Bryan Heiderscheit, PT, PhD is a UW Health physical therapist with a doctorate in bioimechanics and advanced expertise in orthopedics and rehabilitation. Bryan is also a professor and vice chair for research in the Department of Orthopedics and Rehabilitation at the University of Wisconsin School of Medicine and Public Health as well as the director of UW Badger Athletic Performance.

Bryan has advanced expertise in treating sports and running-related injuries in athletes of all ages and activity levels. He diagnoses and treats knee and joint pain, bone stress injuries and overuse injuries, such as Achilles tendinopathy, which causes swelling and pain in tendons and muscles.

Educating people and involving them in their care are high priorities for Bryan. He gives athletes the knowledge, guidance and motivation they need to play an active role in their recovery.

In addition to clinical practice and teaching, Bryan directs research that helps improve how clinicians manage orthopedic conditions. Bryan’s research team works to better understand and prevent certain types of sports injuries such as hamstring strains and bone stress injuries. They also develop rehabilitation strategies for a successful recovery and return to full activity after surgery.

Listen to this episode of The MOVEMENT Movement with Dr. Brian Heiderscheit about the science of running.

Here are some of the beneficial topics covered on this week’s show:

– How biomechanics and injury risk research is about analyzing movement patterns to identify how they influence injury risk.

– Why different shoes can significantly affect a runner’s gait, leading to changes in foot strike patterns and landing mechanics.

– How cadence and step rate are important factors in running mechanics.

– Why the relationship between cadence and impact forces during running emphasizes the implications of foot positioning and muscle utilization in mitigating loading forces.

– How the impact of shoe selection on running mechanics is evident, with different types of shoes affecting gait patterns and performance.

 

Connect with Bryan:

Guest Contact Info
LinkedIn
linkedin.com/in/bryan-heiderscheit-a82a37217 

Connect with Steven:

Website

Xeroshoes.com

Twitter
@XeroShoes

Instagram
@xeroshoes

Facebook
facebook.com/xeroshoes

Episode Transcript

Steven Sashen:

I’m Steven Sashen from The Movement Movement podcast. You can find us at jointhemovementmovement.com or all the various places where you can think of where you’d find Join The Movement Movement. Actually, if you go to jointhemovementmovement.com, you’ll see Twitter and Facebook and YouTube and iTunes and everywhere else. And this is a podcast for people who want to learn the truth about how to move healthily, happily, strong, have healthy, happy, strong bodies, and to cut through the mythology that people have been propagating that might keep you from doing that.

If you’ve been listening to the podcast, you know that typically it’s just me doing a lot of ranting. Well, I’m happy that that’s not the case this time. I have my friend, Dr. Brian Heiderscheit. We will be exploring something interesting. One of the many things we’ll be exploring, could you improve your running and get rid of your injuries by moving faster without running faster? I know that sounds crazy, but we’ll jump in and find out how that works.

So first of all, Brian, hello.

Dr. Brian Heiderscheit:

Hi, Steve. Thanks for having me on. Appreciate it.

Steven Sashen:

Yeah, that’s really kind of you not for saying, “Hey, thanks for doing this again, because the recording didn’t work the last time.” So that’s what happened. Here we are again. So I’m going to ask you a question that I asked before, maybe you have a better answer now. You’re a PhD, which means you have a doctorate of philosophy technically, so say something philosophical.

Dr. Brian Heiderscheit:

No, no improvements at all. You know that it’s going to be the same. I have nothing impressive to say.

Steven Sashen:

That’s actually very zen you. There’s no improvements at all. Okay. I’m just going to stick with that one. I’ll stick with, “After zen, mountains are mountains and rivers were rivers.”

Dr. Brian Heiderscheit:

I suppose that would be true.

Steven Sashen:

Okay, so we started this conversation originally 20 minutes ago, and I asked you how you got to where you got to, and you were talking about how originally you were doing research on footwear, shoe companies were selling you stuff. If you had to sum up what you discovered from that in an elevator pitch, elevator sentence, what would you say that you discovered?

Dr. Brian Heiderscheit:

One of the challenges definitely is that when we tried to do the testing on the different shoes, on the material properties of the shoe, that they did not well represent what would happen when people ran.

Steven Sashen:

That’s interesting. So what happens in the lab does not equal what happens in real life.

Dr. Brian Heiderscheit:

Exactly. And that wasn’t our intent of testing the shoes was actually to give information about the shoes themselves, not to interpret five, six, seven miles down the road and say what they actually would do in terms of injurious performance, but of course, that’s many times how that information is extracted.

Steven Sashen:

So wait, you’re saying that you did not give information that showed that shoes improved performance or reduced injury, but the shoe companies then would take your data and say that that’s what they did?

Dr. Brian Heiderscheit:

Yes, correct. We did not do that. Whether the shoe companies or others who interpreted it incorrectly, yes, we did not do that.

Steven Sashen:

It’s funny, there are some researchers who will remain nameless, but if they’re listening, they will know who they are, who are especially trying to prove that minimalist and barefoot running is frankly bullshit. They have studied VO2 max, which is basically how well your body uses oxygen, for people who don’t know, and what they showed in a small study that has not been replicated, that involved people who claimed to be proficient barefoot runners, even though I know none of the people that were in that study, and I know all the local barefoot runners, and the conclusion was that the barefoot runners, their VO2 max was lower than the people who were running in regular running shoes. By the way, the regular running shoes were sponsored by the company that sponsors this entire lab.

My argument was, hey, who cares? Because what your VO2 max is in the lab doesn’t say anything about how you’re going to perform in real life. And luckily, the same lab is now saying, “Well, we’re still seeing VO2 max improvements with the so-and-so.” I won’t mention the brand by name, but it rhymes with Fike, Vaporfly, but we don’t know why and we’re not saying that it’s going to change the way you perform in real life. And I actually had someone say, “Well, how come so many people are setting personal best in that shoe?” I said, “For the same reason other people are setting personal bests in other shoes.” It’s like, it’s not what people say.

So anyway, so that’s the short version of what you discovered then, and now, what’s got your interest now? What are you doing both either in research and/or clinically?

Dr. Brian Heiderscheit:

Yeah, so in both environments, we’re truly trying to look at how people are moving and if we think that their movement could be influencing their injury risk. And if we do think so, then what changes can we make and how?

Steven Sashen:

So we’ll jump into that in a second, but I realized that since we skipped and did our intro a second time, I didn’t give you the luxury of saying where you are and what you do.

Dr. Brian Heiderscheit:

Oh, sure.

Steven Sashen:

Dinner party.

Dr. Brian Heiderscheit:

A professor.

Steven Sashen:

Dinner party, dinner party. Hey man, what do you do?

Dr. Brian Heiderscheit:

I work at the University of Wisconsin Madison. I’m a professor in the Department of Orthopedics and Rehab, as well as the physical therapy program. I direct the University of Wisconsin Health Runners Clinic and have a clinic within UW Athletics to help with the major athletes.

Steven Sashen:

Cool. And to let people know, Brian and I met through an event that he puts on with Dr. Irene Davis from Harvard and Dr. Chris Powers at USC called The Science of Running Medicine, which you can find at scienceofrunning.net. If you’re a physical therapist, you’re going to want to go to one of these events. This is where the three of them, let’s just say, argue to some extent about the best way to evaluate and treat runners and running injuries, and we will jump into that in just a bit in fact.

