The event was at the tail end of a multi-day conference organized by Dr Mark Cucuzzella, the 2nd such conference this year (previously conducted in January) on running injuries and prevention, bringing in experts from all over the world. This informal discussion served to provide insights and inform the public about some of the topics of discussion and the expert opinions of those individuals involved. As mentioned in my last post, the panel included a wide range of industry experts:
Dr. Robert Wilder
- Chair of the Department of Physical Medicine & Rehabilitation and Medical Director of the Runner’s Clinic at the University of Virginia.
Dr Hiro Tanaka
· Fukuoka Japan; Chair Exercise Physiology University of Fukuoka
· Author of over 100 papers, ran 2:38 marathon age 50 and 3:11 age 62
Blaise Dubois PT/Sean Cannon PT
· Quebec City, Canada; International Leaders in running injuries
· Authors and Instructors of over 40 international conferences
· Boulder, Colorado; Newton Running
· Clinical Acupuncturist and Manual Therapist treating elite runners for 15 years
Dr. Mark Cucuzzella,
· West Virginia University, Coach USAF Running Team, National Level Masters Runner
· National speaker/teacher of healthier running; sub 2:35 marathons in 4 decades
· Orem, Utah; Ran 2:45 marathon age 12
· Founder of Altra Running Shoes
· Rockford, Michigan
· Lead Training Rep Merrell Barefoot Division
· Okemos, Michigan; Running Retail leader for 30 years
· Developer of Good Form Running- system now taught to 1000’s
Below are some of the notes and key points I made throughout the event that I thought would be useful to others as it relates to running form/mechanics, proper running shoe selection, and injury prevention/health issues.
- Body awareness, running form, and good mechanics are the keys to staying healthy. Constant awareness of these elements are the best form of preventative medicine. Rather than reactive response following an injury, maintain a constant sense of your body and take the necessary actions to PREVENT injuries, rather than respond to them.
- The most important aspect of running form is landing under your center of mass. However, your heel should still settle on the ground, which creates the elastic recoil that will propel you forward. Without this element (heel kissing the ground), you limit your body's ability to move itself forward, which creates inefficiency.
- Learning how to run properly should be the number one priority for any runner. Once you have developed proper run mechanics, you have eliminated one of the most frequent causes of injuries and can select a shoe that allows you to maintain that form throughout.
- Learning proper run mechanics is best done barefoot, as it provides the best sense of proprioception. However, it can be done with shoes, which may allow a runner to fall back to improper form due to the built up cushioning and lack of ground feel. In other words, cushioned shoes will not do as good a job at forcing proper run form.
- You need to have specific mobility and stability in your legs in order to run effectively in minimalist shoes. This can be accomplished through routine strengthening exercises, mobility work, and learning proper run mechanics. Going straight into minimalist shoes without properly assessing these factors is a frequent reason for injury among runners using minimalist shoes.
Proper Running Shoe Selection
- Shoe selection should be based on the shape of a healthy foot. If your foot cannot fit comfortably inside your shoe, it will not provide your foot the ability to perform as it was intended. A good method to determine this is to remove the footbed from the insole of the shoe and stand on it. If your foot does not fit inside the footbed, the shoe will not properly fit and may cause your toes to be pushed together, limiting your body's natural stability and proprioception.
- The common approach to properly fitting individuals for shoes based on whether or not they pronate (gait analysis) is a flawed approach. Pronation could be caused by weaknesses in the hips/pelvis, but this is rarely considered as a reason for pronation during the shoe fitting process, forcing many people into shoes with excessive pronation control, when it is not necessary. Multiple studies have concluded that instances where individuals were fitted for shoes based on their pronation (ie placed in shoes with anti-pronation technology if they pronated), the rate of injury increased. However, there are people that may need shoes with pronation control - but it is a very small minority where there is a true issue going on.
- Regardless of shoe type, people tend to be less injured in the shoes they are the most comfortable in.
- If you want to prevent injuries, you must be consistent and gradual in your approach to anything - whether it is new shoes, increasing mileage, increasing intensity, etc. You should calculate the total stress you put on your system at a given time and use that as a baseline for any attempts to increase it in the future. Too much to soon is almost always the cause in the onset of injuries.
- The most common patterns of injuries involved muscle weakness in hip strength/stability, glutes, abductors, hip flexors, ankle mobility, calf, achillies, and plantar fascia. Single leg stands that incorporate multiple functional movement exercises can help resolves the kinds of imbalances.
- When compared to a sedentary lifestyle, running reduces one's death rate by up to 63%. In order to ensure you remain a runner for life, you must be able to remain healthy. And a healthy runner is a happy runner.
- For high mileage runners transitioning to more minimalist shoes, it will take much longer for your body to tolerate the osteo-structure adaptations. If you are undergoing this process, you must be patient to give your body the necessary amount of time to adapt to the new stress.
- Glucosamine chondroitin may only provide a slight benefit in symptomatic osteoarthritic conditions to help with pain, but it does not sustain cartilage. In order for it to take effect, it requires approximately 4-6 months of usage. However, there are no known harmful side effects, so there is no inherent risk in trying it if you are experiencing joint pain.
- Use of NSAIDs is strongly discouraged at all times, except for a very, very short term acute injury. Even if taking it after exercise to reduce inflammation, it will continue to dehydrate and stress your body, which will limit your body's ability to recover by taking away its resources to naturally heal itself.
I really enjoyed attending this event and found the practical information that was shared to be useful. While I already was aware of many of the topics and conclusions discussed, I will certainly incorporate all of this information into my knowledge base and apply it to my training and coaching techniques. I'd strongly encourage others to attend similar events if they are held in the future.
Being a runner is always a learning process and you should never believe you know all there is or that you know enough. Constantly challenging what is considered "normal" can lead to innovating approaches to tackling problems that we all face. As runners, we are bound to get injured at one point. Knowledge is power and the more of it you have at your disposal, the better equipped you will be at managing yourself and remaining a runner for life.