The Breakthrough Running Clinic | Physical therapist

The Breakthrough Running Clinic

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25.01.2022 Pistol squats: if you are not back in the gym and need to progress your single leg squats, pistol squats might be the answer. Feel free to hold onto something for balance but should be used to pull yourself up. You may need to elevate your stance leg on something to make your range of movement easier. Good luck! #running #strengthtrainingforrunners #squats #pistolsquat #legworkout

25.01.2022 Single leg squats against a wall is a great beginner exercise for runners. If single leg squats are your goal but you currently lack the strength and balance, the wall is a good addition. Play around with your range of depth with the squat to find a difficulty that is challenging but achievable. 3 sets of 10 each side is a good starting point. #running #squats #strengthtrainingforrunners #workout #marathonrunningtraining #marathon #quadworkout

22.01.2022 The soleus is the most powerful calf muscle and most responsible for propulsion in runners. However, a straight leg calf raise will bias the gastrocnemius muscle instead of the soleus. So try this exercise out. Bend knee calf raises. It takes a bit of practice and coordination, but keep your knees bent the entire time and move your entire body up and down. Studies show that it’s more effective to use a seated calf raise machine because your knees are bent at 90 degrees AND you can load them up with heavier weights (recommended). But if you don’t have access to a gym this is a good start. #running #calfworkout #gymmotivation #marathontraining #calfstrength #runfast #strengthtrainingforrunners

22.01.2022 Swissball hamstring rollouts. A great exercise to burn the hammies. A good progression for high hamstring tendinopathy if you still want to avoid tendon compression. Mixes in both concentric and eccentric strength. When curling the knees try and keep a straight line from shoulders to knees. Keep those hips high off the ground. Requires practice and balance. Good luck! #running #runstrong #strengthtrainingforrunners #hamstringworkout

21.01.2022 It was awesome have Dr Izzy Moore on today’s podcast talking about how a runner can change their running technique for performance, injury treatment and injury prevention. Have a listen on the Run Smarter Podcast #running #podcast #runninginury #gaitretraining #performance #runfast #runsmart #marathonrunning #marathontraining

21.01.2022 This study looked at 204 people with more than 3 months of lateral hip tendinopathy and assigned them to 1.) Corticosteroid group (one ultrasound guided injection) 2.) Strength exercise & advice group (14 sessions over 8 weeks, advice on tendon loading and a home exercise program) 3.) Wait and see group (one session of advice about condition). Results found better outcomes in pain & function questionnaires for the exercise group at 8 weeks and 52 weeks compared to the other 2 groups. Exercises within the exercise group included strengthening of the hip abductor muscles and dynamic control of adduction during function. Starting with side lie hip abduction, bridging, squats. And progressing to single leg standing control, side steps with band and scooters.

20.01.2022 Click on the link for a brief intro into the breakthrough running clinic https://youtu.be/NpQPgVsIHfw

18.01.2022 Shoes are the only bit of equipment you need to run. It makes sense to gain insight into a running shoe assessment. Once you have participated in this i'd love to hear what you found in the comment section. Step one is to find the oldest pair of running shoes. In this step we are analyzing the wear & tear of the tread. During this step its worth mentioning that pure running shoes (ie. not been used for a lot of walking), can help with assessment accuracy. Next, have a ...close look at the location of sole wear. Compare this from right to left and from heel to toe. This pattern is different for every runner because everyone has a different technique. Step 2: You need to section the area into ‘zones’. See the second picture I posted of my shoes and the 4 zones you need to inspect. Look closely, because there may be subtle differences from right to left which might indicate a harder foot fall, or a stronger push off on one side. Step 3 is interpreting these zones: When the majority of the sole is worn out through the ‘forefoot’ (zone 1 or 2), it increases the likelihood of being a forefoot runner. That means the initial contact on the ground is towards the toes, increasing the demand on the calf, achilles and foot structures. Balancing the equation, this running style also reduces pressure on the knee. On the other hand, if the worn out pattern is within zone 3 or 4, this runner is likely heel striking. This equation is balanced in the opposite direction with more force generated through the knee on impact and less demand on the calf complex. If zone 1 or 4 is showing a worn out pattern, this indicates a wide step width. Zones 2 & 3 show evidence of a narrow or ‘crossover’ running pattern. This can be an issue for SOME runners and if you are constantly managing injuries like shin splints, achilles problems, ITB syndrome or patellofemoral pain, it might be worth investigating with a health professional. Share your experience with shoe wear & tear, what zones and if there are any differences from right to left in the comment section below. #running #shoes #runners #shoeassessment #runningform #nike #adidas #hoka #feet #run See more

