Tag Archives: Running


by Jonathan Ide-Don, PT, DPT, OCS


Cadence is the number of steps (or strides) a runner takes in a set amount of time.  It is often expressed in steps per minute (each foot hitting the ground counts as one step) or strides per minute (one cycle of right foot then left foot hitting the ground counts as one stride).  Other names for cadence include step rate, step frequency, and turnover.  Cadence is also one component that determines running speed:

Cadence  X  Step Length  =  Speed


Cadence is one of the key factors affecting running mechanics.  If a runner maintains a constant speed, but increases their cadence, their step length will shorten as well.  A shorter step length and faster cadence can have effects on muscle activation patterns, joint loading, and the overall movement patterns.

Cadence is one factor that is under conscious control of the runner, and short-term changes can be seen immediately with easily accessible tools or cues.  Making long-term changes stick will require practice over a period of weeks to months.


Key points from the research:

Running with a quicker cadence results in the following:

  1. Shorter step length (Fletcher 2010)
  2. Less vertical displacement
  3. Shorter stance time
  4. Better shock attenuation (Hamill 1995)
  5. Less energy absorption at knee (Heiderscheit 2011)
  6. Less energy absorption at hip
  7. Less braking as the foot hits the ground
  8. Increased gluteal activation (Chumanov 2012)


There appears to be a general consensus that a minimum of 170 to 180 steps per minute is a good cadence to shoot for.  Pose running teaches at least 180 steps per minute, but faster if the athlete is able to perform the proper technique.  Chi running also teaches an ideal cadence of 180 steps per minute.  Blaise Dubois, a physiotherapist based in Quebec City, also advocates a cadence of at least 170 steps per minute.  He recommends increasing the cadence to 180-185+ steps per minute for faster workouts.


  1. Increasing cadence lessens forces at the knee and hip joints
  2. Increasing  cadence lessens risk of stress fractures associated with repeated, excessive loading of the bone
  3. Increasing  cadence increases gluteal activation, which may positively affect alignment of your knees, ankles, and feet during running

If you are looking to prevent future injuries, or to return to running following an overuse injury, increasing your cadence 10% over your preferred cadence may be beneficial.

A specific target for your cadence is largely dependent upon the individual.  However, shooting for at least 170-180 steps per minute may be a good place to start.


1. Running intervals with a metronome

If you have a smartphone, you can download free or really cheap metronome apps onto your phone.  As part of your warm up, run for 30 to 60 seconds with the metronome matching your footsteps to the metronome beat, rest for 1 minute, and repeat 3 to 5 times.  Then shut off the metronome, and go out for your run and try to maintain your goal cadence.  My personal favorite is the Steinway & Sons free app for the iPhone:


2.      Running with music with specific beats per minute

Build a playlist!  Running with music can make some runners feel like they are working less hard to maintain a certain speed (Bood 2013).  Even better, the music can serve as your metronome.  Check out the websites below to search and find songs to build a playlist at different cadences:




3.      Running drills with a metronome

These drills are excellent technique drills as part of your warm up.  Using a metronome while practicing the drills is a great way to practice the rhythm of running at a faster cadence.  Try each drill 3 times each for 30 seconds, matching your footsteps to the metronome beat.




4.      Jump rope

Practice jumping rope with both feet hitting the ground with a quick, light hop.  Jump rope is a great way to teach your body how to quickly get your feet on and off the ground.  Progress from 2 feet jumps to alternating right foot / left foot jumps.  Focus on quickly picking the heel straight up toward your sit bone, hopping just high enough off the ground to clear the rope.   30-60 seconds of jumping with 30-60 seconds of rest for 5-10 rounds is a great way to start.

5.      Use mental imagery

For those runners who work best with a mental image, some of my favorite cues I have heard are “run like you are running on hot coals,” “Hot feet,” or “run like you are running on thin ice.”  Try different mental cues, and find the one that works for you the best.


