Shoe Review: HOKA ONE ONE Clifton Edge

Sponsored by Zappos Running. All opinions are my own.

Is heel striking really that bad for you? This is a common concern in the running community and has been a topic of debate for years. An extended amount of research has been done on foot strike patterns but has ultimately been inconclusive as to whether it actually is the cause of injuries and/or limits performance in any way. Poor performance and injuries are usually caused by a mixture of things—overall weakness, history of other injuries, overtraining, and faulty form, all together are major culprits, among others. Believe it or not, wearing the wrong types of shoes for YOUR feet can be a primary cause as well. The good thing is many shoe brands are coming out with so many options that it’s actually not so hard to find a good pair—as long as you do your research!

I was lucky to get my hands on a pair of HOKA ONE ONE Clifton Edge from Zappos and was impressed from the moment I tried them on! First off, the color choices, although only two, are amazing, so I’ll probably make a purchase for the moonlit ocean color very soon! Zappos offers a free VIP membership program that comes with a package of benefits like free expedited shipping, free returns for 365 days, excellent customer service, along with their incredible selection of products.

Running with Less Impact—Yes Please!

If you are a distance runner, you know the trauma that running all the miles can do to the body. I, myself, love a high mileage program. It’s worked for me for years, but only if I incorporate the proper recovery and take care of my body. The HOKA ONE ONE Clifton Edge has a visible extended heel that may scare some runners into thinking it will limit their pace or just feel uncomfortable, but my review on this feature is a positive one. It actually felt the opposite for me—it made the constant pounding feel much less impactful.

I am a big heel striker, which used to make me anxious until I learned that it’s actually not directly linked to injuries after all. The problem with heel striking is that it shoots the pounding all the way up the joints. Within the first few steps of taking my Clifton Edge out for a short, easy run, I noticed the shoe actually promotes a more mid-foot strike pattern. This is a plus for me, because it made the transition into the push-off phase much smoother. In turn, I felt since the shoe created this mid-foot strike on impact, it allowed me to apply a slightly better forward lean, which is part of good form! Of course, any permanent form improvements are made by the runner, not the shoe! 

The Best of Both Worlds

An extremely lightweight shoe is usually not the most cushioned one. The HOKA ONE ONE Clifton Edge, although a narrower shoe, provides a comfortable ride compared to what you may think when holding the shoe by hand. The Women’s shoe weighs about 8 ounces, which is on the lower to medium end of most supportive shoes. Instead of feeling tighter with the narrow fit, it felt more “fitted”—meaning the materials conformed to the shape of my feet as to support them. It has just enough cushioning to protect my feet during long runs, but not so much that it compresses my foot when I want to go fast. I have a neutral foot and gait pattern so this stability pair was perfect for me for runs of any distance.

So far I’ve taken my Clifton Edge out on a short 45-minute easy-paced run and a 90-minute aerobic run and they felt just right! I’m looking forward to trying this pair out for race-paced workouts and hill sessions, since the comfortable ride and smoother heel-to-toe transition are more ideal for fast and higher impact running. If you are a neutral runner looking for a lightweight shoe that’s also super good-looking, I highly recommend the HOKA ONE ONE Clifton Edge from Zappos. Don’t forget to sign up for the VIP membership and take advantage of the many benefits!

Awkward Tightness in the Legs? It May Be Compartment Syndrome

The most common area of the body in which runners complain of pain is the lower leg. Of course when you think about the mechanics of running, the lower leg receives the majority of the impact since it carries the most weight throughout the running cycle. This is why conditions such as knee pain, and more commonly plantar fasciitis are frequent. One of the more misdiagnosed conditions seen in recreational runners and elite athletes is chronic exertional compartment syndrome (CECS). During exercise blood flow increases and muscles expand. The pain from CECS is felt when the lower leg areas become swollen during exercise, if the fascia, which is basically a sheath that wraps around the muscles, does not expand with the muscles.

Symptoms

The type of pain usually felt with CECS is aching or burning in a specific area of the lower leg that begins at a certain time after beginning activity. Most commonly, the pain occurs in both legs and either in the posterior compartment (calves) or anterior compartment (shins). Along with pain, numbness or tingling, as well as tightness can be felt that worsens as you continue the exercise. These symptoms usually subside within 10 to 20 minutes after stopping the activity.

