Running and The Performance Matrix Part 1
Running and The Performance Matrix Part 1
This is the first of a three-part blog looking at running injuries and the application of The Running Matrix – Movement and Performance Screen, as a tool to help reduce the risk of injury and enhance performance in runners.
The first part provides some background on running injuries from the research. The second part outlines a case study and discusses the link between movement faults, injury and running technique. Finally the third part provides a detailed summary of the application of The Running Matrix and our Exercise Catalogue to provide a retraining approach to our runner. We hope you enjoy!
The overall annual incidence for running injuries varies between 37 and 56% per runner 
The most common injuries occur in the knee, lower leg and foot, including:
Patellofemoral Pain (PFJPS)
o Illiotibial Band Syndrome (ITBS)
o Patella Tendinopathy
o Achilles Tendinopathy
o Medial Tibial Stress Syndrome (MTSS)
o Plantar Fascitis
Due to the repetitive loading of distance running, 50 to75% of all running injuries relate to overuse and reported recurrence rates range from 20 to 70% 
These statistics highlight the need to address movement faults in runners for prevention and management of injuries.
Kinematic studies of runners give us valuable insight into how those who have an increased injury risk move differently
A prospective study that examined running kinematics found that those who reported ITB injury at follow up, initially demonstrated increased peak hip adduction and knee internal rotation angles. 
The same movement faults were found in a retrospective study comparing those with a history of ITBS (though currently pain free) with matched controls.
In a study that examined kinematics at the point of running fatigue, greater knee flexion at foot contact and internal rotation of the leg was measured in those with a history of ITBS.
Together, these studies suggest that movement faults precede and persist after injury; becoming more pronounced with fatigue. These findings have important implications for detecting and managing weak links.
However the following questions are worth considering:
1. Will all individuals have the same combination of movement faults (or weak links)?
2. Which weak links take priority in each case?
3. Do the weak links observed relate to motor control (co-ordination) or strength (power) issues?
4. Without sophisticated 3D motion video analysis in the clinic, how can we assess for movement faults in runners?
5. What about problems further up the chain?
This is where the Running Matrix can help – let’s answer each question in turn
1. The screen report provides an individualised assessment of weak links that are pertinent to running injury or technique issues.
Meaning that training can be tailored specifically to that individual to address their specific combination of weak links.
2. The report also prioritises weak links and assets using a ‘red /green/ amber’ system so that we know where to focus first.
In the clinic where time is an issue for both the therapist and the client, getting to the priorities can save time that may have otherwise been spent on more generic programmes.
3. The testing detects weak links at the level of low level stability (motor control) and high level core strength.
This is important as the training strategies to address aspect each need to specific.
4. The running matrix is a clinic friendly tool that assesses multi joint movement
Multi joint movement is particularly relevant to running activities
5. Problems throughout their entire kinetic chain are assessed.
In a sport such as running where linkages occur throughout the chain to generate rotational control, assessing the system as a whole is key to getting on top of running problems.
Part 2 of this blog for provides more detail on this with reference to a specific case study.
. Van Mechelen, W. (1992). Running injuries. A review of the epidemiologicalliterature, Sports Medicine 1992: 14 (5), 320-35
. Dias Lopes, A, Carlos Hespanhol, L, Yeung, S and Pena Costa, L.O. (2012). What are the Main Running-Related Musculoskeletal Injuries? A Systematic Review) Sports med 42(10) 891-905
. Nielsen, R.O., Nohr E.A., Rasmussen, S. and Sørensen, H. (2013). Clinical Commentary: Classifying Running-Related Injuries Based Upon Etiology, With Emphasis On Volume And Pace. The International Journal of Sports Physical Therapy 8(2).
. Noehren, B.W., Davis, I.F., and Hamill, J. (2007). Prospective study of the biomechanical factors associated with iliotibial band syndrome. Clinical Biomechanics 22, 951-956.
. Ferber, R., Noehren, B. and Hamill, J. (2010). Competitive Female Runners with a History of Illiotobial Band Syndrome Demonstrate Atypical Hip and Knee Kinematics. JOSPT 40(2), 52-58.
. Miller, R.H., Lowry, J.L. Meardon, S.A. and Gillette, J.C. (2007). Lower Extremity Mechanics of Illiotibial Band Syndrome During an Exhaustive Run. Gait and Posture 26, 407-413.
Find out more about TPM Running Solution here
Written by Juliana Samson, Michael Nicol & Clare Pedersen
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