Do I Sound Like A Broken Record?
Having worked in running injury management and blogged about it for a fair old time now, it can be tempting to sit back and think that the message is now out there, that my work has been done and I must sound like a broken record. But the truth is, my ramblings are but a drop in the ocean for every week I see runners in pain who have either read or been given information & explanations that are highly unlikely or sometimes just downright wrong.
This has prompted me to put together a summary of the ‘myths’ that continue to plague our industry and in doing so can often delay recovery and/or increase the risk of future injury. So that the information sinks in, I will break this piece down into two or three blogs giving people time to ask questions and/or discuss in the comments section at the end. For those of you already familiar with the issues I raise I will apologize in advance; however, in the case of the therapists & runners for whom this news is new, I look forward to reading your feedback in the comments section and hope this series of blogs provides a valuable insight into evidence based running injury management & prevention.
Are Running Injuries On The Decrease?
According to research, the incidence of running related injuries (RRIs) ranges from 19.4% to 79.3% (depending on the source). One of the most interesting pieces of information to come from such research is that since the early 1980’s, there has been no decrease in the incidence rate. So despite all the advances in technology, the shoes, the running schools, the visits to injury clinics, people are still getting as injured from running as much as they were over 30 years ago. How can this be? Don’t we know what causes running injuries yet?
The simple answer is no. Sadly, much of the fancy gear and latest fads you see in magazines, DVD’s and websites is not backed by much evidence, if any. Despite current high quality research into running related injury (lack of this has been part of the problem) science has yet found reasons for what causes the majority of running injuries. Exactly why some runners get injured whilst others don’t remains a bit of a mystery. One of the biggest problems with this lack of certainty is that it leaves many injured runners open to an awful lot of misinterpretation and myth, which when wrapped up and presented as ‘magic bullets’ tends to understandably sell like hot cakes.
What Do Runners Think Causes Injury?
In order to start some myth busting, it is useful to first have an idea of what the average runner currently believes are risk factors for injury. Fortunately, we have a study by Bruno Tirotti Saragiotto that set out to do just that: ‘What Do Recreational Runners Think About Risk Factors For Running Injuries?’ (2014). The top answers given by the sample population of runners were as follows:
• Not stretching
• Wearing the wrong shoes
• Excess of training
• Lack of strength
• Not warming up
• Not respecting the body’s limitations
This study concluded that a vital part of reducing running related injury is education, because some of the beliefs expressed above are either lacking considerably in the evidence department or in some cases downright wrong.
If there is one thing that running research is pretty much agreed on, it’s that static stretching before a run does not help reduce injury or increase performance. In one study (Pope 2000), 1538 male army recruits were put through 12 weeks of training, with half of them performing a 20 second static stretch for each of six major leg muscle groups during every warm-up. After the 12 weeks, lower-limb injuries totalled as follows: 158 in the ‘stretch’ group, 175 in the ‘non-stretch’ group. The study concluded that as long as you have a normal range of movement (and let’s remember running is not like martial arts or ballet – it really doesn’t require a lot of range of movement), stretching is ‘unlikely to do anything to prevent injury’. Some studies went even further. Wilson (2010) concluded that stretching may even decrease performance & increase energy cost, neither a particularly attractive proposition for any runner.
How about static stretching after a run?
Most runners who stretch after a run do so because they feel (or have been told) it reduces the amount of soreness over the next few days (DOMS: delayed onset of muscle soreness) and believe that it will help reduce risk of injury. Some runners find that missing out a post-run stretch results in more next day soreness, for others there is not really much difference if they stretch or not. Some runners are surprised to find that they are actually less sore if they do not stretch after a run.
As the mixed batch of responses to post exercise stretching suggests, there is no research to support the idea that stretching after a run can reduce next day soreness. If anything, data collected just highlights the fact that there is too much variety in human physiology to draw any solid conclusions. As far as showing that stretching after a run reduces risk of injury, this is virtually impossible. There are simply too many other factors that could be responsible and the research gives exactly that conclusion. As we mentioned above, if for some reason you have a reduced range of movement in a specific muscle group then yes, specific stretching to help restore that range could help, but as a method of general injury prevention it likely that too many runners spend too much time after a run trying to achieve a range of movement they will never need.
