Tag Archives: run

Functional Training: Identifying and Rectifying the Basics

A belated Happy New Year to all.  I hope that 2017 is off to your desired start, and if not, you’d better hop to it as we’re already one down and eleven to go.  No pressure though.

Being someone who gratefully works with a steady diet of athletes on a daily basis, this post is all about placing emphasis on stepping up your performance on activities like running by intelligently going beyond exclusive upright, uniplanar, cross-crawl repeats; aka running.  It is quite common for a seasoned runner to present with an issue, along with a lack the strength, stability, and/or mobility to correctly perform basic movements.  This can translate into the inability to move efficiently and pain free while navigating the obstacles of the day, but is exponentially put on display when those everyday tasks like walking, are altered in intensity and duration in the form of running.  Unsteady stabilizers, shortened tissues and insufficient or incorrect neurological firing patterns and muscle recruitment can all spell disaster and frustration for any athlete, but especially us runners.

Below, we’re going to go through a few tests and potential, subsequent remedies to work at, and then retest.  These are all designed to serve as self-help to hopefully identify and rectify a possible impedance to optimal performance.  

(It should be noted that the handful of tests and remedies shared in this article serve as a general assessment and are based on some of the most common issues seen in daily practice.  If you are truly having an issue or any question, your best bet is to work with myself or any of the other trusted and skilled practitioner.  There are a good variety of us, and each can provide their unique approach that may be right for you.)

Let’s dive right in:

Hip Hinge Test:

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This is a good test to assess posterior chain mobility, mainly in your glutes and hamstring.

Test:

Maintain a braced and neutral spine, drive your hamstrings back and tilt your torso forward, allowing your arms to hang.  Hinge from the hips and try to keep your legs straight and shins vertical.  If you are unable to flex your hips to 90 degrees while keeping the shins vertical, actively mobilizing the hamstrings is a good place to work and then retest.

How to Fix It:

The banded hamstring floss is my personal preferred, do it yourself, hamstring mobilization technique.  Wrap a band around your upper thigh, just inferior to the hip and create tension by walking forward. Optimal positioning would be to also have both hands in front of you, on the ground, without rounding the back.  If this is not possible, use a chair as shown in the picture.  Keeping the back as flat as possible, create a flossing motion by repeatedly straightening and bending the banded leg and driving the hips back.

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Bi-Lateral Squat:

This test is used to identify the commonly seen hip flexor and quadriceps dominance that most are plagued with for a variety of reasons, including prolonged, uninterrupted sitting. 

Test:

Stand with feet about shoulder width apart and perform a squat.  Ideally you should be able to lower to the point that your hamstrings are close to parallel to the ground, while keeping your tibias (shins) perpendicular to the ground.  If you find that your knees translate forward past your toes, it can be a contributor to a longer stride, leading to an unsteady lever arm that can lend itself to issues anywhere from the hips to the feet.  Ideally you want your squat and stride to be more posterior dominant, mostly in the form of gluteus maximus recruitment.

CORRECT

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INCORRECT

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How to Fix It:

To work on this, stand with your knees about an inch from a chair and practice initiating your squat by hinging at the hips, sticking out your rear, and working on sustaining your balance as you lower your hamstrings towards a level parallel with the floor.  To return to the starting position, keep the knees and hip back and concentrate on firing and sticking out your rear.  Repeat until this becomes your default firing pattern when performing a squat.  The key things being worked on here are true core stabilizing balance and optimal recruitment of your glutes.

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The flip side to reversing the anterior dominance, is training that gluteus maximus to fire.  When asked to, many aren’t even sure how to do this.  A good way to begin to reacquaint yourself with the designed ambulatory and running workhorse is by performing a knee to chest bridge.

dscn4509Pull in your right knee, and hold it against your chest.  While keeping the shoulder blades and head on the ground, push up with the left leg, getting into a bridge position while keeping your right leg against you.  Practice this for 12 to 15 reps on each side, concentrating on what it feels like to contract and relax the gluteus maximus that is responsible for pushing into the bridge, and propelling your forward efficiently when you run. Once this is mastered, not only in execution, but the ability to fire and feel the glute, appropriate progression in conditioning can be made.

