Friday, August 6, 2010

Pain-Free Running, Part V

Much of the stuff in my prior running posts (here, here, here and here) went out the window when my back gave out on me almost exactly a year ago. This year (2010) has been a rebuilding year for me: Once my back recovered (see my back injury post here), I had to completely change my run and bike, both equipment and technique.

If you've read my posts about TitanFlex bikes (here, here, here, here and here), you know what I did: I got a TitanFlex Veteran bike. A future post will discuss the details of the bike changes: This post is about running.

As my back injury post mentioned, I've had to become a toe runner. When I began triathlon, my running technique started with me as a hard heel-striker. Early pain caused me to become a mid-sole runner with a strong arm-swing. When I tried to run after my back recovered, even the impact of a mid-sole strike was more than I could tolerate.

I had to find a way to keep the impact of my feet hitting the ground from reaching my lower back. I was already wearing some of the most advanced shoes available, and adding more cushioning would mean reducing the stability I needed. I didn't need cushioning: I needed suspension.

When I had my carbon bike, the saddle soreness issues I had were handled by switching to a seat with a better design and more cushioning. My running shoes already had the best design with the most cushioning I could find. When my back problems persisted, I was certain a TitanFlex was in my future, because I knew I could add suspension via the TitanFlex titanium boom. Could I add something similar to my run?

The only things I could think of were either to run with my knees bent, or switch to toe-running. Since running in a squat didn't seem practical, that meant toe-running was my only viable option. Toe-running would permit my foot to flex up and down to absorb more of the running impact before it got to my knees, hips and then to my low back. From a kinematics perspective, it was an elegant solution.

From the perspective of my body, it seemed to be an impossible goal. I have always had plantar fascia (PF) issues related to my extraordinarily flat feet, something handled by orthotics (to provide PF support) combined with reducing toe/calf use (to minimize PF stress). While running on my toes would reduce impact, it would cause a massive increase in PF stress. It would also mean my heel-stabilized running shoe would no longer be able to help keep my feet and knees aligned, meaning more torque could be delivered to my knees, and I already had a history of minor knee problems.

Things did not look good at that point. I was very worried that I would have to stop running, which would mean no more triathlons for me. Which meant I had nothing to lose by trying toe-running, even if it did cause additional damage. The irony of the situation is that I had spent the prior year learning to reduce calf muscle use in both my run and bike techniques.

I started toe-running during the last part of the physical therapy (PT) I was receiving from Rehab United for my back. I started with slow toe-jogging for 1/4 mile, gradually building my calf strength. The first thing I noticed was that the thick heels of my 'motion-control' running shoe were getting in the way, allowing my heel to strike before the calf had finished its job. So I went and bought some running shoes with thinner heels. I didn't really care about what shoe I got, since I had no idea how to tell a good toe-running shoe from a bad one. All I knew was that I wanted a shoe with a lower heel and a good fit. I wound up with and pair of last-year Asics that were on sale for dirt cheap.

By the end of my PT I could toe-run for a mile on a treadmill at a 10-minute pace. And I was doing it pain-free! There was one very odd thing about this: I had never before been able to comfortably run on a treadmill! My bowed legs meant I needed to do a bit of heel pivoting between my heel strike and the rest of my foot coming down, which the rubber treadmill resisted, meaning that treadmill running always gave me knee pain. What was going on here?

Moving from the treadmill back to the street had its own issues. When I started to run more often and at longer distances, my knees started to hurt again. This time, I knew it wasn't ITB Syndrome; It had to be something related to the foot and/or ankle. The only thing I could figure was that errors in toe placement and/or foot angle were adding torque to my knees. I needed to control both where I put my toe down, and ensure my foot angle was correct.

Since the biggest kinematic change was that my heel was no longer touching the ground, I adjusted my stride to allow my heel to barely touch before I pushed off. No impact, just a touch, to make it easier for me to tell what my foot angle really was. The thing is, when I made that change, the knee pain went away! I had no conscious awareness of my foot ever being at the wrong angle, so I wasn't sure what was going on. My best guess is that touching the heel gave enough feedback for me to intuitively (sub-consciously) adjust my stride to keep things in alignment.

