Return To Running 101 (every runner’s master guide) || WBWL Ep 104

This will be the most detailed episode that caters to injured runners, former runners who want to return to running, or any recreational runner looking to optimize their running economy long term.

I dive into:

• Why running is important for humans in general for longevity sake
• How you can return to running safely through mechanical stress quantification (video explanation here: https://youtu.be/BUJpvs0Rkwc)
• What I look for when I'm evaluating running form with online or in person clients (go here to book a free consultation: https://go.flexwithdoctorjay.com/apply)
• Proper shoe wear that is right for you with running.
• What are proper strength & mobility principles to ensure minimal to no setbacks with return to running

My free gift is a gold mine of information to those wanting to return to running or run without injury. Head to https://flexwithdoctorjay.online/runners-ebook for your free downloadable ebook and pdf!

Please share, subscribe, follow, and if possibly leave a 5 star review. I’d greatly appreciate it!

Transcript

0:07

Welcome back guys. I'm Dr. Jason Won, orthopedic physical therapist, and today I wanted to talk about returning to running 1 0 1. So if you are somebody that is interested in running or if you're somebody that was a previous runner and wants to return to running, but maybe you're uncertain of how to get there, you're maybe fearful of maybe injuring yourself. So maybe you're of later age, like 30 plus. I wanna share with you a lot of different strategies and principles that you can use in order to return to running safely. Now, why should you listen to me? Because eight years. I've been eight years as a certified running trainer from the running clinic.com. I'll leave the description of the running clinic.com because there's a number of different resources like returning to running training plans that are absolutely free on A PDF. There's a running shoe database, there's a minimalist index, and there's a lot of research based articles and even beginner's strength training that you can utilize from the website. Go to the running clinic.com and you can access a number of resources there. And so I want this to be probably the most detailed and comprehensive. Episode on how you can return to running safely. And I, myself, at age 36, I'm still running, I'm still sprinting. I used to deal with a lot of other chronic knee issues from stemming from either over training or wearing the wrong shoe wear. I've also had a number of different Achilles issues in the past. And so for me considering that I do strength training, I still do a mixture of running basketball, I wanna share with you strategies that I use even to prevent ru prevent running injuries from happening too. So where we'll start off first is this we're going to start off with, first of all. Going through why running is important for humans in general. The second thing we'll do is we will teach you how you can return to running safely through a principle called mechanical stress quantification. We'll also look at what I look for when I'm working with somebody, either online or in person, and how I evaluate their running form. So I actually get them on a treadmill and film them. And actually, I'll tell you the step-by-step things that I look for. I'll also talk to you about proper shoe wear that is correct for you in terms of running, because not all running shoes are created equal. Clearly there are different features and different benefits. There's also pros and cons to different types of shoewear, so I'm gonna go into that as well. I am also gonna go into what are the proper strength and mobility principles to ensure minimal to no setbacks when it comes to you returning to running. And the last thing I wanna share right now is a free gift to you. So the free gift, I'm not gonna wait till the end. I want to give it to you right away. But I actually have my own book on injury prevention for runners. So if you are somebody that is truly interested in a detailed ebook, a free PDF that you can utilize right now, actually wrote an ebook months ago when I did a couple running workshops in San Francisco. So if you're interested in downloading that, go to flex with Dr. J online slash runners ebook again, flex with Dr. J online slash runners. Dash ebook. I'll leave a description in the in the episode here, and you can download that absolutely free. Either share it with a friend that wants to return to running, if you're gonna have an accountability buddy, or if you just want to utilize it for your own purposes. Okay, so with all that said, let's talk about why is running important for humans. So just to break down, walking and running, there is always two phases. There is a stance phase and there's also an air phase. So there's a phase where one leg or both legs are up in the air. When we are walking, it's always gonna be one leg down on the ground. However, when we're running, it's a mixture of single leg hopping. Okay, now single leg hopping is, there's always gonna be this phase where our body is completely suspended in the air, and there's also gonna be a phase where there's always one foot on the ground. Okay? Now these two phases are gonna switch a little bit, right? So when we are walking, our feet are not moving as fast. So it's usually going to be about 80% stance phase and about 20% on the air phase. However, it switches when it comes to running, there is more of a 60 to 40 ratio where 60% of the time we're spent in the air and at 40% were spent on a single leg. And this depends on your cadence, how fast you move how strong you are, how fast you can get up off the floor. So those are gonna be important principles that we talk about. But in terms of running, there is an air phase and a stance phase. Now running is very important for humans'cause I perceive it like this. I'm gonna talk to you about a relative more just. Conscious way of thinking of it when we're runners if you can run and you have the capacity to run, you should run. And the reason why is because humans are born to run. And however, society nowadays is that most of us spend a lot of time working on our career and our finances. We're all very career driven and we all spend a lot of time at the computer now. So a lot of us start to lose the ability to run or even sprint at a much earlier age relative to previous decades. But if you have the ability to run, you want to be able to do so because running is a faster mode of transportation. And also, if you can always run, you'll always have the ability to walk, which seems like common sense. But if you can run in life, then you'll new, you'll never lose the ability to walk. So if I can run into my nineties. I can always walk in my nineties. Some people lose the ability to walk, into later ages too. So if you have the capacity and you have the strategies on how to continue to run into later ages, you should, I. Because if you can always improve and maintain a sense of velocity and speed research does actually show that you decrease your risk for falls. I say this to a lot of my clients that are interested in running all the time, is that the average time it takes to walk across the street is 2.2 miles per hour. So if it's 2.2 miles per hour that's the average time it takes to cross the street. Guess what happens when you start to walk slower than 2.2 miles per hour? One, you might not be able to get from one block to the other safely, and it might be a red light by the time that you but by the time you get close to across the street, and also if you do start to walk slower than 2.2 miles per hour, you increase your risk for falling by 400% by fourfold. And that's a crazy statistic. So if you are increasing your risk. A falling by four folds, that means that