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Cracked the code: Solution for 7 years of persistent running pain

By Felicia Sciortino, PT, DPT, OMT – Runeasi expert

For the sake of privacy, we’ll call the patient “Ashley”. Ashley is a 42-year-old who loves to run and has been a runner for many years. Unfortunately, for the last seven years, she’s been battling a persistent, nagging pain. She reported several painful areas, namely her right posterior hip, her posterolateral thigh, her lateral knee, and the bottom of her right foot. The pain progressed to the point that it began to affect her walking and even her work. Looking for answers, she turned to Google and tried shortening her stride. Years went by with no improvement. Frustrated but determined, Ashley sought help from Endurance Ally after numerous unsuccessful attempts with other healthcare options.

Diagnosing the Issue

At Endurance Ally, we dug deep into Ashley’s symptoms and conducted a thorough objective exam. Here’s what we found:

  • Limited Right Hip External Rotation: This could explain some of her running issues.
  • Short Rectus Femoris (both sides): This muscle tightness was likely impacting her stride.
  • Positive Straight Leg Raise (Right): Indicating nerve tension or lumbar issues.
  • Tenderness and Hypertonicity: In her right lumbar paraspinals and gluteus medius.
  • Trunk Flexor Weakness: Core stability issues affecting her posture.
  • Bilateral Hip Abductor and External Rotator Weakness: The right side is weaker than the left.
  • Lumbar Decompression Relief: This temporarily eased her symptoms.

The Running Analysis

Using Runeasi’s cutting-edge software, we took a closer look at Ashley’s running form. The results were eye-opening:

Running quality score first assessment
  • Overall Run Score: 44%.
  • Asymmetries: impact L>R. Likely compensatory.
  • Flight Ratio: 39%, indicating a “bouncier” running style.
  • Cadence and Speed: Her cadence was 178 at a speed of 4.7 mph, higher than necessary and affecting her running efficiency.

One of the tips Runeasi suggested was to “imagine she was running under a low ceiling” to help correct her form.

Crafting a Treatment Plan

Here’s what worked for her running form:

  1. Zone 2 Running: To minimize global inflammation associated with higher-intensity workouts.
  2. Softer Landings: To reduce impact loading on her body, specifically “run quietly so no one can hear you” and “run with soft steps”
  3. Longer Strides: To shift the propulsion forces from her calves to her hips.

To support these changes, we focused on strengthening her larger muscle groups like the gluteus maximus and hamstrings. Plyometric exercises, such as squat jumps with soft landings, were added to improve her shock absorption.

Core and Soft Tissue Work

We also targeted Ashley’s core to enhance her trunk control during hip extension and prevent excessive lumbar extension and anterior pelvic tilt. For immediate symptom relief, we used soft tissue mobilization on her gluteus medius and TFL, dry needling on her lumbar paraspinals, right gluteal muscles, and calf. She started with self-lumbar traction but eventually didn’t need it anymore.

The Transformation

By her fourth treatment session, Ashley was running pain-free for the first time in 7 years. Her running form reassessment showed remarkable improvements:

Improvements after intervention
  • Runeasi running quality score: Jumped to 72%
  • Impact Magnitude: Decreased from an average of 9 G to 3.5 G, which is nearly a threefold reduction.
  • Increased Speed: Better running quality at higher running speeds.
  • Enjoyable Runs: She felt her runs were easier and more fun.

Conclusions

This serves as a compelling example of how running data assists us in identifying weak areas and guiding our progress. we must be cautious when applying one-size-fits-all solutions, such as relying solely on running cadence. Ashley is now back to running pain-free with her husband, often leaving him in the dust! She plans to keep up with her strength training and looks forward to checking in a few months to monitor her progress. Go Ashley!

Picture of Written by Felicia Sciortino, PT, DPT, OMT

Written by Felicia Sciortino, PT, DPT, OMT

Felicia, Founder of Endurance Ally, is a former D1 runner and current triathlete who received her Doctorate of Physical Therapy from Boston University in 2019. She recently moved to Greenville, South Carolina with a dream of helping as many endurance athletes as possible stay healthy and happy. With a history of running injuries herself, she understood the frustrations of being unable to compete and more broadly, the effects of not being able to do what she loved. She created Endurance Ally to provide quality physical therapy services tailored to each individual and with a level of expertise and compassion that endurance athletes deserve.

5 rEASONS TO USE OUR APP

1. Global movement quality

Track and improve your client’s Runeasi running quality. Identify their weakest link with our advanced visualisation.

2. individual recommendations

Get individual training and cueing recommendations to improve your client’s weakest link.

3. Real-time feedback

Engage your clients through visual gamification and watch how they self-optimize to your verbal cues.

 

4. Session trends

Learn more about your client’s running quality during daily training. Our session trends show when and where the quality drops with fatigue.

5. Quick comparisons

Compare pre-post data to show intervention effects on the movement quality. 

3 REASONS TO CAPTURE DATA USING THE RUNEASI BELT

1. No motion artifacts. The Runeasi belt is secured tightly against the body and the skin to capture the actual movements of the body’s center of mass. Attaching or clipping the sensor directly to the pants would allow the sensor to wobble from side to side (i.e., measuring the wobbling of the pants, and not the human body.

2.  Easy to standardize the sensor’s positioning. The Runeasi belt makes it easy to consistently position the sensor close to the center of mass. Attaching the sensor directly to the pants would dramatically affect the reliability of the outputs as the height and tightness of the pants will affect the results. Moreover, these pants attachments often shift sideways while running which further decreases the data quality. 

 3. Comfortable to wear.  Hundreds of runners confirmed that they immediately forget about our belt while running. This allows them to move without any restrictions and allows us to capture movements that are representative of a client’s true biomechanics.

SENSOR SPECS

LAB GRADE SENSOR

Accurately captures full range of motion and kinetic parameters by leveraging wide sensing range (16 Gs) & high sampling frequency (1000 Hz)

WATER & SCHOCK PROOF

Built to withstand high intensity training and sweating. Suitable for the outdoor elements, come rain or shine. Robust to handle the repetitive and ruthless impact shocks of running.

Lightweight & SLIM

Seamlessly integrates onto the body to support movement without restrictions. Weight: 9.4g/0.33oz with battery. Dimensions (36.6mm/1.44” dia. X 10.6mm/ 0.42” thick)

No charging wireless

Replaceable coin-cell battery with operating time up to months, depending on the usage. Bluetooth® 5.0 radio for effortlessly transmitting data real-time or post-session.