Tag Archives: sports wellness center


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

Young Pitchers and Injury Prevention

Baseball season is here and teams are ramping up their practices and training time to prepare for the upcoming season. I’m not just talking about the professionals either. Kids need to start training for their little league season and get in shape to prevent injuries during the season.

Overuse injuries during youth sports are on the rise and about 20-40% of youth baseball players suffer from elbow pain alone. Sometimes this is caused by training errors and sometimes it is caused by things we can’t change like biology, but we should try and train most effectively to prevent injuries as best we can.

Competition is a driving force behind wanting to learn new pitches. Kids want to learn new pitches so they can strike out more players at younger ages. A 12 year old boy has his parent take him to a Giants’ game and he sees Lincecum’s nasty curveball. He wants to learn how to throw one and 3 weeks later, he develops elbow pain and is not able to pitch for the rest of the season because it was too much for him.  When this happens it is imperative that the young athlete rest and begin rehabbing.

However, injury can be prevented with proper throwing progression with various pitch types.  Below are some published guidelines for when it is okay to begin to throw certain pitches and how many pitches should be thrown at various ages.

Age Begin throwing a… Total Pitches per game Total Pitches per week Total Pitches per Season Total Pitches per Year
8-10 Fastball 50 75 1000 2000
11-12 Change-up 75 100 1000 3000
13-14 Curve ball 75 100 1000 3000
15-16 Slider, Forkball, Split finger, Knuckleball 90 3000
17-18 Screwball 105

Here are some guidelines on safe return to sport after rehab from a throwing injury.  Here are more guidelines for safe progression in other positions and age groups in throwing sports.  When in doubt contact a medical professional to be evaluated for risk factors affecting pitch mechanics.

Play Ball!

Little league elbow. Benjamin HJ, Briner WW Jr. Clin J Sport Med. 2005 Jan;15(1):37-40.

Tabata Training: What is it?

Even for those with well established exercise and gym routines, the New Year is a great opportunity to reassess your fitness program. What goals you have for your training? Do you want to lose fat? Improve endurance? Add muscle size and strength?  Are you simply bored with your program?  If you’ve answered “yes” to any of the above, it might be time to try Tabata training.

 “Tabata” is a type of training you probably haven’t heard much about, but more and more people are learning about and benefitting from its results. Tabata is a form of high intensity interval training and provides the same benefits of traditional cardio workouts—but with a little more spice to it. Even better, instead of a typical bout of cardio exercise lasting in excess of 30 minutes, Tabata can be completed in 4 minutes!

Tabata was first founded by a Japanese physiologist named Izumi Tabata.  Along with fellow scientists, Tabata conducted a study to compare moderate intensity training versus high intensity training. They discovered that athletes training at moderate intensity (5 days a week for a total of 6 weeks at 70% intensity, lasting an hour each time) demonstrated a significant increase in their aerobic capacity (cardiovascular fitness), but had little to no gain in their anaerobic capacity (ability to perform high intensity activities like weight-lifting or sprinting). On the other hand, athletes performing a high intensity training program (4 days a week for a total of 6 weeks at 170% intensity lasting 4 minutes total), demonstrated superior aerobic capacity improvements compared to their moderate intensity counterparts  as well as a 28% boost to their anaerobic capacity.  What does this mean? High intensity training appears to improve muscular strength and endurance as well as cardiovascular fitness.

So what does a sample Tabata design look like? Keep in mind, almost any exercise can be incorporated into a Tabata regimen. However, a basic outline of the Tabata training principles are as follows:

  • 4 total minutes of training
  • 20 sec of intense training, 10 sec of rest = 1 round
  • Total of 8 rounds

Sample Tabata Routine:

  • Push ups for intervals 1 and 3
  • Body weight squats for intervals 2 and 4
  • Medicine ball slams for intervals 5 and 7
  • Sprints or jump rope for intervals 6 and 8
Check out this video for more examples of good Tabata intensity exercises.  

Now, that you have the concepts of Tabata training, you’re ready to begin incorporating it into your regular exercise routine. Make sure to give yourself a proper warm up and cool down to prevent any injuries. At CPMC’sSportsWellnessCenter, we integrate Tabata training during our one-on-one fitness programs and Total Body Fitness classes on Tuesday nights at 7 pm and Saturday mornings at 10 am. Come check us out!

