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I, Kristen, am undergoing running form re-training. (Insert collective moan from my running population out there.) No one, and I mean no one, wants to undo what they have naturally done for over half of their life, so between sleep and running form, I have in the past rarely liked to mess with what “works” for a patient unless the situation is dire. As a runner/physical therapist myself, I had not once before this year overhauled anyone’s running, but around February, I started to feel a bit convicted about my own form. I had planned to run another Flying Pig Marathon with my brother, but he nearly dropped me as his running buddy after our first long (12 mile) run due to my poor attitude. I was frustrated.
My “Achilles heel” in running is my gimpy left side. I can manage it pretty well with a healthy mix of corrective exercises and dry needling. But why does it always default to gimpy? I am so determined to find-root causes in my patients; why am I satisfied with band-aides for myself? These thoughts circled my brain the last 4 of those 12 miles with my brother.
Now before you burn me at the stake chanting, PHYSICAL THERAPIST, HEAL THYSELF!!, I want you to know that I treat a lot of physical therapists here. Sure, it sounds odd to most people, but as one of my physical therapist patients said, “You can’t be objective about yourself.” And we love objectivity here in the PT world. We usually try to ignore this fact, but it eventually catches up with us. In February, it finally caught up with me.
So I recruited my personal PT (aka husband), Colton and my PT/pro-triathlete friend, Evan, to analyze a video of me running (see below). Now, I don’t think you have to be a movement specialist to look at me running and think…Ouch. I’ve been a naturally heavy heel striker my whole life, but this heel strike has morphed into something, well, unnatural. Both Colton and Evan issued the sentence: Time to transition to a midfoot strike.
By now, you have likely heard of the midfoot strike, which is basically the idea of not kicking your leg out as far in front of you when you strike so as to not crash down on your heel as much, essentially landing more within your center of gravity. Overall, the impact is lighter on your ankles, knees, and hips, and you spend less time in contact with the ground. (This should not be confused with a forefoot strike, which is hitting the ground with the ball of your foot. Forefoot strikes are extremely effective for sprinting but also extremely injury-prone for distance runners.)
Sounds great, right? Well, it is not for everyone. If you rarely get injured while running, run low mileage, or run primarily on grass, you can likely get away with whatever strike you want. Transitioning to a mid-foot strike is more for the folks who have tried a lot of other remedies, but similar injuries persist. Heel striking has actually been shown to be more efficient, which means that unless you were born a midfoot striker (as many elites are), you will likely use more energy midfoot striking. Aside from this research, I know this is true, as I can typically hop into a 5k with little training and run a 20:30. This spring after putting in more miles than I have in recent years, I slogged along at 22-flat. Research is scant as to why this is the case, but by my estimation, midfoot striking requires more knee drive. Ironically knee drive is controlled by the hip flexors and core, and I for one know that my core was quite frequently kicked back and chillin’ during my runs over the past 16 years.
So I may have traded speed in for function momentarily, but I believe that, just like anything else in the body, these muscles can with time be trained to be efficient. I don’t for a second believe my speedy days are behind me. But do you know what is behind me? A whole lot of hip and low back pain.
I started campaign in February doing 1 mile increments on a treadmill positioned by a mirror. I had/have a rather large corrective exercise regimen. I make myself stop if I feel myself slipping back into my old form. There is very little mental tuning-out while running right now. I feel like to put on my shoes is to sign myself up for a course rather than to head out to my mental happy place. My body gets worn out quickly from the inefficiency. I couldn’t remember the last time I was truly sore or fatigued from running, but I have been in a constant state of it for months now. And to be honest, that part is kind of awesome. The times may not show it, but I physically feel like I am in the best running shape of my life because I am forced to use more of my body while midfoot striking.
But I am not there yet, and that is why I caution you: If you think it is time for you to transition to a less injury-prone running form, it is important that you do it under the care of physical therapist. Many people become injured (at the very least discouraged) from changing their form incorrectly, too quickly, or without proper supporting musculature.
I estimate that this entire transition will take me one year. Habits are hard to break; neural connections take a lot of time to form. But I welcome you to follow along on the journey if that voice in the back of your head telling you to change your form got a little louder after reading this.
References:
https://www.runnersworld.com/health-injuries/a20793434/heel-strike-uses-less-energy-than-midfoot-strike/
https://www.roadrunnersports.com/blog/running-foot-strike/