Running posture, glutes, cramps and Achilles tendinopathy

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I’ve written several times about my problems with Achilles tendinopathy and plantar fasciits. I’ve also written an article about cramping. My solution has been to strengthen the lower legs for the Achilles problem, and strengthen the adductors and hamstrings to fix the cramping. I think the strength work has helped, but there’s more to the story.

A few weeks ago I attended a running seminar with Jay Dicharry, a physical therapist and running/cycling coach. It was a superb course and I got to revisit some biomechanics and running technique concepts to which I’d been exposed in the past.

We discussed stacking the ribs over the pelvis while running. This posture helps take pressure off the lumbar spine and it puts the pelvis in a position to optimize the use of muscles that attach to the pelvis, especially the glutes. This posture enables a runner to use the glutes to propel the runner forward which is an efficient way to run in that the gluteus maximus is the largest muscles in the body.

I realized during this discussion that though my running technique had improved, I could improve it a little more. Specifically, I saw that I wasn’t using my glutes enough to run and as a consequence, I was using my calves and probably my adductors (which extend the hip along with the hamstrings and glutes) too much. Forward propulsion wasn’t being distributed evenly among these muscles. The glutes weren’t doing their fair share to create hip extension and the abs weren’t helping maintain good pelvic position. The calves and adductors were doing too much work. The overexertion was causing excessive strain on the Achilles and plantar fascia, and causing early fatigue of the adductors which led to cramps.

I believe I can also trace my ~10 years of low-back pain to this faulty running technique. Again, my lack of glute contribution demanded that I use lumbar extension to get my leg behind me.

This position brought on low-back pain, hamstring/adductor cramps, and Achilles/foot pain.

 

I’ve been running a little differently lately. I’ve become more aware of where my ribs are positioned in relation to my pelvis. I’ve also tuned in to my glutes. I work to feel them contract to push me forward. I’m aware of my ribs being stacked over my pelvis as I run.

This position is better for me. I’m stronger, more efficient, and I don’t hurt. The glutes and abs are doing their job.

This isn’t the first time in my fitness career that I’ve reexamined something I thought I understood only to realize I’d missed something significant. Coming back to information like this is similar to reading a good book a second time in that I see the same information in a different way. This second exposure to core and glute function expanded my understanding tremendously.

Thoughts on Posture: Part II

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In the previous post, I discussed a few thoughts, ideas and myths surrounding our posture. A key concept is that posture actually isn’t tied very strongly to back pain. There are still good reasons to learn and practice good posture though.

Proper posture while lifting

Let’s think of a squat or deadlift. In these exercises, the legs are the engines that drive the exercise. They provide the “oomph” to move the barbell (or whatever implement) we’re holding in your arms/hands. The trunk is the transmission between the engines and the arms/hands/object.

The deadlift done wrong (left) and well (right.)

Keeping the spine braced in a neutral position ensures the best, most efficient transfer of force from the legs into the barbell. If the spine twists or bends then we leak force and risk injury.

Hold this posture during a push-up.

Glutes, abs and shoulder muscles are engaged. Keep it this way during a push-up.

 

 

Similarly, look at a push-up. Here, the arms and the shoulders are the drivers and the rest of the body is the implement we’re moving. We again want to keep the trunk rigid and braced, not loose, deflated and floppy. With proper technique we get a more thorough range of motion and stimulate the working muscles more. By doing a push-up in good posture, you’ll essentially get more out of the exercise than if you do it with poor posture. Risk of shoulder and back injury is reduced too.

Bad push-up!  No!

Bad push-up! No!

We can expand our view of posture out to any number of sports from running to golf to tennis to whatever else you like. In the vast majority of our sports, we want to keep solid posture so we can most effectively transmit force (usually) into the ground and into something like a club, a ball or an opponent.

In the grand scheme, good solid posture will enable you to lift more weight which will enable you to reach your fitness goals faster and more effectively. We can also make our sporting movements more effective through the use of good posture. You’ll avoid injury too which will allow you to train longer and more consistently.

Posture and safety.

Okay, in the last post, I mentioned that pain isn’t strongly linked to posture. Yet in this post (above) I’ve suggested that braced, neutral posture while lifting can help prevent injury. Am I contradicting myself? Not entirely.

If we load our joints at the far ends of where they can move then we do risk doing damage to joint tissues and this may bring on pain. So we want to avoid excessive spinal flexion, and/or spinal extension, and/or spinal twisting when lifting. Yes our spine can and should bend and twist, just not under heavy load. Rather we should put the spine in neutral and brace with the trunk muscles before we lift.

