Running Strong: Video Analysis, Running Re-education and Strength and Power Program for Runners

The Running

Strong Program

What is it?

A 4 session program to improve your running and decrease your chance of injury.

What is it composed of?

  • Detailed analysis of your running history and programming to find predictors of injury
  • High Speed Camera (240 frames/second) analysis of your running form
  • Pelvic Drop
  • Detailed functional evaluation of your physical function designed to find weak links
  • Custom created corrective exercise and performance based exercise program including 3 follow up sessions

Is it covered by insurance?

 

Yes.  I am both a physiotherapist and chiropractor.  Each session can be billed separately and our rates are well within the normal fees charged for regular physiotherapy sessions

The cost?

$400.00 for the initial 1 hour session plus 3 follow up sessions.

The timeframe?

The timeframe is surprisingly flexible.  Some people need a follow up session within a week of the initial evaluation.  Others might need a follow-up session within 3 weeks.  Having this flexible time frame allows us to tailor the program to your needs.

Can I work with my existing coach or personal trainer?

Absolutely.  In fact, this is encouraged.  I regularly work with running or triathlon coaches to create safer and better training programs.  If you already work with a personal trainer we can speak with your trainer about encorporating the running performance program into your existing exercise sessions.

About Me:

I am physiotherapist and chiropractor with a MSc in Exercise/Spine Biomechanics.  I have published more than 20 peer-reviewed academic papers on exercise science and injury.  I regular work with runners and multisport athletes from beginner's to Olympic athletes.  I currently write injury prevention articles for Triathlon Canada.  I am also an instructor with therunningclinic.ca - Canada's, if not the World's, leading course on the prevention and treatment of running injuries.  Last, I am the clinical director of Medcan's Run Well 3D Kinematic Analysis Program for Running Injuries.

Related Posts

1. Running Strength: Moving beyond the Core

2. Running Biomechanics: Clinical decision making in running analyses

3. Gait Modifications for Runners.

 

Ditching the Plank? Strength training is core training.

marilou-deep-overhead-squat.jpg

Background The piece was part of a companion piece on resistance and "core" training for runners.  The thrust of that piece was that general resistance training should come first before gut-blasting 5 session/week plank marathon sessions should occur.

Purpose: core exercises are rampant and extremely hyped. They are much too popular and I think many athletes not working with strength coaches focus on the core and perhaps neglect other body parts.  A not at all new thesis is that many simple core exercises can be replaced by compound exercises that have other goals (e.g. train the legs) but still require great core activation.

deadlift down
deadlift down

When I was actively researching exercise biomechanics a goal was to try to document the EMG dosage of the entire trunk and hips during ever single exercise.  My thesis was that basic core exercises (curl ups, bird dogs, superman, bridges) were not necessary for many athletes and the general population.  I still advocated them to patient (and still do) but really thought you could have a comprehensive conditioning program without doing them -we could get an appropriate core workout by training squats, deadlifts, olympic lifts, sprinting, knee drives, plyometrics etc.  In our pilot work we were seeing trunk muscle EMG activity during squats, deadlifts, cleans, jumping, pull ups, pushups etc that was comparable to the activity seen during traditional core exercises. It wasn't as high as we thought but it was still comparable to standard core exercises (The reason it was not as high as we predicted was later explained in an excellent paper by Stu McGill here).

When I was a biomechanics researcher most of my work focused on cataloging the "dosage" of muscle activity during exercise. I wanted to create a massive document that quantified the muscle activation dosage for the trunk and hips during every exercise. But then I was slowly pushed out the door.  And naturally this type of research was not considered valuable at the chiropractic college where I worked.  Because, you know back cracking is so much more important for the body then exercise.  (where is the sarcasm font?).

Below, I am trying to catalog trunk muscle activity during strength training exercises that are not traditional simple core exercises.  It is a bit crude and not complete but if you know of other research please send it along.

