You can Run Pain Free
If you want to run pain free you have to believe the following:
- running is a skill
- running involves absorbing, stabilizing, and creating force
Running is a Skill
Yes, we are all "Born to Run", but sadly most people over the age of 10 in the United States have lost the ability to do so efficiently, effectively, and most importantly pain free. Olympic athletes spend thousands of hours perfecting the skills involved in their sports. From archery to weightlifting, basketball to judo each athlete masters the minutia of absorbing, stabilizing, and creating the forces needed to perfect their skills and sports. Olympic runners are no different. If you want to run pain free you must see yourself as an athlete. You do not have to be able to run an Olympic qualifying time, but you must be willing to wrestle with Newton's 3rd Law of Motion and it's implications on your stride.
Running is Absorbing - Stabilizing and Creating Forces
We all remember Newton's 3rd Law of Motion: "When one body exerts a force on a second body, the second body simultaneously exerts a force equal in magnitude and opposite in direction on the first body." (1) What this means is that when your foot lands on the ground (1st body) it is exerting force into the ground (2nd body). The ground exerts a force equal to the force you land with back at you. Your body must then absorb that force, stabilize your body, and then create enough force to propel you into your next stride.
Your stride will dictate how your body absorbs these forces. I have seen pain free running accomplished with multiple types of strikes. My goal today is not to try and convince you to become a heel, mid-foot, or forefoot striker. My goal is to introduce you to a process that will allow you to find your own perfect and personal stride. Right now I want to make sure that you are aware of the fact that how your foot lands determines how each joint above it will respond. How your foot lands also determines which muscles will carry the majority of the absorbing, stabilizing, and force generating workload.
Almost all of the running pains and injuries people come to me with are from overuse and inefficiently absorbing and stabilizing landing forces. Once you identify how you are landing, who is absorbing and stabilizing, then you can determine which of the four steps you need to focus on. So like it or not, that 9th grade physics class is a needed part in understanding what it is going to take to make you a pain free runner.
Step 1 - Get an Evaluation
You need to have an outside observer evaluate your running form. An experienced eye will be able to quickly help you understand what you are doing, why you are doing it. I take things one step further with a literal hands on biomechanical, neuromuscular, and soft tissue evaluation with my clients. This is an in-depth look for me and my clients. I am better able to see how they are absorbing, stabilizing, and creating forces. This processes allows me to better educates the runner in the full spectrum of their stride and let's me know two important things: 1) What treatment will be the most effective. 2) What self-care will be most effective.
One caveat on getting an evaluation. You want more than going to a running store with a treadmill. Take the time and energy to be evaluated by a coach or therapist who has an experienced eye and a toolkit beyond a shoe recommendation to help you run pain free. You will need more then a shoe recommendation going into the next step.
Step 2 - Treatment
You end goal for this step should be to:
- get out of pain
- understand how you got into a pain cycle
- prepare your body to better absorb and stabilize, the forces created by running
- have a proactive set of recovery tools to assist in managing your running workload
As I mentioned above, almost all of the running pains and injuries people come to me with are the result of overuse and inefficiently absorbing and stabilizing landing forces. When a muscle gets overused it gets tired. Tired muscles shorten in length to protect themselves. Shorten muscles create a constant tension on the tendons they attach to. This constant tendon tension sends a pain single to the brain saying, "Hey I'm tired! Get someone else to do the work!"
The conventional quick fix is orthotics or a more supportive shoe with a dose of anti-inflammatories. This approach does changes how your body absorbs the forces and mask the pain. But, only helps you reach one of the goals during the treatment step, it gets you out of pain. In my experience, this approach ends up causing more problems then it solves.
I have found a more productive approach to be first addressing the protective neurological loops keeping the muscles tight. Then returning them to their full resting length. I do this with my clients using a series of hands on bodywork techniques and exercises. I strongly encourage you to find a problem solving massage therapist, physical therapist, or chiropractor who does hands on bodywork. They can assist you in understanding and treating the underlining neurological compensations and protective loops that may be holding you back and keeping you in pain.
Once you are able to get the muscles relaxed and at their full length the tension is taken off the tendons. With the tension removed, the overuse pain can be greatly reduced and even eliminated in one treatment, in my experience. If pain levels are not reduced or if you have sharp pains then tissue or structural damage may be the cause of the pain. An experienced therapist should be able help you sort that out. Moving forward in this hypothetical I am assuming that there is no tissue or structural damage.
