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Should We Retrain the Gait of Asymptomatic Runners?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Kevin Kirby, May 31, 2014.


  1. Members do not see these Ads. Sign Up.
    I wanted to create a new thread here on Podiatry Arena that explores the theory of gait retraining in runners, expanding on the discussion that Ian Griffiths and I just had in the thread on Use a Wider Base of Gait for Medial Tibial Stress Syndrome.

    There are many who believe that symptomatic runners and asymptomatic runners can have their running gait patterns retrained to become more efficient and less painful. While I agree that symptomatic runners may benefit from some gait retraining in some conditions, is there any evidence that running gait retraining may also benefit asymptomatic individuals? I don't think so.

    However, a whole industry has developed based on the concept that rearfoot striking is an improper way to run where runners pay money to be taught to run "more efficiently" (i.e. Pose, Chi, Alexander) even though the runners taking these courses are asymptomatic. How can we really know that gait retraining every runner to run with a supposed "ideal" gait pattern is really best for that individual runner given their peculiar anatomical and functional anatomy of their lower extremities? Do we think we really know more about their bodies than their central nervous systems don't already know?

    Would like to hear the comments of others on this topic.:drinks
     
  2. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    If it ain't broke, don't fix it.

    All the fan boys would disagree, but:
    - two studies have now shown that Pose is a more uneconomical way to run
    - the preponderance of studies probably now show that the generic injury rates between heel vs midfoot/forefoot striking and barefoot/minimalist vs traditional shod are the same
    - the preponderance of studies probably now show that the generic running economy between heel vs midfoot/forefoot striking and barefoot/minimalist vs traditional shod are the same

    Its evidence vs propaganda and rhetoric.

    Having said that, there is some pretty good consensus among running technique coaches (not the Chi, Pose et al fan boys) about some features that do constitute good running technique, so a case could be made for intervention in those features if not occurring. There are other characteristics of running gait that there is probably not a good consensus on --> probably not intervene in that one.
     
  3. leoneenan

    leoneenan Member

    Kevin
    Interesting question but too broad in range. Each runner is individual and their goals need to be understood to determine whether it's worth changing gait.
    An international 10k runner with a short stride length and poor forward lean can attempt to increase stride length by overstriding and subsequently heel striking. Working to improve float time and stride length may result in less of a heel strike but the goal of retraining is not solely on foot strike. Improved efficiency leads to improved capacity for performance so retraining is worth the effort.
    On the other hand a recreational 10k runner running for health and fitness reasons may not see any real need for improved performance as completion of the distance and the calories burned is their goal so the retraining of gait is possibly not necessary if they are asymptomatic
    I think running efficiency or movement efficiency is something worthwhile the amount of effort and time spent on it can only be decided by the individual. Retraining should not be focused on foot strike patterns as this has become marketing propaganda or worse a quick fix for correct coaching.
    Buying a pair of 'shoes' to retrain gait?
    A bad workman blames his tools
     
  4. BEN-HUR

    BEN-HUR Well-Known Member

    This is an interesting topic... one I think about on a regular basis (well, sort of... there are a few other things I ponder on).

    This topic reminds me of an article written in 2010 about Alberto Salazar's interest in tinkering with gait/form/technique of his elite stable of athletes (in particular the problems encountered with Dathan Ritzenhein). I found it a fascinating article which fits quite well into this thread...

    The Perfect Stride:
    Can Alberto Salazar straighten out American distance running?


    By Jennifer Kahn... November 8, 2010
    http://www.newyorker.com/reporting/2...urrentPage=all

    The following quotes I found interesting from the article...

    It's a long article but the second half is where it gets really interesting...

    The Gabe Jennings comment was also interesting (2nd last paragraph) - re.: being able to successfully change your style/technique beyond a certain age (no doubt related to another interesting area i.e. Neuropathway development).

    I don't hear of Ritzenhein these days... but certainly hear of Galen Rupp (who Alberto also coaches) who just recently broke the American 10 000m record at the 40th Prefontaine Classic... in a very impressive time of 26:44.36 :eek:.
     
  5. Matt:

    Thanks for the thoughts of Alberto Salazar and his opinions on gait retraining.