your balance is not as good as it once was. And also guess what happens in your later age. When you do increase your risk for falls, you also increase your risk for fractures, namely hip fractures. And if you sustain a hip fracture basically your life expectancy after a hip fracture is about five years statistically. So why? It's like there's a cascade of events as a result of not deciding to run. Or let's say in your thirties and forties, you're somebody that's in your thirties and forties, maybe you gave up running because too stressful on the knees, too stressful on the hips, Achilles, et cetera. And I honestly think it's you just tossed it up as a loss. Nobody really taught you how to continue to run or work through it. And so you just gave it up. But I encourage you to think that based on this episode running 1 0 1 or Injury Prevention 1 0 1, how to return to running is that you hopefully will find some motivation and even the right strategies and how to return to running safely. Okay? So that's the really important reasons why also running has been shown to improve your mitochondrial density, your VO two max, your respiratory preserve. So it keeps your lungs healthy, your heart's healthy. Cardiovascular activity, when done five to six times a week for at least 30 to 60 minutes you actually decrease. All cause mortality by about 30 to 35%. And this is statistics, so maybe about 20 to 35%. But from the research, if you increase your VL two max, if you actually continue to run through life, you're not just gonna improve your lower leg density. So that's another benefit, is actually maintaining proper bone density to the entire system as a whole, but specifically your legs. So that's really another important aspect of running. But also, like I said, you decrease your risk of dying of anything by about 20 to 35% by keeping your cardiovascular capacity up, and that's keeping your brain as well as your heart as well as your lungs healthy. Okay, so hopefully I've highlighted a lot of the benefits of running and why you should consider running because I see this all the time where people are like, what do you do for exercise? I walk and I always say that walking one is not stimulating enough to build strength and to maintain muscle mass. That's one. But also walking is a very low intensity and not challenging the heart and lungs to the capacity that you need. All in all the, your heart, your cardiac C, your cardiac output will decrease over time. Your lung capacity will decrease over, over time. Your respiratory reserve and the ability to breathe through any strenuous exercise will also decrease over time. So that's why I always find that. I think amongst the many cardiovascular exercise out there, running to me is actually the most beneficial because of bone density increase, because of the demands on the heart and everything. And I do find, yes, there's elliptical, there's biking, and a lot of stuff. A lot of those are, less stressful on the entire skeletal system. So I like things that stress my system so that my skeleton stays strong. And also I think about a lot of these other more modified versions of running like elliptical, it's just not going to challenge the body as much. I understand that if you have a lot of pain in your knees or your hips or your lower back, and the doctor said, stop doing more intense activities on the system like running or they, you may be even told that running is bad for your knees, your lower back. I beg to differ, right? This is very old school way of thinking where doctors are trying to play it safe. They're trying to not stress the system at all. A lot of doctors, they don't know, how to rehab somebody properly, so they'll just play it safe. They'll give you something overly conservative if your knees hurt with running, just stop running. Just go to biking or go to elliptical or just walk. And it's unfortunate that a lot of our society succumbs to. I guess expertise when these are not experts, right? These are just people that have general knowledge about musculoskeletal system, about exercise, fitness, cardiovascular activity, and weight training. So if you know that's part of what we're gonna talk about is like if you do weight train, you will build the muscular capacity in order to run. Okay? So hopefully I'm hitting on the right notes on like the indications for why you should run. Okay? So let's talk about now part two, which is how you can return to running safely through something called mechanical stress quantification. Okay? So mechanical stress quantification, and maybe I'll link a graph or I'll link a YouTube video from the running clinic.com. Mechanical stress quantification in a very lay term is basically stressing the body enough through running where it does have positive adaptations, but not stressing it so much that it leads to an injury. Okay, so if I were to pull up this graph here, there is a graph in which basically on the on the x axis is like the amount of like steps, okay? The amount of steps or even the distance or the time. So you're quantifying the amount of stress to the body. And then on the y axis is basically the amount of force output or like the amount of stress on the skeletal system, right? So basically the longer you run, the more stress in the system. The faster you run, the more stress on the system, right? So those are all the on the xxi, which is that quantification. And then, so basically what we're thinking about is there is this window of adaptation, right? We call it like the ZOA, I call it like the zone of adaptation. So the zone of adaptation is anything under the line. There's two lines for the zone of adaptation, the top line. Is your capacity, right? So your capacity is the amount that any given structure in your body can tolerate. Okay? So for example, a battery a battery on an average phone is 4,000 milliamps, right? So that's the battery capacity. And so if we're thinking about an injured area that you're trying to resolve and you want to return to running, so let's say it's your right knee. Your right knee has a specific capacity for load, and that would be the top line of your zone of adaptation. And so if you surpass that line, then you could incr. So basically if you surpass that capacity, then that area might hurt or that area might become symptomatic. So for example, if you're going from no running at all and you decide to run a mile right now how does your body respond after not running for years? You may flare something up, right? So you might surpass. That top line, which is the capacity for your right knee. And the right knee might get inflamed, you might develop tendonitis. And so this is the most common thing. The be. The thing that you should understand is that when it comes to like injuries is specifically with running, is it because of poor genetics? Is it because of your shoe wear? So this is the thing I want you to understand and write this down. 90% of all running injuries come from over training. Over training in the form of increasing speed too fast, increasing distance too fast. It's training too frequently when you weren't ready for it. It's the improper shoe wear. Maybe it's cha an acute change in shoe wear. It's basically any training variable that you change too quickly, too soon can basically surpass will enable. The chances of you getting injured by surpassing that capacity line that we talked about. Like I said, zone of adaptation, we talked about that first top line, which is your capacity line. So if you run a mile and you're not ready for it you increase the chances of injuring that knee or straining that knee or causing some sort of inflammatory response. Okay? Now the line below the capacity line, so there's always like a little distance between the lines. And again, that yxi is the total amount of mechanical