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Running analysis San Diego

Running Analysis San Diego

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Running Analysis San Diego

Case Study 1- Runner’s Knee

In this running analysis case study, we look at what is exacerbating our patient’s “runner’s knee”. He is a triathlete, who is new to the sport. The knee pain is worse following runs and hard efforts on the bike. Stretching, foam rolling, Active Release treatments seem to help but the pain always returns. He has never had a running analysis, so we put him on the treadmill to see what his running technique looks like.  Watch the complete in depth running analysis below.

Additional Information

Before the running analysis, we performed a physical exam. Our patient is 6’3″ and weighs around 190 lbs. As mentioned in the video, he was found to have a slow cadence, over stride, and demonstrated a cross over gait. Those findings with a runner of his size can create a lot of impact force with each step. To reduce the strain in the knee, it is crucial to get his feet to land closer to his body. In his case, increasing cadence helped accomplish this. It is important to note however that not everybody will need to perform the same corrections to get the foot closer to the body.  This  is what makes a running analysis so valuable; each runner may need to work on different cues to accomplish the same goal.

Future Considerations

Watching the running analysis above, you may think “But he can work on this, and this, and this to help with his form too!”. I believe he can work on more cues and drills to help with his running form. BUT if you give a runner too many cues to work on immediately, they will likely get overwhelmed with the information and not properly execute the cues/drills. Further more, they will likely end up running very stiff, and out of sync making the runs feel terrible!

For these reasons, we will only give 1 to 2 cues/drills to work on at a time. We want our runners to ENJOY running while making beneficial changes to their running technique! So for our patients case, we recommend 4-8 weeks to start working on changing his technique. Then we perform a second running analysis to get a new baseline and then make further recommendations from there.

Schedule your running analysis today at www.peakformhealthcenter.com! Our running experts at Peak Form Health Center in Mission Valley, San Diego have worked with hundreds of runners. We are located near Hillcrest, Normal Heights, La Mesa, Ocean Beach, Point Loma, and Clairemont Mesa. Our exertise will get you back to running injury free and increase your performance!

The Running Clinic Certification

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Congratulations to Dr. Travis Rose, DC CCSP for successfully completing the course in “New Trends in the Prevention of Running Injuries”! This course, taught by The Running Clinic, teaches health care providers about the latest methods to treat and manage running injuries. Dr. Rose is currently the only healthcare provider with this certification in Mission Valley, San Diego.

Running Clinic Running Doctor San Diego

The following is a quick Q and A with Doctor Rose regarding running injuries.

Q: Having taken this latest course, put on by The Running Clinic, what were the main takeaways to prevent running injuries?

Dr. Rose: The main takeaways for injury prevention and increasing running efficiency were the following: 1. Run with a cadence between 170-180 steps per minute, 2. Limit the up and down motion while running (decrease vertical loading associated with injury), and 3) Use as little of a shoe as possible as this allows you to run more naturally.

Q:  Was there information that surprised you or went against conventional running information?

Dr. Rose: The biggest “eye opener” was the fact that there is zero research to support prescription of specific shoes for specific types of feet. Many people put their trust in companies to tell them which shoe to buy based on treadmill analysis. Unfortunately there is research that shows that shoes don’t limit pronation like they claim to do. So why give somebody a big bulky shoe when it doesn’t do what it is designed to do? Instead, work on the items listed above and become a better runner!

Q: What is the biggest cause of injury in runners?

Dr. Rose: It is when a runner changes something. For example, a runner runs 25 miles per week, same distances for each run. But then decides to run an extra 10 miles one week. That change in volume is what will likely cause an injury to pop up. Another example is always running on concrete or hard trails, then deciding to run 10 miles on soft sand. The body was not ready to support a long soft sand run and an injury occurs.

Q: There is a lot of information for exercises online to help improve running technique, can a runner do home exercises and fix their running flaws?

Dr. Rose: Unfortunately no. I used to be under that assumption when I was an injured runner. I would get frustrated when I would do a ton of strength exercises and core work to then run 2 miles and have that all too familiar pain come back. Running gait needs to be corrected to take strain off the injured area. Using myself as an example, I suffered from repeated shin splints due to cross over gait. It did not matter how much glute or calf strengthening I did because once I ran incorrectly again, the tendon would get overloaded and I would be back to square one. Once I learned to run with a wider step width and have a faster turn over (faster cadence), my injury went away almost immediately and I was able to slowly build back up.

