A pleasure to join
@SportsmithHQ
sharing thoughts, practices and current research on sprint mechanics in hamstring injuries. 🏃🦵⚙️
Hopefully the episode provides some interesting discussions and thoughts for practice.
This week's Pacey Performance Podcast...
@chrisbramah
talks:
• Running mechanics' impact on hamstring injury risks
• The Sprint mechanics Assessment Score (S-MAS)
• Lumbo-pelvic control and overstriding interventions
• Avoiding S-MAS set up issues
Listen via links 👇
I am so happy to be able to say, the longest 8 chapters (and 7 years!!) of my life are finally over!
PhD complete ✅
The association between running kinematics & common overuse injuries in runners. Implications for injury & rehabilitation.
Throughout 2021 a pretty solid routine has been morning coffee ☕️ with a good read of all things sports science & medicine 📚📰
So if you’re interested in lower limb🦵injuries, biomechanics 🦾🦿⚙️, endurance or sprint running 🏃♂️🏃♀️
Here are 12 of my top reads from 2021 👇🏻👇🏻🧵
Ever wondered what running biomechanics are associated with common injuries? 🏃♀️ 🏃♂️
Well have a read of our new paper via
@AJSM_SportsMed
We aimed to identify global kinematic contributors to running injuries & found some interesting findings
Great new paper looking at muscle contributions to acceleration:
Highlights the key role of the plantarflexors for acceleration.
Soleus the primary muscle for vertical support ⬆️
Gastroc for forward acceleration with ⬆️ demand during early accel. ↗️
New paper: Relationship between performance & biomechanics in male middle distance runners.
Faster 1500m runners:
• ⬇️ swing hip RoM
• ⬇️ ankle plantarflexion at contact
• ⬇️ trunk flexion at toe off
• ⬇️ swing knee flex RoM
• ⬆️ peak VGRF
Can gait retraining improve kinematics & clinical outcomes in runners with PFP?
We found a single session (⬆️ step rate) results in improvements as early as 4 weeks.
Including:
⬇️ Hip Add, CPD & Knee Flx
⬇️ Pain: 6.2 to 1/10 NRS
⬆️ Weekly run distance
🆕 Exploring the role of Sprint Mechanics in Hamstring Strain Injuries 🆕
In our new article we discuss the mechanistic link between sprint running mechanics & hamstring strain.
@jb_morin
@TomDosSantos91
@zentrumsport
Here’s another fun
@iaaforg
fact:
Foot strike patterns of the World Championships Marathon:
Women’s race:
73% rearfoot, 24% midfoot, 3% forefoot
Men’s race:
67% rearfoot, 30% midfoot, 3% forefoot
Again, the top 8 guys don’t change much throughout the race.
#running
Systematic review of Medial Tibial Stress Syndrome in Runners: 👇🏻
Risk Factors:
⬆️ Pelvic drop
⬆️ Hip int rot
⬆️ Navicular drop
Abductory twist & early heel lift
⬆️ Weekly running distance
Factors may influence loading of the medial tibia & load dose.
Some really interesting data from the
@iaaforg
biomechanics reports.
Men’s marathon:
Despite fatigue, these guys are still able to maintain their mechanics in the later stages of the race.
How? ⬇️ stride length & maintain cadence
New from our group led by
@DrStevePreece
Biomechanical characteristics of high performance endurance runners
We compared the biomechanics of 14 high performance & 14 recreational runners at different speeds.
Here’s what we found 👇🏻👇🏻👇🏻👇🏻
Femur rotation appears to have the biggest impact on patella cartilage stress. Highlights importance of hip control during running!
10° ⬆️ in femur rotation & adduction ⬆️ patella cartilage stress by 77% & 43%
#running
#knee
Fancy a sneak peak of our biomech lab? 😝 Probably one of my favourite work places. Looking at all things running & cutting related, from hamstrings🦵to ACLs and back to sport. 🤕➡️🙌
#biomechanics
So pleased to finally announce the official launch of The
#Running
Clinic
@MIHP_UK
with
@jpmrogers
@AthleticsDrLeon
&
@SalfordUni
Our new multidisciplinary service for running injuries, illness & performance providing access to Sports Docs, Physio, Physiology & 3D gait analysis
Can increasing step frequency improve running economy? A 10 day training program with ⬆️ cadence resulted in:
• 11% ⬇️ oxygen consumption
• 5.1% ⬇️ heart rate
Maybe gait retraining can improve running economy after all... 🧐 🏃♀️ 🏃♂️
Interesting article in
@PTiSJournal
Eccentric hamstring strength deficits persist for up to 72 hours post game. 📉
Potential for increased injury risk due to fatigue induced strength deficits of the hamstrings. 🏃♂️💥🤕
Effect of hip angle on neuromuscular activation of the adductor
longus & adductor magnus:
Adductor Longus ➡️ hip flexor from hip extension (& early hip flexion ranges)
Add Magnus ➡️ hip extensor from all ranges of hip flexion.
