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Guest Columnist Author: Mark Cucuzzella MD, FAAFP Last Updated: Nov 29, 2012 - 7:11:02 AM



Family Doctor Researches Running Techniques

By Mark Cucuzzella MD, FAAFP
Apr 26, 2009 - 6:17:00 AM



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(HealthNewsDigest.com) - I have been a runner since age 13 and ran competitively at University of Virginia in the mid 80’s. My interest in medicine was sparked after experiencing our team physician Dr. Danial Kulund of Charlottesville try some seemingly bazaar at the time and innovative approaches to running injuries. He was the first to have people run in the pool and built orthotics in his toaster oven. It seemed like there must be better ways to treat these maladies and Dr. Kulund blazed his own path. Oft injured Mary Decker Slaney was one of the first of Dr. Kulund’s patients to have running rebirth by his methods. Runners train in water now not just as injury rehab, but for prevention and supplemental training. 20 years into my medical career I am reviving the passion I felt at that time by witnessing how ChiRunning is giving many, including myself, running rebirth.

Dr. George Sheehan was another pioneer and his ideas were also way ahead of his time. I read “Running and Being” in high school and did not really understand a lot of what he was talking about then…but now I do. Holism, prevention, understanding movement and the root causes of injury- that is the holy grail of running pain free for life.

“If athletes were given less care and more thought, the doctors might come up with some original ideas on why illness persists, why injury doesn’t clear up.
If more non-physicians could be induced to lend their ideas and talents, we might see a completely new approach to sports medicine.”
Dr. George Sheehan 1975

A modern innovator applying these innovative and integrated principles is Jay Dicharry at The University of Virginia Speed Clinic. His inquisitiveness and pursuit of new methods gave me the opportunity to present ChiRunning research at the 2008 UVA Running Medicine Conference. Jay connects form, function, performance, and injury prevention and empowers those he sees with insight, cues, and detailed instruction to self correction.

We live in a sportsmedicine world now where running injuries are still treated with rest, ice, new and bulkier shoes, stretching, MRI’s, other fancy tests, and various other devices. Despite all this care, of which there is little to no evidence base, we are still getting injured at the same high rates. Runners are becoming former runners not by choice, but out of suggestion from the health care field as the answer to their body’s discomforts.

I’ve been through the pain cycles too in younger years. Frequently hurt, I managed a personal best of 2:24 a couple times in the marathon. Severe pain in my feet led me in 2000 to have bone resections for severe arthritis changes in both great toe MTP joints (joint where toe attaches to foot). I could not dorsiflex (bend up) either great toe MTP joints due to the degenerative changes. I thought my days of running pain free were done….this was the orthopedic message. Perhaps take up another activity? None were as convenient and relaxing as running.

After taking a few post operative months off in early 2000, I was set on trying to retool how I ran with only one goal- getting out and enjoying myself. I lived off a wooded park in Denver where everyone ran, Washington Park . It had a crush surface 2.5 mile loop which one never tires of.

I studied Pose and some other methods and found the concepts made sense for impact reduction and optimizing forces and momentum. I also tried to figure out how the Kenyans ran….they had no shoes so had to have low impact styles. I trained “easy” by the method made popular by Phil Maffetone and used by Priscilla Welch and Mark Allen.

This method focuses on becoming completely efficient at one’s pure aerobic heart rate. This is the level where fat utilization is the primary fuel source. It builds the aerobic system to its maximal potential. The runner becomes efficient in form and metabolism, building millions of capillary beds and the mitochondria to produce aerobic energy at a set low heart rate. With weeks of patience the pace drops and drops with the same low heart rate. The runner morphs from a pure gas car (glucose as fuel) to an efficient hybrid, using electric (fat) as primary fuel and turning on the gas when you need it.

Surprisingly off this “easy” running and study of some technique I rebounded to run a 2:28 at 2000 Marine Corps Marathon after only 4 months back to running and no more than 60 miles per week.

I could visualize the “land with bent knees” and “under center of mass” that the methods were describing. I understood what not to do…do not land on the heels, but did not really get what to do. What areas did one focus on to generate movement? How could I explain this simply to a patient or runner?

I coached Team in Training in Denver and was the regional doc there. I shared these principles of low impact and aerobic only training with a group that often became hurt unless guided correctly.

I continued to have successful marathons but still had occasional breakdowns in later miles. Ran a 2:39 at the 2005 Marine Corps which was not really satisfying, but figured I was getting older and busier with life (kids now).

In December 2005 there was an article in the Sunday Washington Post on ChiRunning. The short article was intriguing and led me to buy the book. After the first read and a little practice, I realized what I was missing in trying to find and teach efficient injury free running- draw the power from the core and “lift the legs” while off loading the feet. The cues to gently engaging gravity were right in line with my other love- cross country skiing. This was a method I could visualize completely. But more importantly as a physican I knew this was a teachable method for the masses of recreational runners who were often injured, trying to run more comfortably, or afraid to or told not to run anymore.

Here was a succession of results off ChiRunning and 60 MPW max and turning 40.

2006 Boston Marathon 4/06- 53rd overall, 2:31.45
2006 Ottawa Marathon 5/06- 8th overall, 2:32.05
2006 Air Force Marathon 9/06- 1st overall, 2:31.47
2006 Marine Corps Marathon 10/06- 1st Master, 11th overall, 2:32.45

This was 4 marathons (all 2:31-2:32) in 6 months all feeling comfortable with little recovery needed. There definitely was something to this technique as I could not do this even in my younger years.

2007 and 2008 have also been satisfying and successful. 3 sub 2:35 marathons, another Masters win at Marine Corps, and 2 successful 50 milers at the JFK 50 (16th place in 2007 and 11th place and first Master in 2008). Could not imagine lining up for the ultra distance without the secret weapon of ChiRunning in the tool kit.

As a physician seeking to find new innovative ways to treat injury, the method cryed out for study. The first step was surveying the users for results and comments. In late 2007 Danny Dreyer sent 25,000 email surveys with a 10% response. This is good in the world of survey research. The results showed dramatic decreases injury and effort, and a quick learning curve. The part which really convinced me to continue to validate this method was the over 1000 comments, many of which were nothing short of life changing testimonials to ChiRunning.

My wife is a researcher and she told me once “The plural of anecdote is not fact”. So we are continuing our studies of ChiRunning now with prospective trails.

The beauty of focusing on form is that we all continue to improve, sometimes in small steps and often in leaps. None of us are close to perfect. We dream of one day running on water. I’ve had the privilege of attending the 4 day ChiRunning instructor course in October 2008. The immersion course accelerated my learning. In 2008 has been one of the most successful fall running seasons in my life, and more importantly I’ve learned how to better help others.

As voiced by many in the ChiRunning survey; this method has given me running longevity, made it easier and painless, and has given me confidence I can run forever into the retirement home. The ChiRunning methods are applied physics and biomechanics that any runner can apply to their benefit. No pain…no gain- a thing of the past. No pain….thank you- the ChiRunning way.

Mark Cucuzzella MD, FAAFP is Associate Professor of Family Medicine West Virginia University - Lt. Col. US Air Force Reserves

www.chirunning.com

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