Showing posts with label running. Show all posts
Showing posts with label running. Show all posts

Sep 8, 2014

Three Non-Negotiables for Running

dr. Mark cucuzzella, Healthy Running Conference, improve running performance, Jay Dicharry, prevent running injuries, running, running economy, running essentials, running gait, running injuries,
Running a half-marathon indoors is as boring as it sounds.

Howdy Folks! Howdy? Why do I say that? I don't know but here in Miami everything keeps on thinking that I am saying "How ya doing", so perhaps I need to find a new greeting. Nevertheless, lets get back on track. Speaking of track...Do you run, work with runners, or want to run? I wrote today's post to share with you all some concepts that I learned from Jay Dicharry and Mark Cucuzzella at the Healthy Running seminar.

So guess what...? There is a lot more to running that going in circles around a track or bombing down trails in the woods. How about we break it down and discuss three critical components to running?These are critical for running "better" without taking a hit to your economy or risk of injury. I didn't say these three concepts will make you the best runner or prevent 100% of injuries. However, if you don't have these three things then you my friend are missing a few pieces of the puzzle.

1. Runners Need Mobility. Not More but Not Less.

What the heck does that mean? It means you need just enough mobility to move what needs to be moved without creating a compensatory movement pattern. It also means that going above and beyond that threshold may not be beneficial. We are talking Goldilocks here, not too tight and not too loose. We need you to be just right. The good thing here is that "just-right" probably fluctuates between body type, activity type (sprinter vs. distance vs. hurdlers), and running form. However, there are some minimums. We need enough mobility to allow our legs to extend behind us. This requires adequate hip extension, ankle dorsiflexion, and first ray dorsiflexion. We need other joints to be mobile as well but these are the essentials. How much? We are looking for 15-20 degrees of hip extension, 30 degrees of ankle dorsiflexion and another (ankle is already dorsiflexed to 30 degrees before measuring great toe mobility) 30 degrees of metatarsophalangeal (MTP) dorsiflexion of the first ray on top of that. These are not "normal" ranges of motion for these joints but these are the amount needed for running.

running, running gait, running essentials, Jay Dicharry, Dr. Mark Cucuzzella, Healthy Running Conference, running injuries, prevent running injuries, running economy, improve running performance,

2. Runners Need Stability.

If you try to drive a car with poor alignment very far then you are in for a hard a time. The human body is no different. You need a stable and properly aligned "chassis" for efficient energy transfer. This means you need enough "core" control or stability to maintain your alignment while running, for the entire run. You need to be stable from stride 1 through mile x/the finish. This requires stability in all three planes and not just the sagittal plane where many of us tend to hangout. I see poor stability as a common fault for many of us. It is challenging to have proper motor control, especially for long periods of time. We do not want unstable levers to interact with and try to control high/rapid forces.

running, running gait, running essentials, Jay Dicharry, Dr. Mark Cucuzzella, Healthy Running Conference, running injuries, prevent running injuries, running economy, improve running performance,
You need to be stable from beginning to end.

3. Runners Need Strength & Power.

You're a runner, right? The prime example of an "endurance" athlete. Pure cardio, pure aerobic metabolism, purely about getting in the miles or minutes. Wrong. Runners need proper levels of strength and power as well. There is plenty of evidence to show that weight training can be very beneficial to endurance athletes and runners! Your hips (glutes) need to be able to propel your entire body up and forward...very very quickly, many many times. In addition, vertical ground reaction forces (vGRF) in running peak at about 2.5x body weight! Think about that for a second...That would be the equivalent of a 150lb runner doing a single leg back squat with 225lbs on the bar for a total of 375lbs through one leg!

What about plyometrics? Economic running is very plyometric in nature...it is all about how well you can store and release elastic energy! If we are going to have stable levers from non-negotiable #2 then lets take advantage of that and apply some large forces through them!

running, running gait, running essentials, Jay Dicharry, Dr. Mark Cucuzzella, Healthy Running Conference, running injuries, prevent running injuries, running economy, improve running performance,
Gravity is relentless. You need to be strong because we are always fighting it.

