Forefoot strike running: Do you have enough calf muscle endurance to do it without a cost ?

Below you will find an article on footwear and running. Rice et al concluded that 

“ When running in a standard shoe, peak resultant and component instantaneous loadrates were similar between footstrike patterns. However, loadrates were lower when running in minimal shoes with a FFS (forefoot strike), compared with running in standard shoes with either foot strike. Therefore, it appears that footwear alters the loadrates during running, even with similar foot strike patterns.

They concluded that footwear alters the load rates during running. No brain surgery here. But that is not the point I want to discuss today. Foot strike matters. Shoes matter. And pairing the foot type and your strike patterns of mental choice, or out of natural choice, is critical. For example, you are not likely (hopefully) to choose a HOKA shoe if you are a forefoot striker. The problem is, novice runners are not likely to have a clue about this, especially if they are fashonistas about their reasoning behind shoe purchases. Most serious runners do not care about the look/color of the shoe. This is serious business to them and they know it is just a 2-3 months in the shoe, depending on their mileage. But, pairing the foot type, foot strike pattern and shoe anatomy is a bit of a science and an art. I will just mention our National Shoe Fit Certification program here if you want to get deeper into that science and art. (Beware, this is not a course for the feint of heart.)

However, I just wanted to approach a theoretical topic today, playing off of the “Forefoot strike” methodology mentioned in the article today.  I see this often in my practice, I know Ivo does as well. The issue can be one of insufficient endurance and top end strength (top end ankle plantar flexion) of the posterior mechanism, the gastrocsoleus-achilles complex. If your calf complex starts to fatigue and you are forefoot striker, the heel will begin to drop, and sometimes abruptly right after forefoot load. The posterior compartment is a great spring loading mechanism and can be used effectively in many runners, the question is, if you fatigue your’s beyond what is safe and effective are you going to pay a price ? This heel drop can put a sudden unexpected and possibly excessive load into the posterior compartment and achilles. This act will move you into more relative dorsiflexion, this will also likely start abrupt loading the calf-achilles eccentrically. IF you have not trained this compartment for eccentric loads, your achilles may begin to call you out angrily. Can you control the heel decent sufficiently to use the stored energy efficiently and effectively? Or will you be a casualty?  This drop if uncontrolled or excessive may also start to cause some heel counter slippage at the back of the shoe, friction is never a good thing between skin and shoe. This may cause some insertional tendonitis or achilles proper hypertrophy or adaptive thickening. This may cause some knee extension when the knee should not be extending. This may cause some pelvis drop, a lateral foot weight bear shift and supination tendencies, some patellofemoral compression, anterior meniscofemoral compression/impingement, altered arm swing etc.  You catch my drift. Simply put, an endurance challenged posterior compartment, one that may not express its problem until the latter miles, is something to be aware of. 

Imagine being a forefoot striker and 6 miles into a run your calf starts to fatigue. That forefoot strike now becomes a potential liability. We like, when possible, a mid foot strike. This avoids heel strike, avoids the problems above, and is still a highly effective running strike pattern. Think about this, if you are a forefoot striker and yet you still feel your heel touch down each step after the forefoot load, you may be experiencing some of the things I mentioned above on a low level. And, you momentarily moved backwards when you are trying to run forwards. Why not just make a subtle change towards mid foot strike, when that heel touches down after your forefoot strike, you are essentially there anyways. Think about it.

Shawn Allen, one of The Gait Guys

Footwear Matters: Influence of Footwear and Foot Strike on Loadrates During Running. Medicine & Science in Sports & Exercise:
Rice, Hannah M.; Jamison, Steve T.; Davis, Irene S.

http://journals.lww.com/acsm-msse/Abstract/publishahead/Footwear_Matters___Influence_of_Footwear_and_Foot.97456.aspx

A marathon a day, for over 120 days…..on one leg, battling cancer.

So you think you are tough ? This guy was tough. A marathon a day for over 120 days…..on one leg, battling cancer. 

Rest in Peace Terry. You are not forgotten. You made a mark on my life, thank you for that. Watching you skip on the good leg, giving your prosthetic enough time to swing through mesmerized me, the biomechanics of it all. If i look back, this was the first time I payed attention with great detail to someone’s gait. I was in awe, you moved me, your mission moved me, your heart and spirit moved me. Your life made a difference in mine, so I may help others.Dr. Allen
Today, June 28th, every year here on The Gait Guys, I remember Terry Fox. Every year I post a reminder of perhaps one of the toughest dudes who ever lived. Today , this day, 1981 Terry Fox died. I grew up in Canada. I was barely a teenager when Terry began his plight, The Marathon of Hope. 

His mission, 26 miles a day, every day, until he had crossed the expanse of Canada to raise awareness for cancer. He made it an amazing 120+ days in a row, 3339 miles, one one leg, before his cancer returned. The whole country stood cheering watching him do something no mortal man would attempt, let along with one leg, and cancer. Today we pay a tribute to this true rockstar.
Let this video move you, just in case you think you are having a rough day.

https://www.youtube.com/watch?v=xjgTlCTluPA

Global body compensations in ACL deficient knees.