You can train the core without actually targeting the core

I want to reiterate - the core is still important.  No part of the body should be neglected. But perhaps there is a more efficient way to train the core.

Below I will highlight the muscle activation of the trunk during simple core exercises and then compare this with the trunk muscle activity during compound lower body or full body exercises. What you will see is that the muscle activity in the core is comparable or exceeds that of traditional core exercises AND you are getting the true beneficial effect of working the legs and the hips.  All values are expressed as percentage of that muscle's maximum activity.

Prone Bridge (Pr Br), Side Bridges and Supine Bridges (Su Br) (from a crummy paper of mine here)

Table 1

(Pr Br = Prone Bridge, Su Br = Supine Bridge, IO = Internal Oblique, RA = Rectus Abdominis, EO = External Oblique - source: my old research here)

Curl ups and Leg Raises (My only good publication  Here)

http://ptjournal.apta.org/content/81/5/1096/T1.large.jpg

Core muscle activity during Compound movements that don't specifically try to target the core

Squats: 

From our pilot work and some research findings a few years ago the amount of EMG activity in the anterior/lateral core was a bit of a disappointment. it was a lot less than we thought. I had hypothesized that the "ab" muscles actually worked a great deal during a squat.  I was wrong.  In the following table from Bressel (2009)we can see that ab activity during a loaded barbell squat at 75% 1 repetition max was pretty low.  The only muscle to see any significant activity (around 40% of max) was the internal obliques and only when the subjects actively braced their spine.s

An aside: A neat implication for this relates to the FMS test of the overhead squat.  I hear the great trainers at my work suggest that many people can't do a deep overhead squat because of the strength or stability of their "abs".  This never quite made sense to me.  Its an  unloaded movement and you don't need a lot of activity in this area.  Why would the front of the trunk need to be active.  There is no external torque that wants to extend the back and stability we should know requires minimal co-activation (less than 15% activation).  I can see why a weakness in erector spinae may be an issue but no anterior-lateral muscles could every possibly be a culprit.  Unless its a motor control idea but that needs to be fleshed out more.

Ab activity
Ab activity
Peak EMG activity from Bressel 2009
Peak EMG activity from Bressel 2009

In other work by the great David Behm's group (Hamlyn 2007) they concluded that the anterior and lateral abs were active to a comparable amount during an 80% squat, 80% deadlift, body weight squat, superman and sidebridge exercise.  This seems a bit odd since the side bridge can see oblique activity greater than 40% max.  This suggests the squat and deadlift exercise had comparable activity.  This is certainly in conflict with the Bressel study.  Unfortunately, the authors did not provide the amount of muscle activity that occurred in the abs during any of the exercises.  They just told us that there was no difference.

The Erector Spinae work their tendons off though

Where we do see huge muscle activation levels in the core during squats and the deadlift is in the erector spinae.  During heavy squats and heavy deadlifts (75-80% 1 repetition maximum loads) we see muscle activity greater than 100% of maximum.

Back muscle activity during exercise
Back muscle activity during exercise

Deadlift

From (Escamilla 2002) lifting a weight that corresponds to a 12 repetition maximum:  

Rectus Abdomonis: 60%

Internal Obliques: not studied

External Obliques: 56%

Erector Spinae @L3: 32%

Erector Spinae @ T12: 33%

Again, we see some conflicting activity here.  The previous studies muscle activation levels greater than 75% maximum yet Escamilla found much less.  Regardless, we certainly see significant activity in the core.

Push Up Variations:  (Freeman 2006)

Push ups are awesome.  You get huge anterior and lateral muscle activation especially when you increase speed and stagger your hand position.  What a great exercise.  Stop doing bridges just do push ups.

Kettlebell Swings (McGill 2012)

The following table highlights how well Kettlebell swings and variations can target the majority of the core.  However, we don't see a lot of activity in the rectus abdominis or external obliques.  These findings suggest that other exercises still need to be incorporated to train these muscles to full capacity.

mcgill kettlebell swing EMG
mcgill kettlebell swing EMG

Overview of core activity during compound exercises.

