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Forward Lean and Ankle Dorsiflexion

By Dr. Scott Greenapple

The purpose of this brief article is to speak about some concepts and techniques of what many therapists, chiropractors, and coaches consider as proper running form. I purposely write to instill controversy and thought-provoking ideas because without questioning, we leave ourselves open to following the latest fads and not always the best advice.  There are many things to cover and I will only address a few concepts in this article: forward lean and ankle dorsiflexion.

Over the past 25 years, I have been fortunate enough to study and hang out with whom I consider to be the top running biomechanists in the US and Canada.  We observed runners and video footage of every type of track and field athletes, as well as golfers and tennis players. Regardless of differing theories and opinions, there are laws of physics that trump all theories and should be followed.  I must say, that I do have definite opinions and do not agree with the one-size-fits-all theory that many techniques such as Pose, Chi and natural running form suggest.  I will expand on this later.

First off, let's address the concept of running form.  Many coaches and athletes want to have their running form or gait evaluated with video.  However, a video of a runner either on a treadmill or at the track for a short period of time only gives a small amount of information. It  may show signs of good gait, or signs of "issues." It may show signs of an incorrect form, but it does not address why.  As with any patient or athlete, a functional movement screen will provide the most amount of information about their weakness or limitations.  I also follow that with manual muscle tests to see about any neuro kinetic dysfunction, where muscles fire in incorrect sequence due to poor muscle memory, or previous injury. Remember, the number one occurrence of an injury to a runner is a previous injury.  Recurrence happens when the dysfunction is left unfixed, only the symptoms are helped. After a functional assessment, the best way to video a runner is when they are well into a run, tired or fatigued.  My best success is at the 2 mile mark of a 5K; the 4-5 mile mark of a 10K; and so on for the half and full marathon.  We had videotaped very high level runners after they crossed the finish line as they were decelerating and found lots of issues with their strength.  The better the runner, the better they cover up their faults during the race.  Now, let's talk about some form.

The forward lean:  Many theories of "proper running form" will tell you to lean as you run.  Most tell you to lean at the ankles.  If you watch runners, especially when they are tired, they will lean at the waist.  In fact, if you lean too much from either the ankles or waist, you will put undue stress on the back of your body, known as the posterior chain. The best advice is to have your leg land under your center of mass or directly under your pelvis.  Posture is key: start upright and tall, put one hand on your belly button, and the other on your sternum.  Bend very slightly at the waist to stack your lumbar vertebrae, then go. You can find pictures of this on the web - search for a good friend of mine and great biomechanist Jay Dicharry to see some great examples.  Remember the key to good form is being strong enough to hold the form throughout the run/race. The one-size concept just does not make sense, as the individual's weaknesses and strengths are what matter.  

Next is the angle of the ankle known as dorsiflexion.  This is a big issue to me.  Theories of the proper form methods will tell you to lean at the ankles.  But, what if the ankle is not flexible or strong enough to get into that position?  You end up with Achilles, plantar, calf, and hamstring issues. This is very common in triathletes with a strong swimming background due to their feet having extreme flexibility in plantar flexion (toes and feet pointing down) as opposed to dorsiflexion (toes and feet pointing up).  In running, a good angle of dorsiflexion at the ankle, accompanied by strong Achilles and calf muscles, enables the body to absorb shock in landing and to spring back and push off.  The gastrocnemius and soleus are the key calf muscles for this.  The angle of dorsiflexion should be 20-25 degrees and the big toe should dorsiflex to about 40 degrees.  If the dorsiflexion is not there, you will spin off the forefoot or put too much stress on the plantar fascia causing the cursed plantar fasciitis.  Below, you will find a simple test to evaluate your ankle dorsiflexion and exercises/stretches to help the posterior chain or calf to let go and let you get into the proper position.  Remember, you do not get strong from running, but need to be strong to run!  Start with function, address issues of weakness with treatment of soft tissue and joint restriction, add strength exercise and drills to change the neuro kinetic motor control theory, and then look at the gait to see if there are any biomechanical insufficiencies.

For more, check out the following videos!