Having worked with runners of all ages, shapes, sizes, and ability levels through the years, we are always looking for ways to improve our approach to diagnosing and treating running injuries. We’ve done this long enough to realize that the prescription commonly given in most health care facilities that sounds something like “if it hurts when you run, just stop running” simply doesn’t work. Rest simply doesn’t change mechanics, and runners who are told that stopping running is their only option normally are going to terminate their care with you ASAP.
Most running injuries are based, to some degree, on a biomechanical flaw that must be diagnosed and corrected in order for the pain to go away. One common biomechanical flaw, and one of the first things that we commonly assess in our runners, is their cadence. Cadence is the average number of times your feet strike the ground in a minute and ideally should be ~180 strikes/minute for shorter-statured runners and ~170 strikes/minute for taller runners. The idea is that most runners have a cadence that is too low, and they cover too much ground with every stride. This increases the load of each stride on their lower body. When a runner is diagnosed with a low cadence, our first intervention is to equip them with a metronome to help their body keep the rhythm of their newer, faster turnover. Many of you have entered our facility to the rhythmic, sometimes maddening tune of incessant beeping of the metronome with a runner trying to keep pace on the treadmill. A 2008 presentation by Willy et al revealed that cadence re-training lowered peak impact in runners by ~18-19%. This reduction often makes a significant improvement in the runner’s pain with running.
I give you all that information as a backdrop to say that I was very interested to read a research article in the August 2017 edition of The Journal of Orthopaedic and Sports Physical Therapy (JOSPT) entitled “Sound-Intensity Feedback During Running Reduces Loading Rates and Impact Peak”. Now I won’t bore you with all the specifics here, and I encourage those of you who are interested to find the article online and give it a read, but I found the results of the study to be very compelling. Basically runners were given a decibel meter (a free app that had been downloaded on an iPad) and told to try to decrease the sound intensity of their foot striking the treadmill using the decibel meter as instantaneous feedback. After 15 minutes of sound intensity feedback training with running, most runners (~80%) showed a 20% reduction in the peak impact on their lower body. This is a greater reduction than we would expect with cadence re-training.
Based on this research, we now have another, possibly improved, tool to reduce impact forces on a runner’s lower body and may eventually be able to step away from the incessant beeping of the metronome as our go-to tool for one of the most common mechanical flaws in our ailing runners.