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Browsing Tags knee pain

Build Your Run Series: Injury Prevention (FREE Webinar Replay)

June 25, 2020 · by Garrett McLaughlin

Injury prevention is a hot topic in the running world, and for good reason. Runners are searching for the best strategies to stay injury-free and thriving within the sport. But, is preventing injury actually attainable?

In this webinar, I presented on the topic of injury prevention by thoroughly reviewing the research. What I found was a lot of conflicting information compared to what is commonly seen around the running community. It’s my hope that you will use this to be more objective and fine tune your program to create the best results possible.

What you’ll learn is…

The most common running-related injuries
Which risk factors are associated with injury
Important injury prevention tactics and their effectiveness
- Foam rolling
- Static stretching
- Strength training
The role of footwear in reducing your injury risk
Q&A

–> Click here to receive instant access to the webinar.

I hope you enjoy this webinar! Comment below or contact me directly if you have any questions or comments regarding injury prevention. And, if you want to get down to business and implement the best strategies to improve your running, click here to learn more about the Healthy Running Program.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

The Impact of Cadence on Running Mechanics

February 20, 2020 · by Garrett McLaughlin

| Article written on February 20th, 2020 at 12:25pm | Follow Garrett on Facebook and Instagram |

Cadence is a hot topic in the running world, and for good reason. When manipulated properly it can positively impact your running to improve efficiency and reduce strain on sensitized tissues. As always when it comes to changing your running form, it’s important to understand the research, seek the guidance of a trained healthcare professional, and do so in the safest way possible. This article will cover some potential benefits that cadence manipulation can have on your running mechanics.

Let’s start by defining cadence… Cadence, also known as step rate or step frequency, is the number of steps you are taking per minute (spm). An easy way to calculate this is by counting the number of steps on your conversational pace run for 30-seconds and then multiplying that number by 2. This number should vary depending on your pace, intensity, and terrain. So keep it simple by calculating cadence during your long, slow distance run first. If you’re fortunate enough to have a Garmin watch or other wearable technology, it’s likely that your cadence has been tracked all along.

Over the years, there has been a lot of debate surrounding cadence. Famous running coach, Jack Daniels, and local running stores who offer Good Form Running Clinics, often propose 180spm as the gold standard. The problem with that number is, it does not take into consideration the unique characteristics of you as a runner, how many steps per minute your body auto-regulates to, and your injury history. When altering running mechanics, it’s important to do so on an individual basis and while considering every variable. This may or may not mean 180spm ends up being the right cadence for you. And, truthfully, there was no mention of this number in any of the research articles I reviewed.

In the following sections, let’s comb through the research to determine how much impact increasing your cadence can have on your running. I will highlight various research articles and discuss the key findings of each. This will serve as a good review of the literature and you can dig deeper into any article that interests you.

Article #1: Influence of Stride Frequency and Length on Running Mechanics by Schubert et al

Objective: To determine how running mechanics change when manipulating stride frequency and stride length.

Findings:

The knee was the most affected joint when cadence was increased, which displayed a more flexed position at initial contact and less peak knee flexion during the stance phase
The ankle demonstrated a more plantar flexed position at initial contact with a higher cadence
The hip displayed less peak hip flexion and adduction during initial contact with a higher cadence
The foot lands closer to the body’s center of mass when cadence is increased
There was a reduction in peak vertical ground reaction forces
There was a reduction in center of mass vertical excursion
Increasing cadence reduces ground contact time which in turn increases leg stiffness

Click here to view this article.

Article #2: Effects of Step Rate Manipulation on Joint Mechanics During Running by Heiderscheit et al

Objective: Assess the biomechanical effect that a 5% and 10% increase in cadence has on the hip, knee, and ankle joints to determine if it is a possible strategy to reduce lower extremity injury rates.

Findings:

Step length decreased as cadence increased
Decreased center of mass vertical excursion
Reduction in braking impulse at initial contact
Foot inclination angle, peak vertical ground reaction force, and step duration only differed with a 10% increase in preferred cadence
Rate of perceived exertion increased when cadence was 10% greater than preferred cadence
A 5% increase in cadence reduced energy absorbed at the knee by approximately 20%
A 10% increase in cadence reduced energy absorbed at the knee by approximately 34%
A decrease in preferred cadence produced a similar increase in energy absorbed at the knee
A 10% decrease in cadence produced a significant increase in energy absorption at the ankle and hip joints, however, a 10% increase in cadence only reduced energy absorption at the hip joint

Click here to view this article.

