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Athletic development specialists dedicated to the art and science of excellence in movement

Reasons to NOT Coach Running Form

In recent years the barefoot craze took hold of the running world.  Fortunately, excitement has receded as barefoot devotees get hurt, realize they haven’t gotten any faster, and find that their beloved Tarahumaras still haven’t won a darned thing and got their butts kicked on their home country at the Mexico City Olympics.  Hopefully barefoot training will return to its rightful place as an adjunct to shod running rather than a full replacement… 

So what’s next?  It’s likely the next running craze will focus on running form.  Heck, this craze has already taken hold in many places with “Form clinics” popping up all over the place.  While I believe there are potential benefits of such clinics in proper context, most clinics and form coaching provide superficial treatment to a complex area.  The reason we don’t do “form coaching” is that gait is an area that cannot and should not be addressed in isolation of other movement patterns.  I’d view any group “form clinic” with a hearty dose of skepticism.  If you aren’t going to commit to years of purposeful practice in this area, you’re better off leaving form alone and allowing it to evolve with improvements in overall movement.

Changing form in healthy runners is actually a new development.  Although gait has long offered a lens into the nervous system in rehabilitation settings, “the idea of using gait retraining in patients without neurological injury/pathology is rather uncommon.” (Heiderscheidt 2011)  Many coaches have seized on the idea of “form coaching” as an appealing quick fix for the consumer. With athletes often disenfranchised from the medical system, the idea of throwing some running form cues at an injury is alluring to many runners. 

In this post we’ll cover several factors often overlooked in the gait retraining process.  When you read these, you may reach the conclusion that actively changing running form for distance runners has very little place outside the medical setting.   And that’s the point.  Unless you have the ability to conduct a complete physical assessment or partner with someone who does, then running form coaching becomes an exercise in mere cosmetics.

One problem is that running form coaching ignores the role that fatigue.  Something may look “wrong” in someone with a history of injuries, but to conclude that form is the cause of the injuries is misguided.  Many runners note that pain sets in beyond a certain distance…But if form was the cause of pain, then why aren’t they hurting all the time or when they start running?  Clearly something besides form is at work.  If you have an audit system to parse the relative contributions of these factors, that’s wonderful, but very few people go through this effort.  It’s far more commercially appealing to say “let’s just fix your form with a few drills and all will be well!”

Evidence has shown that stride variability with the onset of fatigue is tied to injury.  Repeatability of the stride can be more important than actual form.  Meardon (2011) found that stride times of runners became more unpredictable during the course of a fatiguing run and that injured runners exhibited a tighter relationship between stride unpredictability and fatigue, “likely due to movement errors associated with fatigue necessitating frequent corrections.”   

Similarly, Clansey (2012) found that peak rear foot eversion, peak axial head acceleration, peak free moment and vertical loading rates increased during a series of repeated runs at lactate threshold pace.  Each of these changes is noted as a risk factor for tibial stress injuries.   While some claim that changes in form can make a runner more “efficient” and thus thwart the onset of fatigue, rarely does anyone provide proof that a form change actually improves efficiency.  To do so would require tools such as force plates, 3d motion capture systems, and devices to measure energy expenditure.   Without such measurements, “efficiency” is a hopelessly bald claim designed to lure the gullible consumer.      

Physical limitations play a role but are often overlooked when coaches move straight into sport specific movement corrections such as running form.  The run is an advanced form of gait and requires a measure of basic mobility, stability, and coordination to be accomplished safely.  For example, hip weakness tied to hip internal rotation (Souza 2009) and is tied to patellorfemoral pain.  Hip internal rotation was more predictive of pain than hip structure.  You aren’t going to fix such a weakness just by throwing the standard battery of running drills at people without getting to the actual cause of the movement dysfunction.  Personally, I think there is still plenty of value in drills as part of a carefully dynamic warmup tailored to the individual needs of the runner, but not in the haphazard manner most commonly applied by coaches.

