Distance Running - Is It Healthy?

Distance Running and Joint Health Distance Running and Joint Health

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A few days ago, I reviewed a NY Times article which espoused the benefits of running on joint health.  If you'd like to see my entire write-up, I've provided the blog link below:

Running Blog

The biggest issue I had was when the author stated that the best way to keep your knees healthy was to "not get injured."

Really?  It's that simple, eh? (Cue Canadian Flag and maple syrup)

So that got me thinking - how many runners get injured every year?

And while I know people love to run, what can they do to prevent injuries?

Part of the problem at hand is you have people like Jillian Michaels from the Biggest Loser espousing that "distance running is the best way to lose weight."  Obviously I'm biased because I think strength training and other forms of energy system training (EST) are superior, but let's see what kind of information is out there. 

My goal was to go into this without my typical bias towards running.  I did, after all, compete in cross country in high school!

Let's begin by going over some of the relevant research that's available first and foremost.

 

Jacobs SJ, Berson BL.  Injuries to runners: a study of entrants to a 10,000 meter race.  Am J Sports Med.  1978;6(2):40-50.

In this study, Jacobs et. al provided a questionnaire to 451 entrants of a 10k race.  47% of the entrants had suffered an injury in the past 2 years.  After digging a little bit deeper, the following factors were associated with injury:

-       More miles per week

-       More days per week

-       Faster race pace

-       More races per year

One final note:  The questionnaire also covered treatment of said injuries, and in this case 76% who received care had reported good to excellent recovery.

 

Lysholm J, Wiklander J.  Injuries in runners.  Am J Sports Med.  1987;15(2):168-71.

In this study 60 runners were followed over the course of a year.  Out of those 60, 39 suffered injuries.  What's even scarier, out of those 39 participants they actually suffered 55 injuries!  That means that many of these runners suffered multiple injuries within the same calendar year!

The study goes on to compare the differences between sprinters, middle distance runners, and marathoners.  I was most interested in the middle distance runners, because this description covers the "recreational" runner who saunters into your facility.  Not surprisingly, the most often injured  areas to these runners are backache and hip problems. 

This confirms a lot of what we see at IFAST - the prototypical "rec runner" has terrible core and hip stability.  Typically their first 2-3 months with us is just building these up to more normal levels so they can resume training.

One final point to note: This study mentions that marathoners were actually injured less frequently than sprinters and middle distance runners per 1,000 hours of training.  Now, I'm not ready to take this 100% at face value, as a whole host of factors need to considered here.  Quite simply, there's a profound difference between the training styles of all three types of athletes including training intensity, what constitutes "training" (marathoners just run for a long time, sprinters run really fast then take long breaks, etc.) , but it leads me to the following question:

Could it just be that people who run marathons are biomechanically more efficient and basically born to run compared to their lesser counterparts? 

It's definitely something to take into account.

 

Macera CA, Pate RR, Powell KE, Jackson KL, Kendrick JS, Craven TE.  Predicting lower-extremity injuries among habitual runners.  Arch Intern Med.  1989;149(11):2565-8.

In this study, 583 runners were followed for one year.  In that time frame, 252 men (52%) and 48 women (49%) suffered injuries.  This study wasn't particular illuminating, but it did confirm that

-  One of the greatest risk factors for future injury was a previous injury

-  You were at increased risk if you'd been running less than 3 years

 

Marti B, Vader JP, Minder CE, Abelin T.  On the epidemiology of running injuries.  The 1984 Bern Grand-Prix study.  Am J Sports Med.  1988;16(3):285-94.

The researchers in this study used a questionnaire to determine the injuries of participants in a 16 km race.  Out of 4,358 male runners, 45.8% had sustained injuries in the previous year.  Risk factors for injury included more mileage, and a history of previous running injuries.

Following our earlier thinking, this study went on to describe that in 33-44 year olds (1,757 participants) the number of years running was inversely related to the incidence of injuries.

 

Walter SD, Hart LE, McIntosh JM, Sutton JR.  The Ontario cohort study of running-related injuries.  Arch Intern Med.  1989; 149(11):2561-4.

In this study, 1680 runners were followed for one year.  In that time frame, 48% suffered at least one injury.  Again, the greatest risk factor for injury was a high mileage. 

Most importantly for our purposes, runners who were injured the previous year were at 50% higher risk for a new injury during the follow-up period.

 

Summing up the Literature Review

While this is definitely just a cursory review of the literature, it definitely provides us with some food for thought.  Here are the cliff notes, in case you didn't read all that!

-       Per the research above, anywhere from 45-65% of runners will be injured in a given year.

-       Running mileage seems to be heavily associated with injury.

-       Previous injury is a great predictor of future injury.

-       New runners seem to be at increased risk when compared to older runners (not necessarily in regards to chronological age, but "running" age).

 

My Current Thoughts on Running

After reviewing the literature, here are some thoughts I have in regards to recreational distance running:

-       I'm starting to think that running isn't that far off from the Bulgarian system of weightlifting.  If you're unfamiliar with the Bulgarian system, it's best described as a meat grinder.  Take a ton of athletes, put them through intense workouts multiple times per day, and whatever comes out on the back end comprises your Olympic team.



Is recreational running really that much different?  It's not on the same level with regards to volume and intensity of training, but sit back and think about that general premise for a second.

Several of the above studies mention that those who have been running longer are actually less likely to get injured.  Again, it comes down to biomechanics - who is biomechanically designed to run?  Those people who are genetically gifted and built to run typically do so more successfully, and with fewer injuries than their counterparts.  The Bulgarian weight lifting team is going to be comprised of the guys who can best tolerate the workloads associated with their sport.