What are the mechanisms underpinning Arthrogenic Muscle Inhibition?
Great article by
@Lepley_Adam
&
@LindseyLepley
discussing peripheral, spinal and supraspinal responses to injury which may influence persistent deficits following injury.
Common High-Speed Running Thresholds Likely Do Not Correspond to High-Speed Running in Field Sports
Great paper📝with implications for hamstring🦵injury🤕management. Common training & match load thresholds📊do not accurately represent tissue demands!
This is the first I’ve seen of the daily mail article and it is not a true reflection of our work or beliefs. They haven’t contacted me and seem to have lifted quotes from some comments I gave to another source. So this is secondary, synthesis of our article. My opinion is 👇🏻
New study in
@PTiSJournal
46% of male distance runners had ultrasound imaging findings of tendon pathology.
Despite having no symptoms!
Greater years of running experience was associated with tendon pathology.
Poor form from someone who’s supposed to be a professional! 😠
Making our work out to be their own via
@instagram
A lot of time & energy when into this. Only for someone to pass it off as their own without citation... It’s open access so no excuse:
Transition to forefoot strike running (FFS) with 12 month injury incidence follow up:
No difference in injury rates between those who maintained RFS & those transitioning to FFS. However:
RFS ⬆️ knee injuries
FFS ⬆️ foot & leg injuries
Eccentric versus eccentric plus isometrics for Achilles Tendinopathy:
At 3mnth both groups ⬆️ VISA-A scores. 😃
However, no additional benefit observed adding isometrics!
Interestingly, exercises were BW only. Would load progression be different? 🤔
For those who like numbers...
Our final version detailing the repeatability, measurement error and minimal detectable change of running kinematics. 🤓
@leehphysio
@DrNiamhGill
@DrStevePreece
Really pleased to see this appear in the inbox today 😁
Accepted workshop for
@IOCprevConf
“Are running mechanics limiting the development of the endurance athlete?”
Survey of injury history amongst runners: 🏃♀️🏃♂️
• 80% reported a history of injury
• 57% reported a recurrent injury
• Approx 40% continued to run with injury
• 33% ran against the advice of medical professionals
@PTiSJournal
How do we use 3D biomechanics to inform injury management in the return to sport & performance process? 🦿⚙️
3D motion capture gives us greater insight into individual function & performance beyond what we can see with the eye 🔍🏃♂️
Example: What can you see in this video?
Adaptation of Running Biomechanics to Repeated Barefoot Running: an RCT
Acute response to barefoot:
⬇️ vertical loading rate
BUT🚨🚧 at 8 weeks barefoot ⬆️ vertical loading rate
Suggests short term positive adaptions may not last at longer term!
Following a 12-week running program for beginner runners there were no changes in kinematics or saptiotemporal parameters. 🏃♂️ 🏃♀️
Do we really self optimise our mechanics? Or are our mechanics predetermined? 🤔
Fatigue matters: An intense 10 km run alters frontal and transverse plane joint kinematics in competitive and recreational adult runners.
interesting article
@chrisbramah
Prospective study of 123 runners 🏃♂️ 🏃♀️ 20.5% developed MTSS 🤕
Risk factors included:
⬆️ Body mass
⬇️ Previous activity level
⬆️ Dynamic foot pronation
⬆️ Soleus EMG amplitude during absorption & push off
If you’re interested in ITBS, here’s some of our slides from
@spc2019
abstract presentation. Looking at differences in running kinematics between male & female runners with ITBS.
#SPC2019
Could we be seeing two different mechanically driven ITBS injuries?
@SalfordUni
@MIHP_UK
Are the number of calf raises relevant before returning to run? 🏃 🦵
Interesting discussion from
@Seth0Neill
Below is some of our data on number of calf raises in injured & uninjured runners along with % asymmetry. 👇🏻
We've often heard that people need to be able to complete >30 or >35 heel raises before returning to running.
Can anyone point me to a paper with this quote?
#New
👟💥New study by
@chrisbramah
showing contralateral pelvic drop & forward trunk lean at midstance as common denominators for several running injuries⚙️💡
🇬🇧🇪🇸🇫🇷 Discover new exclusive infographics each week on sport science on YLMSportScience app
📲
Relationship Between Running Economy and Kinematic Parameters in Long-Distance Runners
Better running economy correlated with:
⬇️ knee flexion/ extension range of movement
⬇️ hip & knee abd/ adduction range of movement
How do we increase running speed & how might this influence clinical practise?
