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Pre-Race & Mental Toughness

This is likely the longest I’ve trained for a single event: more than any other marathon and roughly three or four weeks longer than my two Ironman’s. This whole debacle started seven months ago in December. With my son on the way and a few naysayers in my ear, I decided to prove that it’s possible to train, do well, and still function in society.

I continue to treat patients full-time while running two separate businesses (RunSmart being one). The long hours (typically 65-70+/week) took their toll, which I believe had some effect on my DNF at the Buffalo Marathon. The last three weeks leading up to Buffalo were atrocious. Each run was a struggle to finish. I thought an early taper would be a cure all, but it wasn’t. I toed Buffalo feeling sick, tired, and worn out. Truthfully, from mile two I knew I was in trouble. I was exhausted.

Grandma’s Marathon brings me new life. The bug that left me sick for Buffalo faded over the course of two weeks. Since, my runs have been nothing short of awesome. I needed it. For a month stretch I struggled to find any speed. The combination of tired legs and the sensation of breathing through a straw left me with zero confidence. I felt slower than when I started.

When my breathing finally returned my “speed” and confidence were drafting right behind it. I’m excited and nervous for tomorrow. I’ll take that over the fear I felt for Buffalo. I have a few specific time goals, but ultimately I’m seeking to trump my 2:55 that I ran in 2014 at Boston.

I’ve begun tackling new aspects of training between my DNF at Buffalo and the start of Grandma’s Marathon in Duluth, MN this Saturday. I’ve been delving more into the psychology of sport. We all know running is so mental (beyond the reasons explained by our non-running friends). How can we find the strength to push hard to a finish, when as little as 10 minutes prior we couldn’t have dreamt it? So the last few weeks have lead me on a quest to improve my mental strength and focus.

In his book “Unbeatable Mind: Forge Resiliency and Mental Toughness to Succeed at an Elite Level” Navy Seal Officer Mark Devine states,

“You have to win in your mind, before you can win in battle. There are no limits on what can be achieved when we remove the mental barriers we set for ourself.”

Now, I don’t plan on lacing up any combat boots, but I believe the word battle can be used as a metaphor for any of life’s challenges. Planning and believing in success may be able to accelerate us to a new level. One that we may have not thought possible.

Since Buffalo, I’ve been training my mind as much as my body. We’re all capable of much more in life and sport. The trick is carrying the confidence and mental strength to allow the brain to control the body—not the other way around. You see, the brain doesn’t feel pain—it only perceives it. Much like your strength and endurance, your mental resiliency is trainable. Many believe that you can train your mind to persevere. I’m beginning to find this myself.

By no means do I find myself to be an expert in mental strength. Actually, I suck at it. I’ve folded in races with the “good enough” attitude only to retrospectively question my efforts. I’ve only recently begun to appreciate the mental toughness in life and sport. I will continue to explore options through research and expert opinions, but I leave you with the challenge to train both your mind and the body.
I will put this to practice tomorrow in Duluth, hoping to run my way back to Boston, a PR, and home in time for my first father’s day.

Let me know in the comments below, on Facebook, or throw me a Tweet if you have any resources or thoughts on mental toughness. I’d love to hear them!

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Endless Pursuit of Prevention

We’re all on a quest to seek improvement. For some, improvement takes the back seat to simply being in the action, but even those who have their sights on finishing certainly would like to see improvement from one race to the next.

Unfortunately, steady improvement can be challenging, particularly with injury rates soaring upwards of 80%. It’s tough to find continued improvement when you’re frequently sidelined with a sore wheel. Looking at the statistics, one would assume the runner can-do attitude would yield an endless pursuit of injury prevention. In a sport where we’re all seeking longevity, it appears our can-do attitude can wait until tomorrow. Where is the urgency?

Unfortunately, we can find the cause of most injuries by looking in the mirror. Most runners fall victim to thier training plans that are high on running but low strength training. Most runners will admit that they’re a little afraid of higher volume weeks. With most runners nervously navigating their training plans, one would expect the response to be a focus on quality and prevention, not quantity and quantity. Too often runners are forgetful of their injury past. The frustration of a running injury often conveys a commitment to prevention next time around. It’s always, “next time I’ll pay more attention to strength, stretching, etc.” As injuries fade so does that of our commitment. Post-injury amnesia leaves our oath to prevention at the door.

