Strength Training in Long Distance Runners

If you have ever met a long distance runner for the first time, chances are it was not in the shutterstock_195157721gym. Generally, understood as the hippies of the athletic world, these fitness nomads are the type of people who decide to run 15km to the starting line of a race, finish it and then run back home again. Mostly content with their own thoughts and rhythm of their own heartbeat, motivation builds itself from the constantly changing scenery which is passed in a single adventure.

The stagnant visuals of the gym, whether on a treadmill or lifting weights does very little in terms of excitement for a long distance runner but what it can do for performance is a topic worth exploring.
For much of my time as a runner the people I have met who share the same interests have been quite set on getting/staying lighter, measuring what they eat, measuring their heart rate, the distances they run daily/weekly/monthly….it becomes quite compulsive. So the mention of lifting weights and getting in the gym instantly brings visuals of bulky muscle and restricted movement, when in fact developing strength can truly benefit not only performance but decrease injury risk as well.

A number of resistance based training components have surfaced in the research looking to improve athlete injury risk, run economy and performance including speed. The three primary resistance based training modalities which have been investigated include strength, speed and the combination of the two, power. Additionally, the resurgence of balance as a mechanism for reducing injury risk has also brought forward the importance of sensorimotor resistance training.

 Manolopoulos, et al, 2015, found that sensorimotor resistance training produced similar improvements to strength training in balance and force output. This should be taken into consideration when a running program is being designed with strength elements as sensorimotor training can be completed in a shorter amount of time due to needing to be completed before neural fatigue occurs. Similarly, a Systematic Review by Hubscher et al 2010, established that the neuromuscular effects associated with balance training were effective in the prevention of lower limb injury, specifically at the knee and ankle joint. However, what does not seem to be well defined is the dosage of balance training required to accomplish the desired effect.

Over the last twelve months we have looked at running economy associated with footwear and foot strike. Running economy can be defined as the energy expenditure during a steady state oxygen uptake to maintain a submaximal running velocity. A number of studies have shown a positive relationship between strength training and running performance. More specifically, the relationship of running economy and muscle stiffness in the utilization of an efficient stretch shorten cycle in force production. It is suggested through the literature that one strength training session a week is not enough to produce significant changes in running economy, however, 2-3 sessions a week can increase the running economy of middle to long distance runners.
A systematic review by Beattie et al, 2014, stated that muscular force adaption are dependant of the current strength level of the athlete, the exercises administrated and duration of the strength program. For a neuromuscular inefficient/ non-strength trained runner the most appropriate training type appears to be general maximal strength program for best development of force, power and reactive-strength.

That which is not made clear by the evidence is an agreement on the dosage of the strength programs in endurance athletes, with every paper including between one and five sessions per week for three to six months. However, one paper by Kilen, Hjelvang, Dall, Kruse and Nordsborg, 2015, found that there were similar adaptions to multiple training components as long as the total volume is the same.

There is no doubt strength training can have a positive effect on performance and injury risk for long distance runners. For those who truly wish to be their best at their chosen sport, sometimes it means having to suck it up and do the things you do not want to do. Many people who are involved in long distance running do so as a hobby in which they occasionally enter a competition or fun run and for those who do take this approach to training, strength development should also not be over looked, as the prevention of injury will keep you actively participating long into the future.

Until Next Time,

Jackson McCosker
Director/ Chief Editor


Balsalobre-Fernandez, C., Santos-Concejero, J., & Grivas, G. (2015). Effects Of Strength Training On Running Economy In Highly Trained Runners: A Systematic Review With Meta-Analysis Of Controlled Trials. Journal Of Strength And Conditioning Research, 2361 – 2368.

Beattie, K., Kenny, I., & Lyons, M. (2014). The Effect Of Strength Training On Performance In Endurance Athletes. Sports Medicine.

Bolger, R., Lyons, M., Harrison, A., & Kenny, I. (2015). Sprinting Performance And Resistance-Based Training Interventions: A Systematic Review. Journal Of Strength And Conditioning Research, 1146 – 1156.

