Restoring Load Capacity in the Runner

Presenter: Rich Willy, PT, PhD

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April 22-23

This course is a two-day (14 hour) course that emphasizes putting the latest evidence into practice to provide innovative solutions for the athletes with relative overuse injuries. Diagnoses to be included will include patellofemoral pain, iliotibial band pain, and the most common bone stress injuries of the lower limb, including tibia, metatarsal, navicular bone stress injuries. Specific training load prescription and strength and conditioning practices to both prevent and treat various injuries is a foundation of this course. Lastly, this course will cover strength and conditioning for the runner to improve performance. Overall, there will be an emphasis on hands-on, laboratory experiences of the didactic components of this course so that attendees can immediately put into practice newly learned skills. Case studies will be used throughout the course to provide relevant examples.

About Rich

This course is a two-day (14 hour) course that emphasizes putting the latest evidence into practice to provide innovative solutions for the athletes with relative overuse injuries. Diagnoses to be included will include patellofemoral pain, iliotibial band pain, and the most common bone stress injuries of the lower limb, including tibia, metatarsal, navicular bone stress injuries. Specific training load prescription and strength and conditioning practices to both prevent and treat various injuries is a foundation of this course. Lastly, this course will cover strength and conditioning for the runner to improve performance. Overall, there will be an emphasis on hands-on, laboratory experiences of the didactic components of this course so that attendees can immediately put into practice newly learned skills. Case studies will be used throughout the course to provide relevant examples.

Richard Willy PT, PhD

Biography: Dr. Rich Willy is an Associate Professor in the School of Physical Therapy, University of Montana (Missoula, MT, USA) and the Director of the Montana Running Lab. He received his PhD in Biomechanics and Movement Science from the University of Delaware and his Masters of Physical Therapy from Ohio University. Dr. Willy has been a clinician for over 20 years specializing in the treatment of the injured runner. He has presented on lower extremity injuries to multiple Olympic sports medicine staffs from around the world as well as to the National Basketball Association. He has published over 60 peer-reviewed papers primarily on two populations: endurance runners and tactical athletes. His research aims to develop clinically effective treatments for individuals with patellofemoral pain, Achilles tendon injuries, and bone stress injuries. His research has been funded by the United States Department of Defense and the Foundation for Physical Therapy. He and his work are regularly featured in Runner’s World and Outside Magazine. Dr. Willy treats runners and athletes of all levels, from the new runner to the elite competitor.

Course Objectives

At the completion of the course, the participant should be able to;