So when you’re analyzing movement now and trying to find ways for people to run better, healthier, et cetera, what’s the thing that you’re focusing on primarily?

Dr. Brian Heiderscheit:

So we try to come up with standards that can be done in just about any sort of clinical setting. So we’ve done a number of high-tech research studies that have shown us some relationship between movement patterns and potential biomechanical loads and injury risk. But the challenge is that most clinicians don’t have access to that sort of technology, or at least can’t afford a lot of the technology. And so we’ve tried to make other measures or other movement measurements that they can do in a clinic setting.

Steven Sashen:

So some of the stuff that you’re talking about involves force plate data and just looking at kinematics, basically how joints are moving and joint angles and various things like that?

Dr. Brian Heiderscheit:

Yeah, so when we’re doing the research studies, we’ve got our optic motion capture system, eight cameras all synchronized with force plate platform data, some muscle EMG pattern recordings, all being fed back into a single computer. We can recreate that individual movement as best we can using some of our models.

Steven Sashen:

When you say this, it reminds me, so the panel discussion that I was on at the American College of Sports Medicine last year, there were some guys from Adidas who had their motion capture stuff and they were all really proud of it, and they showed two things that I didn’t have the time to go, “Are you kidding me?” But the two things were the first was showing a runner from the side and how when the runner’s foot hit the ground, it’s like, “Look, we can actually see the impact forces when they hit the ground. Isn’t that cool?” But what they showed was this massive spike of force that was heading in the opposite direction the person was running, so they’re slamming on the brakes while they’re landing on their heel.

And they were going, “Isn’t that amazing we can study this?” No, no, no, no, no. You’re missing the big thing here. They just put on the brakes. Let’s not even talk about what it means to send that force spike through your body. There’s some arguments about that. I think they’re bad arguments. I think it’s pretty obvious you don’t want that. As much as you can reduce it, you want to reduce it, but regardless, even if you think that it’s totally fine, it makes no sense to be having that much force going in the opposite direction you’re trying to run.

The second thing, they showed a runner from behind just when their foot hit the ground and they showed the direction and the amount of force that was going in different directions, and so what they showed, the runner’s foot first hits the ground and there’s a force vector pointing at like 45 degrees out. I don’t remember it was in or out, frankly. But then it almost immediately switches to 45 degrees in the other direction, then to like 30 and then to 20, and then it finally gets straight up and down when the runner hits mid-stance.

And all I could think is, “Dudes, this is in the motion-controlled shoe that you’ve spent 50 years developing. Really? That’s the best you can do?” And they were looking at it again like it was super cool that you could capture this. And I’m looking at it like, “Wow, that’s super cool. You just proved that what you do doesn’t work.”

Dr. Brian Heiderscheit:

Yeah, that’s some truth to that for sure.

Steven Sashen:

So when you simplify things to give clinicians something that they can work with, what have you landed on, pun intended?

Dr. Brian Heiderscheit:

Well, the main thing is that most clinicians are going to have access to what they see, but of course, your human eyes, the eyes are not going to be able to capture the level of detail that you need to look at some of the running mechanics pieces. So we provide a way that they can utilize just a simple high-speed camera that most of us have available to us through our phones or something else that allows us to slow down the movement pattern and look at very particular aspects of the movement pattern that can give us insights into biomechanical loads.

Steven Sashen:

Can you be a little more vague, please?

Dr. Brian Heiderscheit:

Yes, I can absolutely be more vague. That’s the big picture. The specific things that we look for in terms of flaws in movement is how much the person moves up and down, how much their center of mass, if you want to call it that, their-

Steven Sashen:

How bouncy they are.

Dr. Brian Heiderscheit:

Their head, you could use their shoulder, how much they bounce.

Steven Sashen:

Oh, actually, hold on, I want to pause there. That’s an interesting thing, because a lot of runners that I see, they collapse in their midsection. They basically run and they look like a spring.

Dr. Brian Heiderscheit:

Totally. Yeah, yeah, yeah.

Steven Sashen:

Yeah, yeah. So if you only watch their head move, their head may stay straight while their body’s just collapsing left and right, or the other way around where people get super stiff and then they get really bouncy. And I think about Glen Mills, who’s Usain Bolt’s coach, Glen says that before Usain became an actual a hundred meter runner, they spent a year just working on his core strength because he had been really collapsey and they had to tighten that up. So that’s an interesting thing to consider. It’s like watching how bouncy someone is, but if they’re not bouncy, it could be that they’re not necessarily doing the right thing still. So that’s intriguing.

Dr. Brian Heiderscheit:

Yeah. Yeah. I mean, ideally you’d be tracking it at their hip, right, and you see how much that’s moving up and down, but you’re absolutely right. We do see the same thing where their trunk tends to extend or flex and extend and flex as they’re moving, and so therefore their head does this thing, so exactly what you described.

Steven Sashen:

Yeah. Okay. So we’re checking to see how bouncy they are, and what else?

Dr. Brian Heiderscheit:

Yep, see how much they bounce. The second thing we look for is what we think of as being an overstrider. And overstriding is one that a lot of people are like, “How do you even define that?” Overstriding does not mean a long stride length. Obviously as you run faster, you have to have a longer stride length. Stride length should increase. Overstriding really is what we’re talking about is that instant of landing where that foot is positioned relative to your center of mass.

Steven Sashen:

And so what would you call bad versus good?

Dr. Brian Heiderscheit:

In terms of distance, that’s the hard part because that’s the hard thing about any sort of movement mechanics, that almost all of it scales with speed to some extent. So if we try to put a value on and say, “Oh, you should land 10 centimeters ahead of your center of mass,” well, that only works if I’m running at a certain speed.

Steven Sashen:

Certain speed. Well, and this is something that I’ve pointed out to people is they’ll watch video of somebody running and they’ll talk about them overstriding or not and have no sense of what speed is. And the real effect of speed is if you’re moving across the ground much faster, your foot can touch the ground further in front of your body, but it’s not getting weighted until your body’s over it because your body’s moving that fast.

And so really, that’s where a force plate comes in handy because you can see where the force happens in relation to the center of mass, but in lieu of that, so when you’re giving people guidance about what they want to look for, what’s good or bad in terms of overstriding, what do you tell people if they don’t have access to a force plate and they’re just looking at video and trying to maybe factor in speed?

Dr. Brian Heiderscheit:

So what we try to do is there’s a couple of other surrogate measures such as looking at the knee angle, how flexed your knee is at initial contact, and then also looking at your shank or the lower leg, the tibial, and how far off of vertical that is. You want to get that closer toward the road.

Steven Sashen:

So ideally then you’re looking for more of your lower leg, your tibia to be more vertical, and the knee to be-

Dr. Brian Heiderscheit:

20, 25 degrees roughly.

Steven Sashen:

Yeah. So basically, with that small knee angle and a vertical tibia, that basically means you’re trying to get your foot underneath your body. I mean, that’s a short version of that.

Dr. Brian Heiderscheit:

Yeah.

Steven Sashen:

Do you care or do you have any thoughts about where your foot is sitting the ground in that situation?

Dr. Brian Heiderscheit:

In terms of a foot strike angle, foot inclination?

