Naturalizing Your Running Style: A Step-by-Step Guide

In recent years,natural running has become more popular as a way to improve the running experience and reduce the risk of injuries. Transitioning to a minimalist style running may offer numerous benefits, but it's essential to approach this transition gradually and mindfully. In this article, we'll examine how to make the switch safely and effectively. Please keep in mind that these “steps” do not need to be followed sequentially- all steps should be kept in mind as you initiate your transition.


1. Understand the Benefits

Before you begin the transition, it's essential to understand why you're making this change. Natural running techniques can promote better biomechanics, strengthen your core, feet, and lower legs, while reducing the risk of common running injuries. Having a clear understanding of these potential benefits will help motivate you through the transition period.


2. Start with the Right Footwear

If you’ve been wearing conventional running shoes, there’s a good chance they’ll get in the way of making the transition. Conventional running shoes tend to have a drop, or decreasing sole thickness from heel to toe, which will predispose you to land on your heel instead of your forefoot or midfoot. Conventional running shoes will also likely have much more cushioning than minimalist running shoes. The lack of cushioning in minimalist running shoes, combined with the improved ability to land on your forefoot or midfoot, will encourage running technique that forces you to minimize the impact through your feet and to absorb any impact through your muscles instead of relying on the cushioning of the shoe. Therefore investing in a pair of minimalist running shoes can be very helpful in making the transition. There are various minimalist shoe options available, from barefoot-style shoes to those with minimal cushioning. Visiting a specialty running store can be helpful, but one advantage of minimalist running is that once you learn to run naturally, your choice of shoes matters less than it does with a more conventional running style. With natural running, the purpose of the footwear is to provide traction while protecting your feet from sharp objects, chemicals, and infectious agents while staying out of the way of proper technique.


3. Transition Gradually

The key to a successful transition is to take it slow. If you've been running in traditional cushioned shoes with a heel-to-toe drop, your body needs time to adapt to the new demands of minimalist footwear. Start by incorporating them into a small portion of your runs, perhaps 10-20% of your weekly mileage. Gradually increase this percentage over several weeks, and don’t be afraid to back off if you notice increased aches and pains.


4. Focus on Form and Technique

As you start running in minimalist shoes, pay close attention to your running form and technique. Here are some tips to keep in mind:

-Shorten Your Stride: Minimalist running often involves shorter, quicker strides. Focus on increasing your cadence and landing with your foot under your hips.

-Adjust Your Foot Strike: Aim for a midfoot or forefoot strike rather than a heel strike. This reduces the impact on your joints by allowing your muscles to absorb the impact and encourages a more natural running gait.

-Maintain Good Posture: Keep your back straight, shoulders relaxed, and head up. Engage your core muscles to stabilize your body.

-Relax Your Feet: Allow your feet to move naturally inside the shoes. Avoid trying to grip the ground with your toes.


5. Strengthen Your Feet and Lower Legs

To adapt to minimalist running, it's essential to strengthen the muscles and tendons in your feet and lower legs. Consider incorporating exercises like calf raises, toe scrunches, and walking in your minimalist shoes into your routine. These exercises can help prevent overuse injuries during the transition.


6. Listen to Your Body

Pay close attention to any signs of pain during and after your runs. It's normal to experience some muscle soreness as you adapt, but persistent or sharp pain should not be ignored. If you experience pain, reduce your mileage and give your body more time to adjust.


7. Patience is Key

The transition to minimalist running is not a race. It can take several months, or even longer, for your body to fully adapt to this new style. Be patient with yourself and avoid pushing too hard too soon. Your body needs time to build the strength and resilience necessary for minimalist running. This is a situation where getting in too much of a hurry to make the transition or increase mileage can set back your transition over the long run.


8. Seek Professional Guidance

Consider consulting a running coach or physical therapist who specializes in natural running. They can assess your running form, provide personalized guidance, and help you make a safe and effective transition.

In conclusion, transitioning to minimalist running can be a rewarding journey, but it requires careful planning and patience. By starting gradually, focusing on form and technique, and listening to your body, you can reduce the risk of injuries and fully enjoy the benefits of natural running. Remember that every runner's transition is unique, so tailor your approach to your individual needs and goals.

