Goal
Each year approximately 75 percent of runners become injured or develop pain that results in time off from running. This can be avoided. Our goal is a combined effort to help runners recognize what they are doing wrong, correct it, then gradually increase their running to the level they wish to obtain.

Injuries
Most running injuries are secondary to overuse and improper form. This can be plantar fasciitis (heel pain), shin splints, stress fractures, knee pain, low back pain, IT band syndrome, and many others. Too often runners will blame the “shoe” for their problems and resort to trying numerous shoes and orthotics before finding the actual source of their problem.

Examination
The process starts with a thorough history of the patients running patterns and injuries. It is important to bring your shoes to your first appointment along with any orthotic device you may be using. Most injuries can be diagnosed by simply reviewing a runner’s training regimen. After we have diagnosed the injury or ailment that you are suffering from, we have the ability to analyze the runners’ form and gait with the help of the PT Center of Akron.

How to we obtain proper form?
Proper form is popular topic now amongst runners as we are seeing a gradual change in the construction of running shoes to those whichare less supportive. Many elite runners have worn minimalist shoes (racing flats) for years and were able to do so by running with good form. So what is the trick? Do we have to spend many hours and lots of money on lessons like those who golf do to obtain that “perfect swing?” It turns out that our bodies have the ability to run this way, yet interfered with this by the use of traditional footwear in our society. If you watch children run, they typically carry a smooth graceful form that intuitively encompasses the criteria that running specialists are defining as “perfect form.”

New Balance has partnered with the creators of Good Form Running to help educate shoe stores and runners across the country. Click on the link below to learn more about running with proper form.

Our office can help determine if your injury is secondary to improper form and with the help of the PT Center we can fine tune your running and reduce your chance of injury.


Will running in a minimalist shoe fix my foot pain?
Unfortunately it’s not that simple. The first step to fixing any running injury is to find out what is creating it. Running injuries are typically due to overuse or improper form. Too often an injured runner will try fixing an injury by getting the latest and greatest running shoe, only to find the pain persists. While changing to a minimalist shoe sometimes does cure an injury, it is not a direct result of the shoe. More then likely the runner changed their form.

The key for any running injury is to review the training history and see if a pattern points toward an overuse injury. Next observing the runner’s gait to uncover any traits of inefficiency and improper form is crucial. Once the diagnosis is made and underlying factors are discovered, allowing the injury time to heal while concomitantly fixing the runners gait is the goal.


Do Shoes Really Make a Difference?
It is not uncommon for patients to present to my office with explaining that they have spent hundreds of dollars on shoes and have yet to relieve their pain. Wouldn’t it make sense the more one invest in a running shoe, the less likely one is to sustain an injury? Unfortunately it is not this simple.

With a rise in the interest of barefoot running, shoe manufacturers have created shoes that have created a new category which has become known as “minimalist running shoes.” It can also be argued that minimalist shoes are the same thing as racing flats which have been around for many years and are worn by elite runners the day of race. People are using this type of shoe as an everyday running shoe and not just reserving it for race day.

As important as they may seem, shoes are actually there to “protect our feet” not to support or cushion the arch. Form becomes far more important then shoes in preventing or reducing injury. To often runners try to fix their injury with a shoe, when the problem could be arising directly from form.

Traditional Running Shoe
A traditional running shoe are typically one of 3 types:
1.Cushioned
2.Structured Cushioned
3.Motion control

They are designed for the respective foot types of a high arch, normal foot, and flat foot. The construct consists of some mild or moderate arch support, a sole designed to only flex at the forefoot, and a thick cushioned heel. The shoe encourages heel striking, which is an unnatural way to run and increases unnecessary force to the lower extremity.

Minimalist Running Shoe
Minimalist running shoes are just that – minimal. They are basically a soft flimsy shoe that allows the foot to function as though it were barefoot. Minimalist shoes do not shock absorb or control motion because when we run with proper form our feet can do this innately. Really, the only protection our feet need is from environmental factors such as rocks, glass, and hot surfaces such as sun baked asphalt. It is really a misconception to think that our feet need arch support or cushion.