Q: Any other advice on running injuries that you learned?

Dr. Rose: When in doubt, get it checked out. Running should be fun and injury free. I hear too many stories from patients about how tight and sore they are after every run. Or that pain is something “you deal with as a runner”. Not true! Get evaluated by a running doctor who can get your gait back on track. If there is not a running doctor in your area, there are a few pieces of wearable technology that can help. One being Lumo Run which gives feedback on cadence, vertical bounce, hip drop, hip rotation, and braking force. If you already run with a running watch, usually they have features that you can use (like cadence) to start really emphasizing proper technique.

Dr. Travis Rose DC CCSP and Dr. Kevin Rose DC DACBSP are Chiropractors trained to treat a wide variety of sport related injuries. Schedule a visit at our Mission Valley, San Diego office!

Hip pain running doctor San Diego

Types of Hip Pain and Running

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The hips play an important role during running. Running is essentially a single legged sport once you break down the movement.  The hip not only helps propel the body forward but also is a stabilizer of the lower back and the leg during the gait cycle. Due to the demands placed on the hip, it is susceptible to overuse, and acute running injuries. A running doctor can help by diagnosing the problem correctly and developing a treatment plan to get you back to running pain free.

Common types of hip injuries found in runners

There are many types of running injuries that can occur at the hip. Pain may be felt in the front, outside,inside, or back of the hip. Certain cases runner’s will describe the pain as deep in the hip joint. We will categorize the most common types of injuries we see based on location of the injury:

Front hip pain in runners

  • Hip flexor strain
  • Rectus Femoris/quadricep strain
  • Iliopsoas bursitis
  • Iliopsoas tendinitis/tendinosis
  • Rectus femoris tendinitis/tendinosis
  • Hip impingement
  • Hip labral tear
  • Stress reaction/stress fracture
  • Hernia

Outside hip pain in runners

  • Gluteus Medius tendinopathy
  • Iliotibial band syndrome
  • TFL strain
  • Trochanteric bursitis

Inside hip pain in runners

  • Adductor strain
  • Adductor tendinopathy
  • Iliopsoas tendinopathy
  • Hip impingement
  • Hernia

Back hip pain in runners

  • Hip osteoarthritis
  • Hip labral tear
  • Gluteal muscle strain
  • High Hamstring injury
  • Piriformis syndrome
  • Low back pain referral
  • Sciatica

To complicate the injury spectrum, there are cases where runners feel pain in the hip but is a referral from joint/nerve impingement from the lower back. Also if the hip is weak and injured, other injuries to the lower back, knee, shin, and foot may become prominent. Receiving a diagnosis from a running doctor trained in diagnosing and treating runners is very important.

Hip pain treatment

Our sports chiropractors at our Mission Valley office are trained to treat a wide variety of running injuries. We specialize in Active Release Technique, Graston technique, running form analysis, and rehabilitative/performance exercise. Schedule today to get evaluated by a running doctor who knows how to get your training back on track!

Increase your Cadence!

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Increase Your Cadence!

Increasing running cadence will help reduce your risk for injury, and make you a more efficient runner (potentially faster runner as well)! Now that you know the benefit of increasing cadence, let’s go back and look and some of the main points that go into tweaking this aspect of running.

Break the Injury Cycle

Annually, 37%-52% of runners experience a running injury. That is VERY high injury rate! Many of the injured runners I treat are new to running, want to manage the symptoms before their upcoming race, and then stop running afterward because of the nagging symptoms they are experiencing. The following year, the same cycle occurs: signed up for another half marathon, developed an injury, barely made it through the race, and then stopped running due to the nagging symptoms. Stop it! Make changes to why you are injured and then you will no longer have to worry about dealing with nagging injuries. The BIGGEST change you can make is improving your turn over or in other words, increasing running cadence.

What is Cadence?

Running cadence is the number of times your feet come in contact with the ground, measured in steps per minute (every time either foot touches the ground) or strides per minute (every time the same foot touches the ground). The goal cadence is 170-190 steps per minute or 85-95 strides per minute.

This moment was late in a Half Ironman run, my cadence dropped to 170 (normally run comfortably in mid 180s) and began running with more of a heel strike pattern; you can see the lead leg out in front of the body which will increase shock to the body.

