Dr. Doug Adams is a Physical Therapist who has published and spoken at an international level on all things related to running. Doug has taught thousands of professionals his systematic approach to providing personalized plans for runners through the Certified Running Gait Analyst and Endurance Running Coaching courses. He also designed and created a portable 3D Motion Analysis system called Helix 3D for analyzing and categorizing running form that is used widely throughout the Department of Defense and commercial sectors. He is adjunct faculty for the 711th Human Performance Wing of the US Air Force and does research on novel approaches to preventing injuries and improving performance. Currently, Doug treats some of the top professional runners both as the head physical therapist for Tinman Elite and at his Physical Therapy clinic Omega Project PT in Wilmington, Delaware that specializes in treating endurance athletes and runners.
Listen to this episode of The MOVEMENT Movement with Dr. Doug Adams about how to fix the 5 top running form problems.
Here are some of the beneficial topics covered on this week’s show:
– How gait analysis is a crucial component of improving running performance and preventing injuries.
– Why overstriding – landing with the foot too far in front of the body – is a major cause of running problems.
– How making a 10% reduction in stress with each step can significantly improve running performance.
– Why the average runner shouldn’t compare themselves to professional runners.
– How developing an efficient spring-like system is crucial for runners to optimize performance and reduce the risk of injury.
Connect with Doug:
Guest Contact Info
Instagram
@rundnasystem
Facebook
facebook.com/groups/rundna
Links Mentioned:
rundna.com
Connect with Steven:
Website
Xeroshoes.com
Twitter
@XeroShoes
Instagram
@xeroshoes
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facebook.com/xeroshoes
Episode Transcript
Steven Sashen:
What is the number one thing, the most important thing to know, pay attention to, adjust, tweak, et cetera, if you want to be a happy, healthy runner? Well, we’re going to dive into that today on this episode of The MOVEMENT Movement, the podcast for people who want to know the truth about what it takes to have a happy, healthy, strong body, starting eat first, those things that are at the end of your legs that are the foundation of the rest of your body.
We’re also here to break down the propaganda and the mythology and sometimes the outright lies you’ve been told about what it takes to run or walk or hike or play or do yoga or CrossFit or skydive or dance revolution or play golf, whatever it is. And especially, if you want to do it enjoyably and effectively and efficiently. And did I say enjoyably? Trick question. I know I did, because, look, if you’re not having fun, you’re not going to keep doing it. So, do something that you enjoy.
I’m Steven Sashen, co-founder, co-CEO of Xero Shoes. I got the t-shirt to prove it. And I’m the host of The MOVEMENT Movement podcast, which we call it that. That was almost a sentence, because we… and that involves you, more about that in a second. It’s really easy. We are creating a movement about natural movement, letting your body do what it’s made to do, not getting in the way.
And so, the way you can get involved is really easy. Go to our website, www.jointhemovementmovement.com. There’s nothing you have to do to join. There’s not a cedar handshake, there’s no money involved. That’s where you find all the previous episodes, the ways you’re going to engage with us on social media, and where you can go to leave a thumbs-up or a like or a review or hit the bell icon on YouTube to get notified of new episodes, subscribe to get notified about new episodes. In fact, that’s really the gist of it. Just spread the word. If you want to be part of the tribe, subscribe. So, here we go. All right. Let us have some fun. Doug, do me a favor, tell people who you are and what you do and why you’re here.
Doug Adams:
Well, that was a great intro. I love that here. I love The MOVEMENT Movement here.
Steven Sashen:
I’ve done it 200 times. It’s just-
Doug Adams:
I know.
Steven Sashen:
… I hit the button and it comes out of my face. But thank you.
Doug Adams:
Yeah. No, that’s great. I’m in. I’m signing up for The MOVEMENT Movement myself here. So, I am a giant running nerd, is probably the best way to describe me. So, I’m a physical therapist by trade. And I’ve got a shirt on to show that I’m the CEO of RunDNA since we’re touting our shirts here. So, basically, RunDNA provides the tools and the training for people that want to specialize in working with runners. We provide that infrastructure. So, if somebody’s looking for education or technology or resources and they say, “Hey, I love the running community. I want to serve them, I want to help them. And I’d love to make a business out of it,” we are the source for that, man.
Steven Sashen:
But I’m going to interrupt you, because for people who aren’t looking to have a business helping runners, let’s get into the part that’s my favorite part, which is the how you’re doing that or how these people are doing the thing that you have developed, which is what we’re going to be talking about predominantly.
Doug Adams:
Right. Because it all comes back to the runner at the end. And that’s what I’ve spent my career on. And so, because I’m a giant running nerd, I work with runners all day every day. And part of building RunDNA was also really building up my own running practice. And I now work a lot with the military. I am the team PT for a professional Adidas running team. And I basically just work with running and runners all day long. So, lots to share with the actual running community as well here.
Steven Sashen:
Okay. Man, you’re just not giving me what I’m looking for.
Doug Adams:
No, no, no.
Steven Sashen:
So, here’s where I’m going. The tool that you use that is the primary thing that you do to help these runners is what, Doug?
Doug Adams:
Gait analysis. Running gait analysis there, yes.
Steven Sashen:
Now, there’s more to it than that. I want to put a bookmark in that because there’s more to it than just gait analysis. There are a lot of people who are trying to do gait analysis. You walk into almost any running shoe store. They’ve got a treadmill with a camera and a 20-year-old kid who learned how to hit rewind on the tape recorder. And do they have video recorders? Whatever they have, to look at it and tell you something. But you’re in a whole different game. And so, actually, let’s talk about what you’ve developed first. And then, the next thing I want to jump into is where we met part and how relevant that is to where we met and how this relates to anybody listening to this who either is a runner, wants to be a runner, knows a runner, used to be a runner, thinks about running, running. So, talk about your magic technology, which is really, really cool.