Steven Sashen:

Yeah, foot angle or basically the obvious heel strike midfoot, forefoot.

Dr. Brian Heiderscheit:

So our big approach with that is that I’m less concerned about the exact angle they hit the ground in or if they use a forefoot midfoot or rear foot strike pattern. But I usually define it four ways. So you’ve got a forefoot, midfoot, rear foot and then heel strike. I consider heel strike to be this bigger category because when you think about the potential angles that your foot can get in, you can go into 40 degrees of an angle and still be towards your rear foot, whereas forefoot strikers are going to be in a much, much smaller range. You don’t see a 40 degree forefoot strike.

Steven Sashen:

No, but the thing also though is obviously footwear is going to make a difference, because if you put a big heel underneath someone, then you’re more likely to hit that in advance and have it hit ahead of your body or more accurately, or another way of saying that is if you actually have that small knee angle and vertical shin angle, it’s actually harder to land on your heel because it’s basically already kind of behind you. So those factors I assume play into it as well, especially… Do you test people both in and out of shoes to see what that looks like?

Dr. Brian Heiderscheit:

We don’t do too much out of shoes, but what we do, for example, with our athletes who run collegiately, most of them are wearing the exact same shoes or very, very similar shoes, and we test them at a whole range of running speeds so we’re able to make comparisons and look at, do individuals with different shoes land in different distances ahead of themselves or the same shoe at different speeds, how does that factor in? And interestingly enough, even when they’re wearing similar shoes, they can have a whole range of overstriding risk.

Steven Sashen:

When I was spending time in Bill Sands’ lab, who’s a former head of biomechanics for the US Olympic committee, he was at Colorado, mesa University is what they’ve, I think, since renamed themselves to, what he saw is every different shoe changed people’s gait unless they were internationally ranked, typically middle distance runners and lower, like anyone running the 1500 or lower. You could put bricks on their feet and nothing changed. But anybody north of that or anyone who’s not that skilled, every shoe made a difference. And same thing, if they were jogging, it was sometimes different than if they were at full speed.

I also saw things… We took some habitual or people who were well-trained barefoot runners and then put them in a pair of Five Fingers and they went from barefoot running with a midfoot or forefoot strike to heel striking and overstriding in their Five Fingers. And here’s the kicker, they didn’t know they were doing it, so it was fascinating to see.

Now, the one thing that Bill would do, he’d put you on the treadmill and it was like five feet wide, 10 feet long. He puts you in a Mission Impossible harness, so in case you hovering, you don’t land on your face and go flying off the back of the treadmill and make an America’s Funniest Home video video, but he would put you in your favorite shoes and watch you filming it 500 frames a second, then he’d have you run barefoot.

And we saw that maybe 90, 95% tops when they went barefoot, their gait changed into something that was way closer to what you described without any instruction. And I found when I was in his lab, if I gave people who were still overstriding and heel striking, like 30 seconds of instruction, it would change. So we were seeing dramatic differences with just that simple intervention. Now, whether that would stick when they put on shoes or not, it’s a different story, but it was incredible to see how quickly people would adapt.

Dr. Brian Heiderscheit:

Yeah, I agree. People can change their heel, like you said, whether it’s an external trigger that does it such as the shoes or terrain or gradient or whatever it might be, or if you try to use some sort of a verbal cue.

Steven Sashen:

Yeah. The verbal cues, I found people doing two things that really surprised me when I first started seeing it, but it made sense after I saw it. The first was people who would overstride, they’d have their foot way out in front of them, and then they’d plantar flex. They’d point their toe to the ground, so they’re prancing when they ran.

Dr. Brian Heiderscheit:

Exactly.

Steven Sashen:

Why are you doing that? They said, “Well, I’m supposed to land on my forefoot.” It’s like, “But not like that.”

Dr. Brian Heiderscheit:

Exactly. I’ve seen quite a few people, not just for forefoot strikers, but those who have read something and decide that they’re going to adopt that running style and they adopt it in a way that you’re like, “Wait a second, time out. That’s not what we were after at all,” whether it’s some other cue or change that they’ve run about.

Steven Sashen:

Right. Well, the other one that I found is people who run, they look like Groucho Marx, so they bend their legs a whole lot and they’d still overstride, but they’re kind of catching their foot on the ground and then pulling it below them, so they’re not applying a lot of force, but it looks like-

Dr. Brian Heiderscheit:

Looks like they’re skiing.

Steven Sashen:

Yeah, kind of like cross-country skiing.

Dr. Brian Heiderscheit:

That’s exactly right. Yep. We see that same thing.

Steven Sashen:

Yeah. And again, it’s like-

Dr. Brian Heiderscheit:

It’s just exhausting.

Steven Sashen:

Right. I know. It’s like, “How did you think to do that?” And then I realized, oh, you’re supposed to put less force in the ground. You’re supposed to bend your knees. They came up with those cues and they found a way that works with them. I’ve talked to some people who refer to themselves as accomplished barefoot runners because they’ve run half marathons and marathons, and then they run like that. I mean, it’s allowed them to do it, but I wouldn’t call it necessarily the best choice for the future.

Dr. Brian Heiderscheit:

Yeah, absolutely. I cannot imagine trying to run faster.

Steven Sashen:

No, you’ve definitely got a limit. And that’s the thing is one of the things that I’ve seen, especially if they’re barefoot runners doing that, when they put on something like one of our products, which allows them to run faster, suddenly they discover form cues or form problems that they didn’t know they had because they form changes and they say, “Hey, this shoe is making a bunch of noise.” Like, “No, no, you’re making noise because you’re slapping the shoe down because it’s just the variation that you’ve made from your Groucho Marx thing to being able to have more form or better form, but you haven’t adapted to that yet.”

It’s really fascinating. Lana likes to call our shoes a coach because they’re giving you information you can use, but I’ve seen some people have interesting relationships with their coaches.

Dr. Brian Heiderscheit:

Oh yeah, for sure.

Steven Sashen:

I know, and partly what inspired this conversation, is that one of the things that you focus on in the Science of Running Medicine events is cadence. I know that’s another thing that you look at, and this is full of mythology.

Dr. Brian Heiderscheit:

Oh my goodness, is it ever.

Steven Sashen:

So please jump in.

Dr. Brian Heiderscheit:

The reason we went toward cadence and step rate is not because it was the solution, but because it was something that people could understand and could utilize as a cue to trigger some of the changes we were after mechanically. And that’s what’s been the challenge is people forget about the rest of what I just said and they focus on, “Step rate is the answer and the solution,” and therefore we got all these issues that we’re trying to correct now.

Steven Sashen:

Well, so let’s talk about what is valuable in cadence and define it for humans who don’t know it, and then let’s talk about the part that gets lost where people think it’s a one size fits all panacea for all running problems.

Dr. Brian Heiderscheit:

Yeah. So step rate is the number of foot strikes that occur per minute. If you count how many times your foot hits the ground or both feet hit the ground, now you have the number of steps per minute.

