Attention Runners: You Need Strength Training

Attention Runners: You Need Strength Training

70% of Runners will get injured this year

Runners are a unique breed that will do anything to improve their perofrmance.  They will buy the newest shoes, massage guns, normatec boots, goos, etc.  However, there is one thing they will do at all cost….. AVOID THE WEIGHT ROOM.  This lack of committment to the weight room not only contributes to training errors which are the cause of the majority of injuries runner’s experience.  But it also may be the missing piece to taking your performance to the next level. In this blog Ill touch on not only the injury reduction we see when we incorporate strength training with our normal running, but also the expected performance benefits.

Injury Prevention

70% of competitive runners sustain an injury, which prevents them from training for at least 1 week, each year! The biggest thing we can do to prevent injuries in runners is having a well designed training plan.  This includes, increasing mileage and intensity appropriately. Strength training can play an important role in the injury prevention plan as well.  Everytime we take a stride while running our body is absorbing force 3-4 times our body weight.  So we need to be STRONG.  However, most strength and conditioning plans are not effective for runners due to their lack of specificity.   When we think about common running injuries, we think about plantar facititis, achilles tendoniits, Patella femoral pain syndrome, hip and low back pathology.  Our training should be targeted at intervening on the root causes of these injuries. 

Plantar Fasciitis:

between 4.5-10% of runners each year will experience plantar fasciitis.  In this above study, we see that incorporating foot strengthening can significantly reduce this risk of injury.  Many times foot strengthening and mobility work goes hand and hand with calf strengthening mobility(see nxt section) if we are able to get these to work together instead of playing tug of war, we can expect injuries to decrease considerably.  

**My keys to strengthening our feet is getting barefoot and moving on a single limb**

Achilles Tendonitis

Achillese tendinopathy, the chronic condition of achilles tendonitis, is often associated with deficits in endurance and torque of the plantar flexors.  Much of this weakness is associated to the highly neglected soleus  compared to the more thought about gastrocnemius.  The soleus is a much thicker muscle and is the powerhouse for sprinting jumping landing, and all things running. Incorporating lots of strengthening/mobility work of the soleus gastrocs and achilles will help avoid achilles tendonitis.

**Easy modification for alot of exercises is to put the athlete in a split stance with a floating heel. This floating heel will add extra volume of isometric training to the soleus**

Patella Femoral Pain Syndrome: Runner's Knee

In a a previous post, Runner’s Knee, I talked about what you need to do if you are suffering from runners knee.  But when we look at the root cause, it can be high attributed to quad and hip weakness/lack of motor control. The main predictive measurement for at risk individuals is knee abduction moment.  My research that I presented at this years APTA CSM, was groundbreaking in that we were able to improve knee abduction moments(in adolescent female soccer players) for upto atleast 6 month post our 6 week training plan. Our training plan included core strengthening, plyometrics and strengthening.  All of which were centered around strengthening our hips.

**Form is critical for developing motor control to avoid the knee abduction movement pattern**

 

Hip/Low Back Pathology

Our entire body is interconnected an a deficit at one part and can present as an issue at a completely opposite part of the body.  However, hip and low back pathology are highly correlated to each due to all the muscles interconnected in these two segments.  I would argue much of the issues we see are caused by lack of hip extension.  This is usually caused by weak/or inhibited glutes that are unable to create hip extension.  Since our bodies are master compensators, we use our back to get into this extended position. this puts a tremendous amount of stress on our lumbar spine and low back muscles.

**With runners i love spending much of the workout in a spit stance, to constantly be working on hip extension and putting them in a more functional position**

Running Performance

The amount of runners who actually strength train is terrifyingly low, even at the elite level.  Strength training has consistantly shown to increase performance for all levels of runners in all distances. Now this doesnt mean you will be spending every day in the weight room. Instead the effective dosage is 2-3 times a week for ~45 minutes.  This little committment has shown to pay major dividends.

Strength Training has been shown to...

Improve your race time!

These improvements were seen across distances and skill level.  One consistant result between studies is that strength training became more important later in the race.  Individuals who had strength trained performed significantly better at the end of the race.

Improve Running Economy(Fuel efficiency)

Running economy is like the fuel efficency of your car.  Strength training makes it so we need less energy to do the task.  This becomes very important at the end of races and when we begin to stretch out our mileage.

Improved Power and VO 2 max

Strength training also adds to your horsepower.  Strength training and plyometrics have been shown to increase power potential of our muscles.  This improves our top end speed. It also has been shown increase the horse power of our cardioplumonary system byt signifcantly increasing how much oxygen we are able to process.

