An End to All Injuries
A Calgary professor is leading the world’s largest running injury study. He’s on the verge of figuring out how pattern recognition in biomechanics could change the way we run and virtually eliminate injuries for everyone.
Calgary’s Dr. Ferber is leading the world ’s largest study of running injuries: a global exploration into the biomechanics responsible for your runner’s knee, plantar fasciitis, IT band syndrome and even that niggling pain in your Achilles you only feel when it’s cold. He could be on the precipice of a technological revolution in running which could produce an injury-free future for all runners.
What type of runner are you? It’s an often asked question that might solicit answers such as: competitive, fair-weather, ultra or social. In many cases, and at some point for pretty much every type of runner the answer is also injured.
But research being undertaken by University of Calgary professor Dr. Reed Ferber could be about to change how we answer this very simple question.
Dr. Ferber is leading the world’s largest study of running injuries: a global exploration into the biomechanics responsible for your runner’s knee, plantar fasciitis, IT band syndrome and even that niggling pain in your Achilles that you only feel when it’s cold.
“We know that between 48 and 65 per cent of runners sustain an injury every year” says the professor of kinesiology, “and that runners sustain injuries at an average rate of one per 100 hours of training. It’s a significant risk but one we believe we can mitigate with greater understanding of the biomechanics behind injuries.”
More than 40 clinics around the world, from Australia to Europe, have been feeding into Dr. Ferber’s 3d gait analysis database which now has data on more than 6,000 runners of all ages, genders and levels. Recently, I joined them.
With sensors fixed all over my lower back, hips, legs and shoes a visual representation of my skeleton appears on a screen above the treadmill. Then me and my skeleton go for a run. Meanwhile, Dr. Ferber’s software analyzes every square centimetre of my form: how my feet land, the degree of inf lection from heel to toe, how long my feet are on the ground, what are my hips and knees doing, how are my ankles, shin bones and pelvis rotating. The information is fed into the database and my metrics are compared to everyone else in my sub-group: competitive, female runners with a rear foot strike.
“The database is all about drawing comparisons,” says Dr. Ferber, himself an avid runner with four marathons under his belt. Runners are often told not to compare themselves to other runners, but Dr. Ferber sees this as an essential form of comparison. “It lets us see what your biomechanics are doing compared to your counterparts. And that way we can see what’s different and potentially a problem.”
Ferber says that men and women run differently, that forefoot and rear foot strikers are prone to different kinds of injury and that pace and experience also change how we run. “By comparing like with like, we can draw meaningful comparisons faster and with much greater accuracy.”
Dr. Ferber accurately diagnoses an issue with my left hamstring which has been bothering me for months. Furthermore, he’s able to tell me why. “It’s actually stemming from an over-rotation of your tibia which is most likely coming from a weakness in one of your calf muscles.”
With his research hub in the Calgary Running Injury Clinic, Dr. Ferber is able to provide both insight and solutions to patients. The physio team at the clinic prescribes me a program of exercises using a theraband – essentially a giant elastic band – to strengthen the muscle responsible. “By getting to the root cause of the injury, we’re able to treat it successfully from day one,” says Dr. Ferber. “As a researcher, it’s great to see my research in action making a difference to people.”
Dr. Ferber’s database has helped more than 2,000 other runners in the last two years with the diagnosis of often chronic and previously unsuccessfully treated injuries: from novices training for their first marathon to varsity crosscountry runners and elite triathletes like Calgary’s Ellen Pennock.
Pennock desc r ibes her s el f as “moderately injury prone” and considers running to be the sport in which she’s most prone to picking up injuries. Like most runners she feels “niggles” here and there as well as more serious stress reactions and soft tissue strains. All of which cost her valuable training time. “It’s one of the biggest roadblocks as an athlete – training inconsistency due to injury,” she says. “It’s really frustrating.”
Pennock estimates she’s unable to run due to injury for an average of three weeks a year. Recently she had a 3d gait analysis with Dr. Ferber which shed light on where some of her “niggles” might be coming from. “The analysis showed that I switch from a forefoot strike to a rear-foot strike depending on what pace I’m running at . It also showed that I have instability in my left side due to ankle and hip weakness.”
Since undertaking Dr. Ferber’s prescribed exercises, Pennock says her running feels much stronger. She and her coach are using the information to support healthier training practice as she enters this year’s race season. “I hadn’t been feeling good as a runner for a while and I definitely feel like I’ve gotten my fluidity back. I feel more stable.”
Future athletics st ars are also benefiting from Dr. Ferber’s approach such as University of Calgary varsity cross-country runner Conne Lategan. Having suffered from recurring shin splints, Lategan had missed an entire season until she went for a gait analysis which, when comparing her to her sub-group, revealed a landing pattern which was putting excessive force on her tibias.
Having undertaken Dr. Ferber’s rehabilitation plan, Lategan is now back running with her team and doing well.