For those who have grabbed the reins, do you know if you’re even heading in the right direction? Unfortunately, even those who are trying to steer their running down a path of speed and durability may be off course altogether.

This is the tricky part. Most over-the-counter strength programs can provide gains in fitness; after all, that’s their intention. If your goal is to supplement your fitness then continue, but for those looking to compliment their running, these programs, but not all, will rarely satisfy your need for speed and durability. The goal is to use a strength program as a catalyst to your training, not a twice a week time filler.

Take the runner I outline below. A 2008 bike crash left her with a fractured hip, eventually yielding a surgery with pin placement for fixation (not the type of hardware were all looking for). The surgery erased an entire year of running. Flash foward a few years and she continually battled frequent injuries. Every marathon build left her running on eggshells, simply looking survive long runs and higher mileage weeks. Although most of us can’t relate to fracturing our hip, we all have our own baggage that shapes the way we move: pregnancy, surgeries, sprains, strains, bony structure, etc.

Enter runner-specific strengthening. A commitment to our BaseSix Bootcamp, changing her run form, and small tweaks to her training plan paid off. She punched a ticket to Boston, while stealing an unexpected PR in the half marathon. The plan was simple. Integrate the RunSmart BaseSix Bootcamp into training. The emphasis on incorporating was as important as the runs themselves.

“On average I did them [BaseSix Bootcamp] three times per week. I felt like I recovered quickly from longer tempo workouts and long runs, so I had very little down time where I felt beat up.”

This runner is not the only one, find more stories here. I can’t emphasize enough that not all strength programs are equal. If you’re already implementing strength workouts into your plan be sure they are running specific (if your goal is to supplement your running). If you’re not finding the time for strength, it’s time to stop pulling the blankets over your eyes and plan for success–not hope for it. The pursuit for injury free running is eternal.


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1980 Called: They Want Their Slant Board Back

The slant board has been professed to enhance performance, prevent injury, and provide benefit in rehabilitation. It’s (unfortunately) associated with assisting in the treatment of plantar fasciitis, Achilles tendonitis, patellar tendonitis, and even hip pain. It sounds too good to be true. Well, the truth will set you free!  The truth is that most running injuries are preventable with proper running mechanics and preventative exercises.  That is, if you can weed through all the generic mumbo jumbo. If you had a simple conversation with your injured tissue, and believe me they can certainly talk when irritated (injured), they would scream, “I’m overworked, not underworked!”

Typically, when the physics of the repetitive running associated impact becomes too great, muscles and tendons become tight and sore. Tightness can mean artificial strength and stability. Both tight tissue and strength can check rein movement, which is why a tight muscle can mimic strength in the short term.  But make no mistake, the tight muscle posing as a strong one cannot mimic the same function.  The weakened muscle posing as a strong one will fatigue quicker, while being unable to sustain the workload.  Reminisce of how tight you felt in a hard workout.  Said tightness is likely providing some degree of stability, but those muscles are anything but strong.

Enter the Slant Board: Standing on it for minutes and hours since the 1980s.  The slant board is great for symptom relief regarding any accrued tightness from poor running mechanics and muscle weaknesses; however, it never addresses the underlying cause of injury.  This is often the case for revolving door injures—those with repeated overuse injuries to the same tissue (calf, hamstring, etc).  Again, the truth will set you free.  I have a saying I use with my patients:  “Stop punching the bruise and expecting it to get better.”  The mechanical irritation of all injuries (plantar fasciitis, achilles tendonitis, “shin splints”, etc.) are begging for help from their upstairs friends and neighbors at the hip and core. Change the mechanics of how your tissue is absorbing the impact of running and now you have real, lasting results.

Those sore feet, legs, shins, and knees will look up and say thank you to their friends and neighbors for doing their part.  Static end range unidirectional stretching on a slant board is like icing a bruise… it feels great when you do it, but when you go out and run with the same impact on the same tissue you get the same results.

