November 17, 2007

The Exercise Every Runner Needs To Do

My phone's been ringin' and my email's been pingin' with lots of runners suffering some type of ache or pain - and they want to know what to do about it. Many of the common overuse injuries incurred by distance runners can be caused by the same problem: weak hip abductors, especially the gluteus medius. In my 10+ years of professional experience working with distance runners, every single athlete I have evaluated has been weak in this area.

Here's why:

We like to spend what free time we have running on the trails, which works the "front to back" muscles, but neglects the "side to side" muscles like the hip abductors. When the hip abductors are weak or fatigued, it becomes difficult to stabilize the pelvis in the frontal plane, especially since we are only in contact with one foot on the ground at any given time while running. Because everything is connected, weak outer hip muscles cause the entire leg to overpronate: opposite hip "drops", knees "cave in" (potential cause of anterior knee pain aka patellofemoral joint pain, patellar tendonitis, IT band syndrome), foot overpronates (potential cause of achilles tendonitis, plantar fasciitis, peroneal tendonitis, posterior tibialis tendonitis), etc. It also means that something else has to try to compensate for the weakness (TFL, quadratus lumborum, piriformis). This is a bigger problem for women because we have a wider pelvis, and therefore a longer moment arm.

Good alignment

Weak gluteus medius

The good news is, it's easy to strengthen these muscles, even without any special equipment. There are several ways to accomplish this, the easiest being side lying straight leg raises. Be sure that you maintain proper alignment - an easy way to do that is to lay on your side with your back against a wall. As you raise your top leg, make sure that your foot remains in contact with the wall (kind of like doing snow angels with one leg).

A more advanced version will also strengthen the core, especially the quadratus lumborum in the low back: hip abduction from a T stand.

Other options include lateral tube walking (put a loop of elastic tubing around your ankles and walk sideways) or standing hip abduction using a low cable (try not to hold on to anything with your hands).

These are just a few options for strengthening the hip abductors. Remember, their job is primarily stabilization, so go for endurance rather than maximal strength. Try just one, or do them all if you wish.
As Nike says, Just Do It.


Wayne said...

Thanks, Kel. I've been waiting for this post since you mentioned it was coming. I like to look at the positive side of things... so I'll use being weak in this area as evidence that I really am a distance runner. :) My left hip is where I start feeling things when I do too much (distance or hills)... and from the "side lying straight leg raises" I can tell that's the weaker side. As far as the "T stand" move, that's going to take some work. I keep tipping over. hehe

Kel said...

Wayne, it's common for one side to be weaker than the other. If the T stand is too much, you can add an ankle weight to the side lying leg raises. If balance is the limiting factor, try doing the T stand with your entire forearm on the ground instead of just your hand. Other options are activities like ice skating, roller blading, swimming breast stroke (frog kick), etc. Keep at it! :)

Carl Gammon said...

And thanks from me, too, Kel. I have a "Thera-band" and have been using it for the side walking. I like that exercise as I can go back and forth across the room and work both sides easily.

Don said...

Hi Kel,

Do you have any similarly-cool exercises for the adductors?

Thanks, Don

Kel said...

Don - but of course :)

Just a few based on the hip abduction exercises shown here:

From a T-stand: lift the bottom leg off the floor instead of the top leg. Great core workout too.

Standing cable: place cable/tubing around other ankle (closest to stack) and move leg across the body to work the inner thigh.

Side lying: place foot of top leg on floor in front of you - lift bottom leg straight up toward ceiling.

Other options: push ups with hip adduction shown in my hamstring post, wide stance squats, squeeze a slightly deflated volleyball or soccer ball between your knees while sitting, etc.

Lots of options.