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