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

Podcast 105: Adding strength to your system.

Show Sponsors:
newbalancechicago.com
Softscience.com

Other Gait Guys stuff

A. Podcast links:

direct download URL: http://traffic.libsyn.com/thegaitguys/pod_105f.mp3

permalink URL: http://thegaitguys.libsyn.com/podcast-105-adding-strength-to-your-system

B. iTunes link:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138

C. Gait Guys online /download store (National Shoe Fit Certification & more !)
http://store.payloadz.com/results/results.aspx?m=80204

D. other web based Gait Guys lectures:
Monthly lectures at : www.onlinece.com type in Dr. Waerlop or Dr. Allen, ”Biomechanics”

-Our Book: Pedographs and Gait Analysis and Clinical Case Studies
Electronic copies available here:

-Amazon/Kindle:
http://www.amazon.com/Pedographs-Gait-Analysis-Clinical-Studies-ebook/dp/B00AC18M3E

-Barnes and Noble / Nook Reader:
http://www.barnesandnoble.com/w/pedographs-and-gait-analysis-ivo-waerlop-and-shawn-allen/1112754833?ean=9781466953895

https://itunes.apple.com/us/book/pedographs-and-gait-analysis/id554516085?mt=11

-Hardcopy available from our publisher:
http://bookstore.trafford.com/Products/SKU-000155825/Pedographs-and-Gait-Analysis.aspx

Show Notes:

Tech update:
*UPDATE: Fitbit lawsuit data and consumer reports
http://www.engadget.com/2016/01/23/consumer-reports-fitbit-tests/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810794/

Can exercise hurt your heart ? How much does it take ?
http://www.npr.org/sections/health-shots/2016/02/01/464457884/can-extreme-exercise-hurt-your-heart-swim-the-pacific-to-find-out

Lowest effective dose of exercise
http://www.health.harvard.edu/blog/how-much-exercise-do-you-really-need-less-than-you-think-201512088770?utm_source=twitter&utm_medium=socialmedia&utm_campaign=120815kr1&utm_content=blog

Working out not live longer ?
http://www.details.com/story/apparently-exercise-doesnt-make-you-live-longer

Relationships between static foot alignment and dynamic plantar loads in runners with acute and chronic stages of plantar fasciitis: a cross-sectional study
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-35552016005000136&lng=en&nrm=iso&tlng=en

Should you add strength training?
Effects of a concurrent strength and endurance training on running performance and running economy in recreational marathon runners.
Randomized controlled trial
Ferrauti A, et al. J Strength Cond Res. 2010.
http://www.ncbi.nlm.nih.gov/m/pubmed/20885197/?from=%2F22776883%2Frelated&i=8

The microcirculation of skeletal muscle in aging.
http://www.ncbi.nlm.nih.gov/m/pubmed/16611593/?from=%2F14630882%2Frelated&i=16

Microcirculation. 2006 Jun;13(4):279-88.
Effect of aging on the structure and function of skeletal muscle microvascular networks.Bearden SE1.

Future of injury management ?  Regrowing tissue ?
http://www.huffingtonpost.com/kevin-r-stone-md/the-future-of-surgery-regrowing_b_9073096.html

Heat Exertion and Gait Decline

Changes in gait characteristics are found when exertional heat stress is experienced during prolonged load carriage.  As heat stress increased, step width decreased while percent crossover steps increased. Reduced stance time variability, step width variability, and percent crossover step were observed.  These are frontal plane gait parameters for the most part. 

Think about these things during your long summer run or as you go deeper into those last miles of your long run.  Simple muscular fatigue in the frontal plane hip-pelvis stabilizers are going to render the same results.  This is quite possibly why many problems and injuries crop up in the latter miles of your run. 

Reference:

Gait Posture.

2016 Jan;43:17-23. doi: 10.1016/j.gaitpost.2015.10.010. Epub 2015 Oct 23.Using gait parameters to detect fatigue and responses to ice slurry during prolonged load carriage. Tay CSLee JKTeo YSQ Z Foo PTan PMKong PW

The Power of Observation: Part 2

Let’s take a closer look at yesterdays post and the findings. If you are just picking up here, the post will be more meaningful if you go back and read it. 

The following are some explanations for what you were seeing:

torso lean to left during stance phase on L?

if he has a L short leg, he will need to clear right leg on swing phase. We have spoken of strategies around a short leg in another post. This gentleman employs 2 of the 5 strategies; torso lean is one of them

increased progression angle of both feet?

Remember he has femoral retroversion. You may have read about retrotorsion here. He has limited internal rotation o both thighs and must create the requisite 4-6 degrees necessary to walk. He does this by spinning his foot out (rotating externally).

decreased arm swing on L?

This is most likely cortical, as he seems to have decreased proprioception on both legs during 1 leg standing. Proprioception feeds to the cerebellum, which in turn fires axial extensors through connections with the vestibular system. Diminished input can lead to flexor dominance (and extensors not firing). Note the longer stride forward on the right leg compared to the left with less hip extension (yes, we know, a side view would be helpful here).

circumduction of right leg?

This is the 2nd strategy for getting around that L short leg.

clenched fist on L?(esp when standing on either leg)

see the decreased arm swing section. This is a subtle sign of flexor dominance, which appears to be greater on the right.

body lean to R during L leg standing?

This is again to compensate for the L short leg. He has very mild weakness of the left hip abductors as well, more when moving or using them in a synergistic fashion (ie functional weakness) than to manual testing.

Well, what do you think? Now you can see how important the subtle is and that gait analysis may complex than many think.

We are and we remain, the Geeky Guru’s of Gait: The Gait Guys

OK, quiz time. The Powers of Observation.

Perhaps you have been following us for a while, perhaps you are just finding us for the 1st time. Here is some back ground on this footage. Let’s test you observation skills.

Watch this gait clip a few times and come back here to read on.

This triathlete presented with low chronic low back pain of about 1 years duration. The   pain gets worse as the day goes on; it is best in the early am. Running and biking do not alter its intensity or character and swimming makes it worse. Rest and analgesics provide only temporary relief.

Physical exam findings include limited internal rotation of both hips (zero); a left anatomical short leg (tibial and femoral, 5mm total); diminished proprioception with 1 leg standing (<30 seconds). MRI reveals fatty infiltration of the lumbar spinal paraspinals and fibrotic changes within the musculature; degenerative changes in the L4 and L5 lumbar facet joints, degeneration of the L5-S1, L3-L4 and L2-L3 lumbar discs.

Now watch his gait again and come back here for more.

Did you see the following?

  • torso lean to left during stance phase on L?
  • increased progression angle of both feet?
  • decreased arm swing on L?
  • circumduction of right leg?
  • clenched fist on L?(esp when standing on either leg)
  • body lean to R during L leg standing?

How did you do? If you didn’t see all those things, then you are missing pieces of the puzzle. Remember, often what you see is not what is wrong, but the compensation

The powers of observation of the subtle make the difference between good results and great ones.

Try some of these tips.

  • break down the gait into smaller parts by watching one body part at a time: right leg, left leg, right arm, left arm, etc
  • watch for shifts in body weight in the coronal plane (laterally) and saggital plane (forward/backward) as weight transfers from one leg to another
  • watch for torso rotation (watch his shoulders. Did you notice he brings his torso more forward on the left than right when walking toward us?)

We are (and have been) here to help you be a better observer and a better clinician, coach, athlete, sales person, etc. If you haven’t already, join us here for some insightful posts each week; for our weekly (almost) PODcast on iTunes; follow us on Twitteror on Facebook: The Gait Guys