Deep Squat:

This test is utilized to identify a variety of mobility issues necessary for proper movement as it can shed light on limited hip range of motion.

Test:

dscn4521Again, stand with feet slightly wider than shoulder width apart, but no narrower. Keep your toes pointed directly forward and attempt to lower downward into a deep squat, with your hamstrings resting on your calves, your spine neutral, and your knees slightly outside of your feet.  The photograph paints a better picture of what we are shooting for here.

A variety of dysfunctional movement patterns and restrictions can be identified through this test, but the most common are the inability to keep the spine neutral (back straight) or the backside from rotating underneath you, indicating a lack of hip flexion.  Another commonly seen issue is the inability to externally rotate the hips and get the knees outside of the feet.

How To Fix It:

If you noticed an inability to keep the spine neutral or the backside rotating underneath you, and we are zoning in on limited hip flexion as the culprit, we often see this as a product of a femur that sits anterior in the hip joint.  Again, not to be a dead horse (horrible saying), but this can be an additional product of long uninterrupted sitting, as the femur head gets pushed forward in the joint space.

dscn4562We can begin rectifying this issue by working on resetting the hips to their biomechanically optimal orientation.  Begin by kneeling on the ground and extending one leg out behind you. dscn4566Follow this by shifting the majority of your weight onto the grounded knee (mat or some sort of padding highly recommended for grounded knee) by aligning that knee directly underneath the hip.  Keeping that weight on the knee, sit the hips back in the direction of the grounded leg, which, when done correctly, creates a posterior, lateral pressure in the hip joint. 

dscn4571This can be further amplified by taking the foot of the grounded knee and placing it in front of the knee of the extended leg, and then sitting back again. (see picture)  Working on getting in and out of this position for 2 minutes on each side can assist in encouraging that femur into a more optimal position within the hip joint, allowing for improved range of motion in the hip, necessary for running.

If you noticed an inability to, or you struggled with getting the knees outside of the feet (while keeping the feet flat and facing forward), you can work on improving your external rotation in the hip.  Often times we see a lack of external rotation in runners who notice their knees knocking together, an inward pointing foot, or chronic, tender adductors (muscles along the medial thigh).

dscn4576To begin to rectify this issue, start with getting down on your hands and knees, and step one leg forward, keeping your shin perpendicular to the ground.  Keep the back flat, hips square dscn4580and lead foot facing forward.  Keeping the lead foot flat on the ground, drop the lead knee to the outside of you, while actively driving your hips into the ground.  Encourage this movement further by placing one hand on the knee and pushing the outward (see picture).  This movement, when done correctly, simultaneously mobilizes the hip into external rotation, while actively stretching the adductors.

A common theme seen here is generally reversing the anterior dominance, improving range of motion and mobility, and become better well acquainted with recruiting, firing, and utilizing your gluteus maximus and other posterior chain musculature for optimal hip extension and propulsion forward.  

These serve as just a sampling of the functional tests we implement with all of our athletes, but especially the runners, as part of an initial and ongoing assessment in order to identify, and correct any imbalances and asymmetries that may be contributing to that painful issue up or down the kinematic chain.  If you have any questions on how to perform these tests, feel free to reach out. If it “just doesn’t feel right,” or causes pain, definitely refrain and save it for working with your trusted healthcare practitioner or trainer.  These tests are designed to identify problematic issues, and the subsequent remedies are provided as potential ways to begin to fix the problem, contingent upon the fact that they are performed correctly.  Proper supervision and advisement from a trained professional is always well advised.

