SR homepage June, 2008
In this Issue:
Excessive Heelike 
Weak hamstrings - A recipe for knee pain. 
Thai Massage For Runners
Boston 08 - "Dreams do come true"'  
Coupon: $3 off 'Right on Hereford, Left on Boylston"

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Common Mistakes in Running Form - Excessive Heelike 

Running with your natural form may not be quite so natural on your musculo-skeletal system.  Sedentary jobs, past injuries, non-running activites (biking, rowing, skiing, ballet, etc), and fallen arches in your feet are all possible causes of muscle tightness or weakness (and/or spinal and hip mis-alignment) that may negatively impact the efficiency of your running form.

This article is the first of a series that will highlight commonly found deficiencies in a running gait.  Possible corrective actions are offered, however, with the causes of running deficiencies being too vast for this context, a thorough review of your gait by a running specialist is recommended before proceeding with these.

Excessive Heelike

Note the forward leg (the leg depicted with the more solid line) is landing quite severely on the heel of the foot. This point of contact is also well in front of the hips and both of these factors, excessive heel contact and initial contact too far in front of your center of gravity, results in sudden, sharp forces on the hips, knees, and lower back. They also contribute to a loss of efficiency, and speed, as forward momentum is slightly halted with each landing as breaking forces are applied to the body in the opposite direction.  The dotted leg, and more correct version, shows a landing on the heel that is at less of an angle and more closely beneath the hips and center of gravity.
Possible causes:
  • The incorrect cognitive attempt to lengthen a stride by reaching forward with your lower leg.
  • An excessive push backwards with the trail leg, which results in a more horizontal reaction throughout the lower body.
  • Weak or mis-firing of the hamstrings, glutes, and quadriceps resulting in a limited amount of paw-back motion.
  • Leaning backwards or minimal forward lean.
Possible corrective actions:
  • More of a focus on the paw-back motion of running (the motion of bringing the leg down and back just prior to touching the ground). 
  • A slightly lean forward of the body (at the heels not the hips!).
  • Over-all increase in leg strength and improved proprioception so a more ballistic motion exists in your stride.  

Knee, hip, and lower back pain are common in runners with this stride.  Since these areas can be effected by many factors, the first step is a slow-motion view of your running stride to determine if an excessive heelike is indeed a possible cause.

Boston Running Center - Head Coach
Gait Analysis Info
Weak Hamstrings: A Recipe for Knee Pain 

Forty-two percent of running injuries occur at the knee. So, let's face it. We're at risk. The more we can do to prevent these common problems, the more we can keep ourselves healthy and on the road. 

Think of the knee as a hit taker. It is victim to what's going on in the hips, ankles, and lower extremity muscles. For runners, knee pain is usually a manifestation of weakness or restriction elsewhere, with hamstrings (muscles on the back of the thighs) being the usual suspects.
When running, jumping, or placing weight on a bent knee, a force three to four times your bodyweight travels through the joint. Stair or hills increase the force to six times your bodyweight. This force encourages the femur (thigh bone) to slide forward on top of the tibia (lower leg bone). In a healthy knee, the hamstrings contract, holding the knee together and preventing this forward sliding of the femur. When the hamstrings are weak, the femur slides forward too much. This places a shearing force across the knee cartilage, which is able to withstand compressive forces (pushing down) but not shearing forces. Over time this will cause the cartilage to degenerate or die. Once degenerated it can easily tear, even without trauma. Weak hamstrings also cause the femur to press into the back of the kneecap. This can damage the tendons and around the knee and cartilage on the back of the kneecap.
Patellar tendonitis, tracking disorders, chondromalcia patella, meniscus damage, patellofemoral syndrome, iliotibial band syndrome, and osteoarthritis can all result from weak hamstrings. Many measures can be taken to address the painful knee structure such as surgery, medication, and bracing. However, these measures don't address the whole problem. If hamstring weakness is not corrected, the problem will likely remain. Determining why the hamstrings are weak is the most important part of the treatment process.
Scar tissue, overuse, muscle imbalance, nerve entrapments, postural stresses, and muscle tears are all examples of problems leading to weak hamstrings. Most running injuries are overuse related. To understand an overuse injury, it's helpful to first understand what happens in an acute, traumatic injury. When a muscle, tendon, or ligament is torn, the healing process involves the creation of scar tissue (a.k.a. adhesion or fibrosis). This is necessary to connect and bind the torn tissue.
Scar tissue can also result from overuse such as training errors, repetitive motions, and postural stresses. Overuse causes soft tissue (muscles, tendons, ligaments, and fascia) to increase in tension; this tension decreases the blood supply and increases free radical concentrations. Free radicals attract cells that produce scar tissue. As scar tissue accumulates, weakness, inflexibility, and pain set in.
Unfortunately, by the time knee pain presents, simply strengthening the hamstrings may not be appropriate treatment. You can't effectively strengthen a muscle that has a problem. The problem must first be fixed and then the muscle can be strengthened. A doctor who specializes in these types of injuries can guide you towards appropriate care.
The most important information I hope to present here is the value of hamstring strength for preventing knee injuries. By maintaining hamstring strength, you are effectively decreasing your likelihood of developing a future knee injury.
 Dr. T. Grace Steinley, DC, CSCS
Thai Massage for Runners

What is Thai Massage?

