Tag: injuries

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Can biomechanical analysis cure Dathan Ritzenhein’s injuries?

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My new Sweat Science columns are being published at www.outsideonline.com/sweatscience. Also check out my new book, THE EXPLORER'S GENE: Why We Seek Big Challenges, New Flavors, and the Blank Spots on the Map, published in March 2025.

- Alex Hutchinson (@sweatscience)

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Dathan Ritzenhein just announced that he’ll be running the New York City Marathon this November, joining a stacked field that already includes Haile Gebrselassie and Canadian hope Simon Bairu. One thing that jumped out at me from the press conference (as reported by Letsrun) was his coach Alberto Salazar’s assertion that Ritz’s injury problems are a thing of the past thanks to some high-tech analysis:

“Gordon Valiant – the head of biomechanics for Nike – did an evaluation of Dathan and was able to find some things that are unique to Dathan with the way he runs and strikes his foot. With that (study completed), we now have some modified inserts. I wouldn’t call them orthotics – just an insert into the shoe where he has an abnormal amount of force near his third metatarsal. It seems to have alleviated his symptoms completely and we’ve retested him in the lab and shown those forces have been lessened tremendously.”

For those who’ve been following the barefoot running debate, this should raise some flags. For years, critics of the big shoe companies have pointed out that measuring forces in a lab setting doesn’t necessarily equate to a change in injury rates. Australian minimalist advocate Craig Richards said as much in an article I wrote back in 2008:

“Shoe researchers and manufacturers will try and bamboozle you with the results of hundreds of biomechanical studies,” [Richards said]. While these studies tell you how your stride is affected by the shoe, “they cannot currently tell you what this means for either the injury risk or performance of the wearer.”

Fair point — though, as I pointed out last month, minimalists are suddenly more enthusiastic about biomechanical studies now that Dan Lieberman and others have provided them with some studies of their own.

Anyway, we now have a study (with n=1) in which the manipulation of biomechanical forces in the foot is hypothesized to solve a longstanding injury problem. The outcome measure: whether Ritz makes it to New York in one piece, with an uninterrupted build-up. Here’s hoping!

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Platelet-rich plasma for muscle injuries

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My new Sweat Science columns are being published at www.outsideonline.com/sweatscience. Also check out my new book, THE EXPLORER'S GENE: Why We Seek Big Challenges, New Flavors, and the Blank Spots on the Map, published in March 2025.

- Alex Hutchinson (@sweatscience)

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The current issue of the British Journal of Sports Medicine has a couple of articles on platelet-rich plasma therapy, the experimental treatment that made headlines thanks to the Anthony Galea scandal and its links to Tiger Woods and other famous athletes. It’s most commonly used (in sports circles) for tendon injuries, but Kimberley Harmon of the University of Washington takes a look at the evidence for its use in muscle injuries (the full article is available for free at the BJSM site). Her conclusions are pretty much what you’d expect:

There is theory and preliminary evidence regarding the effectiveness of PRP, but its use is still investigational. It is incumbent upon physicians using this treatment to disclose its experimental status and to follow outcomes in a structured way. Further studies are needed to establish the effectiveness, indications and protocols for using PRP in the treatment of acute muscle injuries.

In other words, nobody really knows yet — but if you’re a pro athlete whose livelihood depends on getting that muscle or tendon fixed, it’s probably worth a try.

What I actually found most useful in the article was that it starts with a clear, detailed description of our current understanding of how muscles heal on a cellular level — the carefully choreographed sequence of platelets, growth factors, cytokines, neutrophils, and so on. This is a topic I was looking into recently during the research for another article, and I would have loved to find such a clear explanation.

(As an aside, she discusses the role of prostaglandin E2, which is affected by non-steroidal anti-inflammatory drugs like ibuprofen: “Recent studies have shown that NSAIDs likely tip the delicate balance of regeneration versus fibrosis toward fibrosis (scar).”)

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Shorter strides are easier on your knees and hips

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My new Sweat Science columns are being published at www.outsideonline.com/sweatscience. Also check out my new book, THE EXPLORER'S GENE: Why We Seek Big Challenges, New Flavors, and the Blank Spots on the Map, published in March 2025.

- Alex Hutchinson (@sweatscience)

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Yet another study advocating shorter, quicker strides when you run has just been posted on the Medicine & Science in Sports & Exercise site. In this one, researchers at the University of Wisconsin had 45 recreational runners run on a treadmill at their preferred stride rate, then increased or decreased the stride rate by 5% and 10% (keeping speed constant, so a faster stride rate resulted in shorter strides and vice versa).