What we see here is muscle activity during compound movement exercises (Squats, Deadlifts, Push Ups, kettlebell swings) that is comparable to or exceeds that which occurs during many basic core exercises.   This means you can be evidence based and train the primary drivers of locomotion while still covering your bases and address all the muscles of the trunk.

In a nutshell:

- push up variations are excellent for the front of your core (rectus abdominis and obliques)

- loaded squats and deadlifts are great for the posterior and lateral core

- kettlebell swing variations train everything with the exception of the rectus abdominis

Going Forward and Limitations

We are missing (or I can't find it) is good data comparing plyometric or more ballistic exercises with traditional mat based core exercises.

The problem with different research groups is that they use different techniques and its difficult to compare across studies.  You can see that with the different results in almost the same exercises studied above

Anyone want to send me an 8 channel EMG unit and 16 fit volunteers for one week? Once you get research ethics approval you could literally hammer out the data collection on ten research papers in a week.

Some Caveats

- basic core exercises still have value.  Sometimes focusing on the core is necessary to get very high levels of activity in certain muscle groups.  An example would be the "stir the pot" exercise to target the anterior/lateral trunk.  You can't get these high levels of trunk activity if you do a cable  punch with heavy resistance (another surprise and arrow in one of my previous theories that we found in some pilot work).

- core specific exercise can still be valuable if you do some corrective exercise work.  I am not saying to stop doing that. If that is your philosophy and approach this article takes nothing away from that

- people with pain or dysfunction may also benefit from doing some core specific work.  These could be bird dogs, glut bridges or pelvic floor work.  There is still value in these exercises.  I'm not saying to abandon them

Form, footwear and footstrike: an e-book on running mechanics review with injury insights

This post is a link to a pdf ebook on the presentation I gave for the MSK-Plus course November 25, 2012.  Below I give a brief intro into the confusion that surrounds these topics.  If you note a huge amount of uncertainty, a whiff of grey and lack of simple answers than your interpretation is correct.

 

The pdf file is form footwear and footstrike running mechanics ebook nov20 2 2012.

Related posts

1. Barefoot running and footstrike style overview

2. Gait modifications to influence impact loading

3. Barefoot running and running economy

4. Running in the backseat: lack of hip extension and its possible relationship to injury

5. What we know and don't know about running injury prevention

Overview

We can change the following variables of running:

1. Kinematics or changing the position of the body (e.g. trying to not let your knees collapse inwards) or the timing of events (e.g number of strides per minute)

2. Footstrike style

3. Footwear: barefoot, "barefoot shoes", minimal shoes, traditional cushioned shoes with an attempt to "correct" something

We also hope that changes in mechanics will occur.  Some variables that may be related to injury:

1. Rate of impact loading

2. Joint forces

3. Muscle loading, timing or activation levels

4. Joint kinematics

 

We assume that making one change will result in positive changes in other variables. The big assumption is that we know what is bad in running.  It sounds so simple, but in practice it is not. Especially when we deal with something like pain and injury.

What you will see in the attached e book is that nothing is that simple.  Changes in many variables related to running often don't result in the "positive change" in some running variable that we hope for.

 

Below is a brief introduction to the modifiable variables and their relationship to running mechanics and to a less extent injury.  The attached pdf file goes into a little more detail.

 

Modifiable variables during running

Run barefoot or run minimal

I wish it were this simple.  We have some data suggesting that some barefoot runners will run with a forefoot strike, reduced stride length and other changes and thus they will have a decreased rate of impact loading.  We have no data suggesting that making this change reduces injury and the link between rate of impact loading and injury is a wee bit murky.  We also have a number of research studies showing that just changing to barefoot is not sufficient to result in decreases in the rate of impact loading.