Also known as Thai Yoga Massage, Traditional Thai massage is an authentic healing art and unique form of body therapy developed in Thailand over 2,000 years ago. It is believed to have been developed to aid the Buddhist monks to prepare for many hours of sitting in meditation in the lotus position. Not only was it used as a therapeutic method of healing, but as a way to maintain health and well-being.

In Thai Massage one can find similar techniques being used comparable to such western techniques such as: Trigger Point Treatments, Myofascial Release, and Lymphatic Drainage, to name a few. A recipient of Traditional Thai massage can expect a deep, full-body treatment, starting at the feet and progressing up to the head. Using a sequence of gentle, flowing exercise movements, the recipient's body is moved, loosened and stretched at the joints and the muscles. This unique type of massage influences the energetic side as well, restoring and harmonizing the flow of energy throughout the body with applied acupressure on energy lines of the body based on Traditional Chinese Medicine. Sessions are performed on a comfortable mat on the floor, with the recipient dressed in comfortable loose fitting clothing. The practicioner not only utilizes her hands to apply the massage, but feet and elbows as well. The combination of energetic and physical focus is what makes Thai Massage so unique and effective.

What are the Benefits of Thai Massage for runners?

  • Aids in detoxification of the body and boosts the immune system by working directly on the lymphatic system
  • Increases blood circulation
  • Increases flexibility in the muscles and helps keep joints lubricated through range of movement and flexibility excercises applied by the practicioner
  • Improves body alignment and aids in awareness of body by dissolving energy blockages
  • Aids in concentration, emotional balance, and clarity of the mind by creating a connection between body and mind
  • Shortens recovery time between workouts
  • Increases health and vitality
  • Increases energy levels and stamina
  • Maximizes the supply of nutrients and oxygen through increased blood flow.

Each of these can aid runners' athletic performance, as well as injury prevention and recovery. The stretches administered on the legs target the primary muscle groups and are a great compliment to all the flexing actions usually performed in running. Most of these muscles tend to contract (shorten) due to such extended use. It can also be useful in pre and post events due to its ability to reduce muscular and mental tension that is common prior to competing, and enhancing the body's own recovery process post event, helping to reduce muscle spasms.

Natalia Macias 
Thai Massage Therapist

Boston Marathon '08 - "Dreams come true!"
Crossing the Boston Marathon Finish Line has been on my Dream Board for many years. A Fantasy possibly, but one should be cautious of what they wish for because it could come true. Last November, an email came out at my workplace with an opportunity to run the Boston Marathon (qualifying time waived) for charity. An opportunity of a lifetime- I could really reach this dream and contribute to a great cause. I signed up for the 112th Boston Marathon training program.

Committing to finish the Boston Marathon has taken me on a journey that I could never have imagined. I never considered myself athletic. I've never run in my life, a middle aged woman, very over weight and feeling like a sloth. I had a lot of work to do and had to put the pieces together to make this happen.

What does it take to complete a marathon? With a solid goal in place, finishing the Boston Marathon on April 21, 2008, I started the training program provided by my employer. I quickly realized that I would need much more help and support than reading the book and participating in the runs. I needed a comprehensive plan and a lot of support. My plans quickly expanded with a goal for getting myself in a state of total health - a healthy body, mind and spirit. I watched the Biggest Loser show every week and inspired by the progress the contestants were making and how they were reaching their dreams. I needed my own team of experts to help me pull this together.

Through conversations with friends, I found The Boston Running Center and met with Joe for a "meet and greet" session. I was very anxious, but I put it out on the table. After listening to my story, he said without hesitation, you can to this; it will take some work, and I don't recall anything else he said after that. I met Carol, a Registered Dietician and came up with a nutrition plan, met with Dawn,, my Nurse Practioner, went over my health history, and she gave me the green light to GO FOR IT! I started working with Joe the first week of November and followed a daily/weekly workout plan along with my nutrition plan. It was rough and I didn't see much progress at first. After 7 minutes on the Elliptical machine, I was in tears. What was I ever thinking? I must have been delusional. How was I ever going to do 26 miles and 385 yards? full story
Michele Audet
Thanks for reading!
Boston Running Center

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