Top 5 Fridays! 5 More Things to Look for in Runners | Modern Manual Therapy Blog

Top 5 Fridays! 5 More Things to Look for in Runners

I am currently reading Bruce Wilk's The Running Injury Recovery Program, expect a review in the coming weeks. In the meantime, here are a few things I look for in injured runners.

1) The arms

  • arms are the driver for the LEs
  • other than previous injury, asymmetry is important to correct with cuing, manual treatment, and corrective exercise
  • for example, in the Triathlete case I treated this year, after improving his thoracic rotation and right shoulder mobility, his left knee pain was abolished and he had 3 PRs in 4 weeks
  • check out these videos I posted on Physio Answers via Chris Johnson on arm swing and running economy

2) Thoracic rotation

  • it goes without saying that the thoracic spine is often dysfunctional and tends to have less than optimal mobility
  • this could affect arm swing and/or hip mobility, cause breathing pattern disorders, or overstride
  • look for a loss and help the patient correct it

3) Variability

  • shoes, methods of running (Pose, Chi, barefoot) etc, have all been proven not to have significant differences in running economy (or in some cases economy was worse)
  • however, in looking at injured runners vs non-injured runners, the non-injured runners had more variability to their gait
  • perhaps a reason why introducing Chi Running, or forefoot running (or different shoes) is just introducing variability to a training schedule which is why it helps, rather than being a one size fits all
  • another case example of this is a runner I was treating earlier this year had nearly no hip pain while trail running, but had it reproduced almost every time running on the street
    • was the street too flat, and thus not having enough variability?
    • his training thus overexceeding his capacity?

4) Overstride

  • you want to correct this due to the increased GRF it causes, thus eventually leading to knee pain, stress fracture, or other complaints
  • there are many reasons why a runner would overstride
  • the right leg tends to overstride on hurdlers or distance track runners (outside leg)
  • lack of hip extension on the involved side (leading the pendulum to correct with excessive hip flexion moment)
  • more of an upright running posture
  • too much contralateral arm backswing (thus driving the LE into overstride)

5) Balance
  • not single leg stance (although that is important), but balance between training, rest, sleep, diet, and hydration
  • a recent patient told me he had an amazing 15 mile pain free run right after a Friday night's sleep
    • he woke renewed and primed to run
    • the next 5 mile run was painful, but was after work, after he had been sitting most of the day - nervous system and periphery not primed to move
  • we often forget about simple concepts like sleep, hydration, and diet
Keeping it Eclectic...

1 comment:

  1. I really enjoy your approach to runners. I find the thoracic cage also very important in running. Wisdom Healing Qigong exercises especially hip rotation and "push the mountain" exercise are very helpful for runners looking to open up the stride and have better lift. thanks for the article, Ralph Havens, PT, OCS, runner
    Bellingham, WA