Influence of shoe flaring on foot and ankle mechanics for runners.

Footwear choice for runners will forever be a hot topic. Cushioned, minimal, motion control, zero drop, the choices are endless. What really matters when it comes to footwear selection for runners?

Based on your foot strike pattern I see a few design factors that really make a difference in reducing stresses on the foot and ankle, especially pronation forces. Before we talk about design choice let's discuss mechanics of the foot and ankle during a heel strike and a forefoot strike. Without understanding normal mechanics of the foot and ankle the "why" of shoe selection won't make much sense.

Let's start with the heel strike pattern. The hallmark of this pattern is, of course, the heel contacting the ground first. Normally the first point of contact is the lateral heel, placing the foot in a slightly dorsiflexed position. From here the foot in eccentrically lowered toward the ground as the entire sole touches the ground. This eccentric muscle control is performed primarily by the anterior tibialis muscle. As this occurs the foot is also moving into pronation as a way to absorb impact forces and deal with uneven terrain. Pronation is both normal and necessary for weight acceptance in the gait cycle. Posterior tibialis, located on the posterior and medial side of the shin eccentrically controls pronation. An eccentric muscle contraction is when the muscle is contracting but also lengthening. A concentric contraction is when the muscle contracts while shortening. Eccentric contractions generally more "work" than a concentric contraction. Think of walking down a mountain and how much your quads are working during that activity vs waling up. As you more into the push off phase your center of mass is advancing over your support limb and the foot and ankle begin to move back toward a supinated position as the foot becomes a rigid lever for push off. 

In the video above you will notice the runner obviously impacting the heel with the lateral portion first. There is not excessive pronation in this case but you can see some mild pronation as the foot is moved under the center of mass. It takes quite a lot of eccentric work to move into pronation in a controlled manner.   

Onto the the forefoot strike pattern. The initial point of contact here is the lateral forefoot. Following initial contact, the foot and ankle are moving into pronation almost immediately. In addition to posterior tibialis controlling pronation, gastroc and soleus are also very active in controlling eccentric dorsiflexion or slowly lowering the heel to the ground. Again, pronation here is normal but excessive amounts can be problematic. Often times we focus too much on the degree of pronation and forget to address the velocity of the movement. Velocity is a key component here. 

SOURCE: Stacoff A, Kalen X and Stussi E. The effects of shoes on the torsion and rearfoot motion in running. Med Sci Sports Exer, 1991; 23(4):482-490.

SOURCE: Stacoff A, Kalen X and Stussi E. The effects of shoes on the torsion and rearfoot motion in running. Med Sci Sports Exer, 1991; 23(4):482-490.

In the forefoot strike video above you can see an aggressive supinated position at initial contact, meaning the outside of the forefoot impacts first. Compared to the heel strike video there is further excursion into pronation as well as increased velocity. The velocity here increases the demand on the musculature controlling this movement. 

Now that we have the basics of each foot strike pattern out of the way, lets discuss shoe design. My primary focus here is on flaring of the outsole of the shoe. Flaring is when the outsole extends beyond the upper either laterally or posteriorly.

For the heel striker flaring of the heel of the shoe laterally and posteriorly is not ideal. This flaring will create a longer lever arm for the anterior and posterior tibialis to control as you eccentrically pronate and bring the forefoot into contact with the ground. Height of the outsole of the shoes also plays a role here for heel strikers. Increasing the height of the heel off the ground also increases the lever arm for anterior and poster tib to control. For runners that are known heel strikers, I would highly recommend footwear that reduces the height of your heel from the ground and also has very small posterior and lateral flaring at the heel so we can reduce these lever arms as much as we can.  

This is an example of a small posterior flare shoe. The outsole does not extend very far beyond the heel itself. 

This is an example of a small posterior flare shoe. The outsole does not extend very far beyond the heel itself. 

This is an example of a moderate posterior flare. You will notice the extra material moving behind the heel. The further posterior this flare travels the harder your anterior tibialis and posterior tibialis will have to work to eccentrically lower your foot into a pronated position. 

This is an example of a moderate posterior flare. You will notice the extra material moving behind the heel. The further posterior this flare travels the harder your anterior tibialis and posterior tibialis will have to work to eccentrically lower your foot into a pronated position. 

Here we see a small lateral flare on the R vs a large lateral flare on the L. As the heel striker impacts on the lateral side of the foot, the further the impact site is from the axis the greater the lever arm. With more work required to control a longer lever arm we could see overuse like symptoms with additional training volume for some athletes. This image also shows the heel height difference in these shoes. The higher the heel is from the ground the harder it will be to move from heel strike to foot flat. 

Here we see a small lateral flare on the R vs a large lateral flare on the L. As the heel striker impacts on the lateral side of the foot, the further the impact site is from the axis the greater the lever arm. With more work required to control a longer lever arm we could see overuse like symptoms with additional training volume for some athletes. This image also shows the heel height difference in these shoes. The higher the heel is from the ground the harder it will be to move from heel strike to foot flat. 

Let's not forget you forefoot and midfoot strikers. I absolutely care about flaring for you guys, but I can more about the lateral flaring near the toe box. Since forefoot strikers are contacting the ground with the outside of the forefoot a larger lateral flare is going to cause quite a change in lever arm length. 

Pictured is a small lateral forefoot flare. This reducing the lever arm to the axis as much as possible.

Pictured is a small lateral forefoot flare. This reducing the lever arm to the axis as much as possible.

Here we see a larger lateral flare. The increased distance from the ankle increases the lever arm and work required as the foot moves into pronation. Remember from the video above that the forefoot strike commonly sees more velocity as a runner moves into pronation. Velocity + more work required to control a movement = over stress for a lot of us. 

Here we see a larger lateral flare. The increased distance from the ankle increases the lever arm and work required as the foot moves into pronation. Remember from the video above that the forefoot strike commonly sees more velocity as a runner moves into pronation. Velocity + more work required to control a movement = over stress for a lot of us. 