Steven Sashen:

I want to jump in here because I want you to highlight something that cracks me up. When people talk about, especially barefoot running, in general, the phrase that gets used a lot is, “Shorten your stride.” And when I hear that, my head wants to pop off my shoulders and then spin around and then explode or just explode, either way, because people don’t realize that stride length is just the distance from when your foot hits to when your foot hits. And you can have an appropriate short stride, barefoot stride and have a long stride length because you’re running fast, applying a lot of force into the ground when you do that. But for many people, that is the cue that makes sense because they can’t see behind themselves, they don’t realize that their stride is actually the same length, it’s just that it’s happening in what’s referred to as backside mechanics instead of frontside mechanics.

Dr. Brian Heiderscheit:

Exactly. Well, and whether it’s backside mechanics or whether it’s float mechanics, because most of your increase in stride length as you run faster and better occurs in the air.

Steven Sashen:

Correct, correct. Yeah, yeah, yeah. Okay. So anyway, back to cadence.

Dr. Brian Heiderscheit:

Yeah, so you’re right. When you think about running speed, let’s just say you’re running an eight-minute mile and you have your number of steps per minute and you’ve got the length of each step, and so you put those two together, now you have speed. And so what you’ve said is if you increase your number of steps per minute, that means you have to decrease the stride length. And while there is some element-

Steven Sashen:

If you’re keeping the same speed.

Dr. Brian Heiderscheit:

But there also is a way you can do so without compromising the advantages of stride length because in order to run faster, you have to have a decent stride length.

Steven Sashen:

So just to clarify, if you’re staying at the same speed and you have longer stride length, you have to have faster turnover, faster cadence. But obviously if you’re just increasing, if you’re increasing cadence and stride length stays the same, that’s the same thing I just said, then that’s going to make you run faster.

Dr. Brian Heiderscheit:

Yeah.

Steven Sashen:

So what is it about cadence that is both interesting to you clinically and from an intellectual perspective? And talk about just how it’s become this magic holy grail in the minimalist running world.

Dr. Brian Heiderscheit:

So the reason we got into it was because of what I mentioned before about the flaws of running, which is excessive bounce and over-striding. And when you increase somebody’s cadence, you will reduce their bounce and you can reduce how far they hit the ground ahead of their center mass. They will reduce their over-stride. And so what we do is we utilize those cues at a higher step rate so we can force them to feel what we want them to feel.

And then without necessarily saying, “Oh, what we’ve done is now we’ve taken you from 158 steps per minute to 168 steps per minute,” that means from now on you are 168 step per minute runner. That’s what you were born with. And really, if you look under your scalp, you’ll see tattooed on your forehead 168 because that’s what you were prescribed when you were born. And that’s completely false, right? Obviously if you run faster, that number has to change if you’re running uphill.

Steven Sashen:

So wait, are you suggesting that this idea that most people have that you’re supposed to run at 180 steps per minute might not be true?

Dr. Brian Heiderscheit:

Right, and so then-

Steven Sashen:

You heretic. You heretic.

Dr. Brian Heiderscheit:

Yeah. 180 comes into play and says that that is optimum for all, which just flies in the face of common sense, right, when you think of how different we are in terms of our body size and shape and fitness levels and that we’re all supposed to get up and run at exactly the same step rate makes no sense regardless of what speed we run.

Steven Sashen:

So then two questions come to mind. One is, talk to me about how you work with someone, and obviously they’re doing this on a treadmill at first, they have to get out in the wild and find it differently, but talk to me about how you work with someone to find what is, let’s call it an optimal range, given conditions changing, and also talk about what the value of doing that is. What’s happening when people, other than the fact that by increasing their cadence while not running faster, you’re more likely to end up with that knee angle and shin angle, so vertical shin angle, slight knee angle, foot underneath your body basically, but what else happens and how do you guide people to finding what’s right for them?

Dr. Brian Heiderscheit:

Yeah, great point. So the first one that we want to make sure on is that it’s always relative to where they’re starting from. So we’re not making a guesstimate looking at them and measuring their body height and their body mass and their running speed and putting it into an equation and coming up with, “This is your optimum step rate.” Those don’t exist. Unfortunately, those-

Steven Sashen:

You haven’t done that because you don’t want to be rich.

Dr. Brian Heiderscheit:

Yeah. Well, unfortunately, I think people have tried to do that back in the ’70s and ’80s and it failed pretty miserably. So it’s really not something that we’re able to be able to pick up in any sort of predictive way other than what we do is we look at their mechanics, and like I said before, if their knee flexion angle, if their tibial angle, if their bounce is too much, whatever step rate they’re running at when they’re showing those flawed mechanics, then we want to adjust that step rate. It could be as little as four steps per minute. It could be as many as 14 steps per minute to a point where we see improvements in those flaws.

And then the idea is we use the metronome to guide that change initially, and why do we use the metronome? Because even before we started using step rate, we would just do verbal cueing like you described before, “Hey, bend your knee a little bit more. Bring your foot more under your center mass. Don’t bounce as much. Bring your tibia more,” and number one, the people didn’t necessarily understand what we were asking them to do. And number two, there was too many verbal cues for them to even conceptually understand and figure out the solution to.

So we tried to take a lot of that initial thinking away and say, “Here, follow this rhythm,” and then once we think we got the rhythm there a little bit, then we’ll supplement with verbal cues in a sense of saying, “What feels different? Do you feel like you’re bouncing less? Do you feel like your knee is softer? Do you feel like you’re more under your center of mass off your heel?”

Steven Sashen:

I have three thoughts and I’m going to have to give them to you all at once or I’ll lose them. One is how would you guide people to play with this on their own? Two is do you… I lost the third already. Oh, two is what does it take for people to get used to that new cadence? Because we do the one we do because we’re used to it and something new will feel weird. And the third is in that process, once it looks better to you, do you try to move them over that so they can pendulum swing towards where you think might be ideal? It’s something I do with people where… I’m trying to think of the specific thing that I have them do. Oh, it’s about lean or various things where I have them try to exaggerate something-

Dr. Brian Heiderscheit:

Exactly.

Steven Sashen:

… just because otherwise what’s correct feels weird, and if you exaggerate it, then coming back feels more normal. So again, for people who aren’t going to go into a clinic necessarily want to experiment with this, the process of getting more comfortable with that cadence and then going further and coming back to just however you might use that in the lab.

Dr. Brian Heiderscheit:

I’m going to take those out of order, the second one first, being that how do we get people to get more comfortable with it, how long does it take even? Comfort is a hard one because that tends to vary quite a bit between people. People can reproduce what we’re asking nearly immediately within one or two sessions and bring them back a month later and say, “I want you to run the way I showed you to run before,” they can reproduce that spot on. That doesn’t mean that they were doing it the whole time, but they’ve recalled enough where they can reproduce that rhythm.

Comfort element is something that I think we struggle with and that is that there’s always this… If you take a runner and put them in a very distracted environment, even after undergoing very good gait retraining, that distracted environment, many times you’ll see their old pattern start to push itself out. So it’s always there. It’s just being masked and pushed down pretty heavily, which means that again, for a while there, running is going to take some thought and some cognitive override to make it happen. So comfort becomes challenging because of that.

And related to that, in terms of somebody being able to do it on their own, I’m actually very hesitant about doing any gait changes on people outside of the clinic for what we said before, which is many times, they’ll adopt a pattern that you’re like, “Whoa, that is not what I was after,” and that’s actually very injury risk increasing, such as that Groucho run pattern you described. That is a huge issue for hip flexor over-utilization and all the problems that go with that type of running.