The slant board is used primarily to stretch the calf (gastrocnemius and the soleus).  The problem is, the calf is a muscle that works in rotation, too.  Something the slant board simply doesn’t address. We think of the calf as making up the achilles tendon, but up at the knee, the calf actually wraps around the back and outside of our thigh bone (femur).  In addition, the muscles deep to those muscles (the peroneals and posterior tibialis) also are part of the lower leg.  These deep muscles cross the ankle and wrap around the bottom of the foot, stabilizing it through impact and into pronation.  Standing on the slant board does not provide a stretch that looks or feels anything like what that muscle will experience while running.

The truth will set you free and hopefully free you from your slant board.  Change your form and strengthen in a way that allows your muscles to absorb the repetitive impact of running and now you have lasting results. The dynamics and the physics of the muscles and your running form have much more to say about enhancing performance and preventing injury than any slant board.  Burn it.

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Bracing for Impact: Postural Set & Abdominal Bracing

In an ideal word our body would function as intended; however, bad habits, a medical history plagued by surgeries, broken bones, or overuse injuries, and anatomical deficits in strength and flexibility have other plans. It’s really the difference between muscle strength vs. activation.

If you add strength to a muscle, does your neuromuscular system automatically add it to your movement patterns? Most clinicians can tell you this is rarely true. Our movement habits conform to what’s available. No glute strength? Ok. Well your neuromuscular system will weasel its way to functioning (running) without it. The accommodating nature of our neuromuscular system is good and bad. Through accommodation we continue to compete, play, train, and live. Unfortunately, through said accommodation, the body engrains the poor movement into your motor programming. In fact most of this occurs with zero knowledge of you, the athlete. It makes it a real “B” to fix, too.

Take core strength for example. You would think that if you continue to add strength through an exercise program that your neuromuscular system will graciously incorporate what you’ve earned. Well it may not. Luckily, we have conscious control over our muscles, giving us the ability to train them back into a motor program.

Improving Postural Set

Postural set is an anticipatory reaction from the body to estimate how much strength is needed to complete a task: lifting, pushing, pulling, etc. Have you ever attempted to open a door that was being hammered by the wind only to find yourself face planting into the front of it? Well, your neuromuscular system estimated how much strength (based on past experience) is required to open said door. Unfortunately, its estimation was wrong. Another common example can be found when lifting. Have you ever picked up an apparently heavy object, but found it to be light? Again, your neuromuscular system estimated how much strength to divert to the task. Like before, it guessed wrong.

In the clinical world, postural set can be synonymous with abdominal bracing. We use it clinically to protect the spine and joints of both athletes and non-athletes alike. Postural set (bracing) is all about co-contraction around the spine, creating a more stable and stiff environment for your low back. This is more than sucking it in. Too often a contraction of the abdominals is equated to sucking in and drawing the abdominals to the spine (known as abdominal hallowing). Well, you’re going to be upset to learn that the ancient knowledge of abdominal contraction is wrong.

Although there’s no specific running-related research (that I can find), some research articles can give us a glimpse into the theory of abdominal wall bracing to improve stability. Vera-Garciaa et al compared hallowing (sucking it in) vs. bracing maneuvers when applying an anticipated perturbation to a group of subjects. Abdominal bracing was found to improve torso co-contraction (think contraction 360 degrees around the spine, reduced lumbar displacement (movement), and increased trunk stability. All great things when we’re trying to both absorb shock from the ground and return fire at push off. (Full disclosure this study had 11 subjects)

I see this quite often in the clinic. I can take an individual with low back, hip, or even knee pain and train them to brace their spine properly. The result is a toggling between noticing (no bracing) and abolishing symptoms (bracing).

What does this have to do with running?

Every foot strike and push off is an opportunity to calibrate and train your postural set/bracing. Through conscious effort you may be able to better prepare yourself for the forces associated with landing and push off. Remember, at foot strike your body is exposed to upwards of 290% of your body weight in a mere 5 milliseconds. A little conscious awareness emphasizing core activation may help you “brace for impact.” You’re not looking for an all-out, solid contraction. In fact, I’ve found success with patients just noting a conscious tautness through their midsection.