Did I Just Tear That? Muscle Soreness vs. Cramping vs. A Muscle Tear

Soreness in the calf muscles is a common complaint of people who are trying to adopt a natural running technique because of the extra stress that a midfoot or forefoot strike places on the calf muscles, and that's certainly proven true for me. When I first transitioned to natural running, I managed to avoid the calf pain many newbies report, but that's likely because I was taking it easy while recovering from a badly sprained ankle at the same time. Since then, every time I significantly increase my running distance, particularly if I'm running on pavement, I can expect several days of soreness in my calves.

Recently, my calf soreness has been unusually persistent. Perhaps it's because I've been trying to maintain mileage on my training runs (plus running to keep up with kids) instead of allowing my body's capabilities to catch up with the mileage I'm asking of it. Whatever the reason, my body decided to override my ambitions during a training run the other morning by subjecting me to severe cramping in my left calf muscle (triceps surae complex, likely the gastrocnemius) to the point where, at the time, it felt like the muscle was tearing. The sensation of tearing persisted as I walked home that morning and came back whenever I tried running a few steps over the next couple of days.

Not wanting to lose too much of the conditioning I had gained over the past few weeks, I tried to sort out the nature of my injury so I could have an idea of how to manage the recovery and how long I could expect the downtime needed to adequately heal. I obviously had soreness before and during the run, and obviously had a muscle cramp during the run. The real question, from the standpoint of recovery was: did I actually tear a muscle?

Diagnosing an injury isn't always clear-cut - even for a physical therapist or an experienced athlete. The human nervous system isn't very good at pinpointing an exact source of pain. On top of that, our brains are pretty good at forgetting the details of past pain, and our body composition changes over time (for example, collagen becomes less elastic as we age), making it difficult to compare a current injury to one experienced decades ago. With that in mind, I decided to refresh my knowledge of muscle soreness, muscle tears, and how muscle cramps factor into all of this.

Muscle soreness alone is actually a pretty complex phenomenon from a physiological standpoint. Muscle soreness, sometimes called delayed onset muscle soreness (DOMS), arises from microscopic muscle damage during strenuous activity, triggering an inflammatory response, increased blood flow, chemical changes including the release of inflammatory mediators, swelling, and nerve sensitization; collectively resulting in a sensation ranging from discomfort to outright pain.

By contrast, though it shares the above physiological factors with muscle soreness, the injury of a muscle tear, or strain, itself is relatively easy to understand: A muscle tear occurs when the muscle fibers are pulled apart due to excessive stress, over-stretching, or cramping.

It turns out that muscle cramping is a bit more complex than simple soreness or a muscle tear. Muscle cramps involve sudden, involuntary muscle contractions due to factors that may include nerve hyperactivity, electrolyte imbalances, dehydration, muscle fatigue, reduced blood flow, stretch reflex abnormalities, medications or health conditions, age, and physical condition. Note that any one, or a combination, of the above factors can be the cause of a cramp. It makes sense that muscle cramping should be able to cause a muscle tear. Since a cramp is an uncontrolled muscle contraction, when the force of the contraction exceeds the tensile strength of the muscle, the result would have to be a torn muscle.

Given the fact that my sensation of tearing lingered even after the cramp had calmed down and after I had stretched and rubbed the muscle, I feel it was likely a tear. Though to be fair, considering that there was no visible swelling or bruising, it wasn't too painful to walk on, and it healed as quickly as it did (several days), it could not have been a bad tear.

In my review of muscle strains/tears, I also learned that mild tears may necessitate several weeks of healing, while more extensive tears could require several months and that there are some things that can speed up recovery, including avoiding activities that aggravate the injury, application of cold compresses, use of nonsteroidal anti-inflammatory drugs (as directed by the instructions on the bottle or a medical provider), and tailored rehabilitation exercises.

