Tag Archives: barefoot running

Running Injury Management on Therapedia

Fresh off teaching this past weekend at University of Michigan – a great group of folks joind together for a course called “Putting the Athlete Back in Triathlete: a clinician’s role in care of the endurance athlete.” …….and more content to come.

I’ve been invited to be a part of Therapedia’s webcast series, and its airing Thursday this week. And yes, it will be available to view after the course as well. Check out this link for what looks to be an interesting discussion!


Coffee Talk: TrailRunner Nation Podcast

The guys at Trail Runner Nation podcast gave me a call, and asked a few questions. If you’d like to hear some inside scoop on what you can do to keep healthy and happy on the way to your next PR, grab some of your favorite brew, and tune in here.

We’ll debunk some myths, babble about footwear, talk about why we don’t treat injuries by treating symptoms, and discuss some cutting-edge approaches on strength training for endurance athletes. Its a long hour of conversation, but all this talk is aimed at ways to help make running fun. Because that why we do this stuff. And more fun is, well,  just more fun.

Do you treat triathletes? Join me @ U of Michigan

Multisport athletes have a lot of challenges in their training,  but the training demands of 3 sports seem to creep up on all of us. Athletes spend so much time trying to fit in their volume that the body often gets ignored.

Well, this all ends now. Join me at the University of Michigan April 20-21st where we discuss “Putting the Athlete in Triathlete: a clinician’s role in endurance sports.” During this 13 hrs course, we’ll lay the ground work and discuss how endurance training impacts the tissues of the body, and then move on to detailed descriptions of the mechanics of each sport. You’ll learn how to correlate your musculoskeletal evaluation of the body with a runner’s swim, bike, and running performance. We’ll discuss why swimmers aren’t your typical overhead athletes, you’ll learn how to do bike fits (how to fit the bike to the rider, and more importantly how to fit the rider to the bike) with hands on practice, learn how to identify common gait patterns and cue them out of problems that overload the body, and understand the role of complimentary training and strengthening. At the end of the weekend, you’ll understand how to help your athletes make training easier on their body, and improve their efficiency.

for registration information, click here, and for a hourly breakdown of the course, click here. See you there!

Why does your achilles hurt, and how to fix it

I was contacted by Jason Fitzgerald at StrengthRunning.com to help clear up a lot of the mystery behind achilles issues. Even though this injury can be a major complicator for your training, the mechanics of it are actually quite simple.  If you’d like to check it out, check out this link.

UVA Running Medicine 2013: a recap

What happens when you get 220+ clinicians in the room and talk about running? It was a beautiful day. About 55 degrees and sunny. The remnants of the 10+ in snowstorm on the ground helped dampen the air and made the sun feel even stronger. It’s a beautiful day for a run….but instead,about 220 clinicians sat inside, on their glutes, so they can learn to help you use your glutes better.

The 10th anniversary of the longest running, running specific medical conference produced a host of content to help “us” help “you.” Do you ever wonder why running is as challenging as it is? How your running would change if you had no gravity to fight, arms to swing, or perhaps even legs to stand on? Dr Rodger Kram led us in 2 enlightening presentations on the energetics of gait. Talks like this completely shift how you think about running.

Dr. Eric Carson reviewed the current and future trends on cartilage repair. Take home: right now, cutting edge surgeons are able to offer some pretty incredible proceedures, and they’ll be even more magic to come in the future.

Brian Hoke, PT helped us think critically through our video gait analysis. Anyone can watch a video in slow motion, but learning what to look for is critical.

Your’s truly helped clinicians through their musculoskeletal exams as they relate to a runner’s needs. No one can tlak about “correct running form” unless you understand that each runner is an individual with unique needs and attributes. If you understand how a person’s body wants to work, you can understand how to help that person run. For those of you who read the screen’s in Anatomy for Runners, that 8-point exam just got a whole lot more thorough: 32-points to be exact.

Dr Sibohn Stattua reviewed the literature on the female athlete triad. Turns out that there is more to it than just low energy intake, menstrual irregularity, and poor bone remodeling…..the triad is turning into a square? That’s right, there is a 4th “leg” to the triad, and this one might be even more severe of a long term complication from this complex disorder.

Eric Magrum, PT discussed the current research on the #1 injury affecting runners: anterior knee pain. He told us why runners with chronic pain in the knee try to avoid their pain. The problem is that the compensations we adopt to avoid pain in the knee are just as much of a problem as the original cause itself.

Kyle Kiesel, PhD, PT helped us through an eval process to identify core imbalances that affect far more than just the core.

And finally, Dr Bob Wilder guided us through the process of guiding you back to your running in explaining the best return to run programs after an injury.

Clinicans getting to know their feet: a scene from our lab session

Clinicans getting to know their feet: a scene from our lab session

And that doesn’t even mention the incredible lab session on Saturday by Brian Hoke, Kyle Kiesel, Dr Mark Cuccuzzella, myself, and the amazing cookies that I ate at the afternoon break. Egos were dropped at the door, and we all got down to the same level to help runners do what they love: run.

As always, the conference returns next year……

How should your foot land when you run?

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

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

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

20121001-155217.jpgOK – you go to your doc or therapist. He/she gets a funny orange triangle thing (reflex hammer) and gently taps just below your knee. Instantly, you kick out your leg. You get a look of approval, and your doc moves onto to the next thing….. what just happened here? And what does this have to do with running surfaces I spoke of during my UROC video last week?

Your doc is testing your reflexes: an involuntary and nearly instantaneous movement in response to a stimulus. By nature, a reflex is not something you need to “think about” – it doesn’t require any processing in your brain. Basically, your body gets a signal (input), and it produces some type of response (output). So this very simple action of a tiny tap below your knee cap produces a contraction in your quad without your brain telling your quad to contract. Pretty useless right? Wrong.

