Are you strong enough to run? Part 1 Hip Weakness
I love to run and had a hard time believing my body may not be strong enough to handle the demands I placed on it. To be honest, it wasn't until I had my son that I realized the importance of building a strong foundation before placing the demands of running on my body. This doesn't mean you can't run or should not run. It just means you need to be cautious about your mileage, running frequency, and duration as well as continuously work to strengthen your core muscles. I posted a picture of myself to show you I have a weakness. Can you see the subtle right hip drop? If you look at my right hip, you will see it's dropped compared to my left. Now mind you, I was running in a 50k race in Cincinnati, Ohio. I am not sure at what point the picture was captured, so I may have been running on fumes causing the weakness to present itself. So why is this hip drop occurring? Well, one of the common reasons for a healthy athlete is due to a weak glute medius muscle. This muscle helps to keep your pelvis level during activities like walking or running. One example of why a weakness occurs can be as simple as an opposing muscle overpowering the glute medius, which causes a continued weakening of the glute medius muscle.
Okay, so you might be wondering how do I strengthen this muscle? There are several exercises you can incorporate into your training program that doesn't require equipment; however, I encourage everyone to have a loop band in their fitness equipment arsenal. The pictures below are from Medbridge. Cell phone- click on picture for the Medbridge exercise description. Computer- hover over picture for the Medbridge exercise description.
Side-lying Hip Abduction
Side Plank with Clam Shell
Side Stepping with Resistance at Thighs
Clam Shell with Resistance
2 easy tests to see if your gluteus medius is weak.
Single Leg Knee Bend
2. Bridge- When you perform a bridge you should feel the contraction in your glutes. If that's not the case and you feel the contraction coming from your hamstrings, try to reposition your feet. Avoid placing all the weight through your heels. If you are still feeling this exercise predominantly in your hamstrings, the glute mechanism is off. I am not going to go into detail about the glute mechanism at this time. Now I would like you to try a single leg bridge position. If your hip drops or rotates, that would indicate a weakness in the gluteus medius of the leg that is down.
Single Leg Bridge
Think You're Strong? Strength Training Test for Runners. This is a really good video on YouTube from The Run Experience. The video provides you with good information and strengthening exercises. I frequently watch videos from The Run Experience to give me a new perspective on information for runners.
Are you strong enough to run? Part 2: The Knee
Several things can go wrong if you don't have a strong foundation when you're a runner or when you're beginning a running program. Think of it this way, your body is one sizeable kinetic chain, which means one joint or segment will affect another joint or segment during movement. It's the domino effect. For example, if your left hip is weak, your right hip will drop, which will cause your left knee to cave. See the image below from Spaulding National Running Center. This hip weakness will eventually lead to knee pain and dysfunction. It's not only essential to strengthen your hip and glute muscles but just as essential to strengthen the muscles surrounding your knees. Knee strengthening will provide your knee with stability, and once your muscles are strong enough to absorb the impact, there will be less stress placed on the knee joint.
Anterior knee pain is common in runners. There are several reasons for developing anterior knee pain; however, I only plan to discuss the ideas that are related to muscle weakness and inflexibility. If you are starting to develop anterior knee pain with no associated injury, my first recommendation would be to examine your stretching program. Inflexibility will change your stride length and place undue tension on knee joints. Dynamic stretching is encouraged at the start of a workout and static stretching after your workout. If you are dealing with pain, I recommend static stretching along with dynamic before your workouts. Static stretches should be held for 30-60 seconds and repeat several times. The longer you hold the stretch, the greater chance you will lengthen the muscle fibers. Always make sure your muscles are warm before stretching and don't forget to stretch after your workout.
Static stretching program to come.
My second recommendation for managing anterior knee pain is to look at your lower extremity and core/ hip strengthening program. As stated above, hip, core, glute, quad, and hamstring strength are vital components for healthy knees. Your focus should be on building strength, not endurance. The repetitions should be low and the weight high. I recommend incorporating a strengthening program 3 x's a week.
Exercise videos to come shortly.
Are you strong enough to run? Part 3: Proper Footwear Discussion
Proper running footwear is essential for injury prevention and your overall comfort while running. I started running when I was 11 years old. My parents bought whatever shoes I picked out. We didn't buy a known running shoe brand because of the lack of education on the importance. It wasn't until my later teens early 20's that I started running in Brooks and Asics. I noticed a massive difference in how my body felt during and after my runs. My shins didn't ache, my knees were not sore, and my feet felt regular with no pins and needles because I irritated the plantar fascia with cheap unsupported shoes. Now keep in mind there is no one perfect running shoe for everyone, and in the end, it's a personal choice. I have tried several brands over the years, and my two favorites are Brooks and Asics. I generally lean towards a trail running shoe with cushion and support or a high mileage road running shoe that provides the same cushion and support without the grip. Picking out the right running shoe can seem confusing because there are so many brands and styles out there. My recommendation is to go to a running shoe store and get fitted. You may have heard the terms pronation, supination, neutral, wide, and narrow. How do you know which one means you? That's where the running stores can help, or if you're dealing with chronic pain while running, I would recommend scheduling an appointment with a sports medicine doctor. The sports medicine doctor can evaluate your feet to help determine which type of shoe may be more appropriate. Check out the video below from the Run Experience for more information on selecting a running shoe.
Are you strong enough to run? Part 4: Foot Overpronation
I have discussed how knee valgus (knocked kneed) may be a cause of hip weakness in Part 1 of this blog. There is also another reason why knee valgus occurs, and that is overpronation of the feet. Overpronation means the ankle rolls inwards as you move. If you break down the steps of overpronation, it will look something like this; your heel strikes the ground first, then your foot rolls inward onto a collapsed weak arch followed by an inward rotation of the lower leg that leads to the knee valgus. Remember the kinetic chain! If you overpronate, you are at considerable risk for additional injuries, such as IT band syndrome, shin splints, and plantar fasciitis, to name a few. To help correct overpronation, I recommend starting with arch and great toe strengthening, balance exercises, and soft tissue mobilization. Remember, it takes time to build muscle, so be patient, and the strength gains will happen if you are doing the work. The pictures below are from Medbridge.
Seated Great Toe Extension
Great Toe Flexion with Resistance
Big Toe Mobilization
Big Toe Mobilization Part 2
Seated Plantar Fascia Mobilization with Small Ball
Single Leg Stance
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