By Kristina Pattison, DPT, OCS, CSCS
When the foot and ankle are healthy and stay in alignment with the shin during load bearing, the lower extremity works like a spring–both absorbing shock and storing energy for propulsion. Many key things happen very quickly through the running gait cycle to allow the runner to temporarily “fly” through the air with neither foot touching the ground–the characteristic flight phase* of running gait. A healthy foot and ankle are strong enough to tolerate approximately 3-4 times body weight in force with every step taken while running (or about 450 pounds for an averaged-sized 150-pound runner). Most highly trained runners are able to maintain a cadence of approximately 180 steps per minute which would translate to about 40,500 pounds of cumulative force taken through each leg, each minute, of each run. It’s imperative that the lower extremity is taking those forces like a champ, and not collapsing uncontrollably with every step.
It’s imperative that the lower extremity is taking those forces like a champ, and not collapsing uncontrollably with every step.
-kpat
For us lucky ambulatory bipeds, the act of running on a consistent basis and building up tolerances for loading over a long period of time is the number one most important way to reduce risk of injury. And the most important role I have as a coach is monitoring and planning loading so that the system isn’t suddenly overloaded during an event or momentary lapse of reason by any one inspired runner. As a physical therapist working with runners for the past decade, I can tell you honestly, taking too much time off or skipping training too often is usually the predecessor to overuse injuries. Sounds counterintuitive but subsequently trying to “catch up” on training or “wing it” come race day, is the most common reason for these sudden spikes in volume or overload. The body will develop more load tolerance through little bits of load over a long period of time. But suddenly going from no load to lots of load will never work for us humans.
Part of the reason why this is true is that the muscles, tendons, ligaments, and bones of the lower extremity take a long time to build up strength for higher velocity loading. These structures, including bone, follow the rule that if you apply overload–more stress than the structure is used to–there is an amount of breakdown that occurs. This leads to processes of healing and recovery, and the structure becomes adapted to the higher amount of load. But if too much load is applied too quickly, or not enough recovery takes place, the structure will breakdown too much, and will not be able to tolerate any load. Take bone for example. We know that bone can take a low to moderate amount of force over and over and over again for a really long time–including the force of muscles pulling on bone through tendons. But, if a runner is doing all that pounding with insufficient nutritional support and time for recovery, those bones start to fail–aka stress reactions or “stress fractures” as they used to be called. Common areas for stress reactions in elite male runners are the sacrum and femoral neck–areas of high metabolic activity that need a lot of nutritional support and enough downtime to regenerate.
But for most of us non-elite, recreational or competitive athletes–particularly in the middle ages of 30s to 50s– the likelihood we will be breaking bones because of overtraining is less likely than straining muscles and tendons and spraining ligaments when we go weekend-warrioring off our desk chairs (myself included here). So we need to be extra careful about titrating loads and optimizing loading alignment. For us SUV’s of the sporting world, mechanical maintenance is absolutely necessary if we want to log lots of miles. Winter months are superb for working on full-body conditioning that will contribute to strength of soft tissues and global load tolerance for the lifelong pursuit of health and fitness. Spring is great for working on some power and speed–increasing contraction velocity which strengthens bones along with tapping into our hormonal spring of youth. And summer, sweet summer, is great for just maintaining all that lean body mass with some run-specific conditioning. By this time, your body and mind should be thinking primarily about race-specific training and everything we do should be to make that year-long ace-race running goal a reality. For Flight Phase athletes: try the new lower extremity series (description below) in Training Peaks to build functional stability in the lower extremity while developing neuromuscular coordination for improved loading mechanics.
. . . honestly, taking too much time off or skipping training too often is usually the predecessor to overuse injuries.
-kpat
*Flight Phase: /flīt/ /fāz/ :the period of time distinct to the running gait cycle, when neither foot is in contact with the ground.
LOWER EXTREMITY FUNCTIONAL STABILITY SERIES FOR RUNNERS
This series is designed to work on mechanical alignment and functional stability during loading of the lower extremity. These activities help ensure your knee, ankle, and foot are aligned optimally as you accept weight while walking or running. They also help strengthen these structures so you can continue to walk or run for longer periods of time before fatigue or strain. For this series you will need a step, box, or stack of books sturdy enough to hold your body weight. Set up next to a counter, rail, or wall for light fingertip support and balance.
Stand with the ball of the foot on the edge of the step with your second toe pointing straight forward. Ensure your foot is aligned perpendicular to the step by using your second toe as your “true north.” Your foot may feel slightly turned inward. As you perform these movements, ensure your shin stays aligned over the top of the foot. You may watch your knee cap from above. It will feel as if your knee cap is aiming more toward the outer foot or fifth toe when the knee bends. Also, when your knee bends, your knee cap should not pass the end of the toes–think of this more as an “ankle-bend” than a “knee-bend”.
Try three sets of ten on each leg 3-5 times a week. You may stack all the reps of each exercise into one set on on leg and repeat on the other leg for more challenge.
Kristina “KPat” Pattison is a competitive ultrarunner from Missoula, Montana and performance running coach for Flight Phase Endurance Coaching. She works as a doctor of physical therapy with a board certified specialty in orthopedics through American Board of Physical Therapy Specialties, and holds a certification as a specialist in strength and conditioning through NSCA. Kristina specializes in the performance and rehabilitation of runners and wildland firefighters. Get in touch!