No Quick Fix - Running Gait Leading to Chronic Injured State

Triathlon Forum
1

I became a runner/triathlete a few years back. I’m 34, male & averaging (was) approx 30 run miles weekly. I’ve developed ongoing right foot and lower calf problems that appear to stem from an improper running gait - hypothesis.

My typical running week represented (I say this in past tense b/c I had to stop back in Sept last yr.) 5 miles, 4x weekly, w/ a longer run for 7-10 miles on a weekend day. After some time I began experiencing discomfort in my Rt. foot - b/t my heel bone and achilles tendon. Original pain surfaced during longer runs at first…I’d have to stop and stretch out during the runs. Since then problems have persisted and have affected certain tendons such as my plantaris (sp?) where it attaches to my heel bone and also my achilles. If I try a run to “test” things out, it is not uncommon to have an inflammatory feeling radiate to my soleus in the lower calf. I completely stopped running back in Sept. and began trooping through the medical scenario.

My course of action has included the following:

  1. Started w/ sports orthopedic. X-rays revealed no probs. His standard issue was anti-inflam and rest. No positive impact to the prob. After a couple weeks he referred me to a sports podiatrist.

  2. Podiatrist - More rest, anti-inflams and a new pair of orthotics (I’ve learned I have a pronation issue in my right leg). Months tic by and discomfort continues (slight pain to the touch in my rear heel area). Went for the MRI. No tears but showing inflammation in some of the rear foot.

  3. Started seeing a deep-tissue massage therapist. Now this guy was (is) good. He worked that foot til I cried. I learned that my leg, calf, foot, all tendons are TIGHT. Saw him for 3 weeks and he did help. Problem continues though.

  4. Back to the Podiatrist. He recommended his partner who works in the same practice. (my thought by this time…I’m not running anymore, it’s into Feb of this year, yet my prob still continues)

  5. Partner Podiatrist - After some consultation w/ the orig podiatrist, they elect to shoot me w/ in the foot w/ a cortizone shot. After had a compression wrap for a week. Seemed to help. some. Problem still there if I push in the area. He reschedules me to come back in 4 weeks after I continue resting (I just lost faith in this guy and have written him off).

F*#K!

  1. Went to a Chiropractor as last result. X-rays taken of pelvis and lower spine. Find some misalignment. I was adjusted in my back (cracked), and my calcaneous (heel bone) was adjusted. A 1/2 week passes and I go back today for another adjust. Pain to the touch is barely noticable.

Went for my first test mile run in a long time this afternoon on the treadmill. Had my wife videocam my gait and it’s painfully obvious of the root cause - my opinion. Foot/ankle problems for me will persist with this gait.

Apologies for the long post. My real problem, it appears after all of this, is I have a pronating running gait w/ my right leg. I don’t like orthotics and don’t look to them as a cure. I’ll gladly accept your opinions on this statement… Is it possible to change your running gait? I’ve heard about the Pose method watched Romanov’s DVD on the technique (www.posetech.com). Would this rate as a viable cure to pronation because of the toe emphasis vs. “heel to toe”.

Thoughts, suggestions, anything will be appreciated.

2

Schooner, couple of comments…

  • go to www.julstro.com. Go to the message board and post your issues there with Julie. Give her a day or two and she’ll respond with some insight.

  • have you gotten custom orthotics yet? You may want to look into that.

  • if you could, make some smaller paragraphs in your message. it is kind of hard to read as ONE BIG paragraph. you may get more responses if you do that, and make it a bit easier to check out.

Go to Julie’s site. I think you may get some great positive feedback from her…I have!

3

Thanks for the reply.

Yes, I did get orthotics and they have not helped me.

4

As a heel-striker, I used to get Plantar Fascitis and hip pain whenever I bumped my mileage over 20-25 mi/wk, and my legs always felt trashed after a run. Then I changed, cold-turkey, to a Pose-type gait, ball/mid-foot strike, in April of 2002. After an initial month or two of calf soreness while adapting to the switch, I can unequivocably say that I have had no further instances of PF or hip pain, my legs still feel fresh even after a long run, and I have been able to ditch the heavy, overbuilt stability shoes for sub-11 oz. lightweight trainers.