17.01.2022 How Do I Run More without Injury? The question that 99% of runners would like to know the answer to. Unfortunately, to true answer will tailor to each individual but after reading this blog you will have a better understanding. I would love to hear what has (or has not) worked for you in the past, just leave your comment below. The full blog does contain helpful visuals & links to other relevant content so if that interests you head to my website https://buff.ly/3aVjWhB In o...rder to run more without injury, you need to understand adaptation. The human body is smart when it's thrown into an unfamiliar situation. When we put the body through different demands, it begins to change or 'adapt' to this new environment. This is why a full time cyclist will develop a different body to a swimmer for example. If we apply this concept to running, similar principles apply. Over a period of weeks and months, the body will start responding to the demands of the sport. But a swimmer shouldn't expect bigger shoulders after one week of swimming, neither should runners expect unrealistic distances or speeds without patience. Our focus should be to consistently train within our adaptation 'sweet spot' and continue to 'chase' our ever-growing adaptation zone. Load vs Capacity: A runner should recognize that all the body tissues contain a certain capacity level which you may exceed if running a certain distance and pace, increasing likelihood of injury. For example, someones left calf might tolerate up to 10ks at a 6 minute pace. If this capacity is ignored and is subjected to 13 kilometres, this may result in a muscle tear. This constant balance between load and capacity is being played out in all bone, ligaments and soft tissues in the body and It has been estimated that 80% of running injuries are due to runners exceeding their own capacity. Guidelines recommend an increase in weekly mileage by 10% to reduce injury risk. However, these guidelines are very conservative. For this reason, I recommend an increase anywhere between 10-20% under the correct guidance and based on individual circumstances. The key message here is implementing a well-structured plan, good recovery & patience.

17.01.2022 Great to have Christos on today’s podcast episode. We dive into running economy to help your running performance. Christos does an excellent job at explaining the concepts of lower leg stiffness, passive force generation and running efficiency. Listen where ever you get your podcasts just search ‘The Run Smarter Podcast’ #running #podcast #runningmotivation #marathontraining #runningperformance #runstrong #runfast

15.01.2022 Thanks Colin Hoobler host of the Action30 podcast for sharing his strength training safety tips for runners. There was tonnes of insight including correct technique for squats, lunges, calf raises and deadlifts and recommended intensities, sets and reps. Listen to the full episode by going to The Run Smarter Podcast wherever you listen.

15.01.2022 This study was just released a few days ago so I only have the abstract but is definitely worth sharing. This study allocated 38 recreational marathoners into 3 groups: 1.) Complex training group: heavy strength and plyometric exercises alternate within a single session. 2.) Heavy strength group 3.) Endurance strength group... Each group trained 2x a week for 6 weeks in conjunction with their normal running routine. They were tested and retested with a variety of strength tests, running economy and velocity at Vo2 Max. Running economy & Vo2 Max improved both group 1 and group 2 (RE: -5% to -6.4%, VO2max: 5.7% and 4.2%, respectively). There was no change seen in group 3. Conclusion: Both complex and heavy strength training resulted in greater improvements in eccentric strength and running economy compared to the concurrent low-intensity endurance-strength and endurance training.

15.01.2022 I have listed 3 common running conditions to help provide you with some clarity. Obviously, a correct diagnosis from a health professional is the most important first step. For the full blog + additional info head to https://buff.ly/3aVjWhB Here we go: #1: Patellofemoral pain: AKA 'runner’s knee’, to help determine a treatment plan, a fantastic paper was published by Crossley & colleagues in 2016 which produced these key recommendations: - Exercise therapy was the most import...ant recommendation to reduce pain and improve function. Practically speaking, identify your exercise tolerance and gradually increase strength until full function is restored. Additionally, the combination of hip and knee exercises is recommended over isolated knee exercises. Some examples include squats, lunges & crab walks. - Apart from exercise therapy, combining interventions like foot orthoses, patellar taping or manual therapy can enhance effectiveness. This is particularly useful to reduce pain in the early stages but keep in mind, these may not benefit everyone. -Lastly, interventions such as hands-on treatment & devices like therapeutic ultrasound are not recommended in isolation. #2: Achilles tendinopathy: This is another common running condition due to mechanical overload. Research has shown an 80% success rate with exercise programs that include slow, heavy loading. There is still debate around which type of strength program is more effective (eccentric vs concentric). But whether one program is more effective than the other, the overall message is clear, treatment needs to include progressive exercises. #3: ITB friction syndrome: This injury is not from ITB tightness and rather, too much ‘ITB strain’. Treatment should aid to identify changes in training that may contribute to a spike in ITB load with making the sensible adjustments. ‘Stretching’ the ITB is a debatable topic because the ITB fibres are too thick to provide any stretch. However, stretching the hip flexors and surrounding muscles can help. Some runners may consider running retraining & changes in cadence with the right guidance. You might also want to include hip, knee, ankle strengthen/function retraining.

