Get your Biomechanics assessed early to avoid injuries

There is a difference between osteopaths, chiropractors and physiotherapists. Physiotherapists’ background is often based upon rehabilitation and, in this sense, physiotherapists learn to assess the biomechanics of the joints of the body and then how that movement is coordinated in function. For this reason you see physiotherapists associated with professional sports teams.

Understanding the biomechanics of the body helps to identify the cause of an injury or, if an injury has already occurred, how to rehabilitate a person back to sport. A trainer’s role is to strengthen the body and, in this sense, they will look at how to control movements with specific strengthening exercises. The physiotherapist can complement the trainer by looking at the finer points of joint movement and by integrating other systems of the body, such as neurophysiology, pathology, and the cardiovascular system.

When training for the first time in the gym, or looking to achieve a goal, it helps to have your biomechanics assessed to aid in avoiding injury. An experienced physiotherapist and trainer can work together to protect from potential injuries which can occur if the body already has poor biomechanics. No two people are built the same, and therefore an assessment should be very bespoke. An example of poor biomechanics would be: a person who has a restriction in the ankle joint such that when they do squats, lunges or step-ups this causes a secondary movement in the knee, hip or back – and somewhere pain will start to occur. This is a very simplistic example of how to assess biomechanics, but it illustrates the importance of identifying these problem areas.

Biomechanical issues may not be a problem in the initial stages of training, where the number of repetitions or length of training is low. However, when training distances and intensities increase, these biomechanical issues will start to cause injuries. It is advised that you do not try to work through these injuries, but rather have them assessed, to allow your training to progress smoothly and with minimal chance of injury. The synergy of a physiotherapist and trainer working together is a formidable team in helping to prevent injury –and exists in many professional sporting environments.

Personal Training series: Running shoes and running biomechanics

There are many shoes on the market at the moment for running. Running biomechanics have taken a big shift in the last 5 years.  Running brands such as Asics, Brooks and  Saucony have created shoes which are designed to prevent collapsing of the foot, or increased cushioning for those people with high arches. The general understanding of biomechanics and these types of shoes, is one which involves a heel strike pattern. In this pattern the heel will hit the ground first, the heel of the shoe absorbs the shock; the heel then controls the foot as it passes through mid stance and toe off.

Conventional shoes have worked over time for some people; however for others they have not made any difference, and some people who wear these shoes are still prone to knee, hip and lower back pain. When running with a heel strike pattern it is thought that as the heel strikes in front of the body there is a vertical force passed back up through the leg, the hip, the groin, the knee, and the lower back and that this results in injury.

Over the last 5 years there has been a wealth of research and contentious debate over the benefits of forefoot running. Forefoot running is where a person runs landing more towards the mid and front of their foot, instead of the heel being the first point of contact when the foot hits the ground during running. The foot also lands underneath the body and the stress imposed on joints are reduced.

Support for forefoot running comes from practical demonstrations on treadmills. When someone walks on a treadmill they have a characteristic heel strike pattern; however as the speed of the treadmill is increased they naturally start to run more towards the mid and forefoot. It has been theorised that the body is not designed to run with a heel strike pattern. When videoed at a faster speed on the treadmill the foot can be seen to strike more towards the mid foot and spring off. When seen at its best – like in Olympic marathon runners – the foot will actually hit the ground under the body; it is then kicked up behind their back using the hamstring muscles, before quickly returning to land again directly under the body.

The theory that running on the forefoot reduces joint pressure has been researched. With forefoot running the force of the body passes directly up through the body vertically –thereby relying upon the natural cushioning effect of the quads and the hip muscles. If the body is stiff enough – and the biomechanics are correct – the knee and hip joints can absorb the repetitive loading of running and hence reduce injury to the joints.

There are now shoes which have been adapted for forefoot running. Vivo barefoot is one of these companies and has created a range of shoes designed for walking right through to cross country running. Forefoot running shoes are designed to have minimalistic cushioning in the foot. These shoes are designed for the foot to feel the ground and reaction forces of the ground as the foot hits the floor. When the foot can feel the landing onto the floor, it can stimulate muscles to fire and get immediate push off onto the opposite leg. The soles of these shoes are very thin and Vivo Barefoot have described the sole to being as close to skin depth as possible.

Clients have reported they enjoy using these shoes. They feel completely different to thick soled shoes. They also give a refreshing feel to the foot at contact with the ground. The key is that this ‘feel’ will stimulate better muscular activity, shock absorption and reduction injuries. There are many successful runners in Olympics and World Championships who do not have a forefoot running pattern. It is not advised that everyone run on their forefoot – and a physiotherapist and trainer will be able to tell whether your body is capable of withstanding the pressure required to learn how to forefoot run.

Recently a trainer started forefoot running; it has taken 4 months for him to be able to run on his forefoot for 10km continuous running. To change to a forefoot running pattern requires significant adaptation and change within the body. The runner must allow time for this adaptation to occur because if they push themselves too hard and too fast in training injuries will occur.

I believe forefoot running biomechanics seems to make sense; however I have also seen that not everyone is prepared to take the time to learn how to forefoot run and people who run heel strike can still become world champions.