Running is no different.  While everyone thinks the can run, it's more selective than we give it credit for.

Let's take it a step further and think about it in this regard:  Michael Phelps wouldn't be the greatest swimmer in the world if he was 5'2" with a short spine.  Usain Bolt wouldn't be the greatest sprinter in the world if he was 5'10" or had stubby legs.

I'm sure people will hold me to the stake for comparing elite/Olympic level athletes to recreational runners, but the point I'm trying to get across is that whether you want to admit it or not, genetics play a role.  Great runners are genetically predisposed to run.  Recreational runners, on the other hand, are not only going to be less successful, but they'll generally take more lumps along the way as well.

-       I'm still shocked at how many runners think "time off" is a magic bullet.  Research clearly shows that if you've been injured before, you are at an increased risk to get injured again!  The car analogy gets a little overplayed, but it makes great sense - if a car is out of alignment, putting it in the garage for a few weeks will keep it from getting worse, but it won't address the problem.  The second you take it back out on the road and start cranking things up, the underlying issues are still there.

-       Along those same lines, if you DO get injured, it's in your best interest to determine what your biomechanical issues are and address them ASAP.  There is no magic bullet - but if you really enjoy running, you're going to have to do MORE than simply run to get healthy. 

At IFAST we typically use a multi-faceted approach that incorporates soft-tissue work, mobility training, acute corrective strategies, strength training, and even static stretching to address the underlying issues.

If you don't fix what needs fixed, you're going to be left spinning your wheels.

-       Finally, for those of you just getting into running (or getting back into running), you absolutely, positively must ease into your mileage.  Again, it's been proven time and again that running mileage is heavily correlated to injury. 

Returning to our car analogy, the longer you drive that car the more any little issues are going to be exposed.  The same thing holds true for your body - the further you run, the more those little flaws or asymmetries are exposed.

This was meant to be a quick and dirty blog post, but it turned into something much, much larger.  Hopefully if you are a runner, or work with runners, it's provided you with some insight into getting (and keeping) people healthier over the long haul.

In the future, I'll be sure to review some more literature on the topic, along with provide insight into our training methods.  Until then, good luck and good training!

Stay strong

MR

Comments on This Entry

Posted by Neal W. at 01:45PM on July 18, 2010

Good post. What do studies on weight training show, on all the same variables? Most importantly, injuries per 1000 hours of training.

Posted by Dean Somerset at 04:15PM on July 18, 2010

Another variable to look at is the running style itself. Just like lifting weights with an improper pelvic tilt can pre-dispose injury, running with your foot contact too far to the heel can increase ground force attenuation through the leg and low back, pre-disposing to injury. We can do all the soft tissue release and core strength we want, but if they keep running with poor mechanics, they will be hitting the ground for 50,000 impacts with 2-3 times their body weight per stride with improper balance of force, leading to injury. Looking at a run stride and adjusting it will pay more of a dividend than increasing or decreasing, or even ceasing running, as it will allow for a more balanced force application through the lower body and help with speed, power, and injury prevention.

Posted by Mike Robertson at 08:05AM on July 19, 2010

Dean -

Great points. I feel as though running technique is almost never addressed, when it absolutely should be.

However, let me use a different example - say someone who comes to my gym and wants to squat.

If I assess them and determine their hip/ankle mobility is horrible, their core/lumbar spine unstable, etc., they don't get to squat (at least initially). I take the time to bring up the specific physical qualities they need to squat safely and effectively FIRST, and then start breaking them into the actual squatting.

I could take them day 1 and start hammering technique, and while I'm sure that would help, the underlying issue here is they don't possess the physical qualities to squat safely and effectively. Technique has to come AFTER the qualities are in place.

Running is no different. People want/like to run, and I get that. And technique HAS to be part of the discussion.

But again, so many people don't have the physical qualities necessary to run safely and effectively, at least not at the onset of their training program. They physically aren't prepared to run.

So while I agree 1000% that technique should be addressed, until the physical qualities are brought up to snuff, I still feel like people are going to get injured.

Hope that clarifies a bit. Thanks for the post!

MR

Posted by Ted Winter at 08:43AM on July 19, 2010

@NealW
According to figures in Hedrick, 2008 the injury incidence within competitive Weightlifting is given as 0.0017per 100 participation hours. This is relatively low when compared to many other sports within the article e.g. Basketball at 1.03 and Track and field at 0.57.

Posted by Allan Phillips at 12:00PM on July 19, 2010

The running community has certainly gotten better in terms of recognizing the importance of \"supplementary\" training but there is still a long way to go.

I love this comment:
\"So while I agree 1000% that technique should be addressed, until the physical qualities are brought up to snuff, I still feel like people are going to get injured.\"

Oftentimes, what we see as \"bad form\" is simply the visual manifestation of a runner trying to protect against some underlying movement limitation. If we go in an \"clean house\" by trying to force visually appealing technique onto someone, we\'ll end up causing more problems than existed in the first place. That flailing arm or those uneven shoulders could be the duct tape that holds the contraption together! Don\'t remove the duct tape until you understand the ramifications and have an idea of a corrective strategy. Many runners, especially in the scholastic ranks, do tons of drills thinking they are making progress on technique, when in reality they\'re just killing time.

I think it is helpful to understand how different sub-groups within the running population approach this issue (obviously these are generalizations, but I come directly from the endurance sport world, so I am around these groups more frequently than most gym or clinic based practitioners).

1. \"Old school\" - Just run Baby! Sees injuries as inevitable part of the sport. Why go to the weight room when you can just run more? Sees mobility training as a waste of time, usually because their only form of mobility training was a bunch of random static stretches.

