healthy running the body in balance
Post on 07-Aug-2015
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The Biomechanics of The Biomechanics of RunningRunning
Kinetic ChainKinetic Chain Running transfers force Running transfers force
of the foot hitting the of the foot hitting the ground up the kinetic ground up the kinetic chain to the knee, hip, chain to the knee, hip, pelvic region, lower back pelvic region, lower back and to the upper back and to the upper back and cervical regionand cervical region
Abnormal and Abnormal and inefficient movement inefficient movement can cause injury to can cause injury to joints and soft tissue joints and soft tissue facilitating adaptation facilitating adaptation to running and loss of to running and loss of performance performance
Gait AnalysisGait Analysis
Kinetic ChainKinetic Chain When the foot hit the When the foot hit the
ground force is ground force is transmitted up the leg transmitted up the leg to the trunkto the trunk
Distribution of forces is Distribution of forces is critical to safe and critical to safe and effective runningeffective running
Abnormal balance to Abnormal balance to the forces leads to the forces leads to injuriesinjuries
Walking Gait Analysis Walking Gait Analysis
The stance phase is the period where the foot is in contact with The stance phase is the period where the foot is in contact with the ground and equates to 60% of the cycle when the ground and equates to 60% of the cycle when walkingwalking. The . The swing phases makes up the remaining 40%. swing phases makes up the remaining 40%.
During walking there is a period called double stance, where both During walking there is a period called double stance, where both feet are in contact with the ground. The swing and stance phases feet are in contact with the ground. The swing and stance phases can be further divided into:can be further divided into:
StanceStance Heel strike - The point when the heel hits the floor Heel strike - The point when the heel hits the floor
Foot flat - The point where the whole of the foot comes into contact with the Foot flat - The point where the whole of the foot comes into contact with the floor floor
Mid stance - Where we are transferring weight from the back, to the front of Mid stance - Where we are transferring weight from the back, to the front of our feet our feet
Toe off - Pushing off with the toes to propel us forwards Toe off - Pushing off with the toes to propel us forwards
Gait AnalysisGait Analysis
SwingSwing Acceleration - The period from toe off to maximum knee flexion in Acceleration - The period from toe off to maximum knee flexion in
order for the foot to clear the ground order for the foot to clear the ground
Mid-swing - The period between maximum knee flexion and the Mid-swing - The period between maximum knee flexion and the forward movement of the tibia (shin bone) to a vertical position forward movement of the tibia (shin bone) to a vertical position
Deceleration - The end of the swing phase before heel strikeDeceleration - The end of the swing phase before heel strike
When running, a higher proportion of the cycle is swing phase as When running, a higher proportion of the cycle is swing phase as the foot is in contact with the ground for a shorter period. the foot is in contact with the ground for a shorter period.
Because of this there is now no double stance phase, and instead Because of this there is now no double stance phase, and instead there is a point where neither feet are in contact with the ground, there is a point where neither feet are in contact with the ground, this is called the airborne or flight phase. As running speed this is called the airborne or flight phase. As running speed increases, stance phase becomes shorter and shorter. increases, stance phase becomes shorter and shorter.
Running Cycle
The running cycle is composed of a Swing Phase
Initial Swing: Commences at toe-off and ends at mid-swing Terminal Swing: commences at mid-swing and ends at foot
strike Stance Phase
Absorption: commences at foot strike and ends mid-stance Propulsion: Commences at mid-stance and ends at toe off
These two phases take up 40-60% of the running cycle Airborne period that are when both feet are off the
ground occur at beginning and end of each swing phase
Running Cycle
Hip, Pelvis and Back 25% to 35% of all running injuries are
estimated to be in this region. That leaves the knee, ankle and foot to be responsible for 65-75% of the injuries.
