Forefront Physical Therapy Blog

11/30/2017

Six Ways to Improve Your Running Performance This Offseason - Part V: Running Related Agility

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Agility Training Increases Your Durability & Enhances Your Running Performance

On the macroscopic level, running is predominantly a one-dimensional exercise. When looking at each joint, however, you will find three dimensional movement. Because of this multidimensional movement, runners of all levels should use training that incorporates all three planes of motion. An agility program is a great way to integrate non-linear movement into any running routine. Among other things, agility training challenges vision, dynamic balance, coordination, strength, power, and acceleration/deceleration capabilities. For this reason, it is a great supplementary workout for runners.

Agility training has been shown to improve more than just athletic prowess. A military study looked at how an agility program affected the participant’s endurance, athletic tests, and cognitive function. The group performing agility training improved their VO2 Max, athletic footwork, memory, and concentration. It is theorized that agility training takes advantage of the principle of neuroplasticity, or the brain’s ability to change its connections and behavior in response to new information and sensory stimulation.

Consider picking up an agility ladder on Amazon for $13, or build your own for less than $5. Ideally, an agility program will address all three planes of human movement: sagittal (forward and backward), frontal (side-to-side), and transverse (rotations parallel to the ground).

Want to incorporate agility but not interested in agility ladder training? Consider trying trail running first. This form of running requires greater balance and agility as compared to road or track running, so it could be an alternative or supplement to a more structured program.

Below are my go-to agility drills split into the three different planes of movement. While it may be hard to break a strict running routine, supplementing footwork and agility drills 1-2 times per week might just be enough to break that recent plateau and set a new personal record. Just be careful, agility training, like faster running, creates dramatically more force than your body may typically be used to controlling. So take it easy the first few times you attempt any agility training, and consider meeting with a member of our team at Forefront to develop your ideal, individualized program.

Sagittal Plane Agility

Frontal Plane Agility

Transverse Plane Agility

Single Leg Agility/Stability
Begin with 2 Rounds x 5 Reach/Jumps per side. Progress as you are able to complete all 10 while maintaining proper form and completed without re-setting.

References:
Lennemann LM, Sidrow KM, Johnson EM, Harrison CR, Vojta CN, Walker TB. The influence of agility training on physiological and cognitive performance. J Strength Cond Res. 2013;27(12):3300-9.
Cissik, J. & Barnes M. Agility (Chapter 5). Sport Speed And Agility. Coaches Choice. Monterey CA, 2004

Dr. Dan Benson, DPT, OCS, FAFS

Forefront Physical Therapy
Belltown & South Lake Union
2720 4th Ave #115
Seattle, WA 98121

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11/14/2017

Six Ways to Improve Your Running Performance This Offseason - Part IV: Running Biomechanics

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Changing Running Mechanics Could Help Decrease Your Knee Pain

It is no secret that distance running places a significant demand on the body’s musculoskeletal system. The cyclic impact (ground reaction) forces inherent to running continuously load the lower extremity and spine with every step. Due to this constant, repetitive stress, overuse injuries are common and can likely be attributed to less than optimal biomechanics.

Although the running cycle is complex, we discuss three of the most well known and researched components (foot strike, trunk position, step rate / stride length). Additionally, we will provide a few examples of how altering your running biomechanics may help decrease pain and improve performance.

Foot Strike
The manner in which the foot initially contacts the ground has been classified into three popular subgroups: forefoot, midfoot, and heel strike. A majority of distance runners likely fall into the heel strike category, however, elite performers are less likely to heel strike.

Elite runners who heel strike do so with their foot directly under their body while non-elite runners tend to heel strike out in front of their body - this blocks forward momentum which results in a massive increase in ground reaction forces and an increased likelihood of injury. It does not mean that these runners need to change to a different foot strike, they may just need to address biomechanical issues to improve how they are heel striking.

As a note, research struggles to clearly identify any economical or performance benefit in distance runners when it comes to midfoot or forefoot striking. As speed increases, most runners do, however, tend to naturally shift toward a midfoot or forefoot running pattern.

My recommendation: When necessary, intentionally changing footstrike may be an option to reduce stress on various tissues. For example, heel striking increases impact forces at the knee compared to midfoot striking. Thus, people with chronic knee could pain try a midfoot strike.

Conversely, midfoot and forefoot striking is associated with a greater load on the Achilles tendon, so people with chronic Achilles or calf pain may be advised to use a heel strike. Although changing to a rearfoot strike pattern may reduce the likelihood of Achilles related issues, foot and hip biomechanics are most likely the culprit of the Achilles pain.

Forward Trunk Lean
Running methods like ‘ChiRunning’ and POSE method promote a forward lean of the trunk while running. The biomechanical reasoning behind a forward lean is that it better incorporates the power of the posterior chain.

