Your Kinetic Chain -
What is Anatomically Connected
is Functionally Interrelated

Often is the case when a runner, after experiencing enough pain that their running is impaired, consults a doctor is given what we term a “garbage can diagnosis”. An example of a “garbage can diagnosis” is patellofemoral pain syndrome. If we break this word apart we see it means patella (your kneecap), femoral (your thigh) pain syndrome. Basically after paying your doctor to diagnose your condition you were told that your knee cap and leg have pain! You already knew that. What you wanted was a solution to your problem, not your condition translated into Latin and spoken back to you.

When the health care provider asks “When does it hurt?” Of course you reply “When I run.” The common reply to that response is to stop running or take Ibuprofen (link to NSAIDs page), which can be dangerous. Of course this is not an option for most runners. Secondly your “patellofemoral pain syndrome” is not an Ibuprofen deficiency! Doesn’t it make sense that if it hurts when you run, but not when you walk or do other activity, that it is a biomechanical problem that deserves a biomechanical solution? In order to better understand the premise for this statement it is important to take a quick review of anatomy and basic biomechanics.

We’ve all heard that the “the leg bone is connected to the shin bone; the shin bone is connected to the ankle bone, etc.” This might be a grade school attempt to memorize human anatomy, but if we examine the statement we can find an important biomechanical principle within it. What is anatomically connected is functionally interrelated. If you lose movement in your ankle you will compensate at the knee and hip or vice versa. In no population is this more important than in the running population. Runners use their “parts” more than the average person. If those parts are not balanced and symmetrical it is likely that the runner will experience problems. This brings us to another very popular “garbage can diagnosis”. Have you ever been told that you have an “overuse injury”? This may be a valid diagnosis except for one thing. Imagine being told that you have an overuse injury in your right quadriceps due to marathon training. Isn’t it true that you ran all those miles with both of your legs and quadriceps? How can one side be overused and the other not? The answer is obvious if you know to look for it. If you are asymmetrical then a problem can and will develop on one side. Basically you have a “weak link” in your kinetic chain.

So the answer lies not in naming a condition, but in how to remove the condition. Remember your condition did not result from an aspirin, Motrin or Tylenol deficiency. Your condition most likely was caused by training errors, abnormal biomechanics or asymmetrical stress. For example, imagine running in a shoe that is 6 months old on one foot and a brand new shoe on the other foot. If you started to develop pain on the side with the old shoe one would hope that a good doctor would give the obvious sound advice of putting the same new shoe on that foot. This would restore balance and symmetry to your kinetic chain and remove your symptoms. If you doctor told you that you were suffering from patellofemoral pain syndrome and that you needed to stop running, you would hopefully find a new doctor. This is a painfully obvious example, but the premise holds true for your entire kinetic chain.

A well known and commonly treated condition in runners that is thought to affect the kinetic chain is overpronation in the feet. The shoe companies know this and have designed stability shoes for mild pronators and motion control shoes for heavy pronators. The reasoning for controlling pronation in the foot is to reduce shearing forces at the knee in addition to promoting patellofemoral alignment. By promoting proper alignment through proper foot wear and/or orthotics we promote better function and therefore decrease asymmetrical stress on the knee. By achieving symmetry and balance then we get rid of pain. Malalignment of the feet, knees, hips or lumbopelvic spine can result in a weakness in your kinetic chain and cause functional impairment which leads to pathology and pain. By correcting the alignment then symmetry and balance is achieved and the pain disappears.

San Diego Running Institute has compiled the most current medical literature regarding running injuries and biomechanics. We have trained experts with degrees in chiropractic, strength and conditioning, kinesiology and athletic training. Our unique understanding of anatomy and biomechanics coupled with our in depth knowledge of running injuries has resulted in a clinical running store.

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