Is there an optimal way to run?

The popularity of running continues to rise for those looking to maintain a healthy lifestyle. Not surprisingly, with more people running, the incidence of running related injuries has increased. As a runner, you may ask yourself, is there an optimal way to run that may help reduce my risk of injury and keep me running safely? 
 
Cadence/step rate
An effective gait retraining cue that has shown to be helpful for runners in injury prevention is increasing cadence (step rate). A higher cadence, or the amount of steps a runner takes in a given minute, has been correlated to a decrease in running related injuries (1). By taking more steps, a runner will, as a result, shorten their step length. In fact, runners with longer step lengths were 31% more susceptible to putting stress on their knee cap whereas runners who had a shorter step length were 22.2% less susceptible to putting stress on their knee cap (2). Trying to increase cadence to ~170-190 steps/min and decrease step length may therefore be helpful in decreasing loading forces, especially on the knee joint (3). 
 
Strike pattern
Is there a foot strike pattern I should be trying to achieve? This has long been a controversial topic within the running world. Some experts have thought that transitioning from a rearfoot strike to a forefoot strike will put less stress on the knee joint (4). Although the kinematics of a rearfoot strike may put the knee joint at a more optimal angle and decrease vertical loading rate when running, there is lack of evidence to support this idea (4). Our bodies require a certain amount of time to adapt and transitioning too quickly to a certain strike pattern may put us at an increased risk of injury, especially when trying to adapt to a forefoot strike (4). There is evidence to suggest that focusing more on increasing cadence, instead of strike pattern, will help to naturally transition a runner from a rearfoot strike towards a mid/forefoot strike (5). Altering cadence may be an easier and safer way to alter your gait pattern overall! 
 
Vertical displacement  
Is too much bouncing when running harmful? A term called, vertical displacement, refers to how much a runner is moving in a upwards or vertical direction. Too much vertical displacement can negatively impact your body’s joints and does not contribute to your forward momentum towards the finish line! Try to run “horizontally” by keeping bouncing to a minimum!
 
Although gait re-training can prove to be a valuable tool for some runners, a recent study suggests that one of the most effective ways to avoid injury is educating the runner on proper training loads (6). A common mistake made by runners is trying to do too much too soon. Understanding and implementing a running program that focuses on gradually building up your training load (mileage or speed) is thought to be more effective than gait retraining alone (6). It is important to remember that all runners will respond differently to gait retraining feedback and what may work for one runner may not for another. Most importantly, listen to your body, check in frequently, and be aware of symptoms such as fatigue, soreness and pain. 
 

Written by:

Casey Goheen
Registered Physiotherapist, MPT, MSc, BSc
Allan McGavin Sports Medicine Physiotherapy at Twist (North Vancouver)


Bio:

Casey is a Registered Physiotherapist at Allan McGavin Sports Medicine Clinic in North Vancouver. Casey received her Masters of Physical Therapy degree from Queen’s University, following a Masters of Anatomical Sciences and Bachelor of Science from Queen’s University.

As a long distance runner herself, Casey has a passion for treating running related injuries and promoting safe rehabilitation back to sport. Casey has a special interest in working with young athletes and recognizes the demands of high level sport in this population. Casey is also GLA:D (Good Life with osteoarthritis in Denmark) certified and enjoys working with those experiencing hip and knee osteoarthritis get back to the things they love to do! As a SportMedBC InTraining Clinic Run Leader, Casey is committed to helping you stay injury free, train to perform your best, and achieve your running goals!

 
References 
1. Bramah, Christopher, et al. "A 10% Increase in Step Rate Improves Running Kinematics and Clinical Outcomes in Runners With Patellofemoral Pain at 4 Weeks and 3 Months." The American journal of sports medicine 47.14 (2019): 3406-3413.
2. Willson, John D., et al. "Effects of step length on patellofemoral joint stress in female runners with and without patellofemoral pain." Clinical biomechanics 29.3 (2014): 243-247.
3. “New Trends in the Prevention of Running Injuries.” The Running Clinic. 2018. Accessed 17 Feb. 2020
4. Barton, Christian J., et al. "Running retraining to treat lower limb injuries: a mixed-methods study of current evidence synthesised with expert opinion." British journal of sports medicine 50.9 (2016): 513-526.
5. Willy, R. W., et al. "In‐field gait retraining and mobile monitoring to address running biomechanics associated with tibial stress fracture." Scandinavian journal of medicine & science in sports 26.2 (2016): 197-205.
6. Esculier, Jean-Francois, et al. "Is combining gait retraining or an exercise programme with education better than education alone in treating runners with patellofemoral pain? A randomised clinical trial." Br J Sports Med 52.10 (2018): 659-666.
 

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