  1. Participants will be able to identify key diagnostic criteria for patellofemoral pain.
  2. Participants will be able to create an evidence-based treatment program for individuals with patellofemoral pain.
  3. Participants will be able to specify the running mechanics that increasing biomechanical loading of the iliotibial band.
  4. Participants will be able to identify individuals most at-risk for a lower limb bone stress injury.
  5. Participants will know the diagnostic criteria for tibial bone stress injuries.
  6. Participants will be knowledgeable on the types of biomechanical loads that increase and decrease metatarsal bone stress.
  7. Participants will be able to develop a treatment program for individuals with a tibial bone stress injury.
  8. Participants will be knowledgeable on the biomechanical loads that increase navicular bone stress and how to treat navicular bone stress injuries based on their grade.
  9. Participants will be able to design a strength and conditioning program for a runner.
Key References
  1. Van Hooren, Bas, et al. “Is motorized treadmill running biomechanically comparable to overground running? A systematic review and meta-analysis of cross-over studies.” Sports medicine 50.4 (2020): 785-813.
  2. Warden, S. J., Edwards, W. B., & Willy, R. W. (2021). Preventing Bone Stress Injuries in Runners with Optimal Workload. Current osteoporosis reports, 19(3), 298-307.
  3. Warden, S. J., Edwards, W. B., & Willy, R. W. (2021). Optimal Load for Managing Low-Risk Tibial and Metatarsal Bone Stress Injuries in Runners: The Science Behind the Clinical Reasoning. journal of orthopaedic & sports physical therapy, 51(7), 322-330.
  4. Willy, R. W., Hoglund, L. T., Barton, C. J., Bolgla, L. A., Scalzitti, D. A., Logerstedt, D. S., … & Torburn, L. (2019). Patellofemoral pain: clinical practice guidelines linked to the international classification of functioning, disability and health from the academy of orthopaedic physical therapy of the American physical therapy association. Journal of Orthopaedic & Sports Physical Therapy, 49(9), CPG1-CPG95.
  5. Willy RW, Meira EP. Current Concepts in Biomechanical Interventions for Patellofemoral Pain. Int J Sports Phys Ther. 2016;11:877-890.
  6. Van Der Vlist, A. C., Winters, M., Weir, A., Ardern, C. L., Welton, N. J., Caldwell, D. M., … & De Vos, R. J. (2021). Which treatment is most effective for patients with Achilles tendinopathy? A living systematic review with network meta-analysis of 29 randomised controlled trials. BJSM, 55(5), 249-256.
  7. Tenforde, A. S., & Fredericson, M. (Eds.). (2021). Bone Stress Injuries: Diagnosis, Treatment, and Prevention. Foot and Ankle High-Risk Injuries by David E. Oji; Springer Publishing Company;
  8. Mandell, Jacob C., Bharti Khurana, and Stacy E. Smith. “Stress fractures of the foot and ankle, part 2: site-specific etiology, imaging, and treatment, and differential diagnosis.” Skeletal Radiology 46.9 (2017): 1165-1186;
  9. Gross CE, Nunley JA. Navicular stress fractures. Foot Ankle Int. 2015;36(9):1117–22.
  10. Hutchinson, L. A., Lichtwark, G. A., Willy, R. W., & Kelly, L. A. (2022). The Iliotibial Band: A Complex Structure with Versatile Functions. Sports Medicine, 1-14.
  11. Sancho, I., Malliaras, P., Barton, C., Willy, R. W., & Morrissey, D. (2019). Biomechanical alterations in individuals with Achilles tendinopathy during running and hopping: A systematic review with meta-analysis. Gait & posture, 73, 189-201.
  12. Merry, K., Napier, C., Waugh, C. M., & Scott, A. (2022). Foundational Principles and Adaptation of the Healthy and Pathological Achilles Tendon in Response to Resistance Exercise: A Narrative Review and Clinical Implications. Journal of Clinical Medicine, 11(16), 4722.
  13. Martin, R. L., Chimenti, R., Cuddeford, T., Houck, J., Matheson, J. W., McDonough, C. M., … & Carcia, C. R. (2018). Achilles pain, stiffness, and muscle power deficits: Midportion Achilles tendinopathy revision 2018: Clinical practice guidelines linked to the International Classification of Functioning, Disability and Health from the Orthopaedic Section of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy, 48(5), A1-A38.
  14. Martin, Robroy L., et al. “Heel pain—plantar fasciitis: revision 2014.” Journal of Orthopaedic & Sports Physical Therapy 44.11 (2014): A1-A33.
  15. Rauh, MJ. (2014). Summer training factors and risk of musculoskeletal injury among high school cross-country runners. JOSPT, 44(10), 793-804.
  16. Kardouni, JR., et al. “Timing of Stress Fractures in Soldiers During the First 6 Career Months: A Retrospective Cohort Study.” J. Athl Tr 56.12 (2021): 1278-1284
  17. Milgrom, C., Zloczower, E., Fleischmann, C., Spitzer, E., Landau, R., Bader, T., & Finestone, A. S. (2021). Medial tibial stress fracture diagnosis and treatment guidelines. J. of Science and Medicine in Sport, 24(6), 526-530.
  18. Del Vecchio A,et al. The increase in muscle force after 4 weeks of strength training is mediated by adaptations in motor unit recruitment and rate coding. J Physiol. 2019;
  19. Bohm S et al.,. “Human tendon adaptation in response to mechanical loading: a systematic review and meta-analysis of exercise intervention studies on healthy adults.” Sports Medicine-Open 1.1 (2015);
  20. Eihara, Yet al. “Heavy Resistance Training Versus Plyometric Training for Improving Running Economy and Running Time Trial Performance: A Systematic Review and Meta-analysis.” Sports Medicine-Open 8.1 (2022):.
  21. Blagrove, RC., et al. “Strength and conditioning for adolescent endurance runners.” Strength & Conditioning Journal 42.1 (2020): 2-11.
  22. Barth, M, et al. “Predictors of Junior Versus Senior Elite Performance are Opposite: A Systematic Review and Meta-Analysis of Participation Patterns.” Sports Medicine (2022): 1-18.