Differential Diagnosis

The reason this condition is misdiagnosed is because it resembles other more common conditions such as shin splints and tibial stress fractures. Shin splints are caused by overuse of the muscles connected to the shin bone, causing small tears which result in the muscle being “pulled” off the bone. The pain from shin splints is felt along most of the shin bone, whereas a tibial stress fracture is felt at a localized point in the bone. Both of these conditions, along with CECS, result in pain in similar areas and are usually caused by either improper biomechanics or overuse from adding mileage or intensity too soon during training.

If you are experiencing pain during exertion, especially if it begins within the first 10 to 20 minutes of a run and relieves within 10 to 20 minutes after stopping, get evaluated by a professional. If along with the pain is a sensation of significant tightness in the lower legs, CECS is most likely expected. An MRI will help rule out specific muscular issues. There are newer, more advanced MRI exams that can assess how much fluid accumulation there is in the compartments of the lower leg during activity, which has been found to be accurate in diagnosing CECS. It may limit the need to use the more invasive approach of diagnosing which is compartment pressure testing where needles are inserted into the muscles to evaluate the amount of pressure present.

Treatment

The goal of treating CECS is to relieve the pressure in the affected compartment during exertion. Unfortunately, the first step in treatment is avoiding aggravating activities, such as running. Doctors may prescribe NSAIDs and an icing regimen to help decrease the inflammation. During this rest time from activity, it is effective to include techniques to keep the muscles and fascia flexible such as massage and stretching. Once the symptoms are more controlled, it is important to ease back into running VERY gradually to be able to monitor returning symptoms. As you do this, strengthening all lower leg muscles, including the feet, should be incorporated.

Calf stretching should include performing with the knee straight, to stretch the outer muscles, and bent to stretch the deep soleus muscle.

The simplest way to keep the anterior dorsiflexors (along the shin) loose, is to use the foam roller or other deep tissue massager.

The first exercise most athletes include for the lower leg are basic heel raises. As mentioned above, the calves also include a deeper muscle called the Soleus, that often lacks sufficient strength. You can target these muscles by performing the heel raise exercise with a bent knee, or sitting adding weight to your lap.

Weakness in the ankle and foot may also contribute to lower leg issues. To target these ankle and foot stabilizers, using a resistance band is effective. Other exercises include single leg standing on a stable and unstable surface such as a foam mat or balance disc.

Unfortunately, in the majority of the more severe cases, a surgical procedure, called a fasciotomy, is required. Basically the fascia itself is cut open to relieve the tension in order to allow normal blood flow and muscle expansion to cause less pressure during activity. The recovery time after this procedure is quite short and allows athletes to return to their sport within 6 to 12 weeks. Post-surgical rehabilitation requires the same treatment as the conservative approach mentioned above.

Prevention & Maintenance

Biomechanics, or running form, is commonly blamed for lower leg dysfunction, such as CECS. Research has been done on evaluating foot strike patterns in runners and how these patterns may cause mechanical issues in joints from the lower leg to the hip and spine. When one uses the heel strike for landing during running, the anterior compartment muscles, the dorsiflexors, must act eccentrically to control the foot from slapping onto the ground with every step. This causes overuse and inflammation in the area. Many studies have evaluated the outcome of changing this foot strike pattern to a mid-foot or forefoot landing, and have concluded that this may help control and even resolve CECS. This is a change that should be done gradually, such as beginning with 5 minutes of forefoot strike in a single run and adding 5 minutes every few runs.

Another prevention option is running with shoes and/or orthotics that limit pronation of the foot. Overpronating requires even more work for the dorsiflexor muscles and causes increased tightness to the entire lower leg compartment muscles.

The exercises mentioned above should be incorporated to help prevent CECS and other lower leg dysfunction, as many times weakness and inflexibility are the cause. If you have been diagnosed with CECS or are experiencing symptoms, make sure to back off of the aggravating activities and always ease back into it during recovery. Seek medical advice if symptoms do not resolve or become severe. Remember, the quicker you take care of your pain, the quicker you will be back to doing what you love.

Sources

Tucker, Alicia K, Chronic Exertional Compartment Syndrome of the Leg, Current Reviews in Musculoskeletal Medicine, April 2, 2020.

Gallo, Robert A., Michael Plakke, and Matthew L. Silvis, Common Leg Injuries of Long-Distance Runners: Anatomical and Biomechanical Approach, Sports Health, April 2, 2020.