2. \"I don\'t have time\" - Working folks who have enough trouble getting their miles in. \"If I\'m exercising, I better be running. I took up running since I don\'t like the gym scene\"

3. The weightlifters. Think that a basic strength program will keep them healthy. Add some strength, then all my problems are solved!!

4. Triathletes. Have greatest access to technology and love to parse the minutiae of running form nuances with the hope that a tiny technique improvement will solve all their running woes. However, most of this technique work is wasted because 1) basic movement skills are poor and 2) they usually are too shelled after the bike to maintain decent form anyway in races.

5. High school/college. Since they have up to two hours of practice time available, coaches will just assign a generalized battery of drills that have been passed down by posterity designed to mold their runners\' form into what they think running form should look like. The kids who move well on a fundamental level will end up with beautiful form. For the kids who don\'t move well, the drills end up being a waste of time (since form encouraged by the drills doesn\'t mesh with the kid\'s basic movement abilities and they just go back to what is comfortable during their workouts) or the drills end up causing weakness/injury because the form encouraged by the drills is inconsistent with what the kids are capable of (see comment above about visually \"bad form\" being the duct tape that holds everything together).

Posted by Mike Robertson at 12:18PM on July 19, 2010

@Allan -

Fantastic points - thanks a ton for contributing! I couldn't agree more.

MR

Posted by Katherine Phillips at 03:31PM on July 19, 2010

Couple of points to add as a former college cross country/track coach.

1. Change needs to start at the college level. Distance running is a sport that is passed down from coach to athlete. The number one prerequisite to be hired as a college distance coach is to have been a college runner. Former college runners also fill the ranks at running shoe companies and stores.
2. Strength and conditioning and distance coaches are scared of each other. A team approach needs to be adapted. The strength and conditioning coaches just do not get why a top college 10k runner needs to be running 80 miles a week when his race is 6.2 miles. Distances coaches think the strength and conditioning coach just wants to put big muscles on their runners. Each part of the team needs to understand what the other is trying to accomplish and why.
3. Strength and conditioning has to make an effort to come to distance coaches. Two reasons why:
A. Head distance coaches at the high school and college level have three seasons to coach (cross country, indoor, outdoor) and most of the time two teams (men and women). In many programs the distance coach is head track coach and has a couple of part time assistants. On top of writing workouts they have to act as travel agents, meet directors, recruiters, budget balancers, driver and the list goes on. Going down the hall to talk to strength and conditioning either does not enter the thoughts of a distance coach or is on their wish list.
During workouts distance coaches are supervising around 25 athletes, juggling the stop watches and making sure runners do not take too much rest between intervals. Not much time to look for movement dysfunction.
B. Many distance coaches do not know strength and conditioning can keep their athletes out of the training room! The idea of corrective exercise is completely foreign them and often they see the weight room as social hour. From experience I can say a distance coach will be much more receptive to strength and conditioning if we come to the track, screen the team and do some corrective exercises. Something is better than nothing and lots can be done on the track. At the recreational level runners will show up to clinics at the running store.
4. In general distance runners and coaches see strength and conditioning as good or bad. Not much middle ground and that needs to change.

Posted by Mike Robertson at 05:44AM on July 20, 2010

@Katherine - Fantastic points! I agree that there needs to be a common ground, not only between strength coaches and sport coaches, but between coaches and the individual athletes as well.

One of our goals as any coach should be to educate our athletes. This is something I always try to do w/my runners, to help them better understand where I'm coming from and how I can help them.

Great points!

Best
MR

Posted by Evan at 07:17AM on July 20, 2010

Mike,

Many folks (professional and non-professional strength and fitness enthusiasts) that I speak with are beginning to take the 'why run when you can swing the kettlebell?' approach now.

I can see the value in this for your average trainee but how far do you think this mantra of replacing running with swings or snatches etc with a KB can be taken when you are training athletes who run in their given athletic pursuit?

Hope that my comment is not too far off topic.


Posted by Katherine Phillips at 09:16AM on July 20, 2010

You cannot replace running miles with swinging the kettle bell. Miles and intelligently blended workouts are king. The best way to get faster a running is to run and strength training, yoga, cross training, etc is not a magic pill to drop 2 minutes off the 5k time. The goal of strength training for runners is to become more efficient runners not runners who are really good at swinging the kettle bell. In my opinion cutting the running miles with the justification of strength training is nothing more than an excuse to get out of running. If a runner decides they want to focus on strength training and make that first priority that is perfectly fine. The excuse of “There is no time for strength training and I am going to cut 10 minutes out of each run” just does not fly in my book. When you think about it runners really do not spend that much time running. On the top end age group runners are doing around 4x1 hour, 1x2 hrs and a tempo workout that takes 90 min per week. In total that is 7.5 hours spent running. Professional runners have all day to focus on running and the little things. On top of that runners can go right out their front door and run. Other sports that the masses participate in take up much more time. For example, no one thinks twice about a round of golf that takes 4 hrs, not to mention the commute to the golf course. I really believe 99.9% of runners can afford the time commitment of three 30-45 min sessions of strength training per week on top of their current running schedule.

Posted by Bob Dannegger at 11:40AM on July 20, 2010

A very interesting thread and some good comments,. As a 160 lb 69 year old who started running at age 42 weighing 216 lbs. who also has been coaching 10-20 club runners for 10 years and providing weekly track workouts for 20-40 club runners for 12 years I\'ll add my 2 cents worth.

Disregarding the subject of injuries I\'d like to know what combination of weightlifting and HIIT or complexes or circuits or whatever you want to call them can burn at least 4000 NET calories/week. At 160 lbs. I do that by running 40 miles in some weeks and it doesn\'t even include any EPOC I get from interval workouts, typically 2-3 miles @ > 90% of Vo2Max and/or 3 miles of \"tempo\" runs at 85-90% of VO2Max.

