Injuries & How to Prevent Them: Part 5

31 May 2020

FORM & TECHNIQUE

If we do something wrong or badly we increase the risk of harm, and do it often enough and over a long period of time and the chances keep going up.  Undoubtedly that will also be the case in running.  Poor form and technique will increase the likelihood that injuries could occur, that’s not to say that perfect form and technique eliminates any chance of injury, but that likelihood will be greatly reduced if our technique is good.

Francis et al. (2018) found that 28% of all running related injuries were in the knee, 26% ankle and foot and 16% in the shank.  Women were more likely to incur knee injuries, whilst men are more likely to incur ankle/foot injuries.

 

Factors that contribute to increased load and ground reaction force

  1. Excessive vertical displacement, or too much bounce.  The higher you go when you leave the ground the further you fall back to earth again, the further you fall the harder you land.  Therefore, excessive vertical excursion will result in higher landing forces with every step.  This increases the chances of overuse injuries.

  2. Foot strike ahead of the centre of mass, it doesn’t matter if you forefoot, midfoot or heel strike.  Landing ahead of your centre of mass adds stress.  This is usually associated with the with knee being straight and locked on when your foot strikes the ground.  Low step rate, a step rate (that is the number of steps per minute) of less that 160 is associated with over striding, although step rate will change with speed.

  3. Feet crossing to land in line, as if running along the white lines in the road.  This might look good for models on the catwalk but not so good for running as it encourages too much hip adduction and rotation.

  4. Over pronating, most people pronate a little, but when it becomes excessive then it can be an issue.  Keeping a knee gap as you run means your feet travel in a straight line and increases the likelihood of a good foot strike and reducing that overpronating.  You don’t need shoes to correct this.

Running economy.

If we run with lots of bounce and moving up and down with every stride this is not going to be economical.  We run horizontally, meaning that any vertical movement is wasted energy.  If we land ahead of our centre of mass we effectively apply the brakes every foot strike, again this wastes energy that we put in to that stride.  Increasing our step rate by 5%-10% actually improves our running economy as well as reducing the impact load of each foot strike. (Heidercheit et al., 2010).  Increasing step rate by 10% does not significantly increase oxygen consumption either (Chumanov et al., 2012).

 

Changing foot strike patterns

Simply changing from a rearfoot strike to a forefoot strike was promoted as the answer to all our running problems in the book ‘Born To Run’ indeed we were even told that running barefoot was the way to go.  However, it really isn’t as simple as that.  Whilst being a rearfoot striker increases the load in the knee and hip, forefoot striking will engage the calf muscles more.  Simply running on the forefoot but still over striding still results in excessive loading compared to a shorter stride with a flexed knee (Shih et al., 2013)

 

Putting it right.

In part 2 I talked about warm ups, these should include running drills.  These drills are there to promote good form and technique, so don’t just go through the motions, think about the technique for doing an ‘A’ & ‘B’ Skip, or the reason for doing straight leg runs, high knees, heel flicks, etc.  They all promote good foot landing mechanics, by doing these right you promote good technique for all running.  Consider the use of a metronome app, especially when you use the treadmill, see what you stride count is by counting your steps for one leg for 12 seconds and multiply by 10.  Of course, your step count differs with running speed, but if it’s around or less than 160 then consider adding 5%, the metronome is a good way to running that beat and that step rate.  Get used to the 5% change before maybe adding another 5% if you need to.  Transition slowly, moving from over striding with a straight leg to landing under your centre of mass will engage your calf muscles more, so do this gradually over 3-4 weeks.  Get a gait analysis, it's not easy to see what you're doing wrong or right yourself, a gait analysis can help to identify what should be corrected and how to approach it.  Don't try to change more than one thing at a time.

 

Summary

All the things we’ve talked about so far will definitely help, but it doesn’t matter how flexible we are or how string we are, that won’t compensate for poor form and technique.  That being said, if our form is good but we aren’t strong enough then we are not much better off.  With knee injuries being the most common it makes sense to consider foot strike related to the bodies centre of mass, especially so for women, who are more likely to have knee injuries. 

In the final part we will look at training errors, and how injuries come about because we don’t execute our training in a smart way.

 

Reference:

Chumanov, E., Wille, C., Michalski, M. & Heiderscheit, B. (2012). Changes in Muscle Activation Patterns when Running Step Rate is Increased.  Gait Posture 36(2): 231-235

 

Francis, P., Whatman, C., Sheerin, K., Hume, P. & Johnson, M. (2018).  The Proportion of Lower Limb Running Injuries by gender, Anatomical Location and Specific Pathology: A Systematic Review. Journal of Sports Science and Medicine 18(1): 21-31

 

Heidersheit, B., Chumanov, E., Michalski, M., Wille, C & Ryan, M. (2011).  Effects of Step Rate Manipulation on Joint Mechanics during Running.  The American College of Sports Medicine 43(2): 296-302

 

Shih, Y., Lin, K-L. & Shiang, T-Y. (2013).  Is the Foot Strike Pattern More Important Than Barefoot or Shod Conditions in Running.  Gait Posture 38(3)

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