Here are some of my thoughts & discussions shared with
@physiosinsport
#Need4Speed
Talking all things carbon fibre with
@oliw_physio
Performance gains, mechanisms & possible consequences of their over use.
Thought I’d share some thoughts & some of the ideas discussed for
@BritTri
Performance Learning Week. 👇🏻👇🏻
Foot muscle contributions to transverse arch height:
• Flexor digitorum brevis: raises the 2nd, 3rd and 4th metatarsal heads
• Abductor hallucis: lowers the first metatarsal head
Greater size of these muscles may increase transverse arch height.
Does pelvis & femur morphology differentiate runners with high & low hip adduction angles?
Femoral head anteversion & length found to best discriminate ⬆️ & ⬇️ hip adduction.
Suggests structure may, in part, influence function. 🦴🏃♂️
New systematic review on structural & functional factors associated with MTSS:
⬇️ lean leg girth
⬆️ soleus activity during propulsion
⬇️ plantarflexor endurance
⬆️ muscle shear modulus
However, lack of prospective studies to suggest cause/effect
New from our group, led by
@CStarbuckPhD
The effect of speed on Achilles tendon forces & patellofemoral joint stresses in high performing endurance runners. 🏃♀️🏃♂️
AT force ⬆️ 6.4x BW to 7.7x BW
PFJ force ⬆️ 6.9x BW to 7.7x BW
@richkjones
@leehphysio
Having sent in some comments on the Daily Mail article, they kindly agreed to amend the original article. Aside from the slightly sensationalised headline, hopefully this piece now provides a better reflection of our
@AJSM_SportsMed
paper
@SalfordUni
Qualitative study investigating how runners perceive & manage injuries.
Suggests injury may be in the control of the individual, as runners self regulate training behaviours to manage injury issues.
Highlights the importance of information/ education
Brilliant talk from
@sweatscience
on pain perception in athletes.
Elite athletes have greater pain tolerance. Does this allow them to push the boundaries of performance?
Get comfortable with being uncomfortable!
@spc2019
#SPC2019
Fantastic documentary
#Ambulance
on bbc with some real stand out messages:
1. How hard ambulance crews work
2. The overpowering stress the NHS is under
3. The lack of services for mental health care
4. And how some people can make some ridiculous ambulance calls!
Great article/ find from
@sweatscience
Prelim data showing ⬆️ running economy 🏃♂️ when training in flats v carbon shoes 👟
A point I’ve always made: does frequent carbon shoe use for training ⬇️ musculotendon adaptations for performance 🤔
Interesting paper reporting cut off values for rehab progression:
Peak quadrcieps torque of 1.45nm/kg is associated with “successful” return to jogging post ACL.
However not so sure how we determine successful return to jogging. 🤔
@leehphysio
What are the the biomechanical characteristics of economical runners?
⬇️ ground contact time
⬆️ stride frequency
⬆️ knee joint stiffness
Thought for the morning.. Optimising your
#running
mechanics may improve your Sunday long
#run
. 😉
Sharing knowledge 📚 is not just about what YOU know, but is also an opportunity to learn from others.🤓
Grateful for the invite and opportunity to share some of my work & ideas over the last two days with both
@englandcricket
🏏 and
@Carnegie_Sport
🏃♂️ 🏃♀️
Just going to throw this one out there....
Injury incidence rates amongst cross fit 🏋️♀️
30.5% & 0.27 injuries per 1000hrs
Injury incidence rates amongst runners 🏃♀️🏃♂️
20% to 79.3% & 33.0 per 1000hrs
😲😮😬
Love the title of this paper! “A little bit faster”
As running pace increases, the ankle joint works harder. Changing pace from ~10 min mile to ~7 min mile ankle power generation increases by ~30%.
Need to keep those gastrocs and soleus strong! 💪🏻
Fascinating new study, although small numbers:
Conditioning training + feedback on gait retraining:
• Improved running mechanics
• ⬇️ injury rates compared to placebo
Could gait retraining work for injury prevention after all?
If you’d like to listen to me talking about how we use 3D running gait analysis
@MIHP_UK
and some of our early research findings
@SalfordUni
Have a listen to this little podcast for
@BJSM_BMJ
👇🏻👇🏻👇🏻
ITBS & mechanics in ITBS is far more complicated than we like to think.
My thought:
Agree, HADD alone unlikely to influence distal ITB. But, coupled with tibial internal rotation would ⬆️ strain via the Kaplan fibres.
