Help With Running Analysis: Your Thoughts? | Modern Manual Therapy Blog

Help With Running Analysis: Your Thoughts?


Some of you OMPT Channel Subscribers may have seen this online consult with a young DPT with chronic hip pain.

After finding his directional preference and hip extension/IR loss, he has been able to return to running. However, his chronic hip pain still comes and goes. He has 3-4 days of feeling very good, and being able to run and work out, then Sx return. He is very compliant with his home program of rolling patterns to promote active hip extension with the involved side (prone right leg leading DN), as well as SGIS or another type of loading the right lumbar spine. These tend to centralize his complaints and improve his hip ROM.

Other treatments like PRI and glut strengthening on the opposite side immediately flared up his complaints. Since it seemed as if a few days of running Sx free could be negating any positive effects from the resets he is performing (along with use of a lumbar roll and night roll while sleeping), I requested a running video to be shot and emailed to me. I have his permission to post it on social media and my blog for additional thoughts. What are you seeing? Comment below or on the facebook page. Thanks from myself and the patient in advance for any insight or thoughts you may have!



Keeping it Eclectic...
 

12 comments:

  1. Looks like he's overstriding a bit. What is his cadence? Couldn't count it because of the slow mo. Right foot looks like it's externally rotated more than left. Just some quick thought.

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  2. Left foot sup. and tracking into the midline during flex. Right root ext rot. Watch the vertical discrepancy with R vs. L when he pushes off, he is pushing off more with right foot. Left hip flex pulling early in ext movement

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  3. I agree with Chris Carani about the left foot going from supination to midline. Right foot for me tries to go to midline but comes back in supination.

    This for me shows that he's deviated to the right. Left shoulder is up maybe to compensate the deviation of the pelvis to the right. His hip pain is bilateral? maybe he's avoiding charge in left hip.

    Absolute cadence isn't possible to know, but i think he has a cadence around 170-175 because he lands the feet just in front of his center of gravity with a midfoot strike and not so muck vertical displacement. If someone has a low cadence, feet land far ahead the CoG and a rearfoot strike appears.
    I also think (maybe i'm wrong because the video is in slow motion) that there is a lack of returning the leg foward after impulsion phase, this can be trained. On this link (http://youtu.be/mhite6t8azA?list=UUHWzClgctQF2OGt75yO8b1g) is possible to see at 0:50, 0:57 and 1:35 the specific functional drills that can be done to that phase of running.


    I hope that i could help a little bit.


    Thanks,
    Lisandro Ceci
    PT, Brazil.

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  4. Would you like to see the original video before I slowed it down?

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  5. Dr E,
    2 things that I think could be easy fixes would be try coaching a slight more trunk lean as well as a slightly more aggressive backward drive of the UEs to help with extending the hip and this should also help to shorten his stride a bit.

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  6. I agree increased ER on R LE, he also seems to stay in supination and neutral on right foot, never going into needed pronation and toe off, he lands mid foot on right and heel strike on left. Is his mobility in right ankle a problem? Just my thoughts!

    Like the slo mo... Btw
    Cheers!
    Kelly Halsey, DPT

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  7. I did coach that actually, due to the lack of hip extension. Thanks!

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  8. I just got around to the ankle because he was on/off better for several weeks. Yes, via the video seems like a tibial IR and ankle df mobility issue. He exhibits that in walking gait as well, thanks!

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  9. Agreed on that and had him start on some mobility work for the ankle, plus a slight lean to compensate for the lack of hip extension which will help the right overstride

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  10. Awesome! Keep us updated! Would be cool to see reshoot after mobility improved!
    Cheers!
    Kelly Halsey, DPT

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