- Are you heel-striking?
- Are you landing with your foot in front of the body?
- Are you over-striding?
- Are your arms crossing your center-line?
- If you answered yes to any these, you may be putting yourself at increased risk for a running injury.
- The way you run can reduce shock to your knee by as much as 50% - an amount far more than the shock absorption of cushioned shoes.*2
- This was confirmed by a study by Dr. Timothy Noakes in 2003: "He put runners on a treadmill, hooked electrodes up to their knees, and measured the shock transmitted through them."*2
- See below for details of this soft running form.
Over the course of 2 years, I went to several doctors (chiropractors, orthopedists, sports podiatrists, physical therapists) and tried several different types of shoes for my IT Band/Runner's Knee issues. And nothing helped!
Many health care professionals treat the symptoms rather than the cause. And you can't really blame them. That's what some people want...a quick fix where they don't have to do anything but take a pill or get a cortisone shot. I wanted to fix the problem and not rely on anti-inflammatories, orthotics, braces, or shots. Yes, it was slower and more time-consuming to track down the problem and correct it. But in the long run it paid off. I fixed my running form, which allows me to run more efficiently and without pain.
My quest for answers began because my left IT Band always had stabbing pain after about 8 miles. I came across a reference in Lore of Running*3 that suggested that an over-aggressive treatment of Runner's Knee with orthotics could actually result in an IT Band issue. I had been wearing my $450 orthotics for over a year and my IT Band was not getting better. I figured, what do I have to lose? So, I took them out and started running without them. At first, I didn't notice a big difference. I had a little IT Band pain, but not as bad as previously. But then I started getting aches/pains on other parts of that leg. I was tempted to go back to the orthotics because I had a marathon less than a month away. However, I figured out that I was using the muscles, ligaments, tendons that I had not been previously using due to the way the orthotics caused my feet to move. So, I stuck it out. The IT Band issue became better (I could run full distances now but there was still pain).
Once I solved the IT Band issue, I still had "Runner's Knee", which was the reason I had the orthotics in the first place. It was back to doing more research. After researching the problem with numerous books, articles, and videos, I realized that I had been running incorrectly. I was overstriding, landing with my foot in front of my body, landing on my heels, not keeping my shoulder, hips, and ankles in a straight line, and breathing incorrectly. There wasn't much I was doing right!
- Landing with the foot in front of the body causes the knee to receive the greatest impact from the ground.
- Landing on the heel bypasses the use of the elastic soft tissues in the plantar fascia, calf, and Achilles Tendon that were designed to handle landing. Although there was some disagreement in the articles I read on whether landing should be on the midfoot or ball of the foot, they all agreed that landing should NOT be on the heel of the foot. The heel should only be used for balance. Sprinters mainly use the balls of their feet when running, but endurance runners should use their midfoot for landing. A related topic to heel striking is running shoes with huge padded heels. It has been said that those encourage heel striking and there is a huge movement underway for minimalist shoes and barefoot running. I agree that barefoot/minimalist shoe running can strengthen the feet/ankles. I also agree that it helps promote a better running form because it hurts to heel strike if you don't have padding on your heel. The research that remains to be done is whether there is less impact stress (on a hard surface) using a level (same height forefoot/midfoot/heel), flexible running shoe as running barefoot or using a minimalist shoe. I'm middle of the road on this issue. I run in Vibram Five Finger Bikilas or Terra Plana Evos once a week on a dirt trail. The rest of the week I use neutral, flexible trainers with a level outsole. When using my trainers, I still use a soft running form, which I believe is the benefit of barefoot/minimalist shoe running.
- Overstriding also causes the foot to land in front of the body and wastes a lot of the elastic energy that could be used for the next stride. Both of the sources I found suggested a cadence of 175-180 footstrikes per minute (regardless of stride length) to prevent overstriding. I have created some mp3's I played on my ipod to help me get my foot strike at the correct rate. I started with the slower one, trying to have each foot strike with each beat. Then I gradually increased my foot strike until I was at the 180 foot strikes/minute. Click here for the 170 footstrikes/min mp3 and click here for the 180 footstrikes/min mp3. You usually have to work up to that stride rate by increasing your current rate by a few foostrikes per minute per week.
- Although there was some disagreement on whether runners should lean or not while running, the sources I rely on said that a slight lean from the ankles is very beneficial and what many of the elite Kenyan runners do. The lean from the ankles (not the waist) still keeps the shoulders, hips, and ankles in a straight line, but receives the benefit of gravity aiding forward propulsion. ChiRunning suggests always leaning, with more of a lean the faster you go. The Pose Method of Running and the two articles cited below suggest leaning slightly from the ankles. That makes the most sense to me and has been explained from a kinesiological analysis.