    However, for every good story about some coach who wants to be acknowledged because his athlete did well with gait retraining, there also is likely a bad story about the same coach who injured a runner because he thought he was doing the right thing for that athlete by doing gait retraining. We never seem to hear these stories, do we?

    That is why we need scientific evidence, not anecdote, in regards to gait retraining in runners.
     
  6. Dennis Kiper

    Dennis Kiper Well-Known Member

    Improved efficiency leads to improved capacity for performance so retraining is worth the effort.

    But first, you have to improve functional foot performance to get those improved biomechanics, the body can then be tweaked as necessary in a retraining program.

    On the other hand a recreational 10k runner running for health and fitness reasons may not see any real need for improved performance as completion of the distance and the calories burned is their goal so the retraining of gait is possibly not necessary if they are asymptomatic

    I think you are right to the first part, but if that individual could improve his performance simply by wearing orthotics that will improve his foot mechanics and improve his overall? Wouldn't you suggest something like that to a pt?

    should not be focused on foot strike patterns as this has become marketing propaganda or worse a quick fix for correct coaching.
    Buying a pair of 'shoes' to retrain gait?
    A bad workman blames his tools


    I couldn't agree with you more.

    “When you run a hundred miles a week, your body finds natural positions that work,” the élite Australian runner Craig Mottram points out. “It’s flirting with disaster to mess with that.”

    I agree, a consistantly proper fitting orthotic that doesn't interfere with the runner's style is the best way to allow that person to fulfill his goal.


    “You want the chain of force to travel from the ground through the body with minimal energy loss. That’s what it means to run efficiently.”

    A proper fitting orthotic/cushion is the medium between the ground and the body. It minimizes the energy/pronation loss.
    The fit needs to be consistantly correct and in some cases precise. That will help you run efficiently.




    Ritzenhein began his transformation last fall, but the switch proved calamitous. Already prone to injury, he developed sesamoiditis in his left foot, a painful inflammation in two small bones near the big toe. To relieve the pressure, Salazar dug a hole in the insole of Ritzenhein’s shoe, which he buttressed with duct tape. The modification relieved the sesamoiditis, but it also caused a stress fracture by transferring more strain onto the third metatarsal.

    Is this not biomechanics? With a proper fitting orthotic he would have been much more unlikely to have had that transfer Fx.

    That is why we need scientific evidence, not anecdote, in regards to gait retraining in runners.

    How much do you want to bet that retraining will continue as the way to do it, until a more accurate and reliable orthotic technology becomes available?
     
  7. Craig....I love the "ignore" function on Podiatry Arena...better than anti-hypertensives at lowering my blood pressure....

     
  8. mr2pod

    mr2pod Active Member

    Thanks Kevin for starting this thread which I find very interesting. My mind goes back to the 2012 Olympics - Womens Marathon. Proscah Jeptoo won the Silver medal and yet I could imagine most people would be very critical of her running "form"

    Here is link to a short video - not mine, just simply googled for it.

     
    Last edited by a moderator: Sep 22, 2016
  9. Good point, Scott. Just imagine how many running coaches and gait retraining "experts" would want to subject Jeptoo to their personal "guaranteed" gait retraining protocol. This is the same video I used in the original thread when I mentioned to Ian Griffiths whether this type of running gait should be "retrained" also. Ian said he only retrains symptomatic runners.

    I am very interested in what exact structural deformity makes Jeptoo run this way. My guess is her odd gait pattern is due to a lack of external femoral rotation on the right that causes her knee joint axis to be internally rotated. In addition, my guess is that she has found this is the most metabolically efficient way for her to run.

    Good discussion.
     
    Last edited by a moderator: Sep 22, 2016
  10. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    There was a study I read a few yrs ago and have not been able to relocate! It was in the cerebral palsy literature and they used MRI to determine the location of muscle/tendon insertion into the pelvis and then measured the distances to the centre of the hip joint from those insertions. The key finding was the large person to person variation in the lever arms - this would have gone some way to explaining the variable response to the multilevel surgery you see done in those with cerebral palsy.

    There is no reason to assume that such variation does not exist in the general and running population - if it does this could go some way to explain the variable responses that are seen with the more proximal interventions working or not working and maybe also the variations in "form" (eg Jeptoo) that is seen ... its all about variations in the lever arms.

