– Derek M. Hansen – October 6, 2008 –
I was watching television the other day and came across a commercial for orthotics. It featured a middle-aged woman who was complaining of foot pain and associated problems. She claimed that a simple prescription of custom orthotics cured her problems and she was able to run two half-marathons. The interesting part for me was watching this woman run in the commercial. It was probably one of the worst examples of running I’ve seen for a while. She was over-striding and excessively heel-striking on every stride. There was no fluidity to her stride and she was basically pole-vaulting from foot-strike to foot-strike. In addition, she was also carrying her arms and shoulders very high, creating significant tightness in her upper body and neck. And, of course, she was running on pavement in several scenes.
The prescribing of orthotics may be required at some point in the injury management process. However, assuming that the problem can only be rectified with an expensive insole is irresponsible. The simple fact that the evaluation by the orthotics provider occurs when the athlete is in an “injured” state puzzles me. For example, if I take a police night stick and smash a runner in the knee with it, I’ll bet that they run with poor stride mechanics resulting in atypical pronation or supination. The orthotics provider – unaware of the night-stick experiment – would most likely analyze the athlete and say that he or she feels that orthotics are required to correct the foot-strike issues. The point being is that the supposed health-care provider often makes no connection between the real cause of the problem and the solution they provide. Much like the prescription of pills and drugs, orthotics are seen as the only solution, rather than one possible component of a comprensive solution. As a good friend of mine once said, “If Baskin-Robbins were developing guidelines for the ideal weight for adults, they would likely set it at 350lbs.”
As with any injury investigation, the bigger picture must be reviewed to identify the primary cause or causes of injury. In many cases, a simple fix with running technique can lead to a reduction in pain. Other sources of pain reduction can include reducing overall training volume, implementing an appropriate stretching program, avoiding hard surfaces and introducing a basic strength training program to bolster weak areas. However, these solutions always seem less attractive to the consumer, who is always looking for the magic bullet cure in either pill form or equipment. Unfortunately, our society is over-obsessed with cure-based solutions rather then engaging in a “prevention-based” approach.
For those that are interested in preventing injuries, an examination of running technique can be a worthwhile process. Although it does not take an expert to spot poor running technique, it does take some advanced knowledge to help improve the running mechanics of an athlete – particularly for the recreational athlete competing in mid- to long-distance events.
Some simple ways to improve running technique for recreational athletes involve combining simple technical cues with basic strength training drills. Examples include:
- Mastering you’re A’s, B’s and C’s. Back in the 1970’s, Polish Track Coach – Gerard Mach – introduced a series of sprint drills to Canadian coaches and athletes. These drills were devised to provide running specific strengthening and technical training to athletes who could not run outside at high intensities for a good portion of the year due to winter conditions (i.e. snow). The drills could be carried out in a confined space indoors, such as a gymnasium. What Mach eventually found out was that these drills helped runners training in any environment, and he incorporated them into the training of all his sprinters.
The “A” drill is a basic knee lift drill that can be performed in a marching, skipping or running manner. The “B” drill is commonly done in a skipping motion, but has also been used as a marching and running drill as well. The “C” drill is a butt-kick/heel-lift drill which is most often implemented in a running fashion. In all cases, these drills can be used for modeling technique. More importantly, the drills build hip flexor muscles, postural strength and ground contact power. They can be used to develop speed, strength or specific endurance.
Unfortunately, many coaches do not know how to properly teach these drills. The technique must be optimal in order to yield significant results for your actual running. A good coach will guide you through these drills gradually over short distances, making adjustments where necessary. If properly implemented in the right amounts, these drills will dramatically help your running performance and reduce your incidence of injury.
- Determining proper arm mechanics. Optimal arm carriage mechanics are critical for reducing stress in various areas of your body. The arms counter-balance the force characteristics and action of the legs. At high speeds, the arms must move powerfully through a significant range of motion to counter-balance the power output of the legs. At lower speeds, the arms work subtly to coordinate the upper body with the lower body in a metronome-type fashion. However, over-emphasis on the arms over longer distances can be detrimental to the performance by not only draining energy from the athlete, but also increasing muscle tension in the shoulders and upper torso. This increase in muscle tension can not only constrict breathing, but also increase stress on the spine and pelvis. Good running economy over long distances requires that the arms move smoothly and pendulously through a limited range of motion, with the shoulders relaxed and down.