I have read many internet trainers tout the value of weightlifting for runners including a good one by Eric Cressey a few years ago. However, for many of the reasons mentioned above it is easier said than done. I currently lift weights and run as well. Although not professionally certified in S & C or USATF, I\'m very well read in both fields and have most of Mike and Eric\'s products and am FMS certified. I\'ve screened a few runners and most of them could use something beside running.

Assuming a person\'s sport is long distance running, the major problem as I see it is that it is difficult to weight train and be a distance runner at the same time without impacting either weekly mileage or the quality of the workouts run. Unfortunately, how much mileage and how much and what kind of quality is needed to run a race in a given time is very subjective. I have yet to see an integrated training program that combines the two that provides any research that says if you do this weight workout you can eliminate this much of your running and still run the race as fast as if you just ran. It\'s not only a matter of available time but of recovery. It gets even harder as you get older.

Yes there is research that shows if you follow a certain protocol you will improve your 5k time by x minutes, but they are usually done with a small sample size over a short sample period and usually not experienced or advanced runners.

There is a big difference in giving somebody a weight workout to do while they are simply running, but if someone comes to you and says I want to run a Boston qualifier how much do I need to run and, oh yeah, what weight workouts will keep me from getting injured that won\'t interfere with the training I need to do to run that time?

Even most training programs can\'t reliably answer the question of what training do you need to run the required pace. They may have schedules for certain time zones, but not much help in knowing if you can train at the required level. In his book Daniels\' Running Formula, he has some tables to predict longer races from your shorter race times and his methods for training, but it includes no weight training. He also has 24 week schedules for the marathon so that if you are going to run 2/year you don\'t have a lot of time when you\'re not running much.

In deciding to train for a fall marathon to qualify for Boston again, one thing I did is to approach weightlifting as a GPP activity and did Jim Wendler\'s 5 3 1 program for 4 months, During that time I always followed a squat or deadlift day with a day off, a short easy run the next day, and then a long or quality day on the third day. I often did interval workouts in the a.m. and leg workouts later in the day. However I\'m retired and have the luxury of doing that as well as a 10 month training plan. After the 4 months the deadlifts were requiring more recovery so I took the advice in Joe Defranco\'s \"Westside for Skinny Bastards \" and cut my leg workouts to 2 x 3 at 80% of 1 RM. I can now usually run the day after a leg workout without having dead legs and have increased my weekly mileage from 25-30 to 40.

That all sounds great since I sort of have it figured out for me, but besides time, I have the advantage of a big cushion in running a Boston qualifier. At age 70 I have to run a 4:30 marathon, a 10:17/mile pace but theoretically I\'m in condition to train for a 4 hour marathon about a 9:09 pace. Contrast that with a runner who needs to run a 3:10 but his theoretical time is 3:05. How much of his running can be replaced by weight training? What can he recover from and still run.? I have a very good idea of what he needs to do to run that BQ, because I\'ve been helping runners do that for 10 years with about a 90% success rate. But adding weight training to his schedule, even if I could convince him to do it, I\'m not so sure about that.

Posted by Bob Gorinski at 01:27PM on July 20, 2010

Excellent Mike! Amen at what Allen said, too.

Bob D: one execise modality to burn 4000 calories per week? I don't know if that's sustainable (or very healthy) for anybody outside elite endurance athletes. And I think Mikes "genetics" rules apply there.

bg

Posted by Bob Gorinski at 01:27PM on July 20, 2010

Excellent Mike! Amen at what Allen said, too.

Bob D: one execise modality to burn 4000 calories per week? I don't know if that's sustainable (or very healthy) for anybody outside elite endurance athletes. And I think Mikes "genetics" rules apply there.

bg

Posted by Bob Gorinski at 01:28PM on July 20, 2010

Excellent Mike! Amen at what Allen said, too.

Bob D: one execise modality to burn 4000 calories per week? I don't know if that's sustainable (or very healthy) for anybody outside elite endurance athletes. And I think Mikes "genetics" rules apply there.

bg

Posted by Bob Gorinski at 01:28PM on July 20, 2010

Excellent Mike! Amen at what Allen said, too.

Bob D: one execise modality to burn 4000 calories per week? I don't know if that's sustainable (or very healthy) for anybody outside elite endurance athletes. And I think Mikes "genetics" rules apply there.

bg

Posted by Bob Gorinski at 01:31PM on July 20, 2010

guys - sorry about the repeats...didn't know that was happening

Posted by Bob Dannegger at 05:11PM on July 20, 2010

bg, any good club runner training for marathons or even 5ks and longer easily averages 40 or more miles/week for the entire year. 15 years ago I ran over 2000/year for 4 years in a row with a peak of 2600 and I was in my low to mid 50s at the time. I also got down to 147 lbs.. I know many runners with similar stats. One female I work with has been running > 50 mpw for11 years and still going strong.

A lot of runners run because they like it and are competitors and when you are a basic ectomorph, what else are you going to compete at on a year around basis in most places where you can set PRs, win age group awards, hang out with like minded people, and eat and drink more than your average Joe while losing or maintaining weight. So what if you get injured sometimes. At least they are usually not life threatening nor debilitating. The key to long term fitness is finding something you like to do as opposed to something you have to do to maintain or lose weigh other than eating less which is not that much fun either.