    Variations in lever arms determine loads in tissues and economy of effort of the muscles .....
     
  11. mr2pod

    mr2pod Active Member

    I agree Craig + Kevin. Variations in anatomy, and lever arms plays a big part in it. The body is very good at compensating for its own variables, and will do so generally in the most economic and/or the most comfortable (withou pain) ways.
    I recall going to a "Learn to Run" session where a comparison was made to a gazelle in respect that they "all run the same" and why should we therefore have so many different running styles. There are many variables in our anatomy, let alone external factors that may influence our running style.
     
  12. ggm2011

    ggm2011 Member

    When I played professional sport and any of the well paid running coaches i had never tried to change my foot strike patterns. They mostly worked on what they said was poor mechanics for example i hardly used my arms so had to run with straws in my hands. Lift my left knee as it didn't come as high as my right knee (I had had 3 ops for torn cartilage on this knee). None of these coaches ever measured or tested any muscle or joint range in me it makes me wonder what knowledge they actually had other than making my movements symmetrical. Plus for as much as they would go on about my poor mechanics I held the track record at that club. Wish I knew a bit more back then to challenge their observations.
     
  13. toomoon

    toomoon Well-Known Member

  14. Simon B any reason why you could not post your response in the thread.

    hits that important?

    soon we should all have our own blog we can start a thread and then post links to individual discussion points on our blogs, should make for an easy to follow discussion.

    fwiw I tend to stick to craigs idea of if working don't fix especially for the lower limb, whenever I do any coaching (mainly track,sprinting distances, and not that often) I tend to focus on arm swing if anything.
     
  15. toomoon

    toomoon Well-Known Member

    well Mike it was to try to direct you to other things that might interest you.. or not! Personally I don't think it is "that important'.
    What does fwiw mean?
     
  16. BEN-HUR

    BEN-HUR Well-Known Member

    Hi Kevin.

    I must admit that I was puzzled by your response to my post (could be the result of ambiguity within this writing medium or maybe a preconceived perception of my position on this topic)... hence I must ask, did you carefully read the article I cited/quoted? It is a longish article thus why I quoted the more interesting 2nd half (with highlights) which specifically discusses Alberto Salazar's experience with gait/form re-training with an elite distance runner... whom which also coaches some of the best distance runners in the world (i.e. National record holders & World/Olympic Champions... for those who don't know e.g. Mo Farah & Galen Rupp). Furthermore (for those who don't know) Alberto is a former world record holder for the marathon (2:08:13)... a former world class athlete himself (from 5000m to marathon during the 1980's). He would also have to be regarded as one of the world's foremost minds on distance training, with a wealth of experience & knowledge. Now I know (more than most) that doesn't really account for much if there isn't the science & research to back up (or will back up) such opinions/claims/world views (there is another controversial area I'm interested in which is riddled with inflated views with subsequent inconsistencies within empirical science).

    Yea... but that's what the article was about... (to quote yourself) "a bad story about the same coach who injured a runner because he thought he was doing the right thing for that athlete by doing gait retraining". Frankly, I thought it was a brutally honest account of a world renowned coach admitting that he & his athlete had some real problems with the process of gait/form re-training i.e....

    Then...

    Alberto can probably see now that the following thoughts were inappropriate... or at the least... inappropriately carried out (i.e. verbally & practically)...

    Now that's pretty strong (i.e. tempting) words for an athlete to hear... & too stronger words/opinion for a coach to use! Basically the process was based on... change or you won't make it as an athlete (albeit, the best in the world). Both had a lot at stake on the results thereof.

    Not only did the article highlight the self-acknowledgement that Salazar & Ritzenhein got it wrong... but the article also highlighted other world class distance runners views on the topic...
    - Craig Mottram:
    Gabe Jennings (who I competed against in the 1500m in the States back in 2000):
    Hence I found the article (& the views of world class athletes/coaches) a fascinating read on the potential problems of gait/form re-training with experienced runners... individuals immersed in the issue... in theory & practical application (with a lot at stake... championships, medals, sponsorship etc...).