14.01.2022 A big thanks to Benoy Mathew helping runners with lateral hip pain and glute function. Have a listen on the Run Smarter Podcast https://buff.ly/3hHShCG which also contains a 25% discount code to Benoy's Masters Athlete Symposium

12.01.2022 Running Cadence: How to take full advantage If you would like to view the entire blog, including methods to change your cadence and the effects it has on your body please head to my website https://buff.ly/2RkJ6gH. I would love to hear your experiences with running cadence in the comments below. Whether you need to adjust it or not, every runner should at least know what their running cadence is. This one number can be a game changer for some runners because it can generate a... more efficient running technique. Simply put, your cadence is the number of steps that you take per minute while running. For a recreational runner, this number is not influenced by speed, and you will naturally fall into a running rhythm that feels best for you. Evidence has shown that increasing your cadence by only 5% can reduce loads through your knee by 20%. In fact, Schubert et al, found that increasing your cadence by 5-10% appears to reduce the magnitude of several key biomechanical factors associated with running injuries". To calculate your cadence, you can use smartphone apps like Runcadence or free metronome apps that you can use mid-run by simply touching the screen every step you take for 15-20 seconds. If your cadence is <160 then generally you will benefit by increasing your cadence by 5-10%. If your cadence is between 160-170: then this is a relatively safe zone. Increasing your cadence isn’t necessary unless you need to shift your load or want to work on efficiency. If your cadence is >170: A cadence of 180 used to be considered the ‘magic number’ for running cadence. Evidence now shows that anywhere between 170-185 is considered a great running cadence. If you score above 180, increasing your cadence is rarely recommended and the efficiency benefits often diminish. I hope you have found this valuable and I hope it will help your future running. Please leave a comment sharing your experiences or questions.

11.01.2022 Do I need to transition to a minimalist shoe? This is a shoe that is usually lighter, offers less support and tends to mimic barefoot qualities. For the entire blog posts, including methods to transition safely into a minimalist shoe just click on the link https://buff.ly/2ZcNL8H. I would also love to hear your experiences with supportive, maximalist, minimalist and barefoot shoes. There has been plenty of debate around barefoot running over the past few years and there are s...trong believers in both camps. Should I run in comfortable, supporting, protective shoes? Or do I run in light minimalist shoes and let my feet do all the work? Well, the answer to these questions will depend on several factors, including your your strength and your current running goals. However I like to simplify this dilemma and ask you two questions. 1.) Do you want to improve my running performance? 2.) Are you currently injured? If you answered yes to performance then you might consider carefully transitioning to minimalist shoes, or at least have a pair to rotate with your traditional shoes. Because we are discussing performance, we need to consider your running economy. Practically speaking, your running economy means you are spending less energy to achieve the same running speed. This is a huge advantage! When it comes to Minimalist shoes on running injuries some studies have found minimalist shoe groups do have greater risk of injury if body mass was above 71.4 kg. And from my understanding of load management, that seems to make sense. Clinically, it seems that transitioning to minimalist running shoe will increase the demand on the muscles, joints, tendons located below the knee. This could be a good thing, because if you transition gradually, these structures will actually become stronger and more resilient. It also seems that these shoes reduce joint forces at the knee, the most common location for running injuries. This is in part due to adjustments in foot contact and cadence when adopting a lighter shoe. So comment below on your experiences, and if you would like full detail, including research references and HOW to transition safely click on the link at the top of the post. Thanks for reading

11.01.2022 It is a tough question to answer and a tough study to conduct. This systematic review in 2019 compiled all the available research to try and answer the question if muscle strength, flexibility, range of motion, and alignment can predict lower limb injuries in runners. Unfortunately, the authors found very low quality of evidence and were unable to answer the question. For example, different study results were conflicting, some studies had different definitions of running inju...ries, and some studies were missing key information such as running experience, previous history of injury and weekly mileage. Sometimes the answer of 'we don't know' is an answer in itself. And is worth sharing. I know apart from the variables of strength, flexibility and alignment, a big risk factor for developing any running injury in the future is having a history of past injuries. It seems for the future that studies should aim to improve the quality with standardized assessments when conducting clinical research to predict injury in runners. See more