The astute reader will notice that I recovered over the course of days, instead of the weeks or months that my research said I should require. So why the difference? While no one, health professional or individual experiencing an injury (of which I am both in this case) can have complete knowledge of the nature of an injury or exactly what is going on during recovery, it's helpful to have a theory. In this case, both the pain and underlying physiology associated with the muscle soreness in my calves likely made me predisposed to cramping, and as hinted at above, the cramp consisted of a muscle contraction sufficiently powerful to tear the muscle fibers in my calf. So pushing through the muscle soreness set me up for the cramp. One way of interpreting this is that my body was protesting my attempt to push it past what it was able to safely do at the time. Another likely contributing factor is that muscles that are in pain will sometimes spasm in an effort to protect underlying structures from greater trauma and create more pain in the process. This can become a self-reinforcing phenomenon that sometimes causes pain to persist even after the underlying injury has healed. I've experienced this myself, and I'm pretty sure it's been the source of pain in many of my patients.

Fortunately, there's a lot of overlap when it comes to preventing excessive muscle soreness, muscle tears, and muscle cramping. Here are some tips:

- Warm-up routines and stretching can help to maintain flexibility and reduce the risk of a number of different types of injuries.

- Gradually increasing exercise intensity and duration allows muscles to adapt to progressively increasing levels of stress.

- Targeted strength training exercises can also be used to focus on muscle groups prone to soreness and tearing.

- Maintaining good posture and technique during exercises can help prevent excessive stress on muscles.

- Listen to your body: Pay attention to pain or discomfort during workouts, and stop if needed to avoid injury.

Clearly, I need to pay attention to this advice, but part of the point of this blog is to allow the reader to learn from my experiences, even if some of those experiences are mistakes.

So, we've reviewed what I did wrong that led to injury, but what did I do right to recover so quickly? First, aside from running a few steps to test the status of the injury, I didn't push myself over the days following the muscle strain. On the other hand, I still remained reasonably active with walking, hiking, and some limited downhill running (keeping up with a young kid while hiking). The downhill running seemed to place minimal stress on the calf muscle, but I'm sure I was doing some things to compensate that would have led to a different injury if I did that too much. Additionally, I had some other things come up that interfered with my running routine during this time, which forced a longer recovery.

Also, I engaged in targeted exercise relatively early. Specifically, I found that my calf tolerated unilateral heel raises (standing on one foot while lifting the heel off of the floor and lowering it again in a controlled way), so I tried to do a set to form fatigue on each side several times a day. I did this with the intention of keeping the muscle endurance I already had, but it seemed to help work out the pain of the muscle tear as well.

In conclusion, my recent experience with calf soreness, cramping, and a potential muscle tear taught me valuable lessons about the intricacies of muscle injuries. It's clear that understanding the differences between muscle soreness, muscle tears, and cramps is essential for effective injury management. Whether you're a seasoned athlete or new to fitness, prioritizing muscle health and recovery can help you stay active and injury-free. Remember, if you encounter severe pain or uncertainty about an injury, seeking guidance from a healthcare professional is always a wise choice. Your body's well-being is worth the investment in proper care and recovery techniques.

How To Use The Modified Borg Scale of Perceived Exertion

I wanted to revisit the Modified Borg Scale of Perceived Exertion that I mentioned in my last post. If you read my last post, you'll recall that I did a run where I applied this scale to my workout. Let's explore how this scale can help you optimize your workouts too.

The Modified Borg Scale of Perceived Exertion is a simple yet effective rating system that allows you to gauge your perceived level of exertion during physical activity. Ranging from 0 to 10, each number corresponds to a different level of effort, from resting (0) to maximal exertion (10).

Here's a quick overview of the scale:

0 - Nothing at all: This is the state of rest or no exertion.

0.5 - Very weak: Almost negligible effort.

1 - Weak: Very light effort.

2 - Very light: Minimal effort required.

3 - Light: Easy effort, still comfortable to continue.

4 - Somewhat light: Noticeable effort, but you feel comfortable.

5 - Moderate: You're working, but it's at a comfortable pace, and you could maintain a conversation.

6 - Somewhat hard: Moderate effort, conversation requires more effort.

7 - Hard: Challenging, and talking is more difficult.

8 - Very hard: Intense effort, and only a few words can be spoken.

9 - Very, very hard: Near maximum exertion, conversation is tough.

10 - Maximal exertion: This is when you give it your all, and talking becomes impossible.

Why does this scale matter? As I mentioned in my previous post, the Modified Borg Scale of Perceived Exertion offers an effective way to monitor your workout intensity without using a heart rate monitor. By paying attention to how you feel during the workout, you can adapt your level of exertion to what you're trying to accomplish with the workout.

