Dr. of Physical Therapy Kelly Starrett continues to put out very useful information via his site MobilityWOD.  Torque and Trunk Stability Part I: How to Stand is a recent post.  It discusses trunk and hip mechanics with regard to standing. Does this sound to simple a topic?  Standing?  Perhaps not.

As I’ve mentioned before (here and here) we often don’t walk very well. Strangely, it’s not uncommon for us to stand incorrectly or less than optimally.  As with walking, it so happens we stand a lot.  And if we’re doing it improperly then we very likely are moving toward injury and pain or at the very least, poor performance.

The themes in this video appear in a lot of other MobilityWOD videos (like this one on the set up for the deadlift.)  The concepts of trunk stability via glute and abdominal contraction are hugely important.  As is the idea of torquing or twisting the legs out in order to create stiffness through the legs and hips.   (Similarly for the upper body it’s a good idea to torque out or externally rotate the arms during pressing movements.)

I’ve been using these concepts in my own workouts as well as with my clients and I’ve seen some very good results: more strength, less knee pain and instability, better overall technique.  All of this is good.

If you’re one of my clients then this stuff is homework. If you’re not one of my clients but you want to perform better.  Go ahead and make it homework anyway. See if it helps your squat, deadlift or sitting to standing from a chair–or the ground preferably.

“That is, once the runners were tired, their form got sloppier, theoretically raising their risk for a tibial stress fracture.”
- Runner’s World

Running while fatigued increases stress fracture risk.

I’ve discussed several times (here, here and here) the idea that if we train too hard, we’re courting injury. An article in Runner’s World gives more evidence to support this idea. The article cites recent research from Medicine & Science in Sports & Exercise. As the test subjects ran, researchers monitored several movement patterns that were indicative of tibial stress fractures.  As the subjects ran and became more fatigued, these movement patterns became exacerbated.

To me, the messages are first pay attention to your running form.  Running is a skill.  That’s why I don’t wear headphones anymore when running. Pay attention to how you run!  Second, finish your run when you still feel good.  Don’t kill yourself (except during a race) when you’re training.  Don’t be afraid to quit early or skip a day if you’re very fatigued.

“Liking to run, it seems, may have helped to make humans what they are.”
-NY Times Phys Ed

Running & evolution

Running for enjoyment is sort of a strange thing.  Non-runners will agree with me.  From an evolutionary perspective, doing something that uses up energy and exposes us to injury really doesn’t make sense.  Yet many of us love it.  Why?  It’s this question that’s discussed in a recent New York Times Phys Ed section.  Recent research in the Journal of Experimental Biology examines the matter.  Turns out humans and dogs show increased circulating endocannabinoids post run.  Walking however does not induce the same reaction.  Nor, in this experiment did running have the same effect on ferrets.  Seems that dogs and humans may have a deeply wired reward system that’s tied to running.

The question is then asked why don’t more of us run?  Dr. David A. Raichlen, a professor of anthropology at the University of Arizona, who led the study answered, “That’s the million dollar question.  It appears from our study that we have the evolutionary drive” to exercise. But modern man has learned to ignore it.

I absolutely believe we were meant to run.  And running with a dog?  There’s nothing like it in life.

In the previous post I discussed my difficulty in solving my running-related pain issues.  Analyzing and changing one’s running technique is a challenging thing, but I’m going to attempt it.  I’m mainly going to discuss running here but these concepts apply to walking as well.  (Don’t think that poor walking mechanics don’t matter.  We spend a lot of time walking.  If we’re doing it wrong then we’re really hammering the body into a mangled mess.)

Really important thing #1: Let the foot drop right below you.  Don’t reach out with your heel.

It’s vital to get the foot strike correct when running.  I now realize that for years I was reaching forward with my leg, putting my heel out in front of me, and hitting the ground with my heel. This is bad.  It promotes overuse of the hamstring muscles and de-emphasizes the glutes.

I then spent the past year to year-and-a-half trying a forefoot strike.  I thought this was an effective correction of my heel strike but I was still doing several things wrong.  First, I was still reaching out ahead of me.  As a result I was still using my hamstrings too much and I wasn’t using my glutes enough.  And though I was hitting with my forefoot and avoiding a heel strike, I wasn’t allowing my heel to settle to the ground.