Recreational runners like Vanessa Barretto are also seeking help. “In my 20s I trained for the Calgary Marathon but had to give it up due to knee pain and IT band issues. It’s something that always bothered me.” Now 33, Barretto has been working with Dr. Ferber to fix the root cause of her pain: ankle dysfunction and rotational issues. “It’s still early days but I’m feeling optimistic. I don’t know if I’ll ever do a full marathon but I’m enjoying finally being able to increase my distances.”
But it isn’t just injured runners who are set to benefit from Dr. Ferber’s research. The professor is also looking at healthy runners in a bid to demonstrate that his technology can predict injuries before they happen.
In a recent study, under review by the Journal of Biomechanics, Dr. Ferber proved his theory by analysing 121 healthy runners from the Calgary area. The only commonality between these runners was that they had sustained no i njury i n the last six months. Pattern recognition methodology was applied to their individual gait analysis which divided the runners into two “families” or “clusters” according to their degree of inward knee collapse, knee f lexion, ankle rotation and other bio-mechanical characteristics. Dr. Ferber’s team accurately predicted which cluster would be more prone to injury and then followed the runners for two years, proving their hypothesis.
“Proving that propensity to injury is closely linked with our bio-mechanic cluster means we can help people before, not just after injury,” he says. “We can also tell if people
are moving into a new cluster, which might mean they’re becoming more or less prone to injury.” It’s preventative medicine for runners at its smartest. “And the best thing about it is that as the database continues to grow, it gets smarter and smarter.”
By standardizing the data collection methodology, Dr. Ferber has created an information goldmine for researchers. “The bigger the data-set, the more precise the sub-grouping,” Dr. Ferber points out. “The more precise the sub-grouping, the more accurate the predictions.”
As the database continues to grow, Dr. Ferber has aspirations to start sub-typing runners by age and also plans to add an elite category. In the future he foresees adding life events to the picture: women who have given birth, runners who have had surgery as well as digging deeper into the running patterns of people who do other types of sport such as skiers and triathletes like Pennock.
“By comparing runners within increasingly specific sub-groups and assigning those runners to growing clusters based on their bio-mechanical behaviour, we’re going to change the way runners answer the question: what type of runner are you? We’re also going to change the way runners train, coaches coach and sports brands develop technology.”
In another recent study, Dr. Ferber and his team made a major leap forward in proving the potential for sports watches to become smarter and more useful to runners than ever before. “Smart technology for runners right now is actually super stupid. Sports watches are essentially just expensive pedometers and calorie counters,” he says, countering many of the promises of the current gps brands. “But we’ve proved there’s huge potential for them to emulate some aspects of 3d gait analysis.” In his study, Dr. Ferber used the same technology found in sports watches to identify the experience level and training background of 47 runners with 96 per cent accuracy.
“Injuries don’t happen on my treadmill, they happen out on the running paths. If a sports watch can identify how you run, it can identify when you change how you run. Typically we change how we run when we’re on the verge of injury, already injured or fatigued. If your sports watch could alert you in real time to subtle gait changes, that would be an incredible advancement.”
Pennock agrees. “I use smart technology for pacing and heart rate but if my watch could tell me when I’m at risk of becoming injured so that I can do something about it, that would be amazing.”
Dr. Ferber and his team are currently working with several sports watch brands, including Garmin, to validate their emerging technology.
“We’re constantly working to stay on top of the latest research and we continue to learn more about how form can affect performance and injury risk,” says Amy Nouri, media relations associate for Garmin International. “For example, new ways to interpret heart rate variability which have led to features on our watches that give users guidance on
recovery time post-workout. We’ve also included metrics that can provide feedback on a runner’s form like vertical oscillation and right-left ground contact time balance.”
Another compelling study using Dr. Ferber’s database and an accelerometer was recently undertaken at the University of Michigan. It determined that the accelerometer could identify gait changes specifically related to fatigue: giving it the potential to identify a marathon runners wall, before the point of no return.
Dr. Ferber’s database and the research it enables could also be used to shape training software and coaching methods of the future. If a runner knows their biomechanical profile, the characteristics that make up their own specific gait, that information could shape a customized and therefore far more effective training plan than the one-size-fits-all approach commonly used.
“Pattern recognition and sophisticated gait analysis is allowing us to predict the future,” he says. “Coupled with genuinely smart and responsive technolog y, there’s no reason we couldn’t get to a point where wearable technology is able to customize a plan, respond to how you’re coping with that plan and intelligently guide you towards your training goals and keep you injury-free and healthy.”
The only hurdle Dr. Ferber can see in getting to that point is navigating some potentially complex legal implications. “Making claims about keeping athletes injury-free, when injury itself is such a complex thing, opens brands up to legal issues which they may not be comfortable with. Vibram learned that the hard way a couple of years ago. Promoting the performance benefits rather than the injury prevention side is probably an easier sell.”
“SMART TECHNOLOGY FOR RUNNERS RIGHT NOW IS ACTUALLY SUPER STUPID. SPORTS WATCHES ARE ESSENTIALLY JUST EXPENSIVE PEDOMETERS AND CALORIE COUNTERS.”