Article #3: The Effects of Running Cadence Manipulation on Plantar Loading in Healthy Runners by Wellenkotter et al

Objective: Evaluate the effects of cadence manipulation on plantar loading during running.

Findings:

Total foot contact time and peak force were lower with a 5% increase in cadence
Foot contact time was greater with a 5% reduction in cadence
Faster cadence decreased heel loading and did not increase metatarsal loads
Metatarsal loads were generally reduced with an increased cadence
A 5% increase in cadence was shown to reduce plantar loads 2.4-8.0%

Click here to view this article.

Article #4: Leg Stiffness and Stride Frequency in Human Running by Farley et al

Objective: Determine the relative importance of changes to the leg spring stiffness and the angle swept by the leg spring when humans alter their stride frequency at a given running speed.

Findings:

Stiffness of the leg spring increased 2.3x between a cadence that was 26% below preferred to 36% above preferred
The leg spring becomes stiffer to accommodate a faster cadence and less stiff when accommodating a slower cadence

Click here to view this article.

In conclusion, these research articles show there may be merit when manipulating cadence in certain situations. Increasing cadence may reduce overall load into the affected tissue if you are suffering from a running-related injury and improve running efficiency. Using a metronome can be a helpful tool when increasing to 5% or 10% above your preferred cadence as shown in the articles. It’s recommended to not make any abrupt changes, but do so in a slow and progressive manner which will allow your body to adapt to these changes in running form.

If you have any questions about how cadence manipulation may affect your running or you want more information regarding the Healthy Running Program, click here to contact me directly. Thanks for reading!

By: Garrett McLaughlin, MS, ATC, CSCS, ART

The Secret Behind Injury Prevention: Can You Run Your Next Race Pain-Free?

November 2, 2019 · by Garrett McLaughlin

| Article written on November 1st, 2019 at 4:45pm | Follow Garrett on Facebook and Instagram |

Have you struggled with persistent aches, pains, and various running-related injuries throughout the years? Are you at the point where you are ready to try something different in hopes of seeing better results? If so, this article should provide you with the guidance necessary to reduce your likelihood of injury once a for all.

I hate to mislead you with some attention grabbing title. But, the truth is… Running is a painful sport. In fact, the research shows that up to 70% of runners get injured each and every year. Therefore, the real goal should be how to reduce your risk of injury since it cannot be prevented altogether. This can be done by increasing your tolerance to the demands of running and functioning in a more efficient way.

In the following sections, I will present a few key points for you to consider when emphasizing injury reduction…

Perform a Running Analysis

Since you’ll usually spend anywhere from 3-6 days per week running, the first step is to run more efficiently. How do you go about that? Spend the time and a little money on the front end by paying a trained professional to conduct a running analysis. This can be done in simple ways such as slow-motion treadmill analysis or with wearable technology like the DorsiVii.

Too often do we pay for the best Garmins, self-myofascial release tools, and training programs. In reality, your money is best spent on improving the quality of your movement within the sport. More efficient running form will cause less wear and tear on the body, as well as improve performance.

Complete a Movement Assessment

In addition to analyzing your running form and implementing the corrections which will make you more successful on the road, it’s important to assess general and specific movement patterns. What’s important to realize is that the body is really good at compensating. This means that a movement might appear normal even though the strategy to achieve that position has been altered due to a mobility, stability, or motor control problem.

During an assessment, you will complete a series of movements that can be analyzed by a trained professional. These movements provide a good glimpse into how the body functions in various positions. And, these naturally play a big role in how well you run.

Most movement assessments consist of the squat, lunge, single leg stance, step down, and other relevant drills. They can also be broken down to a greater degree when a discrepancy is found by evaluating one or several of the joints involved. In the end, you can determine your overall movement competency, if there are any imbalances or asymmetries from side to side, and which weak links need to be addressed to reduce your risk of injury.

Correct Your Weak Links

With the running analysis and movement assessment completed, you will have a very good idea of which areas require your attention. What’s important to realize is that there might be several things which are not “optimal,” in regards to your movement. The good thing is, you don’t have to be perfect to be a successful runner. And, by no means do you have to correct everything. Instead, work closely with your healthcare provider to determine what are the low hanging fruit or most important priorities to target first. Start there!

When implementing a corrective plan, patience and consistency are the two key ingredients. You can’t work on your specific exercises once a week and expect it to have any impact. Many of these underlying issues may have been present for months or even years before uncovering them. Therefore, address them daily, progress your program when able, and stay committed for the long haul.