In Lehman's terms, we may want to be cautious about any blanket statements

 

Lose the cushioned shoes and run in flats

I do this but I certainly don't think its the answer for everyone. I also run in cushioned shoes because I think variety is important.  As for mechanical changes when going to flats there is not a lot of robust data out there that supports this in terms of biomechanics.  The assumption is that if you lose the heel on your shoes and the cushion you will automatically start to run with a softer gait.  Again, this is not supported in the literature and research exists showing increases in rate of loading and joint loading with racing flat like shoes.  Again, we need to reserve our blanket statements.

 

Convert from a heel strike to a forefoot or midfoot

The assumption is that heel striking is bad.  Again, not strongly supported in the literature.  Research is mixed with some work showing decreases in the rate of impact loading when going to midfoot or forefoot but we also have conflicting work showing the opposite.  Again, blanket statements are not cool.  The epidemiological research is also in its infancy, is correlational in nature and correlation data sucks for implying causation.

Decreasing stride length and increasing stride rate

This modification may have the most support and may be a common variable in other interventions.  For example, I think that someone might strike the ground with a forefoot strike and have a large rate of impact loading if they have a long stride, while another individual might convert to a forefoot strike and also decrease the length of their stride.  We might initially conclude that the forefoot strike was the variable that resulted in the decrease in the rate of impact loading but really it was just having a shorter stride.  This may also be a factor with barefoot interventions.  Barefooters tend to stride shorter...maybe those barefooters with higher impact loading rates failed to decrease their stride length.  BUT, and there is always a but, we do have a well designed study that showed no changes in impact loading when increasing stride rate (Giandolini 2012).  I am not even sure how that is possible but that was their finding.

 

Kinematic variables

The ebook does not touch on this but these would be things like increased frontal plane projection angle, hip valgus, hip internal rotation, pelvic obliquity, lack of hip extension, increased anterior pelvic tilt, prolonged pronation, lack of pronation, uneven arm swing, lack of trunk rotation etc.  Surprisingly, we have very mixed data on this.  Even the biggies like increased hip internal rotation and hip valgus.  Sure there is some correlational data that shows that some runners with knee pain have greater amounts of hip valgus when compared with controls but the predictive data is much weaker.  We also have data showing no relationship between assumed gait flaws and any current injury.

We don't know if pain begets gait flaws (e.g hip weakness) or if the biomechanical flaw caused the pain.  What might surprise you is that we can often rehab a patient, get them running injury and painfree and they still present with the initial "biomechanical flaw".  My concern with assuming that some biomechanical variables are faulty is that this views the body as being inherently weak and we forget about its amazing variability and strength.  You will see lots of runners with huge amounts of hip valgus/knee collapse.  You will shudder in horror at this.  But sometimes that is just that person's little idiosyncrasy .  They have always done it and they have adapted.  You will try to fix them under the assumption that they are faulty.  But this a massive assumption.

I am working on a large post on the kinematics of gait and injury.  I will go into a lot of detail on this topic

 

OK.  So everything is grey.  What do I do?

 Warning: Opinions ahead.

Gait modifications can help with an individual in pain:  We have good data that a slow return to running with modifications to form can help.  I don't necessarily believe that this is always related to biomechanics in the sense that we are changing mechanics to be closer to an ideal.  I think we are changing mechanics and it is the act of change that is important.  Variability and novelty is important to me in all my rehab programs.  Changing your gait loads the body differently and is also different for the brain.  Different gait patterns may avoid certain physical stressors on the body and may not activate our pain neurotags because of the novelty.  Further, most gait re-training is a slow, gradual return to running.  This exploits our innate adaptive abilities.

 

How should people run if not in pain?

Please note, the suggestions below only relate to running form.  There are a lot of things we can do to reduce the risk of injury.  Below is not comprehensive.