07.01.2022 Conduct your show assessment: Running is a beautiful, simplistic lifestyle. One of the main reasons for its simplicity is you only need running shoes. Therefore, it makes sense to gain insight into a running shoe assessment. Once you have participated in this i'd love to hear what you found in the comment section. Step one is to find the oldest pair of running shoes and turn them upside down to inspect the sole. In this step we are analyzing the wear & tear of the tread. Dur...ing this step its worth mentioning that pure running shoes (ie. not been used for a lot of walking), can help with assessment accuracy. Next, have a close look at the location of sole wear. Compare this from right to left and from heel to toe. This pattern is different for every runner because everyone has a different technique. When first making contact with the ground, runners can either contact with their heel, mid-foot or towards the toes. Step 2: After having a close look at the shoe sole, you need to section the area into ‘zones’. See the picture I posted of my shoes and the 4 zones you need to inspect. Look closely, because there may be subtle differences from right to left which might indicate a harder foot fall, or a stronger push off on one side. Step 3 is interpreting these zones: When the majority of the sole is worn out through the ‘forefoot’ (zone 1 or 2), it increases the likelihood of being a forefoot runner. That means the initial contact on the ground is towards the toes, increasing the demand on the calf, achilles and foot structures. Balancing the equation, this running style also reduces pressure on the knee. On the other hand, if the worn out pattern is within zone 3 or 4, this runner is likely heel striking. This equation is balanced in the opposite direction with more force generated through the knee on impact and less demand on the calf complex. Another element to investigate is a wide or narrow step width. If zone 1 or 4 is showing a worn out pattern, this indicates a wide step width. Personally, I think this is a healthier running style with a well-balanced and aligned technique. Conversely, zones 2 & 3 show evidence of a narrow or ‘crossover’ running pattern. This can be an issue for SOME runners and if you are constantly managing injuries like shin splints, achilles problems, ITB syndrome or patellofemoral pain, it might be worth investigating with a health professional. Share your experience with shoe wear & tear, what zones and if there are any differences from right to left in the comment section below.

06.01.2022 I have good news & bad news for all the runners out there as we experience the inevitable aging process. The bad news: Your running Vo2 max will significantly reduce as you get older. The good news: The rate of decline is influenced by your levels of training.... Take this study by Treppe et al in 1996 who tested 53 highly competitive distance runners over 22 years from their mid-20 and mid-40s. The rate of VO2 max decline over those years was lowest in those runners who maintained high levels of training. In the group who decided to give up their training over the 22 year period, their Vo2 decline was around 15%. Compare that to those who did regular fitness training ~10% decline in VO2 max. And finally those who maintained a high level of training, who only reduced their Vo2 max by 6%. So as you get older and you start noticing a slow decline in max output, do not be discouraged. Keep in mind that your sedentary counterparts are losing health metrics at a faster rate. Keep running happy!

06.01.2022 In a few days time I'll be interviewing physiotherapist Lizzie Marlow and we will chat about all things tib post tendinopathy. Submit your questions for me to ask on the podcast.

03.01.2022 With systematic review from S. Bohm et al collected 27 studies with 37 separate interventions on either the Achilles or patellar tendon (264 participants) to see what is the best loading strategy for tendons. They conclude that: 1.) 'high magnitude loading' (high intensity) is most effective to elicit tendon adaptation and that longer intervention duration (>12 weeks) is beneficial compared to shorter ones. The sets/reps and rep max percentage was not included in the final st...atement but heavier is the preference. 2.) The effect of muscle contraction type (isometric, concentric-eccentric, or isometric) seems insignificant; however, plyometric training may not be optimal to facilitate tendon adaptation. So make sure your rehab program consists of heavier intensities, and is progressive throughout it's duration. Also be patient through this process and expect a rehab duration of >12 weeks.

02.01.2022 The single leg hop may not directly match the movements of running, but is a quick assessment to identify any deficients. Use post-it notes and hop as high as you can on the right foot then on the right foot. Sticking the post-it note as high as you can and compare sides. Apart from the height difference, pay attention to your any discomfort, stiffness, confidence levels, ease of movement, ease of power on each side. If there are any noticeable difference you might want to work on them to have a happy healthy running career. #running #injury #injuryprevention #strengthtrainingforrunners #runstrong #jumping #singlelegjumps