1.      Keep your speed constant.

Some runners who have tried to increase their cadence told me that their tendency is to just want to run faster.  This point is valid, because as running speed increases, running cadence tends to increase as well.  The challenge is can you run at a constant speed, but increase your cadence?  Running on a track, treadmill, or straight flat pathway with distances marked can help you control your pace while learning the faster cadence.

2.      Practice, practice, practice… and be patient!

A running course I recently attended recommended 6 weeks of running homework with drills 3 days per week, which included a lot of metronome drills.  It takes a long time to make permanent changes in your running cadence, as your body likely has “overlearned” its preferred cadence.


Fletcher et al.  Biomechanical performance factors in pose running and heel-toe running.  International quarterly of sport science 2010/2012.

Chumanov et al.  Changes in muscle activation patterns when running step rate is increased.  Gait and posture.   (36): 231-235, 2011.

Bood et al.  The power of auditory-motor synchronization in sports:  enhancing running performance by coupling cadence with the right beats.  PLOS ONE.   8(8): 1-8, 2013.

Heiderscheit et al.  Effects of step rate manipulation on joint mechanics during running.  Medicine and science in sports and exercise.  43(2): 296-302, 2011.

Hamill et al.  Shock attenuation and stride frequency during running.  Human Movement Science.  14(1): 45-60, 1995.

Romanov, N. (2004).  Pose Method of Running.  USA: Pose Tech Press.

Running Drills: Forward Fall into Run

by Jonathan Ide-Don, PT, DPT, OCS

The primary goals for this drill:

  1. Learn how to fall forward while placing your foot underneath your body

  2. Learn how to take short, quick strides


This drill will train your body how to transition from standing still, to leaning forward, to running forward while maintaining short, quick strides. 

Start by standing with both feet on the ground in tall posture with both knees slightly bent.  Pull one heel straight up to the buttock, and balance on one foot with arms in running position.  Shift your weight forward and lean forward gradually.  Once you feel at the edge of your balance, quickly switch your feet by pulling the heel of your other foot straight up to your buttock.  Continue leaning forward as you run, focusing on keeping your strides short and quick with your foot landing softly underneath your hips.


  1. Reaching your foot out in front of your body as you fall forward rather than quickly pulling the heel up to your buttock behind you
  2. Landing hard on your heel , rather than softly landing with your foot underneath your hips
  3. Losing your forward lean as you start to run

Running Drills: The Quick Switch

by Jonathan Ide-Don, PT, DPT, OCS

The primary goals of this exercise:

  1. Teach how to lean forward while quickly switching support between feet

  2. Teach how to maintain a tight core and forward lean


Start by standing just further than arms distance away from a wall.  Lean forward and place both hands on the wall.  Keep a straight line from your ear down to your shoulder, to your hip, your knee, and to your midfoot.  Gently bend both knees.  Pull one heel straight up to your buttock.  QUICKLY switch support by pulling your other heel straight up to your buttocks, and letting your first foot fall to the ground relaxed.  Alternate pulling one foot and then the other off of the ground.

Start switching between feet with a short pause between switches to learn the movement.  As you get comfortable with switching, shorten the pause between switches until you are essentially running in place.

This exercise can be performed for time.  Start with 20-30 seconds and gradually increase until you can perform the drill successfully for 60 seconds.


  1. Driving knee too far forward in front of the body rather than lifting the foot straight up to the buttock
  2. Flicking foot too far out behind you rather than lifting the foot straight up to the buttock
  3. Rounding at the mid or low back as you lift your foot rather than keeping a straight spine
  4. Stomping the ground loud and hard rather than landing softly and quietly
  5. Jumping up off ground when switching between feet rather than minimizing air time


Running Drills: Modified Butt Kicks Moving Forward

by Jonathan Ide-Don, PT, DPT, OCS

The primary goals of this exercise:

  1. Teaching runner how to change speed of running by changing the angle of their forward lean

  2. Combining proper running posture, proper pulling, and a proper forward lean

This drill is a progression from the stationary, modified butt kicks.  This drill is more challenging to the stability of running posture, as it adds one layer of instability:  a forward lean.  Once you have mastered the stationary modified butt kick drill, give this drill a try!