Fore forefoot and midfoot strikers I would recommend shoes that have a very small lateral flare at the forefoot. This will allow for some energy savings in the eccentric control department.

Have you found the flaring of your shoes to be a part of any foot and ankle pain? What characteristics do you look for in a running shoe? 

Is your suspension set up causing your knee pain?

If you have been reading the blog for a while, you know my stance on knee pain and cycling. My thought is that most movement related pain is in fact, caused by movement dysfunction of some kind. Think of a medially collapsing knee during your pedal stroke. This inward movement of your knee causes excessive forces under the patella and over time can cause a lot of symptoms surrounding the knee. Fore more information read, Why is the front of my knee hurting? and Knee pain and cycling, where to start

If you are performing any of the movements described in the above posts, you can expect some knee pain. If you have been working on cleaning those movements up and are still experiencing some symptoms another place to you can look is at your suspension settings.

The last three bike fits I have done on full suspension bikes have been very similar. Riders complaining of anterior knee pain, especially on technical climbing sections. Riding fire roads with their suspension locked out seems to be perfectly fine. With full suspension fits I always start at the rear shock. My preference is the rider has their sag measurements dialed in or at least has an opinion on where they like settings. If they are not familiar with this setting I will take some time to explain it. If you are unsure what sag is, let me spell it out. Sag, is the amount of travel you take up while simply sitting on the bike. As you sit down you should compress the suspension a little bit. This allows for a more active system as you ride. Not only can the shock compress as you hit bumps in the trail but it can also press the rear wheel into the ground as you unweight the bike and provide optimal traction. Sag is your friend for sure. Short travel or more climbing focused riders may like a sag measurement of 20% of the available travel. Long travel bikes or a more downhill focused rider may like 25-30% sag. When you take this measurement, be sure to have all your standard riding gear in place. If you ride with a pack, take this measurement with a pack and water on board. On most air sprung shocks this is easily altered with a shock pump. 

Image via ridefox.com

Image via ridefox.com

Back to the knee, we find most of our riders have the best luck in reducing knee pain by having 30-35 degrees of bend in their knee at the bottom of the pedal stroke. Generally speaking this places the patella in an optimal position on the groove of the femur and allows for great power generation from glutes and quads. Sweet, comfy knees with lots of power. Too little knee flexion at the bottom of the pedal stroke and you can see some hamstring irritation, too much knee flexion and you can expect pain at your knee cap. The issue with full suspension bikes here is that your saddle position is going to change quite a bit. More often than not your saddle height is going to be decreasing as you hit technical terrain and add a lot of power to the pedals. This will result in greater knee flexion angles at the bottom of the pedal stroke. You guessed it, this may also bother the front of your knee. 

As I thought about this more I wanted to try a few different sag measures on my own bike and see how much they changed my knee flexion angles. Here is what I found. 

20% sag here. 28.3 degree knee flexion angle, not bad. Slightly out of our optimal range, could cause some hamstring issues overtime. 

20% sag here. 28.3 degree knee flexion angle, not bad. Slightly out of our optimal range, could cause some hamstring issues overtime. 

30% sag, my standard setting. This is the setting I used to fit my bike and set saddle height. Here we see a 31.3 degree knee flexion angle. Nice.  

30% sag, my standard setting. This is the setting I used to fit my bike and set saddle height. Here we see a 31.3 degree knee flexion angle. Nice.  

Just over 35% sag here, a little too compressed for my liking and showing a 39.1 degree knee flexion angle. This would definitely set me up for some anterior knee pain. 

Just over 35% sag here, a little too compressed for my liking and showing a 39.1 degree knee flexion angle. This would definitely set me up for some anterior knee pain. 

These squiggly lines show that there is is of course some variance in my knee flexion angles, even on the trainer. You should expect much higher variance while riding on the trail. This is why setting up your suspense to keep your knee in the "safe" zone of 30-35 degrees of flexion at the bottom of the pedal stroke is so important. 

These squiggly lines show that there is is of course some variance in my knee flexion angles, even on the trainer. You should expect much higher variance while riding on the trail. This is why setting up your suspense to keep your knee in the "safe" zone of 30-35 degrees of flexion at the bottom of the pedal stroke is so important. 

I was expecting some difference but did not expect to see values this high. With more sag we see a loss of saddle height and a saddle moving backward. Suspension and frame design will potentially change these measurements for your bike. If you are struggling with some pain at the front of your knee and are riding a full squish bike, you may want to double check your sag settings to ensure your knees are moving through a safe range. You just may feel a little better and have some more fun on your next ride. 

Take your pre and post ride routine seriously.

Warming up for a training ride or a race? What should you be doing? Is riding at an easy pace enough?

Preparing your body for a ride should be more than simply getting a sweat going before you hit the road or trail, although that is a good start. We want to prepare your tissues for the positions required for your sport and prime the musculature that will aid your performance. Following the ride you should also spend some time working on ungluing tight tissues as step one of preparing for your next event. 

We get questions every day about what a proper, full body warm up should look like pre ride and post ride so we made a video for you. It covers our favorite dynamic warm-up movements, activation pieces for upper and lower extremity and the most needed mobility work for cyclists of all disciplines. This takes time, we know. If you are spending a lot of time on the bike your body deserves to be taken care of. Don't wait to start a routine like this because you have to. Get proactive and maintain your body better than you would maintain your bike. You have one body, take care of it. 

 

Your race day prep may be a more abbreviated program if time is a limiting factor, we included our go to race day sequnce in the video. 

Ankle pain, be gone.

Foot and ankle pain sucks. I've had more ankle sprains and fractures than I care to admit. Lateral ankle sprains, especially, just plain hurt. However, they usually "heal" up pretty quickly and allow you to return to your sport with seemingly minor inconveniences. Unfortunately, what you don't know about your ankle can, in fact, hurt you.  