For more info on post run stretching CLICK HERE…
WEARING THE WRONG SHOES
If there’s one thing runners want to know, it’s whether they’re wearing the right footwear. Most of you will be familiar with terms like ‘overpronation’ and have probably been recommended shoes according to your foot/arch type (high arch, normal arch or low arch). It may therefore come as a bit of a surprise to some you to hear that multiple studies such as Richards (2009) ‘Is your prescription of distance running shoes evidence-based?’ conclude that the prescription of running shoes using this foot/arch type is not evidence-based.
The problem with labelling a certain amount of arch drop during running as ‘overpronation’ is we really don’t know how much is normal. Anatomical structure and function can both vary considerably from one foot to another, so placing all runners into just three categories simply doesn’t make sense. What the medial arch does on slow motion video is not a viable model for prescribing a running shoe.
The only current model for show selection supported by science is: ‘Are they comfortable to run in?’ In other words, if your local running shoe shop offers you a ‘gait analysis’ as a means to selecting the shoe that’s ‘right for you’, take care as the science they are most likely using is not science at all. There are many, many other characteristics in a running shoe that can play a far more important part in shoe selection, e.g. width, drop, stack height, level of cushioning, lace mechanism so do try on lots and see what feels good for you. The only rule to stick fast to is avoid making a sudden change in shoe type, e..g if you are used to a traditional trainer with loads of support and a high heel to toe drop, don’t suddenly try running in a zero drop minimalistic trainer.
For more info on choosing running shoes CLICK HERE…
Though heelstriking did not appear in the list generated by the Saragiotto study, when it comes to myth busting we really should mention it; Every week I still get runners convinced that they are injured because they are a heel-striker, or I see runners who have forced a change from heel-strike to forefoot strike and are now wondering why their calf and Achilles are tender.
When it comes to clearing up this myth, I often refer to the study by Peter Larson (2010): ‘Foot strike patterns in Recreational Marathon Runners.’ Larson and some of his students filmed marathon runners at the 10km (6 mile) & 32km (20 mile) point and later classified them according to their foot strike. The results were as follows:
• 10km (936 runners):
Heel strike: 88.9%; midfoot: 3.4%; forefoot: 1.8%; asymmetrical 5.9%
• 32km (286 runners):
Heel strike: 93%; Forefoot: 0%
So, either all of these marathon runners were doing it wrong or the act of heelstriking has been erroneously victimised. The important factor is. not all heel-strikes are equal. The reason that heel-striking has got a bad name is that it tends to accompany an ‘over-stride’, i.e. when the leading leg reaches out too far in front of you causing a landing on a either a locked out or close to straight knee. Over-striding has been linked to injury, but the heel-strike has nothing to do with it. Some runners land closer in front of their body and still manage to land on their heel; this form of heel striking has no association with increased risk of injury.
For more info on heelstriking CLICK HERE…
One of ways we can often reduce over-striding is by gently increasing ‘cadence’, i.e. step rate: the number of times your feet touch the ground in a minute. We will therefore end this piece with one of my favourite myth busters, i.e. the one that says ‘we should all be running at 180spm (spm = steps per minute). This myth is the result of a misinterpretation of research done by the famous running coach Jack Daniels. At the 1984 Olympics in Los Angeles, Jack Daniels noticed that the elite distance runners all ran at 180spm or more.
The most important two words in that last sentence are ‘or more’. Many of the elites whom Daniels recorded were running above 190spm. It is also vital to note that these athletes were elites, running at elite paces. Cadence varies with speed. Usain Bolt runs his 100m with a cadence of 221spm. We should never expect anyone running at 10 minute mile pace or slower to have a cadence much over 160spm. If anyone suggests it to you, please refer them to this article!
For more info on cadence training CLICK HERE…
So there we have it, some popular running related myths that seem to never die. Am I sounding like a broken record? Have you been told any of these myths by a therapist, personal trainer or running coach? If so, do please share your experience in the comments section below. We’ll be back next month with some more myths!