stress, right? That's what we call mechanical stress quantification. MSQ. Now that bottom line is the minimal dose response. Okay? MDR. Okay, so the minimal dose response is basically saying that you need to run a certain amount or you need to increase some sort of variable, a certain amount. In order for you to either expand the zone of adaptation, so basically allowing you to have a wider range of variables that in which you can train properly and running. But the most important thing when it comes to getting that minimal dose response, you need to let's say, just start with jogging for one minute. Really lightly, right? A lot of people at the age of 30 to 50 have the ability to jog maybe lightly for one minute, even if it's just like trotting, you're barely even getting off the floor, right? Sometimes I'll just start off with the interval training. One minute run, one minute walk, one minute run, one minute walk. So that bottom line is the minimal dose response. And your job, especially when it, when you're back on a running training plan or a return to running protocol, is you need to get between the minimal dose response and also that capacity line. So if you surpass. The first bottom line, which is the minimal dose response, then what you're gonna do with that capacity line is the capacity line's going to increase, and you want to increase that capacity line as much as humanly possible. So then you'll be able to tolerate longer distances, more speed, and again, increase the intensity, the volume, the amount of time that you can run, which is gonna improve all the other cardiovascular benefits, bone density benefits that I talked about in the beginning. Okay? So that's your zone of adaptation, okay? Which basically is your minimal dose response as well as your capacity line. Okay? So when it comes to returning to running, that is the zone that you want to hit, that zone of adaptation. Now this is talking about principles of how it's to return to running. Now how do we actually quantify that? Now you can either download apps like Strava, S-T-R-A-V-A, you can also download Garmin. If you have a Garmin watch, you can also simply just have some sort of like spreadsheet or even a piece of paper. The variables that I would think about are, again, you're talking about frequency. How often per week do you run? You're also talking about the distance or the time, right? So sometimes you don't take both variables because everybody runs at different speeds. So you would start off with definitely the frequency. So frequency for beginners or return to runners. Usually I'm thinking sometimes around two to three days per week. I. And it depends on your capacity currently. So some people can tolerate four to five immediately, but to be safe and conservative, you'll start off with about two to three days a week of running. The second thing you want to think about is choosing distance or time. And this is variable depending on the client. So a lot of time I'll usually go based on time.'cause time is the easier thing. It's like you can actually set a watch on your phone and actually go for a run outdoors or indoors. So safe variables that I would always go for are either 30 to 62nd runs, followed by one minute walk. And this is what we call running intervals because what we wanna do is we wanna stress the entire lower body system. Through the means of running at a certain speed. And then because we don't wanna run consecutively too long, too soon, because that might lead to strain of tendons, tendonitis, et cetera. You want to give that break, especially to the heart, but especially to the lower body system, you don't wanna overstress your joints, ligaments, and tendons too quickly. So usually I'll have these running intervals where 30 to 62nd run, followed by a one minute walk, and you can repeat that anywhere between four to five times on your first run, and it can slowly increase the amount of running intervals. So if you do one minute run. One minute walk, and you do that five times. That's five minute run, five minute walk, that's a total of 10 minutes of walking, running. And then you can increase that duration by way of adding more intervals. So you add, let's say five to six intervals, then maybe you get up to at least 10 to 12 intervals. So 10 to 12 intervals is 10 minute of running, and then it's also 10 to 12 minutes of walking as well. So that's a very safe way to return to running. And then what do you do from there? Once you hit, a sensitive point of maybe 10 to 12 minutes of run walk interval. Then you can start to increase the running interval. So that increase in the run interval means that instead of 30 to 62nd run, you're going to go 60 to 90 seconds, or 60 to 120 seconds, up to the point where then you're adding on two minutes of run, three minutes of run, four minutes of run, and usually the walking interval that would stay the same. So eventually it'll be just one minute walk still, but eventually you might either one completely wean off a walking, so then it becomes, it's not intervals anymore, it's simply just running. Okay. So that's again, a very safe way to do it. Again, there's Strava, there's Garmin. I like to use spreadsheets and I also like to use just docs where basically the, let's say the columns would be the date that you run. That's one. It's the the protocol that you're run. So that'd be like one minute run, one minute walk, timed four to five. Okay. I also wanna log like some notes. So notes are symptoms, like what you felt during the run, run what you felt after. So that way you have a gauge of like. How much you can tolerate, it's your subjective response. So oh, this was a five outta 10 strenuous activity. It wasn't a 10 outta 10 and my knee was mildly sore, but it wasn't too bad and I want see how I respond the next day. So these types of notes and logging of symptoms is also very important when it comes to returning to running. I like to stay as objective as possible, especially when I'm working with clients. So the objective points are all the numbers of the frequency, the time, how fast you run. All those numbers speak more volume to me than somebody that just, I. Runs and they're just like, I thought it was hard. That's a surefire way of potentially flaring yourself up and demoting your shirt, demotivating yourself from running. You want to have numbers and you wanna log those numbers. Okay? But still you want a journal, a reflection of like how the run felt during neither before or after or during. Okay. So hopefully I've hit the nose on, how you can return to running safely through spreadsheets and Google logging through apps as well. But also understanding the principle of mechanical stress quantification. If you want more insight on what that kind of looks like, I know I'm explaining it through just verbiage. But if you want I can also plug in a YouTube video. It's a pretty quick three minute video, and I'll link that in description as well. Okay, so let's go into part three. Part three is what I look for when I'm evaluating running form. So when I started my business back in 2019, I was strictly just doing more in-person things. So in-person, I was either weight training, I was doing a mixture evaluating stuff, but also, again, I was a certified running trainer. So a few of my clients in San Francisco were indeed runners that were either injured. So I was helping them recover from injuries or there was somebody that wanted to improve their overall fitness, so therefore, it was something, it was teaching them how to return to running after they haven't ran for months or years. Okay. But nonetheless, the principles are the same. When I'm working with people in person, I was looking at people on a treadmill at a gym that I rented out of. So I was filming people about 10 to 15 seconds