Now I’m doing things a lot better.  First, I drop my foot directly below me.  In fact, it feels like my foot is dropping behind me.  Let me emphasize the word “drop.”  I passively let the leg unfold underneath me and let gravity pull my foot to the ground.  I don’t actively try to do much of anything with my foot.  I often pay attention to how things feel down there but I don’t try to pull my foot off the ground or push off in any particular way.  Steve Magness discusses this process in is superb post How to run with proper biomechanics.  I’ve bolded the key points:

Once the knee has cycled through, the lower leg should drop to the ground so that it hits close to under your center of gravity. When foot contact is made, it should be made where the lower leg is 90 degrees to the ground. This puts it in optimal position for force production. The leg does not extend outwards like is seen in most joggers and there is no reaching for the ground. Reaching out with the lower leg results in over striding and creates a braking action. Another common mistake is people extending the lower leg out slightly and then pulling it back in a paw like action before ground contact. They are trying to get quick with the foot and create a negative acceleration. This is incorrect and does not lead to shorter ground contact times or better positioning for force production. Instead the paw back motion simply engages the hamstrings and other muscles to a greater degree than necessary, thus wasting energy. The leg should simply unfold and drop underneath the runner.

I know I’m running well when it actually feels like the foot is dropping behind me.  (It’s not actually behind me, it’s just dropping quite a bit further back than it used to.)  I now focus on hip extension when I run, or using my glutes to drive my leg back.  With this proper foot placement I can feel my glutes turn on and propel me forward.  It helps to have a slight forward lean through this process.

Really important thing #2: Lengthen through the hip

This concept of what I call “lengthening through the hip” has had a massive impact on my walking and running technique and thus my pain issues as well.  Denver-area physical therapist Rick Olderman helped me solve a strange little bodily riddle I’d had for years, and this hip lengthening process was right at the core of it.

For a long time I noticed that standing on my right leg was a lot different from standing on my left.  When I would stand on my right leg I always sort of tipped or shifted to the right.  It didn’t feel right.  My balance would shift in a sort of exaggerated way.  This was happening every step.  Standing incorrectly on my right leg when walking and running also meant I would land badly on my left leg.  Lengthening up and pressing my weight through my hip into my foot solved this issue.

This concept is a little tough to effectively describe in words but here goes:  As my foot hits the ground below me, I think of lifting my trunk away from hip.  In my mind the hip and the rib cage of the stance leg are separating–moving away from each other, and I’m sort of getting taller in the process.  I don’t think of bounding or hopping though.  I’m trying to make my leg longer below me and behind me as I move forward. A slight lean forward from the ankles helps me do this all correctly.

This movement is sort of a subtle kind of thing to grasp.  Describing this process is sort of like describing chocolate to someone who’s never tasted it.  It’s not like simply flexing your elbow or bending your knee.  It’ll probably take a bit of practice to get a feel for this.  The goal should be to take this strange-feeling novel movement and turn it into a habit. The video below should help explain this.

However, just like throwing a baseball or shooting a basketball, running is a skill that must be learned.
- Steve Magness, running coach

For almost 10 years now I’ve confronted various chronic aches and pains.  I love to run but often my running efforts have been derailed by some extremely frustrating issues.  My most recent battle has been with Achilles pain/heel pain/plantar fascitis/somesuch in my left foot.  I’ve been dealing with these issues for about two years–and it’s driven me insane.

Of course the idea of quitting is nonsense.  Humans should be able to run.  I want to run and so I’ve searched for a solution.  I can very happily report that it seems I have indeed found the key and I’ve spent the past eight weeks or so running almost daily.  Seems up until recently I was walking and running incorrectly.  Now I know what I’m doing!

Thanks to Rick Olderman

First I must thank Denver-area physical therapist Rick Olderman for helping me with this process. He’s by far the best physical therapist I’ve ever worked with–and I’ve worked with quite a few.  Rick truly understands movement, not just muscles and joints. He’s helped me see and feel what I’ve been doing wrong and how to change my ways.  If you’re battling with chronic pain and you’re in the Denver area, I highly recommend a visit to Rick.

Tough concepts to discuss

The idea of learning (or re-learning) how to walk and run is sort of a strange thing to consider. Most of us are able to use our legs to ambulate across the earth at various speeds.  We typically don’t need to spend much time thinking about how to do this stuff, we just do it.  But how well do we run or walk?  In my case, I developed poor movement habits–but I didn’t know it.  I never actually lost the ability to walk/run, I just lost the ability to do these things efficiently and properly.  We know that habits are very hard to break, especially if we can’t identify them.

