To fore or not to fore? Learning a new sport.

There are some first’s that will always stick in my mind. My first day at school during which I fell over in the sand pit and got sand in my eyes. Yes, I cried. The first single I bought. Unfortunately, when I arrived at Our Price in Salisbury’s mall they had sold out of the number 1 record of the week,  Los Lobos – La bamba, a great song I think you will agree. Instead I opted for the number 2 record in the chart by  Shakin’ Stevens. Shakin’  Stevens!!!. He of the terrible black suit with white tie and those irritating lyrics you only hear once a year…. “snow is falling, all around me, children playing, having fun….” anyway,  time to leave Mr Stevens behind and move swiftly on to my first blog.

During my work with the military I treat lots of clients with shin pain, ranging from compartment syndrome to tibial stress fractures. Now, on average a solider will run approx 10km 3-4 times a week. A lot of running I think you would agree and a lot of shock absorption required by their musculoskeletal system, principally the shin bone (tibia) and the muscles that attach to the front of it.

A recent study published in the American journal of sports medicine (Diebal et al, 2012), looked at changing 10 patients with compartment syndrome from rear/mid foot runners to fore-foot runners. These patients had already exhausted physical therapy treatment and were considered candidates for orthopaedic surgery.

All 10 subjects were taught to fore-foot run over a period of 6 weeks, with three 40 minute sessions a week. It’s important to bear in mind these runners did not simply go from heel/mid foot striking to a fore-foot strike. They changed a number of variables including cadence (number of strides per minutes), stride length, and running technique (pose method).  None the less 8/10 of these subjects were able to run 5km twice a week, pain free and more importantly avoided surgery. My thoughts on this study are this; if I ever develop anterior compartment syndrome then I would change my running style, no question.

Otherwise I firmly believe if it’s not broke then don’t fix it! If you are thinking of attempting fore-foot running it is not a decision that should be taken lightly. Developmentally, you will have a bio-mechanical blue print which governs the way your muscle and joints interact, to propel your skeleton through the air. To change this will take a period of intense training.

If you are thinking of investing the time to change your running style, perhaps due to re-current injury or to improve your 10km time, you will firstly need to invest in a pair of fore-foot running trainers like Newton’s (there are other fore-foot running trainers available on the market). Those that look to bare-foot running and exploits of African running teams must remember, London is covered with hard unforgiving tarmac. Also, most of these athletes will have lived in small villages and therefore run a number of kilometers just to get to school. These athletes would have been conditioned, over a number of years to bare-foot run. And therein lies the problem, adequate conditioning and skill base is required when learning any new sport whether it is rugby, cricket or fore-foot running.

Another study published in January this year by Harvard University, looked at injury rates in cross-country athletes over a four year period. They found that heel strikers were nearly twice as likely to develop a stress related running injury. Of course, the results of this study should be taken with a pinch of salt, as it was funded by a running shoe company. What is interesting though, is that all runners in the study, whether heel or fore foot strikers, wore cushioned running shoes whilst participating in the study, so don’t ditch those trainers just yet!

Right, I’m off to heel strike it around the park to my Shakin’ Stevens playlist……

If you would like to question Tom’s taste of music or just pick his brain about this article. Please get in touch via techniquephysio@gmail.com

Reference

Diebal AR, Gregory R, Alitz C and Gerber JP. Forefoot running improves pain and disability associated with chronic exertional compartment syndrome. Am J Sports Med 2012 40(5): 1060

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