running injuries

Jae Gruenke Interview

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Jae_Gruenke_head_shotThe interview series keeps on rolling with Jae Gruenke of The Balanced Runner and Intelligent Exercise. Jae is a Certified Feldenkrais Practitioner and running form expert who has helped runners from beginner to Olympian to  relieve pain and improve their performance, and she specializes in helping runners whose problems have persisted despite medical treatment. Jae has a very unique (and very useful) lens on running form, performance, and injury recovery, so I was glad to have a chance to download her brain, so to speak, on this subject.

If you want to skim or to see a more detailed outline of our conversation, you can scroll below the video to find the timeline. Meet Jae:

1:32 Jae’s unique “hardware” vs. “software” approach to help people to learn how to move. In Balanced Runner (and Feldenkrais) they work with what you know about how to coordinate yourself in movement, or the “software” you are running; i.e. the movement habits that you bring to running.

3:38 We are evolved to do this movement [running].

5:00 The number of people who are coming back to running in general (and barefoot or minimalist running in particular) right now after having left it because they thought running was bad or their doctor told them not to run anymore.

6:26 Jae talks about how they find that it is not necessary for people to run in orthotics. They become unnecessary as people learn to run appropriately. “Maybe there are 1 in 1000 who have a real anatomical abnormality that make orthotics truly necessary, but I haven’t met that person yet.”

8:12 One of the big problems with orthotics is that your arch is one of your major springs; it absorbs impact and then returns it to you. That’s where a portion of your momentum comes from, and not just the arch but the whole spring system through the body’s the connective tissue [yay fascia!]. It is responsible for storing as much as 50% of the energy from each stride and generating the force that you need for the next stride. So if you’re running on a stiff support that prevents your arch from doing a normal natural pronation, all that free energy that you could have had from your feet you now have to generate from your muscles. And over the counter orthotics have been shown to create stress at the knee.

10:20 A medically responsible orthotic, for running especially, but even for everyday activity, should have some flex in it.

11:13 If your pelvis is moving properly, you will shift your weight to the weight bearing portions of your feet, and instead of overpronating, you will appropriately pronate. It is actually that easy.

12:16 Jae tackles the buzzword “pelvic stability”: it has been interpreted to mean that the pelvis does not move, or that the pelvis moving around must be unhealthy. Jae explains how if you succeeded at not moving your pelvis you wouldn’t be able to run. So all runners move it some, but if you don’t move it enough, it’s almost impossible to not overstride and so you end up with one of 2 versions of runner’s knee.

14:19 How iliotibial band syndrome happens, and how it makes people appear to be over-pronating and wind up with those orthotics, when really it’s about your pelvis not moving appropriately.

15:55 If you let your pelvis move properly, you are less likely to overstride, and the energetic cost of running goes down. People always PR after learning how to do this in addition to their pain going away.

17:15 what does the Balanced Runner approach look like?

19:31 The best defense against bad advice is the ability to feel what you’re doing and to trust your own sense of what you know to be most comfortable and right for you, regardless of what anyone tells you. And you can always improve the accuracy of your ability to feel yourself.

22:08 What does a Feldenkrais session a la Balanced Runner look like?

24:54 The key thing for people to know who want to transition to minimal footwear or to barefoot running should know is that stress is good for our bodies, it makes us rebuild stronger, but you have to have the stress applied at a rate from which you can recover. So take it slowly. If you want to be running fully barefoot skin adapts within a few weeks, soft tissues in a few months, and bones over a matter of years just as a result of cell turnover. So go slower in the transition than you think you need to.

25:45 Form-wise regarding barefoot running, people usually try to switch from a heel strike to a forefoot strike, which often results in a prancing action which is very stressful to the metatarsals, or they don’t change their heel strike overstriding and so they develop achilles tendinopathy. You have to change what your whole body does.

26:58 What Jae says is the worst advice for barefoot running.

27:15 The basic elements of healthy running form (a list for all you runners who want to know the basics).

28:00 If what’s happening from the hips up is working right, you pretty much won’t overstride. But if you try to fix your overstriding from the ips down you will be unsuccessful.

30:29 Jae’s personal story of how she went from hating running (it felt horrible to her body), to falling in love with it. How Feldenkrais lessons taught her to feel great as a runner, and how no one was talking about what she had found made people comfortable as runners, so she started Balanced Runner!

