Running: A forgotten sport?
Francis Madden
BSc. Physiotherapy; MSc. Clinical Sport Physiotherapy
In order for a mechanic to make an engine run smooth they need to
know how every part of the machine functions to ensure the timing and
tuning is in sync. If the mechanic does not know how the motor runs or
how each part is connected it would make their task quite challenging
wouldn’t you agree? Our bodies are our motors and if we are unaware of
how the parts move or sync it is harder to tune them. Therefore, we will
have a look at what makes our motors run, how they should be running
and how to attempt to prevent them from breaking down.
So on tonight’s menu…we’ll have a quick look at the muscles that make
us move. Overview running form and technique and lastly, we’ll have a
look at what causes injuries and what you can do to condition yourself to
go the distance and be a little more bulletproof
I’m sure you are all familiar with these terms (bones, ligaments, muscles,
tendons, fascia and nerves?) and have a rough idea of what they do?
But do you ever think about how you move and what it feels like?
At university, I had to do a whole year of physics, I still don’t know much
about it but what I do know is that Newton was a pretty smart fellow and
his third law states When one body exerts a force on a second body, the
second body simultaneously exerts a force equal in magnitude and
opposite in direction on the first body and that is basically what we do
when we move we exert forces and how we exert them will have a flow
on effect to our movements. So, let’s start building…
All of you know what a bone is? The white hard stuff that can crack and
break. One could say they are like a foundation that the rest of the
equipment gets tagged onto. The coming together of two bones is what
forms a joint (not the kind you smoke) and these bones are held together
by Ligaments. Ligaments could be compared to cement-like object as it
connects bones to bone. Ligaments have very little movement as it
should be as they are in part responsible for our joints’ passive stability.
When you injure ligaments, rehabilitation becomes really important, as
only muscle adaptation can then help to improve joint stability again. If
you have poor balance and you injured your ankle 20 years ago, it is
probably still the cause except if you did your balance exercises then it
might just be old age. No cure for that I’m afraidJ
Tendons in turn connects muscles to bones. They actually have very
little stretch and poor blood supply which is one of the reasons they take
such a long time to heal when they get injured. Tendons work well under
tension and must be loaded but they take time to adapt and therefore
overloading them could lead to discomfort but so too does under loading
them so they need to be kept happy. Muscles are what drives us forward
and moves our joints there are several different muscle fiber types we
won’t go into any details let’s just say if you can’t out sprint a challenger
on the final straight it is not always due to lack of effort and exercise.
Anyone do their own butchering or have dissected an animal before?
You would have come across the “fuzz” in anatomy referred to as fascia.
Back in the day fascia was kind of ignored but now is believed to also be
a type of organ and is important regarding mobility. Fascia is what keeps
the muscles together and is connected from your head to your toes
forming a type of fascia morph suit so to speak. The clever folks reckon
that when we sleep the “fuzz” becomes thicker. This also happens with
inactivity and therefore we need to stretch and move. I recently read a
very true quote: “Movement can replace many drugs, but no drug can
replace movement.” So be kind to yourself and move. Massage and/or
foam rolling also helps to breakdown adhesions formed by thickened
fascia. If this is something you are interested in you would like the work
of Tom Meyer called Anatomy Trains for some light reading.
Consequently, these building blocks that move us are pretty well
designed and very impressive but they are quite useless without an
engine or chief in charge to tell them what to do, when and how to do
it…
Enters the brain and nervous system. As you can see the whole nervous
system is continuous. All our muscles are innervated with specific
nerves and this is how the brain communicates and the body responds.
So being “disconnected” from our body will most definitely not be
advantageous to our movement and therefore running style and
technique. Training the nervous system is what helps to make the motor
runs smooth and that is achieved by repetition…10 000 hours ring a
bell?
That was a very quick crash course on what makes us move.
Now that you know what makes you move…let’s have a look at how you
move.
As unique as our personalities, so too does our anatomy vary and this
will influence the way we move. At the end of the day we want to be able
to move as effectively as possible, using the least amount of energy with
the best possible outcome. Therefore, when it comes to running style
you’ll most likely get as many opinions as the people you discuss it with.
The question remains how should I run.
https://youtu.be/nGojEyYBmwc
Maybe you have observed some of these styles out and about. Although
I applaud them as being unique, they are not doing themselves any
favours regarding running economy or demonstrating a smooth running
motor.