The key is to teach yourself to co-contract around the spine. Co-contract, brace, set your posture, etc–whatever you want to call it. Six of one really. I’ll work a new article on some simple bracing strategies in the near future, but for those looking to get started…

The Basics of a Good Brace / Set

A good co-contraction is absent of holding your breath. You should be able to maintain talking comfortably (try reciting the ABC’s) and without strain. The force can be graded, but a light push outwards (yes outwards) is the basis of a good brace. Take the pads of your fingers and push into your midsection. From there, push out lightly using your abdominal wall—feel your abs firm under your fingers and your ribs flare. Our abdominals are endurance muscles, so the contraction can be held for extended periods of time. First, though, you need to train them with conscious awareness. Good luck!

References

Francisco J. Vera-Garcia, José L.L. Elvirab, Stephen H.M. Brown, Stuart M. McGill. Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations. J Electromyogr Kinesiol. Volume 17, Issue 5, October 2007, Pages 556–567

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1980 Called They Want Their Exercise Back: Part II – The Towel Crunch

You want stronger feet you say? The obvious answer to anyone Googling their way to stronger feet is to master the use of clawing and/or spreading their toes. You’ll be instructed to tug on a towel (towel crunch) or simply pick up objects with their feet.

As I usually tout in my articles, our strength, flexibility, and drills should lay on the foundation of function, meaning they should look and feel like running. Without going on a 500 word rant about the towel crunch and its inability to look and feel like running, I thought I would talk about muscle function, the foot, and a more effective way to think about foot strength.

Lengthening vs. Shortening Contractions

towel, crunch, exercise
Our muscles can contract to either shorten or lengthen. Eccentric, or lengthening contractions are preformed against resistance. In running, this occurs from initial contact to mid stance (the first half of the gait cycle). Approaching midstance the arch lengthens as it absorbs the shock of landing. In reality, the arch lengthens, the tibia spins, the knee bends, and hip rotates. Remember, your leg is a chain of movement, not simply an isolated motion. Controlling the lengthening contractions is uber important. It will allow you to control landing forces and maintain proper alignment for latter stages (ie pushoff). Once through midstance, the muscles transitiong to a shortening contraction. Shortening, or concentric contractions are found primarily in the second half of the gait cycle: midstance to push off. Concentric contractions provide forward movement, shunting force and torque down your leg, through the foot, and into the ground.

Relating Foot Function to Exercise


When training the foot to perform, the pairing of your exercise can make all the difference. Ideally, your goal is train your foot as a link in the kinetic chain that is your leg. Much like your ankle, knee, foot, and trunk, the arch first must control the lengthening contraction. Before we consider any exercise it’s best if we start standing. You’re weight bearing while you’re running, right? Please weight bear during your strength exercise. Second, exercises performed to improve strength should toggle you through both lengthening and shortening contractions. Truthfully, control during our lengthening contractions is the most important. Lack of control on the front half of your gait cycle can wreak havoc on the latter half. Think of it this way: losing the battle against the ground can change your alignment and posture for the second half.

Feeling tough? Try Day 7 of our BaseSix Bootcamp

The Towel Crunch

Knowing the basics from above, you can see my beef with the towel crunch. First, the exercise only trains half of the gait cycle, and in my opinion, the less important half. Pulling against the towel will train the foot for shortening contractions only. The concentric or shortening contraction associated with the exercise is often performed non-weight bearing to boot. Continuing on my, what could be a lengthy, rant, the exercise is selective to the foot only. In life and running, our muscles fire together, not as a solo act. A towel crunch fails to link your foot the remainder of your kinetic chain (leg and trunk). Standing balance and reaches can help you link your hip to the foot, improve strength, and maximize balance.

We all love to run and for most of us, strength training is a necessary evil to keep us on track with our true passion: running. Selectively strengthening is a time waster. The towel crunch is a perfect example of applying strength training to the anatomy and not function.

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1980 Called They Want Their Exercise Back: Part I – The Clamshell

Terrible Exercise #1: The Clamshell

The principle of specificity is fairly simple. If you want to run well, you should run. You can’t say, go swim a bunch of laps and expect a ton of carry over. This is the same reason that we don’t see the likes of Jim Thorpe anymore. Jim was an accomplished athlete, playing 13 years of professional football, Major League Baseball for seven years, and professional basketball for two. Tack on two gold medals in the 1912 Olympics for the pentathlon and decathlon and you have quite the multisport athlete.