from a side view, if I could get to the front view, I wanted to see the front view as well. But, sometimes treadmills are fixated to a mirror or something in front of you. So at minimum it was always a side view running. For 10 to 15 seconds and I would film it and I would also do 10 to 15 seconds from a posterior view. So the back view, because those are the two most important views I wanna see when it comes to looking at things like stride length and looking at hip symmetry and seeing, if the knees cave in or seeing if the foot crosses the midline or seeing how much vertical translation there is in relation to horizontal translation. So those are a lot of variables that I look at. I don't want to get you confused with all the little small things that I just talked to you about. So there's a principle I say that's called like rocks, pebbles, and sand. When it comes to running and returning to running the rocks, which are larger boulders. Those are the more the most important variables in order to teach somebody how to run optimally. Okay. Then you have your pebbles and you have your sand. The sand is like looking at really small angulations of like how the foot do reflexes and hits the floor. What is the exact angle at which the knee hits the floor? What is the exact angles of all these different things? What, how much hip drop is there? Does the pelvis stay neutral or does the pelvis drop to one side? What is the exact angles? Those are all pebbles and sand. So those are way too complex for this episode today. And those are small nuance things that I would look at if I needed to. So even as somebody that's been training runners and returning runners safely for over eight to 10 years now. I can definitely say that when I was a younger physical therapist, I was looking at all the nuanced angles and stuff, and I was really looking at the pebbles in sand, but I really wasn't solving for the rocks, which are the bigger boulders that will allow you to that will allow you to succeed when it comes to returning to running. Okay. So I want to talk strictly about the rocks, which are the most important variables, and it comes down to three things. Okay? And I'm gonna share with you those three things now. I'm now currently also training people online as well. So a lot of clients, they'll film themselves from a 10 to 15 second view from a lateral view as a posterior view. So if you're interested in getting your running evaluated or if you're looking to get onto any programs I'll leave a link description go ahead and send in the application. I'll also book a free consultation with me so that way we can see if I can build you a roadmap and see how I can help you specifically with your running endeavors. Okay? Here are the things. So the very first thing I would look at is something called cadence. Okay? That is the very first rock. The very first thing when I'm looking at running from either a side view or a postier view is called cadence. Cadence by definition is how many beats per minute, right? So there's cadence in music, but there's also cadence when it comes to how many times the foot hits the floor. Per minute. Okay. So I would call it steps per minute. So the steps per minute is something that's very important. I'll explain why. So if you're somebody that, let's say you're, you're, maybe you're heavy set or maybe you're not that strong. So your feet, each foot, especially when you're in that single leg stance phase, let's say your foot spends much more time on the ground. Per minute. What research shows is that the longer that you spend time on the ground, that increases your chances for injuring something in running. And that kind of makes sense, right? Because if, let's say you're super fast like Usain Bolt, you know your feet are barely on the floor for a millisecond, right? People that can get their feet off the floor faster are the ones that have better running economy. They're more efficient with running. They usually have a higher cadence, so more steps in a minute. And also they spend more time in the air. And that's a great thing because then they're focused more on horizontal translation and they're usually faster. Their mild time has decreased. However, if you think about, again, spending more time in that single leg stance phase, each foot, and I didn't say I should have said this in the beginning, but each time your foot hits the floor. That increases your stress directly to that limb by 300 to 500%. That's amazing. So that increases your body weight or the stress to that specific limb by 300 to 500%. No wonder people get injured all the time because whether they're cadence is really slow or whether they're spending a lot more time on the ground and we want them to get faster but let's say their tendons aren't ready for it, that will increase the stress. And so basically you look at the amount of time, so the amount of time that you're on the floor increases the stress to that limb. Okay. But also the cadence as well. So if your cadence is slow, then you are spending more time on the ground as well. Okay. So the average American, or even the average person that runs especially they, I think they say the average American by research runs at about 145 to about 1 55 steps in a minute. Okay, so 1 45 to 1 55 steps in a minute. That is how many steps they get in. So basically, if your cadence is slow, that is how many steps you get in a minute. That basically means that you're spending a lot more time either on the ground, okay. Or you're somebody that kind of focuses a lot on, like hopping up and down. So that up and down movement is preventing you from actually running forward. And so the more up and down movement that you have, and I'm sure you've seen runners that you, they really see them run up and down almost like Baywatch or let's say you see especially with women that you see their ponytail really goes up and down, rather than kinda like swinging side to side. Usually that increases again that mechanical stress to each individual limb. By, maybe not the minimal, which is 300%, but it may increase the stress to that, lower that limb system by about 500%. And that increases the propensity for injury. So if you are somebody that is serious about returning to running, I always look for evaluating it. I would have somebody usually run and force the cadence right from the get go. That is a rock that we wanna solve right from the first session. So usually I'll have an app on my phone where I'm measuring the amount of steps that are getting in a minute, a k, a cadence. And if I see that they fall between 1 45, 1 55, and sometimes you give'em one 60, which I consider a little slow, what I'll force them to do is I'll have them run at a faster cadence. Now, you cannot just tell somebody to just run faster, okay? Especially if you're outdoors. You can't just say get in more steps in a minute, because usually they'll make the mistake of trying to get more steps in a minute, but then they'll still, then they'll actually run faster. So they're running five miles an hour and you're like, I want to get more steps in. In a minute, you'll tell them they'll move their feet faster, but in turn they're no longer running at five miles per hour. They'll start to run at six to seven miles an hour, and that doesn't increase the cadence at all. That just increases the speed, and that's a no-no, because that's just going to, that's just gonna promote more chances of injury, right? Increasing speed is increasing the mechanical stress of the system. So I love to train clients and I love to only evaluate clients strictly on a treadmill because if, let's say they're getting in they're running five miles per hour, but also they're only getting in 155 steps in a minute. I can keep them at the same speed by way of the treadmill. Clocks them only