Strength Training for Throwing Athletes – Part 2

Are you an injured or at risk throwing athlete?  Welcome back for the second half our our blog on how to prevent a throwing related injury.

See an explanation of The Throwers 10 and the first 3 exercises on our last blog.

This week we will present the second half of our series focusing on upper body strengthening to help prevent injuries and improve performance for all you throwing athletes.  Check out the video below for demonstration of the following exercises.

4: Scaption with Internal Rotation – great to strengthen one of the 4 rotator cuff muscles, but it is now recommended that you perform this exercise with your thumb up (external rotation) to prevent unnecessary stress to the muscle.

5: Prone Horizontal Abduction – a great exercise to work on stabilization of the scapula.

6: Lower trap press ups  – one of the only exercises that targets the lower part of the shoulder blade and is crucial to developing a stable shoulder.

7: Prone rowing – keep your shoulder down and back, be cautious not to hike your shoulder blade up towards your ear.

8: Pushups – Great as an advanced exercises but I would add a “plus” to this exercise as this has been shown to increase activation of the lower and outside part of the shoulder girdle.

9: Biceps curls and Triceps press

10: Wrist Flexion, Ext, Supination and Prontation

If you have further questions you should seek further consultation from a qualified professional.  Check back every two weeks for more blogs written by your CPMC Sports Wellness Physical Therapists.  In the next couple of months we will discuss popular health and fitness related topics including:  PRP, Bikram Yoga and CrossFit.

Strength Training for Throwing Athletes – Part I

What a great World Series this year!  Time for the rest, recovery and rehab for our favorite big leaguers.  Regardless what level you participate at, throwing places high amounts of stress on the shoulder and arm and can quickly lead to injury.   In fact, nearly 60% of young pitchers sustain injuries to their arm, and 15% of college baseball pitchers with current shoulder pain report prior episodes of arm pain in their youth (JOSPT May 20011).  These statistics demonstrate the importance of prevention through instruction on proper throwing mechanics and appropriate strength training.

Traditionally, athletes in throwing sports have been taught to complete a group of  exercises which strengthen the muscles required for throwing. Half of this “Thrower’s 10” is demonstrated in the video below.  Be sure to check back in two weeks for the second half. Additionally, here are a few other tips to help keep you pain-free and out on the field:

  • Be sure to include an appropriate warm-up before all games and practices.
  • If you’re a pitcher, practice from a mound whenever possible to simulate game situations. When a mound is not available, use short distance (120- 180 feet) throws to warm-up instead of long toss. (JOSPT May 20011).  Long toss produces more strain on the elbow and shoulder due to mechanical differences and is not a safe way to warm-up (JOSPT May 20011).
  • 60% of your throwing power is generated from the muscles of the legs and core. Check out our previous articles for exercises to develop improved strength in these areas.
  • Instruction in proper throwing mechanics should be sought only from a trained professional, coach or trainer.

The Classic “Throwers 10”

1: D2 Flexion/Extension

2: External Rotation and Internal Rotation at 0 and 90 degrees

3: Shoulder abduction to 90 deg

4: Scaption with Internal Rotation

5: Prone Horizontal Abduction

6: Lower trap press ups

7: Prone rowing

8: Pushups

9: Biceps curls and Triceps press

10: Wrist Flexion, Ext, Supination and Prontation

Week 1:

This week we start with the first half of our series focusing on upper body strengthening to help prevent injuries and improve performance for all you throwing athletes.  Check out the video below.

1: D2 Flexion/Extension   Great exercises in the later stages of recovery from injury and include strengthening of most major muscle groups in the body.  Remember to point the thumb up as you go up and down.  The shoulder should stay close the body and come closer to your face rather than further away

2: External Rotation and Internal Rotation at 0 and 90 degrees.  Theses should be emphasized, as the rotator cuff is very important for stability and control of the shoulder during throwing mechanics.  New research has shown that External Rotation strength is very important to prevent shoulder pain.

3: Shoulder abduction to 90 deg  No need to complete as this strengthens similar muscles as other exercises in the progression with more stress to structures of the shoulder

The attached videos will help guide you to the correct performance of these exercises.  If you have further questions you should seek further consultation from a qualified professional.  Check back for the second half of our Throwers 10 series in two weeks.