Video Analysis - Taking a Closer Look at My Injury

Around the same time I realized it was time to see a doctor and start shopping around for a good PT, a friend at work handed me a flyer for something called Performance Enhancement Through Video Analysis.  She hadn't gone herself but had made an appointment for her daughter who was dealing with an achilles issue.  I have some odd quirks in my form (shuffle step, short stride) and although it works for me, I wondered if maybe something I was doing caused my injury.  Plus this wasn't the first time I'd dealt with piriformis pain - it was just the worst.

The program is called RunFast and is through the Henry Ford Health System Sports Medicine Department.  I spoke with Dave, the person who runs the program at the Novi location, on the phone.  He asked a few questions about my injury and we set up my appointment for my first week of summer vacation.  All I needed was to wear running shorts and take 2 pairs of shoes - old and current.  

I showed up with 4 pairs of shoes.  I wanted to be thorough.  (I left a couple at home.)

Dave started by gathering information to create a detailed portrait of me as a runner - how long I've been running, average pace (pre and post injury), daily/weekly mileage, usual running surfaces, which side of the road I run on, how much stretching I do, what other exercises I do besides running.  We talked about what I do with my legs when I sit and what my posture is like.  He looked at all my shoes and took notes.  

Next he looked over my legs and feet.  My arches checked out fine and my legs are the same length, which was good to hear.  (Not that I was worried.)  

After giving me the once-over, he did a variety of tests.  A lot of them were in the exam room and then we moved out into the hallway and gym area.  Those were videotaped using his iPad and later put into an app called "Coach's Eye."  The app allows you to watch the videos frame-by-frame to check form, draw lines and angles, and put two video clips side by side to compare.  It's very cool.  I didn't get my report and analysis until 2 weeks after my evaluation when I went back to see him.  Below I'll briefly describe what he tested and make note of some of his findings.


1. First Dave tested my mobility - ankles, feet, hips, and trunk rotation.  Then he checked strength, core, and postural control by having me do bridge, plank, side plank, and resistive testing.

Findings: mildly tight calves (both soleus and gastrocnemius), very tight hamstrings, weak hips/glutes - slightly weaker on right side, piriformis pain not reproduced with any testing of right hip (leading him to conclude piriformis isn't my problem - interesting)


2. Next Dave had me complete a variety of activities, such as squat, hop, jump, balance, step-down with medicine ball.  (This is when he started videotaping me.)

Findings: weak hips/glutes, mild pelvic drop - more on left side, collapsing in of right knee, turning out of right toe (jump, step-down, and squat)

Step-down with medicine ball

Single-leg squat, followed by single-leg hop

3. Then Dave had me complete a gait assessment, where he had me walk with one foot in front of the other, then toe-in, toe-out, and with big steps.

Findings: more pelvic drop and/or pelvic rotation on the right side in nearly all of them


4. Finally it was the moment I'd been waiting for - the running form assessment!  He only needed me to run on the treadmill for a few minutes at my usual pace and filmed me from the front, back, and both sides.  He also had me run a little in the hallway prior to the treadmill.  I hoped for immediate feedback but he just smiled and said I looked the same in both places. Ah well, I tried. When I did get the video analysis, however, it was quite interesting.

[I was not able to embed these on the blog but you can view my running videos by clicking on the following links: treadmill1, treadmill2, treadmill3, treadmill4, treadmill5]

Findings: mild heel strike but shins are vertical at contact (so okay), 192 cadence, right hip not extending, right toe out, more trunk rotation on the right side, more right side pelvic drop, possible trouble driving off left side

Are you noticing a trend here?  My right side is screwed.  Not a surprise considering the pain I've been in.  Then when I think about how long I've been sitting on the couch with my legs tucked to the side, how I only cross my right leg over my left, how when I stand I shift my weight onto my right leg.  When I used to do burpees I would always kick out my right left before my left.  I can't squat and keep my right foot on the ground.  How long has this been going on??

In video 3 (when watched in slow motion), I can clearly see my right arm cranking back, as if I'm trying to power myself forward.  My left arm isn't doing it quite so much but it's crossing over slightly, as well.  How long as THIS been going on??  Is this a new thing that started with my injury?  Or is this the CAUSE of my injury?  In any case, I need to get that ironed out stat!  I've been running along happily giving everyone the thumbs-up (which I learned about at my Good Form Running class), thinking my arms were in proper position.  But - gasp! - they weren't.  All that upper body twisting wrecks havoc on your hips which can cause everything else to collapse inward.  

I have a quick cadence which is a result of my short stride.  I've always just thought of myself as an efficient runner.  However, there are other runners who also have a quick cadence yet they have a much longer stride.  I'm not going to purposely try to lengthen my stride but is my stride short because of some of these issues I'm having?  My hamstrings are so incredibly tight that I feel like I couldn't lengthen my stride if I wanted to! Perhaps with increased flexibility, my stride will naturally lengthen.  

What to do, what to do?  Dave had a LOT of recommendations!  On my first visit he gave me a few stretches but when I went back the second time he spent about an hour with me going over both strength exercises and additional stretches to target the problem areas.  He made sure I was doing them correctly and that I understood why I needed to do them.

Recommendations

Stretches:

• Hip flexor stride stretch
• Pigeon pose
• Soleus (toe against wall)
• Gastrocnemius - using this calf stretcher
• Hamstring

Exercises: 

• Clams with band
• 1-legged bridge
• Side plank with leg raise
• Single-leg step up on bench with overhead press
• Single-leg squat with back leg on bench
• Single-leg balance, hip abduction with band

Sitting/Standing: 

• Use good posture to prevent weight from resting on my hips.
• Do not sit cross legged, particularly with the right leg over the left.
• Do not sit curled up with my knees shifted to the left (right knee on top).
• Keep even distribution of weight on both legs when standing rather than shifting weight to right hip/foot.
• Watch right foot when standing to be sure it's not turned outward.

Running Form:

• Less upper body rotation
• Eliminate the right arm "crank-back"
• Pull-through (get my legs back behind me more) to use more power

Once I get back to running in a couple more days (fingers crossed!), I need to be very mindful of my arms upper body.  I've been so focused on my legs that my arms never crossed my mind!  I also need to be diligent about stretching and strengthening, something I've neglected for at least the past year.  

All in all, I was quite pleased with my video analysis and follow-up session.  Many of the things Dave said went along with what my PT had told me (weak hips and glutes) but having the video component was a nice added feature for me, especially for the running form.  I already had an idea about what my legs were doing but I never would have guessed I was cranking that right arm back until I saw it in slow motion!  Plus, I liked how comprehensive the assessment was, taking every aspect of your legs into account to put it all into one big picture.

I would definitely recommend this for anyone with a running-related injury.  You'll gain a lot of information and leave with ways to help yourself feel heal.  Even if you aren't injured it could be a cool thing too!  You might learn some good preventative tips to keep you running healthy.

The total for two sessions is $125.  I also downloaded the "Coach's Eye" app for $1.99 (it was on sale - I think it's usually $6.99) and had Dave send me the videos.  You can watch the videos online but without the app you won't be able to play around with them and use the additional features that the app offers.  

For more information about the RunFast program or to set up an appointment, you can call or email Dave.  

David Tomsich, certified strength & conditioning coach, physical therapist
Office: 248-344-2331
Email: dtomsic1@hfhs.org


Have you ever had a running form assessment done?  If so, please leave a comment to tell me about your experience.