Gait analysis have been shown to be able to pick up improper of inefficient movement patterns while running and to allow for the establishment of an exercise program to correct these abnormalities
Gait Analysis and hip, pelvis and back injuries Review
Slocum and Bowerman first to document that the position of the pelvis is the key to postural control. Gait Analysis was used in their studies
Gracovetsky and colleagues also moved the biomechanical study of hip, pelvis and low back injuries while running to the forefront
Improper alignment and or movement of the hip, pelvis and lower back can lead to debilitating injuries that can include:
Groin Injuries Hamstring Injuries Piriformis Injuries Back Spasms/hip flexor
spasms Runners Hip injuries
Gait Analysis and the hip, pelvis and low back
Pelvic Movement and running
The Anterior and Posterior tilting of the pelvis when running is noted to increase as the speed of running increases
To improve efficiency and endurance the amount of tilting is to be minimized
Gait Analysis and the hip, pelvis and low back
Hip movement and running As speed increases a reduction in
hip extension is seen and an increase in hip flexion is noted. This occurs at the toe off period of the cycle
Increase hip flex will increase stride length and increase overall speed
Hip extension is limited by the hip joint capsule
Noting an increase in hip flexion at time of foot strike at slower speeds allows for improved absorption at this point of the gait pattern
The maximum values of hip extension during running approaches the limits of passive hip extension.
Gait Analysis and the hip, pelvis and low back
Trunk Position It is thought that the lumbar
spine is the pivotal point of the lower extremity lever system during running
Movement of the lower limb backwards during stance phase is thought to commence with extension of the lumbar spine.
This anterior tilts the pelvis which effectively increase the working range of extension and contributes to the extension thrust mechanism of the lower extremity.
These finding support that the trunk should be in an erect position in early phases of stance
Pelvic Obliquity and trunk movement
At time of foot strike the pelvis obliquity is aligned being slightly higher on the stance side and lower on the swing side.
Pelvic Obliquity is thought to play a role in shock absorption and in smooth ascent and decent of the bodies center of gravity at this time
In stance phase the hip adducts (absorption) and into abduction during (propulsion)
Pathologies and Running
Muscle Imbalance, ineffective and inefficient running technique can lead to injuries to any aspect of the kinetic chain Spine Hips Knees Ankles Foot
Healing CycleHealing Cycle
Inflammation (4-6 Days)Inflammation (4-6 Days) Therapy most effective to decrease inflammatory cycle Therapy most effective to decrease inflammatory cycle
and to facilitate next stage of healingand to facilitate next stage of healing Remodeling (5-21 Days)Remodeling (5-21 Days)
Therapy applied here allows for the injured area to be Therapy applied here allows for the injured area to be stressed in a slow and graded fashion (slow progression stressed in a slow and graded fashion (slow progression of appropriate stress)of appropriate stress)
Maturation (20+ Days)Maturation (20+ Days) Critical area to develop injured tissues (apply appropriate Critical area to develop injured tissues (apply appropriate
stress) and proper balance to avoid further injuriesstress) and proper balance to avoid further injuries Key is to avoid the Chronic Inflammatory Key is to avoid the Chronic Inflammatory
Cycle Cycle
When to get help?When to get help?
Not always clearNot always clear If pain reappears If pain reappears
time and time time and time again rest is not again rest is not the solutionthe solution Balance of Balance of
musculaturemusculature FlexibilityFlexibility
Rehabilitation of the Rehabilitation of the Ankle-Foot ComplexAnkle-Foot Complex
Forces at the footForces at the foot Therapist must first Therapist must first
address the position address the position of the foot and of the foot and provide the proper:provide the proper:
FlexibilityFlexibility MobilityMobility Strength Strength Strength and control Strength and control
to the upper leg and to the upper leg and trunktrunk
Rehabilitation of the Rehabilitation of the KneeKnee
Knee JointKnee Joint Middle joint of the Middle joint of the
kinetic chain kinetic chain High level of three High level of three
dimensional forcesdimensional forces Requires high level of Requires high level of
ligaments and muscular ligaments and muscular supportsupport
Patella position and Patella position and smooth movement is smooth movement is critical to proper critical to proper functionfunction
Rehabilitation of Pelvic Rehabilitation of Pelvic InjuriesInjuries
Force transmitted to Force transmitted to the Sacral Joint and the Sacral Joint and lumbar regionlumbar region Three dimension forces Three dimension forces
on jointon joint Key Stone of lower Key Stone of lower
trunk core stabilitytrunk core stability Low back imbalance Low back imbalance