For instance, if your goal is to improve overall endurance, aiming for a perceived exertion level of around 5 or 6 (moderate to somewhat hard) is ideal. This level of effort enhances your circulatory system's efficiency while conditioning your muscles for longer durations.

However, if you have specific goals, like training for challenging terrains, it's essential to vary your exertion levels. Going uphill, for example, works your muscles in different ways, improving strength and endurance. Going downhill also provides unique benefits, helping to condition muscles for better control and injury prevention.

The beauty of the Modified Borg Scale lies in its flexibility. It empowers you to tailor your workouts to your specific needs, making them more effective and enjoyable. By paying attention to your perceived exertion level, you can make informed decisions about when to push harder and when to dial it back.

In conclusion, the Modified Borg Scale of Perceived Exertion is a valuable tool that can transform your approach to training. It gives you the freedom to adjust your workouts based on your goals, ultimately leading to a more productive and effective fitness routine.

Predawn Yo-Yo Workout and Perceived Level of Exertion

I recently did a pre-dawn run that I feel is a good example of applying some aspects of exercise physiology to training. I went up a gravel road that forks and then loops around to rejoin itself at the fork. I completed the loop and then did a workout that I call Yo-Yo’s at the fork. With a Yo-Yo workout, I go uphill for a ways before turning around and going back downhill to the low point of the Yo-Yo and then going uphill again. The benefit of a Yo-Yo workout is that it mixes up the level of exertion and type of muscle activity to make the workout more sustainable and decrease the risk of injury: running uphill continuously can subject you to an unhealthy level of exertion, and running downhill continuously can be tough on your joints as the muscles that control your descent become fatigued. Added benefits of doing Yo-Yo’s in a place where a road forks before going uphill in either direction were that I was able to vary the grade, the footing, and my surroundings- different sensory stimulation is helpful to keep from getting bored during a workout. In this case, the distance I chose to go uphill was informed by the desire to limit the intensity of my workout and to avoid waking up the people who lived slightly up the road from my turn-around point by riling up their dogs.

So you might be wondering why I was trying to limit my level of exertion. After all, isn’t the whole point of a workout to exert yourself? The answer to that is yes, but within some limits. The level of exertion you subject yourself to during a workout should be informed by what you hope to accomplish during the workout and can be visualized with something called the Modified Borg Scale of Perceived Exertion. It turns out that your perceived level of exertion can be almost as accurate of a measure of how hard you’re working as a heart rate monitor.

Image "borrowed" from http://sterlingwins.com/wp-content/uploads/2017/11/modified-borg.jpg

In the case of this workout, I wanted to improve my overall endurance with a special emphasis on going up and down the steeper grades that are common while running and hiking in the southern Appalachian mountains where I live. For overall endurance, a low to moderate level of exertion is ideal because it improves the efficiency of the circulatory system while conditioning the muscles for longer duration activities. Of course, when running uphill, it’s tough to keep the level of exertion at a low to moderate level. If you look at my Strava recording, you might notice that I walked intermittently during the uphill portion of the loop, but even with the walking, I was approaching a 9/10 or “Very Hard Activity” level. This isn’t necessarily a bad thing, as “vigorous” activity a few times a week is supposed to cut the risk of stroke among men in my age range, but pushing at this level too often is thought to increase the likelihood of coronary artery disease, so like so many other things in life, moderation is key.

I should also mention that part of the advantage of incorporating hills into a workout is the way the incline can train the musculature of the legs. Generally, muscles develop strength and endurance in the range of motion in which they’re exercised, which means that if you’re always running or walking on flat ground, your legs may be really good at carrying you over flat ground, but your performance will likely suffer if you suddenly try to go up or down a hill. The fact that going uphill forces your knees, hips, and ankles to bend more means that your glute, quadriceps, and calves will be conditioned to contract in a wider range of motion, giving you better performance on a wider range of terrains. Going downhill can have benefits as well because muscles work differently to control the movement during descent than they do generating thrust during ascent. The extra challenge of controlling your speed of descent can help to condition the muscles in ways that will help you avoid injury, particularly while going downhill.