This drill starts by performing stationary modified butt kicks.  Lean forward slightly from the midsection while maintaining proper tall posture and pulling technique.  As you lean forward just a couple of degrees, you will start to move forward.  As you lean forward at a greater angle, you will move forward even faster.

Start with a slight forward lean covering 10 meters distance.  Progress by increasing your angle of forward lean and increasing the distance covered to 20-40 meters at a time.


  1. Breaking  at the hips rather than leaning forward as one unit
  2. Leading with your chin rather than leaning forward as one unit
  3. Reaching your foot forward in front of your body rather than keeping your footstrike underneath your hip as you lean forward

Running Drills: Modified Butt Kicks

by Jonathan Ide-Don, PT, DPT, OCS

The primary goals of this exercise:

  1. Reinforce proper running posture dynamically as you switch from one foot to the other

  2. Teach proper pulling technique of the heel straight up to the ischial tuberosity (sit bone)

  3. Improve endurance, strength, and speed of hamstring contraction in the context of running

This exercise is a slight modification of the traditional butt kick exercise.  The primary modification of this exercise is the cue of how the runner pulls the foot up off the ground.  In traditional butt kick exercise, the runner focuses on keeping both thighs vertical, and firing the hamstrings to lift the foot up in an arc behind them to kick their buttocks.  In the modified butt kicker, the runner focuses on firing the hamstring and lifting the heel of the foot straight up in a vertical line to their ischial tuberosity (ie. sit bone).

Notice in the video how the knee comes slightly forward relative to the body, rather than keeping the thigh vertical and the knee pointing straight down at the ground.


Start by standing in tall posture with feet hip width apart, knees soft and pushed out to the side, elbows bent 90 degrees, and eyes straight ahead.  Imagine there is a rubber band connecting from the heel of your foot straight up to your ischial tuberosity (your sit bone).  Fire your hamstring and quickly pull your heel in a straight line vertically up to your sit bone.  Then, fire the hamstring on your other leg to quickly pull your other heel up to your other sit bone.

When you lift your other heel, let your other foot fall passively to the ground and land soft and relaxed on the ground.

Start with a slow rhythm, quickly pulling one heel up, pausing briefly, finding your balance, then quickly lifting your other heel up.  Once you feel comfortable with the quick pulling of the heel, then you can speed up the rhythm.  Eventually the rhythm should match your running rhythm with a quick turnover.  The exercise eventually turns into running in place.


  1. Keeping thighs vertical to ground and kicking heel up in an arc behind you
  2. Jumping off the ground when switching feet
  3. Flexing the low back and mid back forward as you pull the heel up
  4. Landing loudly, stomping your foot on the ground when switching feet

Running Drills: Falling Forward

by Jonathan Ide-Don, PT, DPT, OCS

The primary goals of this exercise:

  1. Teach how to maintain proper posture

  2. Teach how to fall forward

Running can be viewed as controlled forward falling.  Maintaining proper posture from head to toe as you fall forward will ensure that you maintain proper alignment of all of your joints as you run.  Proper posture also facilitates proper muscle activation patterns and stability of your spine, which will decrease risk of injury. Leaning forward slightly while running encourages proper alignment and assists in preventing over-striding.


Start by facing a wall, standing arm’s distance away

Key point #1 Find proper posture in the running position. 
Stand tall with your feet hip width apart.  Imagine there is a string pulling up from the top of your head to lengthen your body from head to toe.  Soften both knees while simultaneously pushing knees outward.  Bend both elbows to 90 degrees (right angle) with hands and shoulders relaxed.  Eyes should be focused straight ahead on the wall.

Key point #2:  Pull your heel up to your sit bone. 
Imagine there is a rubber band connecting the heel of your foot to your sit bone, and lift one heel straight up to your buttock.  Hold this position for a few seconds finding your balance.

Key point #3:  Lean forward. 
Lean forward slowly, feeling as you shift the weight from the heel of your foot forward onto the ball of your foot.  Fall forward maintaining tall posture and catch yourself on your hands.  Push yourself back up to the start position.  Fall forward again, maintaining tall posture.