Doug Adams:
Yeah. So, maybe, give a little bit of a background of how I created it might take us to there. So, I’m a physical therapist, just like I said, and started. And I was really lucky to have great mentorship with Irene Davis, Rich Willy, Lynn Snyder-Mackler, amongst others, and just learn gait analysis as a student. And then, in my early career, I was really lucky to see just really the research side of that. And what we discovered as we were going about it is that, actually, there’s no perfect way to run, but there are imperfect ways to run that can put a lot of stress on the body. And addressing those things makes a huge difference.
And one of my favorite running studies shows you that, for people that think gait analysis is out of reach for them or it doesn’t benefit them, it’s for everybody. It’s for every level of runner, from a new person up to the very highest level. I’ve worked with people that run three 46 miles, and I’ve worked with people that run ten 46 miles. Gait analysis is a crucial component of that.
So, what we did is we started realizing that these imperfect ways, there were categories, and that there’s certain things that runners fit into. And we made up these five categories that we actually noticed were very related to research items that we found that were correlated to high injury rates and poor performance. So, we took these five categories, and I started teaching courses called certified running gait analysts. And we got a lot of great response to that. And we started teaching this. And now, we’ve had about 10,000 people go through our courses. And we’ve had a lot of great response to that. And we’ve got people all over the country, over the world now that are certified to analyze gait, which is a huge benefit for runners.
But then, we started realizing that, to do it at the highest level, we need the most accurate information that’s available immediately. So, I looked around at camera systems and to do gait analysis and quickly realized that I didn’t have hundreds of thousands of dollars to invest in that. So, I built my own camera system that was really designed for clinicians and for runners to get immediate feedback and for them to understand, “Hey, this is my most important thing that I need to do, and this is how I’m going to change it.” And then, when they do, you can quickly retest and see, did they actually make a difference?
So, that’s what we really led us to this point. And then, we’ve done a lot of work with the military. So, we got grants and funding through the military to develop our technology even further. And now, it’s got all sorts of algorithms and apps and everything that go with it. But the net net of it for the runner is that, when you get a gait analysis with our 3D, you understand what category you’re in, exactly how to fix it. You get an e-mail every day telling you, “Here’s what you need to do. Here’s a video of how to do this exercise or this drill and how to go and make a significant change.”
Because if you make a 10% reduction in stress with each step, you can run twice as far before your body breaks down. 10% is easy to do. If you are looking to make a big impact in your running and you haven’t had a gait analysis, that’s probably the thing that’s holding you back from achieving the goals that you really want with running.
Steven Sashen:
Now, I got to put a pin there, because again, there are lots of people and lots of places where they claim to do gait analysis. And more often than not, again, if you go to a running shoe store, they’re going to put you on a treadmill, they’re going to film you from the knees down, maybe if they’re smart, from the hips down, or smarter from the hips down. And they’re doing this so they can say to you something like, “Hey, you pronate. Hey, you supinate. Hey, fill in the blank-ate. And therefore, you need to wear this shoe.” Would it be fair if I just made the statement? Or, you can tell me if you disagree with the statement, “that’s all bullshit.”
Doug Adams:
I think I would agree. So, here’s the thing, right? When people ask me the difference between…
Steven Sashen:
I knew I was pushing you on that one, but I couldn’t help myself.
Doug Adams:
No, I love it. And it’s like, here’s the thing. If you’re not watching it and if you’re listening to it, I’ll explain what I’m doing here. But I’m turning my finger to the side right now here. And if I’m holding three fingers up, if I hold it in two dimensions, it looks like I’m giving you the middle finger here, right? But if I turn my hand, now, you see that I’m not giving you the middle finger.
Steven Sashen:
You’re holding it right.
Doug Adams:
And that’s really what…
Steven Sashen:
Yeah, just to explain it, just for the fun of it, because actually this is a fun thing people can do. Put the tip of your forefinger or tip of your thumb together, say making a circle, hold your other fingers straight up. And then, from the side, if you do it the right way where the thumb and forefinger are facing somebody, it can look like you’re flipping somebody off. And otherwise, you see a 3D, whole different game. So, I think that was a good politically correct way of answering my question.
Doug Adams:
Yes. Well, so the scientific way of answering it is that our eyes only see about maximum 16 frames per second. So, if somebody’s just watching you run, you have to be very careful because there’s something called brain sponging that your brain actually fills in what you want to see if you don’t have a high enough frame rate for it there. So, if they’re filming you in 2D and they’re using higher frame rate, at least 60 frames per second, they’re going to get more information. But like we just did with the middle finger experiment here, it’s okay, but you’re not getting all of the information. And a runner needs the most important information for them. So, if you’re not getting 3D, you’re not getting the whole picture. And best case, it soesn’t help. Worst case, it makes you worse.
Steven Sashen:
What I love about your system is it’s doing two things. You’ve developed something that will give you all the joint angles, joint moment, arms, all the physics that you need in something with 3D information, with the simplest setup I’ve ever seen. Normally, you’ll go somewhere for any gait analysis, and it is. This looks like it’s out of some sci-fi movie for what they have to do and your stuff. I’m exaggerating for the fun of it practically fits in a suitcase and away you go. Just the technology itself is quite brilliant. And the information you’re giving someone is quite impressive as well.
And to the point about frame rate, when I was in the lab with Dr. Bill Sands, who used to be the head of biomechanics for the Olympic committee, he wouldn’t do anything under 250 frames a second. And he would say, “You really need that.” And he was actually filming at 500 frames a second, which needs a lot of light, which makes you very hot when you’re under those lights. But regardless, I thought that was overkill until I saw in my own gait analysis that right before my right foot was hitting the ground, it was averting, turning out just a tiny bit in a way that was putting strain on my hamstring, and literally, anything under 260 frames a second, you wouldn’t have seen it.
So, it was the last two frames in that 500 frames a second. So, it was pretty wild to see. So, there’s that component. But backing up to my rather bold assertion of male cows and their excrement, the thing about what happens when most people go into a running shoe store is they basically learn to tell you something that they can then use to sell you something.
