Category Archives: heel strike

KNEES – RUNNING REBUILT #02

Last week I did Neural Flossing, by the end of the week I was experiencing hip pain in my left hip and stiffness when I stood up after sitting for long periods of time. To combat this, John provided me with a different stretch – putting my legs in a sort of figure of 4 while lying on my back, this stretched my lower hip and upper leg area – after a couple days of doing this the hip pain disappeared. The combining of this and the Neural Flossing is working on increasing the degree of movement in my left leg.

 

physio-neural-flossing-ra physio-neural-flossing-stretched physio-hip-stretch

This week I went on the treadmill to look at how I walk and run; a muscle in my left hip/upper bottom does not engage when I walk, I almost learn back which could be contributing to my back pain, as well as twisting my upper body while walking and even more so when running. While running I bounce up and down a lot and I put my heel out in front of me, which means that I am not exerting energy in the right places while running.

To combat these habits John gave me the following exercises to work on over the week:

  • 5-5: Setting the treadmill on 5 incline & 5 speed, where I need to engage my core and lean forward to promote me walking on the front of my foot rather than leaning back on the heel.  While doing this I put my hands on my hips/upper bottom to make sure my muscle was engaging.
  • Use the treadmill to lean forward like a ski jumper, and using one leg at a time to practice my leg movement where my foot will land in line with my body (rather than out in front), this is through pretending I was on a scooter with an angry horse leg that goes up, round and down. Then using the treadmill to pretend that I was bump starting a car – this was to help me with leaning forward, bouncing less while running, and running with my feet landing below me not out in front of me.
  • Arm Swing – stationary – this is engaging my core and standing like a person about to skip – moving my arms forwards and backwards close to my body in an exaggerated running movement, but not allowing my body to twist as I moved. Then doing this while on the balls of my feet – this I found a lot harder due to my inability to balance.
  • John also sent me a video clip that provided tips on running and form to improve over stepping – it focused on bum kicks, skipping and running barefoot.

arm-swing

This week took a lot of thought as I had to concentrate on a lot of different areas of my body at once, but it’s crazy what difference engaging your core can do.

Heel Fracture

HEEL FRACTURE

No impact Aqua Running - Loan Belts available
No impact Aqua Running – Loan Belts available

‘I suffered a severely fractured Calaneum (heel) bone during a stag do in Berlin in the summer of 2014. It resulted in open reductive surgery where a plate and screws were fitted and I was unable to weight bear for 3 months.

Once able to weight bear I was limping and in quite a lot of discomfort. I would get easily fatigued after periods of standing and after a day on my feet at work would need to spend the entire evening recovering. If I did socialise out after work I would pay for it the following day or sometimes days with further stiffness and pain.
I received hydrotherapy and physiotherapy sessions soon after fully weight bearing and although this helped to a degree it was still painful to walk. I still had a limp, some days were worse than others and I got to a stage where my physiotherapist expressed doubt about his ability to help me any further as I was unable to perform a heel raise on the one foot, usually doable by this stage.

John was recommended to me by a work colleague who had had a running injury. I was feeling mentally defeated at this point as it had been a year since my injury and I still couldn’t walk without some degree of discomfort. I had recently been to a wedding reception after a day at work and as a result the 2 weeks that followed had been more uncomfortable than usual. I was having severe doubts about ever being able to walk properly again.

PHYSIO ASSESSMENT
After explaining my situation to John he worked the surrounding areas of my foot and manipulated areas in my back. I physically saw a change in my flexibility between the beginning and end of this first session. I could now move my right foot back as far as my left which I was unable to do before and it was noticeably easier walking up and down hills as I didn’t have this flexibility before. I’m now also able to perform a heel raise on the right foot and can hold this position for around 30 seconds. My confidence has improved considerably and I’m optimistic that I may even be able to resume more physical activities in the near future.’

