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Running Injury Pandemic!

Running is one of the most popular forms of exercise, but injuries are also very common,

with many runners missing training time due to injury within a year. The yearly injury

rate has been estimated between 19.4 and 79.3% (van Gent et al 2007)(1)

Some sources put the yearly injury rate at up to 82% (.2)

Now that’s a true pandemic!

There are many reasons why this is the case including: hip, gluteal, core weakness and

tight areas that cause joint, muscle, tendon, and even lower back pain. This will throw off

biomechanics, most commonly into a "femoral adduction and internal rotation" pattern with

heel strike. (basically, the hip drops and the knee caves in).

Studies show that impact through the lower extremity increases as step rate decreases affecting how one lands on their foot.(5)

With an improvement in cadence, impact decreases. Change in running form can include shortening the stride out in front, which has been shown to decrease impact during running.(5)

In Chi Running®, the optimal cadence is 170-180 steps/minute, which is generally much higher than runners we see coming into the clinic. The increased cadence is easily followed with a metronome, and results in less time absorbing impact with the ground. This also creates a more vertical leg posture at initial contact (4), which reduces braking impulse and knee extensor moment.

ChiRunning® goes beyond traditional running training by incorporating energy efficiency

and injury prevention techniques into running form. Concepts from the ancient martial art

of Tai Chi are applied to running, creating fluid movement around a well-aligned posture

and strong, stable core. Runners learn to use their core muscles while relaxing the rest of

the body, and utilizing gravity, instead of the legs, for forward propulsion. This creates less

effort, less impact, and less pain running.(3)

As runners learn the method, they learn to run with better form, minimal impact and less injury risk. Proper teaching of running form with timely verbal feedback, as given in ChiRunning®, has been shown by research from Richard Willy, DPT, to decrease impact to the joints(7). Willy’s research shows that getting guidance from an expert physical therapist, using video and specific

drills to address running form is critical to success as a runner.(7)

In one study, ten female runners with patellofemoral pain (in the knee)completed eight sessions of mirror and verbal feedback on their lower extremity alignment during treadmill running. During the last four sessions, mirror and verbal feedback were progressively removed. Hip mechanics were assessed during running gait, a single leg squat and a step descent, both pre- and post-retraining. Subjects returned to their normal running routines and analyses were repeated at one-month and three-month post-retraining.

Subjects reduced peaks of hip adduction, contralateral pelvic drop, and hip abduction moment during running (P<0.05, effect size=0.69–2.91). At one and three months post retraining, most mechanics were maintained in the absence of continued feedback. Subjects reported improvements in pain and function (P<0.05, effect size=3.81–7.61) which was maintained through three months post retraining. Follow-up support of up to eight visits is needed to continue running with good, new habits that will help the runner stay injury free.(7)

For those with a current injury, Dr. Trent Corey offers great solutions and support to help improve tissue healing while you work to get on the road again. Integral to our success is looking at the whole body and person--how it moves through space. To talk to Dr. Trent Corey, click here to book a call.

Trent Corey PT, DPT

Xtra Mile Physical Therapy



1. Bobbie R.N. van Gent Incidence and determinants of lower extremity running injuries

in long distance runners: A systematic review. Br J Sports Med Published Online First: 1

May 2007 van Gent et al

2. Dicharry, Jay. Anatomy for Runners: Unlocking Your Athletic Potential for Health,

Speed, and Injury Prevention. Skyhorse Publishing, 2012. New York

3. Dreyer, Danny. ChiRunning. Simon & Schuster, Inc. New York, 2009

4. Farley CT, Octavio González. “Leg stiffness and stride frequency in human running”.

February 1996 Volume 29, Issue 2, Pages 181–186

5. Heidersheit, BC, et al. “Effects of Step Rate Manipulation On Joint Mechanics During

Running.” Medicine and Science in Sports and Exercise, (43): 296-302, 2011.

6. Morin, JB et al. “Effects of Altered Stride Frequency and Contact Time on Leg-Spring

behavior in Human Running”. Journal of Biomechanics Volume 40, Issue 15, Pages 3341–

3348, 2007

7. Richard W. Willy, PT, PhD,1,* John P. Scholz, PT, PhD,2 and Irene S. Davis, PT, PhD3.

“Mirror gait retraining for the treatment of patellofemoral pain in female runners”. Clin

Biomech (Bristol, Avon). 2012 Dec; 27(10): 1045–1051.



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