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Minimalist running?

For the last decade or so, managing my aging body has become as much a part of training as intervals and tempo runs, and this has had an impact on how I run and what I wear on my feet. This holds true for many runners.

In my twenties and thirties, my foot strike had always varied between midfoot while racing to heel on slower training runs. It always seemed clear to me that if I wanted to run fast, I would run up on my mid- or even forefoot; if I wanted to conserve my energy, I would run on my heels.

However, as I approached forty, I developed chronic disabling hip pain and occasional knee pain. I found that when I stayed off my heels and ran "gently" (encouraged by lightweight training shoes), I could run with less pain. It is easy to feel the difference in joint impact when landing on my midfoot versus my heel. However, when I am tired, this hip-friendly stride seems to come at a cost: it seems to take more energy for me to run with a midfoot strike. But, I make myself do it any way to spare my joints.

Hip Arthroscopy

For several years in my forties, I had chronic pain in my hips whenever they bore weight. My left hip was particularly impaired. It hurt most when walking, particularly after sitting (which I do for about twelve hours a day between my work and commute). When running, my leg would often collapse upon impact, and, as soon I stopped, my hip and quadriceps would stiffen up so I could barely walk.

It turns out that I had Femoro-Acetabular Impingment ("FAI" means the femoral head at the end of my leg bone did not fit well in the hip socket--the acetabulum), which caused a labral tear (the "labrum" is the ring of cartilage that surrounds the hip socket to make the joint more stable) and other damage.

After physical therapy and cortisone failed to reduce the pain, I opted to have surgery. In the summer of 2009, a very talented surgeon (Dr. Brian Busconi at UMass Medical Center) ground down a bulge on the head of my femur responsible for the impingement and cleaned up as much of the damage to the cartilage in my hip socket as he could.

The surgery was successful, and I now run without the severe pain. However, I have significant cartilage loss, including bone-on-bone (Stage 3) osteoarthritis in one spot. The upshot is that I can now run with joy again, but I need to be careful in how I use my leg--no pounding.

In the two years since surgery, my hip gets sore when I sit for long periods, but the more I run, the better it feels. My hip is pain free after very long runs, until I have to sit. Sitting in my car or "ergonomic" office chair are the worst for me; slouching seems to help. During a week of running in the deserts of the Southwest U.S. last year, I had no pain for an entire week--lots of running and very little sitting! What a joy!

Physical therapy has been very helpful, in spite of my imperfect compliance, in my learning about and training my body to maintain balance, flexibility (still a work in progress), and strength in spite of my impaired left hip. Thank you to Lisa Moore at Orthopedic Physical Therapy in Greenfield, MA! In a short time, Lisa has moved me from feeling at the mercy of my hip to feeling confident that I can manage it for pain-free running.

So far, as I've increased my weekly mileage preparing for my run, my hip has felt increasingly good. I'm hoping this is a good sign.

Oxygen Consumption: Midfoot vs. Heel Strike

As I've been running longer training runs in preparation for my trip, I have to resist the temptation to sit back on my heels. It feels so much easier when running slowly to land on my heels rather than my midfoot. But, when I give in, even on the spongy thawing dirt roads in the hilltowns where I live, my hip suffers. When I run in my more upright form, I use my lower leg muscles much more, which seems to take more energy. I had hoped that by now in my training, I would not notice a difference, but I still do. I am curious whether this difference will remain even after running 3,300 miles!

Fortunately, I will get some data to compare to my perceptions! A good friend and training partner happens to run a lab that can test my oxygen consumption at my target running pace, both while heel striking and midfoot striking. How much more energy am I burning with my hip-friendly midfoot stride? Are my perceptions accurate? Will this change after running in on my midfeet across the country?

UPDATE: I was wrong! I was convinced that it took more effort when running slowly for me to run with an upright, midfoot-striking gait. I assumed that if I were only concerned with conserving energy, it would be better for me to land on my heels. I was tested one week before my trip start date, thanks (!!) to Allison Gruber (shown monitoring the test) and Barry Braun (working the Steadycam) from the UMass Amherst kinesiology department. Results revealed that I use slightly less fuel running in my midfoot-striking gait than when heel striking. That is great news, and more incentive for me to run gently, as long as my muscles can handle it. Here is the bottom line for my likely all-day pace:

Midfoot strike: 599.1 kcal/hour = approx. 4938 calories to fuel just my running each day*

Heel strike: 606.7 kcal/hour = approx. 5048 calories to fuel just my running each day*

* Of course, this does not consider pushing the jog stroller with my gear (and snacks!), and all the other ways my actual experience will be different from a treadmill.

Allison, who is currently conducting a research study on footstrike patterns and the metabolic costs of running, stresses that my results are specific to me; which footstrike is more economical depends on the individual runner.

Barry, demonstrating why he is a beloved teacher (and his ability to fully integrate his interests in research, teaching, and eating), tells me that the 4,938 running calories per day equals:

  • 91 oreos, or
  • 8.5 Big Macs, or
  • 16 Boston Creme donuts from Dunkin Donuts, or
  • 1235 baby carrots, or
  • 1452 M&M's, or
  • 411 Pringles potato chips, or
  • 10 Cheesy Bean and Rice burritos from Taco Bell, or
  • Barry's favorite: 2.94 Colossal Burgers from Ruby Tuesdays

Tough choice! (As a vegetarian for the last 30 years, I expect a couple of those choices would be the end of me! No problem with the donuts, however. I'll keep you posted!)

Foot Type

Recently, in a gait-analysis clinic, I learned (or affirmed, since this had been my experience) that my foot type (which is in the general category of Abductovarus Forefoot) is one that could handle running in lightweight shoes with a more upright gait ("minimalist running") and would even be likely to benefit from it.

My particular foot type can be either problematic or efficient for running; it matters how I run. Midfoot striking works well for both my foot type and my arthritic hip. Different body types or foot types might have very different results.

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