GETTING YOUR BERLIN MARATHON RESULT WHILE OVERCOMING STRESS FRACTURES

How Dr. Bart Dingenen empowered Leentje’s return to running with impact measurements

Watch this full case insight video provided by Dr. Bart Dingenen, Physiotherapist at Motion to Balance where discusses the importance of objective gait analysis. 

“Now we always test a cue before recommending it" - Bart Dingenen, PhD

Leentje Hellemans, mother of two, started running five years ago. She has already completed several races including two marathons with one being a silver medal of 3hours 9min! Unfortunately, due to covid-lockdowns last year she suffered from her second consecutive stress fracture. During the lockdown period she couldn’t see her physiotherapist (Bart Dingenen – Motion to Balance) often enough to work on her running technique and form. This year she is ready for her comeback and her goal is to run the Berlin Marathon in under three hours without injury. Runeasi was recently introduced into her marathon preparation to help her achieve this goal.

First evaluation: running gait analysis with biofeedback.

Leentje ran at two speeds, one slower (13km/hr) and one faster (18km/hr). Bart used the biofeedback mode to see her impact in real-time while the Runeasi biomechanics sensor measured her impacts for ~1-2 minutes at each speed. At the slower speed the biofeedback showed that she had already crossed the yellow threshold (elevated) for impact and the red threshold (very high) for peak rates in her left leg. Both of these kinetic metrics are important to look at since it gives a clear view on how large (impact) and how fast (peak rate) the shock wave travels through the leg immediately after the foot lands on the ground.

“It’s feels really good to know how much impact I have while running. It was surprising to see the imbalance between my left and right legs”,  were the words of Leentje Hellemans, the patient. 

At the higher speed her peak rates were very high for both legs. Bart immediately used several cues on her running technique to work on reducing her peak rates. He also observed that she didn’t have her own running shoes that she normally runs in which was probably playing a role in her unexpectedly high impact.

“a real added value to My clinical reasoning.”

Follow-up evaluation: running gait analysis in the real-world.

One week later Leentje returned to Motion to Balance for an outdoor run – this time with her normal running shoes. She ran an easy pace in the forest alongside the physiotherapy practice. Bart sent her off for a brief run along the dirt track after he quickly attached her Runeasi biomechanics sensor and pressed record in the APP. When she returned her data automatically synced and together they analyzed her biomechanics. 

Her impact and peak rates showed interesting changes on her follow-up session outdoors (see picture of comparison below). The most striking differences were the reduction in impact by 39% in her left leg and 23% in her right leg; as well as the reduction in peak rates by 35% in her left leg and 48% in her right leg. These results indicate that her ability to absorb impact shocks is sensitive to the type of surface terrain she runs on and the type of shoes she runs in (and probably an interaction of the two!).

As Leentje progresses her training loads to prepare for her marathon she will need to find the healthy balance between the load capacity of her body’s structures and the actual load on her body. Her history of stress fractures suggests that finding this balance and knowing when too much is too much is not always so easy without professional guidance from a physiotherapist. She will need to produce adequate muscular force to counter the ground reaction forces for every single running step (i.e., local tissue capacity). She will also need the ability to perform (and withstand) the demand of her marathon training and event in Berlin (i.e., sport-specific capacity). These are important considerations explained in a recent article published in the British Journal of Sports Medicine by Gabbett, Sancho, Dingenen, and Willy., 2021. A nice infographic explaining these considerations can be found here. This framework fits perfectly with Runeasi measurements. 

Measuring her impact and knowing how her body responds to that impact will help her progress with confidence at the most critical moments during her marathon training plan. Knowing when to push and when to rest is a key insight to avoiding an overuse injury. With covid-lockdowns a thing of the past (hopefully) she can work on these aspects with Bart with regular follow-up examinations as she nears closer to her race date. We wish Leentje the best of luck!

 

"iT SEEMS IMPOSSIBLE UNTIL IT IS DONE" - NELSON MANDELA

UPDATE: We are delighted to announce that Leentje has achieved her goal to run the Berlin marathon in under 3 hours injury free. In fact, she achieved a time of 2hours, 54minutes, and 14 seconds. Moreover, she placed 7th overall in the women’s 35+ category! She has demonstrated incredible grit, perseverance, and willpower.  Congratulations to her and Bart for this incredible journey and success! 

Case insight provided by: Bart Dingenen, Ph.D.

Case insight provided by: Bart Dingenen, Ph.D.

Bio: CEO & Cofounder Physiotutors.

I work as a physical therapist at the private clincial practice Motion to Balance, Genk, Belgium. Within this multidisciplinary setting, I mainly work with athletes in function of sports-related lower extremity injury prevention and rehabilitation. Together with 4 other colleagues, I am co-associate in this private practice.

As a clinician, I am always eager to improve myself day by day and to deliver state-of-the-art patient care. Good is never good enough. Excellence is only the result of trying to become better and better. To reach these goals, I am continuously learning from my experiences with my patients, reading novel literature and following courses of international experts in the field.

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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

 

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.