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	<title>Comments on: Hip Strength in Females and Patellofemoral Pain</title>
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		<title>By: adarian</title>
		<link>http://www.endurancebasecamp.com/hip-strength-in-females-and-patellofemoral-pain/comment-page-1/#comment-113</link>
		<dc:creator>adarian</dc:creator>
		<pubDate>Wed, 23 Jan 2008 21:27:55 +0000</pubDate>
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		<description>I say it over and over again, how you run will cause most of your problems and if that is not address all the strengthening in the world will not cure the problem.

For instance, the knee should tilt or rotate inward as it comes forward, that is a very natural motion, but a lot of people will tell you not to do it. Just as it tilts inward it will rotate outward as the foot comes back to the ground.

Arms should cross the body as long as the shoulders are not rotating. What one side of the body does doesn&#039;t mean the other side should follow. So if one hand crosses in front and the other doesn&#039;t, no big deal.

Most people run well at a certain pace, but beyond that is where some issue could crop up. Once again don&#039;t think technique, think actions.

 Actions like are my hands  leading the running action, like are my feet coming back towards before contacting the ground, actions like am I working the elbow joint.
 Attempt to command a certain technique will bring more pain and misery.

&quot;Upon examining the side view of my running gait, we saw an immediate and glaring problem. I was over striding and landing full force with a straight leg on my heels. He felt this basic (and fundamental) problem explained almost all of my running injuries: calcaneal stress fractures (or possibly just deep bone bruises), knee pain, and hip pain.&quot;  This is easy to correct. I could show you in two minutes how to correct this issue.
I bet that if you look at the video again, pay attention to your hands. You will find that when the hand stops moving forward so does the foot. And if the hand does not start moving backwards so will the foot stay in front of your body and viola your heel is the landing point, with the full force of your bodyweight coming down with  gravity and speed, get the picture. Also this could be a problem if your run by lifting or pulling your knees forward.
If you arms are moving it does not mean your hands are moving.
In moving your hands you have to work the elbow joint. Running with fixed arms bent will cause many problems also. Once again this is not a technique but an action.

Just my thoughts</description>
		<content:encoded><![CDATA[<p>I say it over and over again, how you run will cause most of your problems and if that is not address all the strengthening in the world will not cure the problem.</p>
<p>For instance, the knee should tilt or rotate inward as it comes forward, that is a very natural motion, but a lot of people will tell you not to do it. Just as it tilts inward it will rotate outward as the foot comes back to the ground.</p>
<p>Arms should cross the body as long as the shoulders are not rotating. What one side of the body does doesn&#8217;t mean the other side should follow. So if one hand crosses in front and the other doesn&#8217;t, no big deal.</p>