So when we utilize gait retraining in my clinic, it is strictly for injured runners, runners who have had injuries, chronic injuries, trying to get back from an injury, then we would utilize this as a solution. I think where I struggle with, and this is an area that we’ve explored briefly, which is do we ever try to change gait in people who are not injured, or from a performance standpoint, we’ve tweaked performance issues a little bit or gait performance issues a little bit, but the idea of trying to preventing running injuries through gait change, that is a really tough one. And the science is way behind on that.

Steven Sashen:

Yeah. I mean, it’s one of the things when people ask me about running in Xero shoes for example. I go, “Well, there’s three reasons I can think of you wouldn’t want to do it.” One is if you don’t want to just spend some time to get used to it, which is kind of silly. It’s like saying, “Hey, my arm came out of a cast, but I’m never going to use my arm again,” so it’s going to take some time to get stronger.

The second is… Oh crap, I don’t remember what the second is. I’m having trouble with lists of three right now. I get three in my head and then one disappears. But the biggest one is if you are a competitive athlete, don’t do it. If your livelihood depends on what you’re doing, don’t mess with it for now. Now if you get injured, that’s a different story. Think if there’s other reasons you may in the off-season want to start experimenting, but don’t be a bonehead. And it’s a really interesting point.

Now, the idea that of people putting themselves in a dangerous situation by experimenting with cadence, I will of course say, “Look, it’s not rocket science. Play with it and see what happens.”

Dr. Brian Heiderscheit:

That’s exactly right.

Steven Sashen:

Use your body as a guide. If something feels wrong, maybe it is. If something feels awkward, that’s a slightly different story because you’re not used to it. But definitely if you can get video feedback, that would be really helpful because then you can watch and just see where your foot’s landing, see what the shin angle is, and these are things that many people can see relatively simply.

And I’m going to come back to that point in a second, but there’s another thing about cadence that’s interesting and I’d love for you to comment on it. I don’t know whose study it was, maybe it was coming out of your lab for all I know, about cadence and force. And I’d made a U-shaped curve because it seemed that with increased cadence, the amount of impact loading forces were lower up to a certain point and then they started getting higher. And of course, speaking as a sprinter, sprinters are trying to get the maximum impact force because that’s what makes you run faster, mass specific force, but distance runners by and large are looking to decrease force within a window. So can you tell me about that aspect and what you’ve noticed there?

Dr. Brian Heiderscheit:

I’m not actually familiar with that particular-

Steven Sashen:

What?

Dr. Brian Heiderscheit:

… relationship, so no, I understand VO2 in cadence and loading rate and foot inclination angles. We see some of those relationships, but impact force gets lower and then higher.

Steven Sashen:

Well, I mean, I think the basic idea is that if you are landing in the way we’re describing, which is basically foot under your body rather than way out in front of your body, you’re just not going to get that massive spike of force initially. And actually, if you’re landing the way that we’re talking about, you’re going to be using your muscles, ligaments, and tendons as the springs and shock absorbers they’re supposed to be more than using your joints to try to absorb that or the shoe, which will never do it to try to absorb that.

So I think that’s the gist is that increasing cadence is another cue that just leads to that form change that can lead to reduced loading forces, but then you get to a certain point, and again, as you start becoming a sprinter, you’re putting more force in the ground, that’s the only way you can do that. So I thought you were going to know that when we were going to have a-

Dr. Brian Heiderscheit:

No, I’m sorry. I should probably should know that one.

Steven Sashen:

Man, I’ll have to look, if I can find it. It’s something that I remember seeing seven, eight years ago. If I can find it, I’ll track it down and send it to you.

Dr. Brian Heiderscheit:

Yeah, that’d be good, because you’re absolutely right. I think when you’re talking about any of these metrics, even in terms of how much you bounce up and down-

Steven Sashen:

Oh yeah.

Dr. Brian Heiderscheit:

It doesn’t mean you want to bounce less and less and less to zero. If you don’t bounce at all, you are very inefficient as well.

Steven Sashen:

It’s interesting you say that. Yeah, there’s some runners that you see that look like they’re just skating on ice and it looks so cool because their head just doesn’t move at all, and some of them are really fast. But yeah, it’s not that that’s ideal. And I’ve played with that and it’s like, I can’t do that one. I don’t bounce very much, but I can’t do that skating on ice thing. It looks super cool.

Dr. Brian Heiderscheit:

But I think the other thing too is a lot of the examples you’re describing also are in the sprinting realm, and again, going from distance running speeds to sprinting, it’s not just a linear change with–

Steven Sashen:

No, no, no, whole different world.

Dr. Brian Heiderscheit:

… but the mechanics change in much different ways.

Steven Sashen:

Yeah. Well, there are certain mechanical changes that are very different and some that are exactly the same. So the basic idea of where you want your foot to land is basically the same. The gist of how you’re applying force is basically the same, but there’s just extremes in sprinting that you don’t see in distance running. But if you look at a good distance runner and a good sprinter and you look at it in super slow motion, some of those differences are really hard to see unless you’re staring at someone at 500 frames a second in super slow-mo. It has to do with how well your knee extends as you’re entering the swing phase. I mean, there’s all these really weird things that when you know them, they’re really obvious, but if you don’t know, it just looks like someone sprinting is just running faster than someone who’s a distance runner, which is not the case at all.

Dr. Brian Heiderscheit:

Not the case at all.

Steven Sashen:

Yeah. So here’s where I want to get into something fun. So back to the Science of Running medicine Events, you and Chris and Irene, you kind of argue about a number of points and you agree on a certain number of points. And I have a theory about… I’m going to say it this way, and I’ll say something and I want to ask you to comment on it.

I said to Irene, who does this amazing presentation about her research, which essentially shows how regular running shoes can be the cause of problems and getting out of those and into something truly minimalist and under truly minimalist… She does what she calls minimalist and partial minimalist, I call it true minimalist and fake minimalist. And so in the true minimalist category, there’s Xero shoes and Vivo Barefoot and some Five Finger shoes and one Innovate shoe that’s no longer made.

But anyway, she shows, “Here’s why running shoes can cause these problems. Here’s why natural movement in a truly minimalist shoe can get rid of those.” And it’s a very well-thought-out linear presentation. And I said, “It’s almost ridiculous that at the end of your presentation, people don’t come running to my booth and tackle me and steal my shoes,” but they don’t. Typically, about half the people in the room will come up to get more information and then about half of them will end up trying what we’re doing and seeing what’s going on.

And I have two theories about why that doesn’t happen. But actually first, I want to stop there and just have you comment on just what Irene has shown and how that does and doesn’t relate to what you’re doing and what your thoughts are.

Dr. Brian Heiderscheit:

Yeah, so you’re right. We do argue quite a bit, and Irene is a fantastic presenter and has a wealth of knowledge and studies that she’s put out over the last several decades that’s really informed her approach to it. I think that there are some extrapolations in their data, not not suggesting that, but to take it to the level of saying that this will reduce injuries and this will enable you to run faster, perform better, those are elements that are still big gaps. And then we all have gaps.

Steven Sashen:

Well, I’m going to interrupt there to say, because I don’t think that she ever says this will make you run faster or perform better.