Most sports have time dedicated to technique, yet running which is the
basis for many sports, seems to lack this component of focusing on
technique. Especially running for recreation.
Do you ever think of how you run? Do you do running drills???
Keeping in mind that injury prevention is why you are reading this. Why
do you think the way we run is important?
You recently learned about anatomy, do you think alignment of joints are
important? What do you reckon will happen if a structure is exposed to a
load for an extended period of time while it is not well aligned? I think
Newton’s third law might come into play here.
Our feet are the first point of contact we have with the ground. I think
they are a quite important component in the kinetic chain, yet we don’t
always treat them very, well do we? Our feet need to be able to carry our
full body weight on a single leg when we run. These loads can increase
by 5 to10 times your body weight depending on the speed and running
technique. You doing the math?
So why am I showing you all these foot pictures…if you have poor
alignment at rest in example standing…imagine the effects it would have
when you run applying a much bigger force through the foot and ankle?
Think lateral ankle pain, plantar fasciitis, Achilles troubles etc. Are most
of you thinking now, so what shoes should I be wearing?
For the record, I am not a podiatrist and I will never endorse a shoe
brand. My philosophy is choose what you like and what you can afford,
but most important choose the shoe that supports your natural foot
movement.
So rather than suggesting what to choose I will suggest what to avoid.
Our feet are spring loaded to help with shock absorption as is shown by
the longitudinal and transverse or cross arches. What happens to a
spring when it is loaded? It expands or stretch. So, if that spring has
nowhere to go what will happen with it?
Therefore, I will suggest a shoe with a wide toe box.
Does anyone enjoy running in high heels? Second suggestion look for a
shoe that has a low drop or pitch as this will help to avoid landing with an
extended knee.
And a last suggestion, this is purely from personal experience. When
you fit shoes put on both, tie them up and walk around in them, if they
are not comfortable straight away they are not going to get better by
running in them.
Last note on shoes. I recently read an article by Simon Bartold who
works as a podiatrist and it was a very refreshing read. The just of the
article is that we shouldn’t classify ourselves as overpronators or
underpronators and be segmented as needing motion control, neutral,
cushioning or structured cushioning shoes but once again find the shoe
or shoes that work with your natural movement within your envelope of
function, I will get to this soon. There is actually no way of telling if
someone is overpronating as this could be your usual movement
pattern. As my husband always says if it ain’t broke don’t fix it.
The next important area is the lumbo-pelvic complex. It is the connection
of the leg to the trunk and if we have poor stability around the hip or our
hip stabilisers fatigue we end up with poor alignment. Referred to as a
Trendellenberg sign.
As we ladies were created superiorly for purposes of child bearing we
tend to have wider hips and often will have to adjust our gait to
compensate for this during running. Furthermore a lack of strength and
fatigue might not always be the culprits. A study done by a clever physio
in the states Dr. Richard Willy found after a 6 week strengthening
programme some runners still demonstrated a Trendellenburg sign (the
hip caving) which lead them to do motor control work too in order to
retrain the brain to improve alignment with running. Once again train the
brain and think of your movement.
So, I said before lumbo-pelvic. Yes our backs work hard when run along
with an engaging core. If you thought running was done with your legs
think again it is a full body incorporation even though it feels like your
legs are the only structures working as they most frequently want to fall
off. Just a last comment on this area our backs, SIJ or other joints don’t
go “out” if there is more movement it is most likely due to previous
ligament injury that involved major trauma or perhaps you have naturally
lax ligaments or are pregnant or given birth within the last six months
and therefore conditioning of the muscular component would be even
more important to maintain alignment along with motor control, to train
that brain.
Do you or have you had a knee injury before?
The poor knee is almost like a middle child, stuck in between the hip and
the ankle. Both these joints, the hip and ankle, have much more freedom
of movement and potentially can cope better under certain pressures
than the knee. Therefore, the knee would often get “injured” even though
the origin of the problem might be higher up or lower down the kinetic
chain.
Due to our unique anatomical variations, there might be a niggle due to
the tissue trying to adapt to load without its familiar alignment or being
tested above its envelope of function…Soon
Now we need to put this all together, foot, ankle, knee, hip, core…I’m
sure by now you’ve figured out that I go by a picture is worth a thousand
words viewpoint… so to make more sense of running form I’ll hand you
over to Dr. Mark Cuccuzela. I attended a running conference that he
presented in 2014 and this was one of the videos that I find explains
running form so well, much better than I can ever dream of.
https://youtu.be/zSIDRHUWlVo
Finally we get to desert, which as we all now is the most important part
of any mealJ
Now we’ll overview injuries, what they are, how you get them and what
you can do to try to avoid them.
