I've recently finished ready the book Ready to Run by Physiotherapist Kelly Starrett. Why did I read this book? Because San Francisco is filled with passionate and committed runners. Many of these have or will get some form of injury. I have learnt about running injuries through my degree but found that my friends were asking me questions about running and telling me about their self-management strategies and I wanted to know where that knowledge had come from. Was there a gap between the perspective of the Physiotherapist and that of the runner? How can that gap be closed?
Kelly expresses two principles that I can closely relate with as a Physiotherapist.
Principle #1: All human beings should be able to perform basic maintenance on themselves.
Principle #2: When you visit a chiropractor, physical therapist, sports medicine clinic, or other body worker, go in with some hard-won knowledge to share.
Key learning points:
- Setting standards to measure your mobility and readiness to run. Each standard has a chapter dedicated to it helping you recognise what 'normal movement and posture' is and providing ways to improve those standards.
- Neutral Feet
- Flat Shoes
- A supple thoracic spine
- An efficient squatting technique
- Hip Flexion
- Hip Extension
- Ankle range of motion
- Warming up and cooling down.
- No Hotspots
- Jumping and Landing
- As you can see from this list of chapters, Kelly has done a great job at addressing the most important aspects of athletic performance from a Physical Therapy perspective. After reading each chapter you really understand how the entire lower limb kinetic chain functions to create the running gait and why other aspects of training such as compression, injury management, hydration etc are so important. For a consumer who didn't know much about running, this is a fantastic guide to help you expand your knowledge without omitting any key areas.
- Being accountable for your own health. Don't need to explain this much further. It's filtered throughout the entire book. Be accountable for your own health.
What did I enjoy/not enjoy about this book?
- The images throughout the book definitely enhance your understanding of the exercises while providing a visual component to help remember technique.
- The book is broken into chapters each relating to a Standard with explanation of that standard, how it relates back to running and tips for improving that standard.
- These standards are not specific to running. They can be applied to any sport that uses the lower limb and these standards about about making sure you are at the normative range for mobility.
- The focus on mobility is so invaluable. There was some research release a few years ago (and I don't have the original article) which we all became aware of, because the outcome of the study showed that stretching before exercise doesn't reduce the risk of injury. And I think this research has been blown out of proportion and taken out of context. If you don't have normal mobility, that is a risk for injury, so make sure that you're not ignoring those mobility issues because of these research findings. Stretch dynamically, warm up your tissues appropriately and prepare for exercise. It's so important.
- Didn't enjoy
- The repetition in the beginning of the book about who the audience of the book is. I know this is being critical about the writing style but there is a lot of padding in the text. Don't let this discourage you from continuing to read. There are golden messages within each page that probably could be distilled down into dot points, but that would then make the book only a few pages. I guess I was eager to find out what messages Kelly was sending to his readers and had to force myself to continue reading before I got to them.
- The tone and style of writing of the book is very direct. His coaching style is one of an educator, motivator, and dictator. At times I found the tone was almost aggressive and forceful - like I was at army boot camp (which I've never been to by the way). Do these stretches! Make the time! I feel like there could have been exclamation marks at the end of a lot of sentences. But after a while, I got used to it, it just wasn't what I was expecting.
- Only at the end of the book does Kelly mention the importance of a sports medicine assessment. This is one thing I'm disappointed about because it wasn't brought up that often. Sure he's trying to encourage people to independently manage their running and running injuries, but there is little advice about detecting injury. Not the overuse type, but the acute structural tissue damage type. If you mis-diagnose your acute lateral ligament sprain as a muscular/tendoninous overuse sliding dysfunction injury, and you take a hard ball to it or try stretch your plantar flexion, you are going to make things a lot worse. Acute injuries need to be appropriately addressed.
- So yes, try work it out yourself and then consult a physician but the answer is not always to just keep running and mobilising. Some injuries need rest, cross training, offloading, and when in doubt, ask for help.
- The last thing you want to do is traumatise your tissues further with these exercises.
How has this contributed to my current knowledge?
The health standards that Kelly talks about in his book are not new concepts for me, but, his approach to making it so easy to work on mobility independently provided me with a broader range of exercises as well as more levels of intensity and complexity.
Many of the treatment modalities that I currently use to manage Plantar Fasciitis, knee pain, shin splints, hip pain, ITB pain, and flicking hamstring syndrome revolve around manual therapy techniques. From experience these techniques are really helpful in the symptomatic reduction of pain. What I'm excited about is being about to transform these manual therapy concepts from a passive treatment to an independent self-management home-based program.
It has clarified for me what the important messages are for me to teach my clients.
- How can you monitor your own health through mobility measures.
- Once you've identified areas that need addressing, set goals on what your client is trying to achieve and improve.
- Knowing how exercises work and why we use them helps to improve compliance and execution.
- Know where the limits of your knowledge are.
- Teach my clients to recognise the point at which they need to come have a chat about their injuries or current training program to work out what the next step is.
- Educate clients more about pain science and what the markers are for pain you can push and pain you need to respect.
I'm considering reading Kelly's other book Becoming a supple leopard and other popular reads in the field of running, to continue making my knowledge of running more well rounded and be aware of the books other runners are consuming.
I'm going to try implement these principles into my advice of self management of clients. I'm going to personally explore the benefits of managing and improving my own mobility and try be creative in the exercises I use.
This book Ready to Run is a great resource for runners and health care practitioners to expand on their understanding of what normal mobility is, while providing exercises to manage and improve mobility and running performance. It is a book on mobility not strength or motor control. What would be awesome is to combine these exercises with a series of strength & control exercises that help to promote your lumbo-pelvic and hip-knee control essential for running.
Stay tuned for a blog on exercises you can incorporate into your running routine from a strength and control perspective.
Ready to Run. Unlocking You Potential to Run Naturally. Kelly Scarrett (2014). Victory Belt Publishing Inc. ISBN-13: 987-1-628600-09-4(sc).