I think the sport of running is over-complicated and over analysed almost to the point of ridiculousness. What’s wrong with just putting on your shoes, heading out the door and putting one foot in front of another.
And I’m not alone in thinking this. Damian Thacker a physio from Sheffield has done a short blog on this topic and is prepared to put his body where his mouth is to prove just how running doesn’t need fancy gadgets or equipment, and so without further ado, it’s over to Damo!
Just RUN!
As a physiotherapist, I see a significant number of runners who have had injuries in the past or who now experience persistent running-related pain. I also encounter many myths about running injuries and technique.
Perversely these concepts alone can generate unnecessary fear and apprehension and can become prominent barriers to people getting better. Along with a lack of variety in training and rigid lifestyles, a loss of vitality can occur, sometimes ending up with the perpetual state of persistent pain and a disconnect from what we love to do, just run.
As our foot strikes the ground beneath us there is obviously a physical connection; however, interruption, disbelief or over-attention to this part of the activity can lead to a lack of harmony. Hence running becomes less seamless and over complicated. The actual capability of the foot to adapt to a chosen surface, to me, is beautiful and far more accommodating and resilient than most believe.
Structuralism, the belief that pain and injury are solely due to a fault with anatomical structure and resulting from a biomechanical cause, underpins most of what is thought about running rehabilitation. Common assessment and management of running-related pain is generally too linear, one-dimensional and focused on corrections. Consequently, people often reduce their running frequency, withdraw from variety, become hyper-vigilant and less adaptable, all of which can lead to fragility.
Rehabilitation can also be overly focused on short-term comfort which can actually increase injury proneness and encourages injury suspension rather than resolution. Becoming anti-fragile and improving emotional and physical resilience is preferable to ensure both body and mind start to adapt more favourably to the challenges we set and expose ourselves to in running.
We all have an individual form or way of running for a myriad of different reasons which include our: strength, flexibility, height, weight, comfort, endurance and energy levels. We also execute many different strategies in reaction to the terrain, conditions, speed, inclination, perceived effort, even our shoes and clothing.
All these reactions, changes and variations are normal, and our mind and body must be flexible and adapt quickly, ideally with little conscious awareness of environmental connections whilst we run. This is flow, or being in the zone. Our foot to road connection need not be too different from other connections such as the shirt on our back i.e. unnoticeable. Settling into our rhythm quickly contextualising any interactions or perceived threats.
Having this physical and psychological flexibility should be recognised, nurtured and then celebrated when assessing and rehabilitating runners. Further, it should be the only real strategy in the prevention and resolution of running-related pain. Certainly, it should be the focus of rehabilitation ahead of moulding people to a utopic running form.
Lingering thoughts, elevated concern, or forced attention onto specific body parts is something to be curbed in a person experiencing running-related pain. Running and training without judgment is key. This is a normal state that a person should be supported towards, giving space for resilience to flourish and ultimately resolution to be achieved.
A new breed of super hero… Welly-man!
So, to highlight this and to test my clinical and personal understanding of the human mind and body, I intend to run the 2017 London Marathon in a pair of bog-standard Wellington Boots. Also, I plan to do minimal running in the Wellington Boots before the marathon, just a few jogs to ensure my socks work well.
Instead, I am relying on a training plan that has created a flexible healthy state where any new stress and strain has been an opportunity to improve resilience through further accommodation and adaptation. This is also what I look to achieve in clinical practice with patients.
The notion of running in Wellington Boots came from a conversation with a patient about running shoes. Something like…
Patient: “so what you’re saying is I’m safe to run in any type of shoe”
Me: “yeah providing they fit and are comfy”
Patient: “..Ok so what about Welly boots? They’re comfy.”
Me: “Yup, even Welly boots!…”
Nine months on and my Guinness World Record attempt is accepted for the 2017 London Marathon on the 23rd April.
Damian
Welly never!!!