- Simple plyometrics for improving foot-strike. Two-foot hops over a short distance, emphasizing the elastic action of the feet and ankles are a great way to improve lower leg strength and enhance elasticity for efficient running. Once the foot is strong enough to act as a natural shock-absorber, more stress is taken off the rest of the body. High level explosive athletes will perform two-foot jumps over high hurdles for their training. However, recreational distance runners need only to perform jumps over 6 to 10 inches in height to get a significant benefit that will transfer to their foot strike. Consecutive jumps can be done over a 10 to 15 meter distance for 4 to 8 sets on a soft surface such as grass.
- Aim for mid-foot striking. Heel striking is very common for recreational runners. Most running shoes have been designed with heel striking in mind. However, heel striking can lead to significant stress injuries throughout the lower extremities, and even chronic pain in the lower, mid- and upper-back. Heel striking, in my mind, is also indicative of over-striding, weak lower extremities and poor mechanics in general. It is the equivalent of pole-vaulting from stride-to-stride, braking all of your forward momentum each time your stride contacts the ground.
Mid-foot striking allows for proper distribution of force throughout the foot, taking full advantage of the elastic properties of the foot and ankle joint. Landing toward the middle of the foot also allows your foot to strike the ground closer to your center of mass (i.e. closer to underneath your hip), thereby reducing braking forces and allowing your hip height to be retained consistently throughout your stride. Incorporating your “A” marches, skips and running drills will help to re-orient your foot strike to the proper location as well as build the foot strength required to maintain proper ground mechanics.
- Stretching on a daily basis. Gentle static stretching can help to re-set muscle tone and elongate shortened muscles after a running workout. I’ve worked with many athletes that had lower leg pain (i.e. foot, ankle and/or shin pain) which we eliminated through a combination of static stretching of the hips, quadriceps and calves. In other cases, light manual therapy or massage of these areas was required to eliminate pain or discomfort altogether. Removal of soft-tissue restrictions is probably the best way to effect positive changes to your running mechanics and reduce the risk of injury. If muscles are hypertonic, they are not able to properly produce the forces required for proper running mechanics, as well as eccentrically absorb the impacts of ground contact. Impact forces are then transferred to the tendons, ligaments and skeletal structures and overuse injuries begin to rear their ugly head. Regular maintenance in the form of light, static stretching and other regenerative activities such as contrast-hydrotherapy, sauna, massage and other soft-tissue therapies must be integrated into your training program.
- Include a basic warm-up progression. Many runners simply walk out their front door and start their workout. The first part of their run becomes their warm-up. The problem with this approach is that the muscles and connective tissues are not warmed-up by a gradual increase in circulation. Without appropriate circulation, muscles are not supple enough to adequately absorb the impacts of the initial phases of the run. Additionally, the joints of the lower extremities (hips, knees and ankles) will not be properly lubricated with articular fluid to ensure that joint cartilage has maximal elasticity for shock absorption. Thus, a lot of damage can be done in the initial stages of a run if a proper warm-up is not included in the session. Some very low intensity running on a soft surface should precede the actual workout, with some dynamic stretching and mobility work around the hips (including hamstrings, glutes, hip flexors and quads).
As you will discover from reading most of my articles, there are no quick fixes and cookie cutter approaches to good health and performance. When it comes to solving issues of chronic pain and over-use injuries, all individuals must be examined using a comprehensive approach. It is entirely possible that some individuals may require the use of specialized orthotics for their shoes to address alignment or support issues. However, in most cases, implementing a collection of good practices and habits will yield long-lasting and cost-effective results. The following Chinese proverb still holds water:
“Give a man a fish and he will eat for a day. Teach him how to fish and he will eat for a lifetime.”
“Give a man a fish and he will eat for a day. Teach him how to fish and he will eat for a lifetime.”
When prescribed indiscriminately, orthotic inserts are a band-aid solution that do not encourage strengthening of the lower leg apparatus and improvement of overall running mechanics. Teaching the body good mechanics and surrounding it with good preparation, including overall conditioning and recovery and regeneration techniques, will yield the best results. And most of all, try to limit your volume of running on hard surfaces such as concrete and asphalt.