The popularity of running continues to increase as alternative forms (trail running, orienteering) complement the traditional sports, track events, road races and triathlons. The physical and psychological benefits are unquestioned and are only challenged by the possibility of injury.
Running Injuries are a great example of the Applied Functional Science principle of Chain Reaction. The spectrum of running injuries is substantial, ranging from the expected repetitive trauma problems in the lower extremities to the less obvious neck and upper back dysfunction. The Chain Reaction Principle not only gives insight into the wide array of possible injuries; but more importantly explains why the “cause” of the pain and discomfort may be found very far anatomically from the symptoms. If interventions are directed only at the symptoms, without discovering the cause, then it is likely that those symptoms will return upon full resumption of running.
To facilitate our understanding, plantar fasciitis will be used as the example. Plantar fasciitis is an injury that most commonly occurs when the attachment of the fascial tissue on the bottom of the foot gradually pulls away from the calcaneus. Without going into detail, the symptoms are usually pain upon rising in the morning that recedes as activity ensues. Whenever the foot is non-weightbearing for any period of time, the tissues recoil only to be stretched and symptom-producing again when activity resumes.
In the majority of cases (not all), the plantar fascia experiences undue stress when the subtalar joint position is too pronated to stabilize the mid-tarsal joint. So when looking for the cause, a movement practitioner (acting as a biomechanical detective) must determine if there is asymptomatic dysfunction elsewhere that is causing the foot to be hypermobile during the propulsive phase of running. Many practitioners are able to identify a tight calf muscle group in the same leg as causing abnormal pronation leading to an “unlocked” foot and plantar fasciitis. Some also recognize dysfunction in the hip as a potential cause as Gary Gray wrote over 30 years ago. Identifying and eliminating the dysfunction can lead to permanent resolution of symptoms.
The Functional Approach to Running Injuries
Because human movement is a “chain reaction”, the biomechanical cause may be much further from the painful foot than might be expected. A common cause for plantar fasciitis in the right foot is tightness in the hip flexor muscles, adductor muscles, or calf muscles of the left leg! Muscles that are either structurally or neurologically “tight” limit joint motion. That limited joint motion reduces the ability of the muscles to load and will ultimately inhibit the explode (propulsion of the leg). With poor propulsion, the pelvis will not rotate as far and as fast as it should. The lack of momentum of the pelvis will reduce the top-down chain reaction and make it difficult to decelerate and transform the foot pronation, leaving the foot “unlocked”.
This loss of the “top-down” chain reaction might also be caused by weak core muscles and limited thoracic spine motion. If the abdominals are unable to stabilize the pelvis, either because of weakness, fatigue, or lack of activation produced by the thoracic spine stiffness, then the foot may remain too mobile during propulsion leading to repetitive trauma to the plantar fascia.
Searching for the causes of plantar fasciitis and all running injuries requires a system of assessment that utilizes the global movements found in 3D MAPS. When global movements are complemented by running specific movements executed in upright stance, the cause(s) of the tissue trauma can be identified.
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