Updated: May 12, 2020
Introduction: Get Your Mind Right
I am a 21st-Century runner. I don't run every day. Or every other day. I deadlift and back squat over 1.5 times my body weight. At 6'2" and 205 lbs., you're not going to mistake me for a marathon runner. I run when playing sports. Or when I'm trying to get off a mountain as fast as possible. Or when I'm trying to keep one of my kids from running into traffic. The ability to run comes in handy in a variety of circumstances.
Running, in all forms, is a high-level skill on par with sports such as Olympic Lifting or Swimming. Acquiring skill takes practice. The lack of skill acquisition as it relates to running has an epidemic of running-related injuries. Running injury stats highlight the widespread lack of skill as it relates to the sport:
There are approximately 30 million regular runners in the US.
There are over 1,100 marathons held each year in the US.
90% of marathon runners sustain an injury during training.
Each year, 80% of runners sustain an injury that forces them to stop running.
There is an inverse relationship between the cost of a running shoe (the US running shoe industry rakes in about $4 billion a year, by the way) and the likelihood of a runner getting injured. In other words, the more expensive your running shoe, the more likely you are to get hurt.
What the heck is going on?
How is it that we're riding a huge wave of growth in our knowledge of the human body and how it best performs, but only 20% of the 30 million runners in this country can avoid injury every year?
The problem goes back to our conversation about skill.
Consider this analogy: if the control arm connected to one of the wheels on your car was coming loose, you wouldn't ask your auto mechanic to put a new bumper on your car. Yet this is how we oftentimes think we'll fix the pain we have with running-buying a better (more expensive) shoe.
The fundamental problem with relying on shoes to allow you to run is that it's actually what stands inside your shoes that make the difference.
No one taught us how to run correctly in school. What should have been treated with the same care and concern as teaching a kid to lift weights with good form has been relegated to the misguided idea that we'll all just figure it out "naturally".
A Systems Check
As a certified practitioner at The Ready State, I'm going to walk you through "The Standards", our 12-point systems check to make sure you've got the physical practices and lifestyle pieces dialed-in to withstand the rigors of running for a lifetime.
There are a few key principles I want you to keep in mind as we embark on this journey together to make you a better, more resilient runner.
This is about performance, not just injury prevention. The standards we apply to your physical and lifestyle practices as it relates to your running are mutually accommodating. Good running skill is a form of injury prevention and good maintenance work before and after your runs and on your days off allows you to be your best running self.
We are changing your task-completion mindset. Running isn't a job to get done. I want you to hold the quality of your running to a higher standard.
It's your responsibility to do routine body maintenance
10 minutes per day. No days off. It doesn't take a heroic effort to make a change. It does take a consistent effort.
Keeping your finger on the pulse of your performance and the signals your body is sending you is a learning process that never ends. Embrace the challenge.
Mobility (that's joint and soft tissue work, plus motor control-moving your body the right way) replaces your old stretching routine.
Standard #1: Neutral Feet
Our first standard is all about paying attention. The idea here is that to support the rest of your body, your feet need to be pointing in the direction they were designed to point: forward. When you stand in any other position, be it pigeon-toed (feet pointing towards each other) or duck-footed (feet pointed out), or some third, horrid combination of the previous two positions, you end up hanging on your joints. The funny thing about your joints, they're mainly designed for motion, not bearing all the load of your body as your legs slam into the ground while you run.
Living in the middle is ideal, stray too far in either direction and trouble will find you.
The root cause of poor foot position is most frequently just a lack of body awareness. If you don't have a reference for how to stand and walk with good posture, keeping your toes and feet pointed straight ahead isn't going to happen. Instead of letting your arches collapse, knees cave in, hips tilt awkwardly, and low back strain to hold you up, we recommend you try the Bracing Sequence:
Your glutes and abdominals are scientifically created to keep your pelvis and low back in a good position. Additionally, your glutes control excessive rotation in the thighs. Next time you go shopping, try to observe how many people walk with their knees almost banging together. It's a good bet if you look down from their knees their feet are pointed in some direction other than forward. If you look up, you'll probably find they either walk hunched forward or overextended (sway-backed).
Good position of your trunk and pelvis allows you to point your feet straight ahead and create tremendous power to run, jump, land, change directions, and lift with greater power output.
A better position equals better performance. I love simple math.
WHAT TO DO IF YOUR FEET AREN'T NEUTRAL
We divide the issues we see with our runners into two main buckets: Mobility and Motor Control.
If your feet are stiff, you're best suited to start with the mobility drills we demonstrate in the video below:
But if your feet are flat on the ground, you've got yourself a Motor Control issue. We need to rebuild the strength in your feet. The exercises reviewed in the video below are a good place to start:
A FEW WORDS ABOUT SHOES
There's a misconception that the problem with your feet, and the reason you hurt when you run, is that you don't have the right shoe. If I get a custom fit shoe, the thinking goes, I'll be able to run without pain. Or, I can spend $300 and get a laser-fit custom orthotic.
The shoe industry has created a false construct to sell you the perfect shoe. If your foot is classified as neutral (normal arch, your foot doesn't roll in or out as you walk) you are the lucky winner of a "Stability" shoe. If you are flat-footed (little to no space between the arch of your foot and the ground, your feet tend to point out and roll in when you walk), you get to strap on a "Motion Control" shoe. If you have a particularly high arch (foot tends to roll out as you walk) you will-allegedly-do best with a "Cushioned" shoe.
There's a problem with trying to fit the shoe to the foot. Shoes have no influence on how frequently you will injure yourself when running. For the sake of saving you time, we’ve omitted the laundry list of references that highlight this last point. But I digress. The shoe industry has failed to fix your feet, let alone your ability to run without hurting yourself.
There is zero scientific evidence that your $150 motion control shoe reduces your risk of injury. Ditto for that custom fit orthotic. So now you're out well over $400 dollars and you're not any closer to actually solving the root cause of your pain.
WRAPPING IT UP
There's really no getting around putting yourself in the right position to run well. Your feet have to point straight forward, as do your knees, and your spine needs to look like a spine-not a banana or a snake-if you're going to come out unharmed from this fun we call "running". Anything less than normal position turns the conversation from if you'll get injured to simply how long it will take until you get injured with the crappy position and running mechanics you’re using.
The easiest way we've found to apply this standard is as follows: every time you stand up, or before you sit down, go through the bracing sequence. This will take a fair amount of mental focus at first, but as you continue to practice you'll notice two positive habits emerge. First, you will spontaneously find yourself in a better posture more frequently. Second, and more importantly, you'll catch yourself slouching more often, which is the first step in fixing the problem.
And if you are or you know someone who is a dedicated and often-injured runner or athlete involved in a running-dependent sport, we are here to help! You can call our office and schedule a free 15-minute phone consult with one of our Doctors of Physical Therapy.
Let me know if you need anything else and have a great weekend!
-Dr. Tim Cummings, PT, DPT