Identifying and dissecting poor walking/running habits is pretty tough.  We’re talking about fairly complex processes that we do without thinking.  It’s like blinking or breathing.  Analyzing this stuff is challenging and then teaching someone a new method of walking or running is even tougher.  As a strength coach and personal trainer, I can say that we rarely consider how to teach someone proper gait mechanics.  At the Science of Running, big-time running coach Steve Magness discusses this issue in his excellent blog post titled How to run with proper biomechanics (This post is absolutely essential reading for any runner or running coach.):

“Distance runners and coaches seem to hate the topic of running form. Most subscribe to the idea that a runner will naturally find his best stride and that stride should not be changed. However, just like throwing a baseball or shooting a basketball, running is a skill that must be learned. The problem with learning how to run is that there are so many wrong ideas out there. This is partly due to the complexity of the process and partly due to a lack of understanding of biomechanics. It’s my belief that the wide range of “correct” ways to run has led to this apathetic attitude towards running form changes by most athletes and coaches.”

Over the next several posts I’m going to discuss my understanding of gait mechanics and how you can analyze and improve your gait.

Recently I mentioned that you sit too much, and we looked at a hip mobility complex to help you combat the effects of sitting.  Here’s another very good hip mobility process from Kelly Starrett at MobilityWOD.com.

I’ve been doing this drill myself and with other clients and we’ve been seeing very nice results from loosening tight low backs to improving squat performance and generally realizing that we’ve got all kinds of tight, gunked-up tissue in our hips. All this tightness and restriction can mean trouble for knees, ankles, low backs, shoulders–all sorts of parts. Try this drill. Keep working on it. Do it frequently especially after long bike rides or any long period of sitting and before your workouts.

A recent study from the Institute of Human Nutrition at Columbia University indicates that lack of sleep contributes to overeating and thus obesity.  Here is the conclusion:

The findings of this study link restricted sleep and susceptibility to food stimuli and are consistent with the notion that reduced sleep may lead to greater propensity to overeat.

What’s happening here?  Researchers found that, “Overall neuronal activity in response to food stimuli was greater after restricted sleep than after habitual sleep. In addition, a relative increase in brain activity in areas associated with reward… in response to food stimuli, was observed.”

So it seems that sleep restriction caused subjects to like food more.  They found it more rewarding.  Weird!  The take home message is obvious: Get some sleep!

In this study subjects either slept about nine hours or were restricted to only four hours.  How much sleep should you get?  Ideal sleep time may vary from person to person.  WebMD says, “Most adults need seven to eight hours a night for the best amount of sleep, although some people may need as few as five hours or as many as 10 hours of sleep each day.”  If you’re a hard-training athlete then you probably need to be on the high side of those numbers.

The New York Times Health section discusses a study from the University of Colorado in Boulder comparing the metabolic costs of running in shoes vs running barefoot.  The results suggest that shod running is more energy efficient than unshod running.  These results deserve a few questions.  First some background on the study. 

Subjects of the study were 12 barefoot runners–runners who knew how to run barefoot in contrast to novice barefooters.  “It was important to find people who are used to running barefoot,” says Rodger Kram, a professor of integrative physiology, who oversaw the study.

These runners were then asked to run several times in a yoga sock on a treadmill or while wearing the 150 gram Nike Mayfly, a lightweight running shoe.  Then the researchers taped 150 grams’ worth of thin lead strips to the top of runners’ sock feet. By adding an equal amount of weight to the bare foot, they could learn whether barefoot running or shod running was more efficient.  The study reports these findings:

1. For every 100g (3.5oz) (the average weight of a deck of playing cards) added per foot, energy cost increases by approximately 1% whether running barefoot or shod.

2. Running barefoot and in lightweight shoes do not significantly differ in energy cost.

3. When controlling for shoe/foot mass, running in lightweight shoes requires ~3-4% less energy than running barefoot.

So it seems that wearing a shoe is a good idea if you want to conserve energy as you run.  This would be important obviously during a race.  Here are some questions and observations:

1. The positive result of wearing a shoe was seen in 8 of the 12 runners.  That means 1/3 of the subjects saw no advantage from running in shoes.  Extrapolated out to a large population that means a significant number of barefoot runners are at no disadvantage running in bare feet.  I wonder if any of them are more efficient in bare feet?

2. The study was done on a treadmill.  Treadmill running is quite different from real running.  What if the study was done on a road or trail?

3. The study looked at the Nike Mayfly.  What about other shoes?  It’s a light shoe.  Would even lighter shoes be better efficiency?

4. A commentator on the Times article made the following observation: “Flaw: the only way for the comparison to be valid is if the weight distribution of added weights were precisely the same as the weight distribution of the shoes themselves. Anyone who has ever studied the effects of mass distribution on movement would know that.”

So did the way the weight was added to the (mostly) bare feet affect the runners’ efficiency?  What if the weight was distributed differently?