Dr. Brian Heiderscheit:

No, I think you’re right. I think that’s true, which actually I think is a gap, right?

Steven Sashen:

Well, it’s funny. It’s funny, Phil Maffetone, he wrote a book called 159 and his prediction is the first person to run a real marathon sub two hours will be barefoot or in our shoes, something that’s as light as possible, but just giving you something to protect you from the ground, but basically as light as possible, but to determine whether… And we have people who claim they’re setting, and they are, setting PRs all day every day. We hear about people. I’m not saying that we do that. There’s more to it than that.

But yeah, the long-term study on injury prevention and improved performance, that’s an interesting one and a tricky one and an expensive one and a time-consuming one. So that doesn’t exist right now in large part because the people on my side, the truly minimalist camp, we don’t have the cash to put out the money for that research. And what a shock, the big shoe companies, they’re not going to do it because the last thing they want to find out is that we’re right. And I know a number of them suspect that we are right because that’s… Well, anyway, they’ve looked at the research, they’ve experimented on their own, they have that.

So ignoring the performance injury part or the injury prevention part, although she does talk about that and does have some ideas about how making these changes would be preventative, but regardless, okay, so that was an interruption just about what she’s saying and where you’re going from there.

Dr. Brian Heiderscheit:

Well, I was just going to say that, so a lot of her data are based on loading rate information, what we know about how people run and loading rates. And loading rates, as it changes, as it goes down, that’s a good thing. There’s always potential advantages for it. And that’s the hard part, where again, I think the three of us argue on, and that is the importance of loading rate from a ground reaction force measurement, vertical ground reaction force loading rate. It obviously has relevance and meaning and has been shown to have some relevance towards certain types of injuries. It’s just the extrapolation of, is this the one size fits all solution.

Steven Sashen:

Well, it’s interesting you say it that way because I’m going to toss out one argument and then another theory about why people don’t rush and tackle me after her presentation. The other thing she talks about is more than just loading rate is loading patterns and styles. So for example, if you have a shoe with a flared sole, the flared sole is going to hit the ground first. It’s going to create a fulcrum that actually causes your foot and lower leg and all of your body to move in unnatural patterns that then you have to compensate for.

And then of course, like we talked about before, if a shoe breaks down, then that’s going to cause problems as well. If wearing a higher heeled shoe tends to make you be a heel striker, and I like to point out… Here, wait, I can reach and grab this. I can point out that your heel is a ball and if you land on a ball that’s unstable and suddenly you need all these other things to combat that. So there’s other pieces to what she’s doing other than that.

But I’m going to tell you the argument that I made to her about why people don’t rush the stage and then I’m going to say something about you. Here’s the argument I made to her. I said, the people who are in that room think they’ve made the decision about what they have on their feet through a rational process. They think they have concluded by whatever analysis and whoever they listen to that they’re wearing those shoes for a specific good reason.

And if they think what they’ve done is rational, you can’t argue them out of that with data. You can’t give them other rational things that are going to make them… In fact, they’ll look for the tiniest little chink in the armor and go, “Oh, see, that’s got to be all crap because I don’t believe in that and that’s why I’m wearing these shoes that are five inches high and look like stilts and only people in Ringling Brothers wear them when they’re going out on the clown circus.”

So that’s one thing, and I think there’s a way around that. I mean, what I like to say is just look at what’s natural. A quarter of the bones and joints are in our feet and ankles, a quarter of the bones and joints of your whole body, and more nerve endings in your soles than anywhere but your fingertips and your lips. Clearly you’re supposed to use these things and they’re supposed to give you certain kinds of information and do certain things. Do your shoes let you do that? Do your feet feel better at the end of the day than they did at the beginning of the day? Do you feel better taking off your shoes than you did putting on your shoes?

So there’s ways of having the conversation that isn’t just about data, but here’s the other one, and this goes to both you and Chris. And actually, it’s interesting with what you said about how you’ve changed the way you are working with clinicians. Irene presents a very detailed and let’s say complicated argument, but even more, it’s something that most clinicians aren’t going to either have the equipment to implement or the skill to implement or the desire to implement.

It’s like a whole process for analyzing what’s going on, coming up with the right intervention and presenting that to the client, the injured runner so that they can make these changes and monitoring that over time. It’s a very involved thing that I’m willing to bet some of those people in the audience just go, “Oh, wow, I just can’t do that,” and some of them may be right. You know that different people have different skill sets about how to look at something and analyze it and know what a common factor is versus an extraneous factor, various things.

Then you come out, and Chris even more than you, you come out with something really simple and you go, “Hey, let’s just take a look at cadence. Let’s take a look at bounce and just let’s look at those two things,” and they go, “Oh, thank God. I can do that.” And so I’m not saying that you are right or wrong. I’m saying that what you’re presenting is a simpler story for people to latch onto, and I’m intrigued by that because I’m intrigued by the stories that we tell and how that leads to different behaviors. I would argue that you guys actually agree on many more things than you disagree on, but when you’re able to present a story that’s as simple as, “Let’s play with cadence and balance,” then it just seems like it’s easier to wrap your hands around.

And then Chris’s story, arguably, is even simpler, which for people who don’t know, it really has to do with just the angle of your torso when you’re running, and that’s even simpler for people to go because they can just look at that and show other people. The simpler stories seem to, not always, but can win. And I’m concerned about that because I’m not saying, again, that the simple story is incorrect, but I would argue that it’s probably incomplete. And if we give people something they can latch onto that is simple, then they’re not going to want to pick up something more complicated. Human beings try to avoid doing shit that’s hard.

And so this is my fundamental concern, and I’ll stop ranting in a second. My simple story in a way is take off your shoes, find a nice smooth hard surface, go for a really short run, 20 seconds, see how you feel the next day. If you feel good, try to add 30 seconds. If you feel sore, wait until you feel better, then do it again until you don’t feel sore. If you feel hurt, then you want to change something, and here’s a few cues until you’re having fun. That’s the guide. And then start increasing the time.

In a way, that’s a simple story as well, and it overcomes a lot of these things because some of the things that I say is the intervention., Pick up your cadence, check where your foot is, see where your body is, all of those little things, but they’re secondary to go do a short run, see if you’re having fun. If you’re not, come back until you can, and then things to play with. So anyway, but that was my half criticism of what happens in that event in your conversation. I’m curious what your thoughts are.

Dr. Brian Heiderscheit:

Yeah. Well, I would start by saying I think you oversimplified my solution.

Steven Sashen:

Good.

Dr. Brian Heiderscheit:

You’re guilty of that. I hope that I don’t just simply manipulate cadence and because I think there’s a big element to it, because that would be akin to me saying, really, Irene’s solution is just land on your forefoot and that’ll take care of everything else, because that is a big element of what she describes.

Steven Sashen:

It’s true. It’s true. Okay, so then-

Dr. Brian Heiderscheit:

That’s the nugget take home.

Steven Sashen:

Yeah, yeah. Okay. So then for clarification-

Dr. Brian Heiderscheit:

But the elements behind it, the justification for it is much bigger.

Steven Sashen:

Okay, but then, so to make sure that people don’t walk away thinking it’s just about bounce and cadence, get a little more specific. But I would like you to address just the phenomenon, if you will, of how these conversations happen and what people do with them with the goal, of course, is to make people have a better time, be healthy, happy, fun, strong bodies.