Research on this topic is mixed. A recent study concluded that runners who implemented a forward trunk lean as well as an increased step rate (see below) reduced their risk of knee injury. On the other hand, another study concluded that using the POSE method of running for three months actually worsened the triathlete’s running economy compared to their habitual running form.

Due to the mixed results of research thus far, ChiRunning and POSE method should be trialed with caution. Unfortunately, none of these studies account for biomechanics issues, such as mobility and stability throughout each participant's body, which makes it challenging to draw conclusions. Any restriction in posterior chain mobility may result in an inability to successfully implement a forward lean.

As a note, it is essential that runners do not fall into the habit of overly tightening their core when trialing these ChiRunning and POSE running methods as this can actually block the ability of the torso to counter rotate relative to the hips thereby shutting down the efficiency and activation of the core and glutes.

My Recommendation: If you are a runner suffering from knee pain, you may want to consider an increased forward trunk lean complemented with an increased step rate. To implement this technique, subtly lean forward bending at the ankles, forming a straight line from ankles to shoulders. Research shows that about 14 degrees of forward lean can be enough to decrease impact at the knee.

Spatiotemporal (Step Rate and Stride Length)
Running speed is a function of step rate and stride length.   Step rate is measured in steps per minute and stride length is measured in distance from toe off to foot strike. By increasing one or the other (or both), running velocity increases directly.

A decreased step rate (fewer steps per minute) is associated with a greater likelihood of shin and knee injury while an increased step rate coincides with decreased stride length, decreasing the likelihood of running injury. Modifying these two running characteristics is a direct strategy to reduce the likelihood of running injury.

My recommendation: If you are injured, consider modifying your running form by changing your step rate and stride length.   A subtle 5-10% increase in your step rate has been shown to reduce ground reaction and joint forces during running. iPhone and Android apps like AudioStep, Running Cadence Tracker, and RunCadence, can aid in helping you adjust your step rate.

No Right Way To Run
It is important to remember that no one running style or body type wins all races, even at the most elite levels. All runners have individual physical, biomechanical, emotional, and physiological strengths and weaknesses. Thus, a change that works for one runner, may not work for another. It is most important to find and develop your own style of running. Your goal should be to optimize your body’s abilities and address your biomechanical related issues so you can run at your best and without pain.

Be aware that changing running biomechanics may cause an unexpected injury, so don’t change too many things too quickly or too intensely! If you cannot seem to solve your running aches and pains with these quick biomechanical changes, there is likely an underlying problem that needs to be addressed with an in-depth biomechanical examination by your physical therapist.

References:
Kasmer, M. E., Xue-Cheng, L., Roberts, K. G., & Valadao, J. M. (2013). Foot-Strike Pattern and Performance in a Marathon. International Journal Of Sports Physiology & Performance, 8(3), 286.

Warr, B. J., Fellin, R. E., Sauer, S. G., Goss, D. L., Frykman, P. N., & Seay, J. F. (2015). Characterization of Foot-Strike Patterns: Lack of an Association With Injuries or Performance in Soldiers. Military Medicine, 180(7), 830-834. doi:10.7205/MILMED-D-14-00220.

Dallam GM, Wilber RL, Jadelis K, Fletcher G, Romanov N. Effect of a global alteration of running technique on kinematics and economy. J Sports Sci. 2005;23(7):757-64.

Teng HL, Powers CM. Sagittal plane trunk posture influences patellofemoral joint stress during running. J Orthop Sports Phys Ther. 2014;44(10):785-92.

Luedke LE, Heiderscheit BC, Williams DS, Rauh MJ. Influence of Step Rate on Shin Injury and Anterior Knee Pain in High School Runners. Med Sci Sports Exerc. 2016;48(7):1244-50.

Dr. Brad Whitley, DPT
Dr. Dan Benson, DPT, OCS, FAFS

Forefront Physical Therapy
Belltown & South Lake Union
2720 4th Ave #115
Seattle, WA 98121

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11/13/2017

Six Ways to Improve Your Running Performance This Offseason - Part III: Anterior Chain and Chest Mobility

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The Posterior Chain May Get All The Glamour, But Don't Neglect Anterior Chain Mobility

Like the posterior chain, muscles of the anterior chain (Hip Flexors, Quadriceps, Abdominals, and Pectorals) may have limited flexibility due to a multitude of causes. Insufficient stretching, improper running biomechanics, or poor sitting postures may lead to decreased anterior chain mobility. When the anterior chain muscles are tight, motion will occur at other places where it may be a detriment to the athlete. In this blog post, we explore how the anterior chain may contribute to less than optimal running performance as well as knee, hip, low back, and even neck pain and how exercise may be used to improve performance and alleviate pain.

