Treadmill Analysis Part 2 | Modern Manual Therapy Blog

Treadmill Analysis Part 2

Here is the second vid taken 1 week after some OMPT, education, and minor running cues.

Part 1 is here.

Her original complaints included severe ITB "tightness" and pain in her right anterior hip/inguinal area. Treatment last week
  • right psoas and QL release
  • ITB work with the EDGE
  • left hamstring and glut static bridges for endurance (tested inhibited)
  • cuing to bring her right UE closer to her body and avoid swining
  • cuing to think about increasing right hip extension
  • attempting to land with her feet underneath her to prevent overstriding
Here is her second vid one week later. Note that she is also running in her normal 0 mm drop minimalist shoes. She had forgotten her running shoes the week before and had to run in 12 mm drops. She was surprised that she was still heel striking. Like the studies suggest, many runners are mistaken in regard to their striking pattern. The patient was mortified actually, as she teaches running form at a local running shoe shop.



Changes from last week:
  • decreased right UE abduction, but still greater on the right with increased trunk rotation
  • better hip extension with no excessive lumbar hinging
    • also reports elimination of right anterior hip pain this week
  • more stability in her knees (could be attributed to not having excessive shoe support - increasing her proprioception)
To work on:
  • still overstriding on right compared to the left - increasing GRF on the painful side
  • filming outside with different sets of cameras (ground, farther away shot) as many runners have more of a normal gait outside versus on the treadmill 
Are you guys catching anything else? Any more changes from week 1 to week 2?

2 comments:

  1. Hi Erson, to me it looks as if this runner is over striding in both videos despite her switch to minimalist shoes. Did you check her cadence? You could try increasing this by 5 to 10 steps and see if this changes foot strike pattern and over striding. Also, another approach would be to get her off the treadmill and get her practicing leaning/ falling forward at the ankles to get her foot strike under her center of mass. This may decrease the vertical impact pattern. The over rotation could probably be coming from a lot of different reasons and may be difficult to change, but if her cadence increases it will serve to shorten the turnover and possible decrease the the excursion. I could could see this rotation causing some low back pain on the right which may overflow into facilitation through the gluts. The other big question would be any changes recently in her mileage or intensity as this is usually the cause for new onset pain from running. I think we have to be careful to over analyze every little peculiarity while running much like we have begun to abandon the plum line concepts.

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  2. Thanks Patrick. I agree the rotation could be from a myriad of causes. I did tell her she needs to lean forward and get her foot landing more under her. She actually just started training again, but only plans on doing halfs until next fall. By training I mean running more than 5-8 miles. However, this pain is not really new onset, it's somewhat recurrent.

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