With the protective loops turned off and pain reduced a self-care and treatment plan is needed to continue improving the quality of the soft tissue and reeducate the kinetic chain to function properly. The type of self-care can range from passive postural release and static stretching technique, to more aggressive trigger point release and mobility work. *This phase of treatment may include alternative exercises to maintain conditioning while giving the effected running muscles and tissues more time to rest and recover. Supplemental exercises may also be needed to strengthen weak muscles to better assist your prime stabilizers and movers when you get back to running. As you can can see at this point Steps 2 - Treatment, and Steps 3 - Coaching, begin to blend. So moving into the next step we are assuming pain free movement without a running load. During running we're assuming pain levels less the 3 on a scale of 0-10.
Step 3 - Coaching
Coaching is where art meets science. We can argue and explain all the textbook ways the body is suppose to heal, suppose to move, and what the best treatment is suppose to be, but then reality kicks in. The reality that people want to continue to run when they shouldn't be for competition and mental health reasons. The realities of past injuries, age, weight, and life schedules. It is imperative for you to take ownership of knowing when to push and when to back off. In the end you are and will be your best coach. Until then finding an experienced coach to help you through the transition of pain to performance is a must.
A good coach will see what adjustments your stride needs. They will give you the tools and insights you need to make the adjustments. Based on your goals, needs, and body type, they should be able create an efficient program for you. They will saves you, time, energy, money, and a painful relapse. A big part of having a coach is their ability to help you adjust your workload during your recovery. To many people make the mistake of trying to train at the level they think they should be, not where they are. Don't make this mistake. Find a coach that can help you adjust your workload and understand what appropriate levels of pain and soreness to expect.
Step 4 - Equipment
I've run in all varieties of shoes, 5 Finger minimalist, super cushioned, neutral, supportive, and lots of things in-between. So what's the right shoe for you to wear to run pain free?
Remember, running is absorbing, stabilizing and creating forces:
- The shoe you wear dictates how your foot is allowed to land.
- How your foot lands determines your stride.
- Your stride, heel strike, mid-foot, or fore-foot determines how your body will absorb, stabilize, and create the forces generated by running.
With that in mind, the right shoe for you is one that allows your foot to land in a way that maximizes your ability to safely absorb and stabilize the running forces you generate with your stride. Not the one that someone tells you "should" be the shoe you wear. Or the one with the best reviews. Your shoe has a job, help you "maximizes your ability to safely absorb and stabilize the running forces". If it's not doing that then it doesn't matter how "good" of a shoe it is.
A few things to keep in mind in finding the right shoe.
- There will be some trial and error.
- You may find different shoes work better for different goals.
- Go with what works until it doesn't.
If you are working on a new stride there will be benefits and failures for every shoe. Be prepared for some trial and error. Also remember each shoe is going to do somethings well and others not so good. The first question you need to ask is, "What do I need the shoe to do for me?". The second question is, "How is shoe going to help me better absorb, stabilize, or create running forces?"
You might wear a minimalist style shoe for hill intervals and short runs to build foot and low leg strength. A cushioned neutral shoe for longer steady state runs might give you the freedom you need to land optimally with the benefits of a little extra cushion. An intense downhill course may find you benefiting from a heavy cushioned and supported heel. Bottom line: go with what works for you and gets the job done, but be careful. I know it can be tempting to fall in love with a single pair of shoes as your holy grail. Just be ready to try something new if the need arrives.
Equipment needs can also included, wraps, braces, K-tape, compression socks, and yes even orthodics. Some equipment needs will find their way into your life just to get you through a race or an event. Others will become part your regular rotation. My advice for equipment is the same as for shoes. Ask yourself, "What do I need _______ to do for me?" and "How is ___________ going to help me better absorb, stabilize, or create running forces?" When you know the answer to these two questions it will allow you to make wiser and more effective purchases. Don't just guess, evaluate and test.
It's a Process
There is no set timeline on being able to run pain free. There is only a process. A process of learning and refining. Depending on how acute or chronic your pain is will determine the time frame it takes. It could take days, weeks, or even months. If you are in pain running right now you have a few options, quit running, cover up the pain with shots and pills, or learn from the pain through the process.
I do not have the answers to all the problems and pains associated with running. However, the above process has been built on a unique blend of qualifications and experience that continue to grow and evolve. You can make it your own, using your personal insights, experience, and team. And by taking ownership you too can run pain free.
Train Smart – Live Well – Play Often,
PS: Click here to see a list of the pains I have helped runners successfully treat in as little as one session. The above processes is built on real world success, not textbook ideas.
*If you are injured during training for an upcoming event you may need to find alternative ways to maintain your conditioning other than running. Other times alternatives may be needed simply for mental health. Whatever the reasons, there is so much more available and more productive then the "elliptical". Creative pool work and body weight exercises are just a few activities you can explore with your coach.
(1) Newton's laws of motion. (2016, September 16). In Wikipedia, The Free Encyclopedia. Retrieved 15:38, September 30, 2016, from https://en.wikipedia.org/w/index.php?title=Newton%27s_laws_of_motion&oldid=739707435