Mobility as the foundation

Sometimes when we initiate a rehabilitation plan with a new patient one of the first questions that is asked is "why do I have to stretch so often?" and a question that is often thought but not asked is "what's with the emphasis on flexibility?" Well, the long and short of it is that we know that quality movement, movement that is efficient and uncompensated, is the holy grail of painfree physical function. Quality movement is the construct of 3 main principles that build upon each other:
1) mobility
2) neuromuscular activation
3) motor control
We start with such an emphasis on mobility, flexibility, range of motion, etc because, without out it you allow the movement system (i.e. your body) to compensate and therefore, move incorrectly. This reduces the effectiveness of the body to stabilize properly. Incorrect movement and improper stability leads to injury.
To further drive home this point about why mobility comes first, think about a baby for moment. We come into this world with ultimate flexibility. Floppy bundles with unparalleled range of motion. Over the coming months and years we develop muscle strength and neural networks to improve our ability to be stable and move a limb through space. Now that Principles 1 and 2 are in place, thousands of hours of practice create a movement system (you) that now has motor control (#3). And, if we think about the myriad ways a child or adolescent moves through the world with grace, joy, and efficiency (dancing, monkey bars, soccer, etc), its a marvel to wonder where it all goes when we get older. Well, for some reason, we stop moving or, at best, narrow our focus down to one specific movement pattern that we master, such as running, golf, throwing a baseball. A few of us can even make a nice living being an expert at just one way of moving. But there's a price.
Unfortunately, the foundation of quality movement is lost. We lack variability, we stop challenging our boundaries, we stiffen up in areas we don't use, and we lose the mobility we once had. But, all is not lost. The expert movement analysts at Eugene Physical Therapy are skilled at observing how you are moving, breaking it down into its component parts, and first and foremost, restoring that mobility that made you such a whiz at movement long ago.
I'll leave you with this wonderful example of someone who has made the choice long ago to continue to move, well, like a kid.

When you make the choice to go to Physical Therapy, you are making a choice to move better, with more range of motion, more efficiency and power, and with less pain.
See you soon!

What do all those letters mean?

Greetings!
Joe has been gracious enough to let me in on some posts to our clinic blog and I was trying to figure out where to start. One question we get is
What do those letters mean after your name?
Well, lets start with DPT. That stands for Doctor of Physical Therapy. Just so there's no confusion, that does NOT mean we are MDs. It just means that clinician has graduated from a doctoral level PT program. Almost all of the over 200 PT programs in the country offer the DPT. Its a rigorous 3 year graduate program including course work in differential diagnosis, radiology, pharmacology, research, and professional ethics in addition to the standard master's level curriculum. Being a Doctor of Physical Therapy does not mean we can prescribe medicine or order imaging, but rather it is the terminal clinical degree a PT can earn and is a way of best preparing PTs for the ever-changing healthcare field.
The next most common acronym you'll see is OCS. This stands for Orthopedic Clinical Specialist and is a Board Certification Through the American Physical Therapy Association. PTs who have this moniker have passed a day long exam testing their aptitude in the specialty of orthopedic PT.

CSCS stands for Certified Strength and Conditioning Specialist. This is offered through the National Strength and Conditioning Association and represents a provider who has special training in, you guessed it, Strength and Conditioning. There are myriad ways to strengthen your legs, jump higher, run faster and avoid injury; we can best help you do that.
CertMDT is another specialty some of our PTs possess. This is a certification through the McKenzie Institute, a highly respected international post-graduate training system for PTs. This is one of the most well researched and clinically effective treatment approaches for mechanical disorders and it has a large focus on empowering the patient to improve themselves.

ATC is a certified athletic trainer. Commonly found in sports rehab and training settings, ATCs have special training in diagnosing and treating acute sports injuries.

CGFI is a Certified Gold Fitness Instructor through the Titliest Performance Institute. This is a cutting edge functional assessment and training approach that analyses golf swing faults and how deficits in human movement contribute to those faults.

CSFA is a Certified Specialist in Functional Assessment. They have taken courses training them to perform ergonomic assessments and modifications as well as perform Functional Capacity Evaluations to assist in determining return to work status for injured workers.

USATF certified distance coach is a provider who has received advanced training in coaching through the governing body of the US track and field association. This allows them to best tailor an individualized program to help you get back to running what ever your distance goal may be.

