Address These Lower Leg Issues To Avoid Injury and Improve Running Performance

eccentric calf raises

Hello Runners,

In the last three posts I have discussed strengthening the glutes and outer hips muscles, as well as proper activation of these muscles, to significantly improve running performance and minimize the risk of injury.

Another factor that can adversely affect running performance and increase your risk of injury is muscle tightness. I had planned to address muscle tightness issues in this post. However, I recently had the opportunity to have a conversation with massage therapist and ultra endurance runner, Aaron Lange. Aaron practices massage on athletes, include Olympic athletes, in Boulder, CO. In our conversation I asked Aaron about some of the most common issues that occur in runners and how to address these issues. The main issues Aaron encounters in runners are poor running mechanics, overtraining, improper function of the ankles, and lack of glute strength.

In a previous post I discussed proper running mechanics, and in another post I included cues that you can use for proper running mechanics. In addition, Aaron mentioned that running drills and performing strides, in which you are running faster, can help. To run faster you have to run more efficiently, so that is why performing strides and sprints are beneficial. I have discussed these previously, but will revisit these in a future post. I will also discuss overtraining and signs that you are overtraining in a future post. As far as glute strength, Aaron shared this is important to keep your feet from landing close to, or even crossing the midline of the body, because this promotes a turning outwards for the foot. When the foot turns inward or outward this can lead to the most common injuries that runners encounter including: IT band syndrome, plantar fasciitis, knee pain, Achilles tendon issues (tendonitis or tendinosis). Proper engagement of the glutes can minimize this outward movement of the foot.

In the rest of this post, I will talk about what Aaron shared with me regarding issues with the ankle and how to address these. Having proper control at the ankle without the foot turning outward or inward can significantly minimize the risk of injury and results in a more efficient stride, which means you can run faster. As with the muscles at the hip (glutes, outer hips, hip external rotators, etc.), muscle weakness and tightness of the muscles that control the ankle can result in the inward and outward movement of the foot upon landing and then push off of the ground.

Muscle Weakness Issues

The muscles that control the movement of the ankle include the gastrocnemius (outer calf muscle), soleus (deeper or inner calf muscle), peroneals (outside of lower leg), posterior tibialis (inside of lower leg), and flexor halluces longus. The best exercise to address weaknesses in any of these muscles is eccentric calf raises.

To perform eccentric calf raises:

  • Use a step with a hand railing, so that you can balance yourself as needed as you lower your foot so that it drops below the level of the step.
  • Position each foot so that approximately half the foot hangs over the edge of the step
  • Have your legs straight and engage the core so you are as tall as possible
  • While using the hand railing for support as needed, raise up on both feet
  • Then slower lower on one foot so that foot drops to below the level of the step
  • Raise back up on both feet
  • Perform 15 repetitions for each foot
  • Make sure to keeping breath throughout this exercise, ideally exhaling as you slower lower
  • Make sure the foot is pointed straight forward when lower and not turned to the side

I recommend starting with one set of 15 repetitions for each leg with a straight leg. Once you are comfortable with this then increase your frequency to 2-3 times per day. Then increase the number of sets to 2-3. Aaron also performs this exercise with a bent knee, which can better target the soleus muscle.

Muscle Tightness Issues

Most runners statically stretch the calf muscles, at least the outer, or gastrocnemius.  You should also be stretching the inner or deeper soleus muscle by bending the back leg (the one being stretched). Bending the knee will also stretch the Achilles tendon.

Although many runners are good about stretching the gastrocnemius and sometimes soleus, they ignore addressing tightness in the other muscles important for proper ankle function. Some of these muscles are referred at as the “stirrup muscles” and are found on the outside (peroneals) and inside (posterior tibialis) of the lower leg. These muscles can become tight, especially if a runner does not properly control at the ankle and has their foot turn inward or outward.

The best ways to address tightness in these muscles is through foam rolling (for the peroneals) and self-massage while flexing the ankle (for the posterior tibialis).