    Just a short personal testimony: I recently advised a female runner who attended my clinic which a long history of recurrent Anterior Shin Splints (Tib. Ant. strain) to reduce the degree of heel striking & focus more on mid-foot striking. I advised her to start training again with instruction on quantity (km per day), stretches & strengthening ex. for the anterior compartment & foot placement. On the follow-up consult 2 weeks later (running virtually every day) there was no symptoms of Anterior Shin Splints. In this case I correlated a potential gait issue (& subsequent adverse forces) to the injury/symptoms... loading forces was thus moved from an evidently problematic area (anterior) to another area... the calf/Achilles (posterior group), of which there was some soreness, of which quickly resolved. Maybe I was lucky with this runner... gave her the right advice at the right time which suited her physiology. I feel it's a two way street (between adviser & athlete); the coach or Podiatrist needs to relate & provide adequate advice & the athlete needs to listen & understand the information as well as listen & understand the feedback form their own body... feedback from the body reigns supreme over the advice of any coach/Podiatrist. I don't take this route with all patients... just the ones I sense would have the understanding & potential to benefit from attempting such changes i.e. during a consult you can get a sense that some individuals appear vague on such matters & would struggle to understand the implications involved (i.e. not body wise).

    Agreed... & I'm convinced that Alberto & Dathan Ritzenhein would also agree.
     
  17. FWIW

    for what it is worth

    You have your website in your signature, surely as a method of promoting biomechanical discussion a post in the thread which I can read, quote and discuss makes discussion easier is a better alternative?
     
  18. toomoon

    toomoon Well-Known Member

    well .. obviously not from my perspective..but.. we are all different Mike!
     
  19. Matt:

    I liked your story since it agrees with my anecdotal observations also. However, I felt it also needed to be said that quoting stories from coaches and athletes, no matter how famous they are, is helpful to gain a grasp on the opinions held on a subject, but not very good when trying to scientifically provide research evidence to support or refute a hypothesis.
     
  20. We must not also forget that there are large anatomical variations in the shape of the bones of the lower extremity. In Jeptoo's case, it is conceivable that she has what the orthopedic community calls femoral anteversion which would cause her knees to be more internal than normal and her limb in forward recovery (i.e. swing) to be more laterally positioned relative to the midline of her body.

    That is the whole point of me starting this thread. Do we really know enough about the structure and function of each individual to make judgement on whether they are running "inefficiently" and need to be "retrained"??
     
  21. Here's the problem, if we use metabolic efficiency during running gait as the dependent variable, what would be the independent variables that should predict the dependent in a multivariate predictive model, and what would be their relative weightings?

    Metabolic efficiency (Y)= a function of: X1 (?) + X2 (?) + ...Xn(?)

    We could say metabolic efficiency =Genotype + Environment + (Genotype x Environment) which is accurate and tells us that variation between individuals will dictate that there is no single "kinematic ideal" across or within individuals, so there is no single "ideal running style" in terms of metabolic efficiency or anything else, end of story. We really need to partition the variance in both genotype and environment: which genetic factors and which environmental (all non-genetic) factors contribute to metabolic efficiency during running (define running: drive phase of a sprint? Last mile of a marathon? Are these the same?) and how do the environmental factors interact with the genetic factors?

    I'm with Kevin, we don't have anywhere near enough information. Frankly coaches are guessing. That is not to say that coaching and training cannot help with performance. But let's not pretend that all the answers are there, since they aren't. Moreover, if anyone attempted to make all runners, "run the same way" they should surely find their efforts made as many people injured as they healed and as many people slower as they made faster. One of my favourite quotes that I read many, many years ago was something along the lines of: "If you want to win the 100m at the olympics, you need to pick your parents", don't remember it saying anything about picking your coach.
     
  22. Matthew:

    Alberto Salazar said:

    Hello....knock, knock, knock.....Alberto.....ever heard of the Meb Keflezighi, the heel striker that just won the Boston Marathon?!

    How does Alberto Salazar get by saying ridiculous statements like that to another elite runner?? How?...Because Alberto is a former elite runner and he attracts a lot of attention. Did he have any evidence to make a statement like that? Absolutely not!! Does Alberto Salazar have any scientific evidence to support his gait retraining of rearfoot striking elite runners to try to be forefoot strikers? Not a single shred of evidence! And Alberto has been one of the prime movers in convincing people that, somehow, forefoot striking is better than rearfoot striking. Like Dr. Spooner noted, Salazar is probably causing as many injuries as he is preventing them by moving many runners toward forefoot striking.