In Conclusion
Take these three concepts in isolation and they make sense. Look at them in combination and they make even more sense! Hey wait a minute! How do these things even help runners? Well, overall these are needed to better our running economy and that is done by addressing two key concepts of economic running form.

  • Better Storage and Release of Elastic Energy
  • Minimized Loading Rates

Now we just need to take these conceptual ideas and put them into practice, right? Stay tuned for future posts where we will discuss how to evaluate and address these issues.

Jun 27, 2013

Mobilizing Your Ankle, 2 Variations: Video Update

Hey Readers! Here is a quick video that I made a week or so ago on how to do a Mulligan Mobilization With Movement technique to increase ankle dorsiflexion. Ankle dorsiflexion seems to be a common theme on my blog but it is a common restriction but a very important motion to have! In this video I show you a way to do it this alone or with a partner/patient. This won't be a new concept for some but I hope those who have never heard of it find it useful! Enjoy!


Jun 26, 2013

12 Random Reasons To Try Trail Running




I love trail running. If I had trails close enough to me I would have force myself to not run 100% of my miles on trails. I don't think enough people know about the fun that is entailed with running trails and I don't think enough people have given it a try. I wouldn't be surprised if most people assume that its a run filled with blood, bugs, steep hills and sharp rocks. Well, sometimes it is(I consider that a plus). On the other hand, here are twelve random reasons to give it a try.

1) It is a dirty, adventurous, and thrillingly fun time.

2) Trail terrain is so dynamic it takes the monotony out of running. This means your body experiences a more varied array of forces and not the same repetitive stresses associated with road running.

3) Trails are easier on the mind than most roads. I sometimes get bored of my road routes and feel like time drags on. Trails are so jam packed with turns, obstacles, nature and picturesque views that you might not be able to keep up.

Jun 16, 2013

Two Quick New Videos

Hey Everybody,

Here are two new videos that I made this weekend. I am going to start making videos with stuff related to blog content, rehab exercises, running form, random reviews and et cetera. You may notice near the top that I now have a direct link to my YouTube page as well. The first video is an easy test to check your ankle mobility, specifically ankle dorsiflexion.


The second video is for a common exercise for runners. This is intended to be a hip extension and glute activation exercise but ends up being something else entirely! It makes me cringe to watch people do it improperly!


Hope you all have a great father's day and hope you had a great weekend! Here comes Monday...

May 23, 2013

Why do you run?


I was asked a very innocent and nonchalant question the other day. The question was produced by a little small talk but in reality it was a deep question. The answer to this question has many parts or layers and many different but viable responses. I realized that the response that I would give is dependent upon time.

 I wasn’t always a runner or a fan of running. I label the younger or adolescent version of myself as the stereotypical fat or chubby kid. I dreaded the mile run for gym class in elementary school and one day I even faked sick so I could stay at home and not participate in the perceived torture.


I definitely was a stereotypical fat kid.

I didn’t get into running until my sophomore year of college when I worked with cross country and track athletes during my second clinical rotation as an athletic training student. My interests in endurance sports had begun to develop as I had taken up cycling as a recreational and fitness hobby before the start of college. I would assist my preceptor in evaluating and treating these athletes and would be amazed at the durations of their runs. I was shocked but inspired at the same time that people could run for 60-90-120 minutes without struggle and do it several times a week.

May 3, 2013

Researching the Adaptations to Running in Minimalist Shoes

I like research, especially research related to sports medicine and running. I like to read it, discuss it and implement it. Beginning this fall, I will even do some research myself for my Master's Thesis.

However, I find myself a clinician at heart and do not wish to solely do research as my career develops. Even though I have inklings of desire to get a PhD someday. Despite this, I wish I was helping conduct this research study that this article highlights.

http://www.redorbit.com/news/health/1112837371/how-minimalist-running-adapts-muscles-050313/
This study out of UVA sounds very fascinating and I can't wait to see what becomes of it.

Apr 24, 2013

Book Review: Anatomy for Runners: Unlocking Your Athletic Potential for Health, Speed, and Injury Prevention


Title:
Anatomy for Runners: Unlocking Your Athletic Potential for Health, Speed, and Injury Prevention
Author: Jay Dicharry, MPT, SCS
Publisher: Skyhorse Publishing; 1 edition (August 1, 2012)
Pages: 290
Price: $10.67 (Paperback) or $7.99 (Kindle)
ISBN: 1620871599

Well, I've never formally written a review before let alone published one for people to read on a blog. The only reviewing I have done is given my opinion to others that would listen (or pretend to). However, I decided that this book was a great place to start. The quality of information and the way it was delivered has given me the motivation to make an attempt at writing this review. So...where do I begin?