Repeat for 1-2 minutes on each leg


  1. Letting your knees dive in toward each other instead of pushing out as you soften your knees
  2. Leading with your head, jutting your chin forward as you fall forward
  3. Bending at the hips instead of keeping tall posture as you fall forward
  4. Letting your back hyperextend as you catch your hands on the wall

AlterG: Spring Special


AlterG – The Anti Gravity Treadmill

March 1 – April 30, 2013

Get a 1 x FREE trial of our AlterG treadmill when you participate in our Running Clinic.

**Must redeem within 2 weeks of completing running assessment
**Use AlterG for up to 30 minutes
**No transfers allowed

By appointment only

Sports Wellness Center
2360 Clay Street
San Francisco, CA 94115
Telephone: 415.600.5860
email: wellness@sutterhealth.org

Refueling with Chocolate Milk

Remember the days of little league baseball when your post-game snack game consisted of a sandwich (white bread, no crust), Capri-Sun and some cookies?  Most of us have probably abandoned those early favorites and turned instead to water, sports drinks, granola/energy bars, or even possibly the  occasional adult beverage to refuel after exercise or sports activities.  All of these refreshments have one thing in common—they’re all forms of post exercise nutrition.  Turns out what fuel you give your body after exercise is just as important as what you consume prior. In fact, proper post exercise nutrition helps to reduce the risk of injury, improve your performance during the next game or workout, and boost your health and well-being.

In addition to water, athletes need:

•    Protein to help build muscle, reduce muscle breakdown and work with carbohydrates to restore muscle glycogen
•    Carbohydrates to restore muscle glycogen
•    Fluids and Electrolytes to help replenish what’s lost in sweat (sodium, calcium, potassium, and magnesium) and to help rehydrate the body
•    Vitamins and Minerals to contribute to overall health and nutrition

So, you may now be wondering “What do I have in my refrigerator that has all that?” The answer might surprise you—chocolate milk! Athletes such as Michael Phelps drew attention to this at the 2004 Olympics when cameras spotted him chugging Carnation chocolate drinks following his swimming events. Studies now show that chocolate milk aids the body, particularly the muscles, in recovering from bouts of exercise. A recent study published in the Journal of Sport Nutrition and Exercise Metabolism, found that chocolate milk has double the carbohydrate and protein content compared to plain milk, water, and most sports drinks—a perfect recipe for replenishing tired muscles.  Its high water content replaces fluids lost as sweat, preventing dehydration. Plus it packs a nutritional bonus of calcium, and includes just a little sodium and sugar—additives that help recovering athletes retain water and regain energy.  It appears the delicious verdict is in. Chocolate milk is an optimal post exercise drink to promote muscle recovery and fluid restoration following intense exercise.  Need more incentive? It’s also cheaper (and better tasting) than most sports drinks you’ll find in the market.  Not only is chocolate milk good for your health, but chocolate packs good nutrition.
To read about other studies on chocolate milk as nature’s recovery drink, go check out refuelwithchocolatemilk.  If you’re looking for an excuse to drink more chocolate milk, visit our Sports Wellness Center website and sign up for one of our fitness classes.

Top 10 Training Tips for Running Races

With summer coming up and lots of great running races on the calendar, the CPMC Sports Wellness Center is here with some tips to keep you training safe and injury-free before your race. Running injury-free is the best way to become faster and run longer on your race day!

1. INCREASE YOUR MILEAGE SLOWLY A good guideline is to increase your mileage no more than 5% to 10% per week. Add up the miles you ran last week, and multiply by 1.05 or 1.10 to find out the amount you should be able to run safely the next week.

2. PLAN EASY WEEKS INTO YOUR TRAINING Every 3 weeks, plan to cut your mileage by 25% to 50% to let your body recover. Use the free time to sleep more, cross train, and take care of any nagging sore spots. 3. CROSS TRAIN Mix in 2 to 3 days per week of cross training swimming, cycling, elliptical, and hiking are all low-impact activities that will let your body recover while maintaining your fitness. Yoga and Pilates are great choices to address the mobility and stability of your core, hips, and upper body that will all help you run more efficiently.