If you want to learn how to forefoot run it is important that you see a forefoot running coach – such as a physiotherapist who has experience, or an independent specialised coach.

Learning to run on the Forefoot at Vivobarefoot running clinic

 Physical Edge attends Barefoot (Forefoot)  running Lab with Rollo from Vivobarefoot. This was a 6 hour Lab looking at the current biomechanics supporting Forefoot running and then how to run on the Forefoot itself.  The Laboratory is based in Farringdon, London and it contains the latest technology for gait analysis, including video analysis and force plate measurements. 
The training demonstrated the importance of correcting restrictions in the foot before starting Forefoot running. These restrictions can alter the flexibility of the first toe, Metatarsal and ankle. When running it was a key concept to feel pressure exerted through the knuckle of the first toe. This was called the Line of Leverage and shifted the Centre of Mass forward onto the Forefoot. The body is designed to take pressure through this Line of Leverage to help propel the body forward in running.
The way we walk, run and sprint require different biomechanics. If the body adopts the old paradigm of running, heel- to toe, it is constantly exposed to decelerating forces and subsequent injuries. Common areas for injury can be the ankle, knee, hip and low back. Primary areas to keep flexible to enable efficient Forefoot running are the Thoracic spine, hip and ankle. 
The day was an insight into the development of shoes designed to assist in Forefoot running. These shoes have very thin soles to replicate skin and assist in creating the sensation of running Barefoot. Forefoot running in the shoes is comfortable. In winter they can get cold but you can buy socks to keep your feet warm.
Physical Edge noticed when running Forefoot for the first time the calf muscles and soles of the feet can get very stiff and sore the next day. This is an adaption process and a reason why training is done gradually. If you have an injury you can learn to run Forefoot but it will require a period of rest from training. You can do alternative cardiovascular exercises like swimming, water running and possible cycling. 
Physical Edge can you help you prepare your body for Forefoot running and direct you to trained Forefoot running coaches. If you have any questions do call or email us and we look forward talking to you soon.

Latest research findings on cramp in sport/ triathlon

In the July edition of 220 Triathlon there is an article on page 77″The science of cramping” which discusses the research into cramping and how to manage it.

In summary:

The research comparing triathletes and athletes who get cramp with those that don’t identified a common risk factor is exercising at unusually high intensity during a race, family history of cramps and a history of tendon/ ligament injury. Currently there is no exact known reason why cramping occurs.

Studies have found a 6% carbohydrate sports drink can delay the onset of exercise induced muscle cramps in endurance activities, but not prevent them entirely. Low levels of magnesium are linked to increased incidence of muscle cramps. Magnesium supplementation has been shown to help sufferers of “night cramps”

Take away tips:

1. Gradually increase training intensity. Remember unaccustomed fatigue plays a major role in muscle cramps.

2. Stretch regularly, paying particular attention to hamstrings, calves and any other muscle groups that are prone to cramp.

3. Use carbohydrate-electrolyte drinks during longer training sessions/races and/or during recovery, and ensure you consume plenty of calcium and magnesium rich foods.

4. If you’re a long term sufferer of cramps, consider magnesium supplementation.

Personal experience dealing with cramp

I completed the Switzerland Ironman last year and did 1 year of intense training. This year I am doing the Etape De Tour  and increasing my bike mileage from 4 hours to 8 hours on the bike and training 3-4 times per week. I will be going to Portugal to train on my bike in the hills and the heat.

I have suffered from cramp occasionally after exercise but also during exercise. The cramp usually affects my hamstring or calf muscles. I noticed when training for the Ironman muscles were getting tighter in the early stages of training. At this time I was starting to train 6 days a week and running and then cycling in consecutive days. My calves got so tight I had to walk down stairs sideways.

I went to get massage weekly and this helped but I noticed my legs were still very tight with continued training. My experience does fit with the article details above. I usually got the cramps if I pushed hard on time trials or at the end of long hard bike rides. The cramp could occur after training if I had a very hard training session. To get rid of them I stretched and in the end I was massaging my legs immediately after training to loosen them. I also wore compression leggings and this certainly made my legs feel much better.

The most important finding I discovered was the use of Magnesium supplementation. I went to New Zealand and was given a product from the salt Lakes of Utah. I started using it and noticed my legs felt significantly looser. My ITB, calves and hamstrings felt at ease and much better after training. the magnesium was better than the massage in terms of preventing muscle tightness.

I continued to take Magnesium through my training. I added it to my  alkalising drink I took through the day and also to my electrolyte drink in training. In my Ironman I did not suffer cramp during or after the race and my ITB friction syndrome did not occur.

I think I was suffering cramp because of the change in intensity of training and number of days trained and I was sweating out salts in my body and not replacing them in my diet.


I am a physiotherapist and an Ironman and I think the information in the article above is spot on. I would try magnesium supplementation, get massage and look after your nutrition. Stretching and self massage is important as you don’t have the time and resources to get a trainer and massage therapist to work on you everyday. If you do then get them in everyday.

If you would like contacts in the fields of stretching, nutrition, triathlon training do contact us here at Physical Edge and we would like to help in anyway we can. Got to love triathlon.