at five miles per hour. But I can actually run like an app called a metronome where I can actually say this is what 1 55 sounds right? And I'll play the beat and the metronome will play the beat at 155. And I'll say, Hey, now I want you to run at this specific cadence. And this specific cadence is 1 65. So usually they'll hear the beat click, right? And they'll be like, oh. So that's what it sounds like. I'll let them listen to it for a bit, and then I'll have them train to it, right? So while they're running, I'll tell them, use your arms and move your arms to the beat. Of this specific metronome, right? Which is, let's say you're increasing the cadence by 10. So I want you to run at 1 65 and maybe we'll adapt to 1 75 to 180 5.'cause by research as well, is that the best endurance runners, their cadence is at least 1 75 to one 90. And then definitely with, especially with sprinters, that cadence is much higher. Okay. So with regards to that is the very first rock that you wanna fulfill because like I said, just to recap things, is a slow cadence will increase stress to each individual limb by 400 to 500%. You're gonna spend a lot more time on the ground. You're gonna also, you potentially might see these people that are more like kangaroos. They tend to jump up and down rather than focusing on running forward. And that also leads to something called overriding as well, when you do have a slower cadence. And so that, that foot basically that foot. That lands on the floor, that foot is landing in front of their center of gravity. And so when that heel or that toe lands too far forward in front of the center of gravity, so think about like your whole entire, like your head all the way down to your pelvis, that's your center, that's your center of gravity is that you increase the propensity for injury by way of overriding. So a lot more stress on the knees, the hips, the lower back as well. Okay. Cadence again, first thing to adapt to if you're interested. Again, there's plenty of free metronome apps as well. I sometimes will have my clients, like if you can't listen to a beat forever while they're training is also looking at Spotify. Spotify has a lot of playlists where you can test your cadence or you can again, come to evaluate with me either online or in person. I can evaluate you and tell you exactly what to do. Spotify is really great. So I'll tell my clients, go to Spotify. If I tell them to run at a specific steps per minute there, you can actually type that into Spotify one 70 SPM or one 70 BPM. And there's a lot of playlist in which you actually run and your feet land to the beat. And sometimes that's a little bit less insane than listening to just like a, like a click click. It's instead you're actually listening to at least music. So Bluetooth headphones running on a treadmill. I always say that if you're returning to running, always do your best to run on a treadmill because that way you can mo monitor all the variables. More controllably. If you are somebody that like, can't stand running on a treadmill, that's fine. Just understand that when you're outdoors, there's variables like the type of pavement that you're on, there's different ground, and you know that the ground moves side to side. And not just that, it's a little bit harder to control your speed as well. So just take a lot of that into account when it comes to returning from writing. Okay. Let's also talk about the other rocks as well. The other rocks I wanna talk about is sound, right? So sound basically means that when I have somebody on a treadmill, I'm actually listening to the right and left leg. So I'll usually lock my eyes. Onto a specific limb, and I'll also want to hear symmetry. So I like to hear symmetry in terms of the right versus the left limb. Now which one sounds louder, right? Which one sounds softer Because usually softer is associated with potentially that limb is. Either stronger, it's a little bit more resilient, maybe you have better tensile strength in your tendons, so it's a little bit more elastic and it can get out the floor like a spring faster on that limb versus the other limb. Let's say the other limb, it's the injured limb, or that's the limb that has less overall capacity. That limb has less 10 cell strength. The Achilles isn't as spring loaded, so you might hear like more of like a clamp, like a kind of sometimes it sounds louder than the other limb. So a lot of times to correct for that though is if you do hear discrepancies in one limb versus the other, you can try to think about one, like telling them to actually soften up the landing on that side. And a lot of times they just become more acutely aware to land softer on that side. Another long-term strategy that we'll dive into a little bit further is definitely doing more strength training side, so more unilateral or like one single sided type of. Leg workouts where you know that if the louder side potentially is the weaker or less capacity side, is that by way of strength training or maybe addressing certain mobility restrictions, is that you focus a lot of your attention on that louder limb that may be that may have, that may be incurring more mechanical stress. And the other side's perfectly fine. But like I said, most people, they, people sometimes do get bilateral injuries, but especially when we're returning to running, you'll usually notice that one limb is stronger than the other has greater capacity. So focusing on that louder limb makes sense. Okay. So that is another rock to hit on the First Rock being Cadence, the Second Rock. Then being about the not necessarily foot strike. So a lot of people think that foot strike is most important, but foot strike can actually be corrected for by way of increasing cadence or sometimes also monitoring the loudness of each limb when it hits the floor. Okay, so the third one here. So the third one that I always look at is actually seeing how they run in different in different types of shoewear. And so not just shoewear. So a lot of times if somebody comes into the clinic, they're not coming in with two types of shoewear, but how I can test for whether somebody runs. At like they, they run, be more proficiently is actually having them run in the shoes that they brought into the clinic or the shoe that they're wearing, but also having them run barefoot. Okay. So I know that there's this huge viral trend that's still pretty trendy nowadays, but this has been going on for, at least since the early two thousands, is this trend towards minimalistic wear, right? Running, running in shoes that basically mimic more of the caveman days, or just. Increasing the stress to the foot and getting the foot stronger. So there's a lot of research about that, but it's not for everyone. I would say that definitely like 80, 90% of my clients definitely benefit from shoes that are like less clunky and actually less supportive. Even though a lot of podiatrists or a lot of running trainers will say, the very thing, and I honestly, I think it's like a, it's like a selling trap is telling somebody immediately that like you pronate or your foot flattened out, so therefore you're gonna need a supportive shoe, which often come be pines become more expensive, or sometimes that they over pronate you'll get them some sort of heel, heel cup or orthotics or something in order to correct for that pronation In reality. I think that's the wrong way to go about it. And I don't think this is by way of chance, like I know for certain, and I know for a fact and based on like the hundreds of runners that I've worked with, is that these types of things around like telling people that they need orthotics because of over donation or getting people into super overtly supportive and really clunky shoes, that ruins a running economy. If you think about heavy shoes, guess