Pronation: Not Always The Bad Guy

Physical therapists frequently analyze the running mechanics of individuals in a clinical setting, as running is an activity that carries with it a relatively high rate of injury. In fact, per athlete more injuries occur from running than from CrossFit, a sport with a reputation for being injury provoking. Far too often in working with runners, I hear many individuals talk about their tendency to pronate during the running cycle, as if pronation is a 4-letter word and the root cause of all running-related injuries. However, I’m here to tell you today that pronation is a perfectly normal and healthy aspect of the running cycle, allowing us to absorb shock and conform to undulations in the ground, as a pronated foot tends to be more pliable and flexible. Here is a synopsis of the foot position at various points in the running cycle:

• At initial contact (heel strike in approximately 80-90% of individuals), the foot is held in a supinated position, which means the arch of the foot is high and the foot as a whole is more rigid.

• As you transition from initial contact to a foot flat position, the foot transitions from a supinated position to a pronated position in order to quickly dampen the force from striking the ground and conform to the contours of the ground. An inability to pronate during this phase would expose the tissues in your foot to higher amounts of force, making running more uncomfortable. This would be similar to jumping off of a table and landing on locked knees.

• As you transition from a foot flat position to push-off, the foot must quickly transition back to a supinated position from a pronated position in order to efficiently propel you forward. As we mentioned earlier, a supinated foot is more rigid and a pronated foot is more flexible. A greater propulsive force can be generated by pushing off of a rigid foot compared to pushing off of a flexible foot. The inability to re-supinate the foot for push-off would feel similar to running in sand.

So as you can see, pronation is not a bad thing. Too much pronation or at the wrong times in the running cycle could be problematic, but that is true of supination as well. Furthermore, research on the link between pronation and running-related injury is a bit inconclusive. While it is true that some running-related injuries have been correlated with excessive pronation, there is some evidence that it can actually be a compensatory protective strategy in runners.

The foot has been shown to excessively pronate as a result of a lack of stability up the chain, typically at the hip joint. Therefore, it may not always be wise to simply jam an orthotic insert in your running shoes if you have been told you are “over pronating” when you run. A running analysis along with a thorough orthopedic physical therapy examination should precede any decision on the use of orthotic inserts or footwear selection. How we run is determined by more than just the foot and we need not blame all of our running aches and pains on pronation.

Flexibility 101: Static vs. Dynamic Stretching

Have you ever wondered when you should be stretching with respect to your running program? More specifically, have you ever wondered what type of stretching you should be doing? While the research on stretching is a bit of a mixed bag, there are some tried-and-true principles to follow in book-ending your training runs, no matter your experience level within the sport.

Prior to running, we want to avoid static stretching, focusing rather on dynamic movements/stretches to warm up and prepare our muscles for the rigors of running. Static stretching has been shown to temporarily reduce the power output of our muscles, something we do not want to do prior to a run, as a reduced power output may make us slower. In contrast, a dynamic warm-up activates key muscle groups utilized during the running cycle in order to prepare those very muscles for sustained work. It is important that the dynamic warm-up closely mirror the physical demands of running in order to prepare the most appropriate muscles and tissues. In other words, performing walking lunges and skipping motions would be more appropriate than hitting a heavy bag. Finally, the dynamic warm-up should be simple and concise, requiring no greater than 5-10 minutes to complete. If longer or more complex, it is more likely you will skip it! Here is a sample dynamic warm-up routine:

Dynamic Running Warm-Up

Following your run, it is safe and appropriate to perform a static stretching routine, targeting the muscles and joints you stressed during your training run. Static stretching should be gentle and prolonged, holding each position for approximately 60 seconds. More aggressive stretching is not more effective, as it can more easily activate the stretch receptors in our muscles and tendons, limiting the ability for the muscles to relax and let go. Aggressive stretching also increases our risk of over-stretching and subsequently injuring our soft tissues. So keep it light! Key muscle groups to stretch following a run are the calves, hamstrings, quadriceps, and gluteals, all of which are primary movers during the running cycle. Here is a sample static stretching routine:

Static Stretching Cool-Down

Both routines should be easy and pain free. If you are experiencing discomfort with any of the positions, stop and move on. If possible, consult with a physical therapist or other medical professional if you have any questions or concerns regarding your specific stretching routine.