I’m going to use pronation as an example. There’s a footwear, let’s call, I don’t know what to call them. In fact, I’m not even going to mention the name. Anyway, big deal footwear guy who used to be Mr. Anti-Pronation and then changed his tune. And when people asked him why he changed his tune, he said, because in the research there’s now enough showing there’s no correlation between pronation and injury. So, it’s not something that needs to be corrected.
Now, that said, there’s hyper-pronation, there are other things that are related to that. And of course, now that I said that, everyone’s going to go, “Oh, well, I must hyper-pronate. Otherwise, they wouldn’t have recommended this shoe.” So, trust me, the odds of you hyper-pronating are very slim, ironically, unless you’re often wearing one of the shoes they recommend. And to explain that, just to get into the physics, but then back to you for the wind, Doug, if you have a shoe that’s recommended with has a big flare, if you look at the heel of the shoe, you look at it from behind. And if the sole flares out, then there’s a high probability you will be a hyper-pronator because the thing that touches the ground first, that outside edge of the sole, is actually making your foot slap the ground as it comes to being essentially horizontal. And that can cause hyper-pronation because if you don’t have the muscle strength to control that, and most people don’t, especially if they end up wearing those shoes… so, that’s neither here nor there.
So, one of the things that I really loved, we met at an event called the Mountain Land Running Summit, which is put on in Park City, Utah by a physical therapy rehab training facility. And they bring about 200 physical therapies from mostly around Utah-ish, but people fly in from all over as well. And it’s a bunch of researchers talking about the cause and cure of running injuries. And the thing I want to really harp on, because we’re getting get into the five categories of problems, but I want to start with my favorite, because, A, it’s my favorite, and B, you did something that I adore that I want people to play with.
So, I’ve been at these events for years. And usually, there’s arguments about what caused the running injuries. And this time, there were some, let’s call them, minor variations on a theme about what causes running injuries. But there was one thing that every one of the people who has anything to do with gait brought up. And they all agreed on this. And that is perhaps the number one cause of problems is overstriding, is landing with your foot too far out in front of your body. They all said that. That’s the first time I’ve ever seen that happen. And these were people with very disparate backgrounds, very different practices, some of them just total researchers, some clinicians, some trainers, but every one of them, overstriding was a problem. Is it fair to say that that might be one of the five categories of things that are problematic?
Doug Adams:
That is the number one category of what is problematic. So, you nailed.
Steven Sashen:
That’s my favorite. Well, now, here’s the next favorite thing. So, you had a treadmill set up with your system recording people, and you get this cool 3D stick figure of you showing how you’re running. And tell me if this is accurate. It’s probably not. But everybody that I saw that you did analysis for, and these are physical therapists and some of them are really accomplished runners, every one of them are overstriding.
Doug Adams:
At that conference, particularly, I think it probably was about 75% were overstriding.
Steven Sashen:
Yeah. I didn’t see everybody.
Doug Adams:
Yeah.
Steven Sashen:
Well, the part that I also loved is the people that were overstriding, if you ask them if they were overstriding, they would’ve assured you that they were not.
Doug Adams:
100%, yeah. That’s what’s so challenging about running and why I say that running is one of the most highly skilled activities that people ever do, far more challenging than even something golf, that everyone thinks that golf or hitting a baseball is really hard. But those are discreet activities where you get feedback about a very definitive start and end. And running is a continuous activity that you get no feedback. And how fast do you run is not a determinant of how well you’re running from a form and technique standpoint. So, running is one of the most challenging things to actually know if you’re doing well. And that’s why the 3D information gives you the feedback and the information that you need to actually make a difference.
Steven Sashen:
Brilliant. And I want to highlight that because a lot of people will look at some analysis that someone has done of professional runners, which first of all, it’s just to the point we made before, video at between 16 and 60 frames of second tops, where what you’re seeing can be easily misinterpreted, because what an elite runner is doing, especially with how fast they’re moving across the ground, is very different than what you’re doing if you’re going at half that speed. So, someone will say, “Well, that guy landed on his heel.” It’s like, yeah, his heel barely touched the ground and his leg is moving so fast as it’s coming back underneath his body, that for all practical purposes, he didn’t. Or, more importantly, who gives a shit? Because that guy’s trying to make as much money as he can before he’s washed up, because he needs to support his village. So, the fact that someone is doing X doesn’t mean it’s the right thing to do for you, if you want to have a long, I don’t even want to say career, I’ll say career, a lengthy running career, even if you’re a career as a total amateur who’s just doing it for fun.
Doug Adams:
Yeah, 100%. Replicating professionals is a great way to get injured. When I first started working with professionals, they were trying to replicate each other. And that was causing all sorts of issues, too. They’re like, “Oh, well, I see the Kenyans run this way, or I see Kipchoge is running this way. I should run this way.” And it’s like, no, you shouldn’t run that way. That’s not the way… and what you’re doing that you think is running like that professional doesn’t look at all like what they’re doing, too. And they just don’t get the feedback. So, it’s very challenging for them if they don’t know what it actually looks like.
Steven Sashen:
Well, what you just said is basically, a researcher named Benno Nigg. He’s basically staked his career on what you just said, which is don’t arbitrarily change your form because that’s going to get you injured, which I disagree with. And I would imagine you do as well. The arbitrary part is the key part.
Doug Adams:
Yeah.
Steven Sashen:
But he basically says, don’t change your form. There’s a way that’s natural for you to run, and you just want to do that, which I disagree with because, A, you learned that form in part because of the shoes you started wearing, because those impact your form.
Doug Adams:
Mm-hmm.
Steven Sashen:
And B, you give someone the right cue, the right feedback, it will change your form. And if you do it smart in a good way, he would never say that about gymnasts. It’s like there’s a correct way of doing a double back flip, or the way you do a double back flip is like, no, no. There’s a way to do a double back flip, fundamentally. Minor, minor variations, but the overarching things, identical about anyone who can do a double back flip.