The principle of specificity has been around for a long time and is still practiced today. At the simplest level, the theory equates to practice makes perfect. I’ll use the word perfect in a loose sense of the term. There’s nothing perfect about the way any of us move, some simply are closer to perfect than others. Through the principle of specificity our body adapts, forms movement habits (motor engrams), and makes the given movement easier and more efficient (even if the movement is incorrect). Specificity helps you develop motor programs through thousands of repetitions. The body uses repetition of a specific task (ie running) to refine the neuromuscular system, eventually forming a habit and allowing you to run on autopilot… literally.
So again, your body adapts to the stress you place on it.

Which begs the question, why, when it comes to our strength exercises is specificity thrown out the window? This is the tip of the functional exercise iceberg. We know about human movement than ever before, yet, both countless trainers and clinicians continue to prescribe crappy exercises.

If your training is specific, why isn’t your strength program? You wouldn’t train for your next marathon by playing more Ping-Pong, right? (Please say no)
Remember, our neuromuscular system responds to repetition and consistency. With tweaking of repetitions, resistance, and movement we can often refine the way we compete and move. Our exercise and training must match our chosen task, whether it’s running, biking, swimming or playing the piano. Due to the overwhelming capacity of crappy exercise, this article will be broken into a few parts.

Let’s take a look at some exercises that are performed all too often, but fail the principle of specificity or functional exercise.

#1 The Clam Shell / Hip Abduction

terrible, exercises, for, runners. clam
“I went to physical therapy already and I wasn’t getting better so I came to you.” I hear this quite often and I usually take a stab at few exercises they were performing. I’m usually right. The clamshell and hip abduction are nearly a direct hit every time. Maybe it’s the fact that this exercise is recommended in nearly EVERY hip strength article? Or maybe it’s because your clinician doesn’t understand specificity. Sure, the clamshell is great… in 1980.

Here’s a video that explains this more…

Now, I hate dealing in absolutes. I’ve actually given this exercise in rare circumstances. First, for patients that is post-op and need to get some basic muscle function. Second, weight bearing restrictions limit their ability to stand. Finally, I’ve used this exercise on athletes who simply cannot tolerate exercise against gravity.

So will you ditch this exercise? What other exercises do you think are questionable?

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Two Effective Ways to Add Core Strength to Running Program

We’re all busy. Although I’m a huge advocate for dedicating a day or two to runner-specific strength training, some weeks are simply harder than others. Shuffling long hours at the office and/or caring for an expanding family can cause you to back burner your strength program. I, like you, know that running will always win the battle for exercise. The choice between logging 30 minutes of strength or a few miles is an easy one. Run.

It’s easy to let the momentum of a missed workout snowball into a week or longer. Luckily, small tricks can keep you from unraveling your commitment to stay strong and healthy. As far as I know, the concept of adding core strength as discussed below has not been mentioned elsewhere. I’ve used this technique successfully for both my athletes and in my own training. The techniques below serve a far greater purpose than just adding strength. They’ll teach you to better control your breathing, too.

Core and Breathing

“Don’t forget to breathe.” The amount of time I spend telling patients bright with a red hue is astounding. No, they’re not embarrassed, they just equate core contraction with holding their breath. Contracting your ore doesn’t equate to becoming a vapor lock. Doing so increases intra-abdominal pressure and is simply not functional. It’s overwhelmingly common, though. Athletes and non-athletes have difficulty with proper firing patterns. It’s not local to core contraction, either. Handfuls of runners tend to choose movement patterns that inhibit their butt muscles and activate their quads.
This is where the beauty of adding core strength to runs makes sense. It’s effective and efficient. It will teach you to dissociate your breath from a core contraction—an important piece for when you breathing becomes labored. Sure, I’d rather have you work a multi-faceted strength program (like our BaseSix Workout), but with limited time we’re looking for the biggest bang for your buck: core strength.