I used to be a fairly good golfer in my early 20s, close to a scratch player as long as I played on a course that wasn't too long. When I first started running to lose weight I read a book by Dr. George Sheehan where he talked about sport and that sport is like play to a child but we should select something we could be good at. He said that ectomorphs are not naturally built to do hitting sports and are built for endurance events like running. So I set a goal to qualify for and run the Boston marathon. It took me 7 years and in that time I learned more about what it can take to accomplish a goal than all the goal setting seminars I went to provided by the company I worked for.


Posted by Bob Gorinski at 07:40PM on July 20, 2010

I hear you Bob D: find something that suits you physically and mentally, and push yourself to be the best you can, which involves not getting injured. My roomate in college was a pro biker and he constantly biked and ate, with a little classwork throne in. Mega calories to sustain his goals for biking.

I was primarily thinking in terms of the question posed above:

"...what combination of weightlifting and HIIT or complexes or circuits or whatever you want to call them can burn at least 4000 NET calories/week."

it's stated as if finding some other way to burn that many calories is the primary objective of the HIIT complexes or circuits or whatever. I don't think it is.

I would still contend that running that much (to support eating that much?) MAY not exactly be healthy and sustainable for most folks...in pretty much the same way that repeatedly hurling a baseball with max effort may not be healthy and sustainable for most folks. Pitching (baseball) at elite levels is also a war of attrition, as are many other sports. I think MR's points regarding genetics and the need for training peripheral areas related to the sport are well put.

Posted by Ken at 08:19AM on July 21, 2010

This is a very nice post. However, you seem to have missed out on new developments in running that seem to explain why so many runners are getting injured. Basically, most adults do not have good running technique. Actually most adults who live sedentary lives and who wear modern footwear (particularly modern running shoes). If you are interested more information, the following link is a good place to start http://www.barefootrunning.fas.harvard.edu/.

Posted by Bob Dannegger at 09:27AM on July 21, 2010

Bob G

My response about burning calories with weights and Hiit was based on my observation by most trainers on the internet that they disparage running (or "cardio") as a way to burn calories. Of course they are all strenght cocahes so they wouldn't be biased would they? I think the worst one was by Rachel Cosgrove where she posted a figure of herself looking fat after doing an Ironman triathlon and shortly afterward looking slim and trim from weights and metabolic training. http://figureathlete.tmuscle.com/free_online_article/training/the_final_nail_in_the_cardio_coffin&cr=

I know 5 people who have done Ironmen and none of them looked like her first picture, in fact 4 of them look more like the second picture and the other is a bit less musclular. The only explanation I can think of is that she ate too much. I actually emailed her about that, but she never responded. Many runners make that same mistake, especially at first. They think if the run 4 miles/cay they can eat anything they want.

Regarding injuries running and the risk of doing it long term, that may be true. But many long term weight lifters screw up their shoulders (mine was messsed up for a few years), tear their pecs, and even drop weights on their foot as Cressey did recently! As the old saying does, no risk, no reward.

Posted by Bob Dannegger at 09:36AM on July 21, 2010

Ken, I am well aware of barefoot running and have written 2 articles about the subject in our bi-monthly running club newsletter. I also enjoyed Born to Run. However, barefoot running is not a panacea for solving everyone's running injury problems and in fact may well cause an injury in some who were fine before. If you go to http://www.sportsscientists.com/search?q=barefoot+running there is a series of 5 articles + a few additional that cover the subject very well. Another opinion is at http://www.educatedrunner.com/Blog/tabid/633/articleType/ArticleView/articleId/797/Default.aspx

Posted by Ken at 10:55AM on July 21, 2010

I'm not particularly concerned with the barefoot part. I'm more concern with the implications for running technique. It appears that most people are getting injured when they run because their technique is terrible, and my experience as Pose Running coach bares this out.

I've read the articles you mentioned and Born to Run. I think all the lines of evidence currently support a few ideas. Most people in the west do not have good running technique. Bad technique is the cause of most running injuries, and people who take the time to learn sound technique dramatically reduce their rate of injury. Again, my experience bares this out.

I know that there isn't much to go on with hard science yet, and that many studies on the subject have been poorly designed and executed, but it seems to me that the evidence is mounting to support the idea that technique is the key to reducing injury, and modern running shoes are doing more harm than good.

Posted by Allan Phillips at 12:12PM on July 21, 2010

“It appears that most people are getting injured when they run because their technique is terrible”

But again, we get back to the fundamental question of WHY is their technique terrible? Is it a run-specific motor learning issue or is the technique an evolved trait based upon the runner’s fundamental movement abilities that actually prevents them from getting even MORE injured. Additionally, sometimes the person is simply training like an idiot and is developing bad technical habits because they are always trashed (or alternatively, not putting in enough training volume to ever advance their fitness and ingrain sound technique). Bottom line is that ‘forcing’ technique upon a runner can cause more problems than initially existed in the first place if you don’t know the type of problem you are dealing with.

If the person manages to avoid getting hurt from forcing foreign technique upon the body, the next best scenario is that we end up simply wasting time because once we remove some oxygen, add some CO2 buildup, and pump the muscles full of waste products during hard races, the last things the runner is thinking about are the nuances of running form. Take someone who naturally ‘sits back’ with an excessive posterior pelvic tilt. Based on visuals alone, we might tell this person to lean forward a bit. We might even get all fancy and use a video camera and then assign some special drills a few days a week. But we would have to be insane to think that a few little spurts of form drills or even just “mindful” running during normal runs is going to effect meaningful change in the pelvic position of a runner who LIVES with an excess posterior tilt 160+ hours per week.

Before going in there and chopping apart the form with a machete, we need to screen and assess. Personally, I’m an FMS guy and having been through the TPI golf program I’m also able to utilize the SFMA methodology as well. But ultimately, I don’t care what methodology you use, as long as you get to the bottom of what is causing the bad technique and can follow it up with the appropriate corrective strategies based upon what the person’s body presently is CAPABLE of doing.

