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Running Performance Clinic at the Precision Wellness Center

 

I am proud to introduce the Running Performance Clinic at the Precision Wellness Center on the campus of Cabrillo College. The Running Performance Clinic is dedicated to providing an athlete-centered environment for runners that can efficiently enhance the movement system and bridge the gap between rehabilitation and performance.

The Precision Running Programs are aimed at uncovering the specific asymmetries in your running pattern. Whether you are in pain or not, asymmetries lead to inefficiencies and repeated abnormal movement patterns, which ultimately create tissue damage and pain. If left unaddressed running may no longer be an option for you. The identification of these asymmetries allows for the prescription of a precise corrective exercise program to remedy your specific imbalances and inefficiencies ultimately allowing for skilled running and uninterrupted training.

The entire program is based on peer reviewed research and clinical expertise that deals specifically with the skill of running and injury prevention.

My objective is to develop and deliver the best rehabilitation to performance programs that are specific to the patient's/client's goals. My desire is to promote running as a healthy lifestyle, and bring that lifestyle to the community, the Central Coast, California's youth, and nationally.

Check out the link (http://www.facebook.com/pwccabrillo) to a video of the Precision Wellness Center.

Enjoy the Process!!

Jeff Moreno, DPT, OCS

Precision Sports Performance

 

Olympic Trials 1500M & 5000M Slow Motion Video

I shot some video of the 1500/5000M Final at the Olympic Trials for both the men and women. Video was shot at 210 FPS with less than 1-2 laps to go. It is nteresting to see the different types of running form at such an elite level. The two runners with exceptional running economy were Matt Centrowitz and Morgan Uceny. Look for Morgan Uceny to possibly medal at the Olympics. Her form is exceptional.

 

Enjoy!

Jeff Moreno, PT, DPT, OCS

Precision Sports Performance

http://youtu.be/A4U3-taEhwk

http://youtu.be/-booQPtQ1hc

http://youtu.be/0rQmlIlQbRA

http://youtu.be/874TrKbwJ2g

PERCEPTION vs REALITY!

A client of mine sent me this photo and I just had to share it with you. I laughed when I first say this photo because it speaks truth in the?precetion of?my own running form. What we precieve as?normal posture, movement, and running form can actually be?far from normal. The poor prection of normal movement can lead to dysfunciton and pain in runners overtime if not addressed.

Runner's, learn if your perception of normal posture and running form is correct. It will save you a lot of time and lost training in the future.

 

Jeff Moreno, DPT, OCS

Precision Sports Performance

 

RUNNING FROM THE INSIDE OUT - 360 Degree Core Training for Runners, a Shift in the Core Training Paradigm

 

The Beauty of Running with a Hightly Stable Core

Above are two amazing runners, Carl Lewis from the past and Matthew Centrowitz, the future of US distance running. These two amazing runners exemplify high levels of abdominal stability and control. This enables them to produce efficient force into the ground resulting in speed and endurance.  Runners first need to understand the function of the core including what muscles make up the core before they can take full advantage of their role in supporting and controlling movement from the inside out.

The core muscles function to prevent excess movement in all planes of motion. These muscles provide a stable base so the arms and legs can do their job in producing and transferring force to the ground efficiently and effectively.  Every muscle, 360 degrees surrounding the body from the shoulders to the pelvic floor represents the core, and each one of these muscles, big and small, play a role in providing an environment of stability. A paradigm shift needs to occur in our treatment and training of runners 360 degrees surrounding the core. It is essential that every athlete understand that not one of these muscles ever works in isolation, therefore, why are they often trained in isolation? The core represents a team of muscle that co-contract to provide stability and control. The co-contraction of these abdominal muscles in runners is analogous to an orchestra comprised of many musicians with different instruments, but each with a common goal to produce an environment that is highly controlled and always in harmony with each other.

One of the most important, if not the most important, muscles in the core is the diaphragm. The diaphragm is not often thought of as a muscle, and is often forgotten and undertrained in many athletes. The diaphragm has two primary functions. First it aids in respiration, and secondly it helps to stabilize the core through an increase in intra-abdominal pressure. Like any muscle, the diaphragm can function optimally or suboptimally. For runners, the ability to efficiently bring oxygen into the body and provide trunk stability is essential whether you are an elite or recreational runner.

The diaphragm is most efficient for respiration and core stability when the spine is neutral. A neutral spine is one that maintains the normal curves of the spine (see pictures below). 