    Alberto, stick to running and coaching, leave the biomechanics and sport injury treatments to someone that understands the biomechanics of running and sport injury treatments. If I were to do what Salazar did, gait retraining someone into new injuries then causing a stress fracture by mismanaging orthosis adjustments, I could be sued for malpractice. What will happen to Salazar as he continues to do this to other runners? Probably nothing!

    Even more reason to take a stand against the gait retraining of asymptomatic runners to save them from coaches who think they know much more than they really do about the "proper way to run".
     
  23. BEN-HUR

    BEN-HUR Well-Known Member

    Yes Kevin, I am fully aware of what Alberto said... I highlighted the very same quotes you did in your last post within my previous two posts i.e.
    As well as both coach & athlete admitting they got it wrong...
    Like I said, the article was a brutally honest account of the problems associated with gait/form retraining in older conditioned (elite) athletes. Now the title of your thread is... "Should We Retrain the Gait of Asymptomatic Runners?" I personally would not (as a saying which has been cited before states - "if it ain't broke, don't fix it") - but it might depend on what level of gait retraining we're talking about i.e. arm motion, hand position, shoulder posture... as opposed to lower limb mechanics. Besides, Dathan wasn't exactly "asymptomatic" when he came to Alberto... there was a history of injury baggage... which ironically grew whilst attempting to address perceived attributes associated with it.

    When I was training for the 1500m, my coach would hound me on my arms - they would tend to move circularly rather than back & forth, particularly when I was pushing hard at the end of 1km reps or at the end of the race. I hated being hounded on this as my arm motion was reflective of my desperate attempt to push harder... besides, it really wasn't that bad (not as bad as Roger Banister's arm action or that guy in Chariots of Fire... to note more famous accounts). Could have changing my arm action whilst pushing at the end of a race prevented injury - doubt it. Could it have made me more metabolically efficient - possibly, but marginally at best. Did hounding me on this (whilst under stress) help with my overall wellbeing as an athlete & my relationship with my coach - it added more strain & frankly wasn't worth it for the potential minor benefits it may have given.

    I wonder whether anybody hounded Paula Radcliffe on her head action - it certainly looks odd... & possibly not metabolically efficient (but at what degree?). But my personal take is that whilst theoretically ideal biomechanics for an individual will help with offsetting injury threshold limits... & help with performance via improving metabolic efficiency... minor issues, or idiosyncrasies (if you will) may also serve as a comfort factor to an athlete going through a high degree of stress (physically & emotionally). This is an issue I have not noticed discussed before... but remove this (trait) from the athlete (via drumming/hounding it out of them) may just remove more than what you bargained for. Hence caution is needed for even the perceived minor issues. Not everyone has to look "pretty" & "graceful" when they run... i.e. like Sebastian Coe - who I know Peter Coe (father/coach) worked on his form to some extent.



    We all (should) know about the more in depth biomechanical/physiological issues associated with this topic i.e. joint morphology/angles/congruency etc... as well as muscle/tendon integrity affecting injury threshold & metabolic efficiency... & the congenital implications thereof. After all, this is a Biomechanics forum within a Podiatry forum. Some individuals have the right attributes to run efficiently (dare I say... "Born to Run")... then there are those who have a more optimal package (which includes the cardiovascular factor) which can enable them to be world champions & world record breakers. Others are not... to varying degrees. I have said for a long time... running is very good a weeding out such individuals... but we as Podiatrists can help these individuals partake in something they love (or later acquired the love)... without such individuals meeting their injury threshold too soon... i.e. via the likes of orthotic therapy. Which then opens the question... is orthotic therapy a form of gait retraining?

    I have also said that it helps for humans to start running at a very young age - & keep running ... if they want to develop optimal neuropathways for the running motion based on their individual physiology/biomechanics. Yet we know this doesn't happen... humans sometimes take up running later in life (if at all)... carrying with them a whole load of attributes (i.e. weak core muscles, tight limb muscles) reflective within poor lifestyle baggage (& not just the kind around the belly & hips :rolleyes: ).