How does this help decrease risk for injury?

Increasing running cadence to 170-190 steps per minute, decreases the vertical loading rate during the gait cycle. Basically, you run with less bounce and less impact to your legs reducing the amount of force traveling through the body. Running with a slower cadence (< 170) allows your foot to travel further away from the body before initial contact, and results in more of a “braking” force once contact is initiated (see photo). Your muscles, tendons, ligaments, and joints absorb that extra shock and remain under load longer due to the foot being further away from the body.  Increased load + increased time under load = increased strain to muscles, tendons, ligaments and joints which will eventually lead to failure once enough strain has accumulated. Main take away, increasing running cadence decreases the vertical loading rate, loading time, and overall strain in the body.

How do I measure cadence?

Easy! If you have a GPS watch, there is a setting for cadence (most watches these days) that you can select to show on your display screen while running.

If you do not have a GPS watch with that function, then use a timer and count your steps to get your cadence as follows: count the number of steps you take for 20 seconds. Take that number and multiply by 3 to get your steps per minute. To make the math easier, count every time the same foot touches the ground to get the number of strides you take. Multiply by 3 to get strides per minute (85-95 strides is the goal).

How long will it take to run naturally with a faster cadence?

It can take 3-6 months before you are able to run at that range effortlessly. We recommend doing cadence drills twice a week. Do not over think your cadence and force yourself to run with a faster cadence every run. Increasing running cadence takes time and patience. Every 6 weeks, run 3 miles and try to keep the cadence elevated the entire run; remember what the average cadence was and try to increase it the next test run.

The only way I can get my cadence up is to run faster, is that normal?

That is very normal initially. However, with practice you will learn how to run with a faster cadence at all speeds! Technically you can “run” with a 170-190 cadence while not moving. What changes is the width of the steps when changing speed but the cadence should still fall into that range. Our advanced cadence drills help with this.

Beginning Drills

Cadence

Garmin Fenix with cadence option

No GPS watch- Run 20 seconds as you normally would, count your steps (or strides) for the next 20 seconds, then go back to your normal running for the last 20 seconds. Repeat 5 times

GPS watch- Set the display to show cadence, run for 1 minute working on getting your stride turn over quicker. Look at the watch periodically to see the cadence. Repeat 5 times.

RunTempo- Application for smartphones. It is a metronome that you can set a specific cadence. Every time you hear a “beep” your foot should hit the ground. If you know your cadence is let’s say 155, set RunTempo to 165 and run for 1 minute. Once you can easily match the cadence, bump up the cadence by 5 until you are in range. Once in the proper range, experiment by working at the different cadences 170-190 to see where you “feel” the best.

Advanced Drills

Cadence Test- Every 6 weeks, run a 5k and try to keep your cadence high the entire time. Make note of the average cadence after the run. Use that average cadence as your new benchmark for cadence drills. If you averaged 165, perform drills with the goal of 170 or 175. Repeat test and check again 6 weeks later.

Treadmill Roller Coaster– Once you can easily run in the 170-190 steps per minute range, now is the time to work on maintaining the cadence at different speeds. Set up a treadmill for 2 minute intervals. The first two minutes, set the treadmill to the slowest pace you can maintain your elevated cadence. For the next two minutes, bump up the pace to a tempo effort. The goal is to maintain the same cadence when switching from the slower pace to the quicker pace. What changes is the step width, but cadence should be the same! Repeat for 5-10 rounds.

Super Cadence Drills– Find a long gradual downhill. Run with a “as fast as possible” cadence on the way down for 1 minute. The goal is to get your cadence as fast as possible often reaching above 200 steps per minute. Repeat 5-10 times. I recommend this drill for triathletes to get there legs used to having a very quick turn over so when they run off the bike and their legs feel sluggish, what feels “slow” is actually still in the recommended cadence range due to the practice at running with an extremely high cadence.

There you have it, one of the easiest yet best ways to correct running form is increasing running cadence. If you are dealing with an injury, please get evaluated by a sports minded healthcare provider. At our Mission Valley sports injury clinic, we help countless runners overcome injury. Changing cadence while injured may result in worsening of symptoms so it is important to have a proper evaluation before making any significant changes to your workouts.

Peak Form Health Center

Please call 619-818-4306 or visit www.peakformhealthcenter.com to schedule!
2635 Camino del Rio South #200
San Diego, CA 92108