Hip Flexors & Quadriceps
Running places a significant demand on the hip flexors and quadriceps (quads). As the foot prepares to push off the ground, the hip flexors and quads become stretched through hip extension, internal rotation, and abduction which allows for a rapid elastic recoil effect - the energy created by this stretch is what drives the knee forward during swing phase to successfully set the leg up for the next foot strike. Tight hip flexors and quads limit hip extension which is one of the most common causes of low back pain with running (and walking too). Limited hip extension may also contribute to knee pain, overuse calf injuries, and IT Band Syndrome.

Improve Hip Extension (Hip Flexor & Quad Stretch)
Try this stretch by starting in a kneeling position with one knee down (back foot can be elevated against a box or wall as shown below) and the other foot planted on the ground in front. From this base position, tuck the pelvis under by contracting the abdominals and glutes. At this point you will likely feel a stretch along the front of the thigh. Maintain this tucked position and slowly swing the arms through all three planes of motion to drive a 3-dimensional hip flexor and quad stretch.

Pectoralis Minor and Major (Pec)
Just as suboptimal hip flexor and quad length limits full extension of the hip, limited pectoral mobility prevents full chest expansion (a fundamental component of aerobic exercise) and thoracic spine rotation (a fundamental component of core engagement). Tight pecs result in forward, rounded shoulders and may be accompanied by forward head posture which places more stress on the neck. These are classic postural problems caused by sitting but can be addressed through functional mobility and stretching drills.

Improve Pec Flexibility
Start by placing your hand on wall or door frame - your hand should be placed high enough that your elbow is above shoulder height. Gently push your chest forward, past the elbow and hand until a stretch is felt through the front of the chest. If you are stretching your left pec, your left hand should be elevated on the wall and your left foot should be forward. Pulse the chest forward (1 inch or less) to achieve a more dynamic stretch. Try repeating the stretch but use rotational pulses this time. Be careful to lead with the chest and not with the shoulder itself, as this may cause shoulder discomfort. Please make sure you adequately squeeze your shoulder blade down and back so that you keep the front of your shoulder (anterior shoulder capsule) safe.

Rib Mobility
Although not limited just to the anterior chain, rib mobility is an essential part of a runner's overall performance. Like pectoral flexibility, rib mobility is essential for optimal breathing. The ribs need to rotate and translate 3-dimensionally during breathing, and with poor rib mobility, cardiovascular performance may be compromised. Improving rib mobility will likely coincide with improving thoracic spine mobility as the two are intricately related.

Improve Rib and Thoracic Spine Mobility
While doing small forward lunges, move the arms in the patterns listed below:

Right Leg Forward: right arm reaches overhead to the left, left arm rotates across the body to the right
Left Leg Forward: right arm reaches overhead to the left, left arm rotates across the body to the right

*Inhale deeply while moving into the rotation, and exhale while returning to the starting position

These exercises are meant to improve hypomobility through areas that are vital to running biomechanics and performance. Completing these exercises intentionally and consistently will improve the way you move and make you more efficient with your running or sport performance.

Dr. Dan Benson, DPT, OCS, FAFS

Forefront Physical Therapy
Belltown & South Lake Union
2720 4th Ave #115
Seattle, WA 98121

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11/6/2017

Six Ways to Improve Your Running Performance This Offseason - Part II: Posterior Chain Mobility

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Loosen Up Tight Calves, Hamstrings, & Glutes With These Stretches

Now that we have covered how to improve foot and ankle mobility in our last blog post, our next task will be to improve mobility through the posterior chain! The posterior chain is defined as the group of synergistic muscles on the back of the leg such as the calf, hamstring, and glute muscles. Posterior chain immobility is common among runners who have significantly increased running workload, introduced speed work prematurely, lack functional cross-training, or sit too much.

Posterior Chain Biomechanics: The Calf
The calf is made up of two muscles (gastrocnemius and soleus) and they play an important role throughout the running cycle. When the foot is first landing on the ground, the calf is tasked to slow down knee flexion and ankle dorsiflexion and foot pronation. The calf is then used to extend the knee and assist in propelling the body forward to the next step. If calf length is limited, increased forces will be absorbed at the knee, foot, and ankle instead of through the muscle itself. This impairment could lead to common running injuries, like stress reactions, shin splints, or plantar fasciitis as well as a number of other issues further up the chain.

