Running technique Part III: The Scientific evidence for running technique

Today is Part III of our series on Running Technique. The two key questions we are looking at addressing are :

1. Is there an "optimal" running technique? I think we are probably all in agreement that there is, the tricky part is defining optimal...
2. Is this "optimal" technique the same for everyone? In other words, should we all be running the same way?
3. Can running technique be taught, or is it learned? This is perhaps THE key question, because if technique is learned,then it stands to reason that everyone might learn their own technique and run differently. On the other hand, if technique is to be taught as a complete "entity" (as suggested by running techniques like Pose and Chi), then it suggests that what we do naturally might be incorrect, and we need a technique makeover.
4. When running technique is taught, how should it be done? There are two schools of thought on this one. The first is to teach it wholly, effectively relearning HOW to run. This is the mass market approach, and is done in courses where Pose and Chi (and probably others) are taught. Participants get taught the theory and then instructed in how to run. The second school of thought suggests that the principles, rather than the PRODUCT, are important. That means that running technique can be taught by observing each runner on an individual basis, and then applying what are known to be sound and correct principles to modifying that technique. I hope that the distinction between this approach and 'generic, one size fits all' training are obvious.

In previous posts, then, we've looked at the concept that what we do naturally might be incorrect, we discussed the philosophy or running as a learned or taught skill, and we looked at the biomechanical principles of Pose (and to a lesser extent, Chi).

In today's post, we look at some of the scientific evidence for the teaching of technique. We're dealing predominantly with question 4 from above as we move through this evidence. We're looking at the question, then, of whether it's possible to change the running technique, and what the implications and outcomes of this change are. Some evidence is anecdotal, some is 'hard(er)' science.

The Pose study - evidence that it changes technique

I guess the starting point to answer this question is to ask whether the teaching of Pose is actually able to change the technique to begin with? For example, there are millions of products that make claims, but they don't work because they don't even produce the change they claim to - imagine a hair colourant that leaves your hair the same colour as before! So the first question to ask is whether a supervised course in Pose running (or Chi, for that matter - it just hasn't been researched, to the best of my knowledge) is able to produce MEASURABLE changes in technique?

First point here is to define those changes. What are we looking at when we say that running technique is changed? Running technique, as I'm sure you can appreciate, is a pretty complex thing - arms, hips, shoulders, head position, movement of feet, landing patterns, swing phase, support phase, you name it - there are so many ways to look at technique that just "looking" at a runner doesn't allow you to know what is different. You might sense that there is a difference, but you can't know what it is, unless you objectively measure it.

To do this, you need some specialized equipment. And luckily, we had that here in Cape Town in 2002, when the Pose study was done. The background to that study was that Nicholas Romanov contacted Professor Tim Noakes and discussed the possibility of coming to Cape Town to perform a research trial. Tim agreed, and to cut a long story short, Romanov and two colleagues flew out to Cape Town to work with some of the researchers on this study.

The study - the only research on the technique so far

The study consisted of twenty runner volunteers (Jonathan and I were both part of this group), who were trained by Romanov and his team for a week. We began with theory lessons of how we should run, and this followed by a pretty intensive week of practical training. We're talking two sessions a day, lasting an hour each, under the supervision of three coaches, with substantial individual attention for all the volunteers. We did drills, got taught how to run, and how not to run. The first point worth making is that this situation is vastly different from that which occurs when a Pose or Chi course is run. Normally, there may be upwards of twenty athletes per coach (often way more than this). We had perhaps 3 athletes per coach.

In terms of measurements, every volunteer had his/her running biomechanics assessed running one of three ways - the first was "heel-toe", the second was "mid-foot" and the third was Running Pose. This assessement, called clincial gait analysis, measures a number of different factors, called kinematic and kinetic. Briefly, you look at things like stride rate, stride length, joint angles on landing and at different parts of the stride (kinematics), and then also at forces in the different joints (kinetics).

So that allows the research to establish whether the runners had different biomechanics as a result of learning the technique.

