Why Running Hurts

 

It’s rare to come across a person who can run pain-free.

The injury rate associated with running is incredibly high (up to 70% of all injuries in recreational and competitive athletes). But does it make sense that we can’t run without something nagging or hurting us? Why does the repetitive action of running create chronic injury in a body that was designed to run? We suffer from “shin splints”, “runner’s knee”, back pain… the list goes on… often times we find blame in the shoes we wear.

Depending on who you talk to it’s “absolutely vital to buy the latest pair of Hoka One One maximum cushion running shoes”, or  it’s- “buy the Vibram barefoot running shoe, it’s ‘zero-drop’ and that’s how we’re supposed to run”. Then of course you’ve heard the horror stories of people who ran in those minimal shoes and suffered from some injury.

running

Running & Walking Gait

Let’s back up for a minute and think about what’s going on during running and walking gait in the most simple explanation possible.

Walking, a movement natural to the human body, involves having one foot in contact with the ground at all times. It involves the whole body, from head to toe, working as one… it’s not just your legs moving. Simply put, your whole body moves and rotates around the spine. In good walking form, the pelvis must move smoothly and when the foot contacts the ground there is a heel strike, a flat foot, a heel-off, and a toe-off. This heel contact in walking allows us to use our glutes and stronger hip muscles to stabilize the pelvis and move us forward over the ground.

(Here’s a good spot to think about the implications of a treadmill: a machine that propels your legs behind you rather than YOU propelling your legs behind you).

Weak and inactive glutes prevent the pelvis from stabilizing. When understanding an active posture, your glutes also act to stabilize the knee and ankle. If you look at a passive posture (silent glutes), you can see the knee collapse in and the arch of the foot drops into pronation. When we create torque in the hips and activate the glutes, you can see the knee rotate externally and the plantar surface of the foot becomes pulled up into a neutral arch (see video). This becomes important because if we aren’t properly using the glutes to create stability, it translates into repetition after repetition of a collapse of the knee and therefore over pronation aka collapse of the arch in the foot (read: overuse injury).

Running is actually a very different pattern of movement that involves having no foot in contact with the ground. It requires some serious forces to travel through your body and those forces actually work in an “up and down” (read: jumping) fashion rather than horizontal (distance) like it appears. Our bodies were designed to land on the forefoot (rather than the rear foot). This allows your calf muscles to eccentrically control and lower your body as it drives into the ground. This helps to dissipate loads placed on your body.

When the mechanical forces are analyzed, a heel strike running pattern (heel to toe) comes down to rapid, high-impact, dead on forces through your heel (up to 3 times your bodyweight). Ouch.

A pattern of landing on your forefoot (toe to heel), however, shows a slow rise in force with no distinct impact that can actually be measured. The forefoot strike prevents some pretty serious loads from jolting your body stride after stride. This is represented nicely in the graphs shown below, and the detailed analysis is also found here.

 

Take away: Walking is heel to toe. Running is toe to heel. Running on your heels is like driving your car with the E-brake on.

heelstrikepost

Fun Fact: When designing prosthetic legs, you might notice that the design makes it impossible for it’s ewearer to heel strike. This is because there is no way to design a prosthetic limb that can withstand the tremendous loads required for heel striking… Striking isn’t it?! Highly cushioned shoes is the only way to make a heel-striking behavior possible.

 

running-with-prosthetic-limbs-1107259-TwoByOne
Why Do We Heel Strike

So if it’s natural for us to forefoot strike, why do we heel strike?

 

Sitting

Deskbound-Kelly-Starrett-300x255In Kelly Starrett’s book Deskbound, he discussed the effects of sitting. When we look into a child’s movement, we know that when they are a toddler up until around kindergarten they maintain perfect, natural movement. They can run, squat, lunge, and move their bodies with ease. Watch any baby move and you will see what I mean. It was noticed though, that sometime after the kids entered the 1st grade, they lost their natural ability to run and their mechanics were completely different. They were heel striking. This is the time in our lives as kids that we  start our career as chronic sitters. Sitting affects our neurological and musculoskeletal systems to the point that our fundamental ability to run is altered.

 

Shoes

In the 70’s, athletic shoe design began a rapid revolution. It began with making the shoe clunkier, with a heel cushion to lift the heel in addition to orthotic structures like arch supports to create “stability”. But what really happened was this extra cushion and “support” completely silence the stability capabilities of the foot and ankle. Consequently, running mechanics began to change, supporting the heel strike. Unsurprisingly, injuries started to occur more often with running. Shoes make the foot dumb and blind, basically.

To accommodate the issue with injury and pain due to running, more and more high cushioned shoes were designed to accept the impact that running has on the body. The goal of the shoe AND the problem with the shoe is that someone who experiences pain with running in a light/minimal shoe can now run miles pain-free with altered running technique.

 

 

The problem with high cushioned shoes
  1. Bandaid on a bigger issue274889120-13153212-1

I think it’s great that these shoes allow
people to run farther to get their heart rate up and 
exercise, however the bigger picture is what gets me. The body is still heel striking, and loads and undue stress are still being placed where they don’t belong. Accumulatively, that’s millions of “bad” reps over miles and miles and miles. The body is resilient. It can take it… and take it… and take it… until it simply can’t. A part will break down eventually. More issues will manifest elsewhere. Relieving the pain and discomfort of running by adding a cushion does not address why you have pain with running in the first place.

  1. Stability

Our feet are the one point of contact we have with the earth (unless we’re walking on our hands). We have hundreds of thousands of proprioceptors in our feet that let our brain know where we are, what we’re walking on, and what our legs are doing. Our feet are the most-sensory rich parts of our body. For a reason. When we add 2- 3 inches of thick foam to that, stability is lost. The brain can receive almost no information from our feet in this environment. The shoe becomes a cast for our 33 foot joints (yes! 33… more on that later) and the 4 different layers of (10) intrinsic muscles of our foot become atrophied. These muscles control fine motor of the foot.  When these muscles atrophy, posture of the foot changes and just as with any postural change, you can imagine how this can become a problem.

  1. Anti-Mobility
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Doesn’t this look a lot like a cast?

Even just standing with shoes with a heel to toe rise alters our posture and standing mechanics. And let’s just think about the implications of standing with our heels raised. If we are constantly keeping our ankles at a shortened position, our muscles shorten and adapt to that position (read: tight calfs). Its the same concept with our hip tightness and sitting in a chair with our hips stuck at 90 degrees. When we then ask for that range of motion that we lost, it puts a ton of stress on structures like our achilles tendon. Who wants to have that rupture? We’ll talk more about what shoes do to our feet later. But for now understand the global concerns with the shoe in terms of altered posture and mechanics of running.

How to transition to barefoot shoes:

SLOWLY.

The main issue with barefoot shoes is that people transition far too quickly (asking joints to move in places and muscles to work that haven’t been called upon in YEARS). Chances are your foot has lost a ton of mobility, and the muscles in your feet are likely atrophied and weak (at least some of the important ones).

Don’t freak out.

Stay tuned to learn how to rebuild your foot and transition into pain-free running 🙂

 

References

One Comment on “Why Running Hurts

  1. Information translation- Sam is the BOMB! Love from the heel striker;)

    Like

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