So, yes, I would say it is definitely possible to change your gait.

(As a disclaimer, I must say that I never purchased the Pose book or video. I read about Pose/forefoot striking on this site, the Pose site, Gordo’s site, and http://www.gordonpirie.com/ and went from there. The best advice I can give you is to work on increasing your cadence, shortening your stride, and striking the ground underneath your body rather than in front of it. Don’t focus on the forefoot strike; it will come when the other pieces fall into place.)

Edit: Let me add that I now run 40-50 miles per week with no problems. I am 35, entering my 3rd season of tris.

5

Heel striking can kill a would-be runner’s legs. I’m not a typical runner - 5’6, 155 in race shape. My 10k PR is 44:39. I’m pretty slow. I’m also not light, and have flat feet. With a history of ankle, knee, shin and lower back problems, I knew that my chances of being able to run long were slim. I sought help. Bought the Pose book and video. It helped. Then I got busy. And fat. When I tried running again, it ws hell - and incredibly hard on my legs.

Recenty I’ve rediscovered Pose, but this time with the help of a coach. He videotaped my run. Worked with me on drills to correct certain aspects of my technique. Made me a lighter runner. I still have a LONG way to go, but truly feel that a personal coach is the only way to go. Some people are lucky, and born with a runner’s build. They take to it naturally. Others, need help. Professional help.

My advice would be to go to the Pose website and look for a coach in your area. I’m less inclined to suggest a weekend workshop because for the same amount of money, you’ll get private time with a coach at a pace you’re sure to absorb the info. If you hit a plateau, (s)he’ll be able to work through it with you. Even go back a step or two if necessary. That just isn’t possible in the “weekend workshop” framework. (note - I feel the same way about TI)

Pose can help. Gordo has his version of running, which is somewhat Pose-like. He gives some drills and ideas to work through on his website. But in my opinion you can’t beat having someone actually there to watch, show, and correct you. On-line coaches are fantastic for many things, but technique development isn’t one of them. (His advise is free however, so by all means go read it)

PS - Although I wear orthotics in my normal shoes, I don’t run with them. If you’re running properly, anything but the softest and thinnest footbed will interfere more than help.

6

I ramped up mileage too quickly a few years back and got an overuse injury so I’m familiar with the process you just went through. Here’s a couple of observations and ties into the recent NSAID thread.

From your post:
Step #1 - My impression from my experiences and from what you wrote. The Dr. didn’t know what the hell was wrong so he prescribed drugs to treat the symptom. How did he think this was going to solve the problem?

Step #2. - Same analysis as Step #1 except the orthotics are an attempt to solve the problem.

Step #3 - Same as #1
Step #4 - Same as #1
Step #5 - Same as #1

Step #6 - Don’t know, I didn’t get this far with the Dr’s. After 5 steps of taking my $, not listening to me and trying to stuff me with pain killers I stopped.

The orthotics did help solve the immediate problem. I recently switched to a more pose like running style and that seemed to help tremendously, although like another poster I’m self taught.

7

Agree with baldguy. I had the same experience.

I know this works. Change your running style. Get off the heels and land midfoot. Short fast stride. Land under your body not out front. Ditch the orthotics and heavy motion control shoes. Have some support but not too much. Start slowly. Run barefoot in a park. A little at a time, 10 mins. Learn how to run again it takes time. It took me 12 months and I am now injury free.

You can do this if you have the desire.

8

Sheesh TR, if you’d stop sneaking out at night in those pantyhose and high heels, you might get better.

9

Some more info… My running cadence is extremely low. Ideal cadence is 80s-90s? Mine is somewhere in the 60s. People have mentioned to me that my gait is noticably long. I’m completely heel to toe.

As for moving towards midfoot/ball of foot stride, I gave it a try on the treadmill last evening for a mile. Going to plan on incorporating some ankle strengh routines to help ramp up. Seems to put a lot of pressure on the bottom of the foot (tendons) when going through the change.

I appreciate all of the feedback.