I would say that the lateral ankle sprain gets the least attention in most rehab settings and often has the most implications when rehabbed improperly. You can get away with a lack of range in the ankle for a while and feel ok. You can get back to your sport while there is still some swelling near the joint and perform well. I wouldn't recommend either of those situations but in the case of the ankle it has become common place to return to sport very quickly and ignore some important factors. For example, if you sprained your knee and it was visibly swollen and bruised you would probably proceed with caution. I see an entirely different mindset surrounding lateral ankle sprains.

My standard foot and ankle modeling look, decent.

My standard foot and ankle modeling look, decent.

My super swollen ankle after a trail in Moab swept my leg, hard. Gross. If your knee looked like this you wouldn't be expecting to get back to sport in two weeks. Why assume that is ok for the ankle?

My super swollen ankle after a trail in Moab swept my leg, hard. Gross. If your knee looked like this you wouldn't be expecting to get back to sport in two weeks. Why assume that is ok for the ankle?

We traditionally think of lateral ankle sprains as a mild injury.  There are of course grades and classifications for these type of injuries. Ligament injuries are classically graded in one of three categories, 1-3. A grade 1 being a mild stretching of the ligamentous structure and a grade 3 being a complete rupture of the tissue. A vast majority of the sprains I see fall into categories 1 and 2. The mechanism on injury usually involves some degree of plantarflexion or pointing of the ankle downward like you are on the gas pedal and inversion or rolling inward. 

The two most commonly injured lateral ankle ligaments are the anterior talofibular ligament and the calcaneofibular ligament, pictured above. 

The two most commonly injured lateral ankle ligaments are the anterior talofibular ligament and the calcaneofibular ligament, pictured above. 

If you've experienced this type of injury you know they do tend to swell quite a bit. Whether you have a fresh sprain or suffered an injury a few months ago, addressing the issues that come with long term swelling can be a crucial part of your success. I usually see swelling stick around form these injuries or extended periods of time and cause a lot of continued pain and range of motion restriction. A quick and easy way to address this swelling is with a technoque called voodoo flossing. We use a thick band to apply pressure to the joint and surrounding tissue and add range of motion. It works wonders on what we call "cold and old" swelling that has been around a joint for a long time. We will be attempting to move that fluid and restore proper blood flow. Check out the video below for more info on this technique. 

So you are addressing your swelling now. Awesome! Next step is to improve your range of motion, specifically dorsiflexion. Dorsiflexion is critical to all athletic movements, running, cycling, hiking, walking, etc. You will feel the effects of limited dorsiflexion range eventually. The most common issues I see that link to a lack of this ROM include anterior ankle impingement, achilles pain, plantar fascia pain and even toe pain. Those of you who are experiencing pain from a bunion should pay attention. Lack of dorsiflexion often causes a medial collapse at the midfoot to fake the range and this can result in off axis loading at the big toe. Ouch. The implications of this range of motion are far reaching, you should ensure you regain dorsiflexion as soon as possible. Check the video below for a few of our favorite ways to improve your ankle dorsiflexion. 

Seems basic, I know. Don't let lingering swelling or limited mobility in your ankle stop you from doing what you want. Get proactive and start making a change before you are forced to stop your sport. 

Do you carry a heavy pack often or sit at a desk? I bet your first rib needs a little help.

Recently I wrote about shoulder pain and how thoracic spine mobility can alter the mechanics of the shoulder. Today I want to dive in on a topic that gets a lot less attention, the first rib. 

Do you know where your first rib is located? If you are searching for the rib near the middle of your body, try again. The first rib is at the top of the rib cage. 

source, wustl.edu

source, wustl.edu

You will notice the first rib is quite high in the trunk. It is most easily found by pressing down through your upper trap, behind the clavicle, close to the neck. 

The first rib does not seem too glamorous. Most people I discuss the first rib with have no idea where it lives or its importance. 

Let's take a closer look at the anatomy here.  The first rib attaches to the spine and the sternum. the musculature that attaches is more interesting. The scalene muscles which originate at the cervical spine end up attaching to the first rib. The neurovascular bundle coming from the neck also pass near the first rib. 

source, instantanatomy.net

source, instantanatomy.net

Whoa, that's pretty complicated. A lot of things are happening here. Now, check out this lateral view of the neck and first rib.

source, healthtap.com

source, healthtap.com

Again, whoa. Now, imagine you are sitting slouched at your desk all day at work. The scalene muscles may just become shortened and stiff in that position. Obviously, there are a few critical tissues near the rib and scalenes that could be irritated here. Another common scenario I see often is mountain bikers, hikers, skiers wearing heavy packs for long periods of time reporting neck pain, numbness or tingling in the upper extremity. Think the first rib could be part of that problem? Hell yes!

So, the rib may be part of your shoulder, neck or arm pain, now what? Let's get it moving a little bit. A great mobilization I often use for the first rib uses a yoga strap or a piece of climbing webbing. I wrap the webbing around my shoulder, near the neck and sit on the ends to pin them down. Next step is to sit up tall to create tension on the strap and add should range of motion. Try a minute or two in this position. Back off if you feel numbness or tingling in the arm.

Yoga strap wrapped under the leg and over the shoulder to add pressure to the first rib. 

Yoga strap wrapped under the leg and over the shoulder to add pressure to the first rib. 

While sitting tall, add range of motion with the shoulder and search for tender zones .

While sitting tall, add range of motion with the shoulder and search for tender zones .

A second, more aggressive mobilization can be done in the squat rack. Place the bar in the rack around shoulder height with some weight. Step under the bar and apply pressure to the upper trap near the neck. As you stand up you will be mobilizing the first rib. More range of motion with the shoulder is good. It won't feel good but it is good. :) As always, no numbness or tingling here. 

Bar near the neck, pressure through the upper trap onto the rib. 

Bar near the neck, pressure through the upper trap onto the rib. 

Press your trunk upward into the bar and add range of motion with the shoulder. Ouch. :) 

Press your trunk upward into the bar and add range of motion with the shoulder. Ouch. :) 

Do you have a favorite technique to mobilize the first rib?