In order to prevent something you need to know how you get it in the
first place. What would you classify as an injury? According to my
Dorland's medical dictionary these are probably the three most common
type of detriments that we experience an injury harm or hurt; usually
applied to damage inflicted on the body by an external force, sprain a
joint injury in which some of the fibers of a supporting ligament are
ruptured but the continuity of the ligament remains intact and strain 1.to
exercise or use to an extreme, potentially harmful, degree. 2. excessive
effort or undue exercise. 3. an overstretching or overexertion of some
part of the musculature. What do you consider the main factor to tell you
that something is not quite right?
PAIN…When we experience this we usually stop and think something
must be wrong? But why do we experience pain? What causes us to
sometimes stop in our tracks?
We’ve all experienced pain, but have you ever thought about pain? What
do you think causes pain? The international association for the study of
pain defines it as an unpleasant sensory and emotional experience
associated with actual or potential tissue damage or described in terms
of such damage. Pain is a subjective experience created and shaped by
our thoughts and feelings within an environmental context.
So would you say that pain always = damage? This fortunately is not
true all pain does not equal damage to tissue but why does it hurt then?
It hurts because we have a brain and your brain is trying to tell you
something.
I’m blonde and growing up I could never understand how a Panadol or
neurofen “knows” where my pain is to make it better, that is until I
learned not too long ago that all the pain we experience is generated by
our brain. So why does your toe hurt if the pain is in the brain?
All our anatomical structures have receptors called nociceptors these
guys respond to temperature, chemical and mechanical changes in our
tissue. So here I am running a long and trip over something, what
happens next…if there is a temperature, chemical or mechanical change
my nociceptors will be triggered and send a signal to the spinal cord
here the operator decides if it needs to go to the boss AKA the brain or if
it is no biggy. If it goes to the brain the pain system can be triggered.
When the brain reckons the body, tissues may be at risk and some form
of action is required you will experience pain (Moseley, 2003).
Therefore, pain is a protective mechanism and our experience of it and
reaction to it is learned.
So now it hurts…most injuries are classified as acute or chronic/overuse.
The main difference is the mechanism of injury. An acute injury usually
involves some type of trauma a fall or a trip etc. with sharp localised pain
potential loss of movement or strength, depending on what has been
affected and the initiation of the inflammatory process that is identified
by pain, swelling, redness and is our bodies way to naturally brace itself.
Please do not ever do the following do not pop an ibuprofen, voltaren,
diclofenak, brufen or any other form of anti-inflammatory medication as
soon as walk through the door! Inflammation is the first step in the
healing process and should be allowed at least 72 hours to do a good
job. If after this time, it is still sore and swollen then yes take some antiinflammatory medication. You can take pain relief in the form of
paracetamol if you have pain. You can apply some ice for about 5
minutes but recently the clever guys said this potentially is not really
doing much and can even hamper lymph function that helps with
healing. You can rest but don’t stop completely if you sprained your
ankle you can do activities that does not aggravate it and if it causes you
to limp get crutches as limping will cause adaptation of the nervous
system and would prolong healing. The sooner you can move as before
without aggravating symptoms or pain the better. Depending on the
severity of your acute injury it can take up to 8 weeks to heal and
sometimes longer. In this time rehabilitation is really important and if
something still hurts after about 5 days regarding the pain intensity and
aggravating factors, you probably need to have it checked. I will talk
about the chronic/overuse injuries soon, but first something that I am
sure you are all familiar with…DOMS
So you have been running on and off doing super sevens cruising along
and then you decide I need to ramp this up I want to run a half
marathon. Wait…what is this? Run21…that sounds AbFab I’m going to
sign up for this…next thing you know you are jumping and planking,
doing push-ups, doing sprints and you are feeling great…until the next
morning… you make it out of bed you feel a little more rigid than usual
but you’re ok and as the day wears on you start sympathising with the
Tinman from the wizard of Oz as everything is seizing up. Your DOMS
has arrivedJ Relax, this is completely normal and just your bodies way
of saying oi we haven’t done this for a while. There is actually not much
they know about this condition and the best thing for it is to continue. It
can last up to 7 days with the second day often being the worst, but will
improve. This is one of those times you can push through a little even
though you might not be able to lift your armsJ
We are all human, right? If Superman or preferably Wolverine is around
please feel free to come introduce yourselfJ
And because we are mere mortals we break down every now and again.