Mar 12, 2013

Ankle Dorsiflexion: The What, Why, and How.


Dorsiflexion. This important motion occurs at the ankle and is seen when the dorsal(top) aspect of the foot and the anterior(front) aspect of the tibia(shin) move closer together. This motion is seen with and is necessary for proper execution of many basic human movements including squatting, running, walking, jumping and more. This motion is a vital part of most functional movements and proper function up and down the entire kinetic chain. Even minor tasks such as sitting and standing from a chair or walking up and down stairs requires adequate dorsiflexion of the ankle.

There are many issues related to inadequate dorsiflexion including many lower extremity injuries and and foot deformities. Evidence exists that problems here can be related to falls in the elderly, patellar tendinopathy, ACL injuries, lower extremity kinematic changes, and patellofemoral pain syndrome to name a few. This motion could be limited by several different problems such as soft tissue mobility(muscles and fascia), bony abnormalities, joint capsule restrictions(belongs with soft tissue mobility), and impingement of these structures.


The human foot and ankle are masterpieces of complexity and natural engineering.

When a person is deficient in dorsiflexion they are not automatically limited in the aforementioned movements(besides dorsiflexion, duh) or tasks such as a squat. The human body is great at incorporating compensatory movements to allow a continuance of motion to increase our ability to survive but at the cost of our ability to thrive. 

For example, lets say I have a patient named Jim Shorts who comes to me with complaints of knee and low back pain as well as a history of chronic plantar fasciosis. Jim loves going jogging, playing basketball, and working in the garden with his wife. 

These are very common symptoms and could be caused by a variety of issues but for the sake of this post lets discuss how they could be related to dorsiflexion of the ankle. Before we even begin to evaluate Mr. Shorts lets think about how dorsiflexion might be needed during each these activities. 


Running

  • The ankle plantar flexors(think calf muscles) and plantar fascia may be eccentrically (resistively stretched) loaded at initial foot strike depending on landing type (heel strike vs mid-forefoot landings).

Initial Contact

  • As the gait cycle changes from initial contact to mid-stance, the ankle moves into a more dorsiflexed position. At this moment, vertical ground reaction forces are at their highest(Active Peak on the graph below) and loading of the achilles tendon is reaching its maximum peak. To allow proper dispersal of these forces and to allow some of this energy to be stored and then reused the achilles must act as a spring.  Dr. Mark Cuccuzzella has made a video that highlights these principles of running mechanics and he does a much better job of visually and audibly explaining it than I can in writing.
  • Steve Magness, writer of the blog Science of Running, and Head Cross Country coach at the University of Houston wrote a great post on the most vital components of running here as well.



Midstance

















  • The ankle plantar flexors are now on maximum stretch(maximum dorsiflexion) and are maximally loaded now must assist the posterior chain(gluteus muscles and hamstrings) to propel the body forward and slightly upward(propulsion phase & toe-off).

These components involving the ankle and its ability to dorsiflex are vital to running and any sports that involve running. If motion is impaired we should not expect to be efficient or safe from injury. Would you expect a car to have maximum performance or to be safe from harm if you had improperly sized or damaged shocks? 

I like the analogy of the ankle plantar flexors to be a group of rubber bands. If you have soft tissue problems then these rubber bands may be tied full of knots or could be thought of as dried out and having lost their snap. If you have bony or joint capsule restrictions then you may not have the ability properly stretch out a healthy rubber band to allow maximum performance or perhaps this inability caused a degradation in the health of the rubber band itself. Double Jeopardy.


Basketball & Gardening
  • Requires the ability to run(discussed previously)
  • Requires the ability to jump
    • You need to be able to shoot a jump-shot, lay-up, dunk or to go up for a rebound.
  • Requires the ability to land after jumping
    • You need to safely come down after jumping and be able to dissipate the forces from impacting the ground.
  • The above can be summarized by the ability to squat. (*Only the squat applies to gardening, unless you are into some extreme gardening stuff that i've never heard of before.)
    • You also need to be able to properly squat to get into sport-specific positions of basketball such as a defensive stance and you don't want to bend at the waist to work in your garden(some people still will). 