To reduce muscle tightness in the peroneals:

  • While lying on your side, place a foam roller directly underneath the outside of your lower leg between the knee and ankle
  • Support your upper body using your forearm and free hand. Adjust pressure into the roller with your free hand and foot.
  • Slowly roll up and down the length of the peroneals (outside of the lower leg between the knee and ankle) while slightly rotating the leg periodically for 20-30 seconds.
  • Repeat on the other side.
  • Be sure to keep breathing while rolling
  • You may also want to apply pressure on the most tender area of the peroneals and hold for 20-30 seconds while you continue breathing

To reduce tightness in the posterior tibialis:

  • While seated cross one leg over the opposite knee.
  • Apply pressure with your thumbs on the muscle just on the inside of the ridge of the shin
  • Slowly flex and extend the ankle
  • Start for 30 seconds and gradually build up to 1-3 minutes daily
  • Repeat on the other leg

 

Please let me know if you have any questions, or if I can be of help in any way.

Also, please feel free to share this with anyone you feel might benefit

Your friend and coach,

Brian

 

References

Jay Dicharry. Anatomy for Runners. Skyhorse Publishing: New York, NY, 2012.

National Academy of Sports Medicine Essentials of Corrective Exercise. Ed. Michael Clark & Scott Lucent. Lippincott, Williams, & Wilkins: Baltimore, MD, 2011.

Goals Set the Direction, But Habits Are Best For Becoming The Runner You Want to Become

“When nothing seems to help, I go and look at a stonecutter hammering away at this rock, perhaps a hundred times without as much as a crack showing in it. Yet at the hundred and first blow it will split in two, and I know it was not that last blow that did it – but all that had gone before.” – Jacob Riis (social reformer)

Happy New Year Runners!

Each year approximately 40 percent of Americans make New Year’s resolutions. Unfortunately, by the time February arrives most have quit, and will probably make the same resolution next January. Why weren’t they successful? Most likely they didn’t develop the proper behaviors and habits necessary to be successful. Yes, goals are important and provide direction, however it’s the systems and habits that we develop, that are most important to our success.

I recently finished reading James Clear’s Atomic Habits, which I highly recommend. He shares some valuable insight on how to develop good habits, and eliminate bad ones. In this article, I will touch upon a few insights that might help you get started in developing the habits you need to become a better runner and achieve your running goals.

Goals are helpful in that they provide us direction. Such as if we were flying from Los Angeles to Maui, it is helpful to know which direction we need to go. However, if we set a course starting from Los Angeles to land in Maui we would not arrive, if we did not make adjustments along the way. Similar with our running goals. We may have a goal of completing our first marathon, or breaking four hours, or qualifying for Boston, however if we don’t develop the proper plan, get in the runs and support work (dynamic warmup, cool down, strengthening exercises, and cross-training) and develop other important habits, we’ll not optimize our training. Instead, we may develop an injury and we won’t develop the endurance and/or speed necessary to achieve our goal.

Take Small Steps with a System-Focused Approach, Instead of Goal-Focused

One important principle from Atomic Habits is developing systems that set you up to become the person necessary to achieve whatever goals you set for yourself. Thus, to become a better runner such things as: proper training and nutrition plans, running form, support work, sleep, and hydration are important. If these are implemented on a consistent basis, incremental progress will be made leading to improved running performance, which then lead to better race results.

One of my favorite coaches of all time is the late Coach John Wooden, who had his players focus on making some small improvement each day that would help improve their game. These small improvements compound over time, like when you invest in mutual funds. Wooden put the emphasis on improvement and not on winning basketball games and national championships. As a result, some of Wooden’s players became some of the best basketball players in history (Kareem Abdul-Jabbar, Bill Walton), and his teams won ten national championships, including seven in a row.

It is interesting to note that Wooden did not win his first national championship until he had been coaching at UCLA for 16 years! So, it took him a while to develop and successfully implement a system that would maximize his players’ performance, as well as his own coaching abilities. Similarly, if you are growing bamboo. It takes a significant amount of time for a bamboo plant to lay down an extensive root system. Then, all of sudden, a whole bunch of bamboo appears!

A systems-first mentality also allows you to fall in love with the process rather than the product/goal and you don’t have to wait to give yourself permission to be happy. You can be satisfied anytime your system is running. This is important because we are hardwired for immediate gratification. The goal-first mentality forces us to delay gratification until the next milestone is reached. The goal-first mentality also creates an “either-or” conflict in which you are either successful or a failure. Also, a goal-oriented mindset can create a “yo-yo” effect, which once the goal is achieved, you revert back to old habits. This is common with those trying to achieve weight loss.

