After running my first marathon I had Bilateral IT band syndrome AND plantar fasciitis in both feet. I felt like my soul was torn from my body and I was ready to throw my running shoes out of the car on the way home. How could anyone want to do this over again?!?! Who would want to go through the grueling training, dietary restrictions, and constant inflammation AGAIN?!?!
Well I did.
But I made sure to do it better this time. I became a student of the sport. Read every book I could get my hands on, talked to professional coaches, doctors and other therapists to put together a plan that worked for me. I learned about everything that I was doing wrong and how I was responsible for the fact that it hurt so much. As a Physical Therapist I had a leg up with knowledge on anatomy, biomechanics, and injury prevention, so absorbing all this information was not only easy... It was FUN.
While there is so much more information out there, I've put together a 2 part series on some of the more important points I come across while working with runners of all levels. I get asked a lot of the same questions so hopefully this can give some clarity on how people should be running, who should be running, and why they should be running.
Does This sound Familiar? “Running on concrete is so bad for your knees.” “Running is bad for your body.” All common responses I hear when talking to patients about running. It makes sense considering the extreme amount of forces that your body needs to absorb. The main factor in healthy, sustainable running lies in a certain RATIO OF STRENGTH TO MASS. Mass determines how much force is shooting back up your legs with every step and Strength is how well your body is able to absorb those forces.
As a culture we have adapted our bodies away from the strength and resilience needed to run. We lose mobility in our hips and trunk, weaken our feet, and wear down our bodies with poor dietary decisions. But our bodies were perfectly engineered to withstand the forces associated with running. With finely interwoven fascial slings and trains, as well as, adaptable feet and hip girdles, the forces shot up from the ground into our bodies with every step can be absorbed and dissipated to have little effect on us.
That said, if you do not do what is necessary to maintain your body's resilience then NO! Running is not meant for you and it can take a big toll on your joints, cartilage, and muscles. So the question is not whether or not you can run, but rather “Can you provide your body the maintenance it requires to keep up the strength and flexibility needed to run?” It would also help to find a movement professional who can take a look at your running form and assess its efficiency through an extensive evaluation and examination process.
Toe Running vs Heel Striking
Finding the best way to shock absorb has been a hot topic for runners because when you hit the ground you are taking anywhere from 3 to 4x your body weight through one leg with every step.Have you ever tried a single leg half squat? How about with 3 of your friends on your back. Those are the types of forces we are talking about. How does one most efficiently take in all that stress... repetitively… thousands of times over, without breaking down your body.
Over the last decade a very interesting conversation has begun about how your feet should contact the ground. The traditional HEEL STRIKING (where your outstretched leg hits the ground heel first to create a great long stride length to propel you down the road faster) has been challenged by the thought of Toe Running (where the heel almost never touches the ground and the runner’s posture is more upright with a shorter stride length).
Heel striking is the classic approach but comes with increased forces through the shin bone. There is a “Breaking Mechanism” that happens when the heel strikes the ground and sends a force vector directly into the ground that gets reverberated back up the shin bone. This can eventually cause annoying shin splints or even a tibial stress fracture. OUCH!
Toe running means you contact the ground first with your forefoot (not up on your toes like a ballerina). This cancels out that “Breaking Mechanism” as you are never really pushing into the ground, but rather attempting to glide over it. The problem with toe running is it requires a great amount of strength in your feet and ankles that few have due to our heavy shoe wearing society. This bulky, heavy footwear or shoes that hold our feet tightly in unnatural positions never let our feet move the way they were intended. As a result they become weak and reliant on these external supports. When people switch over from heel striking to toe running they start to experience a whole new type of injury: Stress fractures in their feet. UGH!!
A) Amateurs (most runners): Most aren’t here yet. You haven’t reached the point where you need to make these kinds of changes to your running form. It’s like asking which brand of sneakers will make me a better basketball player when you have yet to lock down the fundamentals of the game. Start with the basics of running: Strength to weight ratio, posture and arm swing, hip mobility and strength. These factors play a HUGE role in shock absorption that need to be dealt with before you start addressing the finer points of your running quality.
B) Experienced Runners: You more dedicated runners, fine tuned-machines, gluttons for punishment, and addicts of endorphins. You have spent countless hours figuring out what is best for your body, searching internally for the true effects of change in training, diet, and running form. You are still battling aches and pains that you choose to blow over with the power of determination and true grit. You have found temporary solutions through compression sleeves, ointments, and shoe choices. Nothing is really working to get rid of those nagging injuries for the long term. You need much more than a “quick fix” article can provide. You need a specialized movement analysis and breakdown of the more intrinsic deviations seen while running. Find a professional you can trust, who has been educated in running form. Find one who is experienced in the distances you want to run so they understand the mindset. Then you can get the answers on how YOUR foot should be hitting the ground based on how you’re built, your strengths, your weaknesses, and compensations.
Let the debate continue on how a runner SHOULD hit the ground, but for now focus on what works best for you and how you can make your hips and legs stronger to keep your joints healthy and to keep you on the road/trail doing what you love.
Stay Tuned for much more information on training styles, formats, and mindset on the next blog coming out next week. Part 2 of Running for Life.
Any Questions? Text, Email, Call, or find me on social media. I love talking about all of this and I am well aware that there is way deeper to dive into each of these points.
Dr. Leo Valenzuela PT, DPT
Los Leones Physical Therapy