runClinical

If you are a runner who is suffering from pain when you run, or preventing you run then Run Clinical is for you. The purpose is to allow you to give a detailed history focusing on your training program, racing program, previous injury history and then on the current injury, what has been done, and what interventions you have had. This allows us to give a targeted clinical examination but most importantly assess you on our video treadmill. Looking at you run is the most important understanding of what is happening. Bring your runners and orthoses or anything else you use. I  may  occasionally delay the running assesment until we have appropriate MRI or imaging, in case we think the injury poses you unacceptable risk. We have identified common features we think are associated with injury in the way you run. The way you body takes load is important. The angle of your foot leg, pelvis and trunk is important, as this effects the way your muscles work and we will work to gradually change these if we think they are the underlying mechanism. All runners benefit from strength work targeted at the posterior chain muscles, and we will discuss how to do this and a program.

Our Approach

The way you run is important, most people just get out and run, but imagine what your tennis serve would be like if you took the same approach.  Why do some people get injured and others don’t? It is about the room for error or tolerance- people differ and how much you train, how fast you build a program and how you take load on your legs all matter. Some manage that balance, other don’t – but you can run injury free. The angles your joints make when your run are called kinematics, and the loads your muscles and joints end up with are called kinetics – and these are both linked. Bigger muscles can do more work  (take more load) but commonly don’t. The smaller muscles of the shin or calf do too much and therefore result in pain.

It's not about the shoe, but how you run.

We take a top down, not foot up approach. I believe treating these issues with running shoe prescription, or orthotics is like “trying to adjust the tracking of a car with flat tyres” – expensive and pointless.

We need to look at your kinetics and kinematics first…and training program and then gradually over a week or two retrain the way you run.

Occasionally, I see a patient who has pain whose running technique is fantastic – ad then we need to look as to why the pain is presenting – often a more challenging group.

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Back, butt and hamstrings are prime movers.

How do we usually end up – well we have a few common features

Cue One: We usually coach an increase in hip flexion – this allows a umber of things to change. It increases your flight time – which is linked to speed, it shortens your stride length and usually results in a vertical shin at initial contact, and also stiffens the leg in stance phase – all good things in terms of efficiency

Cue Two: We usually work on a mid foot landing  - not because you cant run forefoot or rear, but usually it makes learning the transitions easier

Cue Three: This varies dependent on the goal, some runners need increased leg stiffness to reduce knee loading, others need to increase step width to reduce lateral knee loading and assist hip muscle extension, or you might ‘fall forward ‘ trying to use gravity which puts to much work on your hip flexors and quads.