Rob Maschi PT, DPT, OCS, CSCS
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1 Running Lecture Series Drexel University Physical Therapy & Rehabilitation Sciences Run with the Dragon. Rob Maschi PT, DPT, OCS, CSCS
2 Topics Running biomechanics and role in injury Over striding (cadence) limb stability Strength training: Plyometrics Core strength training to prevent or recover from injury Improve run performance Running gait analysis Motion analysis laboratory Clinical gait analysis
3 High injury rate in runners Why do runners get injured? Overuse is the common mechanism
4 Cause of Overuse Injury is Multifactorial Training Mileage, Intensity Injury Threshold Dosage Anatomy Strength Flexibility & ROM Neuromuscular control Running Technique Structure Mechanics
5 Cause of Overuse Injury is Multifactorial Training Mileage, Intensity Injury Threshold Dosage Anatomy Strength Flexibility & ROM Neuromuscular control Running Technique Structure Mechanics
6 Cause of Overuse Injury is Multifactorial Training Mileage, Intensity Anatomy Injury Threshold Dosage Structure Strength Flexibility & ROM Neuromuscular control Running Technique Mechanics
7 Running Mechanics Is there a correct way to run? Incorrect ways to run Movement patterns that: increase biomechanical stress to bone and soft tissue Inefficient Thanks Brian Hoke
8 Biomechanical Errors Over striding Technique issue Limb stability Neuromuscular control issue Control in 3 planes of motion Account for most injuries Preventable or fixable
9 Over striding Foot contacts ground too far in front of your body
10 Over striding- why is it bad? Larger vertical displacement of COM Larger vertical velocity of impact Greater impact loads (Magnitude and rate of loading) Putting on the brakes Inefficient
11 How do you reduce over striding? Running velocity = step length x step frequency (steps/min) Variation among runners Elite: 180 steps/min Recreational: steps/min
12 Decrease joint loads Small changes in step length equate to large changes in loads across the knee joint Willson, Lenhart 5% increase in step rate = substantial decrease in energy absorbed at knee Heiderscheit
13 Increase step rate Miller A, Willy RW. Retraining fixes faulty gait in injured runners. LER (6):
14 Science behind the fad Barefoot running Minimalist shoe Pose running Common denominator= increased step frequency Position of foot at initial contact closer to COM
15 Barefoot running Change foot strike pattern?
16 Strike pattern, load and injury RFS Foot and Ankle: lower demand / load Knee: higher demand / load FFS knee and hip: lower demand / load Foot and Ankle: higher demand / load Daoud 2012
17 Injuries in barefoot and minimalist runners Plantar fascia, Achilles tendon, calcaneus, metatarsal stress fractures Transition? Barefoot heel strikers significant increase in impact loads
18 Learning a new strike pattern Old dog, new trick inconsistent strike patterns during transition mixed landing pattern increased tibial shock May increase injury risk Cheung 2014, Olin 2013 What is injury rate in properly transitioned barefoot runners vs traditional (shod) runners?
19 Vibram class action law suit Settlement: 1. $3.75 million to provide partial refund 2. Vibram has agreed to discontinue to make any claims that Five Fingers footwear is effective in strengthening muscles or reducing injury in its marketing and advertising campaigns, unless the company discovers new scientific evidence that proves it.
20 Is it necessary to go barefoot (or minimalist)? Leave your shoes on and change stride length?
21 How to fix it: Count cadence Over striding Count foot strikes per minute Work towards 90 each side Shorter, quicker strides Drills Arm swing/quick feet Increase leg turnover Run barefoot? Hills Use as a cue to shorter stride, midfoot / forefoot strike Running up hill shortens stride
22 Over striding How to fix it: Set target cadence Use metronome Cadence App Song playlist organized by cadence
23 Cadence Training Protocol (Single session) 5-10% increase in step rate 2 min with metronome 1 min without metronome 1 min with metronome 1 min without metronome Stop, restart runner independently produces new pattern Repeat above training if necessary
24 Limb stability
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30 Running is a single leg activity
31 Must be stable on one leg
32 Not stable
33 Why is alignment important? Studies demonstrate poor control of limb position is related to injury
34 Alignment
35 Tests for stability Single leg squat Step down Medial collapse Pelvic drop
36 Tests for Stability
37 How do you improve limb stability? Strengthen Gluteal muscles!
38 Gluteal Muscle Strength: Runners with PFPS & ITBS Decreased hip abduction strength Powers Ireland Robinson Cichanowski Dierks Souza Fredericson Decreased hip extension strength Powers Souza Robinson
39 Noassatall Syndrome Typical runners build NO GLUTES!
40 Hip Strengthening: Basic Concepts Progress from two leg activity to one leg activity as stability improves Emphasize good form and alignment High reps, low weight (body weight)
41 Establishing core strength Squats Bridges Step ups Plank
42 Why Planks and trunk stability? Activating core improves control of limb movement Stable trunk (abdominal muscles) improves hip muscle function Ability to recruit gluteal muscles Ability to generate force Shirey, Oh, Cynn, Boren Stable platform
43 Planks
44 Side Planks
45 Bridges
46 Squats
47 Lunges
48 Dynamic Lunge
49 Focus on alignment
50 Lateral hip strengthening
51 Single leg training
52 Run-specific movements
53 Train for stability Unstable surfaces Bosu Foam rollers (1/2 rollers) Wobble boards
54 Plyometrics Technique to develop power To train the muscles to become more explosive Stretch muscle followed by contraction of muscle Jumping Running causes increased force production of same muscle
55 Plyometrics Benefits: Improved neuromuscular control Decreased peak landing forces 22% Hewett Decreased magnitude and rate of loading Irmischer Improved limb stability (decreased hip adduction) Myer
56 Plyometrics Benefits: Improved Running Economy (How much O2 is required to perform at a given intensity) Jung, Turner Performance times Sprinters and long distance runners Paavolainen, Rimmer, Spurrs
57 Plyometrics Good form is essential Good Bad
58 Plyometric Progression Stair hops Cone hops Cone hops/turns Box jumps Front Lateral Alternate legs Split squat
59 Plyometric Progression Stair hops Cone hops Cone hops/turns Box jumps Front Lateral Alternate legs Split squat
60 Plyometric Progression Stair hops Cone hops Cone hops/turns Box jumps Front Lateral Alternate legs Split squat
61 Plyometric Progression Stair hops Cone hops Cone hops/turns Box jumps Front Lateral Alternate legs Split squat
62 Plyometric Progression Stair hops Cone hops Cone hops/turns Box jumps Front Lateral Alternate legs Split squat
63 Video gait analysis
64 Motion analysis laboratory collecting data to answer research questions about groups /sub groups of runners. Clinical running analysis runner wants to know about their own unique biomechanics (running form) Am I running properly?
65 Clinical Running analysis Review training and injury history Musculoskeletal exam Strength, flexibility, core control, structure Movement screening Information about muscle strength and activation patterns
66 Clinical Running Analysis Video analysis Dartfish 2 D motion capture software One camera / No markers
67 Gait analysis
68 Biomechanical analysis Assess movement patterns related to injury risk
69 Running analysis Report: Recommendations: shoes/orthotics gait retraining/form changes exercise/treatment suggestions training modifications.
70 Thank You Go Dragons!
71 Questions?
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