By Dr Kevin Maggs (@runningreform)
The majority of patients in my clinic are runners. As a chiropractor, this may seem strange, but I have developed a niche due to my background in biomechanics and a penchant for running.
I see a wide variety of conditions during a typical day, but at the same time, certain scenarios become repetitive.
“Are these shoes good for me?”
The question, “Are these shoes good for me?” or any variation of that theme is certainly one of the most commonly repeated questions. When you have a “Groundhog day” moment like that on a daily basis, you start looking for more efficient ways to handle it. Many patients respond well to visual learning, so I often search the web for appropriate media that fits with current evidence. Unfortunately, I am usually unable to find anything suitable.
So, when I see a need for something, I try and fill that need.
I’ve dabbled in 3D animation and use a free program called “Blender”, to make short, evidence based videos for my patients to watch. My hope is that these videos offer a well thought out visual explanation/ representation– and an improvement on what I could do “off the cuff” in the office.
Here is a sample of these videos:
1. Tendon Compression: Tendons are particularly vulnerable at sites where they wrap around and are compressed by bony protuberances. During the initial stages of treatment, it is often important that patients understand this concept and try to avoid positions or exercises that may increase compression.
Here’s a BJSM review by Jill Cook and Craig Purdam that examines the potential role of compressive loads in the onset and perpetuation of tendinopathy and more: Is compressive load a factor in the development of tendinopathy?
2. The Science?? of Prescribing Running Shoes: an article in the BJSM asked if prescription of distance running shoes is evidence based? This video is a patient friendly version that everyone should understand.
3. Increasing Anterior Ankle Impingement by Limiting Pronation: In order to fully understand this video, I would highly recommend reading the accompanying blog post (found here) which fully explains the concepts.
I frequently encounter patients suffering from anterior ankle impingement, running in zero drop shoes or shoes and orthotics that limit midfoot pronation. I use this video to explain why this is probably a poor choice.
4. Craigs Test:The idea of femoral anteversion isn’t easy to understand without some visuals. This video is very helpful.
5. Hamstring Tension During Running: This video explains various factors of sagittal plane position of the pelvis will affect hamstring tension during running.
This BJSM Hamstring podcast cluster gives you the opportunity to hear from the hamstring experts. I would highly recommend these!
6. The Forward Lean Reducing PFPS Forces: This is one of the first videos I ever made, and so the quality isn’t that great, but it still does the job. There are studies that report increased trunk flexion angle will reduce patellofemoral joint forces. While this is true, this video demonstrates an alternative. Since I published this video and related blog in 2012, further studies have supported the notion that a forward lean reduces knee forces, but increases hip/low back forces.
In addition to above, have a listen to present-day expert in PFP, Associate Professor Kay Crossley on treatment for patellofemoral pain in this BJSM podcast. She discusses (i) the outcomes of the 3rd International Patellofemoral Retreat (BJSM 2014, see below), (ii) the best PFP treatments and evidence for them as well as (iii) new insights into knee pain after ACL reconstruction.
Ideas for further videos? I’m open to suggestions. Contact me here.
Kevin Maggs is a chiropractor in Virginia, USA and operates the website runningreform.com. He studied Kinesiology at the University of Waterloo in Canada and is experienced and trained in running mechanics and running injuries. He is also an instructor for Active Release Techniques and spent many years travelling and treating the professional triathletes for the Rev3 triathlon series. He is an avid runner and has completed many marathons and full Ironman races.