We’ll get to the logistics later; I need to type this out while it’s all fresh in my mind.

Let’s get this straight: Boston is a baseball community. We all live and die by the Red Sox.

However, it just so happens that we have a big endurance training contingent, too, given that the Boston Marathon is quite possibly the most storied endurance training event in the world each year. As a result, I’ve had the opportunity to interact with more endurance athletes in the past 15 months than at any other point in my career. I’ve trained some in-person, consulted with others in an online context, and just observed a whole lot more.

One thing I’ve noticed from day 1 was that a lot of people have ankle, knee, and hip pain that is only a problem with longer duration runs – but it’s fine with shorter sprint sessions. Now, I’ve always been a big advocate of sprinting for its body composition benefits, but never stopped to think about it as a corrective exercise modality in itself.

Then, this weekend rolled around. On Saturday, when I was speaking at the NSCA Northeast Regional clinic in Rhode Island, Steve Plisk’s presentation got me to thinking. And, on Sunday, I got this email from one of my mother’s co-workers who I had helped overcome some knee issues:

Eric and Sue,

I just wanted to let you both know that I completed my first marathon (The Maine Marathon) this weekend in 3:40. My goal was to break 4 hours, so I was pleased. Sue-I want to thank you first for having a son like Eric and for putting me in touch with him. Secondly, thank you, Eric. I was able to complete the race without any knee pain thanks to your advice (Mobility DVD, foam roller, and for encouraging me to build strength and speed training into my workouts). I truly appreciate you taking the time out of your busy schedule to help me.

Patrick

Consider this: I never actually evaluated or met Patrick in person. I was just working off of trends that I see in runners that lined up with what he told me about his knee pain. Early on, he had told me that his knee was fine with short runs, but the problem started around 30+ minutes of jogging. This is a problem I’ve seen with more than a dozen runners in the past year. Presumably, as fatigue sets in, running mechanics/efficiency change and pain kicks in. Why?

1. As the duration of exercise increases, the stretch-shortening cycle (SSC) takes on a lesser role. In other words, the longer you run, the less you rely on reflexive actions (storing and releasing of elastic energy in your tendons) and the more you start to “muscle” things.

2. Stride length decreases over time. This is related to both #1 and the fact that the muscles doing the propelling just aren’t conditioned to keep up the same level of force production.

One of the things Mike Boyle did a great job of pointing out years ago in his original Functional Strength Coach DVD set was that many people are seeing imbalances among the hip flexors. Certain classes of athletes (and weekend warriors) over-recruit rectus femoris and tensor fascia latae and don’t get enough psoas involvement. This is largely due to the fact that the psoas is the only hip flexor that continues to be active above 90 degrees of hip flexion. So, in other words, the more total hip flexion we get, the more psoas recruitment we get.

With that in mind, consider most modern cardio equipment – most notably stairclimbers and most of the ellipticals on the market; you simply can’t get enough hip flexion to balance things out. Running isn’t much different. Sprinting clearly offers an advantage in this regard.

Now, we know that foam rolling, mobility work, glute and psoas activation, and strength training are all effective in treating the problems. However, that doesn’t speak much to the modification of the running program itself. In the past, I’ve thought that sprinting was great simply because it:

a) as another form of mobility work, it gets us out of this “hip flexor trip”

b) is fantastic reactive work (helps to improve SSC function)

c) leans people out faster (less weight to lug around when running)

d) teaches people that they have to go faster before they go longer (imagine a pitcher who can barely throw 90mph then overthrowing in an attempt to throw 90mph for 120 pitches; his mechanics are going to change sooner than later)

Then, after listening to Plisk’s talk, I realized that there is an “E” as well. Steve first showed elite sprinters in slow motion during a race and pointed out that they were striking the ground directly underneath a completely upright torso at near-top speed. Nothing new here; I knew that guys needed to be strong and mobile to “naturally” create optimal horizontal propulsion to maximize stride length. Conventional wisdom among misinformed coaches is that you just have to “reach” to get your stride length up, but in reality, one winds up going heel-toe and driving with the parking brake on instead of popping through the balls of the feet. When striking directly under the body, ground reaction forces on that single leg are roughly four times body weight (one more reason to be strong!).

Next, Plisk noted that the world record marathon time is getting closer and closer to the 2-hour mark. Do the math and you’ll realize that these guys are running 4:30 miles; that’s an average of over 12 miles per hour! This is an amazing feat – and one you definitely can’t do with heel-toe technique; you have to be efficient, just like a sprinter. Sure enough, look at the elite marathoners, and they’re running on the balls of their feet and landing underneath the torso – not out in front.

Let’s look to the novice runner, though. He or she might do fine with the balls of the feet for the initial aspect of the race (when SSC function is high), but as fatigue sets in, heel-toe kicks in. That four-times body weight ground reaction force bumps up to six-times body weight at top speed in this situation. Can you see how that might be a problem for someone who already has a compensation pattern – or just flat-out weak tissues?

This is also one reason why footwear can make such a big difference – and why some foot and ankle experts can tell so much from looking at the wear on your shoes and the callus patterns on your feet. If you are in shoes that magnify ground reaction forces, you have two things working against you:

1. More deceleration to do (meaning you’re braking yourself and running slower)

2. A lot more pounding on your joints (and there are 26 bones in your foot, so that’s a lot of joints)

Now, here’s where things get pretty counterintuitive. If you ask the layman how to minimize ground reaction forces, he’ll likely tell you to make the shoe thicker. Unfortunately, the research says otherwise (this is where those of you who don’t like reading stereo instructions can fast-forward to the big section entitled “Cliff’s Notes” below:

From:

Divert, C., Mernieux, G., Baur, H., Mayer, F., Belli, A. Mechanical comparison of barefoot and shod running. Int J Sports Med. 2005 Sep;26(7):593-8.