    But hey, we're all human - we all make mistakes... even under the most sincerest of intentions (as was Alberto's & my coach). We learn & grow from our mistakes... this is how humanity rises & improves... particularly when we endeavour to push the envelope... the boundaries of human performance. Alberto admitted he made a mistake with Dathan... but that experience may have developed Alberto to a wiser coach which no doubt has reflected in his coaching of World & Olympic champions (i.e. 1st & 2nd at London Olympics for the 10 000m as well as Galen Rupp's recent American 10 000m record of 26:44.36). Thus I personally feel your assessment of Alberto's views (in hindsight) were a bit on the harsh side (albeit, I understand where you are coming from as a Podiatrist & a runner). Anyway, views of which (reflecting the pinnacle of human performance i.e. world class distance running) I feel were suitable for highlighting within this thread... based on my perception of the following...
    Anyway Kevin, we are no doubt on the same page... except coming from a different perspective (& adding a different perspective)... & I've probably written too much.
     
    Last edited by a moderator: Sep 22, 2016
  24. Chris McDougall called me the Angry Podiatrist....just trying to keep my attitude in line with my new handle.:rolleyes:

    My point about Alberto is that many of the local coaches I know who have been keen on getting runners to forefoot strike and not heel strike (even though these runners are only running at 8:00/mile pace). These same coaches often quote Alberto Salazar as to his feelings about rearfoot and forefoot striking: "Alberto Salazar trains his runners to forefoot strike and he has produced national champions...blah...blah...blah..."

    Of course, I shouldn't complain, because these coaches do produce plenty of injured runners for me to treat because their coaches tell them: "Heel striking is bad form". :craig:

    With all that said, I do believe that the more novice the runner, the more they can benefit from some instruction on proper gait form. I have been doing this for a quarter century with my novice runner patients, but never for my more experienced runners, and have had generally good results with no injuries, to my knowledge.

    My biggest problem is with coaches who try to manipulate the gait of experienced runners who are not injured and with coaches who try to tell all runners to run the same way (e.g. "heel striking is bad form, don't do it!"). I think this opens up the runner to an increased risk of injury.

    Please, let's give a little more respect to the central nervous system's ability to develop, over time, a running movement pattern for the individual that is metabolically efficient and non-painful. I think that this important physiological and neuromuscular consideration is totally lost on many coaches and some clinicians.
     
  25. Deka08

    Deka08 Active Member

    Simon B,
    You stated gait modification is a good........etc
    Is there a difference between "retraining" and "modification"?
    I find there is. I am happy to look at minor tweaks to someone's gait, but retraining for me is a complete breakdown and rebuild. I am not confident in my experience to do a rebuild.
    Cheers
     
  26. opodiatry

    opodiatry Welcome New Poster

    Having had a collegiate and post collegiate running career I had tried to change a wrist position, not because of any perceived enhancement in performance, but more to limit ridicule from other runners for its appearance ( think Frank Shorter).
    I am at a lost as to how you are going to change a runners form when one has to be aware of what is transpiring around them in the race. Perhaps in something as long as a half marathon or longer where you have nothing to do for almost and hour plus, but at any distance less than that, too much activity going on to worry about form.
     
  27. I would tend to agree with you that it's difficult to imagine trying to think about changes in running form during a track event shorter than a 1,500m/mile. However, when I ran 5k to ultramarathon races, I would often try to find the most relaxed style of running after the first 200 meters of the race in order to run the fastest with the least amount of energy expended.

    During my high school racing days, back in the early 1970s, my coach gave runners on my team suggestions about arm position, hand position during workouts. We also practiced, during intervals and windsprints "pumping our arms to help bring our feet around quicker" or something like that. However, thankfully, my coach spent very little time, from what I remember, worrying about footstrike or stride length since he felt that would come along with experience and training.

    None of my college cross-country or track coaches while running for the UC Davis Aggies from 1975-1979 ever told us to change our running form since they I guess if they figured if we had made the team that they would then pound us into the ground with intervals and twice a day workouts until we ran faster (not really but sometimes that is what it felt like!). Back then, we ran in racing flats for workouts on the track, ran barefoot occasionally on a grass field for one mile intervals, ran in training flats on the roads for longer workouts and didn't ever feel the need to call racing flats "minimalist shoes" or toe the line at a race barefoot. None of the collegiate runners that I trained and raced with at UC Davis understood all the barefoot/minimalist running propaganda that occurred over the past five years and basically thought it was all BS, as did most other serious competitive runners.