10

Yeah, 85-95 footstrikes (one foot) per minute is what I shoot for. Count the number of strikes for one foot for 15 secs. then multiply by four. Do this every ten minutes or so to make sure you aren’t getting lazy.

It will feel strange at first, like you’re taking baby steps (your heart rate will be higher, too), but your body WILL adapt.

11

i’m a convert to the pose (or pose-ish) method.

my problem was a strange lower-outside knee pain that doctors couldn’t seem to accurately diagnose or cure. much like your situation it was frustrating because treatment was always complete guess-work on their part. (i realize that some degree of guessing and trail-and-error is par for the course, but this seemed baffling beyond the norm). after 2-3 weeks off, and employing the new gait, its never come back.

some disclaimers here though:

-i think i leaned towards the pose-type of gait naturally anyway. i’d stray into heel-striking when on my long slow distance days… perhaps over-emphasising the “slow” part. this i no longer do even on the long days. its hard for me to run slow with pose gait, so i simply don’t. still have one long day, but i now run it fairly quick (not all-out of course). i find it takes some real concentration to keep in form as i get physically and mentally more fatigued.

-in the first few months of transition, i had a few foot problems. i experienced strains or pulls (not sure which) in the meaty, outside portion of both feet (at different times). only had to lay off for a couple days and all was well again, but don’t be suprised if you run into something like this. might also want to look into shoes designed for forefoot strikers, which could help with here.

-i only employed what i was able to glean from free sources (internet) or ones i’d already purchased (ex. training bible) so my use of this method corresponds on the major points, but there’s probably some fine-tuned stuff thats taught that i don’t do.

either way, its going on two years and all’s well, so its definitely worth trying.

good luck.

12

Schonner,

Give Pose a try. It will help you for sure. I used to run in MC shoes with Orthotics. I switched to “Pose like” running about 9 months ago. Went straight to ligthweight trainers. You should really count on at least 3 months to get familiar with the new running style. It will feel very difficult at first. So it is best to take this on at least 4 months away from any race and give your body plenty of time to adjust.

Cadence of 85 is the MINIMUM you should aim for 90+ is best.

  • Lionel
13

I got a $10 handheld metronome and gradually increased my cadence to a max of 95. When I started with the metronome I had trouble finishing 3 miles with it at 85 cadence, in fact, I had to rest a couple times. I only used it once a week and the other days I just tried to keep the cadence comfortably high. Now, I can go 6+ miles at 95 cadence and never miss a beat. I’ve never felt better.

14

Are you sure pose is for him?

Granted, I don’t know ANYTHING about pose, but I tried being more of a mid-foot striker on my own and ended up with a strained calf that will not go away. Turns out I have flat feet and protonate, which on its own puts a lot of pressure on the calf; trying to be more of a mid-foot striker pushed my calf over the edge.

I’m interested in learning more about pose, even though the two orthopedists I’ve seen and my PT don’t believe in mid-foot striking…but do you really think pose is good for everyone?

15

Turns out I have flat feet and protonate, which on its own puts a lot of pressure on the calf; trying to be more of a mid-foot striker pushed my calf over the edge.

I, too, have flat feet and USED to pronate; Pose-style running has eliminated the injury problems I had (as detailed above).

As I mentioned previously, the real keys are shortening your stride, increasing your cadence, and landing underneath your body rather than in front. If you just switched to striking with your forefoot but kept a long stride, low cadence, out in front of your body, it’s no wonder you ended up with calf problems.

Work on those three keys and don’t focus on where your foot lands. A fore/midfoot strike is a product of a short, quick, balanced stride.

16

some interesting stuff here. this doc is a sub 14 5k runner if that makes any difference to you.

www.nwfootankle.com

17

Schonner, I would give the forefoot/midfoot striking a try, it might work for you as well.

Some of my observations, I started out as a heal striker and loved it until my mileage started going up, then came a rash of injuries, one after the other that had me looking into other forms of exersize. All this was with slow running not speed work.