So what does this workout lack? I feel like, from the standpoint of conditioning for running or hiking on a variety of terrain, it’s pretty good. If you look at the Strava recording, you might note that it was fairly short, only 1.94 miles, which is a fair criticism. On the other hand, when you look at the fact that it’s a significant fraction of the distance and elevation gain of the longer hikes I’m trying to stay conditioned for, while investing less than a half-hour in it, this looks like a pretty relevant workout.

If you want a similar degree of insight applied to your exercise routine you should know that I’m preparing to offer one on one fitness and wellness consultation, as well as group instruction. In addition to contacting me through email at everett.stook.pt@gmail.com, you can also follow me on Facebook, Strava, and YouTube. Thanks for reading!

Bare Your Sole

I have posted this article on other blogs, but I chose to post it here as well because I feel that it's a good representation of my philosophy about running and physical activity in general. It provides a sample of what you can expect if you attend one of my natural running workshops.

In various blog entries you may see me mention barefoot running or minimalist running or a natural running gait pattern, but what do these terms actually mean?

For many of us (myself included before PT school and further self education) there's the tendency to think of running as "pounding the pavement"- putting one foot in front of the other without any real thought about technique. Most of us, at least in western cultures, have been taught by default that running is just a matter of plodding along and hoping that we don't get hurt as the miles add up. If we make adjustments to our approach to running, it's more likely to be changing out our shoes than an adjustment to our technique. 

Having said that, when it comes to injury prevention, running efficiency, and general enjoyment of the sport; there is strong evidence that technique is more important than footwear. And, surprisingly (at least to those of us who started running in the second half of the twentieth century) less cushioned or supportive the footwear arguably promotes better technique. There is historical, evolutionary, and biomechanical support for this position.

The historical and evolutionary evidence go hand in hand. For the vast majority of human history, we did not have access to synthetic materials used to cushion modern running shoes, yet running predates the emergence of our species. Bram Stoker, Thomas Jefferson, and Philippides are examples of historical figures whose running exploits predated EVA foam, gel, and air cushions

Australopithecus afarensis footprint

intended to protect modern runners from the impact of running. (I know, Philippides dropped dead after making the 26.2 mile run from Marathon to Athens, but that was likely due to cardiac problems rather than choice of footwear. Cardiac problems associated with long distance running is a possible subject for a future blog entry.) It has also been suggested that running may have contributed to the hunting prowess of early humans, giving them a source of calories and protein that allowed for the growth of larger brains. In addition, the oldest documented fossilized human footprints date to at least 3.6 million years ago, and although not belonging to the same species as modern humans, the footprints and other fossil evidence implies upright walking with a gait pattern similar to our own. 3.6 million years is a long time to go without modern footwear if it's really that important.

From the standpoint biomechanics (my area of expertise) barefoot running makes a lot of sense. First, let's look at conventional running shoes and how they influence running technique. The conventional running shoe, developed over the course of the latter half of the twentieth century, focused on adding cushioning, particularly at the heel. This increased bulk at the heel, promotes an increased heel strike. Running with a heel strike, in turn, means a tendency to impact the ground with the foot ahead of the center of mass of the body and the knee straight. Having the foot impact the ground ahead of the center of mass negates some of the forward motion, thus wasting energy. More significantly, impacting the ground with a straight knee sends the force of the impact through the lower leg, upper leg, through the hip and into the back. With heel impact and straight knee, there isn't a whole lot that the muscles can do to absorb shock.

Running barefoot, or in shoes without a rise from toe to heel, it's easier to land on the forefoot or midfoot, with the foot directly under the center of mass. In addition to being able to move forward without the wasted energy of landing ahead of the center of mass, this makes it easier to land with the knee slightly bent. Landing with a bent knee means that the quadriceps (the muscles on the front of the thigh) and the gluteal muscles (the buttocks) can absorb much of the shock of impact. Also, landing on the forefoot or midfoot means that the ankle has room to dorsiflex (bringing the toes closer to the knee), which gives the calf muscles the opportunity to absorb shock as well. Studies utilizing special plates that can detect the intensity and direction of impact while running have shown that the ability to recruit the above muscle groups is much better at managing the impact of running than any shock absorbing materials that can be built into shoes.