Shoulder pain? Start at the thoracic spine.

Shoulder pain is not ok. Never. At some point in athletic history the acceptance of shoulder pain became the norm. If your shoulders are smoked after a day of climbing, or riding the bike, or pressing weights over your head, you need to take a 30,000 foot view of your upper extremity and spinal mobility and mechanics before you are forced to stop playing your sport. 

First things first, what you don't know about your mobility can hurt you. Let's dive into the basic position requirements for a healthy athletic shoulder. 

Your shoulder is a fairly complicated joint. Below you will see an anterior view of the body. You will notice the shoulder is basically a floating joint. Attached to the bodies central bony anatomy only via the clavicle. The scapula, commonly called the shoulder blade, floats on tops of the ribs and supported by various muscular attachments. 

image source, medvisuals

image source, medvisuals

Position changes related to the shoulder blade have direct impact on the shoulders function. A very important part of the shoulder blades resting position is the thoracic spine. An image below shows some of the various muscular attachments around the thoracic spine and shoulder blade. Whoa, complicated.

Take note that the ribs attach to the thoracic spine. As we already know the shoulder blade is "floating" above the ribs thus their position plays a roll here. More importantly, the thoracic spine is the foundation for this position. A forward slouched posture or a flexed thoacic spine will tend to drive the entire shoulder complex forward. You've seen this at the gym and the office. This forward shoulder position can lead to quite a bit of over stress at the anterior shoulder and is often a player in limited shoulder flexion range of motion. 

The most common shoulder ROM restriction I see clinically is flexion. Shoulder flexion is taking your arm straight up over your head. Ideally, you will have 180 degrees of ROM, instant access. Without that ROM, compensations show up and the mechanics of the shoulder blade become faulty. Think impingement, bicep tendon irritation and more. 

The perfect starting place for most folks when troubleshooting shoulder pain or limited ROM is with the thoracic spine. We want to improve the extension and global mobility in order to free up the mobility you already have at the shoulder. 

Check out the video below for a few quick tips on addressing your missing shoulder flexion ROM. Test out your ROM before trying these drills and see what kind of improvement you get from mobility work around the thoracic spine and shoulder blade musculature. Look for more posts and videos soon as I expand on the complex athletic shoulder. 

Why is everyone talking about hip flexors?

Hip flexors, anterior hip, psoas, all of these are terms you may hear referencing the iliopsoas or hip flexor group. More specifically this refers to iliacus and psoas, the largest and most powerful hip flexors. 

These muscles have attachments on the top of your femur, the inside of your pelvis and your spine. Yea, literally on your spine. This muscle group is quite robust and acts powerfully on the lumbar spine, pelvis and femur itself. Primarily responsible for hip flexion, bringing your knee toward your chest, you can imagine this group is more often than not, in a shortened position. Desk warriors, cyclists and folks who commute find themselves in hip flexion a lot.  In my clinical practice, I find a vast majority of my clients present with approximately 0-5 degrees of true hip extension. When I say true hip extension, I mean this ROM is coming from your hip, not your low back arching into extension. All humans should be shooting for around 10-15 degrees of true hip extension. Without this mobility, you can expect to experience some low back pain, knee pain, IT band pain among many other possible pain sites. Lack of hip extension mobility seriously limits your ability to utilize glute max optimally. That's a big ass problem. 

Imagine only being able to move your elbow 50 degrees. There would be no doubt that a problem is on the horizon. That said, most of us are walking around missing a lot of our hip extension mobility and we are none the wiser. What we don't know can hurt us.

Not only will restrictions in your hip flexors length cause mechanical changes down the kinetic chain you can also experience referral pains from the muscle itself. This is very common and often misunderstood as its referral pattern is usually to the low back or anterior hip or thigh. 

Stretching of your hip flexor is a great idea for anyone who is in a flexed hip position often. We have spoken about ways to stretch your hips before but if you need a reminder I will link a video to my favorite stretch below. Sometimes you need more than stretching to address a stiff psoas. Manual release techniques are a great way to achieve pain relief here. This could be done with the goal of reducing referral pain in the low back you suspect is coming from the hip flexors. Below you will find a few of my favorite ways to release my hip flexors. Think of these release techniques in the same way you think of foam rolling your quads of glutes. 

Lateral leg pain, more than just the IT Band

In an earlier post, we explained why foam rolling and stretching your IT Band is not the most effective way of getting rid of your IT Band pain. Rather, you should get to the root cause of the pain which is usually due to lack of hip stability, strength, poor motor control, etc.

However, for the sake of this topic, let’s assume you already know this and are working on it. This issue takes time to fix and clean up, and in the meantime you still have lateral knee pain.  It’s important to point out that there are several additional factors that can contribute to IT Band pain and like most injuries, it’s multifactorial. So let’s dive in.   

The Problem: If your pelvis is dropping in single limb stance and your knee is diving inward, you’ll have already irritated the structures that attach to the lateral leg which include the gluteals, hip flexors, and quads. If you irritate them enough, they’ll start talking to you in the form of pain, so you should address these issues while fixing the hips. Knowledge of anatomy is incredibly helpful here to make sense of the mechanics happening in the lateral leg.  These muscles attach and pull on the IT Band. One function of the IT Band is to serve as an anchor point for Gluteal Max/Med/Min, TFL, and Vastus Lateralis.

This is one reason why the IT Band is a steel cable and you can’t stretch it. So stop trying!  As a result, the muscles that surround the IT Band often refer pain along the IT Band when they get irritated and pissed off because of your crappy movement.  (Shame...shame...shame.)  *Notice how the Vastus Lateralis sits right UNDER the IT Band!

Referred pain is often felt during a heart attack.  One of the most common signs is left arm pain. Even though the left arm is perfectly fine, the cardiac muscle is referring pain down the left arm. The problem is the heart muscle not the arm. Skeletal muscles refer in the same manner.