And, last but certainly not least, is the FAAOMPT designation. Jeff is one of only 4 PTs in Lane county (only 21 in Oregon and less than 500 in the country) who have achieved this highly respected level of training.

Well, I know that was a bit of alphabet soup to wade through but we hope it sheds some light on the wide range of specialty certifications the Physical Therapists at Eugene Physical Therapy possess and how these advanced training programs can best serve you.

We sincerely hope we get the chance to help you regain your function soon.
Cheers!

"Letting Go"

I orignially posted this on my personal/running blog regarding my injury experience this winter. Per popular demand, it's been reposted here:

LETTING GO

Free at last! Free from the death grip of Pain and Injury.

As laid out below, I've gone through several interesting processes during this L leg injury. The final -- and most important -- was LETTING GO.

On Wednesday January 5th, my boss, who's sick of not having his run partner around to drag him around town, put his foot down and insisted on a noon treatment, followed by a run. Prior to that, I was content -- if not mildly excited -- by the progress I'd made POOL RUNNING; that is, literally running ON the pool surface (in the shallow end). By that point, I could do 20-30 minutes with very little soreness.

That day, Jeff did some "Strain/Counter-strain" treatments, which identified "trigger points" -- places in muscle that were very tight and sore, due to increased muscle tone (this is important to note for later!). Then he taped my calf/achilles (to unload it), then insisted on a run. I was not particularly confident, but I went along.

We made it maybe 3/4th of a mile before I felt The Tightness come on, then turned back. Same s##, different day. It wasn't terrible, just not good. The rest of the day, if felt crappy -- "tight, achy, throbby, irritated". I told him so that night, via email.

His response? "It's IN YOUR HEAD".

And he was right.

Did I MAKE UP the fact that my leg hurt? No, but my constant worry, obsession and PROTECTING of the leg was changing my muscle (and arguably nerve) tissue tone -- all day long. The next day, after his comments, I noticed I would go through the day with my left leg FLEXED and TENSED. For HOURS. Imagine flexing your bicep halfway, but maintaining it ALL DAY LONG. How good do you think it'd feel? Now add a stressful, repetitive sport activity to that constantly flexed arm. Think it'd be "pain-free"?

Jeff and I agreed: Running had become A THREAT. And based on that threat, I would mega-tense my leg and make it this stiff, dysfuncional STUMP, rather than a smooth, relaxed, powerful limb. And, until I could TURN OFF that tension and bracing, and no longer view running as a threat, I had to rest.

Jeff wanted two weeks off, then a week. I took exactly ONE DAY off, then got after it.

The first couple days: 1 mile, with lots of self-talk: "Relax. You're fine! LET IT GO!". I would literally say these things aloud, trying to keep my lower leg relaxed, even when it perceived "The Stiffness". The first few days of real mileage -- 3-4 milers -- were a challenge, but I kept talking myself through it.

And within a week -- NO PAIN. The Tightness? GONE.

Incidentally: the reason the pool felt so good was because the WATER presented a stimulus to my skin -- on my leg and throughout my body -- that distracted from the protective, straining "Is it there? Is it there?" mind-body effect. Once I was able to replicate that with my mind, on dry land, I was completely fine.

Last Saturday, a week+ out from not being able to run for ten minutes, I did a 14-mile, 5.5-hour snowshoe up Maiden Peak. No pain. Legs were sore as hell, but no pain! The next day, I ran 10K with my roommate Matt, and besides being rolled up on by Jordan Hasay, it was a great run!

It was that easy. As soon as I was able to LET GO, my muscle tone became normal, and I quit re-straining it. I continue to stretch both calves and achilles with relative diligence, but nothing else.

Yesterday I ran with Jeff for the first time since November 22nd. We did 5 miles on the river path. My stride felt great -- long and smooth -- and we were rolling along at 6:30. Per a strung-out, panting Jeff afterwards: "You are officially discharged!"

“It’s All in the HIPS!”

The Problem; A Solution

A year ago, I wrote a two-part series on the importance of running mechanics – not only for running health, but for optimal performance.

In those posts, I pointed out that no one teaches us how to run; rather, we do so be "just doing it", with the premise that if you "do it enough", it will eventually become efficient.

Since that time, when working with runners – both as a clinician and coach – I frequently ask my patients/athletes the following question:

HOW DO YOU RUN?

It's a simple question that, in generality, should have a simple answer. You can ask it over any other sport. For example:

How do you shoot a basketball? Cradle it in your dominant hand, fingertips on the ball, wrist extended; to shoot, extend your arm upward and flick your wrist forward towards the basket.