how your cadence is gonna be? Your cadence is gonna slow down tremendously because you're having to lift this heavy shoe off the floor. And a lot of these motion control technology shoes where it has it, it correct for let's say over pronation or let's say it has like a lot of ankle support, for example. Again, if you think about motion control technology, if you are depending on the shoe for stability or. Correcting for certain things, then you're not teaching your body intrinsically how to correct for it. So a lot of times I'll see that chronically people's foot muscles will atrophy their foot muscles will decrease in size and density. A lot of times when they're, they're in these motion control shoes, but then they decide to wear sandals, they can't tolerate walking in sandals or walking in more minimalistic wear. So there's a lot of cons to being in motion control shoes, you might feel better initially because motion control shoes they're thicker they're more bulky. So it makes your feet feel better initially. But what it will do in the long term is it will teach you improper running mechanics. It will slow down your cadence. It might make you heel strike or overstride harder. So it's going to increase the propensity to injure other areas even though maybe your Achilles or foot feels better. You might notice that in clunkier shoes, that your knees hurt more, your hips hurt more. This is exactly what happened to me. Running in shoes, like I'm not, I'm menos. And these shoes were really cl they're quite clunky. The heel was really thick, so like it protected the heel from feeling the cement. And the shoe as far as like how much it could bend, it was really the forefoot, which is the only, the toes that was the only part it can bend. But the midfoot and the hind foot, it was super stiff. So I was, I was already a pretty decent runner. And when I started running consistently, what I noticed is that I think I was overriding, I even evaluated myself and I noticed I was overriding a lot. But what I noticed that like my knees were getting extremely achy, even just sitting still, my knees would just ache for a long period of time and I had to stand up in order to relieve it. Like I said there's a lot of research to show that. More supportive motion control, heavier shoes are not going to always be for you. Okay, so going back to that third rock of shoe wear is even though maybe somebody has never ran barefoot, I want to see how their man, their running mechanics change with wearing their shoes versus wearing without. And so if somebody is what I call a positive adapter, what I'll notice is a few things. One, i'll, one, I'll notice that their cadence improves, right? If there's not a bulky shoe to weigh that foot down, then their cadence should improve. That means that if they're 1 55, you should notice immediately that they, that cadence goes up at least 10 beats per minute, if not more. So that's a pretty cool thing to see. And maybe that means that they benefit from a shoe that's less supportive with a little bit more flexibility, and that's lighter and also has less of a heel, a toe drop as well. Okay? But sometimes I'll see negative adapters, and there's not a lot of them, but somebody that, let's say they're running in shoes and I can see their foot strike their cadence and all that. And then I'll have them wear no shoes, and I'll have them do the same treadmill test at the same speed. And then I'll notice that either they get worse. Like you can hear their feet just like clamp. They sound like. Sounds like echo's hitting the floor. So they, their feet, they, it feels worse. Or let's say their cadence doesn't improve. So variables that don't improve, I might say, wow, that person doesn't necessarily benefit from a more minimalistic shoe wear. They need to focus actually more on actually the nuance things I told you about the pebbles in the sand. So I'm actually correct how they run. I might force them to increase their cadence. I might get them on a good strength and mobility plan as well. But right now I'm not gonna switch out their shoes. But if somebody adapted and their cadence and the running economy improved, I would definitely switch them. To a shoe immediately that was more minimalistic, right? And sometimes you don't have to start off with the vivos and the things that are like complete a hundred percent minimalist. There are grades of minimalism. And so that is actually in my runner's ebook that you can download. There's actually five criteria that define the percentage of minimalism. And then also there are a couple shoe databases and things that you can get directly from my ebook. And so when you click on that that database, you can actually pick the types of shoes in order to slowly adapt towards a more minimalistic wear, especially if you are a positive adapter. So again, go to flexor dr j.online/runners ebook, lead that into description. It can download that book for free. Which is essentially a lot of the stuff that I'm referring to right now. Okay. So those are my three rocks when it comes to evaluating form. Like I said, I've done hundreds of evaluations in person and then obviously there was the pandemic. The pandemic kind of forced people to be open to online work. And believe it or not, especially if I'm just filming people. Tons of clients from like the UK all over the world have benefited from getting an online running assessment from me and my team. And we're able to evaluate your foot strike, evaluate your again your, the loudness, the cadence, and all the different things. And we're also able to build you out a custom strength and mobility plan and even look at your nutrition as well. So we have pretty comprehensive plans for runners whether you are a runner returning from injury or thinking about somebody that is returning to running, especially if you're motivated by this episode in which I'm explaining the indication for why you might wanna run. Okay. So the shoe wear part is something I still want to hit on a little bit more. There are a few criteria when it comes to shoe wear. I might not go through all of them, but I want you to be acutely aware of it. It's also very much detailed in my ebook as well. Some of the things you wanna talk about is weight. So the weight of the shoe. Again, one, if one shoe is super heavy like hokas and it's weighing your foot down like an anvil, you better bet that you might start to override. It might make you a lot more cumbersome. It's gonna hurt things up above the feet. So I can't stress enough that I rarely give somebody super heavy shoes because it just absolutely ruins one of the big rocks, which is cadence. That's one is weight. Another thing is heel to toe drop. So basically the distance. So when you measure vertically with a ruler the amount of height of the heel. Minus the height of the toe. So where the toe is, so that is called a heel to toe drop. So if it's completely flat and you're completely flat to the floor, the heel is very much even with the toes, that is what we call a zero heel to toe drop. But for some people that's not always the right thing to start off with. I actually can run very well in heel-to-toe drop shoes, but it took me a while to adapt to it. I was getting a couple achilles issues and like my foot fell overly strained. But over time, over months and years, I've transitioned to shoes that are super flexible and have a straight zero to heel to toe drop. But if you're somebody that has tight Achilles cord, maybe you've had a Achilles injury, Achilles reconstruction, maybe you've torn your Achilles in the past. Maybe you've had some sort of like excessive things to the foot, like stress fractures or metatarsalgia or. Some people that maybe have halal valgus, although that wouldn't be like a clear indication, but anything in which