We received a question from one of our patients about running cadence. He’s preparing for his first marathon and so he asked Tony if his running cadence could improve his running speed. Running cadence, or stride rate, is a measure of how many strides per minute (SPM) are made while running. You can find your cadence by counting how many times your right or left foot hits the ground within sixty seconds, then multiply that by two. It’s important to note that cadence changes with different runs. You can’t discuss cadence without considering stride length. The two of these factors come together to determine how fast you’re running. One runner could have a fast cadence with a short stride and another with a slow cadence and long stride and yet they both could be running together. What is a good running cadence? It was widely thought that a rate of 180 SPMs per minute was optimal but that theory has been debunked. Recent studies show that everyone has their own natural running cadence and there is no such thing as a ‘one size fits all’ approach. As you’re running you will naturally find a pace you feel comfortable with but that’s not to say that you can’t improve your cadence (more on that further into this blog). So which is better - a fast or slow cadence? From a Physical therapy stand point, taking shorter and faster steps will make you a more efficient runner and will reduce the impact on your joints. When you take large strides, you’re stretching your legs out further and landing heavily onto your heels (heel strikes). Heel striking vs. midfoot striking is another debate that we will discuss in the future. Shortening your strides can reduce injury risk because you’re not over activating leg muscles and putting too much force through your knees. Is cadence the most important factor for running? As a physical therapist and a running coach, Tony says no. Experts have taken a look at the different cadences of marathon runners and the numbers are all over the place. There have been runners that win with 155 SPM and others that have won with 205 SPM - so a very large range and there isn’t a clear cut number to strive for. In terms of trying to improve overall performance, Tony suggests focusing on the follow metrics:
These metrics will gauge how hard you’re working on your runs. So in terms of improving performance, cadence is not the most important thing and in terms of injury, cadence is something to focus on. Working on your cadence: You can use a metronome, some higher end watches have one built in. Run to music - find songs that have a faster or slower BPM (beats per minute), depending on what you’re looking for. Tips to improve cadence:
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A patient slipped and fell while taking out the trash. The fall resulted in a dislocated shoulder. The injury left her unable to move her shoulder for a prolonged period of time - eventually causing frozen shoulder, also known as adhesive capsulitis.
Frozen shoulder is a condition where you experience pain and stiffness in your shoulder joint capsule, eventually losing mobility - hence the name frozen shoulder. Signs and symptoms can occur gradually or within a short period of time. For some people it may happen overnight, for others it will gradually get worse over the course of weeks or even months. Symptoms - you will start experiencing pain in the shoulder and then your range of motion will steadily decrease. You may start to notice that you can’t lift your arm past your shoulder, then eventually not at all. How does it happen? Your bones, ligaments, and tendons that make up your shoulders are encased in what’s called a capsule. Frozen shoulder happens when this capsule thickens and as a result, tightens, causing your shoulder to become immobile. Things that put you at more at risk -
The most common cause of frozen shoulder is shoulder surgery. Most shoulder surgeries cause you to be in a sling for a prolonged period of time. This immobility of your shoulder makes you more susceptible to frozen shoulder. How is frozen shoulder diagnosed? A physical therapy can diagnose frozen shoulder by moving the arm around and documenting the patient's range of motion. Your doctor can use imaging tools such as X-Rays, MRIs, or an ultrasound to rule out other possible causes of the pain and stiffness such as shoulder dislocation, torn rotator cuff or arthritis. Frozen shoulder treatment - Some treatment options include…
Thanks for reading! After listening to our last Five Minute Friday episode, ACL Tears, The Basics!, one of our patients wanted to know what to expect after a surgical ACL repair. As discussed in that episode, ACL tears are commonly repaired with graft surgery - taking the tissue of another tendon in the body and sewing it to the damaged ACL tendon. Like any other procedure, swelling is to be expected. Also, it should be no surprise that you will have difficulty with knee extension (straightening and bending your knee). Something that may come as a surprise is what's called an extensor lag - the inability to contract your quadriceps. This means you’ll have difficulty lifting your leg. But this is very common and you will regain contraction in about a week or two after surgery. This is something that will be worked on in physical therapy as well. Will you need crutches or a brace after surgery? You will use crutches for about 1 - 2 weeks after surgery as full weight bearing is increased throughout your rehab. ACL protocols vary but patients usually begin walking without crutches anywhere around day three to week two. Usually you will go from two crutches to one and eventually phasing them out completely. Whether or not you are given a brace after surgery is dependent on your surgeon. Typically, if given a brace after surgery, you will have a bigger, bulkier one - one that is locked in place and only unlocked at physical therapy. As you progress through your rehab, a smaller unlocked brace will be given to you. What are the most important aspects of rehab? Activating your quadriceps and regaining your knee extension are very important aspects of ACL rehab. This is because knee extension (bending and straightening the knee) influences your gait and ability to walk, climb stairs, etc. The number one thing that a patient needs to gain after ACL reconstruction surgery is quadriceps strength. Without it you will not be able to progress to higher levels of activity and your mobility will be limited. Knee range of motion is also very important… Full knee range of motion is also an important aspect of a successful rehab. After surgery you will have a very limited range of motion. The goal is for you to have your full range of motion back around the 6 - 8 week mark. During week 1 - 2 you and your physical therapist will work on getting you to a 90° angle. Week two - six you will progressively work on gaining a full range of motion (140°). Thanks for reading! Stay tuned for more information in the coming weeks.
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AuthorDr. Tony Tanzi: Physical Therapist, Triathlete, Runner, Performance Coach Archives
October 2022
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