Doug Adams:
I give two analogies with that. I say, when I was five, I would shoot a basketball underhand because that’s how I knew how to do it. So, nobody in the NBA shoots underhand because that’s how they learn to do it. But runners think, because they were born to run a certain way, this is how they should do it. So, it’s not true. And then, for my physical therapist group, I say, hey, if you saw a pitcher and they’re throwing and their elbow’s dropping way down, would you fix that? They’re like, “Oh, yeah, of course. Yeah, no problem.” And then, you say, well, you see somebody overstriding when they run, would you fix it? And they’re like, “I don’t know.” And you’re like, “What do you mean you don’t know? It’s the same thing.”
Steven Sashen:
But here’s the thing, the reason they say, “I don’t know,” I would contend is, because, A, they see so many professional runners seemingly overstriding, or maybe they are overstriding, and they don’t know what was being presented by all these researchers that, yeah, that actually is a cause of many, many problems. And maybe because they don’t even know what to do about it, so, they don’t want to fess up and go, “Yeah, I’d want to fix it.” So, in fact, before we get into the other four categories, let’s start with the number one. Let’s talk about overstriding and talk about why it is that it causes the types of problems that it can cause.
Doug Adams:
Yeah. So, when we run, our foot hits the ground, but the ground hits our foot. And there’s equal and opposite reactions, right? So, when you overstride, what happens is that there’s often a very large horizontal and vertical ground reaction force, meaning that the ground hits your foot harder and there’s higher forces experienced. And it causes a breaking moment. So, when somebody is overstriding, I ask them to stand up and I have them put their foot in a position of overstriding. And I say, “Does this look like you’re speeding up or slowing down?” They’re like, “Oh, it looks like I’m putting the brakes on.” It’s like, yeah, that’s exactly it. When you overstride, you’re slowing your momentum down with each step that causes a very large amount of force opposing the way that you’re trying to run. So, that puts a lot of stress and it goes up the body.
And additionally, what we found is that the position that you’re in overstriding is not conducive for absorbing the forces. So, people have heard of the kinetic chain before. I use a train analogy. Our body, our lower body and our upper body, too, acts like a train stop. Each joint, people forces get off at each train stop. If you’re not getting off at one train stop, the next train stop is overcrowded and everyone has to get off. So, if you’re not absorbing force adequately or ankle or your knee, guess where it’s all going to. Your hip, your back, all the areas on the next stop.
So, with overriding, we see that you’re often in a position where the knee is straight, you’re in a heel strike position, the foot is very far out in front of the hip. So, you’re not only increasing the forces, but you’re increasing the torque on the body, right? And the way to explain that torque is, if I were to give you five pounds of weight and have you hold it next to your chest, you could hold it for a long time. If I asked you to hold that five pounds with your elbow straight out in front of you, you could hold it for not nearly as long. So, that’s torque. The further something is from you, the more stress it puts at the center of the rotation. So, my holding the weight example would put stress on my shoulder. The overriding example puts stress at the hip. So, it increases the forces and it puts your body in a way that it’s not really designed to absorb those higher forces.
Steven Sashen:
What do you say to people who say, “Yeah, but all the shoe companies, when I go to the running shoe store, they tell me I’m supposed to go heel toe, heel toe?” What do you say to that?
Doug Adams:
It’s not as much about what part of the foot hits the ground as opposed to where the foot lands in relationship to your center of mass. And now, saying that, the closer you land to your body, the harder it is to land anywhere but the mid or forefoot. For people at home that want to learn that lesson very quickly, jog in place for a second, if you’re healthy to do so. Jog in place for a second. And now, where are you landing on? You’re landing right underneath of your center of mass. So, you’re probably landing on the front of your foot. Now, try it on your heels and see how that feels. And all of a sudden, it will not feel so good. You’ll start shaking your teeth. There’s so much force is happening there.
Steven Sashen:
I’m running in place. That’s different, right? He says, sarcastically.
Doug Adams:
Yeah. But it’s true. What we see is that the further the foot is in front of the body, the more stress that there is. So, when we look at overstriding, there’s a qualitative way to see if you’re overstriding. Whereas, if you do get a video or a picture of yourself running from the side, there’s something called the malleolar line. So, if you draw a line straight up from your outside ankle bone, and if that line, you draw it straight vertically, if that line goes in front of your knee, you likely have some overstriding characteristics in your form there.
Steven Sashen:
That’s the running version of you might be a redneck.
Doug Adams:
Yes, you might be an overstrider if… yeah, you might be a redneck, Jeff Fox over there, yeah. So, overstriding is the most common thing that we see. And when we teach our courses, we teach the therapist the hierarchy of these, because what we see is we’ve talked about these five categories and we haven’t introduced the other ones. But it’s rare that somebody just has one of the categories.
Steven Sashen:
Yeah.
Doug Adams:
If you think about it, when you overstride, your body has to find a way to absorb those forces. And so, our next category is the collapser. And that’s one of the most common things that we see, that somebody that overrides may also have some collapsing mechanics, but the collapsing mechanics go away when you fix the overstriding because they don’t have to overcome the high forces. So, the whole thing we do is let’s prioritize and personalize what you need so that you don’t try to fix your collapsing hip mechanics there and wondering why you can’t make a difference because you’re still overstriding. So, our technology lets you prioritize.
Steven Sashen:
Can you describe what collapsing is?
Doug Adams:
Yes.
Steven Sashen:
Sorry. Will you please?
Doug Adams:
Will I? Yeah, sure, exactly. So, for the biomechanist and the nerds out there, you’re losing the frontal and transverse plane battle. And what that means is that, when we run, a lot of people think that we’re just going straightforward. And they say, “Oh, it’s a single plane sport. You’re just running in a straight line. That’s not very athletic.” But you’re fighting the forces of gravity that are pulling you in the other planes of motion. So, what happens when we run is gravity pulls things, like pulls our knees together. And it forces our hips to collapse. So, when we see collapsing, and collapsing can happen at multiple areas throughout the body, but that’s what we see typically with the excessive or hyper-pronation, genu valgus or the knees coming inward and the pelvic drop where you stand on one leg and the opposite hip drops down. That’s where we typically see collapsing mechanics.