The findings

Sure enough, the gait analysis showed the following changes had taken place after training (compared to before, and natural running in each case):

1. Stride lengths were shorter, and stride rates were higher - this is consistent with what Pose theory predicts, as we discussed yesterday.
2. The vertical oscillations of the sacrum and left heel marker were reduced (this means there was less up and down movement of both the hips and the feet)
3. Pose running had a lower loading rate of the vertical impact force than the BEFORE training running styles. This was explained because during Pose running, the knee flexed more in Pose than in heel-toe and midfoot running. Basically, during Pose, you land on a slightly more bent knee and it lowers the rate of loading.
4. The knee power absorption and eccentric work were significant lower in Pose than in either heel-toe or midfoot running
5. There was a higher power absorption and eccentric work at the ankle in Pose compared with heel-toe and midfoot running
   

So those were the key findings. This is not a biomechanics lesson, but it's worth looking at some of them in more detail. Let's have a look at the implications of these findings very briefly:

The implications of this study

It is possible to change running technique. One week of intensive Pose training was able to change a great deal of biomechanical variables in this group of runners. The stride length, stride rate, knee joint angles and rate of loading were all different. So you can 'teach an old dog new tricks'

The most important findings are Number 4 and Number 5 in the list above. They are worth looking at in much more detail.

Firstly, let's deal with Number 4. What this is saying is that when running Pose, the "eccentric work of the knee" is lower than compared to heel-striking and mid-foot running (somewhat misleading terms - let's just compare to BEFORE training). What does this mean? Well, there is some evidence the knee injuries are associated with higher eccentric work in the knee. This means that in runners who have a high eccentric loading, there may be increased risk of injury. Therefore, the conclusion made is that Pose will reduce the risk of knee injury. In fact, if you go to the Pose website, you will see this claim in the top left hand corner! That's marketing for you!

So this was the very exciting finding, and Romanov and the team were incredibly happy with it. They felt they were vindicated and had proved the benefit of Pose. And to a certain extent, they had. One small problem though...that eccentric loading doesn't just disappear, it goes somewhere else...

Does Pose increase the risk of ankle injuries?

Where does it go? Well, look at Finding number 5 in the list above. You'll see that the study also found that the ankle eccentric work was higher in Pose than with heel running! So that means that what has been taken away from the knee has been transferred to the ankle! The work done on the knee (the definition of eccentric work, by the way) is lower, but the work done on the ankle is higher! Using the same logic, this would mean increased risk of injury in the ankle and calf muscle. Does the evidence support this?

What the published study didn't tell you...what happened next?

That's where the published research ends. This research study was published in the journal MSSE, you can read the abstract here. But what the published study fails to report is what happened next...

Because what happened next was never going to be published in a scientific journal by the advocates for the technique, and would certainly not be reported on the website alongside the claim of reduced work on the knee! For what happened is that of the twenty runners who were trained, more than half broke down with calf muscle injury, Achilles tendon strains and other injuries of the feet! Let me elaborate...

We (UCT scientists, who by now included me, as I'd been brought onboard to instruct the technique) realised that this higher eccentric work in the ankle was something to keep an eye on. So Romanov and the team flew back to Miami, but taught me the basic theories behind the Pose technique, so that we could use it as a tool to do further research if we needed to.

What we decided to do was evaluate all the runners in a 'follow up' study about 2 weeks later. So we left the 20 volunteers for one weeks, so that they could go off and run and get used to running Pose, and then we called them up again and re-assessed their techniques and gave them further training for TWO WEEKS. At this stage, my role was to identify and continue to diagnose any potential problems with technique. We split the group of 20 into two parts. 10 were the "control" group, who received no further assistance or advice. The other 10 were the "follow up" group, who I saw twice a week and gave further advice to. We then measured everyone in the biomechanics lab at the end of the third week.

Calf problems - more common than they should be

What we found should be of concern. Everyone managed to maintain the same running technique - that was a good thing, because it meant that even two weeks later, everyone was still running Pose, whether or not they'd received further coaching.

The problem was that nine out of the 10 athetes who had been left alone broke down with Achilles and calf muscle problems in those three weeks after Romanov left. The ten I worked with had similar problem, but only 5 of them complained of injuries to the calf. No one had knee problems, but suddenly, we had 14 runners on our hands who had calf muscle injuries or ankle problems, despite never experiencing this before! Does Pose running then cause ankle injuries?

One might at this stage be tempted to say that this happens because left unsupervised, the runners adopt a bad technique and stop running Pose. If they were still running the technique properly, they would not develop this problem. That may indeed be true, but I would give three responses to that suggestion:

First, this calf muscle/Achilles problem did not only start happening AFTER Romanov left - it was, in fact, already happening while we were being instructed. Many of the 20 volunteers complained of severe stiffness and burning in the calves when they ran, and pain in the Achilles after a day of running. This pain was not yet full-blown injury, but it did suggest some was on the way.