Reflexes allow us to look at your neuromuscular system. The term “Neuromuscular system” is basically a fancy word to explain something very simple: muscles can’t do anything unless your nerves tell them to. Testing your reflexes let us see if the nerves are transmitting the right signals throughout your body. We know the INPUT is good because we both saw someone whack your knee. What we hope to see is the “right” amount of muscle contraction or OUTPUT. Poor output, such as too little contraction (called “low tone” or hypotonic) or too much contraction (hypertonic) is a sign that the neuromuscular system has a glitch. Little glitches means the system is unstable and produces less than optimal muscle contraction. The reasons for these glitches are a bit outside this blog post! Fortunately, most people will fall into the “normal range.” Performance in this “normal range” is a sign that the nerves do a good job of relaying information throughout your body, and that your muscles produce the “right” amount of contraction. These “smooth” reflexes mean your body has developed a very refined or organized way of moving when its given an input. OK – why are we wasting your time with this little lesson? Gait is pretty much a reflex.

Sure, you can make a conscious decision to walk or run backwards, or skip every third step if you want to. But for the most part, you don’t THINK about taking each and every step when walking and running. It happens sub-consciously at a fancy place in your nervous system called a “central pattern generator.” Over time you’ve learned to fine tune and coordinate this reflex. And spending time concentrating on your running form helps fine-tune this reflex pattern. Ever heard the term perfect practice makes perfect?

Interestingly, when we sprain ligaments, we tear nerves. I explain all this much more in my book, but the key aspect is: torn nerves = less input. Less INPUT = poor muscle control or OUTPUT. What do we do? In therapy we work to improve the INPUT to our body by doing lots of proprioception and balance training so we can get a better OUTPUT. You learn to refine your control, and develop alternate strategies to control your body. Do these gains translate over to running? Yes they do. You can improve your stability after an injury. But you know translates really well to running? Running….on different surfaces!

If you always give the exact same input, you’ll always get the exact same output. If you always run on a treadmill, at the exact same speed, and you never get tired, this strategy works pretty well. Except that isn’t the real world. Your body needs to know HOW to respond when you get a different INPUT. You run up hill, down hill, get tired, change your body weight from day to day, and encounter different surfaces. All these slight differences require slight changes in your technique.

Research shows similar trends for both walking and running gait. When things are always the same, you are more likely to get an injury. When things are out of control you are also more likely to get an injury. But people who have a range of comfortable walking and running patterns have multiple strategies to tap into.

So what’s the take home message here? If you give your body the same INPUT every time, you’ll always get the same response. If you expose your body to different surfaces, you learn to refine your reflexes to produce good quality muscle control on multiple surfaces, and improve control on your typical surface. The trail runners reading this already know, and can FEEL, these differences. However those of you who are stuck on the ribbon of asphault, its time to mix it up. Train on concrete. Train on asphault. And grass. And trail. And uphill. And if it feels weird, its sign that you need to do a bit more of it. Not all at once, maybe just a little bit in small doses. If you can’t take a 4 mile trail home, then maybe run the gravel alley. Jump onto the median and run in the grass for a bit. Exposure to varied surfaces can help you develop as a better runner.

Different input = smoother reflexes

Smoother reflexes = better muscle control

Better muscles control = better runners.



Baby needs a new pair of shoes

It’s pretty tough for a lot of runners to make sense of all the changes in footwear these days. One key message is that shoes don’t run on their own. You are profoundly more important than the shoes on your feet. This being said, footwear construction can and does make a difference. And when we talk about kids shoes, it affects not only how they walk and run, but more importantly, how they develop.
Want to learn a bit more? Check out the “Shoes for Small Fry” article I wrote for Running Times. As a parent, we all try to give our kids an advantage. I’m well aware that there are a lot of things coming up in my kids life that I can’t control. But giving my kids the gift of strong feet is one I can control. Those little feet just might be passing you up on the race course sooner than you think!


My 4yr old’s feet: excellent alignment and strong for her scooter, soccer, and the playground. The right footwear will ensure they look this way as she ages through the big game of life.

any pearls for the aging runner?


Runner’s World asked for some key points to think about as we edge-up in years. It happens to all of us at some point right?

Check it out here

Disclaimer: the advice mentioned in this article is not meant to replace Botox

Do runners with a ball “get it” more than runners?

The media at large has done a dis-service to you, the consumer. They love polarizing images. They love the battle between overly built-up clodd-hopper motion control shoes vs. naked feet. They try to instantly declare one “better” than the other. The reality is that the barefooot buzz has been incredible for ALL athletes. No matter which side of this polarizing topic you stand on, it has directed attention on form. And that’s one of the main things really.

Let’s clear out the sewer lines folks. Barefoot is very DIFFERENT from running in shoes. Sure a good number of folks switch their contact style from rearfoot to forefoot when going barefoot, but a lot DON’T. And while the media loves to harp on this one single factor, its like saying only one tree in the entire forrest is important. And that’s just not true.

Its not so much forefooot vs rearfoot here, its more about where the foot is in relation to the body that counts. Striding too far in front of the body results in bad things. Your feet were meant to be beneath you – not flying out in front. Imagine running over ice. Anyone feel safe over-striding on ice? Didn’t think so……But its not just “runners” who are beginning to take notice. Other “running athletes” are asking question too.

Recently, I had a conversation with basketball journalist Steve McPherson. He was asking me about the apparent rise of injuries in basketball, and wanted to know if anything from all this barefoot hoopla translates over to the hoop. Steve did an excellent job with this piece, “What can the NBA learn from barefoot running?” I recommend you take a look, whether you run with barefeet, wrapped feet, or a ball.