Steven Sashen:
There’s an article or an e-mail that I used to send out, and I don’t even know if I still do actually, where Glen Mills, who was Usain Bolt’s coach, said what turned him from a very good 400-meter runner into the fastest 100-meter runner in the world was working on getting him to stop collapsing, basically working, I don’t want to say core strength, that’s a little misunderstood, but that’s the gist of what he said. It was more to it than that. But basically, making him a tighter spring, a more taut spring, rather than any of those things collapse. And if you watch him run, you see that. It’s like, when he hits the ground, when his foot hits the ground, you don’t see everything being like a slinky, just going… there’s very just a tiny bit of vertical oscillation, mostly from the difference between when he is on his toes for when he is not on his toes. That’s really it.
Doug Adams:
Yeah.
Steven Sashen:
And that’s what they worked on for a year.
Doug Adams:
So, you hit on a very interesting point. I don’t know if you noticed this during the gait analysis, but we have a measurement called stiffness.
Steven Sashen:
Mm-hmm.
Doug Adams:
And we look at somebody’s stiffness. I’ll put a little disclaimer on this. The literature around stiffness is still developing. But what we’re starting to understand now that we’ve done it, interestingly enough here, we’ve been measuring stiffness for years with our system. There’s something called the spring mass model system. And it looks like exactly you described. If you have more stiffness, the spring would go through less motion. If you have a low amount of stiffness, you would go through more emotion as the spraying or an accordion goes.
So, what we’ve found is that, from a performance standpoint, when we find a more efficient form, the stiffness goes up. And the reason that we think that is, is that because your body is efficiently using its natural springiness and it’s naturally getting recoil, so people don’t always… this is a little bit of a clickbait kind of thing, but running is largely passive. And what I mean by that is that, when you run, your body absorbs forces during the first half of your time on the ground, the absorption phase. When you are propelling yourself forward, that is largely passive. 95% of the energy that you absorb in the first half of stance can be returned in the propulsive phase if your body is lined up in the appropriate position.
So, running is not a large push-off activity. It is a large set your body up for success and put your body in the right posture so that you can passively get the return of what your body did working to absorb those forces. So, you have to really be an efficient spring. And that’s why my professional runners, and all runners, but I really work a lot on jumping mechanics and landing and plyometric type activities, because that springiness, that stiffness is really important.
Steven Sashen:
I may be bragging when I say this next thing, if you know what I’m talking about, and I imagine you will. Do you know the RSI test?
Doug Adams:
RSI? No, I can’t say. Hold on, enlightenment here. I want to hear about that.
Steven Sashen:
That’s a test. You put your hands on your hips. And you have to videotape this at 240 frames a second. Put your hands on your hips, squat down, and then just jump. And then, keep your knees as straight as you can. And basically, just bounce your feet and ankles 10 times. And you just average the amount of time you’re in the air. There’s basically some math that goes along with this.
The gist of it is, the higher you’re able to jump, the more airtime you have, the springer you are, starting with your feet and ankles, tiny bit in your knees, very little in your hips, if anything. And anything over, not to get into all the details, if you have an RSI score of over 2.5, you’re crushing it. If you’re an RSI score over three, you’re one of the most elite athletes in the world.
And I’m dealing with a lot of basketball players and I’m in a five, four on a good day. Actually, I’m five, five on a good day, five, four on most days, because I got spine issues, blah, blah, blah. But anyway, when I hang out with these guys, I need to do something to get a little respect. So, I’ll either do a standing back flip or I tell them my RSI is 2.71. And they go, “What the…” so, it gives me some street cred. But it’s a very, very cool test about stiffness because the only thing you’re using is feet, ankles, tiny bit of knees. In fact, your knees barely have time to do anything propulsive. It’s fun.
Doug Adams:
Yeah. And that would make sense because I will say, especially here talking about Xero Shoes, somebody that doesn’t have good foot mobility and good foot control will never have good springiness. Their stiffness score will always be limited. We have a foot assessment we do, and they’re normally junk on that if they can’t do our loading levels there.
Steven Sashen:
And the foot strength thing, this is where what I say to people. So, I ask them, is weaker better than stronger? And they go, “What? No.” I go, if you want to make your arm weaker, what do you do? They go, “I don’t know.” Don’t you use it? Yeah, put it in a cast, right? They go, “Yeah, sure.” I said, so, put it in a cast. Eight weeks later, it comes out what? Weaker, stronger? They go weaker. Cool. What happens if you put your foot in something that doesn’t let it move? And they go, “Oh, yeah, huh.” And then, they look at their shoes. It’s like, “Wait a minute.”
Doug Adams:
Yeah.
Steven Sashen:
That’s just the opening gambit, if you will, because even then they’re going to, “Yeah, but I need that cushioning.” In fact, let’s go back to overstriding for a brief second. There are people who think that, even if they’re overstriding, landing with a relatively stiff leg, et cetera, that the cushioning in the shoe is supposed to take care of that. Thoughts, comments, responses.
Doug Adams:
Yes. All right. So, one important thing that you brought when you were saying that, I think it’s an important topic to bring up. Running injuries have a four-to-six-week delay.
Steven Sashen:
Interesting.
Doug Adams:
Because it’s microtrauma, it’s not football where you break your leg when a 400-pound lineman rolls on top of it. You break your leg slowly, one step at a time over four to six weeks.
Steven Sashen:
Wait, are you suggesting that we run with a 400-pound linebacker who at that first moment just tackles you and you’re done with it? You don’t have to put yourself through the next line.
Doug Adams:
Then, you’re done. You’re out of your misery there, right? Yeah.
Steven Sashen:
That’s part of your system. That’s one of your interventions, is here’s a 400-pound guy. Got it.