Therefore, referred pain can be traced back to trigger points (irritated muscle fibers) that have specific referral patterns throughout the muscle. Below are IT Band referral pain sites which show how each muscle refers pain and then gets confused with “IT Band pain”. Your IT Band may not be the cause of the pain but simply the site of pain.  This is an important differentiation.

Glute Minimus

Tensor Fascia Lata

Vastus Lateralis

The Fix: To resolve these pain referral symptoms you should attack the problematic muscles NOT the steel cable (in addition to fixing the underlying cause). Keeping the muscles loose - stretching and foam rolling (amongst other treatments strategies) will absolutely resolve trigger points and decrease the referral pain process. So, rather than foam rolling and stretching the site of pain (the IT Band), you should instead release the tension and stress to the muscles that attach onto IT band.

1. Fix your hip issues and crappy movement patterns.

2. Stop stretching and foam rolling your IT band.

3. Start stretching and foam rolling trigger points/muscles that attach to the IT band. In that order.

 

Here are a few of our favorite soft tissue techniques to help with lateral leg pain.

 

 

 

 

Real trunk stability for real athletes.

But when are we going to do abs?

“You’ve been doing them this whole time.” That’s my usual response to the ever present question which comes up with our individual sports performance clientele.

That question is like nails on a chalkboard for me. First of all, I dislike the term “abs”, and don’t love “core” either. They both have become synonymous with strict rectus abdominus exercises, i.e crunches, planks, v-ups, you name it… I prefer the term “trunk”, as defined as “ a person’s or animal’s body apart from the limbs or head.” A scientific definition- I like it.

Front and back anatomy.jpg

What most athletes underestimate is the demands of the trunk during training and its demand for stabilization when performing basic strength movements. An understanding of the trunk’s role in sports is seldom grasped by most of our athletes.  Far away, the trunk works in a stabilization/ isometric capacity. It is directly involved with breathing efficiency and skeletal equilibrium in locomotion. Rarely, if ever, do we actively go from a frontal plane neutral position forward (mimicking a crunching motion) in sport activity. So why do “professionals still train those movements.”  Great question- I don’t know.

What I do know is when one is performing proper ground based strength with appropriate pelvic and spinal stability, your “abs” are working, especially as load increases. That means they are performing essentially the same job as when you are running, riding a bike, and kicking a soccer ball. This is direct activity carry over into sport. Not to mention the EMG (electrical signal, correlated with muscle activity) is extraordinarily high when performing deep squats, moderate load deadlifts, and the variations thereof. Its when an athlete does not use these sets of musculature during exercise where we start running into problems. Issues such as the dreaded  “stripper butt,” or “butt wink” can start to arise, as well as groin/hip, and back pain among a laundry list of issues. Another unfortunate byproduct of inactivity of proper abdominal activity during training is that you are essentially leaving strength and by association, performance, on the table. More research is directly linking ground based strength with on field/ in activity performance, so if you are not getting the most out of your time in the gym, you could be compromising your athletic transference. Don’t waste your time in the gym- get your trunk right!

This is Lu Xiaojun - Olympic Lifting gold medalist from China. Do you think he “does abs”? I’ll save you the thought- he doesn’t. He lifts heavy ass weight which requires a ridiculous amount of trunk stability and activation. You’ll never see him doing crunches or sit ups. I promise.

As you can see, Lu Xiaojun is ripped. “Abs” for days.


When performing weighted ground based strength, to maintain a proper pelvic position and optimal activation of hip musculature, one should see a “drawing in” of their abdominal wall, as opposed to the much seen flaring out of the abdomen which happens when you try to “contract your core.” The former creates optimal spinal stabilization and allows your prime movers to push from a stable base. The latter destabilizes your spine and compromises your mechanics - when done under load, we’re talking pain and possible big time damage.

What I’m getting at- mind your trunk. If you are moving correctly, you are always using your “abs.” If you are looking for athletic cross over, don’t do crunches, of any kind, ever. Don’t do “abs.” Brace your trunk appropriately, lift some heavy ass weights, clap for your damn self.  

 

 

Please, stop stretching and rolling your IT band.

Runners, cyclists, hikers, humans, you can finally stop "stretching" and foam rolling your IT bands because I am here to tell you its not needed. I saw another athlete today who had been advised to stretch and roll her IT band for the last 6 months or so and was still not any better.  No more. You do not need to endure the torture of rolling your IT band after every run or ride. 

Let's do a review of the anatomy so we are speaking the same language. The IT band or iliotibial band, runs from the crest of your lateral hip to just below the knee joint. It is comprised of fascia, a noncontractile connective tissue. An example of a contractile tissue would be muscle. It is meant to contract and relax. The IT band does not change length in the same way your muscles do.

The most common site of IT band pain is at the lateral knee but it can also irritate the lateral hip.  

image source, athletico.com

image source, athletico.com

Traditionally foam rolling on your painful IT band or stretching movements are advised. If you have ever foam rolled your IT band you know how much it hurts. Big picture here, this structure is in place fro stability of the lower leg. It provides a stable platform when walking and running. Newer research would argue and say stability alone is not its only place but the structure also recycles energy during walking and running. Almost like a spring. That debate aside, the IT band does not respond well to stretching or hammering on it with foam. The fascia may be pissed off but in the same way I would not advise you stretch your irritated hamstring I cannot advise stretching your irritated IT band. Not only will this be painful but we know this structure is not dynamic like muscle tissue, why try to lengthen it? 

Perhaps a whole new approach is needed. I prefer to look for the root cause of the pain site, it may be upstream or downstream from the symptomatic area. In most cases the way in which you move causes this over stress at the lateral knee. Here at RevoPT I generally see a combination of pelvic drop and medial collapse at the knee during single leg stance.  

image source, East Carolina Biomechanics Lab, Rich Willy

image source, East Carolina Biomechanics Lab, Rich Willy

As the pelvis drops and the knee moves inward the IT band is placed on high tension. Adding velocity and volume to the equation leads to pissed off tissue. Instead of hammering on that tissue address the root cause, the way you move. 

