Physical Therapy for Runners

By Clint Choquette DPT, Habits Physical Therapy, Nampa, ID

When we think about sports and injuries, I think most of us think about sports with high intensity demands like basketball. I think people often think of running and jogging as a safer alternative, which is true to some extent. You do not often see the traumatic injuries with running that you do from other sports. But looking at the research, if you are a regular runner, your odds of having some sort of injury in any given year is somewhere near 50%!! That is high and I think much too high. Now a good majority of those are minor, but we do run risks of having more serious injuries like bone stress injuries and chronic injuries like tendinopathy can keep coming back time after time.

When I look around the world of physical therapy for runners, I see a ton of running analysis. I have my doubts at how good we actually are at making positive changes off just running analysis. I do think that gathering a video of yourself running can be a starting point and can give you some basic information, however I feel there are a lot of false promises out there regarding running analysis. I think it often gets promoted as the most important thing when it comes to running performance, injury prevention, or recovery from injury when in reality I think it is much further down on the hierarchy than that. There are some studies out there that correlate running efficiency with certain running characteristics. Now one would think that if you just train and work on those specific characteristics that you would in turn become faster. Unfortantely it is not that simple. Making changes to running form can be very challenging to begin with. We have a lifetime of an ingrained habit that can be difficult to re-train. And even if we are able to make subtle adjustments there is a not much out there to suggest that we actually get faster.

There is so much that goes into running form. Our individual characteristics make up a huge portion of it including our muscles and tendon lengths as well as our individual bone structure. Some of our form is a bit self-determined by who we are and how we are made and what activities we have done throughout our life. There are also other things like our tendon stiffness and muscle tone that can make someone run a bit differently. Even when we look at elite level runners, almost all of them have their own running characteristics, which to me suggests there is no perfect running form we should be trying to achieve. I think we should work on making our own stride as efficient as it can be.

Now back to the running analysis. There are so many different factors that can be measured or tweaked. I have listened to a few talks from people who spend their whole lives dedicated to running coaching/rehab talk about the complexity of running analysis I think it would gives me some doubt about how effective most of us are at breaking it all down correctly and making the appropriate changes. Even those talks have emphasized how difficult it is to actually change someone’s form for the positive and have that change stick. The other thing I would caution someone who is about to make a switch to their running form would be injury risk. I know that probably sounds interesting, because we always hear we need to change our form to reduce our injury risk. I want to look at the other side of it. We have likely ran one way our entire lives. As a result our body has adapted to handle that particular stress. Lets say for example you are a heel striker with knee pain that wants to switch to a forefoot strike to reduce the stress on your knees. While I do agree that pattern would stress your knees less and possibly lead to a change in knee pain over time, we need to think about the new structures that are now taking on the load. The calf complex and achilles are now taking on way more stress than they have been adapted to for your entire life. The risk of eventually having an overuse injury in that area is very high. If you do feel it is necessary to make a form adjustment you need to do this very slowly over time. I typically will go with changing your load not by drastic form changes, but rather changing the terrain (incline vs not incline), footwear (its amazing how different footwear can shift load), and cadence. But often even these are short term changes to unload the structure that needs it to allow healing time before slowly introducing load again over time. There are other components that go into it, like strength and plyo type training while recovery to help build resiliency in that structure.

Most average runners would benefit most from a safe program that lets them run consistently injury free over time. The longer you can train without a significant break due to injury and the more you can eventually run; you will slowly become a more efficient runner. I think that’s the true low hanging fruit and unfortunately there is no short cut around it. Hardwork, patience, and dedication will eventually get you there. Now the trick is trying to figure out a program that lets you run more over time without getting injured. As we discussed earlier the incident can be as high as 50% that a runner will suffer a setback in any given year. There is no failproof method to preventing injuries but 50% is too high. I won’t make false promises that you can “bulletproof” your knees. That doesn’t exist and if someone tells you that I would be wary of their advice. You could do the best knee exercises in the world and if you increase your weekly mileage too much too often you are going to end up with an injury. There are ways however to greatly reduce your risk of injury through smart training and some time in the gym. Every individual is different and requires a different approach based on what experiences, training volume and injury history you have to begin with. I would be happy to help guide you through this process.

📞 Contact:
Habits Physical Therapy LLC
8 6th St N, Suite 102
Nampa, ID 83687
406-560-1048
habitspt.com