As for the rest of my running gait, everything I had learned before about arm swing and body position still applied, though one minor change was needed: When going uphill, my calves really took a beating (remember that I touch my heel every time), so I needed much more assistance from my arms than my normal swing could provide. I first tried to simply swing my arms harder, but I soon reached the limit of useful motion. At the suggestion of a friend, I added some elbow-flexing during each stride (previously I had adjusted elbow angle only slowly, to account for the terrain, and not during each step). On steep hills, during each stride my arm swing starts with my arm straight at the bottom, and finishes with my elbow fully bent at the top. I use less elbow motion on medium hills, and none at all otherwise.

I soon was back to running my regular 2-mile run pain-free, though at a slower pace. I decided to try to pick up the pace, and found that the extra energy used by the calf was really costing me: I'd suddenly get exhausted, and have to walk for a minute before I could resume running (at my slowest pace). I assumed this was due not only to the increased calf use, but was also due to poor conditioning, and that I needed to improve in that area too.

It is common knowledge that to improve speed and conditioning, we must do intervals. In biking, hill-climbing is often the interval of choice, with timed sprints also included (often in the form of pace-line drills). In running, you can run hills too, but they generally take too long to be short enough to be effective for interval training. That left timed sprints, which in running are included in "wind sprints" and "fartleks".

OK, so I was going to do some intervals, which meant I had to run very fast over short distances. Which led to the question: How fast could I run as a toe-runner? Did toe-running have a kinematic speed limit? Since starting to run mile+ distances as a toe-runner, I had tried to slowly increase my speed, but only over a long-ish distance, which I had found was initially limited by my calf development, and was later limited by my conditioning.

Time for some test sprints. After warming up, I first sprinted for only about 20 steps, to see if anything felt obviously wrong. After briefly recovering at a slower pace, I upped the distance of each subsequent sprint, going flat-out each time. By the time I was too tired to extend the sprint distance, I had covered about a mile, all of which was done with no pain at all.

During the sprints, I didn't pay any attention to my Garmin, since I was totally focused on how the fast pace felt, and to try to maintain a very uniform and controlled stride. And my stride felt very smooth: I remembered what wind sprints felt like 20 years ago, when I was training to improve my 10K speed, and I recalled that they felt very jarring and uncomfortable. Now my fast stride felt like I was gliding over the ground, rather than trying to beat it to death with my feet.

When I got home and downloaded the Garmin data, I was astounded to find that some of my sprints were at a 5:30 pace, and all of them were faster than a 6:30 pace! I don't recall ever having run that fast before. And I did this while running as smooth as silk.

I started alternating my training runs between interval runs and distance runs. I've been seeing improvements in speed over my traditional 2-mile run, and I've been able to extend my distance to include 10K (6.2 miles), all without pain during the run. I've had some minor knee pain after the longer/faster runs, but it is in a new place, just above and below the knee cap (instead of under it), and the pain always fades within an hour or so. I've also had some hamstring weakness, so I've added exercises to my strength training to address that issue. And I've had some ball-of-the-foot discomfort too, so I suppose it is time to go shopping for 'real' toe-running shoes.

The oddest thing is that during this entire process I have had no PF pain, or even discomfort, at all! I'm at a loss to explain this. I did start out gradually, and I'm sure that helped, but it can't be the full explanation. Could it be that toe-running has helped my feet to become better than they were? I've been experimenting with removing the orthotics from my shoes, and so far I see no difference. They still hurt when I stand still for a while, but no worse than before. Yes, my feet are still flat, but they seem to be working just fine that way, with extra support no longer being needed.

That's about where I am today, still working on the sprints and distance. I've equaled my prior PR of 16 minutes for my 2-mile run, and I expect to get faster. My 10K time is approaching an hour, and I expect that to improve as well. It has to! I'll be doing my first-ever Olympic distance race in the Tri Classic in 6 weeks, on September 18th, and I want to finish in under 3:30, hopefully under 3:00!

But to get under 3:00, my bike time has to improve too. Evidently, I need to do more hills and pace-lines.

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