Week 10: Running Assessment

Question 1

Defining characteristics of walking

Answer 1

Heel strike pattern generally
No flight phase
Prolonged stance phase

Question 2

Defining characteristics of jogging

Answer 2

Limited hip flexion
Decreased plantar flexion peak torque
Decreased forward momentum
Greater vertical translation

Question 3

Defining characteristics of running

Answer 3

Mid- to fore-foot strike (maybe - only 10% of people forefoot strike)
Increased hip flexion
Increased plantar flexion peak torque

Question 4

Defining characteristics of sprinting

Answer 4

Fore-foot strike
Forward lean
Very minimal contact time
Increased flight time

Question 5

Is there a difference in lower extremity joint range of motion between walking, running and sprinting?

Answer 5

• 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 .

Question 6

Describe the differences in lower extremity range of motion during walking, running, sprint

Answer 6

• 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

Question 7

FADDIR test

Answer 7

Flexion, adduction, internal rotation; pinching = femoral acetabular impingement or muscle imbalances contributing to this balance (tight hip flexors, tight piriformis)

Question 8

Knee to wall test

Answer 8

Where do they feel restriction?
Soleus length
Achilles issues

Question 9

Q angle

Answer 9

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

Question 10

Why does q angle differ between males / females?

Answer 10

Height difference of pelvis. Males have longer limbs and narrowers pelvis, q angle is smaller in males than females.

Question 11

navicular drop

Answer 11

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

Question 12

Is a navicular drop associated with lower extremity leg pain?

Answer 12

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.

Question 13

Are runners who present with an increase in pronation at an increase risk of injury?

Answer 13

There is a lower injury rate in runners with moderately pronated feet compared to neutral feet

Question 14

Do runners who suffer injuries have higher vertical GRFs than those who remain injury-free?

Answer 14

The vertical GRF loading rate may be associated with some running-related injuries

Question 15

Is vertical loading rate associated with running injury?

Answer 15

Vertical Loading Rate Is Not Associated with Running Injury, Regardless of Calculation Method

Question 16

What happens when you switch to a forefoot strike pattern without changing stride

Answer 16

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

Question 17

What does excessive hip drop indicate?

Answer 17

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

Question 18

Is there an association between hip angle during running and injury rates?

Answer 18

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

Question 19

Is running cadence a risk factor for the development of a running-related injury?

Answer 19

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

Question 20

What are the risk factors for a bone stress injury in runners?

Answer 20

greater vertical displacement of COM

previous bone stress injury

low step count

Question 21

Can motion control shoes alter lower extremity biomechanics?

Answer 21

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)

Question 22

Does heel-to-toe drop influence injury rates in runners?

Answer 22

Heel-to-toe drop is not associated with the incidence of running-related injuries

Question 23

Shoe prescription to prevent injuries?
Written by chris napier

Answer 23

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

Question 24

Does wearing orthotics decrease the incidence of running-related injuries?

Answer 24

Orthotic use increases the risk of developing medial tibial stress syndrome in runners

Question 25

Do lower extremity compression socks limit muscle damage during running

Answer 25

There is no difference in muscle damage

Question 26

How does running uphill vs downhill affect running biomechanics?

Answer 26

Running up hill you need to land in more dorsiflexion

Downhill you have more knee flexion to absorb the higher ground reaction force

Question 27

Is there a relationship between running-related injuries with running surface and terrain?

Answer 27

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

Question 28

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?

Answer 28

• 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)

Question 29

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

Answer 29

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)