Dr. Brian Heiderscheit:

Yeah. But I think it goes back to what you said before, which is that we each approach what we’re hearing with our own biases that we’re coming into the conversation with. I think you have obviously a bias toward Irene’s approach given what you’ve explored on your own and where you’re at now. I’m not saying that you are close-minded to other options. I’m saying that you have… You may be more open to what Irene says.

Steven Sashen:

I would actually contend, I’m not going to disagree, but I would contend that my approach is consistent with both, definitely with you, with Chris, maybe a little less so because I don’t think what he’s saying is as important. I don’t think it’s going to create the effects necessarily that are as important. I’m not saying that I dismiss it, I just diminish the value of it a little more, and I’m happy to talk to him about that, because I don’t know what he’s done in a clinical setting to see how that works, but I’m kind of open to it because what I’m more interested in is just what’s the thing that’s going to basically lead to people having a happy, healthy, good time using their bodies naturally, and that includes what you’re doing.

Again, I’m exploring this because I want to know what the best story is to tell so that people can explore and experiment and discover what does work that is true, that ideally is based on actual research and data, not just anecdotal. I mean, granted, look, we have what, 15,000 reviews and God knows how many emails and phone calls. So while I don’t think that a preponderance of anecdotes equals data, when you have this much anecdotal information, you can’t dismiss it.

Dr. Brian Heiderscheit:

I hear where you’re coming from. And I think the other element that clinically where we’ve evolved to, because this is not where we started. We started my clinical practice 20 years ago, 25 years ago. It wasn’t like, “Hey, I’m going to do step rate because I love it.” It was more about… It’s one thing that led after the next. And part of it is I think where the clinicians, and again, I’m speaking to the audience who comes to the Science of Running Medicine and where they may gravitate toward, a lot of it has to do with what they’re hearing from their patients and what they think their patients will actually follow through on and adhere to, because obviously patient adherence and compliance is enormous.

Steven Sashen:

That’s interesting.

Dr. Brian Heiderscheit:

And insurance companies getting involved and payer systems. Irene’s system is unique. She does have insurance involved with it, but a lot of it’s cash pay as well. Chris’s is cash pay. Ours is completely insurance-based. If people are out of network, then they may pay cash. They have the option for that. So you’ve got a lot of other barriers and constraints.

Steven Sashen:

That’s really interesting.

Dr. Brian Heiderscheit:

So when you do take on Irene’s approach, which she will admit right off the bat, it’s more involved, right? Like you said, it’s a little more complex in terms of how she goes through this retraining, how many sessions. If you are going to more of a forefoot landing and the shift to the Achilles and the calf, you’ve got to prepare all that. You’ve got to have a patient group who is committed-

Steven Sashen:

Committed to that.

Dr. Brian Heiderscheit:

… to that time. And frankly, if we’re dealing with some high school students in the area in the middle of season, it’s not going to work. If we’re dealing with our collegiate athletes, it’s not going to work, not in the middle of season anyway, unless they’re broken down.

Steven Sashen:

Well, yeah, in the middle of the season. You don’t want to mess with things in the middle of season anyway. But backing up, I don’t want to lose your accusation that I oversimplified things, so if you want to clarify. Wouldn’t be the first time. So if you want to clarify or add in the points that I overlooked or dismissed or discounted so that people really get what you can give them, that would be great.

Dr. Brian Heiderscheit:

Well, to get into those little details, you’ll have to listen to the whole course and the whole talk. So again, the idea of looking at all interacting elements of the movement mechanics, the cadence was one of those first steps to bring out a lot of the pieces into play. They don’t always work. It doesn’t always work. Like you mentioned, people can create some sort of solution that you’re not totally after, similar to overstriding. I think that’s a key element, but how do you do that at different speeds and how do you really train that properly and how much is too much? That’s where it comes into a lot of different elements as well, so it gets more complex. And if you just assign a particular step rate of 180-

Steven Sashen:

No, no, and I wasn’t suggesting you step rate because I don’t say that. I have written a number of articles and done a number of things about how the whole mythology of 180 steps per minute is complete mythology. But I do say experiment with that, and I do say play with that. And I do recommend video. I mean, I have a whole theory, a neurological theory about what it takes to make changes in movement patterns, in part because I did research when I was at Duke on cognitive aspects of motor scale acquisition, and one of the things that I notice is some people, they just have no relationship to what’s below their neck. You say, “Are you hungry?” They go, “Yeah.” I go, “How do you know?”, expecting them to say, “Well, I feel this hole in the pit of my stomach,” and they go, “What do you mean? I’m hungry.”

They literally don’t have a relationship to feelings in their body, and they need a whole different kind of intervention than people who can feel things, but they don’t have good proprioceptive skills. You ask them to put your arm parallel to the ground and it looks like it’s Nazi Germany because they don’t know what parallel is. So they need a lot of video feedback because they have a disconnect between what they think they’re doing and what they’re doing.

Some people, they can feel things, they’ve got good proprioceptive skills, they just need cues to speed up the process because they’ll figure it out on their own, but you can accelerate the learning process. Some people are just naturals. And the problem is they have so much fun doing something new, they get tired and they revert to one of those previous steps.

And then there’s the phenomenon that we forget that the process of learning is by nature frustrating because the feeling of frustration is the feeling of laying down new neural pathways and trying to get out of an existing groove, and we forget that we’re supposed to feel frustrated when we try it and then we rest and it migrates a little and then we come back and it’s a little better until we can’t remember how to do the old way, and that is a process.

Irene and I are kind of competing on something. We have some theories about how to do what describing to improve adherence and to make this data available so that people can learn it better on their own or at least keep it better when they leave a clinic. And we are not surprisingly thinking very much the same way for a number of reasons. I don’t really care who wins this contest because I want people to be able to move, whether they’re running, walking, hiking, I don’t give any special magic to running, but it’s just movement in general.

And I do think there are ways to give people information in a way that works for them, that allows them to learn these new patterns and integrate them. And integrating means getting to the point where they’re in the back of your brain and you’re not thinking of them anymore. You just do them. And we know it’s possible because if it weren’t, no one could do a double twist and double back flip. So we know it’s possible to learn highly complex things that we’re not wired to learn. It just takes certain kinds of information presented in a certain way to do it, and no one has done that yet. I think we’re on the brink of that.

Dr. Brian Heiderscheit:

That’s very well-said. And I think there’s, like you said, a lot of commonality between the three of our approaches. And we’ll also admit that we utilize all three of the approaches depending on the patient that’s in front of us at the time and what their needs are. But figuring out how to teach every person who walks in the clinic, that’s the challenge because there is no one teaching solution for every person that’s the same. It has to be robust enough to be able to adjust itself depending on who that listener is.

Steven Sashen:

It’s interesting. Someone asked me once about if you could make an app that just gave people the right cue. I go, “You can’t do that.”

Dr. Brian Heiderscheit:

That’s right. Right. Cue is what changes.

Steven Sashen:

Well, and sometimes it’s the right cue at the wrong time, sometimes it’s the wrong cue at the right time. I just thought of something that totally unrelated to this. When Lana, my wife and I, before we were a couple, I was visiting her and I don’t know what I did or said, something that got her very upset. And after a little while of the silent treatment, I went in and said or did something else that made it even worse. And she said, “Did you think that was going to be helpful?” And I said, “Of course I did.” And either I was wrong or on your deathbed, you look back and you go, “Yeah, hat was pretty good.”