Incorporate a Structured and Progressive Strength Training Program

Runners either have a love or hate relationship with strength training. However, one thing we can’t deny is that a higher level of strength or endurance only increases your tolerance to the demands of running. And, the great thing about that is, you are able to improve your foundation without running more miles. This is crucial as we age.

In my opinion, strength training is not the best term for it. Of course, it’s helpful to be stronger and more resilient. But, there are other characteristics which could better reduce your risk of injury, including: mobility, stability, neuromuscular control, timing, coordination, stiffness, and shock absorption. All of these play a vital role while running and should be addressed within your strength training program.

The big question usually becomes, how do you implement a strength training program alongside your running? Of course, running needs to be your priority. With that being said, there are weeks or months throughout the year where you can be more aggressive in the gym. This is usually following your goal race as you take some time to recover or even early in your running plan while you are still establishing a base. Then, as mileage builds, strength training can back down into more of a maintenance phase. As long as your body is able to adequately recover between runs, strength training should play a role in some way. Anywhere from 1-4 days per week is recommended depending on the time of year.

Understand Intensity, Volume, & the Importance of Recovery

Three of the most important variables in running are intensity, volume, and recovery. These have a very special relationship with each other that undoubtedly play into your likelihood of enduring a running-related injury. Plain and simple, the higher the intensity or greater the volume, the more recovery is needed. When recovery is overlooked for the sake of running faster or more miles, tissue breakdown will likely exceed tissue repair.

Running is infamous for chronic overuse injuries such as tendinopathies and stress fractures. How do these occur? A repetitive load is applied for too long or with too much magnitude for positive remodeling to occur. That’s why it’s very important to listen to your body and reduce intensity or volume when you are excessively tired, not sleeping well, experiencing high levels of stress, during certain times of your menstrual cycle, and/or not hitting your normal paces.

In the end, it’s important to be smart with your training. If you start to notice any of the warning signs listed above, consider what modifications you might have to make to stay healthy. That’s why I always recommend following a structured and progressive plan that builds you up for your goal race, while prioritizing recovery. Not to mention utilizing an experienced running coach to help you make smart decisions.

Like I mentioned upfront, running is hard on the body and there is no way to prevent running-related injuries from occurring altogether. Being smart, listening to your body, and applying some of the strategies I mentioned can help alleviate the risk so you can continue running on your terms for years to come.

Thank you for reading this article. If you personally need help reducing your risk of injury and think some of the strategies I outlined in this article could be helpful, click here to learn more about the Healthy Running Program. This program is designed for runners and will be 100% individualized to your needs. In-person and remote options available!

3 Single Leg Exercises to Reinforce Good Lower Limb Alignment

April 23, 2019 · by Garrett McLaughlin

Article written on April 22nd, 2019 at 02:59pm | Follow Garrett on Facebook and Instagram |

Running is such a dynamic activity that requires stability, balance, and alignment as you bound from one leg to the other. That’s why focusing on these characteristics within your strength training program can make a huge impact on how well you function on a single leg. That is, if you address them properly…

When we look more closely at alignment of the lower limb, it becomes clear that emphasis needs to be placed at the foot and hip. These two areas ultimately control the knee joint, which most people consider the culprit for poor alignment at the lower extremity. Although there is a small degree of tibial (knee) internal and external rotation which could impact alignment, it’s more likely a stabilization issue at the medial longitudinal arch or posterolateral hip musculature. These areas need to possess proper feed-forward and feedback mechanisms during late swing phase, foot strike, and midstance. Basically, they provide input to the nervous system in preparation and response to movement/joint position to maintain optimal alignment of the limb.

Over the years, I have tested a variety of single leg movements on my running clients to determine which will provide the best bang for your buck. In doing so, there have been three which have shown consistent, positive results. Of course, your exercise selection should target your goals and body’s specific limitations. However, from a general standpoint these three exercises are well worth your time if you want to improve stability, balance, and alignment. They include:

Lateral Toe Taps with Band
Lateral Step Down
Slow Eccentric Step-Up

To best explain the key points of each exercise and why they matter when it comes to stability and alignment, I’ve included a video below which will teach you how to perform each one correctly and with the most success. The next step is for you to stay consistent over the next few months and emphasize good control to see positive results and carryover to your running.

