This is the second instalment in Carole Beck’s Running Rehab blog in which she gets her running injuries sorted before running a half-marathon on September 29th. This week, Carole undergoes biomechanical analysis, studying how her body moves. With the results, her running coach Scott Mitchell devises a running rehab plan and exercises.
This week, I had biomechanical analysis – a series of physical tests looking at how I move and the tension of my muscles – in Scott’s clinic at the Park Club in Acton, a glam gym, spa and club in west London.
Here are the results:
- We discovered last week that I strike the ground with my heel (rather than in the middle of the foot as you are supposed to do). It’s a really common problem among runners. This week’s biomechanical analysis showed Scott that heel striking is forcing my knees to bend to gain a longer stride. This is not good – the knee shouldn’t bend when it hits the ground.
- This bending in turn makes me bounce as I run, something that again is common. Inefficient runners go up and down when they run, Scott says, making it harder for their hamstring muscles to function effectively. ‘It’s while you’re in the air that you should cover the distance, not reaching out and trying to get a long stride length,” he explains.
- I also have tight bottom muscles – probably because of a combination of a) my pregnancies, b) sitting down at a computer for work all day, c) a bad habit of carrying my babies/ toddlers on one hip. Again tight glutes is a common running problem, and they can cause the position of the legs to change slightly, leading to pain. For me, these tight muscles are contributing to my left hip rotating inwardly, which in turn, makes my foot pronate in.
- My knees have been sore because all these factors add up to stress on these joints.
Apparently my bottom muscles are locked, so they can’t help stabilise my legs, pelvis and lumbar spine when I run. So to correct this, Scott uses a special physiotherapy trigger point technique to release the tightness in my glutes – or in other words, he jabs his elbow into various – very painful – points on my bottom cheeks for minutes on end to force the muscles to relax.
He also gives me a whole set of exercises to reduce muscle tightness and boost strength. I need to do three sets of 10 of each of these, three times a day (where to find the time?):
Long leg hip lift Lie on your back with one leg stretched out and the foot resting against the bottom of a sofa. Pull the other knee in to a running position, with the toes pulled up. With your arms by your side, raise your hips into the air and slowly lower down.
Glute stretch Lie on your back, with the right knee pulled in towards your chest and the left knee bent but the foot on the mat. Put your right hand on the outside of your right knee and your left hand on the right ankle. Pull this right knee gently in to the chest and towards the left side of the body. You should feel a strong stretch on your bottom. Hold, and repeat on the other side.
Cook hip lift Lie down on the mat, and pull one knee in to the chest and the other knee partially bent but with your foot flat on the floor. Rise up into a shoulder bridge, curling through your spine. Keep your hands on your knee. Hold for five seconds and the lower down gently. (See picture of starting position for this one.) This is a great exercise for the bottom and back of the thighs.
Shoulder bridge Lie on your back with both knees bent and your feet firmly on the ground. Keeping your arms by your side, curve through the bottom of your spine to lift your back off the air up to your shoulders, then curve back down again. (See picture for starting position of this one.) A great exercise for the back, bottom and hamstrings.
Calf stretches Use the bottom step of stairs for this one. Stand on a step with the edge of the step under the centre of one foot, so that it’s half-on and half-off. Lower the heel of this foot while keeping the ball of the foot firmly on the step. You should feel a strong stretch in the back of your calf. (Keep the other knee loosely bent rather than straight.) Hold for a minute before switching sides. Then try a variation: with the ball of your foot still half-way on the step as before, bend your knee towards the stairs. You should feel a stretch at the front of the calf now. Hold for a minute as before.
Lunges Do these one while you’re waiting for the kettle to boil or in TV ad breaks. This exercise builds hamstring strength but also helps you work on hitting the ground with the middle of your foot at speed while running. Hands on your hips, place your leg in a right angle as though you were going to run and pushing it into a lunge, let your foot hit the ground with some force. Make sure your knee and ankle are in a straight line. Lower to the ground. Then try the other leg in the same way, moving along the kitchen/ garden/ your hallway in this fashion.
Full single leg RDL (Romanian Dead Lift) Plant one leg on the floor with your knee loosely bent. Then lift the other leg behind you and lower your upper body so that they make a horizontal line. Stretch out your arms in front of you with your hands clasped and your face looking at the floor. (See picture for this one.) Hold for a couple of seconds.
If these exercises don’t work….
… Scott says we may have to look at putting inserts in my shoes. I’m not so keen but Scott says that they give the foot the tools it needs so that it’s positioned to work better.
Knee supports suck – for me anyway
I ask Scott about the knee supports that I’ve worn while running for 11-odd years now – ever since I trained for my last half marathon and my knees started getting sore. When I don’t wear the supports, it feels as though my knees wobble all over the place, and they hurt even more.
Scott shakes his head. Any benefit of these knee supports is apparently all in my mind.
‘The compression can give you a bit of comfort,’ he explains. ‘But they’re not changing anything structurally. Your knees are going all over the place even with the supports on.’
I’m disappointed – I thought I needed them physically, not psychologically. Fortunately, Scott says there’s no harm in wearing my knee supports, and as I don’t want to deal with this problem yet, I decide to postpone going cold turkey until after my upcoming half marathon.
As well as my exercises, Scott wants me to focus on picking up my heels at the back when I run. But I’ve also got a new running task – to concentrate on planting my leading foot straight down. So no bending the knee, and no reaching for a longer stride.
I set a reminder on my phone to do my stretching and strengthening exercises every day. Sometimes I forget, I’m afraid. But I know I’m only letting myself down if I don’t do them, so I make an effort to squeeze them in when possible – usually once the kids are tucked up in bed.
I’m back on the streets for an early morning five-mile run a couple of days after my appointment with Scott, and consciously planting my foot straight down as much as possible. At first it feels alien, and I have to stop a few times to practise the movement. It feels a bit like trying to rub your tummy while you pat your head at the same time – I can’t necessarily manage to do both movements with each step.
But with practice, and once I get some pace going, it does seem to work and, oh joy, I see that I can move faster with less effort. It also feels as though I’m not heel striking any more too – although that could be wishful thinking.
On the day of my long run, I tackle 13.5 miles. It feels tough still, even with this more efficient technique, but my knees don’t twinge once.
And in the hours afterwards, my body isn’t so sore. I can walk to the park with the kids without wincing, and I don’t stiffen up painfully after sitting on a bench for 10 minutes, like I did only last week.
Is this improved post-run recovery real, or actually all in my mind? Is my running getting better or am I just more used to covering the distance? I’m too confused to know any more after the burst bubble of my knee supports. Hopefully Scott will let me know next week.
SCOTT MITCHELL A physiotherapist and running coach, Scott has wide experience in managing musculoskeletal conditions, including running injuries. A runner, he has represented Australia at the Oceania Games in the 1500m and 5000m. He is director of Move Running, a specialist running clinic in west London. Follow Scott @move_running
Carole Beck, 40, is a freelance writer, specialising in health and parenting. She has three children, aged seven, five, and two, and writes a blog about trying to lead a healthier family life at Healthier Mummy. Follow Carole @Carole_Beck
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