If I have to go out on limb I would suggest four things:

1. Novelty and variety: different shoes, different surfaces, different speeds, different distances.

2. Check your cadence: if you are running a five minute kilometer than  your steps per minute should be greater than 170 per minute.  If  you are "loping" and don't have a quick turnover consider increasing your cadence.  What you are trying to avoid is landing with the foot extremely far in front of the body and this is associated with a close to straight knee at footstrike

3.   With reservation and many exceptions, a midfoot to forefoot strike with the occasional heel strike thrown in:  this one is tough for me to say and I have some hesitancy. If you are novice runner I would probably suggest running with a midfoot strike. I think the bulk of the research suggests that running with a midfoot strike is the way to go.  I know that there is research suggesting heel striking is fine especially if it is not associated with overstriding.  I totally get this.   As  I said, I have some hesitancy - I treat a lot of heelstriking runners and would not consider changing their gait so this suggestion is obviously not a blanket for everyone.  Many heelstrikers have their feet land close to their body and their gait is soft and quick. However,  I also think that thinking about midfoot striking will also help with your cadence.  Last, for slower runners (10 minute miles) I doubt footstrike matters as much.  One caveat, I also think many runners would benefit from using different footstrikes during the same run provided their cadence is not too low.  This is consistent with my views on variety.

4. Gradual increase in running or in changes in form.  This one is obvious.  The body adapts over time we just have to give it some time to adapt.

 

My bottom line

I would be hesitant to change things about someone's form if they have no injury or past history.  If they have had a series of past injuries or currently have an injury this is where I think we can help the most with changes in form.  What you will see in the e-book is that there are so many exceptions to our commonly held beliefs about certain running related variables.  These exceptions make me quite cautious in just trying to change runner's form when you don't actually know what you are causing when you try to make a change.  I am lucky in that I have access to 3D motion capture equipment.  I can see what happens with different changes in form.  But I don't have force plates and I can make no comment on changes in joint loading or impact loading.  And the "running expert physio" dude with one camera (or who just eyeballs a runner from behind) can't say what changes in force (e.g rate of impact loading are occurring) and is also probably wrong about a runner's kinematics should be a little cautious in just making changes based on one or two cherry picked research papers.  What the research in this e-book shows is that many changes we assume to be good end up resulting in elevated levels of impact loading or joint loading.  Thus, I advise caution.

 
 
 
 

 

 

 

What is a functional exercise for runners and athletes?

clamshell open
clamshell open

A recent discussion was sparked by Mike Reinold's thoughts on the Clamshell exercise. I found myself defending the lowly clamshell exercise for runners. I was discussing with other physios whether the clamshell exercise was less "functional" than a band walk exercise (where you put elastic bands around your knees/ankles and walk forwards, sideways or backwards).  I suggested that both were NOT (or equally) functional but agreed that both had their uses. I can tell  you, I convinced no one :)

The consensus against me was that the clamshell sucked and that the band walk exercise was superior.  I tried to argue that this might be true but  not because the Bandwalk was more functional.  We essentially just babbled back and forth with no resolution for 20 minutes. The problem was the word "functional".

What the hell do you mean by 'functional".

When I heard someone say the bandwalk exercise was more "functional" than the clamshell I immediately thought malarky.  Because my knee jerk reaction to hearing "functional" was my brain translating this to "movement specificity" or kinematic specificity.  Meaning the exercise you are training matches the kinematics (specifically the displacements or joint angle motion) of the athletic task (in this case running).

Using kinematic/movement specificity to judge a Bandwalk or a Clamshell was a no brainer.  In terms of function (using the kinematic specificity definition) they both suck.  No runner lies on their side and lifts their leg up (e.g. the clamshell) but no runner runs sideways with a bloody elastic band around their knees.

So lets define "functional"

My knee jerk translation of "functional" to being "kinematically specific" is a little narrow. Our discussion exposed this.  Function to me means that the exercise has some sort of relevance to the task the athlete hopes to accomplish.  Viewing it this way then exercises can be functional or relevant thru a number of different means:

1. Movement specific: this means the exercise task somehow looks like the athletic task it is trying to train.  This means your exercise has similar form (due to motor control) to the goal task.  Further more, it suggests that the neuromuscular recruitment pattern is similar to the exercises (e.g. muscle onsets, offsets, ratios etc) For example, squats are great functional exercise to get out of a chair.

