Posts in Running Injury
Does Running Gait Retraining Translate To Running Outside The Lab?
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Researchers and clinicians continue to explore interventions to reduce the significant numbers of running related injuries. These injuries, mainly overuse in nature, often cause a loss in training time and are found among both novice and experienced runners. In addition to strength training, gait retraining has shown promise in reducing the forces placed across the lower body during running. Simple strategies such as reducing step length (heel to mid foot strike) and landing softer (reducing vertical forces) can quickly reduce forces during gait. In addition, providing runners with real time feed back through simple video analysis and verbal cuing accelerates utilization of these new running strategies. Few research articles have examined the retention rate and transfer of learning between laboratory running gait retraining and a runner’s outdoor training, but a new study shows old running habits may die harder than originally thought.

Zhang and colleagues examined runners’ gait mechanics under various conditions including overground running, treadmill running, as well as, running inclines and declines (Gait Posture. 2019). Each runner’s lower body forces were measured in a biomechanics laboratory during their preferred running gait. Based off this analysis, runners were then provided with 8 sessions of gait retraining with real time feedback (soften your foot strike) to reduce forces across the lower body. Runners were then reassessed to determine if the gait retraining transferred to an outside environment. Consistent with prior research, the majority of runners were able to reduce lower body forces during gait retraining in the laboratory. Outside of the gait retraining, they were able to reduce their overall forces during overground and treadmill running, but peak forces were not reduced during overground running. Not surprisingly, this study highlights the difficulty of changing a movement pattern like running. Consistent, deliberate practice with the principles learned during gait retraining is required to create an automatic process with athletes.

Orthotics Impact on Leg Mechanics

The use of foot orthotics are commonly prescribed for many lower quarter conditions including running injuries, foot and ankle pain, and even low back pain.  As we have described in previous posts off the shelf orthotics perform as well as more expensive custom orthotics, but overall their impact on many conditions is limited.  When compared to more active approaches including Physical Therapy and exercise, orthotics fall short of manufacturer's and clinician's promises of pain relief and improved function.  

A recent study out of the University of Wisconsin examined the impact of off the shelf orthotics on running mechanics (O'Conner et al. JOSPT. 2016).  Authors studied 31 recreational runners in a biomechanics laboratory while running with or without a foot orthotic.  In particular, the authors were interested in the amount of dynamic foot motion at the heel and mid foot during the stance phase of running.  Runners were then grouped based on the amount of motion in their feet during running.  They hypothesized that runners with the greatest amount of motion may benefit most from the orthotic.  The results of this study show that orthotics did not significantly impact motion at the hip or knee and thus the use of orthotics based on a patients degree of foot and ankle motion is not supported.

Athletes are advised to understand the limitations of orthotics to change lower quarter running mechanics and instead work with a local Physical Therapist to correct these running mechanics.