Brian Schiff’s Blog
Injury Prevention, Sports Rehab & Performance Training Expert
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I work with lots of runners, both recreational and competitive, who are seeking to improve performance or overcome injuries. The most common issues I see are iliotibial band syndrome (ITBS) and patellofemoral knee pain (PFP). With every runner, I routinely perform FMS and video analysis to get a better understanding of their movement patterns, gait mechanics and asymmetries.
Without question, they tend to ask me if there is a better way to run. Obviously, every accomplished runner has his/her own opinion on the matter. Some prefer forefoot or midfoot strike, while other do just fine with a heel strike pattern. In essence, we do not have any sound research or biomechanical evidence to declare one a winner. Since I work with many injured runners, I am always seeking to find the most efficient ways to reduce injury risk and eliminate pain.
A paper just published in the September 2015 American Journal of Sports Medicine by Boyer and Derrick sought to answer the question of how shortening the stride length or altering foot strike pattern may impact certain variables. Specifically, the authors sought to compare step width, free moment, ITB strain and strain rate, and select lower extremity frontal and transverse plane kinematics when stride length was shortened 5% and 10% in habitual rearfoot and habitual mid-/forefoot runners using both strike patterns while shod.
One of the most common PT clients I see is an injured runner. There can be a umber of different reasons or factors involved leading up to a running injury, but I wanted to focus on this idea of gait retraining that is taking place today. With the advent of Born to Run and minimalist footwear, people have begun to question and debate what the best way to run is.
Is this suited for everyone?
Let me just say right away that I do not believe there is a simple answer here. Human beings are all unique and have different genetic and biomechanical makeups. What this means in effect is that they have their own set of “issues” if you will that I classify into common categories such as:
- Static alignment problems (arch, knee, hip, etc)
- Static and dynamic balance deficits
- Inefficient gait mechanics
- Muscle imbalances
- Soft tissue tightness
- Recurring pain patterns
The list could go on and on, but you get the point. The idea of “re-teaching” someone how to run differently than their natural motor pattern dictates in not easy and is a decision that should be well thought out and based on sound decision making. We are pre-programmed at birth with certain native motor patterns and running is one of those patterns. Generally, your brain finds the most efficient way for you to run in your own body.
Now granted, some run much better than others. Perhaps we can say athleticism plays a role in this, but as we grow and reach skeletal maturity our body type, training experience, strength and environment are also major factors . With that said, I know that runners with recurrent and/or chronic pain are looking for a finite solution to their problem. They grow frustrated when they are unable to log all their miles or finish a race.
If traditional PT or relative rest fails to alleviate the pain, we must delve deeper and look more closely at their gait. I think video analysis is a great tool for doing this. We use Dartfish at my clinic, and this is very useful for breaking down gait mechanics and detecting things like heel versus forefoot striking, overpronation, asymmetry side-to-side, trunk inclination, etc. Once we find things on video we must also correlate these findings to our clinical screening to uncover a cause and effect relationship.
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