2. Muscle or joint specific: this means the exercise is training similar muscles to the muscles that are being used in the goal task.

3. Velocity specific: this means if your goal task requires you to move fast than you should probably train fast.  Exercises are therefore "functional" if they lead to some sort of carryover to the goal task's speed demands.  We know that you don't actually have to move fast to get this carryover, sometimes just the intention to move fast will garner improvement

4. Movement direction:  if your goal task requires a lot of deceleration than you should probably train the eccentric loading capability during your exercise.  For a runner, you might think they have increased hip adduction during the impact phase of  running which occurs for less than 100 milliseconds.  Thus you should probably train this deceleration ability over that specific time frame for it to be functional.

5. Context: the exercise should be similar to the context of the goal task.  The context might the exercises relationship to gravity or even to a societal or performance context (e.g you train to shoot free throws while people are screaming at you).

So what is more functional the lowly clamshell or Bandwalks?

Trick question! You can't answer this.  There is no functional scoresheet.  The better question is what is more useful to the runner or athlete.   You have to be able to answer why  you are prescribing an exercise in the first place. What is your intention with each exercise? What do you hope to accomplish?  If you prescribe an exercise because it is "functional' than this is just begging the question. Functional isn't enough it has to lead to some specific gain.  And if you think it is functional why is it beneficial?

A case example in the limits of functional justification: The BandWalk

I think most people would argue that the Bandwalk is more "functional" for the runner because it appears to train the muscles used in running in a more similar manner kinematically and more of the muscles that a runner uses when they are running.

But does it really do this?  How much of the previous "functional" components does the band walk satisfy?

Movement Specificity: No runner runs with a band around their knee, they don't run sideways or backwards. On its surface it certainly isn't very similar in terms of joint angles and displacements.  If you think movement specificity is important or practice makes perfect than training a movement that is so dissimilar to running can't be justified in this manner.

Movement Direction: Lateral band walks do not train the hip abductors in the manner that they are used during running.  Eccentric control occurs over very short period under high impact loads when running.  Band walks are extremely dissimilar to this. They are slow. They have an external force that is extremely different to the force vectors that create joint torques during running.  We don't satisfy a movement specificity or even a velocity specificity argument.  Considering this is the Bandwalk still functional?

Context? The band walk looks better than the clamshell that is for sure.  The athlete is standing and shifting weight.  But are they standing a shifting weight like a runner shifts weight? Nope. Is just standing and having weight shift enough to make it functional?  Why not do dumbbell curls while standing and shift your weight back and forth.

Motor Control:  No way.  Doing bandwalks are nothing like the motor patterns used in running.  Timing would be way off, no impact, no feedforward activation of muscles to damp vibration, hardly any storage of elastic energy.  Do you think the "extensor paradox" occurs during a band walk.  Not a chance.  These two tasks are completely separate beasts.  There is no way you can argue you are engraining some motor pattern during the band walk to enhance running.

Is the BandWalk Garbage?

Nope.  It can certainly help runners.  I don't use it but I still think it is reasonable for a runner to train with it. Because it satisfies our simplest category of "function".  It trains a group of muscles that runners need.  These exercises build the capacity of those muscles and this probably transfers over to increased mechanical efficiency and maybe even some injury protection. However,  if you think that it is functional enough to actually change a runners form than you might end up getting some poor results.