Further, even if you do detect weakness, such as the link between hip instability and hip internal rotation, pain can distort one’s perception of what’s happening.  What is mechanically “right” may be actually be painful for that individual. Bolgla (2011) noted that although hip weakness is correlated with patellofemoral pain, the literature is still unclear where the causation lies.  Does weakness lead to pain or does pain lead to weakness?  You certainly won’t find the answer to this question in a one day “form clinic”. 

Likewise, Hart (2009) studied runners with and without low back pain and found the runners with a history of back pain exhibited greater spine extension than the non-painful control subjects.  Such movement may “represent a necessary adaptation used by persons with recurrent low back pain to preserve gait function by stabilizing the spine and preventing inappropriate trunk and lumbar spine positioning.”  In other words, the runners in pain may be running “incorrectly” to protect themselves!  Unfortunately, there are coaches across the land who see a flawed movement, and try to change the movement that the runner is using to protect himself or herself!    

Finally, “incorrect form” may be a type of exploratory movement from the brain to gather information about its surroundings.  Vuillerme (2009) conducted fatiguing hip exercises on one leg of an experimental group.  In bipedal stance, subjects demonstrated greater center of pressure displacements in the foot of the non-fatigued leg.  Authors noted:

"The observed postural responses could be viewed as an adaptive process to cope with an unilateral alteration in the hip neuromuscular function induced by the fatiguing exercise for controlling bipedal stance. The increase in center of pressure displacements observed under the non-fatigued leg in the fatigue condition could reflect enhanced exploratory "testing of the ground" movements with sensors of the non-fatigued leg's feet, providing supplementary somatosensory inputs to the central nervous system to preserve/facilitate postural control in condition of altered neuromuscular function of the dominant leg's hip abductors induced by the fatiguing exercise.” 

What some view as bad mechanics may actually be a subconscious act of the brain to interact with the environment.  Changing this interaction without understanding the individual athlete beyond the mechanical is a misguided approach.  

Conclusion

There are many factors to consider in each individual.  “Form” is but one part of the calculation that accounts for injury, neurology, mechanics, physiology, and psychology, just to name a few fields.  Get to the heart of the matter in each individual case and avoid cosmetic treatments for gait.  This area is ripe for great advancement (just as the barefoot movement was) but hopefully it will not get corrupted by the same misguided paranoia that infected.  Consider form within the proper context and not as a narrowly defined mechanical process. 

References

*Souza RB, Powers CM.  Predictors of hip internal rotation during running: an evaluation of hip strength and femoral structure in women with and without patellofemoral pain.  Am J Sports Med. 2009 Mar;37(3):579-87. Epub 2008 Dec 19.

*Meardon SA, Hamill J, Derrick TR.  Running injury and stride time variability over a prolonged run.  Gait Posture. 2011 Jan;33(1):36-40. Epub 2010 Oct 29.

*Bolgla LA, Malone TR, Umberger BR, Uhl TL.  Comparison of hip and knee strength and neuromuscular activity in subjects with and without patellofemoral pain syndrome.  Int J Sports Phys Ther. 2011 Dec;6(4):285-96.

*Hart JM, Kerrigan DC, Fritz JM, Ingersoll CD.  Jogging kinematics after lumbar paraspinal muscle fatigue.  J Athl Train. 2009 Sep-Oct;44(5):475-81.

*Vuillerme N, Sporbert C, Pinsault N.  Postural adaptation to unilateral hip muscle fatigue during human bipedal standing.  Gait Posture. 2009 Jul;30(1):122-5. Epub 2009 Apr 28.

*Clansey AC, Hanlon M, Wallace ES, Lake MJ.  Effects of Fatigue on Running Mechanics Associated with Tibial Stress Fracture Risk.  Med Sci Sports Exerc. 2012 Apr 19. [Epub ahead of print]

*Heiderscheit BC.  Gait retraining for runners: in search of the ideal. J Orthop Sports Phys Ther. 2011 Dec;41(12):909-10. Epub 2011 Nov 28.

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