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...

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