In order to achieve a neutral spine the thoracic spine must be flexible/mobile in all planes. Motion always goes to the point of least resistance. Therefore, if the thoracic spine is stiff and our pattern of breathing is dysfunctional that will force motion to occur excessively at the lumbar spine and pelvis leading to the inability to control the core during running. When the spine is neutral, correct breathing patterns can occur and better control of the core can be achieved. Visually, this can be represented as two rings lying parallel to each other, one ring comprised of the rib cage and the other the pelvis. For a runner, this can lead to better oxygen intake and utilization and a more efficient transfer of energy to the ground ultimately increasing the economy of running.

When training the core the focus should be on developing proper neuromuscular control while supine, sitting, standing, walking, and finally running, all with the goal of maintaining a highly stable neutral spine. All too often, my colleagues and I are asked for “Core” exercise routines that will produce strength to prevent injury. What our clients and patients soon learn is that each walk, run, or day at work is a core exercise.  Core development is different for every patient and does not stop once you leave the gym or after a hard tempo run. Like running, it is a skill that needs to be intentionally developed overtime.  With poor posture and poor movement patterns we loose the skill and ability of the nervous system to communicate automatically with these muscles. Therefore core training and work/life should be focused on regaining these proper patterns in order to develop a highly stable core. As we practice bracing the core, you will first need to be consciously competent before you can be unconsciously competent. What this means is, as you become more skilled at activating the core correctly, overtime the brain will develop a motor program that allows the core to work automatically.  The Gait Guys developed the acronym S.E.S for developing proper movement, which stands for skill, endurance, and strength in that order. As runners, we often want the strength first before we have developed the skill and endurance of the movement pattern. You must understand that the body will always do what you ask of it. For a runner, that means getting from one point to another in a given time or distance. If strength rather than skill is developed first, the runner will inevitably be less efficient and ultimately lead to a plethora of lower extremity compensations and dysfunctions.

Remember, the function of the core is to create a foundation so that the arms and legs can be highly mobile and generate force. Therefore, exercises like sit-ups or back extensions that move the core away from a neutral spine position should be de-emphasized. Exercises that promote control and stability of the core like planks, side planks, single leg dead lifts, chops, and single leg standing with opposite leg movement should be emphasized. The purpose is to increase the skill and endurance of the core to maintain a neutral spine under force and with movement.

Specificity of training must be established first and foremost. Just like a coach will not train a 1500 meter runner the same as a marathoner, we as health professionals need to understand every patient, client, and runner is different and can not be given a set of exercises without them first developing the skill to perform the movement or exercise correctly. Remember, anybody can perform a plank, but can it be done correctly so that all the muscles surrounding the core are working together and in the right pattern to allow for proper control and breathing? If you are a runner with one injury after another and do not live on the central coast of California find a health professional in your area that understands gait and running mechanics. Most importantly appreciates the importance of proper breathing patterns and its affect on the core.

So together, as runners who want to run injury free, let’s start shifting the paradigm in core training from the inside-out, 360 degrees.

 

Enjoy The Process!

 

Jeff Moreno, PT, DPT, OCs

Precision Sports Performance

 

 

 

Principles of Running by Dr. Mark Cucuzzella

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A excellent video on the principles of running from a biomechanical perspective. If you are a runner you need to spend the eight minutes to watch this video. Enjoy!!!

 

Jeff Moreno, DPT, OCS

Precision Sports Performance

 

 

HOW TO RUN: UNDERSTANDING THE PHASES OF RUNNING

 "Remember the feeling you get from a good run is far better than the feeling you get from sitting around wishing you were running." –Unknown

       Have you ever wondered what really happens when your foot hits the ground while you run? The purpose of this article is to define the three primary phase of running, and describe in detail the loading phase of running.  In addition, this article will explain how the phases of running can relate to efficiency or potential injury and lost training time.

        Let us take a few minutes and review the last article, “Posture & the Secret of Running”. In my previous article I discussed passive and active posture, and how it can help prevent injury and increase efficiency. Good standing posture is the straight vertical alignment of your body from the top of your head, through your body’s center, down through the middle of your feet. From a side view, good posture is seen as an imaginary vertical line through the ear, shoulder, hip, knee, and ankle. This posture will result in the center of mass (COM) being directly over the foot/base of support (BOS) allowing your weight to be evenlydistributedthroughout the whole foot. Remember, the secret of running is the unique ability to control, unconsciously, your center of mass (COM) in relation to your base of support (BOS)/foot. Good static and dynamic posture is one that allows you to be more aware of where your body is in space. Being proprioceptively aware of your body and its relationship to your foot/BOS and the ground is essential for your ability to load, unload, and recovery properly.

