Training for a race is hard, time-consuming work no matter the distance you are training for. The desire to get all the miles in often leads to less time spent on essential aspects of training- strengthening, stretching, cross training and nutrition. All of these aspects of training are important to cross that finish line healthy and injury free. As a runner, I am guilty of these same things and I have paid the price. Even physical therapists are subject to injury when we don’t follow our own advice that we give patients. Today we will discuss the first of these common mistakes.
Common mistake number 1: Leaving out strengthening, especially the gluteals
Gluteal strength plays a major role in proper gait mechanics during your runs. Without it, positional changes happen all the way down your leg that can lead to problems such as iliotibial band syndrome (ITBS) and patellafemoral syndrome (PFS). These are the most common injuries I see as a result of overuse with poor mechanics from running, but I also see multiple cases of tendonitis.
“But I have strong glutes! I do the leg press!”
Great, but have you isolated those lateral hip muscles including the gluteus medius? Integrating lateral movements avoids overuse in the sagittal plane and gives you the stability needed to run forward more efficiently. This often-overlooked muscle is key to keeping your pelvis stable when you are standing on one leg. A good majority of my patients test as extremely weak in the clinic and are amazed at how difficult isolated exercises can be.
When your gluteus medius is strong, it is easy to keep your pelvis level as you stand on one leg. Often, it is weak and instead what happens is what you see below. The hip on the opposite side drops and this leads to multiple changes down the kinetic chain.
Think about how you run- you are often standing on one leg while the other leg is swinging forward. Therefore when you run, you are repetitively putting the above stresses through your lower extremities at force of four to five times your body weight if you have weak gluteals. Ouch! The next picture shows how these deficits can impact your running stride.
Notice the knees caving in and the excessive hip drop. Excessive supination of the foot is seen as compensation, but often what you see is increased pronation of the foot leading to multiple stresses through the foot and ankle leading to tendonitis. This runner had IT band pain, as well as lateral hip pain from these biomechanical deficits related to gluteal weakness.
Women tend to be more prone to running injuries from these biomechanical deficits due to the anatomical differences in the hip structure between women and men. Women have wider hips leading to an already increased valgus angle at the knee compared to men. Men can still have injuries related to this, particularly without adequate stretching and foam rolling during training (more on this coming in part 2 of this series!).
Here are a few basic exercises that help strengthen the gluteus medius to help prevent these common running injuries. Always check with your healthcare provider before starting any new exercise regimen.
Side lying hip circles
Keeping your leg raised and slightly behind you as shown in the picture, perform 10 circles forward and 10 circles backward. Repeat for 3 sets, and then switch sides.
Side plank (alone or with leg lift)
Hold side plank for 3 sets of 30 seconds. Gradually increase your time by 5-second increments as this becomes easier.
For an added challenge perform a leg lift as shown. Perform 10 leg lifts for 3 sets.
Perform at a level of difficulty in which it is challenging but form is not compromised.
Side stepping with band
Place a band around your ankles as shown. Bend knees slightly (make sure your knees always stay behind your toes- this will prevent abnormal stresses through your knee joints) and step to the side keeping tension through the band. Perform 10 steps one way, then switch sides and lead with the opposite leg. Repeat 3 times.
It is a good idea to have an injury screening before you being to train for your race to pick out these deficits prior to them leading to injury. Preventive measures help to keep you healthy, active and injury free! We offer injury screening and stability training for runners at Resilient Physical Therapy and Wellness in Needham, MA- Visit www.resilientphysicaltherapy.com to learn more and schedule your appointment.
Keep an eye out for the next part in this blog series coming soon to learn more about common mistakes made by runners during training.
Written by: Sarah Herschberger, PT, DPTSarah is the owner of Resilient Physical Therapy and Wellness in Needham, MA.
Disclaimer: In accessing this article and its contents you, the reader, understand all information is for educational and marketing purposes and should not replace professional medical advice. You, the reader, take full responsibility for your actions in implementing any of the techniques or advice disseminated within this article.