<p>Most people run well at a certain pace, but beyond that is where some issue could crop up. Once again don&#8217;t think technique, think actions.</p>
<p> Actions like are my hands  leading the running action, like are my feet coming back towards before contacting the ground, actions like am I working the elbow joint.<br />
 Attempt to command a certain technique will bring more pain and misery.</p>
<p>&#8220;Upon examining the side view of my running gait, we saw an immediate and glaring problem. I was over striding and landing full force with a straight leg on my heels. He felt this basic (and fundamental) problem explained almost all of my running injuries: calcaneal stress fractures (or possibly just deep bone bruises), knee pain, and hip pain.&#8221;  This is easy to correct. I could show you in two minutes how to correct this issue.<br />
I bet that if you look at the video again, pay attention to your hands. You will find that when the hand stops moving forward so does the foot. And if the hand does not start moving backwards so will the foot stay in front of your body and viola your heel is the landing point, with the full force of your bodyweight coming down with  gravity and speed, get the picture. Also this could be a problem if your run by lifting or pulling your knees forward.<br />
If you arms are moving it does not mean your hands are moving.<br />
In moving your hands you have to work the elbow joint. Running with fixed arms bent will cause many problems also. Once again this is not a technique but an action.</p>
<p>Just my thoughts</p>
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		<title>By: Brad Hefta-Gaub</title>
		<link>http://www.endurancebasecamp.com/hip-strength-in-females-and-patellofemoral-pain/comment-page-1/#comment-112</link>
		<dc:creator>Brad Hefta-Gaub</dc:creator>
		<pubDate>Wed, 23 Jan 2008 07:03:56 +0000</pubDate>
		<guid isPermaLink="false">tag:blogger.com,1999:blog-19485558.post-1120751487412063207#comment-112</guid>
		<description>Actually, the idea that people need to &quot;learn how to run&quot; is a good one. My current PT basically summed it up like this... &quot;we all assume we know how to run... since we&#039;ve been doing it since we were little kids... but it turns out that there are many more ways to run incorrectly, that can hurt you, then there are ways to run &#039;correctly&#039; that will allow you to run efficiently and injury free.&quot;</description>
		<content:encoded><![CDATA[<p>Actually, the idea that people need to &#8220;learn how to run&#8221; is a good one. My current PT basically summed it up like this&#8230; &#8220;we all assume we know how to run&#8230; since we&#8217;ve been doing it since we were little kids&#8230; but it turns out that there are many more ways to run incorrectly, that can hurt you, then there are ways to run &#8216;correctly&#8217; that will allow you to run efficiently and injury free.&#8221;</p>
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		<title>By: garyd</title>
		<link>http://www.endurancebasecamp.com/hip-strength-in-females-and-patellofemoral-pain/comment-page-1/#comment-111</link>
		<dc:creator>garyd</dc:creator>
		<pubDate>Tue, 22 Jan 2008 17:28:37 +0000</pubDate>
		<guid isPermaLink="false">tag:blogger.com,1999:blog-19485558.post-1120751487412063207#comment-111</guid>
		<description>Thanks Brad for your insight.