Campos-Vazquez, M., Boza, S., Toscano-Bendala, F., Leon-Prados, J., Suarez-Arrones, L., & Gonzalez-Jurado, J. (2015). Comparison Of The Effect Of Repeated-Sprint Training Combined With Two Different Methods Of Strength Training On Young Soccer Players. 1 – 19.

Gonzalez-Badillo, J., Pareja-Blanco, F., Rodriguez-Roseli, D., Abad-Herencia, J., Del Ojo-Lopez, J., & Sanchez-Medina, L. (2015). Effects Of Velocity-Based Resistance Training On Young Soccer Players Of Different Ages. National Strength And Conditioning, 1329 – 1338.

Hubscher, ,., Zech, A., Pfefier, K., Hansel, F., & Vogt, L. (2010). Neuromuscular Training For Sports Injury Prevention: A Systematic Review. Clinical Sciences, 413 – 421.

Kilen, A., Hjelvang, L., Dali, N., Kruse, N., & Nordsborg, N. (2015). Adaptations To Short, Frequent Sessions Of Endurance And Strength Training Are Similar To Longer, Less Frequent Exercise Sessions When The Total Volume Is The Same. The Journal Of Strength And Conditioning Research, S46 – S51.

Manolopoulos, K., Gissis, I., Galazoulas, C., Manolopoulos, E., Patikas, D., Gollhofer, A., & Kotzamanidis, C. (2016). Effect Of Combined Sensorimotor-Resistance Training On Strength, Balance And Jumping Performance Of Soccer Players. Journal Of Strength And Conditioning Research, 53 – 59.

Richmond, S., Kang, J., Doyle-Baker, P., & Nettel-Aguirre, A. E. (2016). A School-Based Injury Prevention Program To Reduce Sport Injury Risk And Improve Healthy Outcomes In Youth: A Pilot Cluster-Randomized Controlled Trial. Clinical Journal Of Sports Medicine, 291 – 298.

Roschel, H., Barroso, R., Tricoli, V., Batista, M., Acquesta, F., Serrao, J., & Ugrinowitsch, C. (2015). Effect Of Strength Training Associated With Whole Body Vibration Training On Running Economy And Vertical Stiffness. Journal Of Strength And Conditioning Research, 2215 – 2220.

Wyland, T., Van Dorin, J., & Reyes, G. (2015). Postactivation Potentation Effection From Accomodating Resistance Combined With Heavy Back Squats On Short Sprint Performance. Journal Of Strength And Conditioning Research, 3115 – 3123.


Treating The Patient, Not Just Their Diagnosis

The art of conversation almost seems lost these days. Demand for rapid responses and digital dialect has seen a disheartening change in the way people communicate with each other. We see the weakening of potential bonds that may have developed over a cup of coffee rather than what has been conducted through poorly punctuated e-mails or text messages.

However, there is a great importance in reducing how this transpires into your clinic or treating room.

shutterstock_182631224.jpgA new patient form can be a marvelous clinical system that helps provide patient personal communication details and previous medical histories, however, with those past experiences and labelled conditions there also comes the unfortunate tailing of pre-conceived ideologies which can skew professional rationalism.
The identification of underlining conditions is necessary in the ruling in and ruling out of particular ailments that may be present however, it is also important to be aware that the existence of those conditions does not always correlate to that which is being presented. This ideal is an important factor for not only the practitioner to be accustom too, but should also be educated to the attending patient so they too are aware of any impact pre-existing conditions may have on their current issue – you can never over educate a patient, as long as it is done correctly.

Too better understand this, perhaps its best to re-visit our article from two years ago looking at the psychology of pain:

“The brain is our interpreter of all messages; it is the deciding factor if we as individuals feel pain. Age and gender have shown to not influence how we feel pain, however; life experiences and cultural identity have an influence on how we express pain.”