Posted by Bob Dannegger at 12:21PM on July 21, 2010

Ken,

I don't disagree that running technique is a problem, but the right technique is not even clear. I'm also familiar with the Pose method and have the book and used to have the tape until I lent it to someone. I failed to see how anyone could run fast that way and never tried it. I seem to remember reading that Romanov said that Michael Johnson used it, but I'm not sure of that. I'm pretty sure Usain Bolt doesn't! There is also a lot of criticism of it for causing calf injuries, especially in newbies.

There are even biomechanical disagreements about how a person runs. The 2 major methods are the pawback model and the spring model. There was a big discussion/argument about it several years ago on the Supertraining Forum at Yahoo.

From what I have seen, one of the biggest problems is overstriding and landing in front of your center of gravity. The modern running shoe helps you get away with that whereas running barefoot won't because it hurts. What helps most runners is focusing on keeping their stride rate at 180 or higher. It's hard to overstride, at least much, at that rate. That stride rate was first discovered by Jack Daniels when he observed that all of the middle and long distance runners ran at 180-184. I have checked the men's and women's stride rate during the Boston marathon several times and the men were clocking 180-182 and the women 183-184. I cured my own hamstring problem that I had years ago just by doing that. It is hard to keep up that rate over time without working on it.

The other big problem which I have been a victim of is running on crowned roads. I've read plenty of advice not to do it, but oftenhere aren't a lot of other options. Even greenways are slanted.

Posted by Ken at 01:02PM on July 21, 2010

@Alen

Why people are running with bad technique is not fully certain. However, it is known that people who do not grow up in overly protective footwear seem to run with very good technique, with very few injuries and generally faster. The general hypothesis is that people are not getting the feedback from their feet that they need to run efficiently. This in not about some "foreign" technique, it is about relearning what humans will do under normal conditions (like growing up not wearing modern overly protective footwear). In the West, we are living life so differently from the way the vast majority of our ancestors lived that most people are not able to do something as fundamental as running without getting hurt.

@Bob

You are incorrect about Usain Bolt. His running technique is perfect Pose form.

There are disagreements in the theory of what propels us forward when we run, but despite these disagreements almost all of these different theories teach identical running technique. I have studied at least 5 different running methods, and I have yet to find any significant difference in the technique that they teach. Since the theories differ, but the technique is the same, I fairly confident that the basics of good technique have been established, and that you correctly described many of the elements of good technique in your reply.

The criticism for calf problems is not justified. People have unrealistic expectations of how quickly and easily they can change technique, and they end up pushing themselves too hard too quickly. I have a lot of problems convincing people who are already running to give their bodies time to adjust.

Posted by Bob Dannegger at 02:04PM on July 21, 2010

Ken,
It's been awhile since I saw the Pose tape, but as I recall, what Romanov was doing and what Bolt does don't look at all the same, but maybe it's because Bolt does it much faster. His stride length looks proportionally much longer than what I recall Romanov's was which looked very short and choppy but it's been years since I saw that tape.

Also, as I recall one thing I noticed that one of Romanov's feet was externally rotated when he ran. I have that problem as well and after reading an article by some podiatrist that said George Bush runs like a duck, I tried to consciously internally rotate my leg before my foot hit the ground. Not too long after that I started having problems with peroneal tendonitis and it bothers me off and on today and that was 4 or 5 years ago. I went to a PT for it a few years ago and she said that the reason my feet were externally rotated was because I have retroversion in my hips and that's the way it is. It's also one of the reasons I'll never get more than a 1 on the FMS squat test.

There was quite a bit of discussion, mostly negative, about the Pose method at bearpoweredrunning.com a few years ago. Barry Ross is a big proponent of the spring model of running. He is a big proponent of deadlifts for running and had Allyson Felix, one of the 2 top 200 meter runners in the world now, doing over 300 lbs. at a bodyweight of about 125 in high school, not too shabby. I used to follow that site but got in a pissing contest with Barry over my criticism of a photo they posted of a kid doing a deadlift that to me looked like very obvious lumbar rounding.

Allen, I got FMS certified to perhaps help myself and some of the runners I coach. However, I didn't realize that the corrective exercises at the FMS site were charged for. That's fine for people that train people for money, but I don't charge the runners I coach a set fee although most of them give me an occasional gift card or chip in to pay my room at an out of town race. Also, I only see them at track once/week if that often and giving someone corrective exercises without making sure they are doing them correctly is just another way for someone to hurt something. I have screened some of the runners I coach and they all have done better than 14 with no 1s although none of them have more than a 2 on the deep squat test. Bottom line is I spend too much time now as a volunteer and have no desire to spend more.

The biggest running form problem I have been able to correct is cross-body arm swinging, very common among females. Whether it would injure them or impact performance is hard to say. However I had one female who looked like a bear when she ran. Just showing her how to hold her arms and do some core stability work made a huge improvement and within 9 months improved on her previous marathon by 45 minutes and qualified for Boston.

I have video taped runners from both the sides, front, and back and other than the obvious overstriding and arm-swinging there isn't much obvious. I did see one female whose left lower leg externally rotated as she swung it back and referred her to a PT. That was years ago before I even knew what an FMS was. It would be interesting to screen her now, but she has moved out of town.

Posted by Adrian at 04:22AM on July 22, 2010

Quick question: How would one fit strength and conditioning in to a typical training week? I feel like I become more prone to injury (long time sufferer of ITB - which has been corrected mostly by strengthening) when my muscles have become sore/tight from heavy strength work - deadlifts and squats mostly.