Gibson, Alexander, Chronic Exertional Compartment Syndrome and Forefoot Striking: A Case Study, International Journal of Athletic Therapy & Training, April 2, 2020.

Mobility Exercises Every Runner Should Be Doing

If you are a runner, then you have probably been told about how important it is to warm up before heading out for your workout. Some of us get a few stretches in and go straight to the run and others are usually short on time so skip it all together. You have probably heard static stretching, such as a prolonged quad pull, is not a good idea before running. This usually elongates and relaxes your muscles, which is something you do not want when you are getting ready to run fast. Instead, we are told to incorporate dynamic stretching, which is actually a mobility exercise rather than a flexibility exercise.

Having good flexibility means you can passively move your joints and muscles through a wide range of motion—passively meaning ‘in a relaxed state’. Having good mobility, on the other hand, means you can actively move your muscles and joints through a normal range of motion, but with proper form and strength. Many runners incorporate stretching before or after runs to treat or prevent tightness in the muscles, which is common in the hamstrings, hip flexors, and calves for the most part. Although tightness can relieve, the actual joint can remain stiff, causing poor running mechanics, which affects stride length, push-off, and torso rotation. All of these outcomes will create inefficient running limiting you from reaching faster paces, as well as increasing the risk of injury.

Ankle Mobility

It is best to include a 10 to 15-minute mobility warm-up routine before every run. This will assure you are properly warm and ready to hit the road (or trails or track). A good plan is to begin with the lower, smaller joints and work your way up. The following ankle mobility drills will get you ready to push off the ground with your full range of motion and keep your calves from overworking.

Rocking

Forward and backward ankle rocking involves the dorsiflexors and plantarflexors of the ankle. While standing, lift the forefoot and toes as high as you can and rock forward to lift the heels. Continue rocking forward and backward for 15 reps or 30 seconds. Rocking with lateral movements will involve the invertors and evertors of the ankle/foot joint. Lift the inner part of the foot while weight bearing on the outer edge and rock the ankles to switch and weight bear on the inner foot.

Rolling

In a seated or lying position with feet unsupported, roll the ankles making circles in both directions—clockwise and counterclockwise. This is a great exercise to do before getting out of bed in the morning, especially if you have issues such as plantar fasciitis. Besides making circles, you can also try writing out the alphabet with your ankles and toes.

Knee Mobility

Circles

Stiffness in the knees is a common complaint from runners. Mobility exercises can help ease this stiffness and create more efficient running mechanics so that the knees do not bear too much pressure during the run. While standing bend your upper body forward and place your hands on your knees. Rock the knees in small circles in both directions for a maximum of 30 seconds.

Quad Pulls

Just like a regular static quad pull stretch in standing, you can incorporate a dynamic version for mobility. Grab your right foot with your right hand behind your back and hold for two to three seconds. Alternate legs until you reach 30 seconds.

Hip Mobility

Glute Pulls

The hips are probably the biggest problem area for runners when it comes to proper mobility. Hip Stiffness and lack of mobility is the cause of short strides, decreased upward knee drive after push-off, and limited torso rotation. Glute pulls, similar to the quad pulls for the knees, will help mobilize the back side of the hips. While standing, lift your knee to your chest and hug tightly for two to three seconds. Alternates sides for 30 seconds total.

Military March

Tightness in the hamstrings’ connections to the hip and knee joint can cause stiffness that limits stride length and upward knee drive as well. Kick up the right leg as high as you can and reach your left hand to the right foot. Switch kicks for 30 seconds.

The Rest of the Body

The legs aren’t the only parts that need to move while running. The arms and trunk need their proper mobility, as they help propel the body forward and stabilize the hips, respectively. Arm swings are easy to do during your walk towards your starting point. Standing upper trunk rotations for a few seconds mobilizes your hips and spine. Lastly, neck mobility can be incorporated for a few seconds as well such as with clockwise and counterclockwise circles. As mentioned, these warm-up exercises will take 10 to 15 minutes and can also be done at other times during the day. After just a few weeks of consistent mobility work, you will notice the improvements in not only your stiffness but also your running form!