Glute medius and maximus are able to help control both pelvic drop and medial collapse at the knee. Skaters and monster walks work really well to both activate and strengthen these muscles.   Practicing a controlled shock absorption strategy also helps stop pelvic drop and medial collapse. Focusing on exaggerated forward trunk lean in the shock absorption phase allows increased glute group activity. By retraining your brain to help you correct faulty movements you stand the best chance of having these become habit and ending your IT band pain for good.

Happy running, riding, hiking!

Active shock absorption practice. Focus on level belt, knee on top of the foot and a forward trunk lean simiar to a squat

Spent the weekend in the whiteroom? 5 ways to recover and hit the reset button.

What a weekend! Powder skiing/riding is tough to beat. 

Now it's Monday and your next weekend adventure is already starting to get in the way of the TPS reports you have due this afternoon. As you daydream about bottomless pow turns you remember your legs are still fried from Saturday and Sunday. The burning question here is, "What do I have to do to recover so I can get after it again next weekend?". 

This is a timeless dilemma for the working stiff powder hound, a group I consider myself part of. Here are 5 tips for a fast and effective recovery as you prepare for another round of bell to bell turns in the deep.

  1. Compress
    • Consider some compression on your legs following hard efforts on the hill or in the gym. The harder you train the more you need to recover and this technique is about as passive as it gets. Compression socks and leggings are a great start to your recovery process. These garments provide graded compression to the limb and help accelerate the bodies recovery process by moving fluid and metabolites out of the limb. This can result in feeling fresh the day after a really hard effort. Easy. 
  2. Hydrate
    • Yea it's cold but you're still sweating. Quick fix, drink fluids. Not PBR though, that won't help this situation. It can be a pain in the ass to hydrate on the hill. I always carry a Klean Kanteen with some hot apple cinnamon Skratch. So good! Physical exertion and high altitude mixed with dehydration is a super mix to ruin your day. Don't be the guy/gal sitting in the lodge at 11am exhausted because you forgot to drink for half a day. After your day take proper care to hydrate in the same way you would after a long bike ride in the summer. 
  3. Mobilize your hips
    • You spent the whole day in some sort of hip flexion. The whole day! Give the front of your hip a break. Got some low back pain from moguls? This will help that too! Must keep the tail tucked and trunk tall, for more quad opening elevate your foot. 2-5 minute static holds, low intensity.  Video below. 
  4. Mobilize your thoracic spine
    • You had a pack on all day today didnt you? Knew it! Your mid back is probably mad. Give it some love with a rotation mobilization. You should be able to rotate up and look at the ceiling, easily. 30 reps both sides. Video below.  
  5. Sleep
    • Your body performs its healing functions while you are sleeping. Late nights out will cut into that time significantly. Don't skimp on this recovery strategy if you are serious about stacking up days in a row of hard efforts. Nothing on this list will replace a good nights sleep. If you are on a trip in unfamiliar surroundings consider an eye mask. Eliminating light can help your sleeps effectiveness for recovery. 

Go take your recovery seriously so you can get out there and get rad again next weekend!

My neck hurts when I ride my mountain bike.

So you're experiencing some neck pain on the mountain bike? Unfortunately, this is fairly common. Here is an example of a very common biomechanical cause, implications up and down the chain and a few quick fixes so you can start to remedy this situation if it sounds familiar.

Let's begin with an overview of your spinal anatomy and posture. These areas are huge pieces of the neck pain puzzle. First, your spine. Your spine is comprised of five specific segments, coccygeal, sacral, lumbar, thoracic and cervical. Cervical spine refers to your neck but we are going to focus more on the thoracic spine (T spine). Thoracic spine is in the middle of your back and has attachment sites for your ribs. This results in an inherently less mobile segment compared to the low back and neck.  

Thoracic spine is comprised of the 12 segments in the middle of the back. 

Thoracic spine is comprised of the 12 segments in the middle of the back. 

As you inspect this model you notice the third image details the "S" curve of the spine nicely. This is normal and in fact advantageous for improved mobility and stability where needed. A missing component in this image is of course the muscular anatomy. Your muscular structures provide dynamic stability to your body. Unfortunately the human body is really good at adapting to positions that are not good for it. One of the most common postural faults I see clinically and out on the trails/roads is a flexed thoracic spine and forward head posture. Spinal flexion refers to the spine moving forward, think chin to chest, spinal extension is the spine moving backward, think looking up to the ceiling.  

Looks a lot like someone sitting at their desk doing computer work or even staring at the phone crushing snap chat. Not cool!

Looks a lot like someone sitting at their desk doing computer work or even staring at the phone crushing snap chat. Not cool!

Text neck...what the hell!?! Stop this. 

Text neck...what the hell!?! Stop this. 

So, you've certainly seen this posture in your office, on the trail, everywhere. The more you chill with this posture the more you are hard wiring this pattern to be default. Not good. In addition, due to the lower amounts of mobility here compared to the lumbar and cervical spine, when a position becomes default, it likes to stay that way. 

The issue here is that as you move your trunk forward into either an attack position or even just cruising along the trail, your eyes will always want to meet the horizon. Meaning as you move the trunk forward you will begin to look upward and extend your cervical spine so you can see the trail. If your thoracic spine is in a neutral or extended position you have access to your full cervical spine range of motion. If you have a rounded thoracic spine, you will need to push beyond your c spine mobility. This can cause irritation in the facet joints surrounding the cervical spine, trigger points throughout the neck and upper back as well as poor positioning while in your attack position. If you are shredding down a technical piece of trail with your t spine in a flexed position you will almost certainly lift your trunk up away from the bars to allow for easier access to cervical spine ROM ie you can see the trail easily. The body is always looking for the path of least resistance. Lifting the trunk up solves your eye sight/c spine ROM problem but decreases your control of the bike. Not good in a rock garden. Check out a few examples of the cervical spine ROM issues caused by thoracic spine misalignment...