The result of a natural gait pattern is not so much "pounding the pavement" as continually adapting to the running surface to minimize impact. In the book Born To Run, author Christopher McDougal describes highly accomplished distance runners brushing the ground with each step. (I'm paraphrasing since the book isn't right in front of me.) While I haven't developed my technique to the point where I can move with that level of grace, it does allow me to run barefoot on asphalt, concrete, and brick with significantly less knee pain than I would experience after running the same distances on the same surfaces in conventional running shoes with conventional biomechanics.

Lightweight sandals and a pair of shorts:
Minimal equipment required!

In addition to injury prevention, there's also an aesthetic, almost spiritual, case to be made for natural running. In my case, I like the idea of moving the way people have moved for millions of years.  I enjoy the feeling of moving unencumbered by heavy (or any) footwear. I appreciate being able to feel the changes in the ground under my feet. When running naturally, I like to think that I'm running the way humans were designed to run. There's also something very compelling about the simplicity of using a minimal amount of gear to participate in a sport.

So how do you get started with natural/barefoot/minimalist running? First, you should approach it cautiously. After a lifetime of wearing shoes, you likely don't have the foot musculature or the coordination in your legs and hips needed to run the distances you're used to without the footwear you're used to without inviting injury. Instead of throwing away your heavy running shoes, try using the most minimalist footwear that you can get away with when walking, at work, and around the house. If your feet feel pretty good after a week or two of minimalist footwear while walking, you can try running short distances (like a quarter mile) in your minimalist footwear two or three times a week and gradually increase the distance and frequency of your minimalist running from there. You might also try experimenting with landing on your mid-foot with a bent knee and your foot directly below your body while running in your conventional running shoes. (This will be easier with shoes that have less of a rise from toe to heel.) It's probably best not to try to incorporate a forefoot strike into running with conventional running shoes. In my (painfully earned) experience this makes an ankle sprain more likely. Most importantly, back off if you develop new aches and pains.

As you transition to a more minimalist style of footwear, you'll probably find yourself automatically adopting a more natural style of running because landing on your heal without the padding of conventional running shoes will be painful enough to lead you to land on your mid-foot or forefoot. If you want more tips on technique and to see this style of running in action, take a look at the videos on Barefoot Running Center's YouTube channel. Of course, you can also seek out a physical therapist experienced in gait analysis and knowledgeable about natural running. A video gait analysis, that will allow the therapist to watch you run in slow motion and offer you advice at every point of your stride, is helpful as well.

A few words of caution: If you choose to go barefoot, you should only do so on surfaces that you are reasonably sure won't cause abrasions, punctures, or burns (including chemical). Even so, you should be prepared for the possibility of these injuries and any resulting infection. Also, those with diabetes should not go barefoot due to the slower healing and greater likelihood of peripheral neuropathy associated with the condition. (I realize that this may not be a hard and fast rule due to differing levels of progression of diabetes and how well the condition may be controlled on an individual basis, but that was the advice proffered to me as part of my training, so that's the advice I pass along here.)

Having said that, I would encourage anyone with an interest in running to stop "pounding the pavement" and give natural running a try!

Introduction

Hi Everyone! Welcome to my blog! I wanted to use my first post to introduce myself. I am a physical therapist with over a decade of experience in neurological and orthopedic rehabilitation. My experience over that time has led me to believe that much of the pain, suffering, and debility I have addressed could have been prevented, or at least postponed, through improved lifestyle choices earlier in life. Because of this I want to educate and empower people to establish better health habits earlier in life in order to prevent or at least ease the suffering of the aging process.

In addition to my training and experience as a physical therapist, my philosophy about what a healthy lifestyle entails is informed by a lifelong passion for outdoor activity. I have been hiking since I was a small child and also enjoy trail running and mountain biking. I have experience rock climbing, canoing, and kayaking; and completed a through hike of the Colorado Trail. My professional outdoor experience includes guiding a variety of age groups on backpacking, canoe, and dogsled trips.

My business aspiration (still in the planning and development phase) is to offer one-on-one wellness and fitness consultation, as well as group instruction in topics like natural running. My mission is to help people live healthier, more fulfilled lives, by optimizing their well being from the standpoint of physical fitness and general self care.

Please check back often for informative articles about fitness and wellness as well as new information about services I will be offering.