    Hopefully this gait retraining fad will also swirl down the same toilet that the barefoot/minimalist fad is currently swirling down into infamy.
     
  28. Leopold

    Leopold Member

    I attended a seminar by Chris Powers a couple weeks ago. He talks mostly on the knee and even more specifically PFPS. One of the main themes in his protocols, for almost everyone, is an increased forward trunk lean from the hip in an attempt to increase the hip joint extension moment and thus decrease the knee joint extension moment. He loves glut max.
    I have PFPS, second to a patellar dislocation a few years back, so I tried it. Very opposite to the classic POSE or Chi position. It's almost like running in a mini-squat with your bum sticking out. Totally energy inefficient and feels like your really lumbering along. But, my PFPS felt a bit better and my gluts felt fatigued.
    I was not impressed by the science that Chris Powers presented, but I'm going to keep dabling with this idea myself.
    And my opinion for what its worth - asymptomatic runners who run for fun and fitness should not consciously change their gait patterns and should be encouraged to NEVER pick up a running magazine. Symptomatic runners need to change something.
    Lee
     
  29. Dennis Kiper

    Dennis Kiper Well-Known Member

    Symptomatic runners need to change something

    Symptomatic and asymptomatic runners need to wear a proper fitting orthotic that can reduce and minimize pronation energy loss and biomechanical instability from overpronation with every step.
     
  30. toomoon

    toomoon Well-Known Member

    Kevin.. in my opinion there is such a thing as "correct running form". This fellow from The Bowling Green Track Club, an American Institution I have visited, is demonstrating excellent form by wearing a very stylish beret whilst running. Now.. if he were to add a cravat, I believe we could call that "perfect form"!
     

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  31. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    ...and don't forget this this photo (used with permission) from Iain Hunter of the mens 10k US Olympic trial - this is the best of the best running very fast - look at the variation.
     

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  32. Simon, the best hat ever worn by a runner was the golf cap of Dave Wottle in the 1972 Olympic 800 Meter Final. It was because of this race, and the gold medal win of Frank Shorter in the marathon in these same Olympics that, I believe, started the "Running Boom" in the United States in the early 1970s. I know it got many of us teenage runners in the US, like myself, motivated to try to be just like Wottle and Shorter. They were our heros!!

     
    Last edited by a moderator: Sep 22, 2016
  33. toomoon

    toomoon Well-Known Member

    You know that i am going to have to argue with you Kevin..and I hope others chime in on this fascinating and technical discussion, but the Bowling Green beret clearly and absolutely gazumps the golf cap in terms of style and form.. hands down winner, especially when teamed with the Freddie Mercury 'tache..
     
  34. Griff

    Griff Moderator

    Hi guys

    As I said in the MTSS thread, I use gait re-training as a tool in runners but try to do so using the current evidence base. To my mind this currently means stride length/cadence manipulations for patellofemoral pain and step width manipulations of MTSS (and maybe ITB). I don't personally change the movement patterns of asymptomatic runners at all (this includes not making introductions of or recommendations of footwear and orthoses).

    That said, I do work closely with a friend/colleague who is a running performance coach who I trust wholeheartedly. He sees runners who are both symptomatic and asymptomatic. He doesn't adopt a one size fits all approach or try to get all runners he sees running the same. I think we all agree that variation is the new normal. However, there is also a reasonable school of thought that good runners, despite their differences in body morphology, running technique, kinematic patterns etc, will all do certain things very similarly. (Of course you will always have outliers in every cohort you look at). I have no hesitation referring runners on to him if during conversations with them that is an avenue they clearly wish to pursue.