Coaches, biomechanists, and athletes may have slightly different answers – and different ways to improve upon that "answer". That, in essence, is sport!

Running is different:

1. The injury rate among runners – versus every other sport – is astronomically high*. Thus, the importance of having an answer to the "how" question is doubly important. To do it well is to do it healthy.
   
2. VERY FEW PEOPLE KNOW HOW TO RUN, OR KNOW HOW THEY SHOULD RUN.
   
3. And if they DO have an answer, more often than not, it is not mechanically ideal.
   

*90% of runners will suffer at least one injury in a given year – about double the injury rate of any other recreational sport.

Here is my answer:

"Forcefully EXTEND and PULL your leg behind you, then as efficiently as possible SWING it through to get ready to PULL AGAIN."

That's it. One statement, two parts. Distilled further:

PULL. flick.

And here's why:

A Mechanical Rationale

Why PULL, you say?

Answer: the most efficient and least stressful way to propel oneself is FORWARD. But rather than PULL (and flick), most people BOUNCE – they simply take their body, slam it into the ground (at a slight forward angle), then it slams back (and slightly forward again). However, the main force vector is INTO THE GROUND.

To PULL is to PROPEL FORWARD. To take up and down energy and direct it forward. The end results is three-fold:

1. Forward energy means FASTER RUNNING.
   
2. Less up-down energy means LESS STRESS, thus LESS INJURY.
   
3. "Angular momentum" of levers (PULL your leg back, flicking forward) results in less weird motions = LESS INJURY, FASTER RUNNING.
   

It's that simple.

A Physiological Rationale

Why PULL? Why not:

• DRIVE the hip forward? (=hip flexors)
  
• PUSH your leg behind you? (=knee extensors, plantar flexors)
  

Answer: to PULL with a straight leg is to engage the Gluteus Maximus as the primary propeller for running. And why is this ideal? Simple: the glut max is, by far, the largest and most powerful muscle in the body. It's nearly indestructible. Ever hear of someone pulling a glut max? Or finishing a run or race saying, "Wow, my glut trashed (or, "MAXED out")!"

Why NOT the forward drive:

• The hip flexor is SMALL (about 1-2" in diameter, a rather thin cord)
  
• A forward drive can easily turn into an UPWARD drive (more up-down motion)
  
• A forward drive does not guarantee a backward extension/pull
  

Why NOT push your leg behind:

• "Pushing" engages – and tends to OVERUSE – your quads and calf muscles (which are mostly shock absorbers and "accessory" movers at best)
  
• Pushing increases vertical excursion = more up-down energy = less efficient
  

My clinical and coaching approach, therefore, is to begin with engagement of the glut max – or pulling with a relatively straight leg. Once that has been mastered, the rest of the "pawback mechanism" (front to back) is emphasized. Only AFTER that has been mastered do we address the forward-acting motions – hip drive, forward striding.

Interested in more? Tired of being injured (and slowed?) E-mail me, or contact us (687-7005).

The TRIFORCE

When describing our treatment approach to patients, I often cite what I call, Three Dimensional Care:

Three Dimensional Care consists of three areas:

1. The Intervention.
2. The Behavior.
3. The Environment.

With each patient we address these three aspects to provide a comprehensive, multi-dimensional solution to a health issue that, in the vast majority of cases, is a multi-faceted problem.

The Intervention.
This is why people go to the doctor, or to any other service industry -- to GET SOMETHING. It could be a medicine, or a diagnostic test. In other health care fields -- chiropractic, massage therapy, PT -- it could be a stretch, and exercise, a joint/tissue mobilization (e.g. massage or adjustment).

This is what people (and insurance) is willing to pay for -- the something. It's perceivable and often tangible, and frequently provides results.

Unfortunately, those results are frequently temporary.

Why? Because these next two are frequently neglected:

The Behavior.
The the vast majority of pathologies, our own behavior -- either knowingly or unwittingly -- either causes or exacerbates the situation.

How we use our bodies -- in motion and at rest -- is ultimately the most important factor in our well-being. More often than not, an issue -- e.g. PAIN -- requires either a temporary or permanent change in how we treat our bodies.

The healthcare professional MUST address this, and help the patient determine if he/she is using their body -- sitting, standing, walking, lifting, reaching, lying, squatting, twisting -- in such a way that is preventing recovery.

