BIOMECHANICAL EVALUATION

Most runners are mechanically wasteful, expending more energy than needed to run at a given velocity. Your ability to perform well during distance running is the bitter reality of the battle for oxygen. But to be able to improve aerobic capacity, you must be able to train a certain number of miles without breaking down. There are no magic formulas to faster times. If you start to raise your mileage, however, and are constantly sore and always breaking down, you probably have a biomechanical imbalance, and should be evaluated.

Every runner who comes into my office with a running complaint is taken outside and videotaped (weather permitting). I know that a dynamic evaluation gives me more information than a static one of the patient sitting in a chair.

I see the patient's form, condition, movement, style, and pick up a lot if little nuances that can't be found any other way.

After the video taping, we go inside and watch the tape together. This is when I tie in the runner's chief complaint with his time sequences of heel contact, shock absorption, adaptation, stance, and propulsion. Next, I measure the runner for a leg length differential. By this time I usually have a theory as to what is responsible for their injury. Then I sit them down, look at their shoes, do the angles and ranges of motion of their lower extremity and classify their foot type.

Once this information is in my head, I am 99% sure of what to do next. 90% of all running overuse injuries are due to an error in their time sequence. This usually requires an equal correct time symmetry biomechanical orthotic to alter the patient back to neutral functioning. If an orthotic is successful in doing this, most patients' pain is 50%-75% gone in three weeks with the rest of the pain smoldering out between six to twelve weeks. Then, by using the orthotic to train, they are now stubbornly resistant to further aggravation. Plus, most runners have week hip flexors (see power stroke article) and tight calf muscles which must be stretched in order to be resistant to injury.

My success rate in treating runners, finding the cause of their injury and returning them back to pain free running is somewhere around 88% to 92%.

I've been doing it this way since 1983. Let me show you my thank you notes, cards and letters of appreciation from my patients. Therefore, if you decide to come to see me, please come with running clothes, running shoes and a VHS tape.

DISTANT RUNNING INJURIES

Biomechanics is a complex subject. If you have a running injury, you must see someone trained in biomechanics who is going to watch you in running motion and can apply biomechanics to your individual problem.

A serious runner myself since 1968, I apply the biomechanical approach to running injuries like no one I know of in Cincinnati. The two main causes of distance running injuries are training errors: either too much too soon, or anatomic factors of the lower extremity.

In running, events must happen at the proper time to be efficient and reduce stress; foot and leg function is a time sequence phenomena. If you are not in the normal time sequence, you are at risk of an injury if your mileage gets too high.

There are six major biomechanical foot types, each of which can break down with overtraining. Only one type, the Neutral Foot, is capable of significant mileage. By analyzing your running motion, I can evaluate your running skills, help correct your technique and any biomechanical imbalances. You will soon find you have the ability to run higher, faster mileage with less risk of injury.

SIX MAJOR BIOMECHANICAL FOOT TYPES

1. Neutral Foot - Time Sequences of shock absorption, adaptation, stance, and propulsion take place at the correct time. Can do lots of mileage.
2. Forefoot Varus - This foot spends too much time in the shock absorbing phase and converts to propulsion late. Symptoms include superficial knee pain, shin pains, Achilles tendonitis, I-T band pain, plantar fascitis, low back pain, etc. Treatment include orthotics that trick the foot into thinking it's down to the ground by bringing the ground up to the forefoot.
3. Rearfoot Varus - This foot functions the same as Forefoot Varus when found with a Forefoot Varus. However, it functions like a Valgus foot (see below) when found with a Valgus Foot. Treatment is with an orthotic with rear foot control.
4. Rigid Forefoot Valgus - This foot prematurely converts to propulsion at a time when it should still be absorbing shock. Symptoms include a tendency to ankle sprains, an unsure gait, every foot pain imaginable, leg muscle problems, stress fractures, etc. Treatment includes an orthotic that tricks the fore foot into thinking all the bones are level with each other by bringing the ground up to the foot. Very rare foot type.
5. Flexible or Plantar Flexed First Metatarsal - This is the hardest foot type to classify. It is capable of functioning like a Forefoot Varus, Rearfoot Varus, and in some cases, like a Rigid Valgus, but not as severe. Symptoms include everything including sciatica. Treatment is with orthotics to put the forefoot in neutral.
6. Equinus - This foot type has the inability to place the foot 10 degrees closer to the shin as the center of gravity passes over the ankle. Symptoms are a foot that spends too much time in the shock absorbing phase and little or no conversion to propulsion. Uncompensated, it is the worst running imbalance to treat. Stretching and heel lifts help most people but not all.

Other biomechanical factors include: angles of the shin bones, knee, hip, and leg length diffentials, structural, and functional.