Doug Adams:
Yes. So, sometimes, the way I’ve described the excessive amount of cushioning that’s in shoes these days here is that it doesn’t fix anything. It just makes you not care.
Steven Sashen:
Yeah.
Doug Adams:
It doesn’t actually change that. It doesn’t absorb it. It’s just it’s enough of a reduction that you just don’t care. But what happens is you get that shoe and you go run on it for four to six weeks and you start getting injured. And you’re like, “Well, it can’t be the shoe because I’ve been running for a month of these and it’s fine.” But what happens is that it’s microtrauma and it’s happening time and time again. And I think one of the big issues, and this is where we combine really well, because when you’re getting a shoe, when you’re looking at it there, you really should be looking at how it impacts your mechanics. Because when we’ve done this, we see that somebody with a very high stack height with their shoe, so just how far your foot is actually from the ground, that causes a lot more control. And you talked about the lateral flare on a shoe as well.
So, those types of elements can really significantly change some of your biomechanics if you don’t know that it’s happening there. So, when you’re evaluating a shoe, we do an analysis all the time to look at it to say, “Hey, listen, it might feel great when you’re walking around the store and you feel like you’re walking on clouds, but what’s going to happen when you’re five or six miles into that and your hips are having to control all that excessive angular velocity that is happening from the increased stack height?”
I’ll give my personal story. I got my Xero Shoes on right here. I’m wearing them right now. Because I’ll never forget this, I had a shoe on and I have a knee injury. For those of you that don’t know me or followed a little bit of social media there with me, I partially tore my patellar tendon. And at the point that we were in Park City together, I was rehabbing it and doing well. But it’s a good story here. I went for a run. And I got to the top of a mountain, and there was a giant moose up there. So, I had to haul down the mountain to get away from this moose. And I’m rehabbing a torn patella tendon. And it’s partially torn.
And so, at the conference that day, my knee was hurting. I was standing there. I was like, “Man, my knee hurts.” And so, Steven comes up and says, “Have you ever tried?” I was like, “Let me try them on. I’d love to try these on.” And instantly, I had knee pain relief there. It was almost automatic there, where I was like, “Oh, wow, this feels so much better because I’m absorbing more forces through my foot. I’m engaging it more.” So, yeah, I think I went off on a bit of a tangent there, but I want to make sure I share that story.
Steven Sashen:
Of course, I love it because you said nice things about me and about our brand. Well, it’s funny. Way back when… let’s see, should I mention this brand? I’ll hide the name. It’s blocka. So, when people started wearing blocka shoes, there was a bunch of Olympian level runners that I was training with. And I said to all of them, “In two years, you won’t be able to run anymore.” And they’re like, “What are you talking about? I’m putting in more miles than ever with these things. They’re great.” I went, “Yeah, I know in two years you’ll be done.” And without exception, two years later, they’re all cyclists.
And the irony there is they don’t have to be cyclists. They can go back to running. They just have to get out of those shoes and stop putting those forces into their knee. I don’t know if you know Isabelle Sacco. She’s a researcher doctor down in Brazil. She took elderly women who had knee osteoarthritis and put them in a minimalist issue. There’s a really inexpensive thing you can get in Brazil and track them over, I think about six months. And for many of them, their knee osteoarthritis went away. For the remainder, just their report of pain was significantly reduced. Their use of pain medications significantly reduced. But for some of them, gone.
And I said to her… I know the answer, but I want to hear it from you. What changed? She goes, “They started stop overstriding and they started using the muscles around their knee to actually act as protectors in addition to moving them forward properly.” It’s like, yep. So, it’s an amazing thing, but we have this idea, it’s like cushioning feels good. You go to sleep on a Tempur-Pedic mattress, feels great. And so, it feels good. So, that’s where I was going to go with this. So, what you said, just don’t notice it, however you said it, my apologies for not remembering verbatim.
But the way I say it is I get a little more into the physics. I go, there’s difference between pressure and force. So, the pressure gets spread out on your foot so you don’t feel it, but the force is still going into your body. And the difference between pressure and force is, if you find there’s a video, many of us have seen it, to one of the first films ever made, it’s a slow-motion film of this big fat guy getting hit with a cannonball in the stomach. He was a like a carnie. And so, you see the cannonball hits him and you watch the fat and all of it. His whole body respond to getting hit with a cannonball. But then, it also throws him back into this trampoline that catches him five feet behind him. And so, the pressure is what makes him not get injured. The force is what shoves this 300 and something pound guy way back into the air practically. And that’s what’s happening in your body. You don’t feel it, but it’s still going there.
Doug Adams:
And if we go back to our stiffness talk, what happens is that our body can adapt almost instantly to different surfaces, and it adjusts the stiffness. So, when you run in a very soft surface, then you’re going to go through increased excursion unless your body automatically adapts it. So, what do you have? You have increased stiffness at all of your joints in the not beneficial way, where all of a sudden you get very stiff at the hip, at the knee, at the ankle because you have such a soft cushioned surface that you land on. So, the stiffness up at the knee goes way up and you go through very little excursion. And now, you’re using a limited range of motion in order to absorb the forces.
Steven Sashen:
Yep, okay. Well, by now, if people aren’t thinking, “Cool,” what are the other three categories we’ve got? Overstriding, we’ve got, well, collapsing. So, let’s hit the next one.
Doug Adams:
Yes. And just a little caveat to it, there’s four types of overstriders and three types of collapsers, too. And there’s subcategories of these for those that are really nerdy like me about it. But with our military studies, we’re actually able to say, “Hey, if you overstride and we figured out, you do this, you’ll get better.” And we showed a 90-second improvement on their mile-and-a-half time and zero injury rates.
So, the next category, and these ones are about even prolifically that we see them, but I would say probably the next most common one is bouncer. So, this is one if you could tell with you but you couldn’t tell with me, and for those of you that can’t see this, I’m bald. So, a bouncer is somebody with a ponytail…
Steven Sashen:
For those who can’t see this, I’m the opposite of bald.