I think that my final outcome (as mentioned) is to help people find interventions to help prevent injury and enable them to run more (which is really the best way to get faster).

Once there is pain or worse injury, seeking the help of an Sports Med MD or rehab professional must be done (of which I am not).  Because there can be one of many reasons for the injury.

When we look at prevention it becomes more broad in prescription; therefore I look at &quot;what causes the majority of x issue?&quot;  Sort of like telling people with high blood pressure to not eat salt.  Most people are not affected by salt intake (I think it&#039;s around 15% that are impacted), but we give that general guideline to follow, b/c who knows how to separate out the 15%?

It&#039;s interesting that you talk about the running form/gait as the issue for your knee pain.

I&#039;ve focused my thoughts around strength training b/c I&#039;m trying to solidify my thoughts around the benefits of using strength training for improving performance (b/c I still believe that swimming more, biking more and running more is the best way).....

And the idea that improving your gait improved your knee issues backs up my idea of running more.  We become more efficient / economical (depending on interpretation) as we run more.

So as strange as it seems, many people need to learn how to run still!  Strength training maybe necessary for some (more and more, I believe) to obtain the durability to run lots of miles... but just as many need to learn to run correctly.

I&#039;ve had a really hard time with my legs as I&#039;ve changed my running gait to run with the Team in Training groups.  I picked up some bad habits!  (not that I needed more).</description>
		<content:encoded><![CDATA[<p>Thanks Brad for your insight.</p>
<p>I think that my final outcome (as mentioned) is to help people find interventions to help prevent injury and enable them to run more (which is really the best way to get faster).</p>
<p>Once there is pain or worse injury, seeking the help of an Sports Med MD or rehab professional must be done (of which I am not).  Because there can be one of many reasons for the injury.</p>
<p>When we look at prevention it becomes more broad in prescription; therefore I look at &#8220;what causes the majority of x issue?&#8221;  Sort of like telling people with high blood pressure to not eat salt.  Most people are not affected by salt intake (I think it&#8217;s around 15% that are impacted), but we give that general guideline to follow, b/c who knows how to separate out the 15%?</p>
<p>It&#8217;s interesting that you talk about the running form/gait as the issue for your knee pain.</p>
<p>I&#8217;ve focused my thoughts around strength training b/c I&#8217;m trying to solidify my thoughts around the benefits of using strength training for improving performance (b/c I still believe that swimming more, biking more and running more is the best way)&#8230;..</p>
<p>And the idea that improving your gait improved your knee issues backs up my idea of running more.  We become more efficient / economical (depending on interpretation) as we run more.</p>
<p>So as strange as it seems, many people need to learn how to run still!  Strength training maybe necessary for some (more and more, I believe) to obtain the durability to run lots of miles&#8230; but just as many need to learn to run correctly.</p>
<p>I&#8217;ve had a really hard time with my legs as I&#8217;ve changed my running gait to run with the Team in Training groups.  I picked up some bad habits!  (not that I needed more).</p>
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		<title>By: Brad Hefta-Gaub</title>
		<link>http://www.endurancebasecamp.com/hip-strength-in-females-and-patellofemoral-pain/comment-page-1/#comment-110</link>
		<dc:creator>Brad Hefta-Gaub</dc:creator>
		<pubDate>Tue, 22 Jan 2008 08:29:57 +0000</pubDate>
		<guid isPermaLink="false">tag:blogger.com,1999:blog-19485558.post-1120751487412063207#comment-110</guid>
		<description>Gary,

Here&#039;s some more feedback on this topic. Mid last year I was having knee pain (coincidentally after getting new orthotics), the PT I had been seeing diagnosed it at patellofmoral pain and started looking for classic weakness issues. I have fairly large VMOs and so she didn&#039;t think it was an issue of VMO strength, and although my hamstrings are tight like most runners, she was actually more concerned about my IT band which she felt was particularly tight. She was also concerned that I had potential &quot;relative&quot; weakness in my gluteus medius muscle on my left side, which she felt may have contributed to instability in my hips, upper legs, and knees.

After a couple months of working on loosening my IT band with rollers and better stretches, and strengthening my glutes with sideways band walking, etc... the pain never really went away.

I finally decided to switch to a new PT, who did a detailed running gait analysis. Including slow motion video frame by frame analysis. After doing a battery of functional tests, and watching my video several times in slow motion the new PT announced &quot;You&#039;re sagittal plane is picture/textbook perfect, I&#039;ve never seen such perfectly tracking ankles, knees, and hips.&quot;

Wow! Great News... so why the pain!

Upon examining the side view of my running gait, we saw an immediate and glaring problem. I was over striding and landing full force with a straight leg on my heels. He felt this basic (and fundamental) problem explained almost all of my running injuries: calcaneal stress fractures (or possibly just deep bone bruises), knee pain, and hip pain.

Since I was only 5 weeks away from my last marathon when we did this analysis, he didn&#039;t want to radically alter my running style. We worked on increasing my cadence to 180+ where my current cadence was more like 155.

