Running from the head down

Andy Franklyn-Miller and John Foster have developed a running re-education programme, which aims to reduce injuries

Of all the things I think I need to learn, running isn’t one of them. For three decades now, I’ve been pounding pavements and pitches, mountains and parks, at least three times a week, fair weather or foul.

After all those miles, you wouldn’t think there’s much more to know about the business of putting one foot in front of another in quick succession. Running is natural, something we learn instinctively from the moment we learn to walk.

This isn’t a view that Andy Franklyn-Miller and John Foster of the Sports Surgery Clinic wholeheartedly agree with. They point to the high level of injuries suffered by runners – up to 60 per cent will suffer an injury in any one year – as evidence that some of us just aren’t doing it right.

“People need to be taught how to run, just as they are taught how to swim or to play tennis,” says Franklyn-Miller.

Injuries cause some runners to pack it in. Others go down the surgical route. Franklyn-Miller and Foster’s contention is that many injuries can be successfully treated by analysing a person’s technique and retraining the key muscles to work in a different way.

The theory is that many of us develop an inefficient technique. This results in excessive forces on the muscles of the foot, leg and pelvis which can cause injury.

But adjusting a person’s running style and re-training muscles can work every bit as well as corrective devices such as orthotics or surgery.

Conscious of my own niggling injuries, I agreed to an offer to try their Running Re-education programme at the Sports Surgery Clinic in Santry which, despite its name, is probably best known as a centre for hip operations for older people.

Both men, one a sports physician and the other a physiotherapist, served in the military, where they treated large numbers of soldiers with lower leg pain. Drawing on the insights provided by barefoot and Chi running advocates, they developed a one-week running course which led to greatly reduced levels of injury.

They broadened their research to encompass all running injuries and levels of ability. “Other people regard running as an end-point, but for us it’s a tool in treating injuries,” explains Franklyn-Miller.

For some injuries, this approach simply won’t work, and their first task is to de-select patients who require other tests, such as an MRI for stress fractures or blood tests for arthritis.

Many running shoe retailers these days offer instore gait analysis with the aim of matching the athlete’s running style to the right shoe. Franklyn-Miller and Foster say their approach differs by analysing a person “head down rather than foot up” with the initial focus on the large propulsive muscles that drive a runner forward. “How the foot hits the ground is the end-point of our analysis,” says Foster.

On arrival, my first task is to lace up my trainers and stride out on their treadmill, on which two video cameras are trained. “It’s not about the technology, it’s the ability for people to see the way they run, and the difference that can be made,” says Foster.

As I jog along, I ask both men whether running is advisable for people as they get older. “Runners need to keep running for their bone health,” Franklyn-Miller replies. “Running doesn’t cause injury. If you run effectively, there’s no reason you can’t continue to run for all of your life.”

The oldest patient they’ve seen is an 82 year old who was running an astonishing 60 miles a week but was suffering the odd injury. “We tweaked his technique and suggested that he run every second day rather than every day in order to allow his body to repair itself,” says Foster.

The video of my jog on the treadmill is instantly available. I’m told I have a good mid-foot strike which minimises the force when I hit the ground. However, my knee drive is very low and my shoulders are tensed and one of the guys describes my running style as “lazy”.

Oh dear. From the rear view, I can see that my knees roll inwards when I strike the ground, which can’t be good. But overall, Foster’s conclusion is “if it ain’t broke, don’t fix it”.

Under the programme, there are four steps to re-educating runners over a period of months. Run tall is the first advice, with the body vertical and a light and floating movement. A rapid knee drive is recommended, with the knee lifted rapidly upwards soon after foot strike.

Runners are also advised to shorten their stride, by aiming to take 28-30 steps every 10 seconds, and to strike the ground mid-foot.

The programme isn’t cheap, with an initial 60-minute consultation costing €300 and a running assessment €500. That would pay for a brace of physio sessions, but Franklyn-Miller and Foster say for most patients two Running Re-Education consultations suffice.