you've had a lot of chronic foot issues, you may not start just right away with a shoe that's a hundred percent minimalist, zero heel to toe drop. You might start off with a heel toe drop that's two to four millimeters and then transition potentially to a zero later on. Okay. Another one is like lateral, like motion control technology. So the amount of technology in the shoe is also in, in is also one of the indicators of how minimalist it is. There's also how much the shoe folds. So one is called an A to P fold, where basically you take the shoe in one hand, the heel, and you take the other part the other part of the shoe with the other hand, which is the toes, and you wanna see if you could fold it into a sandwich. And so depending on how much it folds, is also a product of minimalist versus shoes that are more supportive. And then also if you take the shoe again, face the toe directly to the camera, and you ring it out like a towel, which is more like the hotdog type of like. Mechanism. So like the length side, and you twist it. That's the amount of medial to lateral torsion or amount of flexibility. So you look at A to P as well as medial to lateral torsion of the shoe, and that's what will also be an indicator of how minimalist it is. Okay. So I hopefully that gives you an indication of the minimalist. This thing is called the minimalist index. So based on these kind of factors, we'll determine how, what percentage of minimalist it is. Okay. Like I said, if you are a positive adapter and let's say we notice that your cadence improves and all that, then you may actually benefit from a shoe that's more minimalistic. Alright. Lemme take a deep breath here and if you, again, if you're finding this this information super helpful where, wherever you're listening to this, whether you're listening to the car. Spotify, Google, or you're listening to this on like Facebook, Instagram. I highly encourage you if you can, I am trying to really help a lot more people. So the algorithm kind of feeds into it. If you can, please either leave a like, subscribe, and follow. Please leave also a five star review when you can, and also leave some sort of description so that way more people can get this type of information. More people will be able to view this information, especially if they're searching for certain keywords like running injury, prevention, pain. This is a lot of the stuff that I speak about on my podcast and many of my other episodes. So again, you would be. Really supporting me. If you can like, subscribe, follow, but also leave a five r review, I would greatly appreciate that. Okay, so now let's talk about lastly what are the proper strength and mobility principles to ensure minimal to no setbacks when it comes to return to running? So there, there is so much, there's so much research to show that a proper strength training plan is critical, especially if you're returning to running or want to become a more optimal runner. A lot of my times I'll tell my clients that, let's say you love running but you don't like weight training as much. Or let's say you hate weight training. I always say that's still a necessary evil. You should be weight training. At least write this down, at least one to two days per week. Training legs in the gym or training legs at home in the form of some sort of dumbbells and bands. I. Now, here's why. Because even just somebody that is consistently doing something like let's say, squats for four to six weeks, or even if you're doing calf raises for four to six weeks, research shows that if you are consistent doing that one to two days a week, that is going to decrease your chances of injuring by 200 to 400%. That will also decrease your mile time immediately through improving muscular hypertrophy and capacity. Okay, so that's really important. And also if you think about it when it comes to squats and CREs is that is a weight bearing exercise. So running in itself is a weight bearing exercise. But when you are challenging your system you may not challenging your cardiovascular system as much as running, but what you're doing is you're increasing the stress to the joints, the ligaments, the tendons. You're building the muscular capacity around your joints so your joints don't hurt with running. So that is why when I really started to weight train, that is when I really started to notice that my mile time decreased tremendously. I was not getting hurt as much. So somebody that is fully reliant on just either walking or running as their modes of exercise, and if they're sacrificing that one to two days a week of weight training that they should be doing, the likelihood is you will increase your propensity for injury. The likelihood is you may have to give up running sooner in life. I don't want that to happen to you. And if you are returning to running, definitely start weight training right now. Okay. Weight training at least one to two days a week. Now what are some of the muscles? And we'll break down some of the muscles that are really important. I would like to know, maybe even in the comments, like before I even go to the que before I even like you know the answer, I'm gonna say the question. Go ahead and comment below what you feel is the most important muscle in the legs when it comes to running. I shouldn't have said legs'cause maybe core was like really important for running, but what do you feel is the most important muscle for running? And this is not arbitrary. I really think that this is factual. This is like the most important and the answer may surprise you. Okay? So lemme know in the comments what you feel is the most important muscle for running. Okay. So if you said quadriceps, which is your front thigh muscle. Not true. That is not the most important. It's important. All muscles are important to the legs, but not the most important. What about glutes? Okay, everybody, especially in now. Nowadays, society and in social media, glutes the butt muscles. That's also not true. Now what about hamstrings? Okay, hamstrings, part of the posterior chain, is that the most important muscle? Nope. That's also not the most important as well. The very, the most important muscle when it comes to running. To make sure that you decrease your risk for injuries and you can return your running safely or improve optimal running is your calves. Okay, now your calves is broken down into two muscles. One is your gastroc anus. That is a muscle that attaches from your Achilles cord and your heel all the way up into the back of your legs, and it almost meshes with your hamstrings. And then there's also a muscle called the soleus. The soleus also attaches to the achilles and the calcaneus, but that one actually attaches directly into the tibia so it doesn't have an attachment to the knee. And I'll tell you why that's important in terms of relation to how you strengthen these muscles individually. But the calves are the most important because it attaches directly to your foot. It also has. Interplay with your plantar fascia or the arch muscles. So basically the fascia underneath your foot, as well as the four layers of muscle underneath your foot, it has direct interplay with that because those muscles also attach to your heel just on the bottom of your foot. And so these muscles on the bottom of your foot and as well as your Achilles and your your calve are what we call the wind less mechanism. Okay? W-I-N-D-L-A-S-S. This mechanism is basically a push and pull. A balance of tension between the calf as well as the muscles, the end of the foot. So if you are somebody that is serious about getting back into running, is that you do want to do a significant amount of calf raises. So I'm doing this in the video, like your tiptoes or even weighted tiptoes or weighted calf is. So when you build up the