A Strong Body is Rarely a Painful Body

When you're not running, do you spend more time stretching or strengthening?  In my work as a physiotherapist at the Running & Gait Centre at the Pan Am Clinic, I have had the opportunity to perform many running gait assessments since we launched in November.  We have been performing assessments on injured athletes and on those who simply want to identify any “red flags” within their running biomechanics that could lead to injury in order to prevent any down time.  Already, I am starting to see some patterns and themes develop that confirm what many coaches and successful runners already know.  A strong body is rarely a painful body.

I have been known to say that if runners would spend as much time strengthening as they do stretching, I would see a lot less running injuries in my practice.  Coincidentally, lately I have found myself prescribing far more focused strengthening than stretching exercises to the keen runners who have come to our centre seeking solutions to their running injuries. Don't get me wrong.  Spending time stretching is good, but we can't forget strengthening as well.

Strength needs to be balanced and it needs to be functional.  A joint needs to be supported on both sides, side to side and front to back.  Multiple joints need to be able to work together as part of the whole lower kinetic chain in order to produce the desired motion for any sport.  Strengthening exercises for running need to replicate the desired muscle, joint or lower kinetic chain function as closely as possible to result in optimal biomechanical function and performance.

As your running season progresses and you find yourself spending more and more time logging miles, it’s easy to neglect your strengthening regime.  However, even a few short strengthening sessions per week can create better balance in your body and protect you from injury.  Here are some suggestions when choosing your strengthening exercises:

1. Make it functional.  Always ask yourself, ‘why am I doing this exercise?’  Keeping in mind this article is intended for runners, try to do most of your exercises standing up.  Better yet, consider standing on one foot as much as possible, as 100% of running is spent with either one foot or no feet on the ground.  You will improve not only in strength, but neuromuscular control, balance, proprioception and your ankle and foot cannot help but get stronger.
2. Go minimal while strength training.  As long as it is safe and allowable to do so, wearing minimal shoes or going barefoot while doing your functional strength training encourages your foot and ankle muscles to work more.  You will be able to sense fine adjustments needed to stand stronger on one foot while barefoot than you will with your running shoes on.  Try to keep your arch engaged (pretend there is a pebble or tack under your arch) and your toes relaxed, while avoiding rolling onto the outer edge of your foot. This encourages the deep muscles in the sole of your foot to work optimally. 
3. Work multiple muscle groups at once.  Not only is this more functional, but it is more efficient and every runner knows that time is precious.
4. Don’t neglect eccentrics.  The eccentric or negative function of a muscle is a controlled lengthening contraction.  Running is essentially a controlled fall with every foot strike and your muscles need to slow the impact force of your body weight as each foot hits the ground. This happens eccentrically for most muscle groups and is where breakdown of the body and injury most often occurs.  For each exercise you do, try a 2:1:4 tempo, where you shorten the muscle on a 2 count, hold for a 1 count, and lengthen or return to the starting position on a 4 count.
5. Optimize your core for running.  We all know that having a strong core is important and there are dozens of great exercises out there.  Generally, while running the core functions to control rotation and derotation as we transfer energy from one limb to the other with our arms swinging in the opposite direction.  While you will be generally working your core if your workouts are functional, you should incorporate specific core exercises that involve reciprocal motions similar to running, such as mountain climbers, reverse mountain climbers, and the bicycle.

Bicycle

Mountain Climbers

Reverse Mountain Climber

Reverse Mountain Climber - TRX

If you have very little experience with strength training, consider asking for help from a professional such as a coach, personal trainer, or physiotherapist.  If you know your body is a little bit complicated or cranky, and you want a tailored plan to address your specific weaknesses, consider visiting us at the Running & Gait Centre for a comprehensive biomechanical and physical assessment. We’d love to help!

Kim Sénéchal is the lead physiotherapist at the Running & Gait Centre: Foundation Rehabilitation Services at the Pan Am Clinic.  She is also an ultra marathon runner and run coach.

**This article was originally published in the Manitoba Runners Association February newsletter, On The Run.

Running Strong and Injury-Free: Using the Off Season to Your Advantage

The race season is over.  There are no more race goals, no more training plans on the fridge.  The holiday season has arrived and it’s easy to lose focus and start running inconsistently, setting yourself up for a potential injury. Conversely, maybe you’ve been battling an injury all season and are hoping it will start to heal over the holidays.

The off-season is the prime time to check in with your body.  It’s an opportunity to be proactive rather than reactive.  

Some primary causes of running injuries are:

• Training errors: This includes too much too soon, poor planning and periodization, and overtraining.
• Sub-optimal biomechanics: This leads to less ability to absorb training errors.
• Poor body alignment: Sometimes you can change this, sometime you can’t.
• Muscle Imbalances: Imbalances in strength and muscle length can lead to an asymmetrical gait pattern which is a big predicator of injury in runners.
• Lack of variety:  Running involves highly repetitive movement patterns that can lead to overuse of key muscles if each footstep lands on the ground in the same way.
• Incorrect or worn out shoes: This is less of a factor if you have addressed biomechanical, alignment and muscular factors, but should be considered.

Here are my top five suggestions for setting yourself up to be injury free in the new year.

• Slow down and do a self assessment.  Pay attention to those niggles and pains that you’ve been ignoring all season.
• Identify and correct the risk factors you can on your own.  If your gut is telling you something needs to be changed, follow your instinct.  Make changes slowly and gradually.
• Cross train.  When the weather precludes you from getting outside as much as you’d like, the off-season can present the perfect opportunity to add variety to your training through cross-training.  Consider activities like spinning, cross-country skiing, skating, weight training and yoga.
• Make a plan.  Take the time to develop a training plan for the next season or race.  Hiring a coach can provide invaluable guidance, but there are many good training plans available online.  This will help you train smart by increasing your mileage gradually and intelligently, and balancing hard training days with recovery and rest days. Recovery is as much a part of training as running hard, and it’s important to build rest into your plan.
• Get professional help in areas you can’t correct yourself.  Attempting to make changes to your biomechanics, alignment and strength are best done in the off-season, not at the peak of your training cycle when your body cannot absorb those changes well.  Having professional guidance can help you focus your efforts in the areas you need to address most.

If you are a runner who has been dealing with an injury for a long time with no resolution, or a runner who wants to prevent future injuries from occurring as you reach for your next big goal, you might want to consider visiting the Running and Gait Centre at the Pan Am Clinic for a 3D Biomechanical Gait Analysis.  The centre is the only clinic in Manitoba to offer this highly advanced assessment in a clinical setting.

3D Gait Analysis

During the assessment you will have 16 sensors attached to your joints, and five sensor clusters attached to your legs and pelvis. As you run, six cameras measure your gait pattern.  A report is generated with 16 gait variables, comparing you to a database of thousands of runners.  This data is combined with a very thorough physical assessment that seeks to correlate your gait report with your measures of alignment and muscle strength and length.

You will then return to the centre for a second visit where you will be presented with a comprehensive report and plan for addressing your individual risk factors and weaknesses.  Specific strengthening, stretching, shoe and orthotic recommendations, and targeted physiotherapy treatment will all result in improved running form and efficiency. Research has shown this method to be very effective in helping runners perform pain-free, and to their peak potential.

The Running and Gait Centre is currently accepting bookings for January 2016.  For more information, visit our website or call 204-805-1912.Kim Sénéchal is the lead physiotherapist at the Running & Gait Centre: Foundation Rehabilitation Services at the Pan Am Clinic.  She is also an ultra marathon runner and run coach.

NB: This article was written for the Manitoba Runner's Association newsletter, Dec 2015.