Looking at Mr. Shorts
So we begin to evaluate Mr. Shorts and we have him perform some functional movements to evaluate his movement behavior. For example, we ask Jim Shorts to do a deep squat like he would while gardening and we notice that his heels can not touch the ground and he excessively flexes his trunk forward to allow his arms to work at ground level.

Next, I have Jim show me his defensive basketball stance. We immediately notice that his knees extend past  his toes and that he has that same forwardly flexed trunk position as before. He also complains that this position immediately exacerbates the pain in his knees and low back.

At this point I decide to try something. I take either a heel lift and place it into Jim's shoes or place his heels onto a 2in. board and have him repeat his deep squat. This time Mr. Shorts is able to squat down with his heels flush to the ground (or board) and his back appears to be parallel with his shins from a side view. The only difference here is that we eliminated the demand for proper dorsiflexion. Technically, this might not be the only reason for his limitations but I wanted to show how improper dorsiflexion could change a functional movement. 

This example shows us how problems with movement at the ankle can increase forces and perhaps damage tissues further up the kinetic chain. The next step for us would be to decipher what type of dorsiflexion restriction Jim Shorts actually has but that post is for another day so lets move on to figuring out how to evaluate your own ankle dorsiflexion.

Self Evaluation
Lets discuss how you can evaluate your own ability to dorsiflexion at home. Here are a few links to some of my favorite techniques and how-tos for evaluating ankle mobility.
  1. This first link is credited to Mike Reinold's blog and is an all-encompassing post that is very concise and does a great job of saying everything that I am trying to say with this post. He even has many great videos for working on improving your own mobility.
  2. This link is to a blog post by Jay Dicharry, MPT, CSCS...Author of the book, Anatomy for Runners. Jay is probably one of the premier clinicians and researchers out there today when it comes to running mechanics, research and injuries. This post discusses more than just ankle dorsiflexion and is definitely recommended.
  3. This next link is actually to a video made by Jay Dicharry. This video will show you a quick and easy list of self-evaluation techniques and fixes for somebody looking to transition to minimal running shoes. However, I feel that these are vital to athletes and runners regardless if they are barefoot or wearing Hoka one-ones.
  4. How much dorsiflexion do you actually need? Jay Dicharry recommends at least 25 degrees of dorsiflexion at the ankle and 30 degrees of dorsiflexion of the big toe(measured at 5 degrees of ankle dorsiflexion). Mike Reinold and the minds of the Functional Movement System, such as Gray Cook sponsor the idea of the knee reaching about 5 inches past the toes while in a half kneeling stance. One study found that athletes with less than 36.5 degrees of dorsiflexion had an..."18.5 to 29.4% risk of developing patellar tendinopathy compared to a 1.8 to 2.1% risk for athletes with dorsiflexion greater than 36.5 degrees." I believe most of these values to be too similar to chose one set of thought over the other and suggest them as mere guidelines and not cut points.
How do I fix this?
I had originally planned on writing an entire section on my favorite joint mobilization, static stretching, and soft tissue mobilization techniques but the links I provided in the self-evaluation section have some great techniques included with them already. I feel like I can not top those techniques and I highly recommend them. However, I do want to summarize some thoughts about trying to increase dorsiflexion.
  1. I believe that a vast majority of us living in 1st world countries that grew up with or have been wearing shoes for decades with an elevated heel have limitations in ankle dorsiflexion. There are exceptions to this but I have provided you with information to check for yourself.
  2. I admit that going barefoot or  utilizing a more minimal shoe during training may not be feasible for everyone. However, I do feel that incorporating and wearing a shoe with less heel-to-toe drop or less of an elevated heel during everyday activities such as at work, around the house or out on the town can be very beneficial for restoring proper ankle dorsiflexion. What you wear on your feet 90% of the time probably has a more profound effect on your tissues than the shoes you wear 5-10% of time you spend training each week.
  3. When it comes to increasing the actual mobility with manual work I believe a multi-faceted approach is best. A combination of joint mobilizations, static stretching(post exercise), foam rolling, etc is probably going to be more effective for you unless you or a manual therapist has determined that only one specific issue is limiting you. It would not be uncommon for several of these issues to be a limiting factor for a person.
  4. Do not ignore above and below, tibial internal & external rotation as well as plantar fascia mobility influence movement at the ankle as well.
  5. DO NOT try to treat the symptom by eliminating the need for proper dorsiflexion. Utilization of heel lifts, immobilization, restrictive tape jobs, new shoes and etc. are only treating your symptoms. These MAY be appropriate for short-term relief but they do NOT fix your problem. If you try to take the easy way out and try to eliminate this motion then you are setting yourself up for a different set of problems up and down your entire kinetic chain.
In conclusion, this is going to be an issue with a majority of people. This problem exists in both the physically active and inactive populations. Only the minority of people that I've tested have had adequate ankle dorsiflexion. I would love to see how this compares with a third world country where people have not had the "luxury" of wearing shoes with elevated heels since birth. I bet you can find plenty of pictures in a national geographic magazine where the indigenous tribespeople have perfect squat form and can hold it comfortably with ease.