Doug Adams:
You’re the opposite of bald. And I am a shiny-head bald here. So, we call it the ponytail sign. So, somebody’s got a high amount of vertical oscillation, and their ponytail is whipping up and down because they’re going through a lot of excessive motion up and down.
So, this is, again, a physics problem. What goes up must come down. And so, there’s higher forces as you go. So, as you go up, then you have to come back down. So, it often puts higher forces and, again, some breaking type forces there.
Steven Sashen:
By the way, after we do the categories, we’re going to talk about some of the interventions you gave. And I made a note about that one because there’s one in particular that I get a kick out of. It also was a very common theme at The Science for Running Medicine event, or whatever the hell it is, Matt Lane Running something. Science for Running Medicine’s a different one that Irene does with Bryan Heiderscheit and… oh, I forgot, Powers, his first name, out at USC.
Doug Adams:
Chris Powers.
Steven Sashen:
Thank you, Chris. I don’t know why I’m horrible with names to begin with. And now that I’m 61, it’s even worse. And certain names, it makes me crazy. All right. So, bouncer. So, basically, we’ll come back to intervention for that. What’s our next one?
Doug Adams:
Probably one of the most common ones, and this one’s hard to fix because your brain doesn’t like the fix right away. It’s called a glute amnesiac. So, this is a…
Steven Sashen:
Wait. Hold on. Give me that again.
Doug Adams:
Yes. Glute amnesiac. So, have you ever seen Weekend at Bernie’s? Remember the dead guy in that? He leans back and he’s walking like this. That’s somebody that is shifting loads off of the posterior chain and shifting them to the anterior chain. And they lean back when they run. And I’ve got a great story about this one because this is one we always talk about for our people that take our courses. If you want to be a hero to a runner, you should take our courses.
And this is why. So, I had this guy. He was a big time. He was in a Fortune 10 company. He was in the C-suite. He was a big, big guy. He is like, “Doug, I’m going to fly in. I want two days of your time. I’m running a marathon. I need you to fix me.” I’m like, “Okay, sure.” Pays for two full days of my time. We come in. We chat. He’s like, “I need to get to the point where I can run at least six miles without pain. Anytime I get to five minutes into the run, it hurts.”
I’m like, “Okay. Well, let’s figure it out.” And we get him up on the treadmill. I do a gait analysis. And I see that he’s just leaning way back. I’m like, “Okay. Hey, try this. Try like you’re running uphill or you’re running into a really stiff wind.” And he does it. And he looks at me, he’s like, “It doesn’t hurt.”
I’m like, “Okay. Well, keep running.” So, we run for another two minutes. It doesn’t hurt. And I say, “All right. Go back to your old way. Does it hurt?” And he’s like, “Yeah.” “Okay, go back to the new way. Does it hurt?” And he’s like, “No.” I’m like, “Okay, what do you think?”
Steven Sashen:
What else do you need out of here?
Doug Adams:
“What else do you need here?” So, he’s like, “All right. I’m going to go have dinner. I’ll come back tomorrow morning. And if it still doesn’t hurt, you get the rest of the day off.” And so, he came back the next day. It didn’t hurt. He got back in his private jet and flew home. And he was fine.
He followed up within six months later. Yes. So, it’s, again, to the point of you just have to know what the right thing is for the right person. So, glute amnesiac, when they lean back, it increases the distance of the force application on your knees. So, somebody has anterior knee pain and they look like they’re sitting back or leaning back when they run. That puts a lot of stress on the front of the body and takes stress off the back of the body. So, we teach people how to lean forward from the ankles, not from the waist.
Steven Sashen:
And the right amount because that’s-
Doug Adams:
Yes.
Steven Sashen:
… another piece of that. So, it’s a funny thing. There’s been this whole idea that came out of a number of different sources about when you’re running, run tall. Go up, straight up. It’s like, no, don’t do that. First of all, because most people don’t know what straight up is. Secondly, the odds of you leaning back slightly when you’re doing that is very, very high and more. It’s just not the right cue anyway.
So, the glute amnesia thing, or glute amnesiac, if we’re going to label somebody, and now there’s going to be this whole anti-glute amnesiac thing, it’s like, don’t glute amnesia shame me. This is something that I see a lot. So, I want to break this down a little bit for the fun of it. So, the thing that moves you forward is mostly your butt and your hamstrings. They’re prime movers. Having them move back is what moves you forward.
And I see this often where people don’t know how to use their butt. And I know Irene Davis does a thing where she’ll literally just stick her finger on someone’s glute max and say, “Just squeeze that so you push my finger out.” And some people can’t do it. And I’ve noticed this as well.
And then I do something just to do something really weird. I go, “I know this sounds like I’m being creepy. I promise you I’m not doing this for my own fun. Stick your hand on my butt and feel it while I walk.” And I just take one step and they go, “Oh, Jesus.” It’s like, yeah, that muscle is actually working now. And I exaggerated a little bit for emphasis.
Doug Adams:
All right.
Steven Sashen:
That’s the thing. I go, “Now, try and do that.” And amazingly, many people can get better just because they felt the difference. So, that’s a very entertaining thing. And that right amount of lean. When you said that, all it made me think of is I was on the track during COVID actually, and there was a bunch of little kids running around. And not only were they not overstriding, but they had the perfect amount of lean. It was perfect.
And they had this look on their face. I call it the really weird look called smiling. They just were having fun. And everything was just right. And you could see they’re using their butts properly. And it’s the difference between a good sprinter is all butt, and a mediocre distance runner has none. And there’s so many things. Talk about the things that happen further down the chain when someone’s glutes are just not functioning correctly when they know how to use them.
Doug Adams:
Right. So, it’s interesting. With walking, the glutes are more active from a propulsion standpoint. What we said with running, the glutes are actually their highest activity is right before the foot hits the ground because they’re extending the hip backwards so that we’re not overstriding too much. Then the role on the ground is more actually keeping us stable and keeping us upright from falling over there.