Posterior Chain Biomechanics: The Hamstrings
Other posterior chain mobility dysfunction may occur as a result of tight hamstrings. The hamstrings are made up of four different muscles (biceps femoris long head, biceps femoris short head, semimembranosus, and semitendinosus). These muscles attach to various locations on the pelvis, thigh bone (femur), and back of the shin (tibia) and functionally act as knee extensors (when the foot is on the ground during running, squatting, walking, etc). Although hamstrings do flex the knee when the foot is not on the ground (think flexing your knee to lift your heel to your butt), this is not their primary function despite what you might read online or in text books. The hamstrings do most of their work when the foot is first loading onto the ground - their job, like the calf muscles, is to slow down the forward momentum of the knee. By decelerating this motion, the knee will stop flexing and extend as the femur moves forward over the tibia.

At the same time the hamstrings are decelerating knee flexion during foot strike, they also work to decelerate the pelvis tilting forward (anteriorly) in space. During late stance phase, the hamstrings serve to help posteriorly tilt the pelvis to drive hip extension and further extend the knee to assist with the foot pushing off the ground. Overly shortened hamstrings lead to excess stress on the knees and low back, primarily during the initial phase of loading onto the foot while walking and running.

Keep in mind that we have only really discussed one plane of motion in the above analysis. The hamstrings actually play a critical role, like all muscles, in all 3-planes of motion.

Posterior Chain Biomechanics: The Glutes
The glutes are a classic mobility issue for most runners. If you remember from our blog post ‘Dead Butt Syndrome’, the glutes can become relatively inactive due to our culture of sitting and most exercise being limited primarily to the sagittal plane (running, biking, swimming). The glutes and other hip external rotator muscles work together to decelerate the turning in of the femur during the initial loading phase of gait and rotate the femur outward during the late stance phase of gait.

When the glutes are tight, the femur will be unable to turn in properly during foot strike which makes it difficult for the glutes to stretch and gain the potential energy necessary to assist in decelerating ground reaction forces. This chain reaction is necessary to propel the body forward and help as the leg pushes off the ground. Tight glutes also contribute to low back pain more directly by limiting the pelvis’ ability to tilt anteriorly during foot strike as well as to rotate over the femur (hip internal rotation) throughout the later stages of stance phase of gait.

Take Care of Your Posterior Chain!
Mobility will be improved with consistent, intentional movements, over and over, day after day. Without this consistency, results will be delayed! It is imperative to continually find time before and after your run or workout to improve posterior chain mobility and decrease your chances for running related injuries and improve your performance.

Dr. Dan Benson, DPT, OCS, FAFS

Forefront Physical Therapy
Belltown & South Lake Union
2720 4th Ave Ste 115
Seattle, WA 98121

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Six Ways to Improve Your Running Performance This Offseason - Part V: Running Related Agility

Agility Training Increases Your Durability & Enhances Your Running Performance

Sagittal Plane Agility

Frontal Plane Agility

Transverse Plane Agility

Single Leg Agility/Stability
Begin with 2 Rounds x 5 Reach/Jumps per side. Progress as you are able to complete all 10 while maintaining proper form and completed without re-setting.

Six Ways to Improve Your Running Performance This Offseason - Part IV: Running Biomechanics

Changing Running Mechanics Could Help Decrease Your Knee Pain

Six Ways to Improve Your Running Performance This Offseason - Part III: Anterior Chain and Chest Mobility

The Posterior Chain May Get All The Glamour, But Don't Neglect Anterior Chain Mobility

Six Ways to Improve Your Running Performance This Offseason - Part II: Posterior Chain Mobility

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Six Ways to Improve Your Running Performance This Offseason - Part V: Running Related Agility

Agility Training Increases Your Durability & Enhances Your Running Performance

Sagittal Plane Agility

Frontal Plane Agility

Transverse Plane Agility

Single Leg Agility/StabilityBegin with 2 Rounds x 5 Reach/Jumps per side. Progress as you are able to complete all 10 while maintaining proper form and completed without re-setting.

Six Ways to Improve Your Running Performance This Offseason - Part IV: Running Biomechanics

​Changing Running Mechanics Could Help Decrease Your Knee Pain

Six Ways to Improve Your Running Performance This Offseason - Part III: Anterior Chain and Chest Mobility

The Posterior Chain May Get All The Glamour, But Don't Neglect Anterior Chain Mobility

Six Ways to Improve Your Running Performance This Offseason - Part II: Posterior Chain Mobility

Forefront Authors

Archives

Categories

​Signup To Get Injury Recovery & Fitness Tips!

Pay Your Bill Online

Single Leg Agility/Stability
Begin with 2 Rounds x 5 Reach/Jumps per side. Progress as you are able to complete all 10 while maintaining proper form and completed without re-setting.

Changing Running Mechanics Could Help Decrease Your Knee Pain

Signup To Get Injury Recovery & Fitness Tips!