Physio.co.uk: Running assessment and analysis workshop presentation slides

@Physiocouk #manchesterphysio facebook.com/physio

07/12/16 2
Welcome
Running Assessment and Analysis Course
With Oliver Simpson BSc (Hons), Msc, Dipl (ortho),
MCSP, HCPC
@Physiocouk #sportsmassage facebook.com/physiocouk

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Who are we?
Oli’s Twitter: @physiocouk
Katie’s LinkedIn: www.linkedin.com/katieemmett
Twitter: @KatiePhysiocouk

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Let’s connect
Website: www.physio.co.uk
Twitter: @physiocouk
Facebook: www.facebook.com/physiocouk

Itinerary
8.45-9.00: Arrival & Coffee
9.00-10.00: Running Biomechanics : the basics
•What is the best running style?
•Should we make everyone run like Mo?
•Who is the best positioned to analyse running
•To toe or to heel land- that is the question?
•What to look for?
•Stride Width
•Stride Length
•Simple cues
•Analysing the analysis
10.00-10.15: Break
10.15-11.00: Practical : Let’s run!!
11.00-11.15: Coffee…
11.15-12.00: Analysis using Kinovea/Technique

Running
Biomechanics:
The Basics

Objectives
• What is the best running style?
• What is the best profession to assess running biomechanics?
• To toe or to heel land that is the question???
• Is your running “Chi” in the right orbit?
• Stride width - Who’s a better runner? John Wayne or Kate Moss?
• Stride length – Buzz Lightyear vs Fred Flintstone
• The UK athletics way
• The simple cues
• Analysing the analysis
• PRACTICAL

What is the best running
style?
• Is there one?
• What about Mo?

What about
Phoebe?.....

Should we make everyone run
like Mo?
• No
– Running is self optimised (Moore et al. 2012)
– What is the ‘ideal’?
– New science and poorly funded so no good high
level research
– Heterogeneity of running populations

Should we make everyone run
like Mo?
• Yes
–Running is movement > movements are skills > skills can be
improved
–80% of runners get injured at some point
–New evidence showing positive effect of running mechanics
with training
–Research has shown changes in mechanics can reduce loading
on PFJ
• New science – we don’t have all the answers. YET!

Who is the best positioned to analyse
running?
Running shops?
• Anyone used them? Who was told they
“overpronate”?
• Bias?
Performance vs injury
• Is there a difference?

Who is the best positioned to analyse
running?
• Podiatrist vs physiotherapist
•Bottom up vs top down
• The coach?

To toe or to heel
land…
That is the question

Heel
• Increased GRF – who remember Newton’s 3rd
Law from High
school?
• Loading through hip and knee
• Linked to PFPS due to abnormal loading patterns
• Modern running shoes allow it
• 89% of the population do it (Larson 2011)

Toe
• Greater talocrural and PF loading – tendinopathy,
stress #’s
• Less likely to suffer shin splints
• Reduced knee and hip loading
• 2% of the population do it

Mid-foot
• Awaiting new research currently being conducted but good
initial results
• Closer to COG
• Fits with ideal running cues

Does it matter?
• Speed?
• Level of runner?
• Footwear?
• Centre of gravity
• DO NOT completely change the pattern

Is your running “Chi”
in the right orbit?

• Standard gait cycle (walking)
• Land to stance
– Lateral heel lands with foot slightly supinated > subtalar joint
pronates dueing first 20% of stance (shock absorbtion) >DF
with hip and knee flex.
• Heel to toe
– Supination during heel off > MTP ext with supination =
Windlass.

What to look for?

Spongy Runners
Vs

Pronation
How important is it?

Contact Point

Foot posture at toe off
The Windlass Mechanism

Is your running “Chi” in the right
orbit?...
Problems:
• Do you heel strike when running faster?
• Toe-out stops Windlass
• Toe runners????

Stride Width…
Who’s a better runner? John Wayne or Kate
Moss

Kate Moss
• Increase hip adduction
• Increased rear foot eversion
• Valgus knee
• Increased ITB strain (Meardon et al. 2012)
• Medial tibia loading (Meardon et al. 2014)
NO evidence to show changing Kate’s stride width will reduce her
pain
• Clinical reasoning and normal movement theories

John Wayne
• Evidence showing increased metabolic rate (Arellano and Kram 2011)
• No link to pathology
Ideal stride width?
• 5 studies looking at average stride width from 0.04cm to 4cm
• That doesn’t help!
• Poorly designed studies, difficult to perform a meta-analysis of the papers
due to different methodologies and patient groups.
• General consensus is the patients fist at knee level

Stride Length…
Buzz Lightyear Vs Fred Flinstone

• Heel to Heel…
• Fred wins this race
• Reduce stride length and increase step rate (Schubert et al. 2012)
•Decreased load through hop and knee
•Reduced GRF = reduced breaking
•Foot strike closer to COG
• reduced ankle DF and increased Knee flex
•Increased G-Max and G-Med activation prior to contact (Chumanov et al.
2012)
•Reduced calf and quad muscle forces (Lenhart et al. 2014)

The UK athletics way
• Template they use to assess elite endurance runners
•Tall posture
•Relaxed shoulders
•Efficient backward arm swing
•Foot strike close to COM
•Knee slightly flexed on contact with vertical shin
•Min Lateral movement

Simple Cues…

Simple Cues
• Step rate and length – Metronome app, “run quietly”, quicker
steps, speed up arm swing

Simple Cues
• Stride width – line running, “run with an orange between your
knees”

Simple Cues
• Hip adduction - point your knee caps forwards and contract your glutes
(Noehren et al. 2011)
–Run like a train with feet and knee forwards (Will et al. 2012)

Simple Cues
• Upright posture
– run as if a balloon is pulling you upwards
– High hips
– Squeeze buttocks

Simple Cues
• Hip extension
– Push out the back
– Pull the floor underneath you

Analysing the analysis

• HD Camera with 220 fps
•Treadmill with clear background
• Software/app
• Smart camera – Technique by ubersense, coaches eye

• 5 min warm up
• Running gear!!
• Run at their speed
• Back and side views most useful

Let’s Run!!

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Thanks for coming!
Don’t forget to follow us on Twitter: @physiocouk

Physio.co.uk: Running assessment and analysis workshop presentation slides

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