Bang for Your Buck

Do you have five minutes post run? (The answer is yes) A stable spine can hold a plank for 60 seconds and trust me… you want a stable spine. In a previous article I discuss how to progress your planks to reach the base 60 second hold. Once you’ve established some base strength you’ll be looking to incorporate planks quickly in one of two ways: post run and/or during track workouts.

The first and simplest way is to spend a few minutes post run working through your planking program. Yes, the goal is to hold for one minute, but you may need to start with shorter holds before progressing the holy grail of 60 seconds. For those who are unsure how to properly plank or simply can’t hold a 60 second plank (yet), watch this online or download this video. Our 60 second plank program will show you how to not only hold your plank, but also how to progress them through dynamic movement.

Staying on (the) Track

Another effective means to maintaining good core strength and endurance is to incorporate planking into your interval training. During your rest intervals at the track, spend 20 to 30 seconds holding Level 2 or Level 3 exercises (outlined in our 60 Second Core Program). You’ll continue to recover aerobically; however, you’ll teach your body how to maintain a strong, sturdy core in the presence of fatigue. Also, you’ll be forced to lock into a strong core with labored breathing, an effective way to teach you how to breath while holding your midsection taut. Sustaining a strong core contraction in the presence of fatigue can also help immolate race conditions, possibly holding the ship together as your muscles and run form begin to waiver.

sixty, second, core, runsmart

runsmart, core, strength, plankrunsmart, strength, plank

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How long should I hold my planks?

“I can hold a plank for 5 minutes.” Congratulations? If your goal is win a plank competition keep hammering away, but for those of us looking to run faster with less injury let me cue you in on a little secret: you don’t have to hold your planks longer than 60 seconds.

If you’re a frequent visitor to our articles you’ve heard me beat the topic of core strength to death. I’ve explained the importance of avoiding sit ups and also how to avoid ruining a plank. I’m hopeful that you’ve begun to incorporate them, or at the very list substitute them for your sit ups.

Planks provide stability to your spine, allowing you to control your trunk on your pelvis, while effectively and efficiently transmitting force down the leg, through the foot and into the ground. On the other hand (err… foot?), sit ups create movement around your spine, reinforcing the muscles to be movers, not stabilizers and in the end we want them to prevent movement. Avoiding situps is common practice in the rehab community. You’ll rarely (if ever) see a doctor or physical therapist prescribe sit ups for core strength. In fact, if they’re recommended you should sound a big, loud, hypothetical siren. (You’ll likely want to find someone else). It’s not because we want to rain on your parade; rather, the evidence is fairly lopsided when it comes to your low back, injury prevention, and core strength. Needless to say, planks are the way to go.

Superficially planks seem boring. Staring at the timer only seems to make the seconds tick by slower (much like the microwave / treadmill). No wonder they’re less appealing than their dynamic counterpart—sit ups. However, planks offer a variety of dynamic diversity to build upon. Not only making them more exciting and challenging, but better mimicking the forces of running. I’m not looking for you to tout that you can hold a plank for five minutes. I really don’t care. The goal for your planking routine is to build a base hold (60 seconds) and transition to dynamic movements. The lower and upper body movements of running are important and worth mimicking in your core strength program. A lifted leg or arm creates a spinal pivot point, further challenging your spinal stability.

Building a Plank Program

So the goal here is to build static stability in the spine, transitioning to dynamic stability once the base is established. Your initial goal is to build to focus on achieving a 60 second hold. Once achieved, you should transition away from static hold and begin a dynamic progression. Depending on your current level of strength this may not be a hard task. For others, it may seem daunting. Your positioning during the static plank is key. You’ll want to really lock in posturally, firing 360 degrees around your spine. Doing so will reduce the strain the shoulder and spine.

What’s the best way to eat an elephant? One bite at a time.

That awkward phrase is also how you’ll approach your 60 second hold. Initially, you’ll be looking to break down the static hold into manageable bites. You’ll want to be challenged, but feel strong through the hold. As you’ll notice below, all plank sets equal one minute. Precisely. As you get stronger you’ll hold longer, but with less reps. Once you hit the one minute mark it’s time to transition to dynamic holds. Core strength can be done often, too. I recommend using it as a cool down or warm up to running. As you’ll see below, it only takes a few minutes.