Strong Calves for Fast Running

Runners basically require every muscle in their bodies to be strong in order to run well and with less risk of injury. Even knowing this we continue to pick and choose what body parts we feel are more important when fitting in exercise. What ends up happening is we run out of time during our weeks and squeeze in a few squats and lunges, and maybe a couple of core exercises and head on our way to run. One muscle group that is often ignored is the calves, which are composed of two different muscles—the gastrocnemius and soleus muscles. Runners are not the only ones who require these areas to function at their best, but everyone is in need of strong and flexible calves for basic daily activities.

The basic function of the calf muscles is to lift the heels up and shift the body weight onto the toes. This motion is required for pushing off during stepping, whether running or walking, as well as climbing stairs. The other important role of the calves is for circulation. These muscles are in charge of pumping blood and fluids out of the lower legs and up to the heart. They perform this function by compressing the veins around them when contracting, forcing blood upward and out of the area. When the calf muscles are relaxed, especially for prolonged periods of time such as when sitting at work, the veins in the muscles and the surrounding area fill up with blood and fluid causing swelling.

Calves for Runners

The calf muscles are in charge of that final push-off during running to propel our bodies upward and forward. They play a crucial role in our stride length and pace. Since this muscle group is smaller than the other main groups higher up in the legs, the quads, hamstrings, and glutes, they fatigue at a much quicker rate during runs. During long runs and races, our slowed pace may be greatly due to the calves tiring out. Even if the hip flexors are significantly strong to drive our knees high during a stride or our quads strong enough to extend our leading leg far forward to lengthen our stride, our pace gets affected if the calves are too weak and tired to push off efficiently.

Runners must rely on the feet and ankles in order to keep sufficient balance. Running, especially fast running is considered a single leg balance movement, therefore our stability is important in order to master faster paces. The calf muscles play a role in this stability as they provide the strength required to prevent swaying forward. If the calves are not strong enough for this role, the end result is increased stress to the Achilles tendon. The same goes for insufficient strength for the push-off—the Achilles will have to take the load. Achilles tendon issues such as tendinitis and strains can be a prolonged and limiting condition for runners, which may lead to tendon tears—an issue that will leave you out of running for several months to over a year.

Calf Strengthening

Runners should incorporate exercises for the calf muscles two to three days per week, along with proper stretching techniques after runs. Focusing on both the gastrocnemius and soleus groups and other supporting ankle muscles is key to keeping proper stability in the feet and ankles. Basic standing heel raises are the most common way to strengthen the calves, but since the gastrocnemius group has two heads—the lateral and medial heads, ideally one should also perform heel raises with their toes pointing outwards as well as inwards. To strengthen the soleus muscle group, heel raises should be performed with the knees bent, as in a squat if standing or simply sitting with a dumbbell or other weight over the thighs for added resistance.

To keep the calves flexible, stretching after runs is important. The easiest stretch is to place the balls of the feet on a step, keeping the heel on the ground and lean the body forward. Keeping the knee straight will mostly stretch the gastrocnemius muscles while performing with the knee bent hits the soleus more effectively. Foam rolling is also another great way to break up any adhesions in the muscle groups that are causing tightness. Significantly tight calves are what leads to Achilles tendon strains, therefore runners should emphasize flexibility exercises as much as possible.

Other effective exercises to keep the calves strong and ready for running are plyometrics. Jumping rope, box jumps, squat jumps and any other explosive movements are great additions to your exercise program that will strengthen the fast twitch muscle fibers of the calves and Achilles tendon. Strong fast-twitch fibers are required to perform an efficient push-off during running. Adding in one or two plyometric moves to your warm-up routine before easy runs or in between other exercises is an effective way to incorporate calf strengthening even if you are short on time. If you want to be a fast runner, you must keep in mind that stronger muscles are needed for faster paces.

Sources

Samuel R. Hamner, Ajay Seth, and Scott L. Delp, Muscle Contributions to Propulsion and Support During Running, Journal, Jul 22, 2018

Balance Training: A Key to Injury-Free Running

Most runners are primarily focused on improving their endurance and speed during their training cycles. Strength and flexibility are usually a secondary focus, especially if the runner has had a history of an injury and has been educated on the importance of these components. Balance training, on the other hand, seems to be of less importance to runners. In general, balance declines as we get older—by up to 75% by the time we are 75 years old. This is why older people are prone to falls, which is currently the leading cause of injury and death in the geriatric population. Balance is fundamentally the skill of keeping the body aligned and upright by reacting to changes in our center of mass at all times. Taking this definition into consideration, it seems balance should also be a primary focus during training, since after all, running is basically a one-legged balancing act.