5. The study enlisted experienced barefoot runners as subjects.  Alex Hutchinson of Sweat Science and Runner’s World discusses that issue:

Finally, all the runners were midfoot or forefoot strikers, both barefoot and in shoes. This condition was imposed to prevent confounding effects from comparing rearfoot to forefoot striking efficiency.

These conditions raise an important caveat. One of the proposed advantages of barefoot-minimalist running is that it automatically helps to correct overstriding — an extremely common problem among inexperienced runners. The fact that all these runners were already forefoot strikes suggests that none of them were likely overstriding, which would make them less likely to benefit from barefoot running. It’s possible that a truly ‘random’ group of runners might have been less efficient in the shod condition, because more of them would have been dramatically overstriding.

It’s good that someone has done this study.  The debate isn’t over and it’s always good to have another view.  There’s plenty more studying to be done.

One thing that I keep coming back to is the fact that the fastest runners in the world wear shoes–at least when racing.  So from the performance standpoint there seems to be some benefit to putting something on your feet.  Further, if you’re happy with you performance and enjoyment of running then you should probably stay with what you’re doing whether it’s shod or unshod.

I’ve recently mentioned California-based physical therapist Kelly Starrett, and his very interesting blog MobilityWOD.com.  (I’m doing his Mobility Course in Denver at the end of April.)  One of his posts discusses why sitting is poison for your ability to move.  (Also, check out Why sitting all day is slowly killing you for more details on this evil activity.)  He’s on to something.  Sitting is bad and we need to do something about it.

You sit too much.

By the way, if you’re saying, “But I don’t sit that much,” I have several questions for you:

1) Are you a non-Amish/non-lumberjack American in the modern world?  If you say “yes” then you sit too much.

2) Do you own a car?  If you say “yes” then you sit too much.

3) Is there a desk and/or a computer involved in your life?  Clearly your answer is “yes” because you’re reading this.

4) Are you a cyclist?  If it’s “yes” then you sit too much.

5) You sit too much.

Deep posterior hip muscles

Effects of sitting

So what does sitting do to us?  First, we get restrictions in a bunch of our muscles and tissues.  Particularly we see restrictions in our posterior hip capsule.  This type of restriction can contribute to a condition called anterior femoral glide syndrome, which can cause pain at the front of the hip and generally bad movement.  Further, the various

muscles in this region can become impaired, tight and weak.  Sitting shuts down these muscles and our brain literally forgets how to use these extremely important movers and stabilizers.  All of this can result in various aches and pains, poor balance, difficulty sitting and standing, poor running form, poor lifting form–it’s all bad!! What’s the solution?

Mobilize & strengthen

Superficial posterior hip muscles

The best way to address these restrictions is to move.  We’ve got to move the tight tissues and we have to re-learn how to operate these muscles that have likely gone dormant.  What follows are three drills borrowed and adapted from Shirley Sahrmann and Nick Tumminello.

Simply doing these movements and feeling a stretch in the hip will help loosen tight tissue, but we want to go beyond that.  Again, we need to re-learn how to use these muscles and in order to do that you must contract them as you’re doing these drills.  Think of adjusting the tension of your glutes in much the same way as you’d adjust the tension of your bicep during a bicep curl.  You’ll maintain tension throughout the movement even as the muscle become stretched.  You’ll probably

find it difficult to maintain a perceptible contraction as the glute stretch.  Work on it.  It’s a skill that you should develop in order to overcome pain and perform better.  It’ll take practice but the payoff will be tremendous.

Here are several things from food, books, exercises and blogs of which you should be aware.  This is information and exercise that will improve your health and performance.

Look at this blog: MobilityWOD

MobilityWOD.com or Mobility Workout of the Day is a blog from Dr. Kelly Starrett.  Kelly is a San Francisco-based physical therapist and Crossfit affiliate.  His blog is chock full of how-to videos designed to improve your movement and fend off or overcome injury.  Just the other day I watched Tight Ankles = Bad Squatting.  I tried the drill and my years-long on-again-off-again right ankle pain was gone!  Gotta love instantaneous results!

Read this book: Diagnosis and Treatment of Movement Impairment Syndromes by Shirley Sahrmann

Okay, read this book only if you’re a fitness or injury rehab professional.  Diagnosis and Treatment of Movement Impairment Syndromes is a tremendously detailed text on how to identify and fix movement problems.  I’m wading through it right now and it’s a challenge but the information is amazing. If you’re in the fitness/rehab industry, definitely get this book.  Dr. Sahrmann’s second book is Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines.  I’m looking forward to that one too.