Damian is no stranger to crazy running challenges. He has run 40 marathons in under 40 weeks as well as ran the worlds fastest ‘3 legged’ marathon in 3 hrs 07 secs! He has raised thousands of pounds in sponsorship for the Sheffield Children’s Hospital after they helped his son, and he is doing this ‘Welly Marathon’ challenge again for the Children’s Hospital Charity.
If you would like to support him and his gumboots please click this link here
Can’t wait to hear the outcome!
Interesting post. I concur that too much can be made regarding running form etc. I had a classmate lose a leg and he went on to run 143 marathons in 143 days on one leg (and prosthesis). I also used to treat a psychiatrist with club feet who ran the London marathon with less than a months preparation. The only question might be whether can the ordinary individual live up to the exceptional? Some might but others might find that they fail, because of the way that they have lived their lives. We have people come back to play rugby who might have tolerated a lot when they were 25 only to have their biceps or achilles pulled off when 40. If you aren’t able (or willing) adequately condition your body then perhaps you need to have the ”special” shoes or inserts or different running style or whatever?
TBH I think that with preparation far more is possible than expected by many people (I am still playing rugby and close to 60) . Still I am not sure that I would apply the same rules to an unprepared 40 year old that I might apply to a 20 year old considering hormonal changes, lifestyle changes and differences in how we appear to grow/heal as we get older.
Just some thoughts :’ )
Interesting blog. This approach is great for asymptomatics. Surely patients with overuse running injuries can still benefit from a more reductionist approach. For example reducing cross over in patients with itbs or increasing cadence for anterior knee pain might help patients get back to enjoying running sooner.
Interesting read and good luck with the marathon!
I can see where you’re coming from and think I agree we become very bogged down on correcting biomechanics that potentially may not be relevant and could have been there all their life. I think if I were to change something and I found an immediate improvement in symptoms I might think it’s relevant? I’m not sure many physio’s would know what to do with their patient if they didn’t correct those things? You’d just tell them to run and not worry about it? Then what?
I’m interested to know how you would treat these patients.
Katie
To truly unstructuralize, don’t enter the race. Just run on a day of your choosing.
I absolutely agree. I have been running for over 40 years at distances from 5k to 100k+. I have worn all sorts of shoes, mostly determined by fashion and my ability to pay more as I earned more (not unlike most other things in my life such as clothes and wine!).
Loving the wellies. I run quite a lot in wellies and jeans! Following trail hounds on foot in the winter. I can run when I want, walk when I want love it and great interval training. Generally have a lot of variety in my training doing what I want when it fits in with other plans. Have my first proper 10K week today (conventional kit) one reason and another having an easy week and I’m hoping to benefit from running fresh.
Some years ago (in my 40’s ) I studied Physio as a mature student but didn’t complete the course (mainly due to the offer of an IT Contract) but I had been getting a bit disullisioned – it probably didn’t help coming from an IT background where things either work or they don’t work.
I have an injury myself that despite following the protocols never really got better as I experienced persistent calf tears when running that usually occurred after 20 mins or so even after warm up- including cycling and stretches.
A later review of the literature and a TV documentary suggested there is no evidence that stretching prevents injury.
At the time I mentioned it to one of my Physio lecturers, who thought it may be linked to a minor left sided weakness as a result of back surgery from many years ago – the tears at the time were mainly on the left side, the same side of the sciatic nerve pain.
All this was around 10 years ago and I virtually gave up running and took up cycling – which gives my calf no problem at all.
Recently (I’m now 59) I took part in a Park Run and after 3 km everything was fine until the usual ping in the calf at the musculotendenous junction.
I should add , I have over the years had tears in both legs – I have tried calf strengthening ie calf raises with weights, building distance slowly using a treadmill, calf compression using tubgrip, rub on gels.
I should add I played soccer well into my 40’s which is when the problem first started.
Is there anything you can suggest or is this just a result of age , previous injuries and the calf being prone to tears at the muscle tendon junction as one ages ?
Thanks