Thanks for reading about single leg alignment and stability. I hope this article highlighted it’s importance when it comes to running and being more efficient on a single leg. If you have any questions, please feel free to comment below or contact me directly.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

Considerations for Maintaining Optimal Knee Health

March 27, 2019 · by Garrett McLaughlin

Article written on March 27th, 2019 at 03:55pm | Follow Garrett on Facebook and Instagram |

The knees endure tons of stress during running, athletics, lifting weights, and other daily activities. That’s why it’s important to implement the correct approach to optimizing knee health within your strength training and movement program.

In many instances, runners strengthen the muscles surrounding the knee joint in an attempt to resolve a knee injury and/or prevent a future one from occurring. Building strength and resilience is always welcomed since it creates somewhat of a protective shield around the joint. However, from a biomechanics standpoint, the knee joint is greatly influenced by the hip and medial longitudinal arch. Therefore, solely increasing strength is a short sighted approach to reducing pain and improving function.

Like I mentioned previously, the hip and medial longitudinal arch are key players when it comes to proper knee health. Stability and control at these joints ultimately dictate how the knee will be positioned during movement. This is especially true with running and single leg stance.

Poor stabilization at the hip and arch cause what’s commonly known as, valgus collapse. This means the knee joint is tracking inwards and the alignment of the entire lower limb is no longer in a vertical position. The greater the degree of this collapse, the more stress placed on the patellofemoral joint and knee as a whole. It’s important to realize that this is not a knee strength issue but rather a positional issue.

So, what’s the solution?

Assuming structural issues have been ruled out, implement a thorough and progressive corrective/loading program to build stability, control, and alignment in the lower extremity. This should include exercises that target hip/foot activation AND stability and alignment.

Next, improving the knee joint’s ability to withstand higher loads and ground reaction forces with landing-based plyometrics is a must. Teaching proper jumping, landing, and positioning of the joint during loaded activities will build the resilience needed to return to running with better long-term success and less incidence of future injury.

The following video will reinforce several key considerations when targeting optimal knee health…

I hope this article has helped shine some light on the “other” areas which contribute to proper knee health. I highly recommend seeking an evaluation from a qualified healthcare professional so you can be properly diagnosed and put on a daily corrective program. If improving your knee health is a priority, click here to contact me directly so you can work towards achieving a pain-free and healthy lifestyle.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

‘In the Spotlight’ with Carol Hough

March 10, 2019 · by Garrett McLaughlin

In this edition of ‘In the Spotlight,’ let’s talk with Carol Hough. I met Carol for the first time over a year ago when she attended one of my learn-by-doing seminars at Fleet Feet Sports Nashville. We scheduled a consultation and I was very excited that she was ready to incorporate strength training to support her knee and supplement her running program.

From the beginning, we knew it would be a slow and steady process to begin implementing strength training within the limits of knee pain. Carol stuck with the program for over a year now and has showed strong improvements in many areas!

In addition to her dedication each and every week, Carol brings an upbeat personality and “heckling” sense of humor to each session. To say we have fun is an understatement! And, to get results while doing it is what makes doing what I do so enjoyable.

Without further ado, let’s shine the spotlight on…

Carol Hough

Q: Where are you from?

A: “I am originally from a little town called Leechburg which is approximately 35 miles northeast of Pittsburgh, PA. And, I moved to TN with my job in 1991.”

Q: What do you do for work?

A: “Project Manager in the Underwriting Dept. at Cigna Healthcare.”

Q: When you aren’t working, what are some of your favorite hobbies?

A: “Running and cycling tend to be where I spend the most of my time outside of work. I also enjoy hiking and reading but they tend to take a back seat to running, cycling and of course, Garrett’s strength training class for runners!”

Q: If you could live anywhere in the world where would that be? Why?

A: “Hmmm, good question! After I retire and do more exploring of other countries, I’ll get back to you with an answer on this one!”

Q: You have been known to be called “The Heckler,” do you see yourself as a prankster?

A: “No, I don’t think of myself as a prankster. Although I have pulled some good pranks over the years, they are few and far between. I tend to save my ‘heckling’ for folks I appreciate and have fun being around.”

Q: When you first started working with Garrett, what were the goals you wanted to achieve?

A: “I believe my goal was to strengthen the legs so that I could continue to enjoy running. Due to the arthritis in my knee, it had become more painful to do any kind of distance running or even walking several miles at a time.”

Q: What motivated you to work with Garrett and/or start making changes in your routine?

A: “Arthritic knee issues where I knew that if I wanted to continue running that I needed to do some strength training. I’ve found that I tend to improve more when training with others vs. doing thing exercises on my own. After researching available classes at the Y and other trainers, I attended one of Garrett’s clinics offered at Fleet Feet and was impressed by how he ran the clinic given that folks were at all different levels of ability.”

