Tuesday, March 29, 2011
Sunday, March 27, 2011
My yearly pilgrimage to Charlottesville, VA has concluded with another professional growth spurt waiting in the wings. The university of Virginia seems to be building a reputation as one of, if not the, leader in running research. There is not a more evidence based group of professionals and boy let me tell you they are impressive. You may have heard of the speed clinic. Here is a link to the running times article. This is the tip of the iceberg. I am so proud to be engulfed in the things they are studying. I benefit, YOU benefit, (I would like to take the time to say thank you to my loyal readers) and most importantly, my patients benefit.
They invite researchers from around the country who are studying running and as groups try to help each other gain more knowledge and experience trying to make this world a more healthy place. A really special network of learning. We are identifying problems and testing possible solutions to be accurate in what we prescribe to our patients. There was a lot jammed into 2 days of learning but here is the real world applicable stuff:
-one of the 3 hamstring muscles (biceps femoris) is injured 80% of the time. It is injured in runners right before the foot is about to contact the ground (terminal swing). With the hip in the position it is and the knee at it's respective place the biceps femurs is asked to work really hard and fast at the same time. Once injured you are more likely to have more strains. A scar forms around the injury and without appropriate strengthening the hamstring will learn to fire poorly. It stops firing the way it's designed to fire. The treatment is interesting. Stretching does not help or hurt. Strengthening the hamstring only is not beneficial but strengthening
the gluteals and core will prove beneficial. The way these muscles work together require a running expert physical therapist to provide a skilled progression of activities to remedy the situation.
-stretching remains a problem child. It sure feels good but there are no measurable benefits. The literature does state that stretching takes away from running. Stiff muscles perform better. Even in studies where researchers went to the stretchers house 2 times a week, called the stretcher 2 times a week to make sure they were stretching and there was no change in running injuries, pain, or performance. There was only a slight change in range of motion.
-gait modification. Once we identify a flaw or injury should we change the gait? What's the best way to do that? Well one way of modifying gate that has been shown to be very very effective is stopping the " vertical displacement" of running. That is how much up and down motion you make while running. This brings a ton of extra force that can injure any joint or muscle from the foot up. Here is how we test it: run on a treadmill for about 5 min or so. You want what you would consider your comfortable pace. Then count your left foot hitting the ground for 30 sec. Multiply that times 4. That is your stride rate. If you increase stride rate by 5% you can reduce the amount of force by 20%. That means you can produce and tolerate less force. If you increase it by 10% you can reduce force by 38%. You can go from pain to no pain with a faster stride rate. The change you make is you move your feet under your body and prevent over- striding. Work this up slow, you can get trouble if you don't. Example: 30 eft foot strikes in 30 sec X 4=120 strides per minute. 120 X 0.05=6, so try a new stride rate of 126. How? Try a metronome. How about music at that rate? Step to the beat! For 10%, 132 strides per minute. How does this translate to performance? Healthy running= harder, healthier training=PRs
-most likely the best thing is how these clinicians think. When athletes are hurt they are afraid of what the docs or the pts are going to say. They might make me stop! Well that is not beneficial. Why can't we as health professionals make running an activity that we can work on. When you go to pt, you better be running. Go ready to run. If they do not have a real good reason to keep you from running (
something big), you should run.
The course is always around the charlottesville 10 miler. I ran and will describe that in part 2.