Lack of thoracic spine extension can cause a lot of irritation at the neck as well as place the shoulders in a poor position, that's another blog post. Seem reasonable?

So, now what? Let's fix this issue! Here a few of my favorite thoracic spine mobility exercises to help you gain access to improved extension mobility. 

T spine extension with some lat mobility. critical for the cyclist with neck irritation.

double lax ball at the t spine with overhead shoulder ROM. Yes!

thoracic spine rotation to address those tricky corners of your mobility. 

Get consistent on your T spine mobility, especially if you work at a computer often. Open up those tissues and allow yourself improved access to new ranges of motion to keep your back flat and low with eyes up. Technical lines will feel much better when you aren't fighting a mobility problem. 

Aaron Gwin shows you solid thoracic spine mobility that does not limit his neck mobility.  Braaaap!

Aaron Gwin shows you solid thoracic spine mobility that does not limit his neck mobility.  Braaaap!

 

 

 

Why is the front of my knee hurting?

Knee pain is the complaint I see most commonly in the clinic.  Anterior knee pain, patellofemoral pain syndrome, chondromalacia, IT band syndrome.  There are lots of different names for knee pain with even more diagnosis categories.

I want to talk a little bit about patellofemoral pain. Long story short this pain generally comes from overuse at the front of the knee where your patella glides over the groove in the femur. Side note, overuse is a stupid term really. Running doesn't hurt your knees, the way YOU run hurts your knees.  Let me explain. 

The patellofemoral groove seen above is designed to match up with the under side of the patella itself. This allows for a large surface area for force to be distributed. During athletic movements its quite common to see multiples of your body weight in force to be placed on the knee. The larger the contact surface area between femur and patella the better off you are. We see folks get into trouble when that contact surface area is reduced. The same forces are placed on a small area, repeatedly. Think running, cycling, gym work. Rep after rep. This continual stress causes tissue to become irritable. Simply stated, your knee is going to hurt.

So how does this surface area become reduced in the first place? Knee valgus is the most common culprit I see clinically. What the hell is knee valgus?

This is some serious knee valgus. Ouch!

This is some serious knee valgus. Ouch!

Robert Griffen III at the NFL combine a few years ago showing off some real deal knee valgus. To be clear, knee valgus is lame. The internal rotation at your femur is a critical factor when we talk about anterior knee pain. As the femur internally rotates the groove of the femur, which is the contact surface area of the patella does as well. This is not ideal. When we change that position the patella is setup to glide toward the lateral groove of the femur. More simply stated, as the knee collapses inward the patella tends to ride on one side of that groove versus between the two of them. This reduces the surface area. Ouch. 

This image was taken from an article published by Chris Powers, PhD, PT, JOSPT 2003

This image was taken from an article published by Chris Powers, PhD, PT, JOSPT 2003

This image was taken from an article published by Chris Powers, PhD, PT, JOSPT 2003

This image was taken from an article published by Chris Powers, PhD, PT, JOSPT 2003

The issue here is simple, improve the contact patch or surface area of patella on femur and spread that same force out over a larger surface area to make your knee feel awesome again. Simple!? So the first question I get in the clinic when I explain this concept is, "am I pronating too much?" Probably not! There are certainly cases where excessive pronation is a factor but I do not find that commonly. Think critically about all the joints in the foot and ankle that must translate movement up the chain to create a medial collapse at the knee. It can be done but thats quite a feat. More realistically this movement is coming from the femur itself. Internal rotation at the femur has direct action on the knee joint. Your femur is in fact half of your knee! One to one relationship.

The fix here is to gain more control from your glutes, glute max specifically. The orientation of the fibers of this muscle make it an optimal performer when it comes to reducing internal rotation at the femur. Lay off those quads and focus on the glutes a litte bit more to gain access to better control at the femur and to get back out there, pain free!

 

 

  

You have one body. Take care of it.

Just one. You gotta make this body last. 

It's time to get proactive about taking care of your body.

"I know I should stretch, but I don't."
"My PT told me my hip mobility was a problem, but I haven't had time to work on it."

I get it, everyone is busy. Set that aside for a second and think. If your body and physical activities are priorities "BUT" isn't going to cut it. Period. I want to challenge you to decide just how important climbing, skiing, running or just being pain free while you are moving is to you. If you get a nervous feeling in the pit of your stomach just thinking about not being able to take part of your favorite sport then I am talking to you. 

Commit to taking the steps required to keep your body running optimally. You wouldn't forget about your car for five years and then but surprised when it doesn't run anymore. Why are you surprised that your knee is killing you when you haven't taken a close look at your movement quality, stretched or mobilized in years? The current medical model we work within is very reactive in nature. Wait until you can't take the pain anymore and then go see someone to help you fix it. Sounds a little off to me. If we know your range of motion is limited and your movement quality is poor, why are we waiting until your shoulder won't work anymore before doing something about it?

Act now! So many athletes want to go to the gym and load up heavy weight or go out running for hours and hours. I get it! We all want to be challenged. Real talk, your movement faults aren't going away by doing MORE. Higher load, more reps, longer durations are making your movement faults worse. By engraining these habits now you are making it harder on yourself if you want to clean those movements up later. Fundamentals are critical. If your child is upset that they haven't made the basketball team but haven't mastered the fundamentals of the game I bet you are going to nudge them toward working on the fundamentals.

Education, business, music, we master the fundamentals first. Movement and sport are no different. When you add load, frequency, intensity on top of movement dysfunction you aare building a pyramid, upside down. It's only a matter of time before it topples. 

I will be posting more videos and blogs talking about basic human movements and the fundamentals. Commit. Own your own movements and health. 

 

Get your thoracic spine mobility back on track

Your thoracic spine is the middle segment of your back. Think of the area between your shoulder blades, this is where your thoracic spine lives. Proper extension mobility here is critical for proper mechanics of the shoulder. As we spend more and more time sitting at the computer, staring at our cell phones and having generally lame posture our thoracic spines become stiffer and stiffer. This stiffness can alter mechanics at the shoulder, over stress your neck and even limit optimal breathing during exercise. If sitting up straight is a struggle for you, there is most likely some t spine mobility work to be done. 