So, it can be more beneficial to focus on what you want to become, instead of what you want to achieve, and develop the habits or systems to do so. If instead of waiting until we achieve our goal, we can achieve satisfaction in performing the steps along the way, we will be much happier and are more likely to make good habits automatic. Early on we may want to set up a rewards system for when we are completing the habits that we need to become the runner we need to become. Therefore, if we complete our run and the important support work, then we reward ourselves appropriately. For example, I reward myself with ten minutes of additional guitar-playing time. Over time you may not need the reward system because you automatically include support work on your run days.

So, again even though your goals will direct you, what’s most importance is the system you implement to become the runner necessary to achieve those goals. If you develop the habits and put in the work, the results will follow, just as they did for Coach Wooden.

 Identity Focus

Another important aspect of Atomic Habits is to become identity-focused, instead of goal-focused. Your habits are consistent with the identity you have for yourself. So, in order to change your habits, you have to change your identity. For example, if someone is trying to lose weight, they could change their identity to that of a healthy person, instead of focusing on losing a certain number of pounds. They can then focus on making decisions consistent with what a healthy person does, and could ask themselves, “What would a healthy person do in this situation?”

Similarly, if you have a time goal and/or want to be a Boston qualifier, your identity could be I’m a “sub-3:45 marathoner” or a “Boston qualifier” and put your focus on the habits necessary or consistent with being a “sub-3:45 marathoner” or “Boston qualifier”. You can then ask yourself, “Who is the type of person that would get these results?” Therefore, you would begin developing the sleep habits (such as 7-9 hours of sleep per night, because while you are sleeping the important adaptations to your training are occurring), nutrition habits (proper nutrients to fuel you and support adaptations), and support work habits necessary. You may also determine that it is necessary to work with a coach, so that you optimize your running form for performance and have an optimal training plan.  You may also need to develop the mind-set of focusing on improving as a runner from year-to-year, and appreciate that it may take a couple of years to break 3:45 in a marathon, or qualify for Boston.

Habit Stacking and Designing Your Environment

Techniques such as habit stacking and designing your environment (make it obvious) may help you facilitate the habits consistent with your identity of being a “sub-3:45 marathoner”, for example. After my runs I grab a glass of water to begin hydrating and focus on “relaxing my legs” by doing gentle leg swings, gradually increasing the range of motion. I perform these close to our designated workout room, which has my yoga mat, resistance band, dumbbells, foam roller, and lacrosse ball all laid out in full view (designing my environment). This cues me to perform the rest of my support work, including my strengthening exercises and cool down (habit stacking). Also, I usually play music I enjoy while performing these, which makes it easier to perform. I’ve performed this routine so many times that it has become automatic, and I recommend setting up a similar situation for yourself.

I will touch upon other important principles from Atomic Habits and other behavior change strategies in future blogs, to help you become the runner you want to become and help you achieve your goals along the way.

Summary of Key Points

  • Success is the product of daily habits
  • Goals are about the results you want to achieve. Systems are about the processes that lead to those results
  • Identity the person you want to become and develop the habits consistent with that identity
  • Consistency of habits is important. Start small and implement a proper reward system for immediate gratification once you’ve completed these habits. These habits should soon become automatic.
  • Focus on improvement over time, such as year-to-year, as a runner, not just a one-time goal

Please let me know if you have any questions, or if I can be of help.

I don’t want to leave you with the idea that goals aren’t important. They have their place, as far as providing direction. Also, there are other steps you should take before beginning your training. Click here for a post from last year on goal setting and here to learn of other steps you should take before you begin training.

Also, it’s not too late to get started on training, if you are planning to run a spring half- or full-marathon. I began my formal training for the Colfax marathon last week.

Finally, I plan to lead a half- and full-marathon training group this year for fall half- and full-marathons. The group will meet once per week in Louisville (CO) for a run, and participants will be provided with a 16-week training plan. If you are interested, or would like to learn more, please contact me at brian@denverrunningcoach.com

Your friend and coach,

Brian

References

James Clear. Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones.  Avery: New York, 2018.

