Are you hip enough?
Every week I see lots of athletes who are struggling with different types of pain in and and around joints associated with running. This can be achilles pain, knee pain and hamstring pain all down one side for example.
Those of you that have been in to see me will know that I like to take some visual markers that we then talk through and start to develop based on following the kinetic chain rather than focusing on the specific pain points as is often the way in the industry.
Often runners will have already been on a number of run chat forums and either been helpfully diagnosed by other runners or have decided that it's something based on something they have read.
Shoes and ITB syndrome seem to get most of the blame straight off the bat. The thing is though, everyone is different and have different things to contend with so it isn't always just a case of laying the blame there and moving on. If you want to really get to grips with developing your own run capabilities in my eyes you do really need to take the time to listen to and understand your own body. You are after all an experiment of one.
I do believe that everything starts with the feet and that they are often misunderstood. Runners generally don't look after them which is bizarre in itself given what we ask of them. That said if you stand and look at the skeleton in my practice you will see that there are other factors that have to be taken into consideration. Top down factors as well as ground up to be exact.
I haven't published anything on this before you ask and haven't performed any wide reaching study. This is merely a view of someone who looks at a lot of tight muscles and bodies in pain that I then develop strategies to help run pain free.
The thing is that the more time I spend looking at joints the more I fall in love with how cool the body is. It's a geeky thing before you say, I know. Joints are simple in the main but loaded with huge responsibility.
When I then see someone who presents with lower or upper leg pain there has to be a need to explore whether there is a connection between weak hip stabilisation muscles and any running injuries before we blame it on ITB syndrome or poor footwear choice.
When I look at the bones in your leg on my skeleton Spike, I can see that the overall natural mechanics of the body are for the foot to pronate or collapse inwards, the lower leg to then internally rotate, and with that, the upper leg to internally rotate as well. The foot naturally automatically collapses inwards because of the force created by its contact with the ground. The lower leg has no choice but to follow the foot and so also internally rotates upon foot strike.
Therefore I think that no matter what, your foot and lower leg construction respond to the impact force of the foot hitting the ground by rolling. How much is another topic and a whole shoe industry worth of data but that isn't the point of this post.
The reason for this post is the upper leg. While we want the upper leg to move in conjunction with the foot and lower leg, any weak hip stabilisation strength will prevent you from controlling your femur effectively. This has to then cause the knee to collapse inwards and also as a knock on the foot to do the same.
This brings me back to the pre diagnosis that people sometimes arrive with of ITB syndrome or the wrong shoes. Different shoes may help but some will continue to struggle because the load is too great on their hips and their hips lack strength. I've also seen people of late who have arrived saying that they've had and been treated for ITB syndrome for two years or more with no success. That in itself has to tell you something.
Where did all this start? Well it started with me many years ago and I've developed it from there. Believe it or not I could actually run back in the day and was a decent marathon runner. However when I moved up to ultras I started to get problems with the patella tracking in my right knee. Increased loading and extra mileage were key to understanding my issues. Not blaming it on my ITB.
I also had a friend who had no issues and was what you would describe as a healthy runner. He kindly, along with me embarked on a hip strengthening programme which we did religiously for ten weeks. My knee got better, we both got stronger through the hip area but what do you think was the absolute, really cool, best bit? The answer? He now pronated less at the ankle joint. It was very visible. A study of two then so hardly industry changing. I then encouraged him to get even stronger by working on some foot exercises. So both top down and bottom up rehab.
The thing is though I've been working on all this for some time now and the embryonic development of Core Club and the exercises that I give people are all aimed at athletes regardless of whether they be runners, swimmers, rugby players. I try to look at the mechanics of their sport and take it from there. Specifics come from spending time with people one on one. The outcome overall has to be for people to train and compete pain and injury free.
My rule of thumb regarding hips is that if I give you exercises to do with low level resistance bands and you can feel your glutes, tensor fascia latae, hamstrings, hip flexors etc getting tense very quickly there is a weakness there that will be causing you issues with your sport.
By strengthening up your core and in this case your hips you will be able to take on more training, and will ultimately become stronger and more powerful. It is really important to have core strength, especially at the later stages of any race and I think when you look at some of the athletes who have taken this on and then look at how their times have got significantly better in time bound events such as running and swimming for example you can see that there is a pathway to explore for yourself.
It may well be that you need an orthotic if you are already in one or have recently taken one on. Reprogramming bodies takes time.
Developing a stronger body that delivers better results for you in your sport pain free has to be good for your head and your body though right?
If you think that there would be benefit in talking things through with me please do get in touch.