Knee of Little Faith #03

The focus was very much on footwork in today’s session – a very Strictly Come Dancing-esque affair. The aim of this partial paso doble was to establish the most ideal and body-friendly running technique: weight bouncing on the balls of your feet, slight incline forward, head up, tight core .etc. This avoids the infamous heel strike that many athletes will have encountered at some point in their career. With a natural forward incline too, the runner can utilize the wonder of gravity and literally ‘fall’ in to each stride, thus conserving additional energy that otherwise would be used to drive them forward. This is all neatly analogous to the result of barefoot running, that I touched upon last post. Since then, I have completed some short 30-minute barefoot runs and certainly noticed a difference in my running posture, as well as which parts of my body were now taking up the slack (namely, some burning calves). I could also see that to run efficiently, you needn’t have long strides, but small circular ‘pushes’ at a higher cadence – very much like the pushing leg when riding a child’s (or your own, if you’re fortunate enough) scooter. So, altogether, I should gradually develop a far more efficient, not to mention less-damaging, running style over the course of the year.

The exercise covered today was to visualise what the components of this desired running style were, and how each felt. It went as follows: Lean forward until you feel you are on the balls of your feet and your body wants to fall forward – very much like the Winslet moment at the front of the Titanic (although neither the arms nor Leonardo are necessary). Core tight and head up, to avoid a slouch. Lightly push out and pull back each knee alternatively in a running-like manner. Power-producing arm swings should be included too (swinging forward and back, not up and down), aiming not to let the upper body rotate too much as you do the knee movements – which, again, would waste energy. Hold one knee out mid-stride and allow yourself to give in to the forward urge of your body, falling in to several steps of a run. It should feel a bouncier and lighter gait.

And it certainly did. Lots to take away from this session and apply to my next training runs. John did mention that I need to disassociate my upper body from my lower when I run (and swim), as it has a tendency to rotate, rock and generally divert much-needed energy away from my legs. However, the way things are going leg-wise, I should be on track for a Glitter Ball trophy of my own…

Knee of little faith #02

Consider this the first petrol stop on my road to recovery. On today’s body-fixing menu was a starter of tightness relief, a generous portion of gait analysis and a sprig of athletic literature.

The tightness was to be relieved from my lower and mid-back, from which the aforementioned nerve paths originate. The nerves innervating muscles in my leg and feet come very much in one, unfortunately unyielding, length only. Therefore, the most direct (and, when fit and healthy, the normal) route of nerve to leg components is the best. However, the tightness in my back is distorting the nerve path into a far-less direct and convoluted route around my knee. Being one stubborn, unchanging length, this new nerve path causes a restriction in movement of both my upper and lower left-sided limbs, in particular directions. My hip also lowers to, almost, provide ‘slack’ to accommodate the new path choice. For my left leg, the path shift is placing more emphasis on the side of my little toes rather than the ball of my feet as a collective, when I push off whilst running. This in turns twists my knee inwards, and, hey presto, an unhappy triathlete. Miraculously then, and with equal delight and despair, the conclusion is that my knee, in fact, isn’t the problem child of this whole ordeal, but a mere victim of circumstance. John even checked for any extensive knee damage to no avail. (I feel I should apologise to my knee for my terribly unsubtle disdain towards it over the past few weeks). Anyway, after a good back-clicking session (similar to the sound of fresh snow crunching under the weight of car-tyre) I vowed to adjust my tightness-inducing student posture (‘the slump’) to something a little more back friendly.

Of course, with any good theory, some physical evidence is very much welcome. In my case, this came from the gait analysis. After just a short stint on the treadmill, several aspects of my running gait were highlighted. The first was this hip drop on the left hand side. The other, rather embarrassingly, was the presence of a definite heel strike – as shown in the picture. For this, I blame the years of being lulled into the welcoming arms of running shoe companies and their unnecessarily, cloud-like foam heels – goodbye technique! The (most enjoyable) method of altering this is to run barefoot, which immediately forces you away from the joint-clattering heel strike to the bouncy balls of your feet. This was proven by the Mexican Indian tribes outlined in Christopher McDougall’s best-selling book ‘Born to Run’, and their long-distance running prowess. Safe to say, I have already replaced my trainers with a poncho and pack of plasters.

Mid-stride evidence of a very embarrassing heel strike, found during my gait analysis ...
Mid-stride evidence of a very embarrassing heel strike, found during my gait analysis …

However, there is hope for me yet. Again, a simple posture change – namely from my lumbering, swimming-shoulder hunch to the upright, proud-athlete stance – left my running gait far more eloquent. There was even evidence of the preferred ‘cycling circles’ (more circular motion of my lower legs, which ensure mid-foot landing), as well as a nice forward tilt. Phew – I was beginning to reconsider my activity choices.