Planking Progression: From Easy to Hard
Six Reps Hold 10 Seconds
Four Reps Hold 15 Seconds
Three Reps Hold 20 Seconds
Two Reps Hold 30 Seconds
One Rep Hold 60 Seconds

Planking is an art of sorts. Too often the plankee butchers the process or simply fails to practice good stabilization techniques. As you progress to dynamic holds and movements, be sure to make slow, deliberate, and controlled movements. You’re look to prevent any and all movement around your spine. Take a look:

sixty, second, core, runsmart

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High Arches and Underpronation in Runners

The running world has been inundated with buzzwords. Run form, overpronation, minimalist running, and hip strength are only a page turn away in your favorite publication. While these terms are important, their regurgitation often overshadow other relevant topics. Without even understanding the intricacies of the term of overpronation, you’ve likely been exposed to the term, whether you first laid eyes on it in a magazine, online, or simply heard it being tossed around in your local shoe shop.

But what about underpronation? Underpronation affects a large percentage of the population. Anatomically speaking, it presents a set of challenges to runners who fall in this forgotten group. It was once thought that a flat, lower arch was a detriment to runners. Flat arches became synonymous to overpronation while those with high, rigid arches went completely unnoticed (Having low arches DOES NOT mean you overpronate).

As we outlined previously, the natural motion of our foot while running is to land towards the outside of the foot, setting the foot to spin inwards and absorb landing forces. The motion is a combined motion from the entire foot, including the fore, mid, and rear foot. Without pronation we lose shock absorption, which may influence loading rates and the types of injuries that occur. A recent 2014 study in the Journal of Athletic Training found that runners with higher, rigid arches exhibited a higher initial loading rate and greater peak vertical ground reaction force (impact) when compared to runners with a mobile high arch.1 Anatomically this makes sense. Without a flexible high arch your foot can’t spin. If your foot can’t spin its ability to absorb shock is nullified.

Your landing forces are ultimately the same. We’re not changing gravity nor your body weight. What changes is your means to control the collision between your body and the ground. Simplified, your body’s three tier shock absorbing system (ankle, knee, and hip) has been reduced to two (knee and hip).

Why won’t my foot spin?

Rigid Arch

Sometimes you’re dealt a tough hand. Some individuals are structurally rigid based on development or genetics, while others acquire a rigid arch through a traumatic injury (ie fracture). A high rigid arch will not often convert to a flexible one, although you may be able to squeeze out a few helpful degrees. Luckily, our body has an amazing ability to accommodate a rigid arch. Your knee, hip, pelvis, and spine can find you your range of motion to keep you on the road, but keep in mind your foot might be an injury risk for you moving forward.

Prior Injury / Surgery

Prior injury and surgery is often overlooked during treatment as a causative factor for lack of foot spin. It’s not uncommon to find a runner who will avoid spinning their foot inwards. It often occurs unbeknownst to the runner. It can occur for a variety of reasons. Two common occurrences are to avoid a painful heel (plantar fasciitis) or prior surgery (bunionectomy). Kernozek and Sterikker2 found decreased plantar pressure while walking one year post bunionectomy. A bunionectomy, a procedure that reconstructs and realigns the first toe, caused patients to walk on the outside edge of their foot. Clinically, this happens more often that you would think (research finds improved function and ambulation through physical therapy and gait training). Through subconsciously altering movement the body will avoid spinning inwards at all costs. For some it’s to avoid a painful inner heel, while others avoid a reconstructed big toe. This is true for those with a neutral and low arch as well. Through this alteration a runner may actually function as a high, rigid arch but display a low, flexible arch upon exam.

Tightness

Just like a muscle can become tight, so too can your foot. The majority of our “spin” comes from our midfoot. Tightness can occur for various reasons, including prolonged motion control shoe use. Blocking your foot from pronating can eventually cause adaptive tightness, limiting your inward spin. Luckily, improving your spin can be improved with selective exercises that promote pronation. Try this exercise.

The first step is always identifying the cause of your underpronation (or lack of spin). The above examples are overly simplified and are the tip of the iceberg. Finding a skilled clinician can make all the difference when determining your course of action. For some, pronation or “spin” can improve, while others are simple rigid with little to gain. Go find a skilled physical therapist who can help you.

