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Shepherdstown, first to cure running injuries

By Staff | Jan 28, 2011

So why would a family doctor research running injuries, experiment with running technique and shoe designs and even open a store selling only flat shoes? The answer is a quest to run pain free and share the hard lessons learned to others wanting to keep moving for life.

I have been a runner since 13. As an often-injured runner, my interest in medicine was sparked by our University of Virginia team physician Daniel Kulund who tried some bizarre-at-the-time and innovative approaches to running injuries. He was the first to have people run in the pool for training, and runners rebirth by his methods. Runners train in water now not just as injury rehab but for prevention and supplemental training. I am reviving the passion I felt at that time 20 years into my medical career by working with innovators in a newly evolving Running Medicine field.

Dr. George Sheehan was another individual whose ideas in the 1980s were also way ahead of his time. Holism, prevention, understanding movement and the root causes of injury – these are the basis of running pain free for life. One modern innovator applying these integrated principles is Jay Dicharry at the University of Virginia SPEED Clinic. Jay connects form, function, performance and injury prevention and empowers those he sees with insight and detailed instruction to self correction.

We live in a sports medicine world now where running injuries are still treated with rest, ice, new and bulkier shoes, MRIs, other fancy tests and various devices. Despite all this care, which there is little to no evidence base, runners still get injured at the same high rates. Runners become former runners not by choice but out of suggestion from the health care field as the answer to their bodies’ discomforts.

I’ve been through the pain cycles, too. I discovered in 2000 after years of progressive pain in my feet that severe arthritis had engulfed both my large toe joints. The technical term is hallux rigidus and causes include pushing off too hard from my foot, running and walking in shoes with a heel placing unnatural forces on the toe joints and other biomechanical deficits.

I decided to have bone resections for the arthritis changes in both great toe MTP joints, where toe attaches to foot. The surgery relieved the pain but the joint was still fused straight. I thought my days of running were done; this was the orthopedic message. Perhaps take up another activity? None were as convenient and relaxing as running.

After taking a few months off, I was set on trying to retool how I ran with only one goal – getting out and enjoying myself. I studied what was written on running methods and became particularly interested in common-sense concepts for impact reduction and optimizing forces and momentum. Themes were shorter stride and quicker cadence (not overstriding and braking), a slight forward lean and landing under one’s center of mass. I tried to figure out how the Kenyans ran; they had no shoes so had to have low impact styles.

I trained “easy” by the methods made popular by Phil Maffetone and Lydiard. The methods focused on becoming efficient at one’s pure aerobic heart rate, where fat utilization is the primary fuel source. The runner becomes efficient in form and metabolism, building millions of capillary beds and the mitochondria to produce aerobic energy at a set low heart rate. With weeks of practice and patience, the pace drops with the same low heart rate. The runner morphs from a pure gas car (glucose as fuel) to an efficient hybrid, using electric (fat) as primary fuel and turning on the gas when you need it.

Surprisingly by adhering to this “easy” running approach and focus on technique, I rebounded to run a 2 hour, 28 minute marathon and placed third at 2000 Marine Corps Marathon after only four months back to running and far less training miles than prior. Recovery was easier than ever before.

In December 2005 the Washington Post ran an article on ChiRunning and its creator Danny Dreyer. The piece was intriguing and led me to buy his book. After the first read and a little practice, I realized what I was missing in trying to find and teach efficient injury-free running – draw the power from the core and “lift the legs” while off loading the feet. I could visualize this method completely and more importantly lead others, too. Danny and I still study this method.

An understanding of foot anatomy and function is essential, too. When a heel is elevated, the arch of the foot destabilizes and a domino effect of compensations occur in other joints. I cut heels off of shoes to level them before companies like Newton and Terra Plan produced level shoes. Our retail store sells only shoes that are flat. Not surprisingly after some education and trying shoes for a test jog, runners feel the difference immediately.

No pain, no gain should be a thing of the past. No pain, thank you – the Re-Evolution way.

Complete story at www.zero-drop.com/?p=1485.

Dr. Mark Cucuzzella is a local physician and national leader in healthier running as well as the Race Director for Freedoms Run. In this new monthly column, Mark will explore topics he reflects on in this narrative piece as he helps local runner Shane Harris achieve the goals from his New Year’s resolution to run faster.