The preferred running gait: small circling legs, mid-foot landing and slight forward tilt.
The preferred running gait: small circling legs, mid-foot landing and slight forward tilt.

Overall, another very helpful and informative session to get me back on the highway to hell aka. Ironman Wales.

Standing

Photo showing: Testing off road shoes with AAA-Physio @ Moti BS8. 14kmph : foot contact slightly ahead of body centre of gravity
Testing off road shoes with AAA-Physio @ Moti BS8. 14kmph : foot contact slightly ahead of body centre of gravity

Problem
Top of right glute painful, John has identified that my right foot veers left just at the end of my stride, meaning my hip twists probably causing the pain. It’s only in the last month.

Question is what causes it; shoes, stance or what?
Solutions
1. New tyres – popped in to Moti and the attentive chaps spent 45 mins sorting that in line with John’s instructions. Very different but comfy, hope an old foot injury in my foot isn’t aggravated as it always casts a shadow over new shoes.
2. Posture – while standing – ‘peering over cliff’, this is the one I’ve been concentrating on, feet, knees, pelvis and head, oh and chest and shoulders if a man can concentrate on more than 4 things at once! While sitting – pelvis, shoulders and head (superman eyes)
3. Running style – shorter stride landing on ball of foot not so heavily on heel, pelvis, elbows (pushing back and not too far forward), and the head, again. Needs working on at the next session.
Thoughts
I really should stretch more.
Been running and out on MTB, neither very good. Torn between resting and pain of getting fit again once John has worked his magic vs glute and back pain of continuing exercise.

Why no magic button John can crunch?

1. Route to running & skiing well – Learning to Run with AAA-Physio John S – Updated


running school booking in Bristol
£10 Session and Some FREE Sessions with a BLOG - Ends 27th Dec.

I started running only about a year ago and managed to complete the Bristol 10k last May but have had various injuries as a result of my running ‘technique’.  “Learn to Run with AAA” seems like the perfect opportunity to improve my technique and prevent injury; hopefully it will help me when I go skiing next month for the first time too!

We met at Rubicon at 6.30pm, started with a general chat and some technical chat (who knew there was so much to putting one foot in front of the other?!) before heading out about half an hour later for some practice.  I hadn’t realised but I was running with completely the wrong posture and not really using my arms.  My take home points were to use my arms with a bigger back swing, to correct my posture before starting off and stopping to correct myself if I went back to where my body found comfortable.

I went for a run on Boxing Day and definitely felt an improvement – it took much longer to get tired and I could feel that my running was smoother.  I have had some twinges in muscles that I didn’t know were needed for running so we’ll have to see how that goes in the future!

wk 1. The Trail to 10km PB – Meeting AAA Physio

Right leg cross-over problems
Right leg cross-over problems

Right Knee Patella Tracking Problems
PLAN
“Learn to Run” with AAA-Physio tomorrow

I first met John on 19th Dec at his clinic in Moti, I went to see him because I have pain in my right knee which causing me pain during running.  John got me doing various stability exercises then various movements to test my flexibility and strength in both legs.  This assessment showed that my left leg was very flexible, whilst my right leg was tight in the hip, IT band and also lower back and weak in the glutes.  John suspected that this was causing the pain in my right knee.  John then videoed me running on the treadmill, which was fascinating to watch and illustrates exactly what he was saying in his assessment….you can see the video in this post.

The video (to a trained eye) shows my left leg is working at full capacity whilst my right leg is not because my right hip tilts forward making my right leg come across my body and this is making me loose power when striking the ground and taking off.  John said that the pain in my knee is not permanent…John’s plan is the strengthen my right leg, glutes, IT band and hip flexors through physio and showing my how the run more effectively..I will use his running workshop and physio to do this….I feel that with his treatment, advice and strengthening exercises I can move towards my goals…sub 20mins 5K and sub 40mins 10k.

Learn to Run with AAA-Physio – 10km in Sub 40′

left-hip-drop-before-AAA-14km 

50% reduction in left-hip-drop-after-AAA-14km
50% reduction in left-hip-drop-after-AAA-14km
14km/hr – Spot the Left hip drop