Updates

Here are a few related videos that I have made that should be of value to this topic as well! Enjoy!






Feb 25, 2013

Do you ever get the "runs" from running?

I don't know why I would chose this topic as my first real post. It is a bit private, gross and uncomfortable for most people to discuss. Like most of my ideas, this topic just came to mind the other day while randomly sipping on some coffee.

Gastrointestinal (GI) disturbances or more specifically "Runner's Trots" is an often ignored episode associated with running unlike shin splints, foot and knee pain, or a poor pace. Not many like to discuss it because of the sensitivity but unfortunately many experience it during or after a run.

According to Schommer et al, 20%-50% of distance runner's suffer from an experience like this during or after a run. Besides just diarrhea the Schommer et al report that these disturbances can also include, "...vomiting, nausea, bloating, heartburn and flatulence as well as watery and bloody diarrhea and anal incontinence."

Don't be this guy.

If a quarter to half of all distance runners encounter issues like this then I would consider it a significant problem. The high prevelance rate and wide ranging symptoms of gastrointestinal disturbances associated with running could be due to the fact it is related to a variety of causes.

Some of the mechanisms suspected to be related to these GI disturbances and my thoughts related to them:
  • Visceral Ischemia related to the sympathetic nervous system's response to the need for increased cardiac output .
    • This is a physiological response to any type of exercise that all of us must face. If most athletes undergo this physiological response but the GI disturbances related to running are not the same for all then I have a hard time believing this is the reason. Another reason to ignore this issue is that it is a natural response that none of us can change other than increasing physical conditioning and therefore decreasing cardiac output demands at "x" pace.

  • Changes in motility or bowel movement by mechanical factors. (Think of the potential jostling and vibration of the organs) This mechanism is also related to Gastroesophageal reflux disorder(GERD) episodes experienced by 60% of athletes.
    • This is another unavoidable factor experienced by all runners. This factor could potentially be changed by the individual amount of vertical vs. horizontal movement as well as joint stiffness changes related with surface, motor control/program(ex. running form) and footwear choices. It would seem logical that a change in these factors could influence the mechanical forces experienced by the visceral organs let alone the neuromusculoskeletal system. (Think over-striding weekend marathoner vs. an efficient Kenyan runner)

  • High Dietary Fiber Intake
    • The previous point (#2) mentioned GERD. If we look at some of literature related to GERD we can see there is a relationship with GERD and grains. Tuck, the author of the blog Yelling Stop, does a great job of discussing this here.
    • The Standard American Diet or SAD is often rich in high fiber foods. Fiber is highly touted by most modern dietitians and doctors, especially from sources such as whole grains and legumes. The problem with this is that these foods are often high in natural food toxins that influence the gut's health. Paul Jaminet, co-author of the book and blog The Perfect Health Diet, is a great source on diet and its relation to the function of the gut and health of the gut biota. His post here goes into more detail about these toxins and their negative effects on the gut.