ALERT: Ok, this is big.
It is a huge comment on what the brain and reflexive patterns impart on posture and gait when perceived functional instability is present.
This study aimed to investigate the gait modification strategies of trunk over right stance phase in patients with right anterior cruciate ligament deficiency.
* Here is what you need to ABSOLUTLY keep in mind when you read it. The 3D capture it telling you what they are DOING to strategize, not what is WRONG or what needs CORRECTING (our mantra it seems, sorry to keep beating this concept to death). This again hits home what I have been preaching for quite some time, that arm swing (and you can translate that to trunk movements, thorax, head posture, breathing etc) should not be coached or corrected unless you are absolutely sure there are clean symmetrical lower limb biomechanics (yes, you can easily and correctly argue that you can concurrently work on all parts). IF there is something going awry in a lower limb, compensations will occur above, they have to occur. So be absolutely sure you are not making therapeutic interventions above without making therapeutic corrections below. If you are working on a shoulder/upper quarter problem and are not looking for drivers in the lower limbs or in gait, well … . . good luck making lasting effects. Other than breathing, it can be argued well that gait locomotion is our 2nd most engaged motor pattern that we have driven to subconscious levels , and compensations are abound (but not without a cost), so we can dual++ task.
If you want to dive deeper into this, search our blog and look for my articles on Anti-phasic gait. This is essentially what this study was looking at, and confirming, that there is a distortion in the NORMAL opposite phase movements (anti-phasic) of the “shoulder girdle” and “pelvic girdle” when something goes wrong in a lower limb.
– Dr. Allen

Findings from Shi et al when there was a chronic right ACL deficiency:
-trunk rotation with right shoulder trailing over the right stance phase was lower in all five motion patterns
– trunk posterior lean was higher from descending stairs to walking when the knee sagittal plane moment ended
– trunk lateral flexion to the left was higher when ascending stairs at the start of right knee coronal plane moment when descending stairs at the maximal knee coronal plane moment and when descending stairs at the end of the knee coronal plane moment
– trunk rotation with right shoulder forward was higher at the minimal knee transverse plane moment and when the knee transverse plane moment ended
– during walking, trunk rotation with right shoulder trailing was lower at other knee moments during other walking patterns

http://www.ncbi.nlm.nih.gov/pubmed/27131179

Feature: Arterial disease and cycling – VeloNews.com

“That offseason, his symptoms worsened. Before, it might have taken 20 minutes of riding at 400 watts to feel the sensation. Now, if he rode for five minutes at 350, he’d be riding with one good leg and one numb, powerless appendage.”

Iliac artery endofibrosis is a circulatory condition affecting the legs and is sending more and more cyclists under the knife.
If you are a bike geek like i am (been watching the Tour de France since i was 15) you may take interest in this. If you are a avid bike rider or triathlete you may take interest in this.
But do not stop at the bike when you have symptoms in front of you that sound vascular. If your leg is doing numb on a long walk or run, dead or heavy during exertion, something is going on that needs evaluated. Get evaluated.

Feature: Arterial disease and cycling – VeloNews.com

Obesity and Base of Support

Recently we have been speaking and writing about “base of support” and how a narrow base of support will render a small comfort and control zone of balance in single leg tasking (walking, running, sports etc). We do not notice these things if we are standing on both feet or when walking or running per se, but all one needs to do is test a 30 second single leg stance to see how crappy one’s single limb base of support actually is. Most people will drift the pelvis laterally to get the single foot under the center of the body mass. This is a false support, it is a demonstration of weak support, unless you like to walk on a line/cross over gait. We should not have our knees rubbing together, scuffing our ankles or shoes together. If you do, you have a narrow base of support, have engrained a lazy style of locomotion, and you will wish and attempt to put the center of your body mass over the foot at all times. This is good if you are walking on ice, but that is about it. This is an epidemic, hence the prevalence of cross over gait out in the world. Increasing balance ability will help to increase base of support and hence help with reducing cross over gait (narrow step width gait and running) tendencies. Obesity seems to make this worse. Obesity in our world is wrecking our people, especially our kids.

“Alterations were detected in the intermittent postural control in obese children. According to the results obtained, active anticipatory control produces higher center of pressure displacement responses in obese children and the periods during which balance is maintained by passive control and reflex mechanisms are of shorter duration.”
“Differences in intermittent postural control between normal-weight and obese children ” Israel Villarrasa-Sapiña, Xavier García-Massó

http://www.gaitposture.com/article/S0966-6362(16)30091-1/abstract?platform=hootsuite

Kinetic chain transfer.

Anyone would be silly to disagree with this.
We go into some deeper reasoning back in this older blog post (https://tmblr.co/ZrRYjxTJ6zw9) looking at arm swing and leg swing and pairing of pelvis and shoulder posturing and how clean pelvis function parlays into upper body function in softball pitching.

“Proper utilization of the kinetic chain allows for efficient kinetic energy transfer from the proximal segments to the distal segments. Dysfunction at a proximal segment may lead to altered energy transfer and dysfunction at more distal segments,”

Lower body conditioning may cut upper body injury risk in softball. -Hank Black

http://lermagazine.com/special-section/pediatric-clinical-news/lower-body-conditioning-may-cut-upper-body-injury-risk-in-softball

Gait and Autism spectrum disorder (ASD).

Gait and autism spectrum disorder (ASD):
“ … overall findings of the studies conducted in the area are inconclusive … however, some results suggest an emerging pattern. The current perspective on gait patterns in children with ASD is that there are a number of deviations present in terms of temporospatial, kinematic, and kinetic parameters and that gait, along with other movement pattern changes, may be used to allow for earlier diagnosis of ASD. There is, however, some consensus regarding the involvement of the cerebellum and basal ganglia in children with ASD and the relationship with observed motor deficits. ” – Kindregan et al

http://www.hindawi.com/journals/aurt/2015/741480/