Beginning a Running Program
For years Hal Higdon has helped runners complete half marathons and marathons with his popular training programs. While they are an excellent way to train, they are not specific to each individuals current level of fitness. It’s best to understand the principals of training first and then utilize this to create a program designed specifically for you. Whether you are training for a 5K, or just starting a running program, the underlying training approach remains the same. Our bodies were designed to run, and adapt to the demands placed upon them. By gradually increasing the amount of running one does, they can without a doubt become a better runner.

New Runners
If you are new to running, then a walk/run program is the safest approach. Start with 2 minutes of slow jogging, followed by 2 minutes of walking for a total of 20-30 minutes. Build on this alternating with days of rest until you feel comfortable doing daily with a goal of activity for up to 5-6 days a week. As your body adapts, increase by no more then 10% of time or mileage each week. Once you reach 10 minutes of running your walks do not need to be as long (4-6 minutes should be plenty of rest before running a second 10 minutes). Don’t get caught up with distance or pace when first starting out. Time is more important.

Runners who run 10-20 miles a week
Once you are adapted to running a consistent mileage, it is time to start “changing” your runs. To continue aerobically improving your body, it is best to mix your paces each day. Tempo runs and interval running is a great way to do this. A tempo run consists of running at a pace just below the point of becoming anaerobic. You should be able to sustain this for 15-20 minutes. If you reach a point to where you have to stop, you are going to fast. Tempo runs improve the body’s ability to run faster and efficiently. Always warm up and cool down with at least 5 to 10 minutes of running in addition to the tempo run. Advanced tempo runs can reach 40 minutes.

Interval running is aimed more for those trying to achieve speed for running a shorter race such as a 5K. These should be performed no more then once or twice a week. Ideally an interval and tempo run should be performed weekly for trying to improve speed. There are multiple ways to run intervals – 400 meters (1/4 mile) 800s (1/2 mile) and 1600s (mile) repeats. A 400 would be run faster then a 1 mile repeat. It is important to realize that if your current fitness level allows you to run a 5K at a pace of 8:00 miles, then running a 400 should be faster then this, but not to the point of complete exhaustion. For example, running 6 repeats at a 7:30 pace would be more beneficial and less likely to create injury then running at a 7:00 pace. After many weeks of training this way, you will eventually improve your speed. The goal is to become efficient and speed will follow.

Advanced Runners
I tell all of my running patients the same phrase – “if you want to become a better run, then you have to run more!” It’s that simple. Whether you are training for a 5k or a marathon, more mileage will make you better. It’s important to not get caught up in running those miles too fast. It can be as simple as taking your running from 30 miles a week to 50 and your efficiency will improve as long as you increase gradually. Speed will improve even without doing speed workouts. I have had runners PR in a 5k simply by slowing down their runs to an aerobic rate and just adding more mileage. Of course adding tempo runs also helps improving speed. As previously discussed tempo runs should be done once a week when training for a race, but not during a period of base building. During marathon training, tempo runs can reach 10-12 miles ( in addition to a warm up and cool down).

Something else to consider, the best cross training for a runner is – TO RUN! The only reason to add cross training to your workouts is if you are injured. For example, if your legs feel dead, then rest. If your think your legs are too tired to run but instead you biked, you would be better off going for a easy run (important concept is to not go fast). Strength training and plyometric type activities are fine, just as long as they don’t replace your running that day. Core exercises are excellent to do and even more important is gluteal muscles strengthening.

Transitioning to a minimalist shoe
Here is a sample program to demonstrate the transition process for someone who typically runs 20 miles per week. Shown in red are the miles that should be run in a minimalist shoe followed by the total miles of the run that day. After first running your recommended mileage in the minimalist shoe, you are to change back into your traditional running shoe or whatever shoe you typically would run in. It is important to remember that this is for someone whose body and legs were accustomed to running 20 miles per week. If you run 10 to 15 miles per week, then you would adjust accordingly using the 10% rule. (notice we adjusted the 10% of 3 miles to 0.25 miles instead of 0.3 miles to make for a more standard distance. At the end of 8 weeks, you should be able to run 2 miles comfortably without the risk of injury in your minimalist shoe. Continue to increase in the same manner until your body has adjusted and you are not experiencing soreness. You will find that as you progress to 3 miles you will begin doing your shorter runs completely in the minimalist shoe. Some runners such as though who already ran with a forefoot strike pattern may be able to progress to three miles faster then outlined here without becoming injured. This however is not advised to reduce the risk of injury.