It’s All in the Hips (and Pelvis) Part 1: Hip Flexors

The April issue of Running Times include an article entitled “It’s All in the Hips”, which I felt contained useful information for runners at all levels, on improving running performance, and factors which can negatively affect running performance and potentially increase injury risk. The hips and the pelvis play very important roles in running, in fact I refer to the hips as the steering wheel to help us run effectively. Originally I planned to hilite and elaborate upon the important points of this article in one post. However, I soon realized this would result in a post that was much too long! So I will be sending out multiple posts hiliting the important points and elaborating upon these.

In this article, elite running coach Bobby McGee, who I’ve had the privilege of meeting and who has helped me as a runner and coach, states that the first issue that should be addressed to improve running performance is tight hip flexors. In fact, approximately 85% of runners have tightness in the hip flexors. Therefore this article will focus on the importance of hip flexors, what causes tight hip flexors, and what can be done to address this.

What are the hip flexors and what is their function during running?

• Muscles located on the front (anterior) and inside (medial) of the hip

• Includes the rectus femoris, iliopsoas, hip adductors (longus, brevis, and magnus), tensor fascia latae (TFL)

• Allow us to bend at the hips for such activities as sitting

• During running allow us to, both accelerate our thigh forward, or decelerate the thigh as it moves backward

What causes tight hip flexors?

•The primary cause is overuse of the hip flexors because they are constantly being contracted and shortened while we sit for hours at work, while driving, and during leisure time

• In addition, while sitting the glutes become deactivated and weakened, this will be discussed further in my next article

What are the potential issues related to tight hip flexors?

• Ideally the pelvis should be properly aligned (think of the pelvis as a cup of water, or your drink of choice, which we don’t want to spill by the pelvis tipping too far forward or back), which allows the hips to be more stacked under the torso. This allows you to increase power as your leg drive pushes your body forward (hip extension), rather than twisting your hips forward, arching your back and losing energy in the torqueing. Tight hip flexors will cause the pelvis to “spill forward” and reduce or inhibit the amount of hip extension.

• Low back pain, strains in the hamstring, quadriceps, and groin

• Knee issues such as patellar tendinopathy, patellar femoral syndrome

• IT band tendonitis

What can I do if I have tight hip flexors?

• There are several muscles that flex the hips and these should be foam rolled and stretched

• Ideally, foam roll hip flexors 4-6 days per week

• General guidelines for foam rolling:

• Roll on tight, overused muscles until a tender/sore spot is found

• Apply pressure to tender/sore spots and hold for 30 seconds

• Foam rolling exercises:

Rectus Femoris:

http://www.menshealth.co.uk/cm/menshealthuk/images/Lw/quadriceps.jpg

TFL:

http://stoneathleticmedicine.com/wp-content/uploads/2014/05/TFL-Foam-Roll.jpg Hip adductors: http://icraved.files.wordpress.com/2012/10/foam-roll-adductor.jpg

• After foam rolling, stretch the hip flexor muscles. Hold each stretch for at least 20-30 seconds, perform 1-3 sets of each stretch.

• Hip flexor stretch:

– Kneel in the right knee, with the left knee bent and directly over the left

ankle

– Lean forward, shifting your body weight on to your front leg. You should

feel a stretch in the right leg.

– Hold for 20-30 seconds and repeat 3 times

– Keep the back straight and abdominals tight. Do not allow the front knee to

pass over the toes.

– A folded towel can be placed under the knee on the floor for comfort

http://eplerhealth.files.wordpress.com/2012/01/hip-flexor-stretch.jpeg

• Yoga variation of hip flexor stretch – Kneeling lunge (Anjaneyasana) http://www.yogachuck.com/wordpress/wp-content/uploads/2013/02/Low-Lunge.jpeg

• Hip adductor or “butterfly” stretch: http://www.velogirls.com/resources/publications/stretching101/butterfly.jpg

• TFL Stretch:

http://hilloah.com/wordpress/wp-content/uploads/2011/04/tfl-wall-stretch.jpeg

Please contact me with any questions or comments.

See you on the road or trail,

Brian