Anyway, my observation would be that knee pain would seem to be a classic indicator of some problem elsewhere in the &quot;running system&quot;, and that unfortunately many practitioners are quick to attribute the pain to the most common cause, when more detailed analysis my identify the real source and prevent further needless injury and incorrect and useless rehabilitation.</description>
		<content:encoded><![CDATA[<p>Gary,</p>
<p>Here&#8217;s some more feedback on this topic. Mid last year I was having knee pain (coincidentally after getting new orthotics), the PT I had been seeing diagnosed it at patellofmoral pain and started looking for classic weakness issues. I have fairly large VMOs and so she didn&#8217;t think it was an issue of VMO strength, and although my hamstrings are tight like most runners, she was actually more concerned about my IT band which she felt was particularly tight. She was also concerned that I had potential &#8220;relative&#8221; weakness in my gluteus medius muscle on my left side, which she felt may have contributed to instability in my hips, upper legs, and knees.</p>
<p>After a couple months of working on loosening my IT band with rollers and better stretches, and strengthening my glutes with sideways band walking, etc&#8230; the pain never really went away.</p>
<p>I finally decided to switch to a new PT, who did a detailed running gait analysis. Including slow motion video frame by frame analysis. After doing a battery of functional tests, and watching my video several times in slow motion the new PT announced &#8220;You&#8217;re sagittal plane is picture/textbook perfect, I&#8217;ve never seen such perfectly tracking ankles, knees, and hips.&#8221;</p>
<p>Wow! Great News&#8230; so why the pain!</p>
<p>Upon examining the side view of my running gait, we saw an immediate and glaring problem. I was over striding and landing full force with a straight leg on my heels. He felt this basic (and fundamental) problem explained almost all of my running injuries: calcaneal stress fractures (or possibly just deep bone bruises), knee pain, and hip pain.</p>
<p>Since I was only 5 weeks away from my last marathon when we did this analysis, he didn&#8217;t want to radically alter my running style. We worked on increasing my cadence to 180+ where my current cadence was more like 155.</p>
<p>Anyway, my observation would be that knee pain would seem to be a classic indicator of some problem elsewhere in the &#8220;running system&#8221;, and that unfortunately many practitioners are quick to attribute the pain to the most common cause, when more detailed analysis my identify the real source and prevent further needless injury and incorrect and useless rehabilitation.</p>
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		<title>By: garyd</title>
		<link>http://www.endurancebasecamp.com/hip-strength-in-females-and-patellofemoral-pain/comment-page-1/#comment-109</link>
		<dc:creator>garyd</dc:creator>
		<pubDate>Tue, 22 Jan 2008 02:31:37 +0000</pubDate>
		<guid isPermaLink="false">tag:blogger.com,1999:blog-19485558.post-1120751487412063207#comment-109</guid>
		<description>kate. I&#039;m not sure if you read the other articles or not but they addressesed the issue of other weakness issues associated with patellofemoral pain. To sum them up, VMO strength (inner quad) is important along with hamstring flexibility.  The idea of the abduction weakness has just been very prevelant in my observations lately.  And I personally don&#039;t beleive that a set on the adduction/abduction machine is the best method to address that issue in runners.  I&#039;m trying to put some things together to share how I feel would be the best way to address it.  Hopefully I can share more soon.</description>
		<content:encoded><![CDATA[<p>kate. I&#8217;m not sure if you read the other articles or not but they addressesed the issue of other weakness issues associated with patellofemoral pain. To sum them up, VMO strength (inner quad) is important along with hamstring flexibility.  The idea of the abduction weakness has just been very prevelant in my observations lately.  And I personally don&#8217;t beleive that a set on the adduction/abduction machine is the best method to address that issue in runners.  I&#8217;m trying to put some things together to share how I feel would be the best way to address it.  Hopefully I can share more soon.</p>
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		<title>By: Kate</title>
		<link>http://www.endurancebasecamp.com/hip-strength-in-females-and-patellofemoral-pain/comment-page-1/#comment-108</link>
		<dc:creator>Kate</dc:creator>
		<pubDate>Mon, 21 Jan 2008 20:48:25 +0000</pubDate>
		<guid isPermaLink="false">tag:blogger.com,1999:blog-19485558.post-1120751487412063207#comment-108</guid>
		<description>I used to think that runners knee was for beginners too. Having never had it happen to me when I started out, I thought I was out of the range of it. Now, having run for 6 years, it has hit me a few times.
Overall, I know I need to strength train my entire leg (hips and all) to help this issue and work on my form. Thanks for posting all of your thoughts on these articles!</description>
		<content:encoded><![CDATA[<p>I used to think that runners knee was for beginners too. Having never had it happen to me when I started out, I thought I was out of the range of it. Now, having run for 6 years, it has hit me a few times.<br />
Overall, I know I need to strength train my entire leg (hips and all) to help this issue and work on my form. Thanks for posting all of your thoughts on these articles!</p>
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