Also appears to be sex specific differences in mechanics
For the past 10 years it’s been pretty much accepted dogma that ITB syndrome is due to compression - most likely caused by hip adduction. Yet, I’ve seen no anatomical models/experiments measuring compression and have trouble “seeing” how this even occurs distally
In no particular order:
1. Sprint Specificity of Isolated Hamstring-Strengthening Exercises
From
@CarolinPrinC
& co authors
@jb_morin
@lahti_johan
highlighting max hamstring muscle activity only occurs with max sprinting
Thanks to
@SalfordUni
😁 our
@AJSM_SportsMed
article:
“Is there a pathological running gait associated with coming running injuries?” 🏃♂️🏃♀️
Is now available open access & free to download using the link below: 👍👇🏻
Ever wondered what running biomechanics are associated with common injuries? 🏃♀️ 🏃♂️
Well have a read of our new paper via
@AJSM_SportsMed
We aimed to identify global kinematic contributors to running injuries & found some interesting findings
What conclusion do we come to on the running shoe prescription 👟 🏃 & injury debate, if we only look at the studies in runners?
Could there be a place for motion control shoes? 🤨
New study, again suggesting running mechanics may play a role in iliotibial band syndrome. Including:
⬆️ knee adduction
⬆️ TFL muscle activity
#physio
#running
#knee
Continuing this mornings downhill running theme:
⬆️ in downhill gradient increases:
• vertical impact force
• vertical loading rate
• instantaneous loading rate
With impact forces of up to 3x body weight
Interesting new study using Shear Wave Elastography in MTSS. Reporting ⬆️ muscle stiffness of:
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Stiffness correlated to periosteal thickness. Suggests possible soft tissue tensioning of tibia 🤔
Not the usual morning physio appointment...
Popped in to
@BBCRadioManc
to help
@radiochelsea
&
#Couchto5k
listeners with some running injury advise
Key message: give yourself adequate recovery between runs. Allows the body to adapt & become stronger💪🏻🏃♀️
Effects of a 7 degree medial wedge orthotic at the rear-foot and forefoot during running:
⬇️ Rearfoot eversion
⬇️ Rearfoot inversion moment
⬆️ Knee adduction early stance
⬇️ Knee rotation
⬇️ Hip adduction
Had great fun talking all things injury prevention at the
@EnglandAthletic
marathon program.
Some fantastic coaches, scientists & athletes to spend the weekend with. Snuck some beautiful runs in too!
#marathon
#EnglandAthletics
Staying on the lower limb, 🦵 two papers providing food for thought when it comes to rehab progressions 📈for the calf complex and Achilles tendon
6. Exercise Progression to Incrementally Load the Achilles Tendon
Low carb diets reduce anaerobic performance and power output. Which may impair performance in late stage endurance events.
Basically, if you’re on a low carb diet, you can probably forget about that kick!
With
@IAAFDoha2019
one week a away, I figured it might be interesting to look at why there might be hamstring pulls in the men's 200 and 400m sprints. Just a simple demonstration as to why increases in tendon stiffness (for the same muscle strength) cause muscle pulls/ruptures.
Important to note that muscles act synergistically across the hip & ankle for vertical support and forward acceleration.
Contributions to total propulsive impulse:
Gastroc 37%
Soleus 23%
Hamstrings 15%
Glute med 7%
Glute max 2%
Interesting new study looking at muscle fibre typology & Hamstring injury. 🧐
⬆️ hamstring injury risk found in players with Fast twitch fibre composition.
Proposed explanations include:
• structural diff in FT v ST
• ⬆️ fatigue accumulation in FT
Just because you have no symptoms, does not mean you’re not contributing to the spread of
#Covid_19
.
1 in 3 people may be a carrier, despite having no symptoms!
There’s a reason for social distancing!
Conservative treatment of anterior chronic exertional compartment syndrome in the military:
• 65% returned to duty without surgery
• Average treatment duration of 145 days
At two years:
• 57% were still in active duty
• 48% still had symptoms
Myself and
@clitherbot
are running an
#injury
prevention workshop
@mihp_uk
as part of the
@EnglandAthletic
steeplechase program.
If you’re an endurance track runner, get involved! 8th July. Register with the link below.
Short aerial time
⬆️ stance time
⬇️ vertical displacement of CoM
@BorisJohnson
seems mechanically suited for an ultramarathon here.
But might want to review reactive strength qualities for anything shorter 👌👍😉
.
@nytimes
used
@Strava
data from thousands of runners to look at the effects of Nike’s next% and vaporflys. Since the launch:
• ⬆️ sub 3h marathons
• Faster race times
• Faster times v all other shoes
• ⬆️ likelihood of running a PB
😳😳😳