4. STAY STRONG Runners need to be strong and athletic too! On your cross training days, add resistance training to your routine to keep your core, hips, and upper body strong. Resistance training is a great way to improve your strength, posture, and power, which may help you with your running form and efficiency.

5. WARM UP AND COOL DOWN Proper warm up is important to prepare your body for the demands of running. Dynamic stretching, fast walking, light jogging at half speed, and body weight squats and lunges are good warm up ideas. Cooling down with a light jog, walking, and dynamic stretching is a great way to end your workout and prevent you from tightening up.

6. TAPER BEFORE YOUR RACE A taper is a planned recovery period immediately before your race to let your body prepare itself for the intensity of race day. Tapering involves minimal to no running, and instead replaced with light cross training, rest, and hydration. For a 5K, plan on about a 3-day taper. For a half or full marathon, plan on at least a 7-day taper. The longer the race distance, the longer the taper duration.

7. MAKE A PLAN AND STICK TO IT Take all the tips above, sit down with a calendar, and write out each day of training. Start at the race day and plan your training backwards starting with your taper. Stick to your training.

8. LISTEN TO YOUR BODY This may seem contradictory to the point made above, but if you are having a bad day, it is okay to take a day off. If you had a long day at work or are feeling overwhelmed, try running for a mile and see how you feel. If you are feeling worse, call it a day and plan on getting a good run in the next day instead.

9. GET YOUR SLEEP Get your 7 to 8 hours of sleep per night, at least. A good rule of thumb is to calculate your average weekly running mileage, and add that many minutes of sleep to your nightly rest. Sleep is the time for your body to recover and heal from your run.

10. GIVE YOURSELF SOME TIME OFF If you are planning on signing up for more than one race, try to schedule them at least 3 weeks apart. Give yourself one week to recover from your first race, and then ramp back up for the next race with a taper before the second race.  Run smarter, not harder.

Good luck with your races this summer!

For more information on how to train correctly and efficiently, check out CPMC’s Running Clinic.



This year the Kaiser ½ Marathon fell on an unseasonably warm day. With many years of training experience, I have learned to expect any and all types of weather from sleet and rain to near 80-degree weather.  You just never know what to expect on Super Bowl Sunday in San Francisco.  I crossed the finish line and waited for my mother to also finish.  I waited what felt like forever-immediately I thought, “Gosh is she okay?” – Why is she taking longer than her expected 2:00 race? Then I heard the sirens and saw the paramedics coming to the finish line.  I ran to see if it was my mother – Sadly I saw a young man receiving chest compressions at the finish line. Unfortunately the man at the finish line did not make it.  We are deeply saddened by this news at CPMC Physical Therapy as there were a few of us running the Kaiser who saw him and others in enough distress to receive medical attention on the course.

As a physical therapist – we have extensive training on how to recognize signs of our patients overexerting themselves. We take courses on cardiac and pulmonary rehabilitation. But do YOU know –how to recognize when your body is WORKING TOO HARD ESPECIALLY IN THE HEAT! DO YOU KNOW THE WARNING SIGNS? Here are a few signs of over heating:

  • Dizziness or fainting
  • Increased heart rate and respiration
  • Drop in blood pressure
  • Flushed skin
  • Feeling very hot, sometimes followed by chills
  • Lack of perspiration

Tips that can help you shed heat and race safely:

  • Drink enough fluids and electrolytes before you become thirsty
  • Wear layers of clothing to the race and shed them appropriately
  • In warm weather, wear white
  • If you have dark hair, wear a white hat with good ventilation
  • Wear clothing with good ventilation and wicking
  • Run in the shade as much as possible
  • Run with a buddy, so that they can observe signs of confusion or distress

Sometimes your body gives you clear warning signs sometimes it does not. We just want to let you know of a few warning signs and tips that may be able to help you or a loved one someday.   As for my loved one,  my mom- she had a PR and came 4th in her age group. I missed her at the finish line because she was just soooo fast.