DIY Friday: Plantar Fasciitis

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*Do it yourself! Every Friday we do a roundup of great posts, videos, or other resources around a theme that help people to turn their bodies from cranky to happy.*

A recent chat with the Facebook tribe started to go down the plantar fasciitis rabbit hole, so here I am dedicating a DIY Friday to it! I also have an interview coming up next week with Jae Gruenke, founder of Balanced Runner, and since so many runners struggle with plantar fasciitis it seemed like a theme was emerging.

First, what the heck is plantar fasciitis? The short version is that the plantar fascia (fascial sheet on the bottom of your foot) begins to pull away from it's attachement on the calcaneus (heel bone) and you wind up with some pretty gnarly burning heel and foot pain. In the book Born to Run* author Christopher MacDougall describes it as the runner's version of a vampire bite, because, as runner legend has it, once you're "bitten" with plantar fasciitis many feel you are never the same again. Well breathe deep because I'm here to tell you that plantar fasciitis is one of those things that I actually have in the "easy" category in my brain simply because I see it resolve so often and so readily. Which isn't to say it doesn't take some doing, but here's how:

  • Erik Dalton is a brilliant manual therapist and teacher, and this video is the clearest description I have found of what is actually going on in plantar fasciitis. The article that precedes the video also does a fanstasic job of explaining how it's not just your foot. It's never just one thing. Never, ever. But it's always helpful to be educated on the more global view of any condition, which is what this article handily does! If you are a manual therapist, there is also great content here on how you can treat it in your clients. If you are not a manual therapist, please don't go grabbing your friend's leg and shoving and shaking stuff around! It actually takes a good bit of learning in order to effectively contact fascia and to know how to appropriately work joints like he does in the video, so just mashing on your buddies is likely to cause more harm than good. The article is here, and the video is at the end of it.

 

  • Speaking of taking a global view, as Dalton mentions in his article, "Plantar fasciitis often results from lack of individuality of motion in the calf muscles due to adhesions." That is very true, and taking it a bit further, it is an issue with the whole posterior chain of fascia. Otherwise known as the "superficial back line" as defined by Tom Myers Anatomy Trains work. Here is a great image of that line. So, if you want to resolve your plantar fasciitis, give due attention to everything here along the chain as well.

superficial_back_line_copy

  • Oh look! Here's recently interviewed Sue Hitzmann of the MELT Method preaching it like she teaches it, and is also talking about plantar fasciitis as a global issue:

  • Oh wait! What do we have here!? It's Katy Bowman of Restorative Exercise talking about plantar fasciitis as a global issue (in particular those persnickity hamstrings with some data that talks about why). Hmmm, maybe it's not just about the foot...

Ok, ok, taking all this good input about how it's not just your foot and moving forward with a healing plan for yourself here's what I actually like, a lot, for treating plantar fasciitis:

Smart fascial manual therapy from either a practitioner, or you can MELT at home.

Softness! Learning how to soften your foot is a game of coaxing it to let go, not of yanking it around. I like hamstring stretches that have a fully dorsiflexed ankle (bring toes toward shin) so that you're not missing tight bits in your calves. This would look like lying on your back with a strap around the ball of your foot, and flexing at your hip to bring the foot closer to the ceiling. Though stop when you hit your own end range with the flexed ankle (rather than pointing the toe to get farther). You can also stretch standing on a slant board like this one, again, I like a soft surface to a slant board, and it is also very helpful to think about really letting all the musculature of your foot soften into is as you stretch. Think of your plantar fascia as warm, gooey silly putty that is just oozing onto the slant board. Do not hyperextend at the knee or shove your pelvis forward ofyour ankles while standing on a slant board.

Alexander Technique. Speaking of letting the musculature go, I find so many people micro grip in their feet as a result of stress, or strain and pain patterns elsewhere in the body. I love Alexander Technique as a way to learn about your own micro grips and how to find a way to let them go. I recommend working with a teacher, rather than doing this alone at home, as you will need trained eyes to point out things you have become totally blind to in your own body. Most people are amazed at how much they are subconsciously clawing at the floor with their toes. No really.

* Footnote: If you haven't read Born to Run I highly recommend it. And if you are a runner, I practicaly require it (if I could do such a thing). It has a lot of  fascinating information, particulary when it comes to the evolution of highly engineered running sneakers paralleling the evolution of highly unpleasant runner injuries, and is also a beautifully written and engaging story.