The Environment.
Nearly as important as The Behavior is The Enviroment. What about a person's surroundings is causing, exacerbating or hindering recovery from PAIN? For an office worker with neck, back, or arm pain, it may be office ergonomics -- or how one's work station is set-up.

Take, for example, this case:

An office worker who commutes 30 minutes each day to work is involved in a rear-end condition. Prior to the accident, they "never had back pain"*; however, after the accident -- despite "clear" diagnostic testing (x-rays, MRI), they continue to have chronic and debilitating pain -- worst in the morning, gradually improving in the AM, then worsening again by work's end and bed time.

(*"Well, it's been sore on and off...for twenty years...")

They've tried pharmaceuticals (NSAIDs to prescription narcotics), physical therapy, chiropractic, massage, acupuncture -- with varying results -- but always TEMPORARY.

Must be something siniser, right? Maybe NOT.

More likely is this person is only receiving one-dimensional care -- the Intervention, only.

Upon further examination:

- The worker sits with a flexed posture for a significant portion of his/her day -- in the car, at work, then at home "relaxing" in the easy chair or on the computer (BEHAVIOR).

- The person's work station requires frequent twisting -- from computer to file cabinet -- that, after further discussion -- gradually exacerbates back pain as the day goes on (ENVIRONMENT).

After addressing BEHAVIOR and ENVIRONMENT, the person -- coupled with effective and individualized INTERVENTION (e.g. manual therapy to lumbar spine, self-stretching, core stabilization) improves significantly over 2-3 weeks until their once-chronic back pain is abolished.

A True Story

This exchange actually occured in my office a few weeks ago.

[Joe walks into office, en route to the locker room -- undoubtedly to change after running before work]

Medical Assistant: "Joe, do you know a good stretch for your upper back?" [points to area between shoulder blades] "It's been bothering me for a few weeks..."
Joe: "Sure, try this." [proceeds to demonstrate trapezius/rhomboid stretch] (INTERVENTION)

Joe: "You know, most upper back and shoulder blade pain come from the neck. Make sure to watch your posture while working; a forward head posture can stress the neck and cause that soreness." (BEHAVIOR)
Med Assistant: "It's really sore in the morning..."

Joe: "Your neck can also get stressed out at night time -- do you ever read or watch TV in bed?"
Med Assistant [reluctantly]: "Yes..."

Joe: "Do you look like THIS?" [lays on the floor - literally - and demonstrates posture]
Med Assistant [more reluctantly]: "Yes..."

Joe: "It's likely you're straining your neck in that position. I recommend you read on your side -- or lie flat and hold the book over your head instead! Or read in a chair, before going to bed" (ENVIRONMENT)

In this example, the Medical Assistant's "upper back pain" (read: NECK PAIN) subsided in a few days with Three Dimensional Care. Equipped only with an INTERVENTION (e.g. a stretch, or massage), she likely would've received only temporarily relief.

*****

The next time you visit your healthcare professional, look for Three Dimensional Care. It applies to all health issues.

For example: HIGH BLOOD PRESSURE.

1. "Here's a blood pressure medication." (INTERVENTION).

But what about:

2. "Add a 20 minute walk to your day -- even a brisk walk at lunch can lower blood pressure levels." (BEHAVIOR)
3. "Have you considered replacing the salt shaker on your table with a low-sodium seasoning?" (ENVIRONMENT)

Because, without Three Dimensional Care, your relief from any health issue may be only temporary, or require chronic usage of the intervention -- medications, massage, chiropractic adjustment, or pain drugs.

Springing Forward

Happy Spring, everyone!

With the new season comes new opportunities! Lots of exciting things happening at EPT in 2010. Stay tuned for updates on upcoming collaborations, with these guys and these gals!

Cheers,
-J

A Solution

Thanks to all for a lively debate on the topic of mechanics in long distance running.

To summarize the 4 Fundamental Problems listed in the previous post:

#1 - No One Teaches Us How to Run
#2 - Fast Kids Become Sprinters, Slow Kids Are Distance Runners
#3 - The Complete Disregard for the Dynamic Nature of Running Strides
#4 - The Over-Emphasis on Physiological Distance Training versus Biomechanics

These distill down to one big issue: we're passing the buck on running mechanics, and missing out on making significant improvements in athletic performance.

Based on that premise, as promised, below are some proposed "solutions":

#1 - Recognition of Stride Mechanics as a Relevant Aspect of Performance

You cannot fix a problem if you do not recognize it, or at least consider it within the realm of possibility. Many coaches out there -- elite coaches -- fail to consider or recognize the contribution of individual mechanics in performance.