Balance is (Almost) Everything

Most people will think of running as an activity involving a push-off phase, forward propulsion, and a landing. These are all most definitely parts of the running cycle, but about 50% of running is an action of falling forward. Thankfully, we developed the ability at an early age to stabilize ourselves against falling while running. This natural reaction gets harder to control as we run longer and faster, since the muscles in charge of this action get fatigued. And if running straight with no disruptions gets harder to control when we are tired, then the task of maintaining our balance is that much more difficult when having to make a sharp turn, stepping over uneven surface, or having to make a sudden stop to avoid a collision with a person or object. Improving our body’s balance directly will not only improve running form and posture, but it will also decrease injury risk and pain.

How to Train Balance

Balance is controlled by proprioceptors in our muscles and joints, which are basically tiny sensory nerves that can anticipate changes in our body’s center of mass. When we step on a pebble that causes a loss of balance, the proprioceptors fire this sensation to our muscles, so that they can react as quickly as possible to stabilize our joints and avoid a fall. For the case of running, the main proprioceptors to focus on when working on balance training are the ones located in the feet, ankles, and hips. It is always best to start working from the ground up as the feet and ankles are the first to sense any position changes from running on uneven surface, for example.

Exercise (and Run) Barefoot

One theory of why Kenyans are one of the fastest and most efficient runners is because they grew up walking and running barefoot on uneven terrain, therefore constantly strengthening their proprioceptors and intrinsic foot muscles that control balance. This enables these runners to devote the majority of their energy to forward propulsion while running. Unlike the Kenyans, most of us have grown up running in some good-looking shoes with excellent support and cushioning. On top of that, we opt for road running when training for a marathon. This means we leave our proprioceptors pretty quiet during our entire run. The only time those nerve receptors are active is when there is a sudden change in our position that we are not prepared for.

Strengthen Balance Muscles

A part of every runner’s strengthening program should include core, hip, ankle, and foot exercises. Most of us occasionally incorporate upper leg strengthening, which is important, but often forget to directly strengthen the joints and muscles below. The foot and ankle joint are probably one of the most important body parts for runners, as they carry the entire weight of the body at all times. The feet absorb the initial impact of striking the ground, which makes them extremely vulnerable to injury.

Easy exercises to work the ankle stabilizers can be done with resistance bands, strengthening the four main movements of the joint. For the intrinsic muscles of the feet, towel curls are an effective strengthening exercise. Place a small towel on the floor and try to pick it up with your toes for 10 to 15 repetitions at a time.

Simple exercises for strengthening the hip stabilizers can also be done with resistance bands such as clamshells, bridges, standing legs lifts, and lateral squat walks. All of these moves can be done without the bands, along with bodyweight squats, step-ups, lunges, and heel raises. Isolating one leg at a time is also useful, especially if you have experienced a one-sided injury or low back pain in the past. Incorporating a handful of these moves before or after runs is the easiest way to make sure to get them in.

Uneven Surface Training

One of the most effective ways to challenge your balance muscles and proprioceptors further is to perform lower and upper body exercises standing on a wobble board, balance disc, foam mat, or other unstable surface. This will help work the ankle and hip stabilizers, intrinsic foot muscles, and the entire core all at once. As mentioned above, most runners training for marathons limit their runs to the road. Trail running is a beneficial way to strengthen the proprioceptors as you constantly challenge the joints and muscles with the varying terrain.

Keep in mind the reasoning for emphasizing balance training along with your regular marathon preparation. Good balance will help relax the body more while running, leading to better posture and less tension when fatigued. This means less energy wasted and more to use for the push-off phase and increasing speed. Keeping these specific muscle groups and proprioceptors strong will ultimately make you a better runner by allowing your legs to effortlessly move faster, while lowering your chances of injury and pain.

Sources

Scott Mullen, MD, Jon Cotton, MD, Megan Bechtold, DPT, and E. Bruce Toby, MD, Barefoot Running: The Effects of an 8-Week Barefoot Training Program, Journal, Nov 4, 2019.

Anna Brachman, Anna Kamieniarz, Justyna Michalska, Michał Pawłowski, Kajetan J. Słomka, and Grzegorz Juras, Balance Training Programs in Athletes – a Systematic Review, Journal, Nov 4, 2019.