Running Without Pain

August 23, 2017 at 4:49 PM

Nowadays runners have access to so much information about running, that it can be both amazing, and confusing with many opposing viewpoints.

As a Physio, I have an advantage when it comes to ideas that are hovering in the running sphere. I have seen firsthand when something goes wrong in a runner. I get to see runners when they don’t have the ability to run from injuries; from this, I see their frustrations and sometimes the negativity towards running. From personal experience through dealing with my own injuries, I can understand and relate to these runners’ emotions.

Throughout my many years of being a Physio, I have seen many running related injuries. This process of seeing very similar injury patterns has prompted me to think about how and why these running injuries occur. While you are at University you gain only a simplistic overview of running injuries, without gaining a chance to go into the specifics of these injuries.

I used to believe that when you go running, you were only increasing strain on certain painful tissues, be it the ITB, the patella tendon, or the calf.  When physios see these strains, we focus on getting that tissue stronger, more durable, and able to take more load. We believe that by increasing the strength the problem will be solved. This simple idea definitely works for a percentage of the runners that I see. However, it definitely does not solve all runners’ injuries. These patients that were taken through this process experienced a gain in strength; however, the pain returned again leading to an unsolved injury.

From this, I really started to ask why. Why are you not getting better? Why can’t you run without pain? I went out and tried to find these answers. Some of these answers are definitely not easy to find, and there is plenty of contradictory, misleading and incorrect information out there. However, what I did learn is that running is such a unique movement. It is very different to the movement of walking or the movement of cycling.  While this difference in movement sounds so obvious, it is often overlooked. This is because it appears to look like a similar movement, as your ankles and knees go through a similar movement. But the key difference is that running is highly dynamic. Dynamic movement is what running is, it is the movement that makes running so amazing.

So what does this mean? How does this information help you? 

Firstly, from a rehab point of view, I think people in this running sphere have forgotten this idea, that we have not taken this unique property into account. Has your rehabilitation from a running injury used dynamic movements? 

Secondly, if you’re not injured, does your training take this same unique property into account? Do you prepare your body for dynamic movement? Are you ready for dynamic movements?

Don't get me wrong there is definitely a time and place for strengthening that is not dynamic. But to prepare our runners for running, we need to put some of these specific movements into these programs.

A nice place to start is focusing on the foot and ankle. 

We want the foot and ankle to dynamically propel us forward in the running motion. 

For this to occur there needs to be some basic strength in the muscles surrounding the ankle.

So I always start with calf raise.

If you can complete calf raise, we next go into calf raise walk (Trying to keep ankle around 90-100 degrees). Check out Calf Raise Walk from Auckland Physiotherapy on Vimeo. 

From there we progress into jumping and then into Hopping Forward.

Hopping is quite close to the running motion, however, is not the same. And, one of my rules is that if you can hop, then you are strong enough to run. Can you hop? Does your hop look like the video? 

I want to help people run better, and I want to help prevent running injuries. Across everyone that I see in the clinic and for running assessments, the one recurring theme is that people need to be stronger, not just in basic strength, but in the idea that you need dynamic strength to run. Try the above exercises, start at calf raise, if you find it really easy then move onto the calf raise walk. Do it for a week or two, and then add in the jumping and the hopping. My advice is to go slow to start, and don't overload the hopping too much to start with. This starts the process of developing the specific strength that is so unique to running.

 

Paul White

Senior Physiotherapist and Running Coach