The Art and Science of Preparing for Running

Mark Cucuzzella MD,FAAFP

Professor Family Medicine West Virginia University

Lt Col US Air Force Reserves

Director NaturalRunningCenter.com

Focus on Form

The next practice point is learning how to run correctly. Don’t we all know how to run by being human? Doesn’t improvement come from running more and harder? This may be fine advice if you have never been hurt, always feel perfect effortless motion, and have a rare insight on when to push and when to rest. If you were trying to improve your swimming and in the process were feeling shoulder pains, fighting the water with inefficient strokes, and frustrated to the point of giving up; would good advice be “ignore your form, keep working harder and maybe it will all work out?” Maybe this is why many runners quit the sport for good.

Runners suffer high injury rates (over 50% per year in most surveys) and there is no consensus or evidence on the best approach to the heterogeneous and multifactorial issues which lead to injury. In the most recent survey of Air Force injuries running was the #2 injury sport behind basketball, and many of the basketball injuries were running related. Traditional approaches have focused on (1) treating local injury with rest, ice, anti-inflammatory medications (which indeed may inhibit healing); (2) orthotics and footwear- often with rigid support and heel cushion technology; (3) stretching and strengthening exercises; and (4) modifying training and surfaces. Despite all this “care” we have not had affect on reducing injury rates. What is mostly ignored is prehab- learning proper posture, core strengthening, and movement- as a means to prevent injury

Is there proper running form and can one learn it? Observational and preliminary research data support yes and yes. Highly efficient runners, especially the East Africans, run with these common principles.

  • Landing with bent knees with feet landing softly under the center of mass. No hard heel striking or reaching out in effort to lengthen stride. This is a high impact braking motion and momentum is lost. Run over the ground, not into it. Visualize riding a skateboard or Razor scooter. Ideal ground contact is with your foot under your center of mass, and ideally accelerating back a bit.
  • Touch down quickly and pick up the foot or heel. This is tap,tap,tap…not thud, thud, thud. Keep the knees low and just pick up the heels. High forward knee drive is for the sprinters. Training and understanding elastic recoil is the magic here. We have big rubber bands in our Achilles tendon, hip flexor mechanism, and plantar fascia. The videos and teaching by Lee Saxby are the best to learn this….check them out and practice.
  • Shorter strides with quicker cadence and less vertical movement. Running is a series of short efficient movements. Shorter strides have less vertical movement to get from one point to another, like throwing a ball between two points- the ball must go higher if the points are farther separated. The ideal cadence is about 90 steps a minute, but build up gradually to this.
  • Focus on the core and prefect posture. If you can teach your core muscles to lift your legs as opposed to pushing off with the small muscles of the feet you have discovered new power. Think “run tall” and straighten your spine. Connect the dots between your ear, shoulder, hip, and bony prominence of ankle. (see picture)
  • A slight forward lean from the ankles (not the waist). This harnesses some of the power of gravity. Are you a bit skeptical?….practice ChiRunning for a few weeks and feel the difference. Practice running down a very gentle hill. When you allow yourself to relax and lean gently while maintaining good posture, and let your feet land under you to avoid braking- you are harnessing the power of gravity. This can be applied on the flats as well. Just watch the body positions during any world class track meet or marathon and you’ll see.
  • Elbows bent to 90 degrees to shorten the pendulum. No crossing the center line. Arm drive back, not forward.
  • Relax your breathing. Respiration occurs in the lower lung fields so learn belly breathing. I’ve heard comment that often Kenyan runners look like they have a “pot belly”. They do for the moment their diaphragms are dropping on inspiration. Visualize filling a beach ball below your belly button as you breathe in…then you’ve got it.
  • And finally and most importantly relax your arms and legs while keeping your core solid and aligned. Needle (core) and cotton (extremities) will produce fast efficient movement…try it.

How you visualize or cue these movements is not complex and fortunately programs exist to teach it. All use slightly different focuses. I encourage you to explore any or all of them.

  1. ChiRunning
  2. Newton Running
  3. Cady Stride Mechanics
  4. Evolution Running
  5. Radiant Running
  6. Pose

Can this be learned and does it decrease injury and effort? The author of ChiRunning and I did a survey of folks who have tried ChiRunning. We got over 2500 responses with enlightening results. Over 40% missed more than 10 days over six months before the technique. That number was reduced to 11% in the 6 months after the technique. 45% reported perceived exertion before ChiRunning to be very hard or hard. Less than 5% reported perceived exertion as hard or very hard after practicing ChiRunning. Almost all felt it easy to learn and had recommended the method to others. We cannot draw conclusions from this but is opens us up to new ideas. The study can be accessed with all the comments at Two Rivers Treads Run Softly Page.

We have a volume of Videos housed at Two Rivers Treads video page

March 2009 Running Times highlighted our WVU research and the work of several coaches and shoe designers all working together to help keep people running healthy for life. Family Practice News also featured the research in their March 1, 2009 issue.



About Mark

Mark Cucuzzella MD,FAAFP
Professor Family Medicine West Virginia University
Lt Col US Air Force Reserves
Director NaturalRunningCenter.com


Mark Cucuzzella running