thanks Steve. If you live under a rock, and haven’t come across his amazing blog, I highly recommend checking it out: the Science of Running.

And while I’m at it, I’d like to say thanks to all of you who have purchased the book. I teach all over the country, and the number of clinicians and coaches who already have the book, and actually USE it daily on their teams and patients is, well, quite humbling. I know the little niche I operate in will never reach the status of the Harry Potter, but there are over 11,000 of you around the world reading this book over the past year. I hope its making you rethink the way you approach your training, and your patients, your teams, and ultimately producing better results. If you’d like to pick up a copy, click on the link on the right side of the page!

The work of a decade of my career, bound into the "take home version" for you.

The work of a decade of my career, bound into the “take home version” for you.

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.

 

Road vs. Cyclocross Bike Fit: what’s the difference?

A lot of hype concerning the difference between fitting a road bike and a cyclocross bike could be cleared up if we all agree on two simple things: put the engine in the right place, and then adjust for handling and comfort. Let’s break this down.

Saddle position

Your pedals are driven by large muscles surrounding the trunk, hips and knees. In fact, about 98.8% of the force you deliver to the pedals comes from your hips and knees. That’s right, the ankle only produces a very small percentage of your total power. So it makes sense to have the saddle height and setback (also called for-aft position) the same between your road and cross bikes to maximize power production. Why would you select a saddle position that compromises power output? Keep it simple. If you like your current saddle placement on your road bike, there is zero reason to change it on your ‘cross bike.

Handling and comfort

Good bar position allows you to move around while properly weighting the front end for corners and technical terrain | Photo © Jill Rosell Photography

Good bar position allows you to move around while properly weighting the front end for corners and technical terrain | Photo © Jill Rosell Photography

Okay, now here’s where things are a bit different. Instead of rolling your slick tire down fresh asphalt, you’ve got to contend with dusty pumice, wet grass, rocks, roots, and the nutrient ‘crossers crave: mud! In short, it’s critical to have a good handling front end. This means that you want to have a little less weight on the front so that you can lift your front end over obstacles easier. Careful though, too little weight on the front end will bring your torso too upright make it hard for your front tire to bite and send you skittering wide towards the outside of the turn. Let’s see how this all plays out in fit.

  • ‘Cross bikes typically have a higher bottom bracket. If you were smart, you’d kept your saddle in the same place as your (properly fitted) road bike.  This means that your saddle is higher in the air than your road bike. Since your saddle is higher, your handlebars also need to be higher.
  • Hand-grip placement for optimal handling: A lot of people rarely use their drops on their road bike. Then when on the ‘cross course, they find that they are forced into the drops on steep downhills to brake and get a better grip on the front end. Most riders find the bike is much more stable when conditions get squirrely if they use the drops. So if you are going to be in the drops, make sure you are comfortable.

So what’s the secret recipe to make sense of it all?

It’s simple really; the goal is to get the bars a bit “closer” to you. And you can do this in three different ways. You can run a shorter stem to move the bars closer, you can run your bars higher (by putting a few spacers under the stem or by using a stem with more rise), or a combination of both. I typically recommend that riders start by raising their bars first (because this usually only means moving spacers or flipping a stem). Setting up the bars with some combination of “up and back” will allow you comfortable access to the drops for good grip and handling, and while still allowing you to have optimal engine placement so you don’t lose any precious watts.

Powerful, sketchy, and somewhat comfortable. Yeap; sounds just like ‘cross racing!

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.

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

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

Brain Power: Athletes, Coaches, and Clinicians – Join us for a great event in Bend, or beyond

Today, we’ve got a smattering of amazing educational opportunities to announce:

This Thursday in Bend, OR @ 7:30 at the Westside Clinic: Athletes – Please join Jay Dicharry PT (REP Biomechanics Lab Director) Matt Lieto (Pro Triathlete) and Keats McDougal (Ironman Canada & Tahoe Director) for a night of Mobility and Multi-sport discussion. Jay will provide the latest research on mobility and best practices for multisport athletes. We’ll answer the most common questions: What does stretching do for the body? When should you stretch? How long? What’s the difference between dynamic warm-up and stretching? And how does soft tissue work play into this whole discussion? Next,  Matt will discuss his training plans and and upcoming race prep considerations. Matt will show you how the lessons he’s learned along the way can help you prepare better for your next event. Finally, Matt will lead a Q and A with Keats. They’ll provide an overview and considerations of these two challenging courses. It will help you prep for this year’s race, or feed your stoke for next year!  Stick around after for a question and answer session with our panel. And yes, we’ll have beer. Cost: free. No brainer!

This weekend in Boulder Colorado (7/13-7/14): Calling all healthcare professionals – are you tired of getting your information on running mechanics from the mainstream media? Would you be interested in a immersive weekend of education that is based around hundreds of peer-reviewed articles, hands on clinical assessment, and gait cues? We’ll construct a framework of what we know about running mechanics and their effect on performance and economy. And more importantly, we’ll show you how this information applies not just to the masses, but to your individual patients. In short, this is all the stuff you wish they had told you in Med school, PT program, or ATC curriculum. There are still a few spots left. See here for details.

August 23-24th in San Jose: Tri-athletes and would-be coaches- are you looking to get your Level 1 certification? Then join us for the USA Triathlon coaching clinic. Two days packed full of essential knowledge to help you and your athletes succeed.

Sept 21st and 22nd in Bay Area: Running Coaches – this one is all for you. We are going to delve into the truth behind running mechanics, screening strategies for your team, the impact of strength training to improve performance,  discuss the role of footwear, and more. Andrew Allden chairs this event – he’s brought in a knock out panel each and every time –  Learn to think outside the box to take your team to the next level @ this USATF Level 3 Coaching Seminar. More info here

Yea, I know – blogging and tweeting is supposed to make us all smarter. But you know what really makes us smarter? talking face to face. See you soon!

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