I'm interested how people deal with this.

Posted by Ken at 08:18AM on July 22, 2010

Bob,

It sounds like you are very knowledgeable about running technique.

I can assure you that if you do a frame by frame analysis of both Dr. Romanov and Usain Bolt using the Pose Running standards, they would both meet those standards perfectly. To my eye they look quite similar. However, I think your are right, Usain Bolt is much faster and much taller than Dr. Romanov, and that probably is the reason they look different to you.

I know there is a lot of criticism Pose. The criticism usually is one of 3 things. Criticism of the theory, which is legitimate since the theory is controversial. Criticism of the technique, which usually doesn't stand up under close scrutiny, because Pose technique is similar to every other well know method and technique (despite having a different theoretical basis). Finally, a lot of people just don't like Dr. Romanov, and since they do not like him, they are sure that his theories and techniques must not be valid.

Posted by Bob Dannegger at 02:46PM on July 22, 2010

Ken, you said:
"because Pose technique is similar to every other well know method and technique (despite having a different theoretical basis)"

I don't think that is true, at least as I understand it. As I recall it is quite different than the "pawback" technique defined by Dr. Michael Yessis (one of the old time Russian coaches who has written extensively about kinetics) in his book "Explosive Running". In the pawback technique from stance forward momentem is provided by ankle extension, teh hip is swung forward as fast as possible and in a long distance runner to 45 degrees. At that point the glute/hamstring complex goes through an eccentric contraction to stop forward swing and immediately contract to "pawback" the leg to stance under the center of mass.

As I recall Pose minimizes both hip extension and flexion and seems to be more of an up and down motion that would fit somewhere on the spring based (i.e. pogo stick) method. It was Yessis and Barry Ross that were the main antagonists on the Supertraining forum.

I actually tried to run that way but I never could get my thigh to 45 degrees nor consciously pawback my leg. I got into an email argument with Yessis when I told him it looked like some of the runners in the pictues in the book were overstriding and landing on their heels. We then got into a discussion of stride rate and the 180 steps/minute thing andhe dismissed that as well and said it wasn't important. Obviously he is as committed to his position and doesn't like us peons questioning his long held beliefs. Eventually we agreed to disagree.

Posted by Bob Dannegger at 05:09PM on July 22, 2010

Adrian see my post back on 7/20 at 11:40 a.m. for what I do/am doing. What you are talking about is one of the problems of strength training and running. I don't think there is a cookie cutter answer since there are so many variables, i. e. goals, weekly mileage, current condition, training program, # of days running, etc..

One thing that I will mention that may seem counter-intuitive is that you can do a heavy squat or deadlift workout and immediately, after a bit of running warm-up and mobility exercises, do some fairly short fast running. I've done everything from 20-80 meter flys and 400 meter intervals. However if you go out and try and run 10 miles after that or even the day after wards it won't be a lot of fun and probably very slow. In fact even 4 miles may be tough depending on the workout. Good for losing fat, but not much else if it's too slow.

However, I've done a lot of these workouts in my 60s so your recovery ability is probably better than mine, unless you're using a low carb diet. If so you will really be dragging your butt.

Posted by Ken at 06:46PM on July 22, 2010

Bob,

You made some very good points. I definitely over-stated my position. I'm not saying that there are absolutely no differences, but, I think, in practice, the differences wash out.

I've studied Dr. Michael Yessis's Explosive Running Book and my conclusion was that the resulting technique was not, in practice, that much different from Pose Running, or any of the other methods that I've studied. When watching people run using these differing methods, they end up running with very similar technique. They conceptualize what they are doing differently, and it would be very difficult, but not impossible, to tell the difference between good examples of people trained in these different methods.

The main point I wanted to get across was that these methods do not remotely resemble how most people in the West run, but they are very similar to how people who grow up without the "benefit" of modern footwear run.

Posted by Allan Phillips at 09:25PM on July 22, 2010

If we're talking distance running, do your heavy strength work on the same day as your quality runs (which includes your long run) either right after your run, or preferrably later in the day. This planning ensures that you'll have sufficient recovery between your quality running workouts and you won't be running on legs that are blasted from the gym. The standard 7-day week which includes two faster workouts and one long run simply doesn't have enough free days to fit in heavy weightlifting AND run effectively. Your legs need those easy restorative runs, but if you're always less than a day removed from a quality run or a weightroom lower body session, you'll be in a constant state of struggle and vulnerable to injury.

Sure, you may sacrifice power by lifting on semi tired legs, but your running will suffer a lot more from the weights than the weights will suffer from running. If you are into distance running you're probably not interested in maximizing 100pct of your weightlifting ability anyway. That doesn't mean you can't progress in the gym under this setup, but you do need to make some concessions. To accomodate both goals, plan long term to incorporate periods where you deemphasize one or the other (but certainly not abandon one altogether).

Another option that helps is to put yourself on a 9 to 11 day run training cycle (instead of 7 days) if that is possible for you. The only reason 99pct of us train on a seven day cycle is that Saturdays and Sundays offer the most time to get in our longest run of the week. Obviously on a 9 to 11 day cycle the long run could fall on any day. A slightly longer "week" simply gives you more options to spread things out while still being condensed enought to hit all the key points you want to hit regularly.

Posted by Bob Dannegger at 05:00PM on July 23, 2010

Allan, I agree with you about the best time to do strength work is on a quality day, but I don't think it is productive on a long run day when they start getting over about 12 miles or so, especially if you are doing some of those miles at a faster than easy pace. Even after a 6-8 hour recovery there isn't much left in the legs to make it worthwhile and may well impede recovery for the next quality day. I think it's better to just skip that one. I know I have trouble with it and so does another runner I know that is much younger than I.