can present can present radiculopathy that can radiculopathy that can mask true problemmask true problem
Rehabilitation of Hip Rehabilitation of Hip InjuriesInjuries
Hip jointHip joint Ball and socket jointBall and socket joint High level of High level of
stabilitystability Limited mobilityLimited mobility Critical for straight Critical for straight
hip controlhip control Balance of Balance of
musculature musculature flexibility and flexibility and strength is essentialstrength is essential
Strengthening Requires Strengthening Requires BalanceBalance
Note the complexity Note the complexity of the musculature of the musculature alignmentalignment
Note muscles are Note muscles are not aligned in a not aligned in a linear fashion but linear fashion but more obliquemore oblique
Design promotes Design promotes rotational rotational component of component of movementmovement
Rehabilitation of the Thigh and Rehabilitation of the Thigh and hiphip
straight Hip Controlstraight Hip Control Injury to the lower Injury to the lower
extremityextremity Pain to an area is not Pain to an area is not
always the true always the true source of the source of the problemproblem
Rest not always the Rest not always the cure to the problemcure to the problem
Assessment essential Assessment essential to find source and to find source and avoid further injuryavoid further injury
Upper Body Upper Body involvement in Runninginvolvement in Running
BalanceBalance Coiling movement Coiling movement
of the bodyof the body Efficiency of Efficiency of
MovementMovement Propulsive forcePropulsive force Breaking forceBreaking force
If you have a running If you have a running injury, The Do's and Don'tsinjury, The Do's and Don'ts
DODO Rest, ice, and elevate the leg (if that's what you injured!)Rest, ice, and elevate the leg (if that's what you injured!)
DODO Reduce your mileage to a pain free amount, even though it may be a blow to your ego. Reduce your mileage to a pain free amount, even though it may be a blow to your ego.
DODO Cross-train to maintain your overall fitness level with exercise such as biking, or swimming or Cross-train to maintain your overall fitness level with exercise such as biking, or swimming or perhaps stair climbing.perhaps stair climbing.
DODO Trust and listen to yourself. Irritability, fatigue, insomnia, severe muscle soreness, and getting Trust and listen to yourself. Irritability, fatigue, insomnia, severe muscle soreness, and getting colds and flu easily may me signs that you are overtraining. colds and flu easily may me signs that you are overtraining.
DODO Progress at a naturally comfortable rate. Progress at a naturally comfortable rate.
DODO See a doctor, physical therapist, or other health professional who you trust. If they can't help you, See a doctor, physical therapist, or other health professional who you trust. If they can't help you, they probably know someone who can.they probably know someone who can.
DODO Warm up by walking or jogging slowly for at least five minutes. Warm up by walking or jogging slowly for at least five minutes.
DODO Cool down slowly at the end of your run by walking at least five minutes.Cool down slowly at the end of your run by walking at least five minutes.
DODO Stretch before and after every run, especially the Achilles tendon, hamstrings, and quadriceps. Stretch before and after every run, especially the Achilles tendon, hamstrings, and quadriceps. Remember the best time to stretch is after you run when the muscles are pliable.Remember the best time to stretch is after you run when the muscles are pliable.
DODO Get on a weight training program to strengthen muscles around the hip, knee, ankle, and Get on a weight training program to strengthen muscles around the hip, knee, ankle, and abdominal area. This may take some of the shock away from the knee and hips.abdominal area. This may take some of the shock away from the knee and hips.
If you have a running If you have a running injury, The Do's and injury, The Do's and
Don'tsDon'tsDON'TDON'T
Run though the pain. Your body is trying to tell you Run though the pain. Your body is trying to tell you something–listen to it.something–listen to it.
DON'TDON'T
Think you have to give up running. There's help out there!Think you have to give up running. There's help out there!
DON'TDON'T
Ignore the problem. If you do, it is more likely to come back. Ignore the problem. If you do, it is more likely to come back. Or get worse.Or get worse.
DON'TDON'T
Think that someone else can fix your problem. Physical Think that someone else can fix your problem. Physical therapists and others can help a great deal, but therapists and others can help a great deal, but the ultimate the ultimate responsibility for being injury free is yours!responsibility for being injury free is yours!
Contact InformationContact Information
Dr. Charles CurtisDr. Charles Curtis Dr Charles Curtis MS, PT, DPT, Cert MDT, Dr Charles Curtis MS, PT, DPT, Cert MDT,
Vestibular Rehab SpecialistVestibular Rehab Specialist
ccurtis33@verizon.net 732 320 0768732 320 0768
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