Posture for looks

Why do most people work out? Looks, no? For most of us, looks is somewhere on our list of reasons we exercise. We want to look lean and strong. Adopting good, erect, tall posture will instantaneously improve our appearance. Incredible! Tall posture makes us appear leaner and stronger. Slumped posture makes us look pudgy and weak. Look at the pictures and you be the judge.

(Ironically, when I look around the gym, I see lots of people exercising in very bad posture. Presumably they want good looks yet they engage in activities that only reinforce bad posture. Crunches may be the most effective way of promoting slumped, head-forward-style bad posture.)

Posture and confidence — (Yes posture and the brain are linked!)

Power Posture!

Power Posture!

The same tall posture described above makes you feel better and more confident. Don’t believe me?

He looks like a leader.

He looks like a leader.

Here’s the abstract from a study looking at this phenomenon (emphasis is mine.):

“Building on the notion of embodied attitudes, we examined how body postures can influence self-evaluations by affecting thought confidence, a meta-cognitive process. Specifically, participants were asked to think about and write down their best or worse qualities while they were sitting down with their back erect and pushing their chest out (confident posture) or slouched forward with their back curved (doubtful posture). Then, participants completed a number of measures and reported their self-evaluations. In line with the self-validation hypothesis, we predicted and found that the effect of the direction of thoughts (positive/negative) on self-related attitudes was significantly greater when participants wrote their thoughts in the confident than in the doubtful posture. These postures did not influence the number or quality of thoughts listed, but did have an impact on the confidence with which people held their thoughts.”

Here’s an excerpt from an article in Scientific American on the same subject:

“More impressively, expansive postures also altered the participants’ hormone levels. Using salivary samples, Carney and colleagues found that expansive postures led individuals to experience elevated testosterone (T) and decreased cortisol (C). This neuroendocrine profile of High T and Low C has been consistently linked to such outcomes as disease resistance and leadership abilities.”

and

“Together, these recent discoveries bolster the notion that power is grounded in the body. Not only does power change the body, but altering one’s postures changes one’s power, or at least the psychological experience of it.”

Finally, for a little more about the power of posture, here’s Amy Cuddy discussing the topic in a TED Talk:

Thoughts on Posture: Part I

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Mom often told us to “stand up straight.” (Did she ever explain how to do it though?)Look around you and you’ll see some spectacularly “bad” posture. Slumped spines are all around us.

How important is posture with regard to pain? For a long time, various schools of thought have insisted that poor posture causes back pain, neck pain, shoulder pain and all sorts of other ailments. The fact is though posture and pain don’t really correlate all that well. Research by pain scientists have observed the following:

Posture_types_(vertebral_column)

  • people in pain showing poor posture
  • people in pain showing good posture
  • people without pain in good posture
  • people without pain in bad posture

 

So we see that posture really isn’t strongly linked directly to pain. Further, we can’t really tell the chickens from the eggs: Did poor posture bring pain or did pain bring on poor posture. Or maybe we see both poor posture and pain in someone yet they really don’t have anything to do with each other.  Sort of like hair and headaches. We often see them both in the same person yet we know they don’t really have anything to do with the other.

Todd Hargrove at BetterMovement.com wrote a great post on all of this called Back Pain Myths: Posture, Core Strength, Bulging Discs. He writes the following:

“In one study, researchers looked at the posture of teenagers and then tracked who developed back pain in adulthood. Teenagers with postural asymmetry, thoracic kyphosis (chest slumping) and lumbar lordosis (overly arched low lack) were no more likely to develop back pain than others with “better” posture.

Another study looked at increases in low back curve and pelvic angle due to pregnancy. The women with more postural distortion were no more likely to have back pain during the pregnancy. A systematic review of more than fifty four studies found no good evidence of a correlation between posture and pain. Leg length inequality seems to have no effect on back pain unless it is more than 20 mm (the average leg length difference is 5.2 mm). Hamstring and psoas tightness do not predict back pain.

These results are particularly striking given that many studies have quite easily found other factors that correlate well with low back pain, such as exercise, job satisfaction, educational level, stress, and smoking. Although some studies have found a correlation between back pain and posture, it is important to remember that correlation does not equal causation. It may be pain is causing the bad posture and not the other way around. This is a very likely possibility. People will spontaneously adopt different postural strategies when injected with a painful solution. Big surprise!”

What am I trying to say here? That posture doesn’t matter and that we should ignore it? Nope. I’ll give you some reasons to pay attention to posture:

  • Proper posture while lifting makes you stronger.
  • Proper lifting posture keeps you safe.
  • Tall, erect posture makes you look better.
  • This same tall posture makes you feel better and more confident. (Yes, the brain and posture are strongly linked!)

I’ll get into these topics in the next post.

Fairly Profound Stuff: How to Stand

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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.