One day I was thinking about my gait and I had an epiphany, my heel striking out in front of my body was directing energy DOWN into the ground before my foot rolled to the toes at pushoff. What I needed was to lightly scratch the earth to propel me forward. This concept got me off my heels and striking on the balls of my feet, underneath my body. I have been injury free since (10mos.). Like the posters above, it is hard to run slow this way, it seems to pound more. Don’t get discouraged, if you can do this without pain give this a try. Go to a high school field , best with a track around it. Try some 100yd repeats on the grass barefooted, you need to run a little faster but don’t all out sprint. if you feel OK, try some laps on the track(w/shoes), you will fatigue faster but concentrate on striking underneath your body with the energy of your drive foot driving you forward not down, you can measure your progress on the track. Good luck!!!

18

Just a different angle on your problem:

My typical running week represented (I say this in past tense b/c I had to stop back in Sept last yr.) 5 miles, 4x weekly, w/ a longer >run for 7-10 miles on a weekend day.

I started running late 2000, and had big problems after two months with my tendons (I was actually on crutches for a couple of weeks). I had a similar training regime as you did.

I now have -zero- problems and have at times done 120k weeks. My initial* solution was: train less frequent, but longer (in marathon prep I do 4 runs per week, otherwise 3), that way I always have enough rest to a) recover from running b) notice if something is wrong. AND religously check the camber of the roads/paths I run on and regularly change sides to avoid asymmetric loading of my legs/feet.

Simon

  • now naturally my body has adapted quite a bit and I can run essentially every day if I wanted to.
19

mjpwooo -
I did go to www.julstro.com and post w/ Julie. She has some insight to share, all of which I will take into consideration. Her site is a good resource. I’ll post her response below for those interested in the feedback (her comments have a *** in front). She titled her response email “Not as bad as you think :-)” - How I cherish those that give me hope! THANKS.

**The good news is as I go down your list, I really don’t think it’s as
serious as all the doctors have made it. I’ll type the names of the
muscles you need to search on our website (at the forum:
www.julstro.com) in capitals. When you do the search, try the treatments
I teach. You can also consider getting one of the printed books so you
can see the pictures of how to do the treatments. Let’s give it a
go…

Let me know how everything works for you,

 Julie

Release “aches and pains” in your muscles and joints. You are your own
best therapist! Visit http://www.aboutwristpain.com and
http://www.julstro.com to find common sense answers.

-----Original Message-----
Sent: Monday, February 16, 2004 5:28 PM
To: contact_form@julstro.com
Subject: Feedback from Julstro.com

Response: Hello,
This site was recommended to me from the www.slowtwitch.com forum.

****Thanks, I hope we’ll be able to resolve this problem quickly!

I became a runner/triathlete a few years back. I’m 34, male & averaging
(was) approx 30 run miles weekly. I’ve developed ongoing right foot and
lower calf problems that appear to stem from an improper running gait -
hypothesis.

****You’re probably right, from the sounds of it you need to work on the
PERONEALS (lateral side of the calf), more about that further down in
this email.

My typical running week represented (I say this in past tense b/c I had
to stop back in Sept last yr.) 5 miles, 4x weekly, w/ a longer run for
7-10 miles on a weekend day. After some time I began experiencing
discomfort in my Rt. foot - b/t my heel bone and achilles tendon.

****Do a search for the FLEXOR DIGITORUM LONGUS AND FLEXOR HALLICIS
LONGUS

Original pain surfaced during longer runs at first…I’d have to stop
and stretch out during the runs. Since then problems have persisted and
have affected certain tendons such as my plantaris (sp?) where it
attaches to my heel bone and also my achilles.

****It probably isn’t the plantaris but could well be the GASTROCNEMIUS
and SOLEUS

If I try a run to “test” things out, it is not uncommon to have an
inflammatory feeling radiate to my soleus in the lower calf. I
completely stopped running back in Sept. and began trooping through the
medical scenario.

****Oh my…

My course of action has included the following:

  1. Started w/ sports orthopedic. X-rays revealed no probs. His standard
    issue was anti-inflam and rest. No positive impact to the prob. After a
    couple weeks he referred me to a sports podiatrist.

