Tuesday, August 2, 2016

Running Mechanics: Pushing vs Pulling?

Being a running shoe geek/nerd, I understandably am part of the large Facebook group "Running Shoe Geeks."  I love seeing some of the questions that pop up regarding running mechanics and movement, because that is my profession and all I think about.  As per most new DPTs and medical professionals, we have a difficulty time keeping things short and sweet, instead diving very much indepth into the nitty gritty details that most people don't give two craps about.  We care but our patients don't.  They just want to usually know "yes or no" or "one or the other."  For those that want to look more in depth, here is a post I did recently (as in a few minutes ago) in response to a newer runner who asked about whether "pushing" or "pulling" is better for running mechanics.  I'd heard talk and discussions regarding this many years ago when I was first introduced to ideas of different running form.  POSE running, CHI running and more all toted different ways to become the ultimate running athlete.  Certain drills were pushed by each claiming that you should either pull the ground under you, or push yourself forward.  So is one better??? 

Pulling or pushing really are just two different strategies to accomplish the same thing (forward progression).  These are examples of the incredible number of beautiful ways the human body moves, produces force and accomplishes than many amazing tasks that it can accomplish.  "Pulling" while running involves a great deal more of the hamstrings and hip extensors (hopefully glutes but >90% of runners and people in general don't use those... so really mostly hamstrings) while "pushing" utilizes a great deal more of the knee extensors (quadriceps) and again hopefully hip extensors (again see my above comment on that). One isn't necessarily better than the other in general and you will see elite and casual athletes alike use both strategies. The problem arises when you have weakness or poor neuromuscular control (or both). If you are a pulling runner and you have weak gluteal muscles, no wonder your hamstrings get tight or injured as they are having to do the work of two major muscle groups (and your glutes can produce amazing amounts of power thanks to their surface area, ability to produce high amounts of force and their lever arm in regards to the pelvis, femur and the rest of the leg. So when they are weak.... say because you sit on them all day long, they get ischemic (low blood flow) and your body goes "guess I don't need these" and they atrophy over years... no wonder you can't produce as much force. You are missing a major part of the kinematic chain!!!!). If you are a "pushing" runner, you better have really strong quadriceps and very stable good hip and ankle stability, because if that knee goes too far in one direction medial or lateral, you are going to start screwing up those patellofemoral and tibiofemoral joints (kneecap and knee joints). Those need to stay straight to appropriately transmit forces down your leg and into the ground to get you forward. When you have hip weakness and have uncontrolled femoral internal rotation or you have weak arches/instrinsic foot muscles and have uncontrolled pronation (notice I said uncontrolled. Pronation itself is not a bad thing. It's just a motion), then everything is out of wack, the quads have to shift from being prime movers (which is what they are supposed to do, produce force to get you forward) to prime stabilizers (which is not their normal function. They should be force producers) then they are doing something they are not meant to do by themselves.... then viola! You dramatically increase your risk of injury because one muscle group has the do the work of many! They're not supposed to do that!  Muscles commonly get injured because they are either weak or they have to do extra work that other muscles should be doing.  There are no magic muscles.  Each one has something to contribute to the entire kinematic chain.

It may depend more on what your trunk and whole body is doing. If you have a nice forward lean (which is typical of many elite endurance athletes because you are utilizing gravity and forward moment), then it would make sense to push because you will help propel yourself in the forward direction thanks to that forward lean pointing you that way and helping to direct force. If you have upright body posture, then it would make sense to pull more because pushing will cause too much vertical displacement, and take away from your forward momentum and waste energy.

Interestingly enough, I notice the elite sprinters tend to have more upright body posture and look like they are pulling more because their contact time is so minimal the knee extensors almost look like they don't have time to fully load and push. While elite endurance athletes (especially the kenyans)  tend to push with a forward leaning posture. These are just my observations and may explain why testimonally I have heard of more elite endurance athletes suffer knee injuries and more elite sprinters suffer hamstring injuries. I have no research that I know of to back up the above comments, just testimonial observations.

So is one better than the other? I don't know.  Despite all the above I again don't know of any research studies that prove one over the other (if you know of some please send them to me or post a link in the comments).  Maybe it depends more on what event you are running, what muscles you tend to use more of, where your strengthens/weaknesses are, what your limb lengths are, what your posture is during running and the rest of the day, what you saw most people around you doing when you were growing up or first running (that's my inner pediatric/neurologic DPT thinking about learned motor patterns and mirror neurons.  That's a post for another time) and more.

I would recommend that you look more at how you run, then strengthen the things that you need to utilize appropriately to both reduce injury risk (one of the best proven ways to reduce injury risk? Strengthen the muscles!) and increase your ability to produce force whether in a short amount of time or over a very long period of time.  Because the more force you can produce, the faster you may be able to run... although there are many other factors that I will have to get into in another post.  Alright.  I'm done.

Thanks for reading and don't forget to Tack On!
As always, my views are my own.  My blog should not and does not serve as a replacement for seeking professional medical care.  If you are currently injured or concerned about an injury, please see your local running physical therapist.

-Matt Klein, DPT

Note: A big thanks to Azril Dogaong for getting me to write this!

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