        Running is nothing but a series of single leg hops. These hops result in the transfer of energy from your body to the ground allowing for forward progression. The pace of the runner is dictated by the amount of energy transferred. When biomechanically efficient, the body is able to get from one point to another expending the least amount of energy over a given period of time. When running, the focus should not be on running faster or longer, but how to become more biomechanically efficient.  The goal is to expend the least amount of energy over a given time, speed, or distance. This will result in faster times if so desired, but more importantly it will allow for improved motor programs (better habits) enabling the runner to train uninterrupted and more efficiently.

       In order to understand what the three phases of running are you need to first understand that the body works as a whole and never in isolation. With that said, scientists and coaches have separated the phases of running in order to better understand and conceptualize.  I am going to define what the three phase of running are, with emphasis on the loading phase.

The three phases of running are the loading phase, propulsion phase, and recovery phase (see pictures below). It is essential to understand that the running cycle is cyclical. Therefore, each phase is dependent on one another. For example, if your loading phase is poor you will not be able to achieve a biomechanically efficient propulsion phase, which will inevitably reduce the passive nature of your recovery phase, making you work harder and less efficiently.

Right Loading Phase  

 Right Propulsion Phase (End)

 Left Recovery Phase

       The loading phase starts (see pictures below) when the foot hits the ground. Contrary to popular belief, the foot should make primary contact in the mid-foot or forefoot and not the heel (hind-foot). Making contact primarily in the hind-foot allows for significant braking forces, reduced elastic energy storage, and longer ground contact times which can lead to a number of different injuries. Landing on the outside of the foot is usually not felt but is essential, biomechanically, for the foot to be loaded. This helps the transfer of weight from the outside of the foot to the big toe. This transfer of weight allows for the foot to passively lock-up, creating a natural rigid lever to push off of in the propulsion phase of running.

Beginning of the Loading Phase

       When making contact with the ground, the lower leg from the knee down, should ideally be perpendicular to the ground, this results in the ankle joint being neutral, setting up the calf and Achilles tendon to be loaded for a recoil effect. The recoil effect can be easily understood by taking a rubber band, stretching it, then letting it go. The energy that is created by stretching the rubber band is given relatively for free, it just needs to be taken advantage of.  We call this, in the scientific community, a stretch reflex. At loading, (initial contact) if the heel is off the ground or the foot is taken off the ground too fast, the “free energy” that is given by the calf-Achilles complex (rubber band effect) will be forfeited. This will ultimately lead to more work and inefficiency. I call the calf the “pseudo butt/hip” because it will try to work and act as the hip if you ask it too. Unfortunately this can lead to overstriding, reduced force production, potential calf strains, Achilles tendinopathies, and dysfunction up the chain (leg).

       The knee, when making contact with the ground, should be bent (approximately 20-25 degrees), and the lower leg be perpendicular to the ground allowing for the body’s center of mass to be oriented slightly behind the base of support (foot). It is important to understand that the foot is not where power is generated from; it is only the last point at which energy/force is transferred to the ground. Therefore, you do not want to take the foot off early or land completely on the forefoot, for it is when the foot is on the ground that the transfer of force takes place. Increase in speed is only a result of a faster transfer of energy, not because of the foot lifting off the ground earlier or getting quick with the foot. When the lower leg has completely “loaded up”, shock absorbed, then you begin the propulsion phase or the push phase.

       The loading phase is the phase where most individuals are dysfunctional, contributing to pain and injury. What makes this phase the source of runners pain is the high loading force when we hit the ground. Those forces if not attenuated appropriately can increase stress and ultimately pain at the foot, knee, hip, and/or lumbar spine depending on the runner. For example, let us take a look at two runners that overstride (see pictures below). As you can see on the pictures, these two runners are about to hit the ground with their heels first and with their knees completely extended. With the knees extended, they are reducing their ability to absorb shock as they make contact with the ground. Overstriding reduces the spring/recoil effect that passively generates force. The result will be a significant increase in force at the knee, which can contribute to eventual knee pain. More importantly, this increases the demand at the quadriceps muscles and reduces the hips ability to push them forward resulting in a poor propulsion phase and a more active recovery phase.

 Overstrider

 Overstrider

       Then how do we correct overstriding? Remember, that what you see is usually a symptom of some other problem. Therefore, correcting ones overstride is more complicated than just asking them to reduce their stride length or pull their foot underneath them when they land. Some examples that can cause overstriding include; flat lumbar spine (flexed lumbar spine), posterior center of mass, forward shoulders with thoracic kyphosis, weak butt (gluteals), poor motor control, and dominant quadriceps/plantarflexors. The trick is figuring out what is facilitating overstriding, and treat the cause not the symptom. That is not to say that I won’t address the obvious symptom if necessary. With that said it is really hard to diagnosis and treat the cause of a poor loading phase on your own.  If you are suffering from pain or dysfunction, try to find a running specialist in your area in order to be properly evaluated and diagnosed, so that you can start the road to recovery.