    Lets take golf (because the conversation always has to lead there with me at some point): Look at all of the tour pros. They come in all shapes and sizes, and all have very unique and individual swing patterning. But, if you look beyond that, at what Luke Donald calls the 'fundamentals' [grip, stance, posture] you will see more similarities between them than you do differences. Makes sense to me that there will be running 'fundamentals'. I believe the key one that most people currently agree on is stride length [i.e. where the foot lands relative to the hips/centre of mass]

    I'm no expert on this - will drop my buddy a text and ask him if he'll come on and put down some of his thoughts. In the meantime he is a blog he wrote on along very similar lines: Can we define perfect running form?

    And on the great hat debate you can chalk me up on the side of the beret and moustache. The epitome of sophistication.
     
  35. toomoon

    toomoon Well-Known Member

    I have to agree with Ian, although my views on a 'one size fits all" approach are well known.
    As with all things, a great degree of thought and research has to go into any fundamental change for an athlete, and especially at the pointy, elite end of the spectrum because.. per the Salazar discussion, there does not appear to be the same tolerance for change we might see in recreational runners.
    This is undoubtedly because, like it or not, elites have all been exposed to coaching (as they should).
    There is no doubt in my mind that movement pattern modification is one of the tools we can use to either correct an obvious fault which may very well be a precursor to injury.. overstriding being the obvious one.. or to help manage an existing injury.
    I work very closely with an exercise scientist, and, given the right balance, analysing faults can have a powerful effect on not only injury, but performance.
    I am pretty serious about gait analysis, and obviously this is primarily about identifying potentially injurious loads, which clearly can be down to technique. Seems a bit weird to not at least try to understand this and modify as necessary!
    It also is one of the techniques that has to be considered if the runner wants to get faster. Technique, now irrevocable linked to the ubiquitous and somewhat ridiculous term 'form", is very important, and like running and walking itself, is learned.
    Kevin's point about changing movement patterns for very successful athletes is well made. You do that at your peril, and some athletes get to be fast with extremely unusual styles. I was chatting to Aussie distance great Rob De Castella not that long ago, and this World Marathon record holder told me his style had been described as akin to running whilst trying to grub weeds out of the footpath at the same time. On reflection, an accurate description! He was rarely injured. Examples like this do not however mean that we should discount 'gait retraining" as viable, because as with all things, used judiciously, appropriately, and with knowledge of the credits and debits, it can be and is a very useful adjunct.
     
  36. BEN-HUR

    BEN-HUR Well-Known Member

    Thank you Simon Bartold for exposing me to the beret & "Freddie Mercury 'tache" style... I resonated with it straight away (which must mean something)... hence I will follow that instinct & start adopting the attributes. I can just see me now... running through Centennial Park :rolleyes:... with my compression garments on... & sporting a pair of Vibram Fivefinger Bikilas ;)... I'm excited!

    Kev can keep his golf cap (silly sport anyway).
     
  37. toomoon

    toomoon Well-Known Member

    go the cravat as well Matt.. I promise it is coming back!
     
  38. Ian and Simon:

    You have both made good points. However, I feel we are still in the infancy of this "gait retraining era" and have lots to learn. So much of this is dependent on central nervous system (CNS) physiology. In other words, is gait retraining a long-lasting solution or do individuals revert back to their old way of running once the instruction stops? How does gait retraining affect the metabolic efficiency of running and will the CNS, over time, continually try to bring the runner back to a more metabolically efficient method of running even though this mode of running may be more likely to cause injury? In addition, how long does it take to retrain a runner?

    I am very interested in this subject because it starts to delve into the whole matter of how the CNS "chooses" a kinematic pattern of gait for each individual given that individual's peculiar structure and muscle physiology. In other words, what gives Jeptoo her odd right leg angle during running, is this structural or functional or neurological and is it being done by her CNS to conserve metabolic energy, to avoid pain and/or to bring the foot down on the ground at a certain angle relative to the line of progression?

    Here is a paper coauthored by my friend Marty Hoffman, MD that discusses these concepts in more detail.
     
  39. toomoon

    toomoon Well-Known Member

    I agree Kevin, and i think gait patterns are reasonably "hard wired' in the brain, and this is what makes this challenging. So it may well be that we regard gait retraining as a short term injury management protocol, to be used to unload the injured structure.. while this is happening maybe we can figure out what can be done to make sure the problem does not return once the 'hard wired" movement patterns return!
     
  40. Almost passed out when I read those words.....:cool:;)
     
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