Exercises to Transition to Forefoot

Did I convince you to try forefoot running? Have patience, this transition should take several months. You have been landing on your heels for years, it's not going to change in a couple minutes. It takes time for your brain to change the firing patterns of the nerves, your muscles to build strength and the movement to become natural.

If you're not already walking at home barefoot, DO IT every day. Actually, think about landing on your forefoot while you walk.

Core

Good core strength and stability is the most important aspect in maintaining a forefoot strike running pattern. Due to the inherent forward lean of this running style, the core is always engaged. The onset of fatigue leads to poor form. The chest starts to hutch over (as oppose to forward pelvis over the foot) and hips shift backwards which leads to heel striking.



For clams, side lying leg lifts, fire hydrants and bridges:

stage 1 - perform 3 sets x 12 reps
            - hold plank 10 x 10 sec

stage 2 - hold 10 reps for 10 seconds
            - hold plank 3 x 30 sec

stage 3 - add band repeat stage 1
            - progress to single leg bridges
            - add squats and lunges: use push knee back cue
            - add plank - add knee bent plank and rotation 10 each side

stage 4  - repeat 2 with band
             - continue single leg bridges, squats, lunges and plank (lunges and squat add weight or            bend knees more)

*** Perform stage 1 every day. Stages 2-4 perform 3-4 x week.
*** Do not progress stage until the current stage feels easy.
*** You should have glute soreness after each session.
This should take a minimum of 8 weeks!!! Spend about 2 weeks per stage. 
           

Ankle Strength and Drills

To land on your forefoot you have to have excellent calf strength. Forefoot strike puts extra stress to the calf muscles and Achilles tendon. You are performing an eccentric heel raise with each stride! These drills help with proper form and getting the neurologic input to land on your forefoot.



Calf Raises - With a twist! By turning left and right as you come up, different muscle fibers are being used. In running, the twisting motions occur when your foot lands and when it lifts off the ground. It happens so fast you can't feel it. Start with double leg 2-3 sets of 10, then at stage 3 of core, try single leg 3 sets of 10 reps.

Wall Falls - Forefoot running requires eccentric strength of the calves. Eccentric strength is when the muscle is working while it's stretching. This strength is required during the time the forefoot hits the ground and when the heel lands. 2-3 sets of 10 reps

Falls Into Strides - This takes wall falls to the next step. Fall forward until you can't hold yourself up, then stride for about 20 yards. Keep your back straight and core tight. Please don't fall on your face!

High Knees - This works on front side form. Bring your knee up to your chest without leaning backwards and land on your forefoot. Keep your feet under your body and don't reach forward. This drill is about speed not distance of each step. 10-20 yards

Butt Kicks - This works on back side form. Kick your heel towards your glutes. The tendency is to arch your back because of tightness in the quadriceps and hip flexors. Keep your core tight and back in neutral. Land on your forefoot. Again, this is about quick feet and not distance. 10 - 20 yards

Running Program

Start slow and forefoot run for a 2-3 minutes then return to your normal form for 5 minutes to allow the new working muscles to rest. Repeat until you reach 30 minutes. Increase the amount of time you forefoot running by 1 minute each week as long on there is no pain. So forefoot run 3-4 minutes then walk 5 minute.


Week 1
Barefoot walking in the house using a forefoot pattern.
Week 2
2-3 minutes forefoot running 5 minutes running normal x 3 - 4 for 30 minutes total 2-3 times a week
Week 3
3-4 minutes forefoot running 5 minute running normal x 3 - 4 for 30 minutes total 2-3 times a week
Week 4
4-5 minute forefoot running 5 minute running normal x 3  for 30 minutes total 2-3 times a week
Week 5
5-6 minute forefoot running 4 minute running normal x 3  for 30 minutes total 2-3 times a week
Week 6-12
6-7 minute forefoot running 3 minute running normal x 3  for 30 minutes total 2-3 times a week
Repeat until you reach 3 x 10 minutes of running forefoot
Then transition
15 minutes of forefoot running 3 x week
18 minutes of forefoot running 3 x week
add 3 minutes to each run each week until you reach 30 minutes.

Do not move forward if you have pain. You should be able to comfortably run forefoot for 30 minutes without discomfort before incorporating it into harder runs.


There are a lot of different core and ankle exercises, as well as, running drills. However, I believe these are the fundamentals which build a good base for forefoot running. Remember this takes time to transition!

Look out for a future post on how footwear ( heel drop) can change your strike pattern.