       Next, in the “How to Run” series, I am going to try and answer whether or not it is ok to land in your heel. I get this question almost daily and it is more complicated than answering with a simple yes or no. I also want to know from you as runners, what do you want to know more about running? 

Key Points:

  • Work on standing with your weight evenly distributed throughout your feet.
  • Know what your static posture is and correct it if necessary.
  • Standing Posture=Walking Posture=Running Posture
  • See if you can tell what part of the foot are you primarily hitting the ground with? Heel or Mid-foot       
  • Are you having pain consistently, if so you may be loading improperly and could benefit from a running evaluation?

 

HOW TO RUN: POSTURE & THE SECRECT OF RUNNING

?"The will to win means nothing if you haven't the will to prepare."?? - Juma Ikangaa, 1989 NYC Marathon winner

??????? Have you ever looked at a runner and asked yourself, how do they make running look so easy? What secrets about running do they know that I don

How To Run: Bad Habits That Hurt

Have you ever asked yourself why a runner can run just as fast, just as long, and with the same effort and ability as the next runner, and still end up with knee pain?  What if the strength gains made due to running/training are ultimately what results in injury and loss of training time? What if you’re running form is causing the development of dysfunctional patterns of movement, increasing your potential for injury?

The human body will always compromise quality of movement over quantity of movement. If you ask your body to run a specific distance at a desired speed it will do so with what it has regarding range of motion, strength, and neuromuscular control. However, it may not be the most optimal and biomechanically efficient way. The human body is uniquely adaptable to any physical stress that is placed upon it. Runners cherish this principle of general adaptation, which enables them to improve their basic endurance and general strength over a given time. With this in mind, whether a novice or elite runner, the groups of muscles that are used on a daily basis with normal daily activities are the same muscles used in the act of running. We, in the scientific world, call those patterns of movement, motor programs. A motor program is analogous to a habit that is unconscious. Those habits (motor programs) can prevent or create pain and dysfunction.  If you use those sets of muscle incorrectly during your daily activities, those motor programs will carry over into your running.  So if knee pain is your symptom, you have to understand the root cause of that pain is likely an abnormal motor program that needs to be adjusted or tweaked, not just in your running but also in your daily activities.

Let’s look at a runner with knee pain. The motor program that this runner has in his normal daily activities may allow for them to stand with their weight in their heels and lock their knees out. This increases the use of their thigh muscles and turns off their hip muscles. During running this motor program causes them to have (remember this is all unconscious) their center of mass behind their foot, and results in them straightening their knee too much as their foot is coming toward the ground forcing them to over stride. Over striding increases the force of impact, reducing the knees ability to act as a natural shock absorber. This leads to increases in stress and overuse at the knee.

Another example would be a runner who has iliotibial band syndrome (IT Band) that has developed during training for a marathon. This type of runner commonly stands and walks with their foot turned out and is usually very strong in their quads, lateral hamstrings, and calves. This runner takes that posture and strength into their training and overtime those muscles that are already strong get stronger due to the body’s general adaptation to training. As a result, this runner begins to over extend their knee, which forces their foot to be too far in front of their center of mass. Therefore, the body has to pull the runner forward by overusing their quads and lateral hamstring which rotates the lower leg out relative to thigh and shortens the IT Band. Because of the runners’ form and dominance of the quad and lateral hamstring muscles, they begin to develop pain at the outside of the knee. The pain on the outside of the knee occurs as their foot comes off the ground and their leg begins to cycle back through.

Remember, the body will always do what you ask of it.  Whatever has been “asked” of it during daily activities, with respect to strength, range of motion, and motor control will transfer over into the act of running. These motor programs, if not correct, will inevitably lead to musculoskeletal injury and lost training time. Therefore, the next time you stand and walk, think about how your posture is creating patterns of movement and muscle activation that will be accentuated in your running.   

Next in the “How to Run” series I will be discussing the secret of running, and how static standing dictates how we walk, which dictates how we run. If you have any questions regarding running and/or the above discussion, please feel free to email me. I love to discuss and debate anything related to running.

Enjoy the Process!

 

Jeff Moreno, DPT, OCS

Precision Running and Performance Clinic

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Santa Cruz, CA 95062

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