Achilles. Okay, one, you're gonna improve the tensile strength of the Achilles. The Achilles will become more elastic, so you can spend less time on the ground and more time going forward, which will increase your cadence as well. And also you'll decrease the propensity for developing things like plantar fascia or also stress fractures to the foot as well. And many of the other foot related injuries that can occur. So by way of cal strengthening, you'll make the entire system stronger. And I always say this running at the end of the day is it's highly dependent on what happens to the foot, right? How the foot lands in relation to the rest of the body. So if you know that the most important things is like. What the foot does and how the foot lands in relation to space, how much time the foot stays on the floor is that you really wanna start off with the calve, the muscle that is the most powerful muscle that attaches to the ankle and foot complex. That's one. But also when the calves are weak, right? You do de increase the propensity injuries to the areas of above. Namely, mainly namely your knee, your hip, as well as your lower back as well. Okay? So just take that into account that the cab is actually the most important and the beauty of it. The beauty of saying ah, that should be almost like a sigh of relief, right? Because you're like, Jay, like how do you strengthen hamstrings? What's the best exercise for hamstrings? What's the best way? Strengthening exercise for quads and glutes, there's so many exercise you can do to strengthen those, but the calves is actually overtly pretty simple. There's really only a. Two ways to strengthen the calves. Okay, maybe three, but one is to strictly, again, just start doing tiptoes everywhere you go while brushing teeth, kill tubers with one stone. Start doing more cav raises, right? Quantify that as well. So that's straight. So that's what the straight knee is, where if you do it with a straight knee and then you do your tiptoes, you're strengthening and biasing the gastrocnemius. So that's your more explosive muscle that attaches the Achilles. And then what you do is with the soleus, which is the muscle that only attaches to the tibia and it doesn't cross the knee, you actually bend your knee. So maintain a bent knee position very shallow. I'm actually in that position right now, only about 10 to 15. Maybe 30 degrees of knee flexion. So you're staying in a mild squat and then maintain that degree of knee flexion. And now you're still gonna do your calv raises. So these are called bent knee calv raises, and that's how you're gonna bias the soleus. And the soleus is a more endurance based muscle, and both of these two bent knee as well as straight knee cav raises should be overloaded. So whether you want to increase the volume in the form of repetitions, so you know, think about how many times your foot hits the floor per run. That's, it's literally hundreds to thousands, right? So you do want to tolerate at some point, hun, hundreds of C raises. In a row, right? Or consecutively or break it up into sets. And you also do want to strength, build the size and the capacity of that muscle. So how do you build size and buy a size When it comes to calf races, add dumbbells, right? So hold a dumbbell in one hand, one hand against the wall, and overload those tissues. And also you can also do barbell cav raises, right? So you put a bar on your back, you can load it up, load some plates, and those, that's another mechanism of how to strengthen your calves. Okay? The third way, which is less necessary, is by way of bending your knee, right? So like doing hamstring curls with your knees because you do strengthen your gastroc, right? Even though you're doing, you're bending your knees doing basically bending your knee is gonna bias the primary muscle, which is your hamstrings, but also your secondarily also strengthening your calves as well. Okay? Other muscles to thinking about are hamstrings. Hamstrings is like. It's basically like the slingshot of the leg. So basically, if you want to get faster, you definitely want to do a lot of knee flexion curls, like prone hamstring curls or maybe you're attaching a band to both legs and then you're bending your knee back and forth, so that does hamstring curls. You can also strengthen your hamstrings through hip extension because it attaches to basically your butt bone. So if you're doing a lot of hip extension like deadlifts, lunges, Bulgarian squats, those are all the also other ways to strengthen your hamstrings as well. Okay. Also strengthen your quads. Quads are still important in order to absorb shock or in order to decelerate the knee and the tibia while you're running downhill. So quads are still really important. So quads is a knee extensor. So basically when you straighten your knee, you can feel that quad contraction. So the most important exercises with quads is either you're going to the gym doing leg extensions the common way that most people can get it in at home or at a gym is usually doing some sort of squat variation, a leg press variation. Even lunges are mainly mostly quad dominant, so those are other ways to get in your quads and also hamstring and glutes. That's, that kind of comprises your posterior chain. So make sure you're still getting your deadlifts upgrade exercise I like to get to my clients is like Roman extensions at the gym. So like I said this episode is not to give you a comprehensive here's all the exercises available to strengthen quads, hamstrings, glutes, and calves. But now you know what's the most important, what you should be thinking about. You understand the frequency as well. One to two days bare minimum for any recreational runner you should be strength training. Okay? Alright, so that is what I got for you guys today. I really hope that this episode really gave you a really strong breakdown of what you can do. Whether you're trying to optimize your running and you're already a runner, your experience, but you just wanna get better. Or whether you are somebody that wants to return to running after months and years of not doing it. Or maybe you're coming back from an injury, you got injured during running, you've put it on hold because you're not sure what to do, and you want some guidance on how to return to running safely. Definitely, I feel like this is probably the best episode that I've done when it comes to running injury prevention and returning to running. So like I said, if you got any sort of value from today, definitely please support my channel by clicking the, like subscribing or following, but also leaving a five star review. If you do that to anybody that types in the word running, usually the algorithm kind of finds them and they'll send them this episode and they'll get a lot of value out of it as well. So please do me a favor in doing those things for me. I would greatly appreciate it and it would support me in creating more valuable content like this. And like I said, my free gift to you for this episode. Is my runner's ebook. Okay. An ebook that I created after doing multiple running workshops in San Francisco Bay Area. So please download that, that ebook, it's absolutely free https://flexwithdoctorjay.online/runners-ebook. And lastly, if you're interested in potentially taking the next steps, if you've got a lot of value, but you want, some sort of handholding, you want a plan that is customized to you, maybe even just want a running analysis, whether online or in person, definitely hit me up. I'll leave a description. I'll leave a link in the description for you to apply and also to book a completely free consultation with me and my team. Okay? And I'll leave that in description as well. So I'll see you guys on the next episode and have a beautiful rest of your day. I'll speak to you on the next one.