Can running problems really be diagnosed using a computer simulation, no matter how high tech? Mat Brett finds out...
Despite advances in running shoe technology, over 50% of runners and triathletes are injured every year. The primary reason appears to be poor technique. However, the new Run3D operation in Oxford could well provide a bespoke solution to stop injuries before they stop you.
Dr. Jessica Leitch, Founder of Run3D - If someone takes up running or triathlon and they get injured two months down the line, they might give up the sport forever. We're trying to prevent injuries and to identify the root causes of injuries when they do occur, and so help determine the best treatment.
We're the first centre in the UK that is able to offer three-dimensional motion analysis to all runners and triathletes. We use the most advanced motion-analysis technology to measure your biomechanics accurately in the three planes of human movement. We then compare your biomechanics to an extensive database of uninjured runners in order to identify unusual patterns in your running style.
The results of your assessment can be used to identify the root cause of an injury or to reduce your risk of developing an injury in the first place.
Watching a stick figure of yourself running on a computer screen is frankly weird. You see your legs pounding away but you're not getting anywhere. It looks like you're halfway to becoming an animated cartoon character but this is a serious business. It might just help you avoid picking up a running injury - and can even make you run faster.
I've come to see Dr. Jessica Leitch of Run3D at the Oxford Gait Lab. She uses 3D technology to measure the joint angles of your hips, knees and ankles as you run, and compares them to measurements taken from scores of uninjured runners.
Many injuries are caused by abnormal running biomechanics. By detecting any unusual patterns in your style. Dr. Leitch reckons she can help you avoid injury or can identify the cause of any existing problems, thus helping to prevent them recurring. But what can she tell me about my gait?
'Your right foot is fine', she tells me, ' but you have excessive pronation on your left. It's staying flexible for too long. It's not becoming a rigid lever for push off and that will probably have implications higher up. It's associated with runner's knee.'
Bingo! I haven't mentioned it but I've been suffering with runner's knee in my left leg recently. Not the right, just the left and after half an hour in the lab, Dr. Leitch and her computer haven't just identified it, they've told me what's causing the problem. And that's the first step to putting it right.
Scoring Your Run
The service offered by Run3D is designed to identify the underlying causes of run injuries and to provide a long term solution, as opposed to a quick fix.
'There are four key elements that are likely to predispose you to running injuries', says Dr. Leitch. ' These are your biomechanics, your muscular strength, your muscular flexibility and your anatomical alignment'.
'Physiotherapists can measure the last three relatively easily but they can't accurately measure your biomechanics, so we've developed this diagnostic tool. We measure movement at each joint - ankle, knee, and hip- and we also measure a set of functional parameters. This gives you an overall view of how you faired in your biomechanical assessment.'
The results are based on how your movement compares to that of runners who have been uninjured for more than two years. All that information is contained in Run3D's extensive database. For example, if your knee rotates inward more than those of the uninjured runners in the database, it indicates that you're adding stress to your knee joint, your patella (kneecap) and lower leg. This is stress that could lead to injury- or maybe already has.
Although it's based on advanced technology, the process is straightforward from the runner's point of view. You just need to show up with your kit and run. You don't even need to bring your shoes because Run3D provides you with a neutral pair for your assessment in order to analyse your natural, uncorrected gait.
You're also provided with reflective markers that are attached to your legs and feet. The markers will be 'seen' by infrared cameras around the room and their positions relayed to a computer. Then all you do is run on the treadmill for a few minutes.
Once you've settled into a comfortable speed, your movement is recorded for one minute. During this time, the cameras pinpoint the 3D position of each marker 200 times per second. This allows the Run3D system to construct the animated stickman version of you running.
It's the same technology that's used for films like Shrek. But although the animated stick-man is interesting to watch, he doesn't actually tell you a great deal on his own.
Dr Leitch says that, even after gaining a PhD in gait analysis and working with this system for a long time, she can't identify problems by sight alone. It's possible to measure stride width, cadence and so on by eye. But what you can't see is whether an athlete's knee is collapsing inward too quickly and leading to increased stress. That's something for the technology to work out and its the figures that come out of the computer that are the key.
The Run3D system's real value is in identifying exactly what is causing your injury or what it is about your running that's likely to lead to injury. For example, I was convinced that my knee problem was caused by over-tight quadriceps, so I've been zealously stretching them out for months. It turns out the problem stems from my ankle. I've been focusing on the wrong place. I should have been concentrating on strengthening my foot inverter muscles.
'Runner's knee [patellofemoral pain syndrome] is a difficult one because there are three areas you can look at' says Dr. Leitch. 'We can look locally at the quads. You have four aspects of the quads and they all go into the quadriceps tendon. If the lateral (outer) aspect of your quadriceps is greater than the medial (inner) aspect, it's going to pull it off-line. Recent thinking has been more towards the proximal factors - weak hips- whereas originally people concentrated on the foot.
'Now people have started to accept that we need to sub-group the causes of runner's knee. Some cases are caused by the hip, others by the knee and others by the foot, but without 3D motion analysis it's difficult to identify which one is which.'
Once the biomechanical report has identified the cause, you can work on the specific problem, usually with the help of a physio. The answer might be to gain strength in a certain area, for example, or to increase your flexibility.
'Most people won't come to us unless they're injured, although are also trying to encourage a proactive approach. Around 50% of runners get injured every year. If we can do this analysis before someone gets injured, we can at least reduce the chances of a problem developing.'
Overall, we left the clinic armed with info to rectify runner's knee once and for good.