Final takeaway for Strength Training for Runners:

Adding a small amount of strength training can be a powerful tool that will transform you as a runner.  But remember specificity is  king.  Running will always be the best thing to make you better at running.  Specificity should be used in the weight room as well; we should mimic running as much as possible.  We must make our lifts look like  and demand our body like running.  You can do this by putting ourself or our athletes in a split squat, triple extension , and utilizing reciprocal pattern movements.  The other important thing to remember is, don’t be afraid to  go heavy.  Every time we land while running our body is absorbing 3 times our body weight.  We need to be as strong as possible.  If you have any questions or want to talk more about this topic please contact me on instagram @compass_performance

References:

Petraglia F, Ramazzina I, Costantino C. Plantar fasciitis in athletes: diagnostic and treatment strategies. A systematic review. Muscles Ligaments Tendons J. 2017;7(1):107-118. Published 2017 May 10. doi:10.11138/mltj/2017.7.1.107

Beattie, Kris1; Carson, Brian P.1; Lyons, Mark1; Rossiter, Antonia2; Kenny, Ian C.1 The Effect of Strength Training on Performance Indicators in Distance Runners, Journal of Strength and Conditioning Research: January 2017 – Volume 31 – Issue 1 – p 9-23 doi: 10.1519/JSC.0000000000001464

Denadai BS, de Aguiar RA, de Lima LC, Greco CC, Caputo F. Explosive Training and Heavy Weight Training are Effective for Improving Running Economy in Endurance Athletes: A Systematic Review and Meta-Analysis. Sports Med. 2017 Mar;47(3):545-554. doi: 10.1007/s40279-016-0604-z. PMID: 27497600.

Berryman N, Mujika I, Arvisais D, Roubeix M, Binet C, Bosquet L. Strength Training for Middle- and Long-Distance Performance: A Meta-Analysis. Int J Sports Physiol Perform. 2018 Jan 1;13(1):57-63. doi: 10.1123/ijspp.2017-0032. Epub 2018 Jan 5. Erratum in: Int J Sports Physiol Perform. 2018 Mar 1;13(3):398. PMID: 28459360.

Damasceno MV, Lima-Silva AE, Pasqua LA, Tricoli V, Duarte M, Bishop DJ, Bertuzzi R. Effects of resistance training on neuromuscular characteristics and pacing during 10-km running time trial. Eur J Appl Physiol. 2015 Jul;115(7):1513-22. doi: 10.1007/s00421-015-3130-z. Epub 2015 Feb 20. PMID: 25697149.

Karsten B, Stevens L, Colpus M, Larumbe-Zabala E, Naclerio F. The Effects of a Sport-Specific Maximal Strength and Conditioning Training on Critical Velocity, Anaerobic Running Distance, and 5-km Race Performance. Int J Sports Physiol Perform. 2016 Jan;11(1):80-5. doi: 10.1123/ijspp.2014-0559. Epub 2015 May 6. PMID: 25946163.

addei UT, Matias AB, Ribeiro FIA, Bus SA, Sacco ICN. Effects of a foot strengthening program on foot muscle morphology and running mechanics: A proof-of-concept, single-blind randomized controlled trial. Phys Ther Sport. 2020 Mar;42:107-115. doi: 10.1016/j.ptsp.2020.01.007. Epub 2020 Jan 13. PMID: 31962191.

Should Physical Therapy School Curriculum Include Strength and Conditioning?

Should Physical Therapy School Curriculum Include Strength and Conditioning?

As I finish my last few weeks of didactic course work for Physical Therapy School, while simultaneously studying for my practice NPTE board exam, I am blown away by how much I have learned.  Topics ranging from Acute care to advanced sports, pediatrics to geriatrics, Integumentary to Cardiovascular Pulmonary and everything in between.  However, there has been one glaring hole in my educational experience; that being Strength and Conditioning.  I have had to try to fill this knowledge gap through other avenues.

Although we claim ourselves as “The Movement” and “Prescribers of Exercise” experts; when I think about the best movement and exercise prescribers, most are not Physical Therapist but instead individuals in the Strength and Conditioning world.  The Sad truth in Physical Therapy, more often than not Physical Therepist are still under loading our patients using 3 sets of 10 and therabands for every exercise.

"But we are Doctors?"

Yes and we should be proud of that!  But we need to leave our letters and egos at the door.  We need to understand that compared to other professions we are uniquely qualified to help highly complex patients, due to the depth and bredth of our education.  However, as a profession we are dropping the ball in terms of being the “movement” and exercise prescription expert.

How Can We Improve As A Profession?

In my opinion, I feel the curriculum at each and every Physical Therapy School should include an entire course on Strength and Conditioning.  I understand many will point out that this may be linked to my orthopedic and sports bias.  However, I would argue that learning the science behind strength and conditioning and evidence based loading principles would be beneficial for every population to drive meaningful adaptation.  Not only will this be meaningful learning to better us as clinicians, but if the school prepared you for the CSCS exam, it would set you up to have a marketable certification that is widely respected not, not just in strength and conditioning but throughout the entire healthcare field.

Expand the Reach of Physical Therapy

As i talked about a few weeks ago in my blog “Does Physical Therapy Have An Impending Unemployment Crisis? ” The Physical Therapy profession, will not offer the job security it has in the past. Instead, more and more programs are being created, current programs are expanding and the job opportunities are growing at a slower rate.  This will  leave about 10% of Physical Therapist unemployed in 10 years. In the article mentioned above, I discussed possible solutions to this dooming problem.  One of which, was expanding our reach as a profession to play larger roles in other sections of health care.  One of which would be serving as primary care doctors in Emergency Rooms and taking the lead on all Musculoskeletal injuries.  However, I believe taking a larger role in “personal training” “wellness coaching” and Strength and Conditioning are other areas in which our profession may be able to expand and maximize our influence.  Another benefit of including Strength and Conditioning coure is that it will prepare students for their CSCS and give students a strong foundation to lead in these areas.

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