The Running Channel and Kiprun have teamed up to provide expert Run Clinics. Run Clinic 3 focused on Injury Prevention for runners with Matt Bergin, Chartered Physiotherapist, running injury specialist and international runner. In Matt’s Run Clinic he covered his approach to working with athletes, and the sort of assessments he’ll work through with them.
How Are The Biomechanics?
A runner’s biomechanics are the leading cause of long-term injuries and niggles
Simple assessments can highlight areas of potential overload due to the way we move, absorb and transfer loads when running
What Do We Look For?
This is not an exhaustive list of our assessments but forms the basis of things we look for:
Foot strike
Impact control
Foot / knee alignment
Pelvic control
Trunk and pelvic rotation / counter-rotation
Stride length
The Process
History of the issue(s) – examples:
Area(s) of pain, stiffness, or tightnessAggravating factors (uphill, downhill, speed, distance etc.)
Is there a pattern (worse at the start and gets easier)
24-hour pattern (e.g., stiffness first thing in the morning)
Patterns of movement
Video gait analysis – the gold standard
Screening – strength (capacity) & movement control tests
Strengthen the weak areas (e.g., calf raises for calf weakness)
Neuromuscular control exercises – develops our brain-muscle coordination during specific dynamic movements (i.e., running)
Movement control exercises e.g., step ups or walking lunges
Running drills
Movement Screening / Control
Simple self-tests to screen for patterns of movement and potential areas of overload.
Three tests I use to test for movement patterns in runners:
Single leg squat (or lateral step down on box)
Forward lunge
Single leg hop
Capacity Screening
Capacity tests assess the strength of certain muscles, or muscle groups, that are susceptible to overload and potential injury in runners.
Single leg calf raise
Glute side plank
What Are We Looking For? – Movement Screening
SINGLE LEG SQUAT
15 reps with good control, range, and foot-knee-hip alignment.
Key pointers check-list:
Alignment of foot-knee-hip
Foot and ankle
Stable arch, no excessive collapsing in
Ankle range – knee over toes
Knee
Aligned over 3rd toe, no excessive twisting inwards.
Pelvis
Level pelvis, no dropping
Trunk
No excessive arching through the lower back
No excessive arm movement
No trunk lean (side-to-side or backwards/forwards)
FORWARD LUNGE
15 reps with good foot-knee-hip-trunk control.
Key pointers check-list:
Alignment of foot-knee-hip
Front foot stability
Pointing forwards
Foot control – no excessive collapse
Ankle range – no heel lift
Back foot control
Pointing forwards, on ball of foot, no turn-out
Trunk control
No forward or sidewards lean
No excessive arching of lower back
SINGLE LEG HOP
10-15 reps – good foot and ankle control on landing, forefoot hopping, light on feet.
Key pointers check-list:
Alignment of foot-knee-hip
Foot and ankle
Stable arch, well controlled landing
Light on feet, no heavy landing on heel
Pelvis
Level pelvis, no dropping
No excessive tipping forwards and arching through the lower back
Trunk
No trunk lean (side-to-side or backwards/forwards)
No excessive arm movement
What Are We Looking For? – Capacity Screening
SINGLE LEG CALF RAISE
Instructions: Stand facing a wall, using only the fingertips for balance.
Standing on one leg raise all the way up onto tip toes, working the full range. Then lower your heel to the ground. Repeat this movement raising up and down on the forefoot, ensuring the knee remains straight throughout (there is also a bent knee variation, but this is a different test).
Maintain a pace of 1 second up, 1 second down. Use a metronome (60s) to help with this.
Do NOT bounce off the heel on landing and try to roll evenly through the foot as you raise up, rather than rolling onto the outside of your foot.
Key pointers check-list:
Foot and ankle
Full range up onto tip toes
Rolling through 1-2nd toes, not rolling outwards
Control on landing
Good arch stability on landing
Pace
One second up, one second down
Gold > 30 reps
Silver 20-25 reps
Bronze < 20 reps
GLUTEUS MEDIUS SIDE PLANK
Instructions: Lay on your side, with the bottom knee bent and the top leg out straight. Place your elbow underneath you shoulder and lean on your forearm. Push through your bottom leg and forearm to lift your waist off the ground, whilst keeping the top leg out straight and level with your body. Hold this position.
Ensure you do NOT roll the pelvis backwards and you do not start to sag at the waist. Also make sure you do not kick the top leg forwards.
Gold > 60 secs
Silver 30-45 secs
Bronze < 30 secs
Scenarios for strength weaknesses/imbalance
#1 – Pelvic drop & trunk lean on single leg squat
Strengthening:
Gluteal side plank – 20-60s, 3 sets OR 6 reps (5s hold) 3 sets
Movement Control:
Step up (30cm box) – 12-15 reps, 3 sets
Running Drills:
Walking lunge +/- single arm weighted – 10m, 3 sets
A-walk – 15 reps, 2-3 sets
#2 – Single leg calf raise < 15 reps and lack of range performing raise.
Strengthening:
Single leg heel raise, body weight – 15-20 reps, 3 sets
Inner range hold – raise on two, hold on one, 5-10 sec hold, 6-8 reps, 3 sets
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