When treating a patient, usually in the first consult it is important find out what brought the patient to see you. Many times the answer is “pain” but then you find out that the patient has had this pain for 2, 6 or more than 12 months. So if the pain has been present for so long, then why is now the time they have chosen to see you? What is their goal?
And it’s usually at this time you find out said patient with forefoot pain has a wedding in three weeks and has a very specific pair of heels they wish to wear…
Nonetheless if that goal means something to them and you can tailor your consults to achieve both your physical and psycho social goals as a practitioner a patient is more likely to adhere to management strategies you put in place.

Additionally, a systematic review by Kamper, et al, found that the use of a multidisciplinary rehabilitation program was more effective than “usual care” or physical therapy alone in the decreasing of both pain and disability of people with lower back pain. This is primarily attributed to the relaying of similar messages through different practitioners and channels, an increase in compliance due to regular rehabilitation appointments and the increased mobility associated with rehabilitative programs. However, it has been noted that with the implementation of a multidisciplinary program also comes cost, resource demands and time consumption.
This again why it is important to develop an understanding about what the patient’s goals are and what your goals are a practitioner. If the treatment of a condition can be brought back to the benefits associated with the patient’s goal, they are more likely to agree to treatment that they may otherwise perceive as a burden.

In many cases trust of a practitioner is a virtue that may be taken for granted, especially when a patient has had poor experiences with practitioners previously or are of the belief that nothing can fix their present issue. In general, we are not trained to deal with attitudes towards ailments, management strategies or doubt placed upon themselves but, when we come up against a road block such as this it is important that we show empathy to a person’s situation not sympathy.
Introducing the patient to another patient who has had a similar condition and been rehabilitated with an improve quality of life or even a practitioner who has seen the benefits of the management plan you wish to pursue can have a fantastic effect on the patient’s confidence.
Similarly, sitting with a patient and having a discussion about how the complaint has impacted them and their lifestyle as opposed to clinically relevant questions can also help humanize the presentation.

I studied podiatry at university not psychology. But it has quickly become apparent over the last three years of treating people how important the wording and delivery of messages can be when discussing issues associated with pain with someone. The old adage “never assume someone knows what you mean by the words you speak”, is just as true in any situation. When conversing with a patient I will generally give them a summary of their diagnosed condition, what we plan to do in the coming appointments, a visual example of what we have discussed or what they should be doing in the coming days (video or demonstration) and a contact number/email if they have any questions. If a patient on remembers approximately 7% of that discussed in an appointment, then it is best to supply them with that stated information in written form.
Until Next Time,

Jackson McCosker
Director/ Chief Editor


Bhatti, A. (2015). Treating The Patient – Not The Disease. Arizona.

Boonstra, A., Reneman, M., Preuper, H., Waaksma, B., & Stewart, R. (2014). Difference Between Patients With Chronic Musculoskeletal Pain Treated In An Inpatient Or An Outpatient Multidisciplinary Rehabilitation Program. Groningen: International Journal Of Rehabilitation Research.

Hoogeboom, T., Stukstette, M., De Bie, R., Cornelissen, J., Den Broeder, A., & Van Den Ende, C. (N.D.). Non-Pharmacological Care For Patients With Generalized Osteoarthritis: Design Of A Randomized Clinical Trial. 1 – 36.

Kamper, S., Apeldoorn, A., Chiarotto, A., Smeets, R., Ostelo, R., Guzman, J., & Van Tulder, M. (2015). Multidisciplinary Biopsychosocial Rehabilitation For Chronic Low Back Pain: Cochrane Systematic Review And Meta-Analysis. Bmj, 1 – 11.

Koenders, N. H. (2015, June 30). Stepped Care Strategy For Patients With Hip And/Or Knee Osteoarthritis In Primary Care: A Retrospective Analysis Of Medical Record Data. Utrecht: Physiotherapy Science Urtecht University.

Lewis, J. (2015). Treating Patients As A Whole And Not As A Disease. 1-4.

Parikh, R. J. (2016). Treating The Patient, Not Just The Disease. Comprehensive Cancer Centers Of Nevada.

Rittig-Rasmussen, B. (2014, November). Physiotherapy For Patients With Pain. Physiotherapy Works. The Association Of Danish Physiotherapists.