  2. Podiatrist - More rest, anti-inflams and a new pair of orthotics
    (I’ve learned I have a pronation issue in my right leg).

****My feeling is orthotics are simply bringing the floor up to your
foot, they aren’t correcting the problem and bringing your foot down to
the floor. This is a major problem for a lot of athletes and it keeps
compounding the problem. More on that later. Actually, you may find
some info about the topic by doing a search on the forum for “ORTHOTICS”
although I’m not sure that it will come up since I don’t think it was
ever a thread title.

Months tic by and discomfort continues (slight pain to the touch in my
rear heel area). Went for the MRI. No tears but showing inflammation in
some of the rear foot.

****Excellent sign of a contracted Gastrocnemius and Soleus. Good that
you had the test, the more tests that are negative, the more likely that
the problem is just muscular.

  1. Started seeing a deep-tissue massage therapist. Now this guy was (is)
    good. He worked that foot til I cried. I learned that my leg, calf,
    foot, all tendons are TIGHT. Saw him for 3 weeks and he did help.
    Problem continues though.

****Wonderful that you found a good massage therapist. I suggest you
continue with him and learn how to self-treat. It takes more than just
once a week treatment to reverse a severe repetitive strain injury. I
believe this is your best plan of action.

  1. Back to the Podiatrist. He recommended his partner who works in the
    same practice. (my thought by this time…I’m not running anymore, it’s
    into Feb of this year, yet my prob still continues)

  2. Partner Podiatrist - After some consultation w/ the orig podiatrist,
    they elect to shoot me w/ in the foot w/ a cortizone shot. After had a
    compression wrap for a week. Seemed to help. some. Problem still there
    if I push in the area. He reschedules me to come back in 4 weeks after I
    continue resting (I just lost faith in this guy and have written him
    off).

****One of the problems of cortizone (aside from the joint deterioration
problem) is it is like putting Ambisol on a toothache. The pain is gone
but the cavity is still there. With cortizone the pain is gone but the
problem still exists.

  1. Went to a Chiropractor as last result. X-rays taken of pelvis and
    lower spine. Find some misalignment. I was adjusted in my back
    (cracked), and my calcaneous (heel bone) was adjusted. A 1/2 week passes
    and I go back today for another adjust. Pain to the touch is barely
    noticable.

****Do a search for PSOAS. This muscle rotates the pelvis, lumbar
spine, and does so many other things that it deserves a book all to
itself!

Went for my first test mile run in a long time this afternoon on the
treadmill. Had my wife videocam my gait and it’s painfully obvious of
the root cause - my opinion. Foot/ankle problems for me will persist
with this gait.

****I’d also suggest you do a search for TIBIALIS ANTERIOR (won’t hurt,
may help), but I think the primary gait problem is probably coming from
the psoas and the peroneals contractions. The PERONEALS pull your foot
up on the outside so you roll in toward your arch/big toe. Also, if the
psoas is contracted, so are the QUADS so you may as well search them
too.

Apologies for the long post. My real problem, it appears after all of
this, is I have a pronating running gait w/ my right leg. I don’t like
orthotics and don’t look to them as a cure. I’ll gladly accept your
opinions on this statement… Is it possible to change your running
gait? I’ve heard about the Pose method watched Romanov’s DVD on the
technique (www.posetech.com). Would this rate as a viable cure to
pronation because of the toe emphasis vs. “heel to toe”.

****Tom, I’m so used to long posts from frustrated athletes, it isn’t a
problem. I’m running really late tonight so I don’t have time to review
the website you mentioned, but I will look at it this week. I hope you
enjoy our website. Be sure to go to the section called “Muscles and
Pain” before you go to the forum. It has a lot of good information that
will explain a lot.

Thoughts, suggestions, anything will be appreciated.

****I think you’ll be able to self-treat this and be back to running way
before the Spring arrives. I look forward to hearing from you.

Wishing you well,
Julie

20

Schooner, it is my opinion that Julie is as close to an athlete’s patron saint as there can be. I love the woman!

And the book has been VERY HELPFUL for me. I’d recommend it. Well worth the price you pay.