Clearly, mechanics is not the only factor in performance, nor is it the "end-all" solution to running greatness. However, recognize that mechanics should hold equal if not higher priority than all other aspects of training -- because the success of all other running-based training relies upon optimal mechanics.

To reiterate:

• Decreased maximum efficiency --> the body absorbs more energy than it transmits --> more tissue stress --> slower recovery --> lower training volume tolerance, or INJURY -- SLOWER PERFORMANCE
  

Stride mechanics should, in the very least, be given equal regard to physiology, training theory, sport psych, and nutrition.

#2 - Belief that Stride Mechanics Can Be Improved Through Coaching

Too many runners and coaches believe that either (A) stride mechanics cannot be changed, or (B) that to do so is a death wish.

Neither is true. I read several comments saying, "So-And-So has weird mechanics and they're GOOD, so why change?"

That's like saying, "Billy's doing easy mileage and hills for training and he's FAST, so why change?" Yet coaches constantly tinker with training methodology -- mileage, workouts, timing, cross-training -- with the intent that optimization facilitates improvement.

This should also be the case with stride mechanics.

Negative, "distaster" examples from a change in training program are just as common (if not more so) than a change in mechanics. And both arise due to:

• lack of knowledge by the coach on what the athlete truly needs, and/or
• poor implementation on the part of the coach and/or athlete

The answer to flawed mechanics is not, "Let's not mess with it, 'cuz it could get worse". The answer is education.

#3- Recognition that "Doing Drills" Alone Will Not Change Mechanics

I've seen countless kids that rule at "A-steps" and "B-skips" with perfectly awful strides. Why? Because the (well-intended) principles of the drills are not consciously and repetitively practiced in stride.

To change form, you have to run differently -- not just do a skip before or after. If the stride does not feel differently to an athlete, it isn't changing.

#4 - Acceptance of Fundamental Norms of Optimal Stride Mechanics

The BASIC norms proposed below, like physiological training systems (aerobic, anaerobic alactic, anaerobic) and subsystems, are based on research conducted in biomechanical labs, or on observational study.

The most detailed, coherent and easy-to-implement resource on running biomechanics I have found is called Explosive Running, written by Michael Yessis, Phd, a biomechanist/Professor Emeritus at Cal State Fullerton. It is primarily from his text where I choose to obtain these norms.

This is not an all-inclusive list. Listed below address but a FEW of the common mechanical errors observed clinically:

Inadequate hip flexion during flight phase

The #1 problem I see -- both clinically and as a coach/runner -- is inadequate hip flexion during swing or flight phase of running. They're simply not getting their leg high or far enough forward.

PROBLEMS ASSOCIATED: inadequate hip flexion can result in a myriad of problems. Instead of their body energy going FORWARD, it is going DOWN, resulting in:

• Shorter strides
• "Shuffling gait"
• Slower running speeds
• Heel striking
  

INJURIES: anterior shin splints, knee pain, ITB syndrome, stress fractures (foot, tib-fib, femur), back/SIJ pain

NORM: 35-45 degrees of hip flexion (as measured from vertical) sustained through swing phase*

(*depending on pace; the faster pace, the more flexion)

Inadequate knee extension during flight phase/early stance phase

The second most common is inadequate leg extension, or "flicking foward" of the tibia on the [FIXED] femur.

PROBLEMS ASSOCIATED: Like insufficient hip flexion, not enough knee extension causes a short stride. But, different from the hip, not enough knee extension results in a bouncy or "squat" stride and overall poor efficiency, as the leg is not acting as a stable lever for power transfer between the runner --> ground --> runner.

• Short striding
• Slower speeds
• Poor frontal plane control of hips/knees (knees going in and out)
• "Bouncy stride"
  

INJURIES: heel/arch pain, medial shin spints, patellofemoral pain ("runner's knee"), ITB syndrome, back pain

NORM: 5-10 degrees of knee flexion at initial contact ("nearly straight"/"slightly bent")

Poor pelvic position or instability

Translation: the pelvis has to be in the neutral position, and neither tilted too far forward or back, or demonstrating excessive side-to-side motion (as seen from in front or back).

PROBLEMS ASSOCIATED:

Excessive forward or backward tilt:

• lack of full hip range of motion, resulting in short striding
• poor transfer of ground reaction forces (runner --> ground --> runner) from trunk <--> legs.
  

