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University running injury clinic helping runners get back on track

Shortly after Mark Jones’ father died of congestive heart failure in late spring 2018, he found an old photograph of his dad. It showed the then-early 20s draftee breaking the finishing tape of an Army running race close to Berlin in the aftermath of World War II.

Jones is 56 and works a desk job in a healthcare company in downtown Salt Lake City. The most exercise he sees, he says, is when he persuades himself to climb the stairs to his fifth-floor cubicle, rather than take the elevator, although he’s so breathless it takes him several minutes to be able to talk.

The photograph of his father in his athletic prime reminded Jones of his recent hankering to start running again, something he had left behind after college. “Seeing my dad like that after just losing him connected me with something deeper, a wish to take control of my body again, to start to push it to its limits of endurance.”

But his early morning jogs that he began a year later were quickly brought to a halt by painful Achilles tendons. A trails-runner friend recommended the Running Injury Clinic run by Laura LaMarche, DPT, at the University of Utah Health Orthopaedic Center.

LaMarche says that over-use injuries like Jones’ pain-beleaguered Achilles “can come from being a novice and jumping into it too quickly.” While she says running, “is extremely high risk for injury, hence my business,” such injuries tend to be due to ramping up too quickly, excessive amounts of running and excessive speed.

“The broader idea that people have that running is bad for you has been negated in many studies, especially when it comes to joint integrity. Running tends to be beneficial.”

LaMarche has run most of her life, noting its benefits both in terms of building strength and releasing stress. “What a great way to accomplish two things at once right?”

She opened the clinic in 2010 after attending a course on treating runners by assessing the mechanics of how they run with a two-video-camera set up to record from the side and behind a runner’s movements.

While a physical therapist might focus only on resolving Jones’ pain flare-ups in his Achilles’ heel by assessing primarily the lower leg and ankle, “If you’re running, you may well be doing something globally that is contributing to the pain,” LaMarche says. “Some of the issues might well be in the hip causing an overloading of the Achilles. Running is complicated: nothing happens in isolation.”

At the heart of issues like Jones experienced is the amount of impact that the body experiences when it runs. If you walk, your weight is the impact your body experiences, but if you run it can be up to three times that. “It takes a lot of work to build your body up to accept that amount of impact,” she says.

LaMarche’s upgraded system provides a full gait analysis and includes an instrumented treadmill which reads forces and features three slow-motion cameras to analyze runners’ mechanics. When she had Jones step up onto the treadmill and run in front of her cameras for 30 seconds, his “loading rate”—meaning the impact of his foot against the ground—resulted in a “beautiful” bell curve, she says, that’s “pretty much textbook. It’s not even two times body rate.” That meant she didn’t have to work on modifying his cadence or step rate, most runners who she sees typically demonstrating too long a stride.

His problem lay, however, in the stability of his right hip which consistently dropped to the right, undermining the efficiency of his gait. Along with replacing his sneakers with what she termed “appropriate” running shoes, LaMarche assigned him some exercises to build up his gluts and calves, which both needed strengthening, and a regime of half-hour walks interspersed with six periods of 30-second jogs until his follow-up visit in three weeks.

“No more than thirty seconds,” she told him. “Don’t get greedy, don’t get eager.” The biggest issue novice runners face, LaMarche says, “is thinking they need to progress all the time, not realizing that the body needs time to adapt and build strength through repetitive impact motion. It’s about being conservative and consistent, doing small times with small amounts frequently through the week to build up regularly.”

If Jones continues with running, LaMarche told him, he has several long-term benefits to look forward to. “It supports joint-integrity, aids bone strength, muscle strength, heart function and health,” she says. And along with what she calls “the global health benefits” of running, also comes qualities that if less readily quantifiable are in their own ways fundamental. “A sense of peace, of stress relief,” she says. “Which is priceless. And it’s free.”