In addition to regaining your thoracic spine mobility we like to add mobility work to the lat muscle as well. Commonly tight in the same folks that have stiff t spine mobility we want to ensure proper length at this muscle.  It's not hard to get this mobility back. Check out of favorite mobilizations below.

Your comfort zone is killing you

Your comfort zone is not keeping you safe. It is holding you back.

So many of us grab on tight to the "safety" of what we know. That could be a training program, a therapeutic modality, even a sport. Just when things seem their darkest you can be sure a breakthrough is near. New strengths gains, new skills mastered and confidence acquired. All of these come just after most will want to give up.

If you aren't constantly challenging yourself you are moving backward. Whether it be learning a new skill, revisiting a fundamental lift or improving your mental game, if you aren't pushing your limits is one area you are really moving backward.

Once you realize that all your goals are sitting on the other side of your comfort zone the sooner you can take action toward achieving them!

Get uncomfortable and get after your goals!

 

Trust me, you're gonna want that hip mobility

Hip mobility. All humans need it. Most of us don't have it. So many athletes respond by continuing on running, riding, pressing, squatting until they can't.  This strategy is not sustainable. I've said this before, we are designed with full ROM in mind.  Instant access. Lack of ROM at one joint generally requires a nearby joint to pick up the slack. Classic set up for over stress injury. This is preventable! Get that hip mobility and stop hammering on your low back. It works.

Here are some easy mobilizations and stretches to help you get on top of your hip mobility before you are broken.  

Athleticism 101

I get a lot of questions about the best practices for improving overall fitness and athleticism. Most revolve around crazy intense intervals, plyometrics or some new fitness fad I've never heard about. I love progression, new and exciting training tools are great.  That said, I very rarely meet an athlete that couldn't use a little refresh on their foundation.

Foundation, beginning, base, footing. This is where it all starts! If your foundation is suspect, stacking on intensity, complexity or volume (or even worse all three) you are going to find out where your limitations are quickly. 

When you think of foundation in terms of athleticism you should be thinking, range of motion and motor control.  As a native Pennsylvanian I always envision a keystone when talking about ROM and motor control.  Without these pieces, nothing works. Your body is an amazing machine and for better or worse it can adapt to shit positions and movements, until it can't.

Sure you can squat or run with your knees well in front of your toes for a while. Then you are going to burn up all the cartilage goodness protecting your joint and it will hurt.  Yes you can do muscle ups without full shoulder ROM until your labrum says no and tears.  This isn't meant to be a scare tactic, this is real life.  This is what we see at RevoPT over and over again. 

You body is going to take the path of least resistance. Every time. If you don't have FULL hip extension ROM when you run you are going to over extend your lumbar spine to fake it.  If you don't have FULL ankle dorsiflexion ROM you are going to medially collapse at the foot to fake it. Hammering super high intensity intervals isn't going to make this any better. Mobility work makes this better.  It's not sexy, its not ground breaking. This is athleticism 101. 


Limited ankle ROM at the bottom of your squat? A lot of us experience this.  Try this mobilization to help your ankle joint regain some of its natural mobility.

Tight hip at the bottom of your squat? Mobilize!

Now you have some ROM, you have to control it! Motor control gets thrown around a lot in fitness and training videos. It's not complicated, it's HOW you move. Your default patterning. Shoot 10,000 free throws and basketball and you've got an idea of how motor control works. You do the same movement over and over, next thing you know you aren't thinking about shooting technique anymore, your just do it. 

It's the same for running, squatting, climbing, running, cycling, throwing and living. Create a movement habit, right or wrong, you'll go to that habit when the going gets tough. Are you really thinking about using your glutes while running up a steep climb? I'm not! I'm holding on for dear life. Motor control is that hard wired pattern that takes over when you are busy playing your sport. 

You need ROM.  You need to control it. If you can't navigate a squat do you really need to be adding complexity to your fitness routine? I say absolutely not!  Squat light until you master it!

If you are out there winning races and crushing it in the gym, great! Get self aware and check in on your foundation.  ROM and motor control are the solid footing of elite athletic performance. Don't wait until you are broken to check in on these areas, do it today! 

 

 

 

Strength and Mobility for Runners

You've asked and now you shall receive!

We will be offering a strength and mobility class specific to runners. We will focus on the motor control patterns specific to runners, how to optimize those patterns as well as common mobility limitations.

Class will run for 8 weeks and will be help Tuesday mornings from 8a-9a.  Schedule before June 7th to receive $50 off your registration.

We will meet at RevoPT once a week to work on technique, running form and mobility.  An online profile on our home exercise platform, Fitbot, will also be provided.  You will be emailed daily with your strength/mobility work for the day.

The programming will be scaled for racers to recreational runners and everyone in between. Come work out with us, be bettered prepared for all your runs and have some fun while you're at it! 

The cost of getting rad

Yes, there is a cost to getting rad. Get over it. If you treat your body like shit, you're going to pay a price. 

Everyone wants to play hard and recover fully overnight with no effort required.  Doesn't work that way. If you spent all week sitting behind a computer and then went out for a 6 hour bike ride on Saturday you are going to need some serious work on your hips. Not a fifteen second hamstring stretch or a few passes on the foam roller.  You need real mobility work. Most of us sit WAY too much and don't spend nearly enough time taking care of our soft tissues. Real athletes need real recovery work. Humans need full range of motion.  Your hips are designed to work with FULL range. Stretching into a range is not full range.  You need full range, instant access. If you've been at a desk job for 5 years achieving full range is going to take some time.

Reality check, today is the oldest you've ever been. You've spent plenty of time in compromised positions.  Get proactive, move well and don't wait until you're broken to make changes. 

Here are a few examples of our favorite hip mobility movements.