I became interested in distance running after reading a book that is now all too familiar to nearly everyone who likes running. The book is called “Born to Run” written by Christopher McDougall. It is a tale about the greatest distance runners on earth, their crazy footwear, the journey of one man to understand their methods and the history of running shoes in the modern era. It is a great read and one that will not take you long to complete at all. Personally I found the section on the history of modern running shoes very interesting and how the invention of the modern shoe may have “dumbed” down our running. What I mean is, the modern day running shoe with all it’s cushioning and heels may be responsible for the modern day runner developing so many issues. The theory behind the big heel cushion was to allow a bigger stride length – Phil Knight of Asics introduced us to the Tiger in 1962 and then subsequently departed and joined rival’s Nike and Bill Bowerman to create The Cortez in 1972. The idea was to dampen the force and yet still allow for an increased stride which in theory would allow the user to run further and faster. This was the theory! Back then and even more so now, several biomechanists and leading professors have questioned the rationale and thus have led a barefoot revolution that really began in 2002.
Dr Daniel Lieberman and Dr Irene Davis are two professors leading the way with their thoughts and studies into running patterns or gait re-education. Dr Lieberman is known the “Barefoot Professor“, the website is very interesting and well worth a look if you are interested in understanding the role of gait patterns and the impact it can have on ground reaction force development and knee control. I would highly recommend it and note the difference between a heel strike and a mid foot strike with peak impact loading rates. Watch the force time graph videos to get what I am about to talk about – trust me you do not need to be scientific to get that landing on your heel seriously decreases the time it takes to hit peak force. This is the the time it takes for peak ground reaction force to be reached. What you will see if that the time is greatly reduced with a heel strike compared to mid foot/forefoot striking. This is not a good thing and the reality is your body is taking the full force in a nano-second every time you take a step during running if you are a heel striker.
Try this: A simple test for you is this; pick a stretch of road, say 100-200m long. Run down the bit of road in your trainers landing on your heels as you run. Now walk back and remove your shoes and repeat the exact same running style. It hurts and you will not be able to do it. Perhaps naturally you even began to explore a mid foot or forefoot strike pattern to dampen the force and pain. This is your natural cushion and what nature intended us to do. The experiment is worth doing if you are to start to understand the journey you are about to embark on with altering your running style forever.Altering one’s running gait or style is the single most important factor in reducing the incidence or probability of injury whilst running in my opinion and also several others. Dr Davis explains this in this series of videos and if you have a spare 45 minutes and want to learn some seriously interesting facts about running then watch them (Part 1, Part 2 & Part 3) She has been performing several studies recently and the research is beginning to support this statement. An interesting study was a case study (1) aimed to strengthen female hips and improve single leg squatting in order assess its effect on running mechanics. There was a positive effect on the women’s hips getting stronger and the single leg squat improving but the amount of hip adduction (knee rolling in) during running was not effected. The reason, in my opinion, was that running training was not included in the study. In order to change a parameter, training needs to to be specific to the need and training running is no different. How many people with knee pain have been to physiotherapy and done strengthening exercises but never actually had there running looked at – I hear a lot of people saying “yep”! Did your pain improve or remain the same?
Another study (2) that Dr Davis was involved in did investigate altering women’s gait pattern in running. All the subjects suffered from knee pain due to running. The running coaching aimed at reducing their stride length and step length, increasing their cadence (steps per minute) and improving their heel lift. The result – all the women showed improvements in their symptoms. This was all without laying a single hand on them to change their pain. Whilst it was only a small case study involving 8 subjects it is yet more evidence to support the need for running with an optimal pattern.A lot of us have had tennis coaching to play tennis better, most of us have had swimming lessons so we can swim better but when have we ever had running lessons to ensure we run better. I would dare say – NEVER. Why not you may ask? Because we just do it naturally. Well, we used to do it naturally until we put some huge cushioned heels on our feet and learned to heel strike. If you are a runner and you are new to it or getting injured all the time then I would argue you need some running coaching. So if you are a runner and getting treated for your knee, hip, back or foot pain and your physio is not looking at your running it may well be worth having a word in their ear as this may need correcting too. Do not get me wrong, I believe you need to look at many areas to get success. These include improving hip strength & calf strength, ensuring muscle length symmetry & joint range symmetry and also correcting running gait. Do all this and the odds are stacked in your favor to getting pain free and remaining that way. But hey, that is just my thoughts.
Scott
Scott Tindal MSc (SEM, London) MCSP
Clinical Director
Studies cited:
1. Willy R & Davis IS. The Effect of a Hip-Strengthening Program on Mechanics During Running and During a Single-Leg Squat. J Orthop Sports Phys Ther. 2011 Sept
2. Cheung RT & Davis IS. Landing pattern modification to improve patellofemoral pain in runners: a case series.J Orthop Sports Phys Ther. 2011 Dec;41(12):914-9.