I also agree something like a 9 day schedule is better than a 7 and that is what I use although sometimes it's 10 in weeks I do a really long run. However, as you said, having the time to do a long run during the week is hard for most people. Another thing that screws up other than a 7 day schedule is a weekly track workout on the same night every week which many running clubs have, including mine.

Posted by Bob Dannegger at 05:08PM on July 23, 2010

Ken, you said:
"The main point I wanted to get across was that these methods do not remotely resemble how most people in the West run, but they are very similar to how people who grow up without the "benefit" of modern footwear run."

It's interesting that Gebreselaisse, the world marathon record holder is a heel striker and an overpronator http://www.youtube.com/watch?v=EAW87NsiGuI

You might also find the following article that looks at footstrike patterns of elite runners
http://www.sportsscientists.com/2008/04/running-technique-footstrike.html

Posted by Ken at 06:56PM on July 23, 2010

Bob,

I'm not sure that that's Gebrselassie in your video. Because he is very clearly not a heal striker in this video( below). In fact I have seen many videos of him running, and I have yet to see one that showed him heal striking. I've even seen Dr. Romanov do a frame by frame analysis of Gabreselassie running, and he was definitely not heel striking.

http://www.youtube.com/watch?v=5D56ZAvcxN0&videos=vmnKx6yDUXk

As far as the article, I've read it before, and I'm not impressed. There hasn't been much scientific study of this subject yet, and most of the studies that have been done have been seriously flawed in design. It will be many years before the science will be of much use settling these arguments.

As far as I'm concerned, there is just too much anecdotal evidence in support of forefoot running. Also if you believe in Evolution, and/or you believe people ran before the invention of the modern running shoe in 1972, and if you understand anything about physics and/or engineering, then heel striking just does pass the common sense test. So until the science starts to catch up, I'm going with common sense, evolution, physics and engineering

I also have to go with my experience, which is that everyone I've trained to go from heal striking to forefoot striking, reduced their rate of injury, and became significantly faster runners. I picked up 30 seconds per mile, even though I dramatically reduced my level of training while making the transition.

I will concede that it is possible to land lightly on the heals, and that some runners do this well. As long as these runners have running shoes, they can probably continue to run this way. However as soon as you take away the shoes, I would be very doubtful that they could continue to heel strike.

Posted by Bob Dannegger at 10:35AM on July 24, 2010

Ken, you could be correct about the runner in that video, but it's hard to say. I've seen another video of him where it looks like his feet are externally rotated at touchdown, but there is not enough footage at the correct angle to be sure.

What is your problem with the forefoot study? The data collection with a high speed camera seemed to be valid, although high speed is undefined. I think the article made another good point and may explain what you see on the video you linked to. The faster you run, the more forward on your foot you tend to land. That could account for the difference in Haile's foot strike diference between the 10k and marathon. I know it applies to me because the first few years I ran I used to have to use "shoe goo" on the lateral heel in a hundred miles or so, but now I can wear shoes 500 or so and there is still rubber there.

I have had mixed success with trying to change runners from heel strikers to mid/forefoot strikers. Even though I tried to get them to ease into it slowly, several of them developed calf problems and one them didn't show up until mid-way through Boston. I no longer try and change them that much, but try to get them to improve their stride rate and thereby heel strike less.

I agree that you won't run barefoot and land on your heel and I personally think mid/forefoot running should be faster and if not changed to too rapidly would be superior. After reading "Born to Run" I went out and ran 1/4 mile barefoot on the asphalt street in front of my house. It felt ok until I stepped on an acorn. I then decided to maybe ease into it by running more often in my racking flats during shorter runs. Unfortunately I soon started feeling the onset of PF and it still lingers.

How do you define forefoot striking as opposed to mid-foot striking?

Posted by Ken at 12:00PM on July 24, 2010

Bob,

The study was fine for what it is, but my criticism is that it really doesn't address some very basic and fundamental questions that are important for this discussion. What population group did the study draw from? How did they grow up (barefoot or in shoes)? What kind of training did they receive? Were they trained to run with a particular technique or were they just running naturally? What was their history with injuries?

We really need to see studies comparing running technique between populations that grow up running barefoot, and those that grow up running with modern running shoes. We also need studies that look at the affect of changing from barefoot and minimalist running, to wearing running shoes as well as from shoes to barefoot.

As far as forefoot vs. mid-foot striking, I think they are two terms that mean the same thing. You can only land one of three ways, on the heal, on the whole foot (flat-footed), or on the ball-of-the-foot. As fare as I can tell, the whole forefoot mid-foot thing got started because the Chi running people where trying to come up with different terminology for their technique, because Chi running technique was and is very suspiciously similar to Pose running technique. I think now some people use mid-foot to mean landing on the ball-of-the-foot with a more shallow angle, or almost flat footed.




Posted by Bob Dannegger at 04:16PM on July 25, 2010

Ken, good luck on getting the kind of studies you mentioned. Unfortunately those studies take a long time and a lot of money and someone that wants to do it. I'm not even sure how relevant it would be. I kind of like one of Dr. George Sheehan's sayings "we are all an experiment of one". I don't know how old you are or if you have heard of him or not.

I have a bit of a different definition of footstrike patterns. I agree on the first 2, but to me, mid-foot is behind the 5th metatarsal. From there your heel lightly touches down before toe-off. What you are calling ball of the foot could be what it looks like how some runners, especially sprinters, run; it looks like they are running on their toes. To land on the ball of your foot (do you mean metatarsal arch) it seems to me you would have to pronate the foot before touchdown, at least to get the whole ball of the foot as opposed to the lateral side.

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