And not as much with propulsion actually, which says that running isn’t a pushing activity. It’s more of a pulling activity. But if you don’t have the glute, if your glutes aren’t properly functioning, and you’re getting some of that pelvic drop, what’s happening is then that contributes to a lot of those collapsing mechanics because then as you drop your hip, then the knee goes inward, the foot goes out, everything down the chain gets interrupted.
And they see that that drives a lot of the stress down the chain. And so, people that are even having some foot pain or things like that, it might be coming from proximally at up at the hip because the body part that hurts is the one that’s making up for something else not doing its job.
Steven Sashen:
Well, this is a great diagnostic thing. You can see it. Many people, they may not be able to see it in their own running because they’re not looking down or seeing it from the right angle, but a quick video can determine some of this. I saw something I’d never seen before on the trail by my house not too long ago. This woman runs by me. And it’s important for the story to say she was decently overweight, probably weighed about 180 when she probably should have been about 130.
Doug Adams:
Okay.
Steven Sashen:
It’s only relevant because, so as she’s running by me and I’m seeing her from the side, I can see that her left leg is tracking well. Her knee is pointing forward. Her foot is pointing forward. Her right leg, the knee was pointing in, basically almost hitting her left leg. And her foot was pointing out, which just struck me as the craziest thing I’d ever seen.
And then she gets by me. And her left glute was a nice full thing for 180-pound woman. And her right glute looked like someone who weighed 100 pounds. There was nothing there. Now, I didn’t stop her of course. That would have been way too crazy. But it made me wonder, did she have some surgery, some accident, some stumbling?
Or was she just doing this for so long that just that muscle attributes so much? But I had never seen such a screamingly obvious visual explanation for what was happening with her, everything from the hip down, then seeing her out-of-sync butt.
Doug Adams:
It’s wild. Then you’ll see that there’s a chance that she had no clue.
Steven Sashen:
It’s no question she had no clue. And I’ve seen professional runners like this. In fact, I remember seeing this one… I actually remember this. I was driving to brunch with some friends. And I see this woman. And you can tell when someone knows what they’re doing to a certain extent. And so, she had that, I’m-a-serious-runner thing going on, but same issue.
She had vastus valgus. Her knees were practically hitting each other. Her toes were pointing out. And just, you can also see in the form, if you know to look, her butt was just turned off. She was a Memento-level amnesiac on that one. She wasn’t trying to solve the crime.
Doug Adams:
The OG glute amnesiac there.
Steven Sashen:
For people who don’t know what that reference was, go watch the movie Memento. It’s great. All right. We have one last category.
Doug Adams:
All right. Let’s see. Weaver.
Steven Sashen:
Weaver.
Doug Adams:
The thing is which one have we already covered? Weaver. So, like Bueller. Weaver. So, with weaving, you have a narrow base of support. So, instead of your feet being a little wider apart, your feet are close together or even crossing over the other side.
So, anybody that’s experienced IT band syndrome, or some of those issues before, this is putting those structures on the outside of your leg under tension. And that can cause some of the issues that we’re seeing with the weaving mechanics there. So, this one’s actually a really easy fix.
Sometimes, this is again just like the lean forward if you’re a glute amnesiac. There’s the run wide or apart if you’re a weaver. And so, I always tell people, “Find a line on the road, preferably the white one, not the yellow one and so you don’t get hit by a car, but find a line on the road, and put one foot on the line, and the other foot, don’t let it touch the line as well.”
So, that gives you a really good external focus of attention that allows you to say whether you’re on a track or a road or things like that. Pick a line. One foot can touch the line. The other foot can’t. And that will increase your base of support and take some of the stress off the lateral structures.
Steven Sashen:
I would say if you’re on a road, that’s one foot on, one foot off works. If you’re on the track, I’d go for one foot on either side because the line is narrower, but that’s just where…
Doug Adams:
The line is narrower.
Steven Sashen:
I want to do this before or after. Let’s do this before. I want to talk about interventions. But I want to ask you, from your experience, and I know there’s going to be a lot of individual variation, we’re talking about engendering new movement patterns. This is my undergraduate research. I did research on cognitive aspects of motor skill acquisition. And one of the challenges we have is our brains don’t like to learn new things.
It’s energy inefficient to learn new things, especially movement patterns. Also, because certain movement patterns identify us as part of a group, typically, our family. You see families who all move the same way. Because of their physiology more often than not. There’s also one other component where typically, the way you learn a new movement pattern, you start really slow so you can make sure you’re doing it.
And you build up over time the speed as you get better at it until it becomes a non-conscious thing. And actually, the fourth thing is we experience it as frustrating, which is actually just the experience of trying to lay down a new neural pathway that we misinterpret as a problem.
It’s like, no, that’s the signal that’s telling your brain, “Try and do something new.” Put all that together. What’s been your experience with how long it typically takes someone, and it’ll be different for each of these different categories perhaps, to fix any of these issues?
Doug Adams:
No, about five minutes-
Steven Sashen:
And to…
Doug Adams:
… in reality.
Steven Sashen:
Well, to experience.
Doug Adams:
So, here’s the thing. I’m being very simplified here, but-
Steven Sashen:
Slightly glib.
Doug Adams:
… you did a nice job of laying it out. And what we found is that we use cues. So, I tell you to run wider apart. I tell you to lean forward. Replicating the cue is not the goal. The goal is for your body to experience and feel a different way of doing the activity. When you have the access to the information with a 3D, you know which cue is going to make the biggest bang for your buck.
Steven Sashen:
Right.
Doug Adams:
So, I’m not joking when I say it takes me five minutes to teach somebody how to run and improve their form with that. And if they have the strength and the flexibility to do so, I can get them to change in five minutes. And it sticks. Now, they need to practice.
Steven Sashen:
Right.
Doug Adams:
And we have them go through a three-week motor learning gait retraining program. But when I bring them back at one week, three weeks, th
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