Q: You’ve had a history of knee pain; do you feel strength training has helped you function better and with less pain?

A: “Yes, strength training has definitely helped and I’ve been able to run some without the knee brace. I’ve also noticed that my knee is more stable when doing the various exercises during class as well as when running without the knee brace. In the fall of last year, I decided to do the ‘Mega Hike’ (26.2 miles) at Long Hunter State Park knowing that I would probably not be able to do the entire distance due to my knee issues and the fact that I hadn’t trained for it. To my surprise, I was able to complete the entire distance without being in too much pain during it or afterwards and I really believe it was due to all the strength training I had been doing with Garrett’s class.”

Q: What are some of the exercises that you really have to focus more intently on due to the knee?

A: “Although I’ve significantly improved on Step Ups and am now doing them with weights, I still have to focus on the stability of my bad knee when doing them.”

Q: Are there specific exercises that you feel are the most beneficial for you?

A: “I guess I’d say the ones where I’m able to see how stable the knee is while doing them such as: Lunges, 2 DB Step Ups, DB Split Squat, Squats in general. However, I’m sure there are others that help as well.”

Q: Since joining the group training program, what are the most noticeable improvements you’ve seen so far?

A: “Most notable is being able to actually do the 2 DB Step Ups with confidence. I’ve also seen lots of improvements with upper body strength and core exercises. And most importantly, I’ve been able to run some without my knee brace without worrying about my balance (knee stability).”

Q: Were these improvements easy to achieve? And, tell us a little bit about any struggles along the way.

A: “The improvements so far probably took longer as I’m not good at doing the corrective exercises that Garrett prescribed on a daily basis. (Sorry Garrett!) I’m focused 100% during our classes but with running 3 days a week, cycling or spinning 2 days a week, Garrett’s class one day a week, 1 rest day a week — my weekly exercise routine is full. I tend to prefer exercising after work and find it difficult to get up any earlier during the week in order to fit in my corrective exercises. However, this year I am now trying to do them on my rest day. ☺ As to other struggles, I would get frustrated at times (and still do) when encountering a new exercise which I wasn’t able to do – most recently it was the Super Plank! Sometimes I was able to acclimate to the new exercise faster than other exercises so that at least I saw improvement. Haven’t been successful yet though with the Super Plank so need to work on that one!”

Q: What are your thoughts on the group training program?

A: “I absolutely love the group training program! The camaraderie of the group is great and we often encourage each other, at least when we aren’t heckling Garrett. The monthly training program is helpful in that we know what we’ll be working on that month. I love the variety in the exercises we do so that it’s not always the same things. During class, Garrett makes sure that our individual form is correct and he makes certain that he knows how you’re doing that week too. So although it’s a group class/training program, I still think there is a lot of individual instruction/attention provided.”

Q: How do you feel strength training impacts your daily life and running?

A: “I’ve seen improvement in my balance/stability given my knee issues as well in my core has benefited as well. In addition, the strength training has helped me improve upon my upper body strength. All of these things working together will allow me to continue running and being very active in hiking, cycling, etc.”

Q: What is that one thing you dislike the most but continue to work on because you know it will help?

A: “At first it was the bear crawls, but I’ve improved there. Currently it is the Super Plank as I’ve not yet been successful in doing the # of reps we’re supposed to do.”

Q: How do you feel Garrett’s services may differ from other professionals in his field?

A: “I believe that Garrett’s friendly personality along with the way he encourages us, regardless of where we are in our abilities, is one of the differences. Garrett gets to know his athletes and is able to quickly adjust an exercise to meet our specific needs when necessary. The monthly training program that Garrett sends out is awesome, especially since he includes links to videos of the exercises so we can see how to do them correctly. I also think that the Orthopedic/Functional Evaluation that Garrett does on a quarterly basis sets him apart from other professionals. Following the evaluation, Garrett provides us with our individualized corrective exercises and works with us to further tailor them to our needs, when necessary.”

Q: Looking ahead, do you have any new goals or races you are working towards in 2019?

A: “This year I want to focus on continuing to improve my stability and begin improving my running pace as it’s definitely not where it was due to the knee issues. My slower pace is messing with me mentally as far as signing up for any races but I need to get over it and just do it!”

Thank you for reading this ‘In the Spotlight’ segment. And, a big shout out to Carol Houghl! Please feel free to comment below with any questions or feedback.

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