References

The core exercises are a modified version of Dr. Chris Powers's Course Evaluation and Treatment of the Injured Runner: A Biomechanical Approach

The running program is a modified version from Dr. Irene Davis's running lecture Spaulding National
Running Center - Barefoot running Training.

Glutes - How to Transition From Exercise to Run

You've been told you have weak glutes. Whether it's hip pain, knee pain, ankle pain, it all can be "healed" by improving glute strength. You are prescribed clams, side lying leg lifts, bridges then progressed to squats and lunges. You feel stronger and released to go for a run. Your symptoms feel better but returns after getting back to your routine.

Recruiting Glutes vs. Quads

Is your strength transferring from a basic clam exercise to running? Are your glutes REALLY activating when you run? For most of us, we are very quad dominant. This means we over use our quadriceps when we should be using other muscles such as our glutes. Our sedentary lifestyle of sitting at work or relaxing on the couch has us disengaging our glutes. The quads have at a mechanical advantage to work. Also, the habitual use of quadriceps enhances the neural input from the brain is going to the quads and not the glutes. In other words, the wiring to the quads is better then wiring to the glutes. When running, demand on the muscles is so high we use whatever muscles are the easiest to recruit. The Quads.

I have seen and used different cues such as "stick out your butt"or"squeeze your butt as you stand up". However, most of my patients and clients have a difficulty "feeling the exercise". AND, the improved strength doesn't seem to translate to running.

PUSH YOUR KNEES BACK

I have been using a different cue to activate the glutes while performing standing exercises such as squats and lunges. While you are performing squats or lunges (or any standing hip exercises i.e. box step ups), pretend like there is an object behind your knee and push back as you stand up. The gluteus maximus is responsible for hip extension, getting your thigh behind you body. However when your foot is fixed on the ground and the knee is given the cue to push back, this extends the knee AND hip. This will engage your gluteus maximus.




Stand up and perform a squat. When you stand up, you feel your thighs press down into the ground and push up. Now try a squat but give the cue for your knees to push back.

FEEL the burn in your glutes.

Now, think of this cue when running. You want to let your knee land normally (with a soft bend), then push back with the knee as your body is moving over your leg. You should feel like your legs are moving in a circle, almost like pedaling a bike. At first, I recommend incorporating this during a warming up, then into sides and finally into your short normal runs. The best way to feel this is up hill sprints!
THIS CUE WORKS BEST IF YOU MIDFOOT OR FOREFOOT STRIKE!

So on top of performing clams, leg lifts and squats add this "push your knee back" cue to the standing exercises.

Please contact me if you have any questions or concerns.

Core: More then Abs and Glutes

As athletes, we spend a lot of time working on our core. We plank. We do sit-ups. We twist. However, there is one muscle which is ignored by most athletes that is use in every stride.  In order to run, swim, bike, you need to breathe. The muscle responsible for breathing is the diaphragm. As you pick up the pace, your breathing increases. Your diaphragm is working hard!

What is the Diaphragm?

The diaphragm is a thin muscle that separates the abdominal cavity from the chest cavity. When it is relaxed it rest up against the chest cavity. When we breath the diaphragm contracts and pulls the chest cavity down. This provides negative pressure in the chest cavity allowing air into the lungs. Typically, the core is just seen as the abdominals and back. The core as a box. The pelvic floor muscles on the bottom, abs and back form the side and the diaphragm is the top.

Photo credit - http://deansomerset.com/core-training-
made-incredibly-complex/

How Does It Affect my Running?

One of the biggest difficulties I see in the clinic is the inability to separate the diaphragm from the core while breathing. When most of us tighten our core, we stop breathing. OR we continue to breath without tightening our core. We have to learn how to disassociate our diaphragm from our core similar to not using your hamstring when firing your glutes. When we are not able to keep our core tight while we running we lose core stability. This will set off a whole cascade of events which can impact the mechanics of our arms and legs.

The diaphragm has multiple attachments including the hip flexors. This is important because most of us have tightness in our hip flexors. Tightness of hip flexors will not allow the diaphragm relax in  resting state. This tightness will limit our ability to take advantage of a full breath. This forces us to take shallow breaths. This can also contribute to the inability to take a full stride. When the leg is trailing behind, the hip flexor is on maximal stretch. A tight hip flexor will pull on the diaphragm limiting full exhalation.

Lastly, and most important, the diaphragm controls our breathing!

Inability to contract our abdominal muscles separate from the diaphragm and tight hips limit our ability to take full breath. Like any muscle the diaphragm can be stretched and strengthened. On top of stretching the hip flexors and strengthening our core we should also work on improving the use of our diaphragm.

