Attain Wellness

Toe Out

This is the first article in a three-part series on running form analysis. In this article, I analyze Attain Wellness Head Strength Coach Ben Ilaria’s and my running form.

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Although running is the most accessible sport to humans (in some cases, runners don’t even need shoes), it is by no means an easy sport. Proper running form is critical to performance, much like how a golfer’s swing dictates whether the golf ball lands on the green or in the water.

So what exactly does proper running form look like?

Leg Positioning

After reading this sentence, stand up and walk around, looking down at your feet the entire time.

Were your feet pointing forward? Out? In?

Your knee wants to point in the direction that you’re moving. Your feet, ideally, should be pointing in the same direction. That said, walking is an activity that produces minor impact forces; force exerted on the knee will be minimal.

Running, on the other hand, produces higher impact forces. If your knee and foot are pointing in separate directions, it will produce too much external rotation of the lower leg, causing tears in the medial meniscus tendon (referred to as “runner’s knee”). (Breakwater) To prevent this injury when running, it is important to make sure that your knee and foot are pointed forward.

Examine the pictures above. What do you notice?

The pictures above show Ben (left) and I (right) immediately after the toe-off phase of the gait cycle. Ben’s right foot is toeing out, whereas mine is straight. If Ben’s foot positioning were to stay the same throughout the gait cycle, he might start to develop runner’s knee.

Upon further observation, however, we notice that Ben actually strikes the ground with a forward-facing foot. Additionally, his knee and foot are pointed in the same direction. So what’s happening?

The answer lies in the hips: either hip tightness (which can cause tibia torsion), or Ben has retroverted hips. (Gonser)

Hip Tightness: Hip extensor muscles (muscles activated by the back leg in both pictures) are made up of the semimembranosous, semitedinosus, bicep femoris, and gluteus maximus. If your job requires you to sit for long periods of time, your hamstrings can become tight.  The standing hamstring stretch can help the hamstrings return to a lengthened position, promoting internal rotation of the leg back to center.

How to perform the standing hamstring stretch:

1. Find an elevated surface; place one foot on the elevated surface
2. Maintain a straight back and elevate your chest by rotating your shoulders backward
3. Tilting at the hips, reach towards the elevated foot
4. Hold for 30 seconds; repeat on opposite leg

Standing Hamstring Stretch

If performed correctly, you will feel a stretch in the back of your thigh.

Retroverted Hips: Some people are born with retroverted hips. Retroverted hips refers to a phenomenon where the thigh bone or pelvis are naturally rotated backwards. (Gonser) To ask someone to turn in their foot can cause more harm than good. Instead, it is recommended to promote a midfoot or forefoot strike and strengthen the muscles throughout the core to promote stability. The pawback drill and plank variations are great exercises to help improve in these areas.

How to perform the pawback drill:

1. Stand tall next to a fence, wall, or other support
2. Raise your inside leg up so that your thigh is parallel to the ground
   1. Your leg should be bent at a 90 degree angle at the knee
3. Lower your leg towards the ground, extending it throughout so that it is straight when it makes contact with the ground
   1. As your foot strikes the ground, drag it back it along the ground to stimulate glute and hamstring activation
4. Begin the next rep by contracting your hamstring and raising your leg back to the starting position

How to perform a plank:

1. Get into a pushup position with grounded feet and hands underneath your shoulders
2. Engage the muscles of the “core,” which include the glutes, abdominals, and obliques
3. Hold for 30-45 seconds
4. If this variation is easy to perform, move support from the hands to the elbows
   1. Additionally, the side plank variation targets the obliques

Incorporate these exercises in your pre and/or post-workout routines. Additionally, if you work a desk job perform the standing hamstring stretch at least two times a day to counteract the shortening effects of sitting and to promote internal rotation of the leg back to the center position.

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This was Part 1 of our Running Form 101 series. Keep an eye out for Parts 2 and 3 to find more ways to improve running form and become a more efficient runner!

Citations:

Gonser, Steve. “Why Do I Toe Out When I Run?” RunSmart Online, 3 Apr. 2016, runsmartonline.com/articles/efficiency/why-do-i-toe-out-when-i-run/.