Week 23: learning as I go and fitting in training

This last week has been a test of my endurance. I have just finished a physio course this weekend and managed to get all my training in for the week. When I have a course on all weekend I can not take my time with my training or rest afterwards. I know I have another 3 weekends of courses before the ironman and it does not do my head any good thinking about what those weeks will involve with training and work.

In the last two weeks I have had little things happen as I have been traning and each time I am  learning  how to fix the problems. On a three-hour ride the crank and pedal came loose. I stopped at a bike shop in Putney and it was fixed with an 8mm Alan key so I bought one in case this happens in the future. The  light on my bike fell onto the road as I  rode over bumps and now I  know to check it is on properly before I ride. The levers that secure my wheel to my bike came loose and so I do a bike check before I ride to Richmond Park.

There are many things that happen when training and it continues to change every week. Being adaptable and flexible is a key to making life manageable with training. I tell myself I must stop taking on social events and from now until July my weeks and weekends have been planned. I like my weekends being free of commitments to rest from training, work and recovering for my long bike rides.

I spoke to Fran (Coach) and he has is now worried about my running as I have not run outside since my injuries. This week I did run to Battersea Park and I discovered the track around the Park had flat surfaces. When the surfaces are sloped it irritates my ITB friction syndrome. Good to know I can run on good surface and it is close to work.

My body is adapting to the training. I can ride up the hills in Richmond Park seated on the bike and breathing easily. It was great to run outside and this will be my focus to improve. It freaks me out a little knowing how many weeks I have remaining before the event. Time to put in harder training.

Leg injury improving with rest and massage and stretching

The pain I have had on the inside of my lower shin is still there occasionally when it is cold or after squats, lunges and long bike rides. I have worked with my massage therapist and discovered it was my flexor hallucis longus tendon that was injured.

I have rested for the last 3 weeks and then have had massage and stretching. I ran for 45 minutes today on the treadmill and my leg felt tight at the start and tight at the end but in the middle it felt as good as it felt with no injury. I ran slowly and hope to run outdoors later in the week.

Deb Shaw: Winner of Forestman 2009 gives her advice.

Deb Shaw  won the Forestman iron distance triathlon  by over 20 minutes in 12:13:52. She  suffered severe low back pain before her training and was out of competition for 3 months. Deb kindly offered to help me with her knowledge when training for an ironman event.

Deb’s first advice was to decide how much time I had to train each week. I would need between 6 and 20 hours a week to train. I must know my strengths and weaknesses and if running is my weakest discipline I am to do more training in this area.

She cycles her training in 4 week blocks and gradually builds each week and has a final recovery in week 4. At the moment I have training blocks which are in three phases; base, phase 1 and phase 2. I think these will be divided into further blocks and I will talk to Fran about Deb’s approach.

Deb suggested I should aim to run 2 hours by January 2010 and if I get injured to ease off training and get massage as this has helped her. I have an achillies injury and have taken this advice to heart. I am not stressed about missing the training and making sure my training does not aggravate the injury. It is getting better and I should be back to training fully by the end of next week.

She uses a Heart rate monitor if she is going to train harder. Fran is going to measure my maximum heart rate in November and then I will start using Heart rates in my training.

Training tips she recommended included breaking my running into long runs, hill runs, short runs and then running off the bike. I should train to ride 155km or about 6 hours in the saddle. Joining a Tri club could be useful because it would make winter training easier with other triathletes.

Deb is aiming to race Ironman Australia in December this year. She is going to La Santa, Lanzarote to train and has kindly invited me. Unfortunately this does not fit in with the progress I am making in my training. In other words I will not be able to keep up with the distance or speed.  I hope to ride with Deb over the next 10 months.

Deb rides with a disc wheel on the back and Zipp 404’s on the front. If it is hilly she recommends 404’s on front and back. I will keep this in mind when I look at wheels later in the season.

I greatly appreciate the time Deb has given me and the advice she has shared. It will be invaluable in developing my personal approach to training. Thank you Deb and best wishes for your next Ironman in Australia.

Recovery from Achillies injury.

In the last week since feeling pain in my achillies tendon on the right I have stopped all weight training. I was feeling the Achilles even in the swim. I have stretched the calf muscle and the plantarfascia on the sole of my foot.  I have massaged my own calf muscle and used the foam roller. The achillies tendon does not hurt o touch but I can feel the tightness in the sole of my foot and my calf on the medial side.

6 days after feeling the pain and resting I can feel it is no longer hurting with light running at a slow pace but  I can feel th tightness in the foot and calf. I went for a run on the treadmill for 30 minutes and if I increased the speed I noticed more discomfort. I kept the speed down and was able to complete the run. I think it will resolve as the tightness from the weight training eases. I will start weight training next week and slowly build up into it again. I have another 2-3 weeks before base training starts.

My nutrition is not good and I have not had enough sleep as I have been out on late nights. My social life has to change as of the end of next week. The ironman is my focus and I must remember it. I recall the word of Dr Justin Roberts, “right now you can complete an Ironman it is just how well do you want to do it”. I want to enjoy it and the effort I put in now will make the difference.