Read on Twitter
Had a runner with s/s of anterior chronic exertional compartment syndrome. Tried to 
cadence from 176 to 184 to see if it would help w/ symptoms. Pain 
from 6/10 to 2/10. While foot strike manipulation may be… https://www.instagram.com/p/CEt743lnQU9/?igshid=pq732qynk2jo
cadence from 176 to 184 to see if it would help w/ symptoms. Pain from 6/10 to 2/10. While foot strike manipulation may be… https://www.instagram.com/p/CEt743lnQU9/?igshid=pq732qynk2jo
Recently, there was a nice discussion on Twitter about strength training and running.
As a PT, runner, educator, and coach I regularly recommend strength training. Here is what we know and don’t know based on the literature (1/n)
As a PT, runner, educator, and coach I regularly recommend strength training. Here is what we know and don’t know based on the literature (1/n)
As @rich_blagrove and team noted, ST improves running economy and tends to improve metrics of running performance https://pubmed.ncbi.nlm.nih.gov/29249083/ (2/n)
It appears to be helpful for other runners, too, ranging from post-pubertal distance runners https://pubmed.ncbi.nlm.nih.gov/29315164/ to highly trained middle and long-distance athletes https://pubmed.ncbi.nlm.nih.gov/26694507/ (3/n)
These improvements in strength and running economy occur without a significant change in body composition (ie mm hypertropny) https://pubmed.ncbi.nlm.nih.gov/27135468/ which is a concern of many coaches and high performing athletes (4/n)
Yet much is not understood as to the “why” strength training helps. The force generating capacity of mm improves https://pubmed.ncbi.nlm.nih.gov/31541409/ but there is no appreciable change in mechanics as noted by multiple authors such as https://pubmed.ncbi.nlm.nih.gov/21765220/ & https://pubmed.ncbi.nlm.nih.gov/21391799/ (5/n)
Factors that may lead to performance gains include delayed activation of energy taxing type II fibers, mm-tendon stiffness, conversion of type IIx fibers into IIa
https://pubmed.ncbi.nlm.nih.gov/23914932/ (6/n)
mm-tendon stiffness, conversion of type IIx fibers into IIa https://pubmed.ncbi.nlm.nih.gov/23914932/ (6/n)
But while strength training seems to enhance performance we have little evidence being stronger the risk of getting injured
A few prospective studies: https://pubmed.ncbi.nlm.nih.gov/29791183/ and https://pubmed.ncbi.nlm.nih.gov/30138779/ indicate no relationship between strength & risk of future injury (7/n)
the risk of getting injured A few prospective studies: https://pubmed.ncbi.nlm.nih.gov/29791183/ and https://pubmed.ncbi.nlm.nih.gov/30138779/ indicate no relationship between strength & risk of future injury (7/n)
But the literature is not 
in agreement. @laceluedke found HS runners w/ isometric hip& leg strength had incidence of knee pain vs those who were stronger https://pubmed.ncbi.nlm.nih.gov/26618066/ & hip ABD weakness was a prospective risk factor for MTSS here https://pubmed.ncbi.nlm.nih.gov/29787473/ (8/n)
in agreement. @laceluedke found HS runners w/ isometric hip& leg strength had incidence of knee pain vs those who were stronger https://pubmed.ncbi.nlm.nih.gov/26618066/ & hip ABD weakness was a prospective risk factor for MTSS here https://pubmed.ncbi.nlm.nih.gov/29787473/ (8/n)
And it seems clear from multiple studies that prescribing resistance training to 1 group but not another finds that RT to be ineffective at protecting against injury:
https://pubmed.ncbi.nlm.nih.gov/31642726/ and https://pubmed.ncbi.nlm.nih.gov/27486011/ (9/n)
https://pubmed.ncbi.nlm.nih.gov/31642726/ and https://pubmed.ncbi.nlm.nih.gov/27486011/ (9/n)
In reality, I would love to see more rigorously designed studies on the matter where strength is assessed before/after intervention w/ loads in an RCT where injury rate is prospectively tracked with medical monitoring. But-that is hard work and requires 
(10/n)
loads in an RCT where injury rate is prospectively tracked with medical monitoring. But-that is hard work and requires (10/n)
Final: So I still prescribe strength training. Injured runners usually have strength deficits-likely due to pain & altered use. And enhancing performance is always good! But it is ok for us to say we don’t know if it injury risk. Leaves room for discussion & future study (END)
injury risk. Leaves room for discussion & future study (END)