But if I didn’t fall and I have been aligning myself why am I hurting? The
causes of Overuse injuries are often categorised according to intrinsic
factors and extrinsic factors and a few of them, like age, gender and
genetics you cannot really change, along with certain structural
anatomical variations. The best way of describing how this all works is
using the envelope of function. You remember I mentioned that earlier?
I thought envelopes were for letters right, what the heck does it have to
do with my injury? With any activity, we apply load to our anatomical
structures that you guys know all about now. Our body is happy in this
zone when it is in homeostasis where everything is balanced. So now
you’ve started Run21 and perhaps loading a little more than usual that
puts your body at a bit of overload, but that’s ok as that will allow our
envelope of function to grow and your tissues to adapt.
The zone where you don’t want to be is where the structures are pushed
to their limits and exceed their maximum load as this is where they will
let you down and fail. Well done you have sustained an injury! Do you
gain anything from this? No!!! I recall being smart was somewhere in the
runner’s invisible toolbox. It does however happen that this occurred
unintentionally and now your are injured don’t wait for 4 weeks and
hobble along don’t be in denial. The sooner you address it the sooner
you can get on with it.
Fig 1. Envelope of function
What then can I do to prevent injury? The best answer for this is to be
equipped! There is no recipe for staying injury free but being informed is
a step in the right direction. Looking at this you are thinking what a waste
of a Wednesday evening this is so obvious…but do you apply it? Let’s
call this our perpetual cycle of greatness as this can be applied to a day,
a week, a month, a year, a life.
goal
recovery
time
preparation
• conditioning
Fig2. Perpetual cycle of greatness
What is your goal? Every time you go out for a run what do you want to
achieve? But also what is my goal in 8 weeks what is my goal in 8
months, what is my goal in 8 years? Failing to plan, is planning to fail.
Time, this is a commodity that we all wish we had more of. Especially if
you work full time have a family, have a life, therefore it is important that
you allow yourself enough time to achieve your goal as well as time to
prepare and condition yourself for that goal!
My goal, I want to run a half marathon, what do I need to prepare and
condition myself for this? To complete a half marathon, you need to take
roughly 26000 steps. To complete this feeling good I need to take about
26000 steps with good form and a cardiovascular system that can keep
me going for the time it takes me to run 26000 steps(Side note, warming
up and stretching is part of preparation and conditioning). To enable me
to go 26000 steps I have to be mentally ready and prepared to put in the
time to get me over the line. How do I do that? I need rest!
Recovery is essential. The Creator of the Universe incorporated a rest
day who are we to think we can go on and on and on. Recovery is
important you can still be active but try something different to ensure you
use different muscles allowing your brain to master many different
movements. Recovery will allow your envelope of function to expand
and ensure that your body keep adapting to load therefore being able to
manage increased loads. Recovery could be after a hard session, a hard
week, a hard race. Allow yourself to recover refocus and perhaps set
your sights on the next mountain to conquer.
I hope you’ve at least learned one thing tonight and it wasn’t a waste of
your precious time that you could have spent setting a goal or preparing
yourself for that goal. Maybe you used tonight to recoverJ
So, what is the take home message?
Remember what makes you move!
If you can master your nervous system you are A for away…How do you
do this? REPITITION!!!
Think of how you should move!
Every time you head out think of how you move, think of why you are
running and choose one thing to focus on regarding technique etc. to
make you run more efficiently
Injury is part and parcel of the sport, acknowledge it and address it,
be prepared!
NEVER EVER use anti-inflammatory medication within 72 hrs. of an
acute injury! That won’t prevent injury but I feel strongly about sharing
this informationJ
Don’t push through pain but learn when you can ignore it a little.
Know your limits, know your body, know it is okay to say enough,
tomorrow is another day or I can hang in there I’ve got this.
Always prepare your body for what you want it to do! Running requires
strength, power, endurance, speed, and a whole lot of will power.
And lastly but probably most important
Enjoy your abilities, enjoy what you can do with it and be thankful for it!
And never underestimate yourself
I thought we could do with a little inspiration…play video
For any questions feel free to email me.
Kind regards,
Francis
[email protected]