The results aren’t that surprising: Increasing stride rate by 5% or 10% reduced the mechanical energy absorbed by the knee joint by 20% or 34% for each stride. The ankle joint didn’t change much, while the hip absorbed significantly less energy only when the stride rate was increased by 10%.

Of note, the researchers point out:

[M]any of the biomechanical changes we found when step rate increased are similar to those observed when running barefoot or with minimalist footwear.

So you could read this as an argument for minimalism — or, alternately, you could conclude that you can get the benefits of going barefoot simply by shortening your stride.

Three caveats. First, if you shorten your stride, you’ll take more steps to cover the same distance. Last year, researchers from Iowa State used a computer model to predict that, for a 10% increase in stride rate, the benefits of gentler foot-strike outweigh the downside of taking more strides in reducing your stress fracture risk. Still, it’s hard to know whether this conclusion is generalizable to other injuries. Second, studies have found that deviating from your preferred stride rate makes running feel harder, though there’s conflicting evidence about whether it actually makes you burn more energy. So this tactic might be most appropriate, the researchers suggest, when you’re returning from an injury and reduced load is more important than efficiency. And third, the study — as with virtually all the studies in the ongoing Shoe Debate — is a kinematic one that makes big assumptions about the connections between joint forces measured in the lab and ultimate injury rates. No one really knows whether “a more flexed knee at initial contact with less peak knee flexion during stance” will translate into a lower injury rate.

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Weak hips cause runner’s knee

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My new Sweat Science columns are being published at www.outsideonline.com/sweatscience. Also check out my new book, THE EXPLORER'S GENE: Why We Seek Big Challenges, New Flavors, and the Blank Spots on the Map, published in March 2025.

- Alex Hutchinson (@sweatscience)

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I’m looking forward to going through the research presented last weekend at this year’s ACSM meeting. For starters, a study presented by researchers from the Indiana University found that hip strengthening exercises reduce or eliminate “patellofemoral pain” (“runner’s knee”) in female runners. This is an idea that has been gaining momentum over the past few years — I first heard about it back in 2007 from Reed Ferber of the University of Calgary’s Running Injury Clinic (and wrote about it here).

The Indiana study is pretty small — just nine runners, with the five who did the hip strengthening exercises lowering their pain score from 7 to 2 or lower (on a scale of 0 to 10) after six weeks of twice-a-week strengthening. The researchers are hoping to try the same program on a larger group of runners. Normally I wouldn’t get too excited about such a small study, but given that the idea is also being developed elsewhere (such as this study about hips strength and knee arthritis that I blogged about last year), it’s starting to look pretty interesting. I suffered through an extremely persistent case of runner’s knee a decade ago that kept me out of competition for almost two years, so I certainly wish I’d known about the possibility that hip exercises might help.

If you want to give them a try, here are Reed Ferber’s suggested hip exercises [pdf, 2 MB].

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National Magazine Award nominations

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My new Sweat Science columns are being published at www.outsideonline.com/sweatscience. Also check out my new book, THE EXPLORER'S GENE: Why We Seek Big Challenges, New Flavors, and the Blank Spots on the Map, published in March 2025.

- Alex Hutchinson (@sweatscience)

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If you’ll pardon a little self-promotion, the nominations for this year’s National Magazine Awards were announced last night, and I was thrilled to pick up three. Two of them were for my piece in The Walrus about the neuroscience of navigation and how using GPS may be affecting our brains.

The third was for a piece in Canadian Running on evolution, barefoot running and injuries, including some interesting thoughts from Chris McDougall, the author of the bestseller Born to Run. (The piece was written last spring, before McDougall’s book was released and rocketed the topic into the public conversation.) I included a brief excerpt from the piece in a blog entry last summer, but now the full piece is available online for the first time here:

The giant screen at the front of the lecture theatre shows, in gruesome detail, a dissected bare foot connected through tendons to ten different muscles in the lower leg, all pulling in slightly different directions. Benno Nigg, a renowned professor of biomechanics who co-directs the University of Calgary’s Human Performance Laboratory, is leading an audience of Australian academics gathered at the University of Sydney through a presentation titled “The Future of Footwear.” During almost four decades as one of the world’s leading athletic shoe researchers, Nigg has worked closely with major companies such as Adidas, Nike and Mizuno. But plotting the future of the running shoe, he now believes, may require a look to the past, at what worked for our ancestors.

“Look at all these muscles here,” he says, gesturing at the dissected ankle. He asks the audience to guess which of the muscles we need in order to walk while wearing a typical shoe. Only two of the ten are needed, it turns out: the tibialis anterior (shin) and the triceps surae (calf). “And all the other ones, you don’t need, because the shoes take over.” Nigg pauses to let his audience consider this piece of trivia, then poses the central question of his talk: “Is that a problem?” [READ ON…]