Bonus Info

Side Cramps

A side cramp is when the diaphragm spasms. If you have a cramp on the right, exhale when when your left foot hits the ground. This provides a quick stretch to the diaphragm which helps alleviate symptoms. If your cramp is on your left, exhale as your right foot hits the ground

Finding balance

The diaphragm is also connected to the parasympathetic nervous symptom. This is the "rest and digest" system which allows you to relax. Everyone is busy and on the go which stimulates the sympathetic nervous symptom which is your "fight or fight" symptom. Certain chemicals are released when the sympathetic nervous symptom is activated which, over time, can be detrimental. By diaphragmatic breathing, the parasympathetic nervous system is activated balancing the sympathetic response. If I can't sleep, I focus diaphragmatic breathing and I usually fall asleep within minutes!

Exercises

Diaphragmatic Breathing

On your back with knees bent, inhale allowing the abdominal cavity to rise then the chest follows. A sign the diaphragm is under-utilized is when the chest and shoulders rise first. To make this more difficult stack a couple of books on your abdominals. Do this for 10 breaths.


This can also be performed in various positions such as sitting, standing or laying down. Eventually diaphragmatic breathing should be natural.

Diaphragmatic Breathing in 3 D

We will work the diaphragm using the lunge matrix.

Stand tall and inhale, as you lunge forward exhale as you bring both arms up. Return to standing and repeat. In the frontal plane, inhale in standing then exhale as you bringing both arms up and to the side. Lastly in the transverse plane, inhale then exhale as you pivot lunge bringing both arms toward the knee.
This exercise provides an additional cue when performing lunges. If you're already doing lunges add the breathing to your routine. You don't have to perform more diaphragmatic lunges.
Perform about 5 repetitions to each side.

*** Side note I have difficulty performing frontal plane breathing exercises. Those who know me know that I had an injury to that side. This is an exercise I will be re-evaluating in a month!

Core Strength - Power of Proximal Acceleration

We all know core strength is important for running. It helps hold our body upright, regulates breathing and gives us explosive power. Planks and crunches are typically part of a runners strength routine. However, planks are a static exercise and crunches accentuates a flexed position. Do those exercises work the muscles specific to running? What other exercises load the core which most resembles running?

A closer look at the running form shows our pelvis rotates with each stride. While one leg is forward the other leg is behind. Meanwhile, our arms are moving the opposite direction of our legs. Our   abdominal muscles are being stretched with each stride.
Opposing motion between the arms and legs helps to stretch the connective tissue of the anterior core in a rotatory fashion. This is important because rotation provides the strongest load (think of the glide versus spin technique in field events).  The stretch of our anterior trunk loads our core, similar to the recoil of a slinky, which helps to accelerate our leg forward.

Note the stretch that occurs across our abdominals

A key component of spinal mobility is rotation occurs in the thoracic spine and the pelvis. The lumbar spine has very little to no rotational mobility. In order to effectively load the core, it is important to stretch the upper back and hips appropriately. Here are 2 links to upper back and hip stretches.
http://3drunner.blogspot.com/2015/03/spine-stiffness.html
http://3drunner.blogspot.com/2014/06/ankle-sprain-how-thoracic-spine-and-hip.html

EXERCISES
Planks with Pelvic Driver
Assume the normal plank position. Keep your arms straight rotate the pelvis towards the floor. To help load the frontal plane, move the pelvis side to side.

Resisted Pelvic Driver
Equipment needed - A belt and resistant band
This exercise requires a bit of creativity. Tie a resistant band to a belt. Then wear the belt. Attach the band with the belt around a post or fence. Place one leg forward with the band from behind. Adjust the belt so the band is coming from behind towards the side of the leg that is forward. Shift weight forward as you push the pelvis forward.

Stride Stance Ball Catches
Equipment needed - Ball or medicine ball
Stand with one foot in front. Use a ball and throw to a partner from the side. This exercise provides a stretch to the abdominals in a rotatory motion. A second throwing position can be throwing it overhead which provides a load in a different plane of motion. Try catching with one hand.
Throw and catch with the arm which is same side front leg.

Recommended 12 - 15 times of each exercise up to 3 sets

TRANSITION TO RUN
During strides or warm up, implement a pelvic drive while running. Visualize a rope in the front of your pelvis pulling your body forward with each step.

These exercises paired with a traditional strength routine will attack the core muscles in all dimensions.  Proximal acceleration is vital for the mechanics of numerous athletes such as golfers, throwers and even swimmers to produce force. So why not runners?!