SPEAR Physical Therapy's Running For Life: How to Keep Doing What You Love, Injury-Free!
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SPEAR Physical Therapy's 16th Street Physical Therapists Laura Muzzatti and Kellen Scantlebury delivered this fun and informative presentation on running and injury-prevention! Learn why a mid-foot strike is better than a heel-strike, and what exercises you can do to make sure you're fit for running (not just running to be fit)!
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SPEAR Physical Therapy's Running For Life: How to Keep Doing What You Love, Injury-Free!
- 1. Running for Life: How to Keep Doing What You Love, Injury Free! SPEAR Physical Therapy Kellen Scantlebury DPT, CSCS Laura Muzzatti DPT
- 2. Running for Life • Fauja Singh finished the Toronto Scotiabank Marathon in 2011 • He was 100 years old!
- 3. • Discuss running trends • Provide framework of normal running mechanics • Optimize running form • Describe signs/symptoms of common injuries • Discuss common training errors • Review the top exercises and activities for runners to reduce injuries Objectives
- 4. • 2012 saw more than 15.5 million finishers in U.S. running events • Since 2000 the number of U.S. race finishers has increased by 80% • The 5K remains the most popular distance • 2013 ING NYC Marathon was 2nd largest race in U.S., with 50,266 finishers Running Trends
- 6. 0 100,000 200,000 300,000 400,000 500,000 600,000 1976 1980 1990 1995 2000 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Year US Marathon Finishers
- 9. Running Form Pay attention to your “Plumb line” (seen above as the line stretching down the runners’ bodies) • Forward lean of the body- momentum • Using abdominals as opposed to arching lower back • Foot landing directly under line
- 10. Runner on the left: Craig Alexander, 3-time Ironman Triathlon world champion; current course record holder. This photo is great for looking at our “plumb line.” If we drop a vertical line through Craig’s ear, it drops through his shoulder, through his hip, and he is about to land directly under that line. This running form correlates with a shorter step length, higher cadence (steps/min), and a mid-foot striking pattern. Running Form The triathlete on the right is what you typically see at the end of an Ironman, and what is frequently seen in non-professional runners. His plumb line drops in front of his hip and his right foot is about to land way in front of the line. He is clearly taking bigger steps than Craig and landing on his heels.
- 11. Foot Striking Patterns Barefoot running and heel strikiing have been a hot topic since the book “Born to Run” came out in 2011 and the popularity of Vibram minimalist shoes quickly followed. An aftermath of “minimalist” shoes started, changing the mindset that had been around for the past 20 years. (continued on next slide)
- 12. Foot Striking Patterns A “rear-foot” or “heel-strike” running pattern results in a rapid, high impact transient (aka a huge spike in force) that occurs right after the foot hits the ground. These impacts add up, since you strike the ground almost 1000 times per mile. Wearing a running shoe makes a heel strike more comfortable, and does reduce the force by about 10%. However, they do not eliminate the impact transient. * What also correlates with the spike in force is that any momentum gained is quickly absorbed as the heel hits the ground. ** You are almost “braking” with every overstride/heel strike and decelerating your momentum.
- 13. Foot Striking Patterns With a forefoot to midfoot striking pattern, the impact transient is absent. By absorbing shock through the arch as the body continues to transfer weight forward, we see a slow rise in force from contact until midstance. • Most important thing to take away from today is learning what your foot and body are supposed to do may be more important than what footwear you are putting your foot into. Regardless of which shoe is on your foot, paying attention to your body mechanics is the most important thing.
- 14. • Running cadence = steps/minute • Optimal running cadence is 180 steps/minute • Taking shorter strides (even by 10%) reduces injury risk! • Tip: Run to a song that has the cadence (beat) you are trying to achieve. Cadence & Stride Length
- 15. • MetroTimer App Monitor Your Cadence
- 16. Running Injuries- Why ME!?
- 18. Why Do Injuries Happen? • Age • Gender • Flexibility • Strength • Weekly mileage • Footwear • Biomechanics • Medications • Hydration • Nutrition • Training Surface • Training Intensity
- 19. Common Injuries Runner’s Knee – Anterior knee pain – Pain with stairs, squatting, sitting – Increased Q angle – Poor running mechanics – Muscle imbalances
- 20. Q-angle • Angle from pelvis to the mid point of the patella • 14 degrees normal for males • 17 degrees normal for females
- 21. Dynamic Q angle A. Normal Q angle B. Abnormal Q angle – puts the runner at risk for hip and knee injuries.