We get the following:

“In order to further compare shod versus barefoot running, 35 subjects ran two bouts of 4 minutes at 3.33 m x s(-1) on a treadmill dynamometer. Parameters were measured on about 60 consecutive steps. Barefoot showed mainly lower contact and flight time (p < 0.05), lower passive peak (1.48 versus 1.70 body weight, p < 0.05), higher braking and pushing impulses (p < 0.05), and higher pre-activation of triceps surae muscles (p < 0.05) than shod. It was concluded that when performed on a sufficient number of steps, barefoot running leads to a reduction of impact peak in order to reduce the high mechanical stress occurring during repetitive steps. This neural-mechanical adaptation could also enhance the storage and restitution of elastic energy at ankle extensors level.”

From:

Robbins, S. and Waked, E. Factors associated with ankle injuries. Preventive measures. Sports Med. 1998 Jan;25(1):63-72.

We get:

”A sense of foot position in humans is precise when barefoot, but is distorted by athletic footwear, which accounts for the high frequency of ankle sprains in shod athletes. It is unclear whether taping and rigid and semi-rigid devices protect against ankle sprains, as all of the studies suggesting this are flawed by inadequate controls. If these devices do protect the ankle, it is not through added support but rather through a partial correction of the deceased foot position awareness caused by footwear. Since taping and rigid and semi-rigid devices interfere with normal movement, there is concern that these might actually increase the frequency of injury at the ankle and/or at different locations. In this respect, taping is less of a concern because it interferes least with normal movement. The best solution for reducing ankle sprains in shod athletes is the use of more advanced footwear to retain maximal tactile sensitivity, thereby maintaining an awareness of foot position comparable to that of the barefoot state or perhaps even improving on it.”

From:

Kurz MJ and Stergiou N. Does footwear affect ankle coordination strategies? J Am Podiatr Med Assoc. 2004 Jan-Feb;94(1):53-8.

We get:

”The hypothesis of this study was that shoe hardness and footwear affect ankle coordinative strategies during the running stance period. Subjects ran at a self-selected pace under three conditions-barefoot, wearing a hard shoe, and wearing a soft shoe-while sagittal and frontal view kinematic data were collected. Dynamic systems theory tools were used to explore ankle coordinative strategies under the three conditions. No significant differences in coordination were found between the two shoe conditions. However, significant differences in ankle coordinative strategies existed between the shoe conditions and the barefoot condition. Changes in coordinative strategies may be related to different mechanisms to attenuate impact forces while running barefoot.”

From:

Opila KA, Wagner SS, Schiowitz S, Chen J. Postural alignment in barefoot and high-heeled stance. Spine. 1988 May;13(5):542-7.

We get:

”The posture of nineteen subjects under two conditions of footwear was analyzed for differences in the location of the line of gravity of the body with respect to anatomical landmarks. Intrasubject comparison of barefoot and high-heeled stance showed that the wearing of high heels caused lumbar flattening, a backward tilting pelvis, a reduction of the distance of the knee and ankle from the line of gravity, and a posterior displacement of the head and thoracic spine. The alignment at the greater trochanter did not vary with heel height, perhaps indicating a need to maintain a constant extending moment loading at the hip joint. The change in lumbar lordosis measured in high-heeled stance is inconsistent with clinical findings of hyperlordosis in habitual wearers of high-heeled shoes. It is possible, however, that changes in postural muscle tone due to the altered pelvic inclination may, in the long term, result in hyperlordosis of the lumbar spine.”

CLIFF’S NOTES

So, for those of you who got bored and stopped reading, we discovered:

1. Peak impact is lower with barefoot running than in sneakers.

2. Typical footwear changes adaptive strategies in the foot, meaning we’re better off with “more advanced footwear that retains maximal tactile sensitivity.”

3. High-heeled shoes suck and have serious ramifications further up the chain. This doesn’t just apply to stilettos; it also applies to those giant basketball shoes you just purchased.

Subjectively, I’ve seen this happen with a lot of my athletes simply from switching from the typical cumbersome athletic sneaker to Nike Frees. Frees aren’t right for everyone, but on the whole, they’ve made me much more effective at what I do. After wearing them for five months now myself, getting into another kind of sneaker feels like putting on a cinderblock.

So, am I telling you that the secret to all running problems is to buy Nike Frees? Absolutely not (although a lot of runners would do well to purchase them for wearing for lifting, sprinting, and footwear during the day).

What I am telling you is that the days of just running long distances to become a better runner are over – especially if you want to stay healthy. While you can have your distance work (if you’re healthy) to develop favorable aerobic adaptations and hit the anaerobic threshold steady-state work to get you used to the burn, to be successful and healthy long-term, you need to:

a. Strength train.

b. Do mobility work.

c. Do soft-tissue work

d. Do plyos and sprint (and that doesn’t mean 800m runs all the time; it means shorter bursts, too)

e. Do some barefoot training.

f. Pay close attention to footwear.

But then again, I’m just a dumb powerlifter who only runs to get seconds. What would I know?

Closing Thoughts

A big thanks goes out to everyone who attended last week’s NSCA Northeast Regional Clinic over the weekend; it was great to meet everyone and I appreciate you all making the trip.

As always, there’s plenty of material in my blog at www.EricCressey.Blogspot.com. Enjoy.

Go Sox!

EC