Excessive side-side motion:

• decreased stance time (=shorter strides)
• less stable/efficient stance leg for propulsion, poor GRF transfer
  

INJURIES: chronic hip flexor strains, posterior thigh pain ("hamstring" or "glut" pain), foot/shin/knee pain due to poor dynamic knee control, SEVERE BACK/SI Joint pain

NORM: Pelvis should be in slight forward tilt and stable in both sagital and frontal planes.

*****

This is just a brief example of the some stride norms. What, exactly, they should be are up for [scholarly] debate, no differently than what %VO2Max constitutes optimal 3K pace versus 5K pace vs the marathon.

The devil is in the details and, as with all coaching, there is both science and art to their adoption and implementation with runners.

But you cannot adopt and implement what you do not recognize, know, or value. Which brings me to #4:

#5 - Improve Coaches Education w/Greater Emphasis on Mechanics

I've been a runner for nearly 20 years. I've been a coach for eight. I hold certifications in coaching from the National Federation of High Schools, USA Level I, and USA Level II. I have a Doctorate in Physical Therapy.

Both USATF Levels I and II cover stride mechanics, as does PT curricula, but, no different than water-cooler discussion, to be GOOD at addressing mechanics requires emphasis and balance in the big-picture.

We, as coaches and runners, need to raise stride mechanics to the same level of discussion, debate, and study as we do physiology, training theory, and sport psych/team dynamics.

We also need to value and legitimize the USATF-sanctioned curriculum by promoting Coaches Education. High schools, universities, and professionals should support this standard of education by encouraging these ed programs and hiring coaches with these certifications.

#6 - Utilize Readily-Available Technology

Several years ago, a complicated set-up was required for a formal biomechanical assessment, including a treadmill, visual markers, an expensive high-speed video camera, and often specialized computer software for analysis.

Today, this technology is so ubiquitous most of us don't realize we already have it.

Digital (still and video) cameras and even mid-grade cellphones can now be used for "video analysis". Here's how:

Step 1: Get out camera or phone
Step 2: Turn on
Step 3: Hit "record"
Step 4: Have someone run by (and the tricky part:), HOLD STEADY.
Step 5: Watch it.

It's that simple, and often a tool I use clinically. Digital cameras and phones are EVERYWHERE -- nearly every kid has one. Use it as a way to evaluate form with nearly immediate feedback.

Greater technological orders of magnitude can be used but, like everything, is best reserved for the serious runner with resources. The most ideal: set up a camera, hook it up to TV, which sits in front of a treadmill. Run and "watch yourself"! This is by far the best method to change form -- real-time feedback.

Whatever you choose, recognize this emergent tool for stride optimization.

#7 - Recognize Important Occasions to Re-Examine Biomechanics

There are specific occasions where it is most important to look at a runner's mechanics:

Repetitive Injury - If a runner, engaging in consistent training, continues to experience the same pain in the same spot, or continues to suffer the same lost-time injury, there is a biomechanical flaw. Too often the buck is passed to, "Oh, she can't handle the training!"/"He breaks down when he runs 70 miles per week". False. His/her mechanics are not allowing that level of training. Rather than give up to "fate", look at mechanics.

A Plateau in Performance - How often do we see runners who do the same training, the same group, the same coach, the same environment -- only to run SLOWER a year later? Often enough to consider the possibility that his/her mechanics have changed.

Burn-Out - When mechanics are poor, they typically cause injury. But sometimes they don't. Instead, they slowly wear us down. Inability to handle the same amount of volume/intensity may signal biomechanical inefficiency -- just enough to hamper recovery but not enough to injure.

ALL THE TIME - No matter how you're running, runners should routinely consider mechanics and ask and receive frequent feedback. "How's my form looking today?" is a simple question, but is not asked of coaches and teammates nearly enough.

It's not enough to "just do drills" and go run. Mechanics require a consistent level of attention, just like any other area of performance.

*****

This list is not a "magic bullet" for world record performance, nor do I claim it to be. Instead, the goal is to raise our awareness, education and expertise with stride mechanics as a vital tool for optimal athletic performance.

Distance runners pride ourselves on success through determination, and overcoming (if not complimenting) natural ability with hard work and a drive toward excellence. There is no reason why we cannot take that same desire and apply it to, arguably, a runner's only "skill" -- putting one foot in front of the other, really fast!

Best of luck in that pursuit. :)