Spaeth, G. L. (2015). Treat The Patient – Not Just The Disease. Review Of Opthamology, 1 – 23.

Tavafian, S., Jamshidi, A., & Mohammad, K. (2011). Treatment Of Chronic Low Back Pain A Randomized Clinical Trial Comparing Multidisciplinary Group-Based Rehabilitation Program And Oral Drug Treatment With Oral Drug Treatment Alone. The Clinical Journal Of Pain, 811 – 818.

Whyte, G., Senior, R., Shave, R., & Sharma, S. (2007). Treat The Patient Not The Blood Test: The Implications Of An Increase In Cardiac Troponin After Prolonged Endurance Exercise. British Journal Of Sports Medicine, 613 – 615.



Running Cadence: Is 180BPM Right For You?

shutterstock_141278242.jpgRunning. Some do it for fun, others for competition. For many it is the primary activity associated with their chosen sport and for some an uncomfortable and at times painful strategy toward weight loss. FootNotes Publishing has looked a lot at running within the last 12 months including; strike patterns and injury, foot strike and performance and running economy.
In the following short article, we look at the idea of running cadence and the impact that can have on injury to the lower limb in running.

It has been found that between 56 – 90% of those training for a marathon will sustain an injury at some time during their training period (Heiderscheit, Chumanov, Michalski, Wille, & Ryan, 2011). There are many factors which can contribute to these injuries and the factors which may pose a problem are highlighted here:


Strike Patterns:



A popular running theory touted in a number of specialist magazines and running blogs has been the promotion of a cadence of 180bpm. Obviously, this is quite a rounded and general number and does not account for individual differences within the population.
Lyght, Nockerts, Kernozek, & Ragan, found that a progressive transition in the change of step frequency and consequential foot strike of a runners naturally chosen cadence to +/- 5% significantly reduced the peak forces experienced by the achillies.
Similarly, (Heiderscheit, Chumanov, Michalski, Wille, & Ryan, 2011), found that by increasing step rate and decreasing step length there was a significant reduction in vertical Centre of Mass velocity and less eccentric energy absorption at ground contact. Despite the increase of ground contact moments there was seen to be less likelihood of lower limb injury.
Despite the obvious procedural differences among the literature it appears an increase in step rate and a decrease in stride length can reduce influence toward injury of a number of biomechanical factors associated with running (Schubert, Kempf, & Heiderscheit, 2013)

This is only a short article, as it feels like we have covered much of the material over and over again. It is important that the other factors outside of step frequency are taken into consideration and assessed before making a decision on changing someone’s running technique. The change in technique leads to loading of other tissue away from an injured area and as such those tissues must be able to handle the forces which are being directed toward them.

Until Next Time

Jackson McCosker
Director/ Chief Editor

Allen, D. (2013). Treatment of Distal illiotibial Band Syndrome in a Long Distance Runner with Gait Retraining Emphazing Step-Rate Manipulation: A Case Report. Journal of Orthopaedic & Sports Physical Therapy, 126.

Heiderscheit, B., Chumanov, E., Michalski, M., Wille, C., & Ryan, M. (2011). Effects of Step Rate Manipulation on Joint Mechanics During Running. Medicine & Science in Sports , 296 – 302.

Lyght, M., Nockerts, M., Kernozek, T., & Ragan, R. (n.d.). Effects of Foot Strike Pattern and Step Frequency on Achilles Tendon Stress During Running. La Crosse: University of Wisconsin .

Schubert, A., Kempf, J., & Heiderscheit, B. (2013). Influence of Strde Frequency and Length on Running Mechanics: A Systematic Review. Sports Health: A Multidisciplinary Approach.




Developing A Training Plan For Your New Years Resolution

As the New Year tick overs, the time for resolution begins. Many people choose the 1st January to kick-start their healthy lifestyle for the year ahead. Sometimes, it’s the 2nd January depending on how big their New Years Eve celebrations were.

