Victory Friday | Issue 132
Orthopedic Insights: Run Right • Rib & Hip Fixes for Neck Pain • Pool Running (Isn’t Just) for (Broken) Runners • The Performance Imperative: How Coaching Makes Me a Better Physio
“Fall seven times, stand up eight.” ~ Japanese proverb
Victory Friday is a weekly digest of reflections, insights, and tools from the world of functional manual and performance medicine. It is a free weekly publication. To support Victory Friday with a paid subscription, click below:
It’s Spring Marathon Season! The weather’s warming (yet still enjoyably cool for morning jaunts) and fitness and spirits are thawing: perfect conditions for peak runs.
In this run-centric issue: how (and why) to run right, augmenting with the pool, whole-body strategies for neck pain, and stride coaching for pain relief and competitive edge. Enjoy!
What I’m Into: Run Right. This weekend is our local marathon. It’s a major focus for runners in the area, who begin training at the start of the year and build toward race day at the end of April.
Spectating on race day or during the organized training runs leading up to the event always gives me mixed feelings.
I love the sense of empowerment that comes from doing something hard, and the strong feeling of inclusion—accomplishing a big goal together with friends, teammates, and the wider running community.
But watching many (if not most) of the runners’ strides… pains me.
50% of all runners develop an injury in any calendar year. And the biggest factor in those injuries is how we run: technique, form.
I don’t blame runners for inefficient running form. I simply wish their support systems:
• coaches and organized training groups
• sports medicine professionals — namely physios, but anyone who claims to be a “running specialist” clinician
would demonstrate the essentials of efficient running and do their best to teach, coach and hold accountable those three essentials:
Posture. A forward orientation that maximizes propulsion and limits landing stress.
Right: optimal forward posture (with hip hinge). Left: the author, demonstrating inefficient posture that makes both hip utilization and efficient landing nearly impossible. Source: Author. Vertical hip strategy. A limb movement and propulsive strategy that optimizes hip (glute and hip flexor) utilization and limits landing stress.
A vertical hip strategy: upward/forward hip flexion coupled with downward/rearward hip extension. This creates a circular shape to the legs (and feet, noted with the red dot at the ankle). Source: Author. Cadence. An optimal (quick) steps-per-minute that limits ground contact time, and thus energy absorption by leg tissues.
Doing so would be tougher up front but result in a lot more joy, and a lot less pain, for a lot of people!
Because I’m a coach, athlete and physio, I demand of myself that I optimize, to the best of my ability, the running technique of each client.
And if more of runner supporters did the same, there’d be a lot more healthy, joyful and fast runners out there!
But whoever you are right now: good luck this weekend, and never stop trying to run better!
Cool Exercises I Like. Rib & Hip Fixes for Neck Pain. My innovative, talented colleagues at The Manual Shop posted another banger of a video demonstrating a whole-body (Systems-based1) strategy for treating neck pain and stiffness.
As we talked about a couple weeks ago, a lot of neck pain and stiffness originates in the thoracic spine2.
But it can also be anchored in the hips.
Physio Antonio Colletti shows us his approach to sustainably restoring neck motion and providing sustained pain relief:
The neck can drive (top-down) dysfunction, but it can also be victim of overall posture inefficiency (bottom-up).
If, say, a guy like this has neck pain:
it may be due to posture inefficiency. Even if this “looks good”, a ribcage “held” in “tall” extension will create hyper-tone in the anterior neck muscles — which are working hard to keep the neck from “falling backwards” on this uneven platform.
An efficient, low-strain spinal column relies on a balanced stacking and angling of the system:
Colletti rebalances this system dysfunction in three ways:
Opening the (closed off, over-extended) posterior upper back.
Closing the chronically elevated sternum and anterior ribs
Mobilizing the hip and pelvis so that it can be a neutral base of support for the whole spine.
If you have neck pain — or treat a lot of chronic cervical issues — your salvation may lie in all the things below the neck!
Joe’s Articles. Pool Running (Isn’t Just) for (Broken) Runners. Did your spring marathon prep already derail you? Even if you’re feeling good, you might consider a pool running session to stay healthy, enhance mobility in ways only water can, and add a novel cross-training to your routine.
When I did this routine once a week, I felt fantastic back on land! (Might be time to get back to it…)
From iRunFar.com,
Performance Flexibility: Pool Running
TL;DR:
Pool Running Benefits: Pool running (and other activity) provides low-to-no impact cross-training that reduces stress/recovery time, enhances mobility (decreased stiffness, joint ROM, spinal traction, better posture), builds strength/power/turnover with water resistance, and allows intensity work without pounding.
Pool Workout Types & Activities (mix swimming, deep, and shallow water for variety):
Straight Swimming: Easy warm-up (e.g., 20 min) or integrated into sessions.
Deep-Water Running (non-impact, often stationary):
Upright “Stairmaster” — high knees/bike motion for hip flexion, shoulder ROM, power, and turnover.
Upright “Elliptical” — longer strides for hip extension (glutes/hamstrings) and core/back stability.
Forward “Doggy Paddle” — moving forward for trunk extension and forward lean.
“Shoulder Challenge” — max effort to lift shoulders out of water for high-intensity/power/turnover.
Shallow-Water Running (partial impact, various depths):
Knee-deep: Quick footwork and hip drive with some weight-bearing.
