RUNNERS….looking to improve your
efficiency, increase your mileage, and stay on the road (i.e. keep injuries at
bay)? As runners, we love to run, and we
crave those natural endorphins provided by each outing. We can get our “runner’s high” by running anywhere
from 2 to 50+ miles. We each know how
our own body responds to training from the inside-out. We carefully plan our courses and mileage to
perfect our training for the ultimate performance at our upcoming 5k, 10k, ½
marathon, marathon, and even ultras. But
sometimes a training program can lack a crucial piece of the puzzle for
improving running efficiency, endurance, and injury prevention.
What is this crucial piece of training
that some runners miss? - HIP
STABILITY
Many believe that hip stability and strength are only important for
lateral movements and motions, like those found in such sports as basketball,
volleyball or tennis. As runners, we
rarely engage in such side-to-side motions.
Generally, when we run, we run in a straight line (unless dodging a
crack in the road or the occasional dog in our path). So why would we need to strengthen the
muscles that control our hips?
Hip stability and strength are important in injury prevention. If our hips are not strong and stable we are
more likely to develop poor running technique that can lead to common running injuries such
as back pain, IT band syndrome, knee pain, patellofemoral pain syndrome,
Achilles tendonitis, plantar fasciitis, and the list goes on and on.
Let’s dive into a little anatomy:
The gluteus medius (aka glute med) muscle originates on the outer side
of our pelvic bone and inserts on the lateral side of the greater trochanter (a
bony projection of our femur or thigh bone).
A view of our posterior hip.
The glute med functions as our primary hip abductor. Hip abduction can occur two ways. First, hip abduction is the action of our
femur moving outward to the side (in the open chain position). Second when in the single limb stance
position (or closed chain position), hip abduction occurs when the hip opposite
our grounded leg elevates.
Left hip open chain abduction Left hip closed chain abduction
So what happens when we lack glute med strength?
Weakness of the glute med can result in “hip drop” during the stance
phase of running, walking or any other time we are in a single limb stance
position. Hip drop during the stance phase
of running can change the mechanics both up and down our kinetic chain (aka our
body). Up the chain, hip drop can change
the alignment of our back and neck which can also affect our shoulders and arm
swing. Down the chain, hip drop can
result in knee valgus (knocked knee) and increased foot pronation (flat foot). Lack of hip stability and consequently “hip
drop” changes the mechanics of our running form which can place excess stress
on areas not typically stressed and subsequent common overuse injuries can set
in.
Lack of hip stability can also affect our running efficiency and
endurance. As we step and our hip drops (which
causes changes throughout our kinetic chain), our body has to respond to keep
us running in a straight path. Thus
energy is wasted correcting for these compensations and therefore our endurance
also takes a hit. The smoother we run
and the less movement laterally and rotationally we have throughout our body,
the better we can move straight ahead towards the finish line.
Want to see if you may have some hip weakness? Here is one way to check out your hip
stability. Start by standing in front of
a mirror with your eyes closed and your hands on your hips. Slowly lift up one leg while balancing on the
other. Open your eyes. Do your hips look level or do they drop?
Level hips = hip stability Unlevel hips = hip
weakness (right side)
So we have talked
about anatomy and why we need hip stability.
So now how do we strengthen it?
Simple! Follow this sidelying series to improve your
hip strength. Start by performing 10
repetitions each side and progress up to 3 sets of 10 repetitions (or 30
repetitions total).
Exercise 1: hip abduction
Start by lying on your side with your lower leg bent and your top leg
straight. Your hips should be stacked
one on top of the other. Raise your top
leg up to the ceiling. Your shoulder,
hip, knee, and ankle should remain in a straight line. Do not let your leg come in front of your hip
and do not let your hips roll backwards.
Exercise 2: Clams
Lying on your side, line up your shoulders, hips and ankles with legs
stacked. While maintaining your heels and toes together lift your knee as high
as possible without rotating trunk or pelvis backward.
Exercise 3:
Complete exercise 2 and leave knee up while you lift your foot directly
up in line with your knee (do not allow foot to go above knee!). Slowly lower
foot with maintaining knee in elevated position, after feet are again stacked
then lower knee to start position and repeat.
“knee up, foot up, foot down, knee down”
Exercise 4:
Complete exercise 3 then extend your knee while maintaining height of
leg, return to bent knee position, lower foot, lower knee.
“knee up, foot up, extend knee, bend
knee, foot down, knee down”
Exercise 5:
Complete exercise 4, but repeat extending knee.
“knee up, foot up, extend knee, bend
knee, extend knee, bend knee, foot down, knee down”
Exercise 6: Bicycles
Start in position of clams with foot up. Now make a bicycle motion by bringing your
thigh up and bending your knee. Then
extend your knee out while simultaneously bringing your leg to the back and
bringing your heel to your butt. Finally,
pull your thigh back up towards your chest with your knee
bent (starting position). Repeat forwards
bicycles. Then reverse and perform
backwards bicycles. Maintain your pelvic
position (don’t allow to rock back and forth) and make as big of a motion as
you can.
Extending knee out
while starting to kick leg back
Bringing leg back and
heel to butt
Coming up in a future blog…..progressing your hip strengthening to the
standing position!
Have more questions regarding this topic or need assistance getting
back to running from an injury? Contact (785) 505-2712 (our hospital location)
or (785) 505-3780 (our south location) and ask to speak with any of our Sports
Physical Therapists. We are here to get YOU back on the road!
Julia Noonan, DPT
Sports Physical Therapist
LMH Therapy Services
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