Week 10: Running Assessment Flashcards
Defining characteristics of walking
Heel strike pattern generally
No flight phase
Prolonged stance phase
Defining characteristics of jogging
Limited hip flexion
Decreased plantar flexion peak torque
Decreased forward momentum
Greater vertical translation
Defining characteristics of running
Mid- to fore-foot strike (maybe - only 10% of people forefoot strike)
Increased hip flexion
Increased plantar flexion peak torque
Defining characteristics of sprinting
Fore-foot strike
Forward lean
Very minimal contact time
Increased flight time
Is there a difference in lower extremity joint range of motion between walking, running and sprinting?
- There is a difference in support and non-support phases between sprinting, running and walking
- There are differences in lower quadrant range of motion between sprinters, runners and walkers .
Describe the differences in lower extremity range of motion during walking, running, sprint
- Greater hip extension in running vs walking during toe off. Hip extension is reduced in sprinting during toe off partially due to person leaning forward and needing to drive legs forward faster!
- Greater hip flexion during sprinting vs running and walking
- Greater knee flexion after heel contact during running vs walking. This is due to higher impact force and needing to absorb initial shock
- Sprinters run with a slightly stiffer knee. There is no bump of knee flexion during heel contact. Important to bounce off the ground rather than absorb the impact forces
- Greater knee flexion, less work for the hip muscles to swing the leg through, greater efficiency
theres more differences, refer to the graph in class
FADDIR test
Flexion, adduction, internal rotation; pinching = femoral acetabular impingement or muscle imbalances contributing to this balance (tight hip flexors, tight piriformis)
Knee to wall test
Where do they feel restriction?
Soleus length
Achilles issues
Q angle
quadriceps (Q) angle can be described as the angle formed by the bisection of two lines, one line drawn from the ASIS to the center of the patella, and the other line drawn from the center of the patella to the tibial tubercle
Why does q angle differ between males / females?
Height difference of pelvis. Males have longer limbs and narrowers pelvis, q angle is smaller in males than females.
navicular drop
Navicular Drop: distance the navicular tuberosity moves from sitting to standing, as the subtalar joint is allowed to move from its neutral position to a relaxed position; indication of pronation of the foot
Is a navicular drop associated with lower extremity leg pain?
A navicular drop is associated with medial exercise-related leg pain
No difference in exercise related leg pain but increase in medial exercise-related leg pain with those with more than 10 mm navicular drop.
Are runners who present with an increase in pronation at an increase risk of injury?
There is a lower injury rate in runners with moderately pronated feet compared to neutral feet
Do runners who suffer injuries have higher vertical GRFs than those who remain injury-free?
The vertical GRF loading rate may be associated with some running-related injuries
Is vertical loading rate associated with running injury?
Vertical Loading Rate Is Not Associated with Running Injury, Regardless of Calculation Method
What happens when you switch to a forefoot strike pattern without changing stride
you land with a more rigid foot and ankle which results in greater forces to the metatarsals and foot. This can lead to a running related injury over time
What does excessive hip drop indicate?
weak hip abductors; can’t maintain a neutral pelvis
increased strain to patellofemoral joint and IT band
Sudden hip drop means they’re struggling with the loads of running leading to excessive strain to soft tissues
Is there an association between hip angle during running and injury rates?
greater hip adduction angle is associated with an increased risk of injury in runners and patellofemoral pain syndrome
- results in poor patellar tracking and increased pressure. patellofemoral pain
Is running cadence a risk factor for the development of a running-related injury?
Step rate goes up, shorter step length
Step rate goes down, longer step length. over striding.
A slower running cadence is associated with an increased risk of running-related injury
An overstriding leg is straighter and stiffer, which reduces your body’s ability to absorb the force of your landing. This can lead to shin, knee, and hip injuries.
Higher step rate was protective of bone stress injury. Less likely to get a bone stress injury
Lower step rate increased likelihood of a bone stress injury
What are the risk factors for a bone stress injury in runners?
greater vertical displacement of COM
previous bone stress injury
low step count
Can motion control shoes alter lower extremity biomechanics?
Motion control shoes can reduce foot pronation
However, motion control shoes do not alter proximal leg mechanics (no changes above the ankle - no tibial rotation or knee valgus)
Does heel-to-toe drop influence injury rates in runners?
Heel-to-toe drop is not associated with the incidence of running-related injuries
Shoe prescription to prevent injuries?
Written by chris napier
Shoe’s change to minimalist shoes results in changes to foot strike patterns and stride length but only initially. after 6 months people transition back to their original patterns
- Not shown to prevent injuries
However, Chris would recommend switching from low heel drop shoe to High heel drop shoe if the patient has a history of achilles tendinopathy
Does wearing orthotics decrease the incidence of running-related injuries?
Orthotic use increases the risk of developing medial tibial stress syndrome in runners
Do lower extremity compression socks limit muscle damage during running
There is no difference in muscle damage
How does running uphill vs downhill affect running biomechanics?
Running up hill you need to land in more dorsiflexion
Downhill you have more knee flexion to absorb the higher ground reaction force
Is there a relationship between running-related injuries with running surface and terrain?
There is no relationship between running surface and incidence of running-related injuries
- We change our mechanics based on our surface
There is no relationship between terrain and incidence of running-related injuries
- We change our mechanics based on the terrain
Why did JK have:
- left achilles tendinopathy
- L tibialis posterior tendon dysfunction
- L IT band pain
- L adductor/groin pain
How did Dr. Napier treat him?
- Slow step cadence –> high impact force
- Long strides –> high impact force
- Hitting the ground harder on left side –> greater impact force
- collapsed arch on left side –> lower ability to absorb shock. higher impact force
- weak hip abductors from observed hip drop. cannot maintain a neutral pelvis. increased strain to patellofemoral joint and IT band and other musculoskeletal tissues.
L adductor groin pain - labral pathology; positive FADDIR
Plan
1. increase step cadence
2. increase strenght
3. monitor training load (training for triathalon)
What did Dr. Napier find when he analyzed TM? What interventions did he prescribe?
Remember: TM developed R ITB pain when started back on track in Spring
Right cross over gait - increasing stress on R ITB
Right arch collapse
Right foot abduction
forefoot/midfoot strike pattern
Landing underneath his COM. vertical tibia at the initial contact.
Plan:
1) Change direction of training around track
2) Strength (glutes)
