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Can biomechanical analysis solve injury problems?
July 21, 2010By Alex Hutchinson
Dathan Ritzenhein just announced that he’ll be running the New York City Marathon this November, joining a stacked field that already includes Haile Gebrselassie and Canadian hope Simon Bairu. One thing that jumped out at me from the press conference (as reported by Letsrun) was his coach Alberto Salazar’s assertion that Ritz’s injury problems are a thing of the past thanks to some high-tech analysis:
“Gordon Valiant - the head of biomechanics for Nike - did an evaluation of Dathan and was able to find some things that are unique to Dathan with the way he runs and strikes his foot. With that (study completed), we now have some modified inserts. I wouldn’t call them orthotics - just an insert into the shoe where he has an abnormal amount of force near his third metatarsal. It seems to have alleviated his symptoms completely and we’ve retested him in the lab and shown those forces have been lessened tremendously.”
For those who’ve been following the barefoot running debate, this should raise some flags. For years, critics of the big shoe companies have pointed out that measuring forces in a lab setting doesn’t necessarily equate to a change in injury rates. Australian minimalist advocate Craig Richards said as much in an article I wrote back in 2008:
“Shoe researchers and manufacturers will try and bamboozle you with the results of hundreds of biomechanical studies,” [Richards said]. While these studies tell you how your stride is affected by the shoe, “they cannot currently tell you what this means for either the injury risk or performance of the wearer.”
Fair point — though, as I pointed out last month, minimalists are suddenly more enthusiastic about biomechanical studies now that Dan Lieberman and others have provided them with some studies of their own.
Anyway, we now have a study (with n=1) in which the manipulation of biomechanical forces in the foot is hypothesized to solve a longstanding injury problem. The outcome measure: whether Ritz makes it to New York in one piece, with an uninterrupted build-up. Here’s hoping!
Alex Hutchinson
Alex Hutchinson is a middle and long-distance runner who competed on the Canadian National Team from 1997 to 2008. He also has a lifelong interest in science, which led him to complete a PhD in physics at Cambridge University in England. Alex is a senior editor at Canadian Running, where he brings his two passions together with carefully researched, but accessible columns on the science of running. He can be reached at science@runningmagazine.ca
Also by Alex:
- The ADA's position stand on nutrient supplementation
- Bone density: running is surprisingly good
- Testing VO2max and lactate threshold
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Alex,
First I just want to say that I enjoy your articles/discussions on the various exercise science topics, great job!
RE: biomechanical analyses to solve injury problems, in Ritz’s case, and I don’t know what his exact injury was, it seems like they identified a problem near the source of his pain (I’m assuming near his 3rd metatarsal head or base) and looked for “curious values” of a relevant biomechanical variable (pressure at the base or head of the 3rd MT). That’s pretty much the only analysis that can be done for for solving injuries using quantitative biomechanical analyses as there are no “baseline/perfect/healthy” lower limb parameters that can be used to compare with injured lower limbs. The closest thing to “perfect” we could get is an analysis within the time period where the runner’s symptoms disapear (post-treatment). But who’s to say that some other problem was created by what cured the original problem? Solving injuries in runners is such an individual task, making any sort of group (combination of N runners in a study) comparisons under different conditions (different shoes, surfaces, strike patterns, etc…) extremely difficult. Just my two cents
Thanks, Max — glad you enjoy the articles, and great to get your perspective. That’s a really interesting point about solving one problem but unwittingly creating another problem. I actually sent an e-mail to someone last night saying “My money’s on a hip or knee injury — because those nasty forces don’t disappear, they just go somewhere else!”
In all seriousness, though, I should say that I actually had a sophisticated biomechanical analysis done back in 1999, after a knee injury had kept me from running for two years. The analysis identified something funny in my right foot, so I got a custom insert built. Then I got another analysis, and it wasn’t “fixed,” so they built another insert. This time things looked better — and sure enough, I was able to resume full training. (Of course, the various forms of physio and strengthening I’d been doing might have been responsible.)
The point is, I do believe biomechanical analysis can be helpful. But as you point out, there are limits (at this point, at least) to where we can apply quantitative methods — so for now, it remains an art where the skill and intuition of the practitioner are as crucial as the numbers produced by the analysis. Hopefully it’ll work for Ritz, but I’d be less confident than Salazar sounded in that press conference.
Anyway, thanks again for the inside look at an interesting topic!