RUN ON!

Foam Rolling 101 for Endurance Athletes

Have you ever been told you need to foam roll as part of your training program? If so, did you know why you were foam rolling or how you were supposed to go about doing it? Here is a quick Q&A guide to those interested in a simple and effective training tool.

What is foam rolling?

Foam rolling is a common form of self-myofascial release most often used by endurance athletes to help combat delayed onset muscle soreness (DOMS).

What are the benefits of foam rolling?

While foam rolling is most often used to treat muscle soreness and enhance recovery following intense bouts of exercise, foam rolling has also been shown to be an effective tool for improving joint range of motion at the hip, knee, and ankle without compromising muscle performance. Therefore, it can be beneficial when used either pre or post-workout. You will often see foam rolling utilized as a therapeutic tool used to treat Patellofemoral Pain Syndrome (i.e. runner’s knee), IT Band Syndrome, Achilles Tendintis, and Medial Tibial Stress Syndrome (i.e. shin splints).

What areas should I focus on?

Targeting sore areas of the muscles in the legs following a training session can be an effective way to enhance muscle recovery and reduce the negative effects of DOMS. Common regions to foam roll in the legs are the calves, hamstrings, gluteals, quadriceps, IT bands, and adductors. Here is a video of a sample foam rolling routine for runners:

What areas should I avoid?

In general, foam rolling is limited to soft tissue, as it is a self-myofascial release tool. Avoid rolling over bony prominences (bumps) or joint surfaces, as this is more likely to be aggravating as opposed to therapeutic.

How long should I foam roll each region?

Studies suggest that foam rolling an area for 30-60 seconds is sufficient to enhance joint flexibility and reduce muscle soreness. No need to roll much longer!

Other considerations...

Foam rolling is meant to be a tool utilized in conjunction with, not a substitute for, other evidence-based training principles. It will not eliminate your risk of getting injured if you are over-training or training inconsistently. As always, please consult your primary care provider or physical therapist if you have any questions or concerns before implementing a new wrinkle to your exercise routine, such as foam rolling. If you experience any progressive increase in pain or discomfort with foam rolling, stop and seek guidance from a healthcare provider or fitness professional.

How To Safely Increase Your Running Mileage

If you are in the midst of training for a marathon or half marathon, or thinking about running one in the future, you will inevitably be faced with the task of increasing your weekly running mileage in preparation for race day. Currently, there are many commercial training programs readily available online, with varying degrees of progression, at various costs to the consumer. But how do you evaluate a training program and select the right one for you? An important consideration is how much should you be increasing your running mileage each week. Research suggests increasing your running mileage no more than 10% per week in order to minimize your risk of injury, while still improving performance. Anything more and you are significantly increasing your injury risk. Contrary to popular belief, the leading cause of running-related injury is overuse or improper training progression, not running form, shoe selection, or running on pavement.  Too much, too soon, and/or too fast can lead to situations where tissue breakdown exceeds the ability of the tissue to regenerate. This is the primary mechanism of an overuse injury. Common overuse injuries seen in runner's include patellofemoral pain syndrome (runner's knee), median tibial stress syndrome (shin splints), Achilles tendinopathy, and plantar fasciitis. So if you are experiencing any nagging aches and pains while running, assess your training program and see how much your running mileage is increasing each week.

Quick Guide To Improve Running Efficiency And Reduce Injury Risk Via Running Cadence

Here in the Pacific Northwest, we have many road and trail running races scheduled in the summer and fall months, as the rainy season subsides for blue skies. No matter if you are planning on running a 5K, 10K, half marathon, marathon, or even ultra marathon, you may want to consider evaluating your running cadence before starting your training program. Running cadence is a measure of the number of steps you take per minute while running, with an ideal rate falling between 160 and 180 steps per minute. Not only has this range been linked with improved running efficiency/economy, but it has also been linked with a reduced rate of injury. To measure, simply count the number of steps you take while running at your training pace for one minute, or count the number of steps you take while running at your training pace for 30 seconds and multiply by two. If you are on the low end of the range or fall below 160 steps per minute, you may be over-striding, putting yourself at an increased risk of developing a nagging overuse injury, such as Patellofemoral Pain Syndrome, which will negatively impact your training. Try measuring it for yourself during your next training run and see where you stack up!