Dr. Brian Heiderscheit:

Right. There you go.

Steven Sashen:

And I don’t don’t know which, and my apologies. I was trying to be helpful. I get it if it wasn’t. Sorry about that. So to be mindful of time, that is both yours and the fact that I got an appointment happening soon, what are you looking at for the future? What are you seeing as what’s upcoming that has you interested and excited?

Dr. Brian Heiderscheit:

Yeah, so what we’re trying to do now is recognizing that running injuries are way more than just movement mechanics, that that’s a part of it, but there’s a whole lot more going on there. We’re in the middle of a prospective observation study where we’ve been collecting data on a fairly high level runners for the last three years from training volume and training habits to sleep habits to nutrition habits to bone density measures to running mechanics to changes in speed and running mechanics over time, on and on and on, and eventually start to sift through all of those factors.

Steven Sashen:

I want to ask you a weird question. Given the fact that we are, as the book title and best-selling album from two unrelated people says, Born to Run, as soon as we start walking, we start running, since this is something that is just part of our DNA, if you will, how do we match that phenomenon that it really is just something that we start doing and we start doing well when we start doing it with the seeming added complexity of trying to address it in the ways that you’re describing?

Dr. Brian Heiderscheit:

Well, I think so much of it is to do with, it is innate in the sense that we know how to do it. That doesn’t mean we know how to do it well, in the sense that you see some really unbelievably bad runners or they just can’t figure it out, or what they’ve done is they’ve taken walking and just walked faster, to a point where there’s just barely a flight phase and it’s really still walking. It’s like walking with a little hop, walking with a little leap, or the fact that people may have run very well when they were kids and playing around on the playground and whatnot, and then they stop at the age of 12 or 14, and then in their mid-30s, after they’ve had a couple of kids of their own and their bodies have completely changed and it’s 20 years later, they now decide that they want to pick up running as an activity or as a hobby, and remembering how to do that and recognizing that you’re not the same person as you were then, movement patterns better change or you got problems.

Steven Sashen:

When I got back into sprinting at 45 after a 30-year break and was injured pretty much constantly for about the next two years, the biggest lesson that I learned, and it took me literally two years to learn this, is when I have the thought, “Let me just do one more,” that’s when I should stop. In my brain, I’m still 18. It’s like, “I could totally do another four or five,” and it’s like, “Just cut it out.” And you know that extra day, no, I can’t do that either.

And watching sprinters get older, watching what changes in sprinting biomechanics is very interesting. You just aren’t as strong as you get. I was at the senior games. I had just turned 50 I guess, so I just qualified. And all the 60-year-old guys are hanging out with me saying, “Oh God, when you get to be 60, it just goes over a cliff.” And the 80-year-old guys walked up and went, “You guys have no idea what you’re talking about.”

But it’s true. And you watch what changes when muscles atrophy. I mean, sarcopenia is a real thing. You just can’t keep the same muscle mass and the same strength as you get older, and then you have to make changes. And the changes are relatively similar that these guys have, and you just hope that you can figure it out in real time because you can’t do it in advance. If you try to make those changes in advance, it doesn’t work. And interestingly, you know what the biggest change turns into? Cadence.

Dr. Brian Heiderscheit:

Oh yeah, yeah.

Steven Sashen:

They just try to get more steps in the ground instead of covering more distance. Yeah, it’s really interesting to see. And some of these guys are still crazy fast. It’s both hopeful, inspiring and annoying. I just don’t see it. So one last question I was going to… Well, here, if people want to find out more about what you’re up to and get information about that, where would you direct them?

Dr. Brian Heiderscheit:

Right. I mean, for the general public, certainly check us out at University of Wisconsin’s website, University of Wisconsin Madison website, and the Department of Orthopedics and Rehab. They can see all of our research that we have going on. For the clinicians in the audience, physical therapists, physicians, other healthcare professionals across the board, if you’re interested in running medicine, check us out at scienceofrunning.net for our annual Science of Running Medicine conference. We go on once a year. Next year we’re looking to, most likely, go be at Mayo Clinic in Rochester, Minnesota.

Steven Sashen:

Oh, that’d be fun. But I know also, there’s other events. What’s the one coming up? People might be-

Dr. Brian Heiderscheit:

The one coming up, so we also have the Running Summit that we host in partnership with Mountainland Physical Therapy based out of Utah. So we will be in Park City Utah in middle of September in 2019. Yeah. This will be our fourth annual event. It’s really a fun time. The agenda and itinerary changes every single conference. We have new speakers internationally that are brought in, physicians, physical therapists and conditioning coaches, a number of pharmacists, sleep medicine experts come in and speak on various running related topics, but again, it’s focused on a healthcare provider audience.

Steven Sashen:

Yeah, it’s going to be fun. I actually just signed up to be a sponsor.

Dr. Brian Heiderscheit:

Fantastic. Yeah. Exciting. Well, I’d love to have you out there.

Steven Sashen:

Yeah, no, I’m really looking forward to it. Well, it’s just over the mountain for me, so it’s a pretty easy trip. And then I go right down the hill into Salt Lake City and go to the Red Iguana for dinner. It’s the best Mexican food I’ve ever had, so that was really the inspiration. I don’t care about you running.

Dr. Brian Heiderscheit:

Well, you know what? There’s a reason why we chose Park City Utah in September.

Steven Sashen:

Yeah, it’s a good one.

Dr. Brian Heiderscheit:

Trail running is pretty amazing.

Steven Sashen:

It’s a pretty fine place. It’s sort of Boulder-esque if you just made it smaller, higher, and richer. That’s really the gist of it. It’s Aspen light is another way of thinking of it.

Anyway, Brian, not surprisingly, this has been a total treat. This is the longest we’ve actually gotten to do this. We did no prep for it, which I knew we wouldn’t have to, so thank you. And I’m really looking forward to… Obviously whatever we can do to be helpful, if there’s anything. Hey, wait, I forgot to ask. I sent you a pair of Prios. What do you think of them?

Dr. Brian Heiderscheit:

I love them. I wear them at the gym every day. They’re fantastic. I haven’t quite used them yet outdoor running. I’m not early. I need a little more prep time for that. But otherwise, fantastic. Love them.

Steven Sashen:

Keep me posted when you finally get up the courage to run. You’ll find that you’ve been kicking yourself by not having done it sooner, is my hunch.

Dr. Brian Heiderscheit:

Fair enough. Fair enough.

Steven Sashen:

Anyway, total treat. And really quick, just to do the sign off. First of all, thank you all for listening and being part of one of my non just solo rants. If you have any questions, feel free to chime in wherever. We can do questions and we will answer them. If I see anything that Brian needs to answer, I will forward that to him.

Follow us on all the places you can follow us, subscribe and like, and share, et cetera, et cetera. Come to www.jointhemovementmovement.com so you can find out more about what it takes to have a happy, healthy, strong body and enjoy walking, running, hiking, or whatever it is you do for the rest of your life. I’m Steven Sashen and I just want to thank you and as I love to say, live life feet first.

 

 

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