Running

Physiology of running

Running is an incredibly popular sport and form of exercise (more than 36 million runners in the USA). When considering “how” of running, most people tend to naturally focus on its aerobic nature. However, depending on the distance or duration of the run/event, the contribution of a runner’s VO2 varies considerably.

Some (such as Tim Noakes, a South African physician) have proposed that other body systems (aside from the Oxygen transport system) contribute an equal amount.

From our experience, we believe that adequate fitness (as measured by a runner’s VO2max) is essential to fully developing one’s running potential. However, technique, muscle strength and even power play very important roles in maximizing said potential. As an example, there are several studies that have been published recently that explain running economy, in large part, is a function of both proper technique (e.g., avoiding so-called “overstriding”) and muscle strength and power. Specifically, running economy (essentially the effort required at a given intensity) has been shown to improve more dramatically with the addition of strength and plyometric (jumping) exercises than just running alone.  Further, proper foot placement during landing and pushing off is essential to improve performance.

Technique is also quite important to both improving running economy (extra movements “cost” more energy) and reducing the risk of injury.  Overstriding, a much talked about concept, has become quite popular of late; we are quite familiar with overstriding and the potential role footwear (including barefoot) plays.  For those reasons, we are proponents of digitized video analysis of the running gait to pick up on either unnecessary or injury-prone movement patterns.

Common running injuries

Gender and Injury Rates

For adult runners, there appears to be no difference in the rate of injury; approximately 25% of both adult males and adult females report injuries

There does, however, appear to be a difference between adolescent males and females. Multiple studies have shown girls have significantly higher initial injury rates, higher recurrent injury rates and higher season injury rates.

Type of Injury

Studies differ, but many have identified the following injury patterns for adults

• General knee pain (20% of injuries)
• Lower leg pain (18% of injuries)
• “Tendinitis” (11% of injuries)
• Patellofemoral or kneecap pain (11% of injuries)
• Some have indicated that adult females tend to have more stress fractures than males
• However, it appears a more likely cause of stress fractures (rather than gender) is inadequate fitness prior to beginning training.
• Adolescent injury patterns are inconclusive, but the following breakdown has been presented by a 1996 article:
• Tibial stress syndrome (20-30% of injuries)
• “Strain” (15-23% of injuries)
• Apophysitis (18-38% of injuries)
• Non-specific knee pain (15-20% of injuries)
• Stress fractures (<15% of injuries)

Why do Running Injuries Happen?

We have been presented with many thoughts as to why injuries happen. Some are supported by research while others are not. The following information has been reported in multiple scientific studies.

Risk of injury does seem to increase with:

• Weekly volume greater than 40 miles
• Year round running
• Long runs longer than five miles
• Surprisingly, most studies show no change in injury risk with running surface, but at least one has shown increased risk when running on concrete versus other surfaces
• Multiple studies have shown that injuries seem to occur when strength deficits exist. Further, it appears those weaknesses existed BEFORE the injury (so the weakness was not a result of the injury).
• Flexibility and injury risk is a little tougher to discern. Most studies indicate that increased levels of flexibility are actually associated with an increased risk of injury.
• However, oftentimes injuries result in losses of flexibility which must then be addressed.

Runners and Running Clubs we’ve worked with:

• Omaha Running Club
• Team Nebraska Brooks
• Cornhusker Flyers
• Multiple Olympic Trials participants
• High School Track and Cross Country
• We have worked with runners from every high school track and cross country team in the Omaha-Council Bluffs Metro Area

Testimonials

My name is Dan, I am a marathoner & have been going to Omaha Sports Physical Therapy for several years now for my minor running injuries.  I have been very pleased by David Potach and the entire staff at OSPT.  Not only do they help me to get back to regular training, they are also athletes themselves who provide physical stretching & exercising as well as advice for cross training & other activities.  With their expertise, I have learned a lot about challenging myself without overdoing my running.  Over time, I have become a better and more consistent runner and have stayed away from many of the smaller injuries that had been much more frequent a few years ago.  I attribute much of this success to the help & the things I have learned from going to OSPT.  I trust their experience & advice to strengthen me to get back to my training when I am injured.  The best example I can give to this is in the spring of 2008 I was preparing for the Boston Marathon & I got a heel injury about 8 weeks before the race.  The timing was horrible, but I worked with David & the staff on a program to calm the inflammation, strengthen it & work my way back into running.  I took it all on faith that they knew what they were doing & that marathon turned out to be my best Boston Marathon up to that point.  I look forward to continuing to use OSPT as needed.

-Dan

How can I begin to express my sincere gratitude?  In these last two months I’m not only had my physical recovery aided, but I’ve also had the rare opportunity to see compassion and sacrifice at its finest.  David, I can’t say that I’m glad I injured myself in the first place, but I’m certainly honored to have met and worked with you.

-Lindy

David and the entire staff at Omaha Sports Physical Therapy are amazing.   The first time I met David I could tell how much he cares about getting his clients back to doing what they love.  He was very thorough and really took the time to figure out exactly what was needed in order for me to run again.  David goes above and beyond the call of duty when it comes to his clients.  I strongly recommend David and Omaha Sports Physical Therapy to all of my friends and family.

-Traci

As a runner for the last 30 years I understand the importance of proper rehab and conditioning to remain in the sport I love.  After a significant injury cost me three months training in 2008 I began working with David and Omaha Sports Physical Therapy.  With David’s guidance 2009 is turning out to be my best year in almost 2 decades, including running my first marathon since 1996.  I highly recommend Omaha Sports Physical Therapy to our Team Nebraska Brooks athletes and to the running community as well.

-Will

After months of hard work training for my first full marathon, I pulled a muscle in my leg.  I had no idea what it was, and the doctor couldn’t give me any advice other than to rest.  With race day approaching, he said I wouldn’t be running.  This of course was not an option for me!  I contacted Omaha Sports Physical Therapy for another opinion.   David and his staff assured me that there was a good chance I could rehab my leg in time for the race, if that was something I was committed to doing.  With this new found attitude I began treatment and was given stretches and strengthening exercises to work on.  After 4 weeks of physical therapy, I was back to running.   I didn’t think it was possible, but the expertise and advice of Omaha Sports Physical Therapy allowed me to complete my first marathon in 4:01- a time I had hoped for BEFORE I was injured!  Thanks to them, I have continued to improve my strength and endurance, and continue to perform the exercises they gave me to prevent any recurring problems.  I have achieved a number of goals since my injury and rehab.   This year I ran a PR 5K in 21:31, a PR 5 mile in 35:27, and a PR ½ marathon in 1:40.  My second full marathon is a week away, and I am hoping to finish in 3:30 and qualify for the Boston Marathon in April, 2010!

-Jill