Second, the group of 10 runners who did receive follow up training and supervision (from me) were still running Pose. Of course, I'm not the founder of the method and so probably should not have too much confidence in my coaching ability! But the biomechanics suggested that they were still doing the technique correctly - the biomechanics was the same as it was when Romanov was supervising (which made me feel a little better, I must confess!)

The biggest problem of all - selling a product that works only because you 'make' it work

Third, and perhaps most important, it doesn't matter whether it was because they ran incorrectly, the point is that they DID. What good is a technique if it gets taught and then is 'forgotten' or unlearned in only two weeks? Remember, these 20 people received the very best training they could - two sessions a day, individual attention, for a solid week. Yet somehow, they still manage to make errors and land up injured! Imagine if they were simply attending a weekend workshop or course, where they are one of a hundred people! What chance would they have then? This is a MASSIVE problem with the techniques (and Chi is included here) - how can you sell a product that is only going to work while the seller is on-hand to advise?

If I may use an analogy. Imagine you buy a television set, with the prospect of high definition images, revolutionary sound quality, 6 trillion colours etc. You get home and it doesn't work. It's black and white, at best. So you call the guy who sold it to you at the store and he says that it works in the store, the problem must be with you...How is that satisfactory? But he comes out to your premises, does some tuning and adjustments and gets it to work. As soon as he leaves, it flunks out on you again and you can't, for the life of you, get it to work the way he did. You call him back, and he says "It worked for me, it's not my problem. And no, you can't have your money back...!"

Crazy example, but I would suggest that this is what is happening with these techniques, both Pose and Chi. I have dealt with Pose, only because that's where the data is. But the anecdotes and reports are the same for Chi. They are making promises (run faster, run injury free) and then teaching a technique (the product) with this promise. You part with your money, but it doesn't work. In fact, it makes you even worse. But there is no accountability, because they can always suggest that YOU are in fact the one to blame. That is not fair, but the science suggests that this is what happens...That is my biggest problem with the mass coaching of a technique.

The anecdotes support this. It was been reported, for example, that whenever a workshop is held in a city, the orthopedic specialists know that they should anticipate an influx of people with calf and ankle problems about a week or two later! So for every positive story you hear (there are some, make no mistake, some people get it right and it works), there are those of disappointment and injury as a result of a 'generic' running technique.

The final factor - the mental cost of running a new way

So far, we've looked purely at the physical and biomechanical changes. But what of the mental changes? Imagine you are 40 years old, been running for 20 years and suddenly you learn a new technique. Suddenly, running is a mental exercise, your 5-mile jog becomes 45 minutes of focus and concentration: Am I landing right, how are my hips, am I pulling enough, I mustn't land on the heel etc. That's a guaranteed way to ruin a run, for MOST people. I received the following email from one of the 20 runners we tested (excerpt only):

Since learning Pose, I can't relax and run anymore. I'm trying to just run naturally, but the training drills we did are still too fresh in my mind (this was 3 months afterwards, by the way). I try to switch off and just run, but it's too difficult. I can't seem to go back to how I used to run, but I'm not sure I'm doing Pose correctly either. It makes my running very difficult, I wish I could just switch off, forget what I was told and run, like I used to, for pleasure"

This gentleman was incredibly frustrated, he'd been shown "the new, better way", but it created a burden for him that he didn't want. I'm not sure what he runs these days, but I suspect he has probably returned to his old technique. This story illustrates one possible risk of running a new technique - can you make wholesale changes to technique without overloading a runner's mental capacity? I don't think so, which is why the subtle change theory is the way to go, in my opinion.

But there is still some merit to the techniques

Having written that, let me now say that I still believe that the fundamental principles on which both are based are CORRECT (I don't think there's a difference between them, to be honest). That means that whatever it is that Pose is teaching, I believe is true - the centre of mass, the pulling of the foot, the balance and fall (all described yesterday). It's all sound. But to try to apply this to a mass audience only creates more problems than it solves. And for that reason, I would strongly suggest for anyone to avoid this kind of "mass customization". Running technique is a one-on-one thing, case by case. Remember, as I wrote yesterday, technique is first learned, then refined and the subtle changes are made.

We will look at these subtle changes in tomorrow's post, the last of our series. Once again, thank you for reading, I realise these are heavy and long posts, but I hope they stimulate thought and debate.

Bye for now!
Ross

Breaking news: Haile Gebrselassie has just broken Paul Tergat's world record for the marathon - 2:04:26. Check out the split times and post-race analysis here!