IM St. George 2011 and Midfoot Cleat Position

Bike Position 2011

Note the mid foot cleat position. I switched to this position approximately 4 months prior to the race because of metatarsalgia I would experience during long rides the past few years. The forefoot pain was bad enough that it hampered my running. Other conditions I think this would be helpful in include: Morton's Neuroma, chronic calf cramping, Achilles Tendinitis, Plantar Fasciitis, any forefoot issues.

The change in cleat position completely eliminated my pain. I did make the necessary changes in bike position as recommended by Joe Friel, Steve Hogg, and others. I didn't do the modifications myself a la Joe, but had Don Lamson with D2 shoes custom fabricate a pair. These are great shoes, but I will make further modifications on future pairs. My original set up caused the mid portion of my shoe to rub excessively against the cranks. I eventually changed to speedplay pedals with longer spindles to accomodate. This has worked fine. Additionally, I would like mine to be slightly more forward than prescribed. Preferably 10 mm, though this link suggests 5mm worked for him.

One must have a real awareness of the bike handling issue that can occur. Turning sharply with either foot in a forward position will clip your front wheel. Unfortunately I learned this the hard way...a few times. I don't recommend this position if you are racing criteriums or technical mountain biking until you have gained substantial experience. My understanding is that Goetz Heine, originator of the position & Biomac shoes, has made custom bikes to help ease this issue.

Additionally, the mid foot position really fatigues my gluteals and upper quads tremendously in comparison to my more standard forefoot position. This has improved, but I would certainly plan on at least 3 months of habituation before any A race.

Shoot me any questions you might have.

J

Eccentric exercises for Runners

I've written extensively in the past regarding the benefits of eccentric exercises for rehabilitation of a variety of overuse injuries.

But I also feel strongly that eccentric leg exercises are very valuable in strength training for runners who may have biomechanical limitations in regard to training volume. I will commonly reduce training volumes in athletes with these concerns and replace some training with eccentric exercises to increase the durability in the muscles crucial for running. Note that most of these exercises were developed to fix chronic tendinopathy. In this use, returning the limb to neutral by the uninjured limbs is important. This isn't the case in using the eccentric training for increasing run durability.

My routine includes strengthening the following muscles:
1. Hip Abductors (gluteals)

The pelvic drop exercise is completed by standing on a step with the exercised leg, while holding onto a wall or stick if necessary for support. With both knees locked, the opposite, noninvolved pelvis was lowered towards the floor. Then, the suspended leg is lowered even further by bending the supporting leg. Finally, the suspended leg swivels and goes through the swing phase of gait by first swinging forward then backwards while the exercised leg stabilized the body by contracting the gluteus medius on that side.

The reference used below describes a different exercise but supports eccentric strengthening for ITB syndrome.


2. Knee Extensors (Quadriceps)

Place your feet shoulder-width apart on an
decline board. Lower yourself while standing on the knee intended for exercise (bend the knee approximately
60 degrees), then raise yourself while standing on the opposite knee. Build up to three sets of
fifteen repetitions, twice a day. You can add dumbells to increase weight as you progress.

3. Calf Muscles (Gastrocsoleus)

Stand with all your body weight on the exercised leg. From an upright position and standing with all body weight on the forefoot, with the heel extended off the back of a step, the calf muscle is loaded by having lowering the heel beneath the step. The foot is then brought back to neutral with either the use of both ankles. In rehabbing injured ankles, non-injured leg is used to return to the starting position.

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The eccentric strengthening of the muscles allow them to be more resistant to the destruction we see during race efforts and hard running.

I hope you find these helpful.

Dr. J

References:
1. P Jonsson, H Alfredson. Superior results with eccentric compared to concentric quadriceps training in patients with jumper’s knee: a prospective randomised study. Br J Sports Med 2005;39:847 850 LINK: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1725058/pdf/v039p00847.pdf

2. M A Young, J L Cook, C R Purdam, Z S Kiss and H Alfredson Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players 2005;39;102-105 Br. J. Sports Med.

3. Alfredson, H., Pietila, T., Jonsson, P. & Lorentzon, R. Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis. Am J Sports Med 1998 May-Jun;26(3):360-6

4. Alfredson, H. & Lorentzon, R. Chronic Achilles tendinosis: recommendations for treatment and prevention. Sports Med. 2000 Feb;29(2):135-46.

5. Fredericson M, Wolf C. Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 2005;35:451–459. 21. Fredericson M, Yamamot