But what comes apparent quite quickly by the number of people that book appointments to start seeing their allied health professional, is the amount of unplanned or uneducated goal settingtraining that is undertaken and leads to those aspirations being put on ice. For many individuals sticking to a progressive, holistic plan is all that may be needed in the early stages of your training or strategy to achieve your goal. For others a more in-depth look is needed to gain oversight of how you can achieve the best results from each session and enable you to reach those goals.

The first step is to write down you goal and place it somewhere you will look at it every day! The best way to do this is by following the SMART Goal principles:
Specific                    – be as succinct as possible, name the event ect
Measurable           – have a measurable outcome (time, kg, cm, units)
Attainable              – makes sure your goal is realistic
Relevant                 – makes sure it means something to you
Timely                     – set an end date

Example: I Jane Smith, will run the Melbourne Marathon on October 15th 2017 in under 3hours 31min.

Once you have your goal the next step is break down that goal into smaller goals and develop a strategy towards achieving those goals. For a goal such as our example “Jane”, a there is a lot that needs to be taken into consideration; training, diet, time management ect. Today’s focus will be on what you would need to consider from a training aspect of the goals you wish to achieve.

When drawing up a training program it is important to analyse the activity you are looking to participate in and understand what kind of training you need to complete to best prepare you for that goal. By analysing the activity properly you can begin to create a picture of what you wish to achieve in each individual training session, what you want to achieve by the end of each week and what you want to achieve in the lead up to each weigh-in, race, beep test or squat.

Important things to identify when analysing your activity should include;

  • What energy systems are being used?
  • What strength requirements are necessary?
  • What movement patterns take place?
  • What is the worse case scenario you may be placed under?

Regardless of the activity you choose to participate in STRENGTH training should be cornerstone of your planned training regime. The development of strength is a neurological adaption to the repetitive application of force. It is a key component when looking to develop POWER or ENDURANCE. Even a long distance runner benefits from spending time developing strength as it may help prevent injury, build speed and utilise energy systems which otherwise may be poorly trained.

Each training session you participate in should have a goal attributed to it.

For example: Today’s session is about increasing foot speed and agility

Once again SPEED is a neurological adaption and any training associated with increasing foot speed should be complete when an athlete is feeling fresh and not experiencing any perceived neurological fatigue. The concept of AGILITY is to change direction at speed, usually in reaction to stimuli. When training for AGILITY it is important to look at the factors which contribute to it as a principle, including; acceleration, reaction time and direction modification.

Each individual training session should include a 5 – 15min “warm up” period that is design to prime the relevant muscles for the impending session. If you are going to be completing an upper body strength session, there is no relevance to jogging for 10min on a treadmill – instead you time is much better spent completing body weight or resistance band activation exercises in preparation for your workout.

After the warm up comes the main body for the workout session. This may include a number of activities and in many circumstances the order in which these activities are completed can be important when trying to get the best results. As a very general rule the following should be obeyed when developing a training plan:

  1. Speed Training
  2. Strength Training
  3. Power Training
  4. Endurance Training
  • The energy system that is to be trained at the time can be dictated by the amount of rest between tasks and type of tasks that are being completed.

A weekly training schedule should include a minimum of two strength sessions a week. Additionally, unless you are an advanced trainer most training sessions should have no less than 8 hours between sessions and in most cases should have as much as 24 – 48hours between sessions. This is important not only for recovery and adaption but to reduce the risks of injury as a result of over-training.
On that note make sure to include rest days in your weekly plan! Rest and recovery is when adaptions take place, if you are under trained and under nourished you may show little progress and at times may even regress.

This article has aimed to show a little more depth to a standard goal orientated program design may look like. There are entire textbooks dedicated to this subject and we have barely summarized an introduction of world of information that is available. Nonetheless, I hope this has sparked some interest in developing a program of higher quality for yourself when trying to achieve that goal.

If you find this information is going above your head my suggestion is to find yourself a certified strength and conditioning coach, someone who has superior knowledge in the application of these principles and have them train you or at the very least develop a program for you to follow right up to the day of your goal.

Until Next Time


Jackson McCosker
Director/Chief Editor