- However, there are some things you have to practice to do this method correctly or you'll end up with sore quads, hips, and calf muscles. Both DVDs Evolution Running and ChiRunning give exercises to do to get used to leaning forward at the ankles while maintaining the straight line between shoulders, hips, and ankles. Also, if you don't keep the pelvis tilted up, you could run into back/quad/hamstring/calf issues.
- "While many older sources proliferate the claim of running erect as sprinters do, new research (Miller 2002; Romanov, 2006) suggests that distance runners should use gravity to their advantage and run with a slight forward lean. ...This (incombination with proper arm positioning...) allows the foot to strike directly below the center of mass and makes it very difficult to over-stride and heel strike." -- K.G. Harper, Nov. 2006, Brigham Young University Hawaii
- In addition to a soft running form, I do the following to help prevent repetitive strain injuries (RSI):
- Vary running surfaces, including trail running.
- Wear level and flexible running shoes, including 1 run a week in minimalist shoes. I believe a huge cushioned heel encourages heel strike. For that reason, I choose trainers with the same amount of cushioning in forefoot, midfoot, and heel. Running once a week on trails in Vibram Five Finger Bikilas or Terra Plana Evos helps strengthen my feet and ankles.
- Perform strength training, stretching, and trigger point therapy to help prevent muscle imbalances and repetitive strain injuries.
- Use the Low-Impact Aerobic Side Stepper 3 times a week to counterbalance the forward motion of running. With running you are always moving your body in the saggital plane as you move forward. The side stepper moves the body in the coronal (side to side) plane, thereby working the underutilized muscles, ligaments, and tendons.
- The non-running exercises take about 3-4 hours/week. I figure that's a small price to pay after having to refrain from running for several months while my stress fractures and torn tendons healed. I put a television in my workout room and time I would spend watching television after work, I spend working out while I listen to and/or watch the tv.
- Do you have to do all these things to remain un-injured? Because I run high mileage and I'm over 40, all of the additional items are necessary for me personally. The more mileage you run, the more you will be susceptible to RSI. If you have a good running form, run low mileage, and are young, you might be able to get away with just the low mileage running. However, the statistics seem to indicate otherwise. 70% to 80% of runners are sidelined with injuries every year. That number is way too high! With proper running form and the other training discussed, I believe that number can be greatly reduced.
- Feet should strike ground as close to midfoot as possible and directly under the body's center of gravity.
- Foot strike should be a glancing blow - foot should not stay on the ground that long. A good mental technique is to imagine your feet are stones skipping across the water. If you leave them on the water too long, you'll sink. Most elite runners only have their feet in contact with the ground for a very short period of time. This mental exercise helps you to keep your stride rate up and also minimizes ground contact time.
- Hips should be forward while the center of gravity should be positioned directly over the foot.
- Slight forward lean from the ankles, but keeping the shoulders, hips, and ankles in a straight line.
- Arms should go forward and back with as little side to side sway as possible and the elbows shold never cross forward past the torso. Elbows should not come forward past the hip and thumb should not go backward past the hip.
- Elbow angle should be 90 degrees or less.
- Knees and feet should drive straight forward and back. High knee lift and high kick back are not necessary for distance runners.
- Keep cadence at 180-182 foot strikes / minute, regardless of stride length.
- Keep pelvis tilted up. A good mental technique for keeping the pelvis tilted up is to try to draw your belly button back to your spine while you're running. This takes some practice but is a good core strengthening technique.
- Downhill running is a great way to run fast without expending a lot of energy. It's basically a controlled fall and you let gravity provide all the forward propulsion. A lot of runners put on the brakes on downhill runs, which is inefficient. Ideally, you want to lean forward, still keeping your shoulder, hips, and ankles in a straight line and let gravity propel you forward (without falling). Obviously, you have to be careful on steep downhills to "control the fall". A lot of coaches will say to maintain the same effort on uphills/downhills and my effort is the same but my pace is much faster on downhills. I can usually take 1 to 2 minutes/mile off my pace on downhills for the same effort. It's like coasting when you run. The only thing you really have to do is "control the fall". With this method and a downhill course, many people that thought a Boston Qualifier wasn't within their reach could probably qualify.
- Uphill running form should be a modification of the flat land form: Shorten stride (keep cadence at 180-182 footstrikes/minute), lean into hill, never let your foot land in front of your knee, and try to keep your foot landing below your center of gravity. You lean a little more than on flat land running and there is more forward drive to the knee, but those are the main differences.
*1 Boston Marathon Medical Directors: Pierre d'Hemecourt, MD (Co-Medical Director), Sophia Dyer, MD (Co-Medical Director), Aaron Baggish, MD
*2 Run for Life: The Breakthrough Plan for Fast Times, Fewer Injuries, and Spectacular Lifelong Fitness
*3 Lore of Running, 4th Edition