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Strength Training and Running Performance – February Newsletter

Strength Training and Running Performance

Holly Warner, DPT

Race sign-ups are already fast approaching for this spring and summer. Now is the time to make time for strength training. In reviewing several articles on the effectiveness of strength training for the endurance athlete, one common theme was heavy resistance strength training. Endurance athletes especially runners tend to shy away from heavy strength training, but when research has found that heavy loading along with endurance training was more effective than endurance training alone in improving performance in both the recreational and highly trained runner. Surprisingly, this doesn’t have to take too much time out of your week and shouldn’t take time out of your training mileage either.

John Fiore demonstrating a lunge with hand weights on BOSUOne study found that performing as few as 4 exercises 2x/week for 6 weeks at heavy loads (80% of 1 repetition max) improved 5K times of recreational runners. The exercises including Romanian deadlifts, squats, calf raises, and lunges and the participants of the study performed 4 sets of 4 reps with 2 minutes of rest between sets of each exercises at heavy loads.1

Another paper found that throughout the literature there is significant evidence to support combining strength training and plyometric exercise in order to improve running economy of the highly trained middle and distance runner. This found that performing only 2-4 strength exercises at heavy loads (40-70% 1 repetition max) 2-3x/week when combined with plyometrics improves running economy.2

With these findings runners may want to consider incorporating heavy load resistance training 2-3 times/week into their training plan in order to improve performance. This also seems to be more effective when performed on harder running days so that the runner is able to rest on the easier days. Learning proper lifting technique and determining the best exercises to incorporate are important for injury risk reduction and program effectiveness. This becomes very important especially if one has a history of injury.

At Sapphire Physical Therapy our goal is to provide the most effective research based interventions to treat running injuries so our runners get back out there feeling stronger and healthier than before.


  1. Karsten BK, et al. The effects of Sports-Specific Maximal Strength and Conditioning Training on Critical Velocity, Anaerobic Running Distance, and 5-km Race Performance, International Journal of Sports Physiology and Performance. 2016; 11:80-85.
  2. Balsalobre-Fernandex, Carlos, et al. Effects of Strength Training on Running Economy in Highly Trained Runners: A Systematic Review with Meta-Analysis of Controlled Trials. Journal of Strength and Conditioning Research. 2016; 30(8):2361-2368.

Muscle of the Month: Serratus Anterior

Jesse Dupre, DPT

diagram serratus anteriorThe serratus anterior is a large, flat muscle that runs from the medial border of the scapula (the edge of the shoulder blade nearest the spine) and attaches at the ribs. The function of the serratus anterior is to move the scapula to the side, and rotate it upward during arm movements. Because of its orientation and attachments, it is the only muscle effective in those tasks, and plays an important role in proper movement and function of the shoulder.

illustration scapulaBecause the scapula has limited bony attachment to the axial skeleton (which consists of the spine, ribs and pelvis), it depends on muscular attachments for movement and stability. Effectively controlling the scapula during arm movements and daily activities is a complicated task that requires coordinated contraction of multiple muscles in order to achieve the correct orientation and provide a stable foundation for the shoulder. Weakness or poor activation of the serratus anterior can result in poor mechanics and reduced stability at the scapula, particularly during pushing or reaching tasks due to poorly timed or incomplete upward rotation. This places additional demands on surrounding muscles, and on the shoulder joint itself. Abnormal scapular movements resulting in poor stability have been associated with increased risk of shoulder pathology in athletes.

image excercise strengthen scapulaIn order for the shoulder to function optimally, all scapular muscles, including the serratus, need to possess adequate strength and activation with the correct timing to accomplish their respective tasks. If the serratus anterior is weak, it is possible to strengthen it with a number of exercises, primarily focused on pushing motions, including the push up plus. If you have shoulder pain, serratus anterior strengthening can be an important part of a comprehensive rehabilitation program.

Scapular dyskinesis increases the risk of future shoulder pain by 43% in asymptomatic athletes: a systematic review and meta-analysis. Hickey D, Solvig V, Cavalheri V, Harrold M, Mckenna L. Br J Sports Med. 2018 Jan;52(2):102-110. doi: 10.1136/bjsports-2017-097559. Epub 2017 Jul 22.

Running Analysis to Improve Efficiency

John Fiore, PT

The strongest predictors of running injury include a prior history of running injury, running throughout the year without a break, and a rapid increase in running mileage of >10% per week (Br J Sports Med 2007). Identifying compensatory movement patterns through a comprehensive running evaluation identifies underlying faulty biomechanics and strength deficits.

The days are noticeably longer and many Missoulians are anxious to hit the roads and trails. The race season arrives early in mountain towns such as Missoula. Before ramping up your weekly running mileage, however, consider the importance of improving the efficiency with which you run. Once reserved for elite athletes and research subjects alone, state of the art running analysis is available in Missoula.

Sapphire Physical Therapy-staff looking over 2D resultsSapphire Physical Therapy provides on-side real-time 2D running gait analysis. We are excited to share this informative, interactive, diagnostic technology with the Missoula running community. LED markers and high-speed cameras provide real-time feedback for both the runner and the physical therapist. Sapphire Physical Therapy uses the Simi Aktisys 2D system. Developed in Germany, the Simi Aktisys software records joint angles along the frontal, posterior, and sagittal (side) planes of motion as a person runs. Planes of movement and joint ankles (ankle, knee, hip, trunk) are recorded and observed as a person runs. The software analyses the measured video data and an easy to read, usable PDF report is produced for the runner and physical therapist. Utilizing 2D video running analysis during a physical therapy evaluation takes the guesswork out of determining the underlying cause of movement inefficiency and/or injury.

In addition to our 2D video running analysis system, we now offer provide a dynamic accelerometer evaluation which can be done simultaneously. Accelerometer date includes foot strike pattern, cadence, step length, impact force (measured in Gs of force), braking force, pronation angle, and pronation velocity. Asymmetries identified through accelerometer measurements are used in conjunction with visual video analysis to modulate impact forces and reduce future injury risk. Real world accelerometer data may also be collected during outdoor running session on the roads of trails. Following a run, the subject’s data can be downloaded to our computer and viewed for practical running analysis feedback.

John Fiore Missoula Physical Therapist discussing 2D analysis with clientOnce a compensatory movement pattern is recorded, the runner can return to the treadmill (or roads-trails in the case of an accelerometer evaluation) and make changes in his or her running mechanics while observing themselves in real-time on the monitor screen. Individualized exercises addressing observed compensations or weaknesses address the cause of observed compensations to improve running efficiency. Walking biomechanics is fairly universal in healthy individuals, but running biomechanics is diverse and very difficult to accurately assess visually or with a hand-held video device in one plane. The Sapphire Physical Therapy staff looks forward to helping Missoula runners improve their running efficiency and determining the underlying cause of recurrent injuries.

Cost for a 2D video running analysis with accelerometer evaluation is $150. The hour-long appointment includes filming, review of video date, PDF printout, a discussion of possible compensations impacting biomechanics, and individualized exercise and treatment recommendations. Call Sapphire Physical Therapy (406-549-5283) to schedule your video running analysis or email me (john@sapphirept.com) for additional information.

Photo: Forrest Boughner (John Fiore Mission)