  • Spicy Foods
    • If you find yourself preparing for a long run or a marathon and you eat spicy foods to fuel your system before your run you should probably expect to have a related GI disturbance. I shouldn't have to explain how to fix this issue.
    • This isn't meant to mean that you shouldn't eat and enjoy spicy foods but you should probably time the consumption of them appropriately. You might want to consider avoiding consuming certain spicy foods if they have extreme effects on your system. You will know best on how you will react to foods by trial and error. Just don't experiment before races or long runs.

  • Caffeine
    • Its known that stimulants such as caffeine increase peristalsis or the speed in which your GI tract works. If you want to use caffeine as an ergogenic aid for performance and are sensitive to its effects on your GI then this might not be the aid for you. However, it may not be an issue for yourself. Caffeine intake with a pre-race meal or during an event with food may assist in sensitivity to caffeine as well.

  • Sugar Alcohols
    • High doses of sugar replacements or sugar alcohols such as xylitol, sorbitol, etc can cause GI issues in large doses, if you have pre-existing gut issues or if you are unaccustomed to ingesting them. Experimentation is key here, and possible avoidance may be desirable.

  • Unaccustomed food intake.
    • I always recommend to my patients/athletes that they never experiment with new foods the day before or the day of competition or events. This is not the time to try a new recipe, ingredient or foreign food.
    • Experimentation is better left for practices or training runs/events. This way when the big day rolls around you will know what powers your mind and body the best without unwanted side effects.
  • Novice Runners
    • This category seems to be a combination of multiple above categories. Poor conditioning, inadequate breathing strategies while running, inefficient running form and a lack of previous experience related to experimenting with diet and its effects on running.
    • Not all new runners experience GI disturbance and veteran runners suffer from GI disturbances as well so I don't believe being just a novice runner is the true factor but more of a combination of the above.
Now that I have finished introducing some of the factors related to GI distress in runners I want to refocus back on factor #3...High Fiber intake. More specifically cereal grains and legumes and how they have impacted my own personal GI during running. I used to suffer a lot of GI distress while running, however, just recently it dawned on me that I haven't suffered any of these issues in about a year. Around a year ago is when I started to really investigate and learn about ancestral health/paleo diet style eating. I then started to eliminate processed foods, refined sugars, and cereal grains.

In conclusion, I believe this might be the biggest factor that has eliminated this problem from my running. I am curious if others have found similar experiences or differences than that of mine. My girlfriend has changed her diet along with me and she also admits to have experienced a severe decrease in GI distress related to running as well. What has your experience been?

First Post.

Howdy potential future readers. I am not sure if I will ever get any future readers but hello if I somehow do garner your attention. I am starting my first blog, this blog, because I would like to create a source or forum where I can communicate ideas with others who may or may not have similar ideas with myself. This type of atmosphere can help me learn from others, help others or debate with others.

The fact that nobody agrees on anything is great. It is a good thing in the world of science and it keeps the regular world from becoming too boring. I would like to write about topics that interest me and as a 23 year old graduate student and Certified Athletic Trainer (not trainer) I have interests in diet, running, health, science, cycling and health care. Some may feel like the future posts will be too far ranging at times but I see all of these topics as inter-related and integrated with each other.

I hope to share personal stories, stories of others, related news and articles of research related to the aforementioned topics and more. I am not promising myself or anyone that I am an English laureate. I can't even promise myself that my writing can rival the average 5th grader's writing but I will attempt to create legible posts for your sake.

My first real post will be based upon the topic of the never pleasant runner's trots and its relationship with diet. This preview to my first topic might repel some potential readers and it may catch the attention of others. Just like runner's trots, it is probably a risk that I shouldn't take.

Below is a couple of pictures of myself to help give voice to my writing.

Grizzly Adams did have a beard.
Evaluating an athlete's injury.

Disclaimer

Disclaimer: Please note that some of the links on this blog are affiliate links and I will earn a commission if you purchase through those links. I have used all of these products listed and recommend them because they are helpful and are products from companies that I trust, not because of the commissions that I may earn from you using these products.

Caution

All content on this blog is meant as instructional and educational. The author and guest authors of this blog are not responsible for any harm or injury that may result. Always consult a physician or another proper medical professional for medical advice.
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