Why programming matters…
Reflecting on an evaluation from last week, of a novice runner, with knee pain. This runner was convinced that there was something mechanically wrong with their body and running form.
Their first words were, “this happened because I am an over pronator, and my glutes are turned off”
I asked them how did they came to this conclusion and of course it was Dr. Google who supplied such great medical advice. During the examination I asked to see their specific training program. See image above ⇪
Suddenly, the plot thickened. Irrespective of this patient’s running form and anatomy, there was a huge spike in the external workload (running miles) from week 4 to week 5.
What you see is a 75% increase in external workload. The standard for weekly running distance progression is 10%, although there are studies that show novice runners with the ability to progress up to 20-30% without injury.
20 MILES/WEEK TO 35 MILES/WEEK IS TOO MUCH OF AN INCREASE IN EXTERNAL WORKLOAD.
I immediately focused on educating the patient on running distance progressions, and how too much too fast can lead to knee pain.
With the active population, programming tends to affect injury rate more than we think. We as clinicians have to stop vilifying anatomical positions and mechanics. We need to take a good look at programming because it matters!