Finding Root Cause
Staying healthy and injury free is a goal for all runners. Whether you are a competitive or a recreational runner, young or old, there are many variables involved in staying healthy and injury free. It is very much like a puzzle. We have been treating recreational to elite runners for over 30 years, and we have seen the science of running constantly evolve and frequently attend medical conferences to keep up with the latest knowledge. A key point in understanding running injuries is to look beyond the symptoms and pain, and truly understand the “Root Cause” of the condition in order to achieve true resolution of the issue. For example, plantar fasciitis is a medical diagnosis, but it is actually a symptom of over use and irritation of the plantar fascia of the bottom of the foot, which in some cases causes inflammation of the plantar fascia. To fully resolve this nagging recurrent problem one needs to understand ROOT CAUSE. Why is the plantar fasica being overused and/or irritated? Medications and orthotics manage the symptom (pain) and the source (the plantar fascia), but in many cases the problem persists because the root cause, that is, how the foot hits the ground is complicated. There is a lot going on there. The foot accepts weight from rear foot to forefoot, the ankle pronates to balance, then the toe pushes off, all in a second, automatically. If any part of that motion is off or misaligned a problem can develop.
The invisible force we know as gravity affects how the weight of your body and its center of gravity are transferred, through the foot, knee, hip, pelvis, and spine in a complicated kinetic chain. Ground Force Reaction (CFR) is always the root cause of all running injuries. Therefore several factors need to be evaluated including mechanical load, skeletal properties, and tissue injuries inclusive of bone and stress injury to fully assess a running injury. There are 5 major components to running form that impacts your exposure to injury while running. All should be assessed in a running analysis.
- Stride length and shin position of landing position
- Step rate
- Step width
- Foot position of foot strike
- Bounce – vertical movement while running
In circling back to resolving plantar fasciitis, the source is the plantar fascia being over loaded, the root cause is figuring out why, which is what we do.
Structure, habit, reflexes are the invisible components to running, walking and function. Medications and orthotics are common approaches to addressing a nagging plantar fasciitis, but function and neuromuscular control answers the questions of root cause. This model approach is pertinent to all types of running injuries including hamstring strain, hip pain, IT band syndrome, meniscal tears, labral tear of the hip, and stress reaction fractures of the shin, hip or femur. As therapists, who specialize in treating runners, we are the experts to figure out “Root cause”, and teach you the patients treatment strategies to fully resolve the injury and to prevent future injuries.