The author, Shirley Sahrmann, DPT is a pioneering, award-winning physical therapist.  She’s a professor at the Washington University School of Medicine in St. Louis.

Take this supplement: Vitamin D

Vitamin D is important for a wide range of healthy human functions.  Vitamin D is a key component of calcium absorption and thus bone health.  Low levels of Vitamin D are associated with asthma and some cancers.  It seems to offer a protective effect against multiple sclerosis and it boosts immune function. Unfortunately Vitamin D doesn’t show up naturally in too many foods.  Some foods are fortified with Vitamin D but supplementation may be the best way to ensure adequate Vitamin D intake.

Humans with sufficient sun exposure have the ability to manufacture Vitamin D.  It’s still cold in much of the country so that means minimal sun exposure–so there’s a good reason to supplement.  (Interestingly, using to much sun screen too often may be problematic in Vitamin D production.  Like many things, eliminating sun exposure may be unhealthy.  Don’t be terrified of the sun.)  Further, people with dark skin and older folks have a tougher time manufacturing Vitamin D.

Recommendations vary but it’s from 2,000 and 5,000 IU per day from supplements and sun is a good idea.  Big men need more Vitamin D than small women.

Do this exercise: the deadlift

Picking up heavy things off of the ground is something homo sapiens have been doing since… well… before we were actually homo sapiens.  As long as there’s  gravity we’ll keep doing it.  That’s what the deadlift is: pulling a weight off of the ground from a dead stop.  The deadlift isn’t just for powerlifters either.  It’s a tremendous total-body strengthening exercise that anyone can do with proper coaching. If you learn to deadlift then you’ve learned to use good body mechanics to lift an object.

Here’s a good instructional article on the deadlift from Stronglifts.com.  And here’s a rather poetic video on the deadlift from Crossfit.

Eat this: coconut oil

Coconut oil seems to carry a whole raft of health benefits.  Weight loss, improved immune function, better digestion, favorable cholesterol profile are a few of the likely benefits of coconut oil consumption.  You can cook with it, put it in smoothies, rub in on you skin and put it in your hair.  What other product is so versatile?

If you’re a client of mine then you’re at least a little aware of how important eyes, visual skills, and visual reflexes are to our health and performance.  As part of the Z-Health Performance System, we’re taught that vision sits atop our neurological hierarchy.  If we have a visual impairment (could be anything from a phoria, a convergence/divergence issue, diplopia or other issues) then literally our survival is at risk.  Now there’s more information regarding the far-reaching importance of our eyes to our health.

The New York Times has a fascinating article titled Aging of Eyes is Blamed for Range of Health Woes.  The article discusses research from the University of Kansas that reveals the impact of aging eyes on our circadian rhythms (aka body clock) and by extension our general health.  The article states, “This internal clock relies on light to function properly, and studies have found that people whose circadian rhythms are out of sync, like shift workers, are at greater risk for a number of ailments, including insomnia, heart disease and cancer.”

Of particular importance is the role of blue light, the cells that pick up the light, and melatonin production.  It seems that some cataract surgery may hinder the relationship between these factors.  Here’s what the article says:

“Researchers in Sweden studied patients who had cataract surgery to remove their clouded lenses and implant clear intraocular lenses. They found that the incidence of insomnia and daytime sleepiness was significantly reduced. Another study found improved reaction time after cataract surgery.

‘We believe that it will eventually be shown that cataract surgery results in higher levels of melatonin, and those people will be less likely to have health problems like cancer and heart disease,’ [researcher] Dr. Patricia Turner said.

That is why [researcher] Dr. Martin Mainster and Dr. Turner question a practice common in cataract surgery. About one-third of the intraocular lenses implanted worldwide are blue-blocking lenses, intended to reduce the risk of macular degeneration by limiting exposure to potentially damaging light.

But there is no good evidence showing that people who have cataract surgery are at greater risk of macular degeneration. And evidence of the body’s need for blue light is increasing, some experts say.

‘You can always wear sunglasses if you’re in a brilliant environment that’s uncomfortable. You can remove those sunglasses for optimal circadian function, but you can’t take out the filters if they’re permanently implanted in your eyes,’ Dr. Mainster said.

Because of these light-filtering changes, Dr. Mainster and Dr. Turner believe that with age, people should make an effort to expose themselves to bright sunlight or bright indoor lighting when they cannot get outdoors. Older adults are at particular risk, because they spend more time indoors.”

Fascinating stuff!!!  (By the way, when you workout, do you exercise your eyes?  Do you consider your eye muscles?  Think about it.)