- 22. Common Injuries Iliotibial Band Syndrome – Lateral knee or hip pain • Tight IT band and TFL • Weak Hip abductors, and external rotators • Poor running mechanics
- 23. Common Injuries Plantar Fasciitis – Soft tissue inflammation and pain – Worse in the AM – Heel pain • Tight calves • Poor mechanics
- 24. Common Injuries Stress Fracture – Localized pain – Pain with running – Pain is focal and palpable • Poor calf muscle endurance • Poor running mechanics
- 25. Footwear Less support More support
- 26. • Establish a Base • Follow a plan • Build up Core Strength • Increase frequency before mileage • 10-15% increase per week to prevent overload • Cross training • Tier your mileage Training
- 27. Example Progression • Week 1- 10 miles • Week 2- 11.5 miles • Week 3- 13 miles • Week 4- 11.5 miles • Week 5- 13 miles • Week 6- 15 miles • Week 7- 17.5 miles • Week 8- 15 miles
- 28. • Dynamic warm up prior to activity • Self STM (soft tissue mobilization or massage) – Foam Rolling – The Stick – Trigger Point Release • Static stretches afterward Training 101
- 29. – Plank – Side Plank – Dead-lift – Clam – Squat – Band walks Top Strength Exercises for Runners
- 30. Plank
- 31. Side Plank
- 32. Dead-lift
- 33. Clam
- 34. Squat
- 35. Band Walks
Notas do Editor
- http://www.runningusa.org/state-of-sport-2013-part-III?returnTo=annual-reports
- Steady, linear growth of finishers running in races over the past 12 years. Note that the percentage of females has skyrocketed since the 90s from 25% to 56%. These numbers don’t account for the non-racer/recreational runners in the country. http://www.runningusa.org/statistics
- 1976 started with 25 000 participants and escalated over the next 35 years until 2013 where we had an all-time high of 541 000 marathon finishers. Transitional statement: If we pick one graph I like this one. Can show how much of an impact NYC marathon had on number of runner *** http://www.runningusa.org/marathon-report-2014?returnTo=annual-reports
- Running is a series of single leg hops that result in forward progression Biomechanical efficiency is the most important key to running, as it allows a runner to get from point A to point B while expending the least amount of energy possible. 3 phases of running in general: Loading phase, propulsive phase, and recovery phase Cyclical nature of running makes each phase dependent on each other
- Plumb line Forward lean of the body- momentum Using abdominals as opposed to arching lower back Foot landing directly under line Foot striking pattern
- Increased Q angle places added stress about the knee joint and hip joint . Want to work to control the knee and hip in space. Imperitive we control this at loading response**
- Poor dynamic q angle can be caused by poor running mecahnics and muscle imbalances. Puts runner at risk for hip and knee injuries. Talk about the repetitive nature of running and how even a small inward deviation of the knee can result in cumulative stress at the hip and knee Why is Q-angle important to me??**
- Second most common injury in runner, leading cause of lateral knee pain. Main reason this happens is because of poor dynamic q angle** Everybody feel your leg this is where it is. Orient audience to what we are looking at. Increased hip add and IR. Impingement zone 20-30 decrease of knee flexion friction happening in this zone. Constantly running on same side of road, leg length descrepencies, excessive pronation. All risk factors Friction from ITB snapping over the lateral leg. Often display increased hip ad and knee IR during running activities. Poor mechanics Target the hips to control what is going on at the knee. Neuromuscular re-education
- 3rd most common running injury and most common injury outside of the knee. Over use injury. Fascai put on constant stretch and often seen in individuals with pronated feet and supinated feet can get this injury because pf so tight any stretch causes pain Pain over medial heel most common Pain with first steps in the am and pain with first 5-10 mins of run. Pain get better with activity and come back after rest.
- Also called Hairline fracture. Overuse injury. Ache that happens when running, gets worse and get pain earlier in run that does not go away with rest Develop gradually. Stress actually is supposed to increase bone strength not cause fracture. Poor calf muscle endruance, poor loading of the LE more loading throiugh the bones and not enough transmitted throiugh the muscles ** If running mechanics are not addressed, returning to running will result in the same breakdown of form and the same overload.
- Vibram 5 fingers, new balance minimus, nike free Nike lunner glide support to mild to moderate over pronator Severe pronation you may look into getting a maximum support shoes until you can work on getting your foot mechanics to be more normal.
- Establish a strong base of running months before you even start training for a marathon. It is crucial.. race in october 16 week training program has you starting in july. Should already be having a few steady runs a week now. 2-3 montsh of gradual building milage will go along way. Endurance race so endure it. Plans help you look ahead and are great way of making a progression around activities in your life. We are all new yorkers have a hectic schedule have to be home Sunday night to watch game of thrones I understand. Plans are easier to follow and can be set up strategically for proper milage and running frequency increases. Again we know injuries happen because to much running or to big increase in milage so plan for your running season. Core strenght needed for many aspects of running . Running begins with core. Proximal stability for distal mobility. I am the spear record holder for plank time held for 15mins and 10 seconds. World record is 1 hour 20 mins and five seconds. Helps maintain proper form and allows for more efficieny with running. 3-4 times a week should be concentrating on core. Increase frequency of running before you increase your miles. Running 5 miles 2-3 times a week. First run that same distance 4-5x a week before you increase millage. Helps body respond faster to training and improve aerobic fitness level. Run more days a week at that same speed increase pace and mileage Be real with yourself, current fitness injury history, and ultimate season goal. For runners running 10-15 miles a week you can go up 15% max or 30 % max As you runn more miles a week the percentage that you increase should decrease. IE if you run 26-35 miles a week you should increase 20 percent increase. Run over 56 miles a week no more then 10 percent increase in mielage Tier runs. Increase for 3 weekn and on the 4th week drop training intensity down to week 2 levels. Body under stress for 3 weeks allow for adaptations in aerobic fitness and ramp down allows for tissue healing and body to recover to decrease chance of overuse injury. Build mileage and reduce injury
- Want to preface by saying this is 10 miles total for a week. Beginning runner here. Up train for 3 consecutive weeks at 15% increase 4th week we detrain drop down to our week 2 milage to allow for active healing, still getting aerobic training in, decrease load on the body, decrease chance for overuse injuries, and breakdown of form. Olympic atheletes use this method. Can work for you. Speak on Boston Marathon winner Picture of road runner progression plan Example of a 8 week tiered traming program for individual that has been and can run 10 miles a week comfrtably
- Research trends toward more dynamic activities. Inhibit muscle firing patterns if static stretching done before. STM is soft tissue mobilization or self massage Pictures of dynamic warm up Video??
- Running is not resistance training. Many people think that running should come naturally, but we all forget that it is a sport.