Now, let's talk about a few instances where how you are running may be affecting the soft tissues (muscles, tendons and ligaments) as well as the joints of your body:
1) Achilles pain/tendonitis- many treat this with rest, ice, compression (gotta love those cute compression socks... they even come in pink :)) and elevation which is the 'go-to' "treatment" method for most injuries. Then, when "healed" the athlete returns to running and develops the same thing again. Why? They didn't change ANYTHING!!! What I have seen more often than not is an athlete who somehow gets ahold of the idea that one needs to land on the ball of the foot or even worse, the toes. They actively plantar flex the ankle (point the toe down into the ground) and as a result the foot still lands in front of the body, huge braking forces are transmitted into the ankle/achilles because the achilles/calf muscles are placed on huge stress doing this and miraculously the calves get extremely tight and a huge degree of micro-trauma occurs as a result. Performed for many days, weeks, months or even years and guess what? You've got a screaming case of achilles tendonitis (inflammation... which research actually is showing is less common than we may think) or worse, tedonosis (degeneration) all potentially leading to rupture (complete tear). So, to counter act this, STOP pointing the toes down and instead lift the toes, slightly, toward the shin, dorsiflexing the ankle. This will increase the "bounce"/rebound effect and at first will cause a bit of calf discomfort but in the long run your calves will adapt and they will no longer be damaged.
Another mechanism that contributes to achilles/calf pathology is a lack of hip extension (how far the hip moves back during the stride). When an athlete lacks hip extension from the hip and they are running something has to make up for that lack of motion. As you now are aware, running is more about what your hips do than what your ankles and the "drive" phase do. Lack of motion up the chain requires something to compensate... the ankle has to plantar-flex more, therefore toeing off more aggressively than need be and the calf takes the stress. In other words, "ouch!" It's all connected in other words!
2) Patello-Femoral Pain Syndrome (PFPS aka Runners Knee)- Ever watch the front runners of a road race? The next time you do watch their legs... how BIG are their legs? Typically, not very. Now pay close attention to their quads (quadriceps)... really nothing to write home about. However where they do excel is the degree of rebound action and fluidity. Now, watch the middle or back of the pack in a race... HUGE quads typically and held together with neoprene (Cho-Pat straps and neoprene compression sleeves) because we are all born with neoprene deficiencies! And, add to that when given exercises to improve their symptoms typically quadriceps strengthening exercises are prescribed because they obviously have weak quads.... sense the sarcasm in that last sentence?
Look at how them move; feet reaching out in front of them with a straight knee upon foot strike creating greater braking forces (ground reaction forces), excessive vertical movement of the body and as a result a greater load being placed on the musculo-skeletal system. No wonder they look like QUAD-Zilla- They need those huge things to stop their knee from collapsing upon every foot strike! This is a 'simple' fix... get the feet as close to UNDER the center of mass as possible creating less stress at the knee and therefore less stress on the patello-femoral joint and quadriceps. Then, in combination with a series of hip mobilization exercises followed by a hip and pelvic stabilization program problem solved. I will add, if you have been diagnosed with PFPS and have been told that you "need stronger quads," find a new therapist/doctor. It is a symptom nine times out of ten and not a diagnosis.
3) Ilio-Tibial Band Syndrome (ITBS)- The IT Band is a thickening of the fascia/connective tissue that is an extension of a muscle called the Tensor Fascia Latae which is a small muscle originating in the hip and who's insertion is the fascia of the lateral (outer) thigh. Typically, people with ITBS complain of lateral/outer knee pain as the ITB inserts on the Tibia (big leg bone) just below the outer/lateral knee joint line. This "Syndrome" is much less about friction of the ITB on the femur than previously espoused in many running magazines and is in fact recent research is pointing to it being a "compression syndrome" instead (1, 2). When a runner, again, 'reaches' out in front of them to elongate their stride and at initial foot strike land with a straightened knee the hip and with it, the IT band is under a great amount of stress. Again, if we allow the feet to land close to UNDER our center of mass we eliminate the strain placed on this rather important tissue/structure and therefore decrease the risk of overuse.
These are just a few of the many syndromes and conditions that are directly related, more times than not, to how we are moving/running. No shoe in the world can change the stresses placed on the body LONG TERM. No single exercise or special strapping system on the planet will change these syndromes/dysfunctions. It all comes down to decreasing the stress your body is under by optimizing your movement patterns... The longer we remain injury free/"healthy," the more training we can perform and absorb and therefore reach our full potential. Don't let 'how' you move be a limiter to your performance... get to work!
Dr. Erik DeRoche
1- Fairclough J, Hayashi K, Toumi H, et al: The functional anatomy of the iliotibial band during flexion and extension of the knee: Implications for understanding iliotibial band syndrome. J Anat 2006; 208(3):309-316.
2- Fairclough J, Hayashi K, Toumi H, et al: Is iliotibial band syndrome really a friction syndrome? J Sci Med Sport
** Part 3 I will discuss important factors that go into an overall plan to become an injury free runner.**