The problem with this last justification for strength coaches and rehab people is that it is too simple.  As therapists we want to think that we have some special knowledge about special exercises.  We don't.  There are no special exercises.  Train hard, train smart, get strong, build power, build tolerance, build capacity, build endurance, build the ability to absorb load, dampen vibration, produce strength at all ranges etc.  Have a generalized, good all around program and you will probably have good results. Maybe through in some assessments to see where your athlete is lacking and then train the hell out of that and you will do better. But, there are no running exercises.  And that is what both the research suggests and gurus suggest.  Pick an expert in a field of strength and conditioning (powerlifting, olympic lifts, corrective exercise, pilates, yoga, core stabilizinationists etc) and they all swear by their success with runners.   They are all probably right.

OK, so is the clamshell better?

No way! The clamshell sucks most of the time.  I got started blogging a lot because of Mike Reinold's post on a research study in JOSPT that looked at EMG in the hip abductors. The clamshell was a touted exercise and  I hated it. I thought runners should never do it.  I thought it was remedial and "non-functional".  My comment is on Mike's site.

The clamshell works fewer muscles, has the person lying down, looks kinematically different than running and doesn't satisfy many of the functional principles I laid out earlier.  BUT, it does train some muscles substantially different than the bandwalk.  This is where it can be a useful exercise.

The clamshell sees the hip flex to 90 degrees and has the patient externally rotate the hip.  At 90 degrees, because of changes in the line of pull of many hip muscles (GMax, GMed, Piriformis) the only muscles that externally rotate the hip are the deep external rotators.  So training the capacity of these muscles might carryover to running.

I used to abhor the clamshell.  Then I started testing more runners with the clamshell. A number who tested strong in many positions would tremble during the clamshell.  Crazy, they had a lovely one leg squat, strong hip abduction but had trouble with 10 or 15 clamshells.  What does that tell me?  Such a massive deficit in function.  Would you suggest clamshells here or something to address that specific movement?  This seems like a case where I would suggest clamshells.  If a runner can't do them I would want to address that deficit.

But, do I want to see every runner doing them as part of a "functional" program. Of course not.  They suck for that.  This is a case a where the exercise prescription is "functional" because it addresses a specific limitation in a specific runner.

OK. What do you suggest?

I have no exercise that addresses all of the components of "Functional" but that's why runners should get a comprehensive program. If I have a bias I lean to training "Comprehensive Capacity".  This means you train runners like they are athletes.  Big multijoint-compound exercises that train strength, high load power (e.g cleans), low-load power (ploymetrics), variable range exercises and unilateral exercises.  The thing with the word "functional" is that is so broad to be meaningless to justify an exercise.  Choose exercises based on some other specific capability of the neuromuscular system you hope to improve.

The Key Question: Why are you training what you are training?

For runners, I only think that we are training the muscle, joint, tendon and nervous system's capacity to tolerate stress that running imposes.  This makes runners more powerful, mechanical efficient and may make them less injury prone although with hip abductor training the research is a bit dodgy.

Do exercises help change running form?

This is seems to be the underlying idea behind an exercise that kind of looks like running (eg. the clamshell).  That training in that manner will improve your running form.  But there is some evidence to suggest that this does not occur (Willy 2011). We probably aren't training form.  We aren't correcting the biomechanics of running by choosing certain exercises.  We aren't engraining some motor programs that carryover to running.  If you want to do any of these things you have to do that while running and with some form of feedback.  Our bodies are not puppets where muscles can be tightened or loosened to obtain some different posture or form. That is a motor control skill not something that changes with other exercises.

So why are you prescribing the exercises you prescribe for your runners?

Please let me know what other rationales are out there.  I don't think this brief article really addresses everything

Greg

PS

This discussion was also quite serendipitous.  I was just finishing a pictorial post of bunch of hip exercises that people can use for their patients.  The pictures are all high quality and the idea is that you download them and put them into handouts or your website and what not.

Hip Centricity: A pictorial of hip exercises

 Related Posts:

1. The relationship between functional tests and athletic performance: Part I – The single leg balance test.

2. Can we treat our patients like puppets? Changing posture through exercise?

3. Running Injury Prevention: What we know and more of what we don't

4. Runner's Strength: Some simple exercise videos for runners.