References:

1. Williams, D.S. Blaise, III, Robin N. Tierney, and Robert J. Butler. “Increased medial longitudinal arch mobility, lower extremity kinematics, and ground reaction forces in high-arched runners.” Journal of Athletic Training 49.3 (2014): 290+. Academic OneFile. Web. 16 Dec. 2014.
2. Kernozek TW1, Sterriker SA. Chevron (Austin) distal metatarsal osteotomy for hallux valgus: comparison of pre- and post-surgical characteristics. Foot Ankle Int. 2002 Jun;23(6):503-8.

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Shin Splint to Stress Fracture: Cause & Prevention

Shin pain can be a frustrating, viscous cycle. Shin pain is not a diagnosis, but rather a vague term for where you hurt. The injury itself can be somewhat minor (shin splint) or rather major (stress fracture). Generally, the development of shin pain can be abrupt, but usually the runner is at fault. A minor shin splint improves as you run (“warms up”), but the absence of symptoms doesn’t translate to absence of damage. As you run the injury slowly worsens and eventually the tide turns. That measly “I can run through it” shin pain develops into distinguishable, distinct, dig with your fingertips type pain.

At first glance you may think that a shin injury is an impact injury. Well, yes and no. Inner shin issues (shin splints, stress reactions, and stress fractures) arise from tensile forces to the bone-not compressive. Our skeletal system craves compressive forces–the bone responds to compressive forces by building more bone, thus making it strong. On the other hand, tensile (pulling) forces are bone kryptonite. The easiest analogy is to think of bending a tree branch. As the branch bends, it’s not the compression side that breaks, but the tensile side. As our foot strikes, the ground reaction force transmits through the foot and up the chain into the spine. The ground reaction force attempts to bend bones at a repetitiously at a high velocity.

These tensile epicenters, the lower inner shin being one localized area, are structurally supported by our muscles. The muscles pull up and prevent the analogous tree branch from bending. Lower shin injuries are not a product of a single foot strike, rather a repetitive, rapid tensile load that occurs during every foot strike. If you’re muscles are simply unable to stop the tree branch (bone) from bending, the result is irritation (shin splint), to bone inflammation (stress reaction), and eventually breaking (stress fracture).

shin, pain, stress, reaction, prevention, cause

A retrospective study found that 50% of stress fractures are found in the bottom third of the tibia.1 Causation is multifactorial. For example, in this article I discuss the link between muscle fatigue and the rate of acceleration and loading while running. In short, increasing fatigue causing quicker loading rates between body and the ground, while the acceleration of the tibia (shin) progressing forward increases. The studies outlined in the previous article are relevant when we link them to other research studies. Milner et al. found that the occurrence of stress fractures in female runners was related to greater initial loading of the lower extremity.2

It all sounds like an impact issue, right? Don’t be fooled. It’s not the landing that’s causing these injuries, but the poor control of landing. Your body weight doesn’t fluctuate when you run (outside of sweating). Body weight is constant, but loading rates can change drastically. Without strength at key areas the loading rates between your body and ground maximize. Another research study focused on female runners showed that, when compared to controls, the stress fracture group demonstrated increased hip (peak hip adduction) and knee motion (internal rotation).3

Ultimately, an unattended shin splint will progress. A slight “ache” transforms into pain that limits you from running (stress reaction) and ends with pain that is present with walking and standing (stress fracture). You’ll want to focus on strengthening key areas with runner-specific exercises. Targeting your hips, knee, and lower leg can help prolong fatigue and devastating tensile forces.

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References

1. Monteleone, G. P., 1995. Stress fractures in the athlete.Sports Med. 26, 423–432.
2. Milner, C.E., Ferber, R., Pollard, C.D., Hamill, J., Davis, I.S., 2006b. Biomechanical factors associated with tibial stress fracture in female runners. Medicine and Science in Sports and Exercise 38, 323–328.
3. Milner, C.E., Davis, I.S., Hamill, J., 2005. Is dynamic hip and knee alignment associated with tibial stress fracture in female distance runners? Medicine and Science in Sports and Exercise 37, S346.

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