Chest-deep: Full-body minimal-impact running; challenges turnover or power.
Interval variations across pool: Quick (max turnover), Big Bounds (power/hip drive), Vertical Leaps(plyometrics, alternate legs), Backwards (core/balance/hip power).
Pool CrossFit/Mix-Ins:
Underwater swim then run.
Diving-board pull-ups (water-assisted).
Pool races with friends for fun/intensity.
Sessions can be short (under 60 min), 1–a few times/week.
Victory Friday. The Performance Imperative: How Coaching Makes Me a Better Physio. A couple stories I like to tell:
• No one ever taught me how to teach running form. Not my USA Track & Field certifications (Levels I and II). Not my Master’s Degree in Exercise Science. And not my Doctorate in Physical Therapy.
I had to teach myself. Or, more accurately, my clients had to motivate me to learn to teach them.
• The first physio client with whom I actively changed her running form was one of the best high school runners in the area (who went on to run at the University of Oregon, and helped them win a conference cross country title).
She was having shin and knee pain. And, in mid-stance, she sort of looked like this:
Nothing I “did” — strength or mobility exercise; hands on work — changed her knee.
I had to teach her to stop doing that.
I was apprehensive about it. Because even in medical circles and, especially — paradoxically, outrageously — in endurance coaching circles, it is considered either unnecessary3 or risky4.
But as an athlete and coach, myself, I could not abide her running that way. She was too fast to run that poorly.
So we changed it. Successfully. She felt better, ran faster and (by all accounts) lived happily ever after.
And now running stride optimization is central to my practice.
But now that I’m back to high school coaching, stride optimization is central to my coaching philosophy. Once again:
How we run plays the biggest role in how we feel and how we perform.
It isn’t easy; some kids take to it quickly. Others struggle to adopt even minor changes, and get frustrated.
But moving correctly — in a way that I know is the least straining and most performance-effective — is more important than any workout, any accessory work, or any pep-talk.
And this season, it’s already paid off:
• Cadence: the biggest performance (and pain relief and prevention) multiplier is optimizing cadence: 180 steps per minute for most (average height) kids5. The younger, less strong kids struggle here, but once they learn it, their performance takes off. And, better yet, aches and pains go way down.
• Posture: perhaps the lowest hanging fruit, optimizing posture — primarily with emphasis on hip hinge — is another easy-to-recognize deficit. Kids that are too upright or back-leaning lose power and beat up their legs. But maintaining hip hinge and forward posture is challenging — often requiring a lot of cueing and/or slowing down workouts in order to “nail technique first”.
The most difficult, though:
• Hip strategy: optimizing hip strategy — achieving upward-forward hip flexion and downward-rearward hip extension — is the toughest. Hip utilization takes a lot of trunk and pelvic stability and hip strength. But kids stuck in an inefficient habit — a low, “elliptical” swing, commonly — have a tough time breaking out of that habit.
Nonetheless, most stride strategies are habits. Breaking habits is difficult, but slowly — but relentlessly — bending habits is possible.
And with each successive micron of biomechanics improvement, performance gains — and pain relief — quickly follow.
So even those small stride wins can create big Victories.
I’m sitting on two fascinating stories of a couple of my runners — upperclassmen boys — who are making small-but-crucial stride changes. We’re a meet or two away from a breakthrough, and I hope to share those Victories, soon.
Stay tuned!
Stride Optimization for All. In the mean time, this imperative to stride coach all running clients has been the key to solving chronic pain in many runners: pain that has thwarted the efforts of many “running specialists”.
Why? Because these specialists failed to address (or at least, adequately optimize) the person’s running form.
But because of my three roles — runners, coach and physio — and because of this seasoned experience (and with it, courage), I will never hesitate to optimize stride, even in the highest-level clients or the most challenged motor learners.
Because nothing trumps moving well.
Take-Aways. Never Be Afraid to Optimize! Change is hard, but never withhold something, no matter how difficult, that could sustainably relieve pain, improve performance, and bring more joy to movement! That’s the power of motor control coaching. It’s challenging, but richly rewarding.
Issue 132 is in the books!
Help people move, function and feel better: please share this publication!
Thanks for reading, and have a great weekend,
Issue 41: Systems & Dimensions. Full and sustained pain relief and recovery of function often requires a comprehensive treatment approach of multiple Systems (body areas: spine, pelvis, abdomen, pelvis, hip, knee, etc) and Dimensions (types of tissue: muscle, tendon, bone/joint, fascia, nerves, blood vessels, etc).
Issue 128: “Hammer Don’t Hurt ‘Em”: Thoracic Mallet Manipulation Frees a Stubborn Cervical Spine. In a case of acute-on-chronic cervical stiffness following a traction injury, direct myofascial and joint work on the neck yielded only modest relief. However, aggressive percussive mallet manipulation of the thoracic spine produced dramatic, near-immediate bilateral improvements in cervical rotation, sidebending, and pain-free tissue tone.
“They’ll out-grow it”, or “Once they run more miles they’ll stop doing that”. 💁🏻♂️
“You might make it worse!” 😱
Cadence can/should be a bit slower for males > 6 feet (and perhaps, women over 5’9” or 10”), whose long-levered limbs are more difficult to move as quickly.