Happy training my friends, and good luck to you as we steamroll forward into another year.  Enjoy yourself out there and our beautiful Florida winter.  As always, if you ever have any questions pertaining to any musculoskeletal issues, the content above, or an overall natural and holistic approach to your health, feel free to reach out. (321-848-0987; dr.rclarke@gmail.com; clarkechiropracticwellness.com)

Be well and continue to STRIVE to THRIVE.

REFERENCES:

Starrett, Dr. Kelly. (2016) Deskbound; Standing Up to a Sitting World.  Las Vegas, Nevada: Victory Belt Publishing

Dicharry Jay. (2012) Anatomy For Runners; Unlock Your Athletic Potential For Health, Speed, and Injury Prevention.  New York, New York: Skyhorse Publishing

 

 

    

 

Running Essentials (Vol. 1)

Being a runner myself, and working with a good amount of road warriors leaves me sympathetic to some of the wear and tear suffered due to this (sometimes) healthy addiction.  While injuries and causes come in all shapes and sizes, there remain various foundational issues that can be applied universally in order to curtail potential issues along the kinematic chain.

Hyper contraction of the hip flexors is a common issue in our society mostly due to the amount of time we spend seated.  In the car during a commute, at a desk glued to computer or a couch glued to the television, around the table while breaking bread with family and friends, even putting in miles on the bike; these all lend themselves to a shortening of the front side hip flexors.

Two immediate issues created by this are a higher propensity for low back pain, and a longer stride out in front while running, which leads to a higher risk of injury due to the increased instability that accompanies a longer lever arm.

Low back pain is perpetuated by shortening and tightness in the chief hip flexor, the psoas.  This muscle has its origin on the lower lumbar spine and when over contracted, will pull down on the lower spine when standing, creating discomfort, and the perception that standing causes pain.  In actuality, while the discomfort is indeed experienced while vertical, the catalyst can be the shortened psoas due to bouts of long, uninterrupted sitting.

Tight hip flexors become an issue while running as it can lead to a longer stride out in front.  The further that leg lands out in front of you, the less stability.  This can interfere with an optimal strike, pronation, and ankle and knee stability.  Unless you are a sprinter or huddler this also is a less efficient way to run.

Modifying gait is a multi-pronged task, with frontside dominance being a key factor.  The flipside to this shortening of the hip flexor is the lengthening and weakening of the antagonist hip extensors, mainly the gluteus maximus and hamstrings.  These posterior chain muscles are designed to move us efficiently and powerfully through life, including while running.

Again we look to front side dominance now being a logical contributor to strain and aggravation to the posterior structures and tissue including the hamstrings, piriformis, SI joint and surrounding ligaments.

Easiest way to begin to avoid this is by breaking up the long, uninterrupted sitting.  Obviously total avoidance of sitting is not possible, but in most cases breaking it up is.

Try to get up and move AT LEAST twice every hour or utilize the increasingly popular and available stand up desk.  Set a silent timer on your phone as a reminder to get up every 15-30 minutes.  Not only will you create more of a balanced state between your hip flexors and extensors (advantageous for low back pain and running) but you will be metabolically awakening your system, which can help control blood sugar/insulin, as well as weight.

Another way to combat this is by working on your movement pattern and neurological firing to the hip extensors.  If when you squat your knees track forward past your mid foot, you are exhibiting front side dominance.  A good way to work on this is to practice getting into a squat with your toes underneath a chair.  The seat of the chair will serve as a barrier to your anteriorly drifting knees and force you to utilize and fire the gluteus maximus, the main hip extensor and power generator during a proper stride.

In directly addressing the actual tightened hip flexors, a foam roller works well with the quadriceps.  However the psoas (and adductors) become more difficult to release due to their positioning and may take the assistance of a trained practitioner in order to reap optimal results.

(The facial expressions and sound effects produced by patients undergoing the psoas release in our office serves as an attestation as to the necessity of the treatment.)

The front side dominant, tight hip flexor issue is obviously not the end all be all when it comes to addressing any problem a patient may present with, nor are the methods mentioned the complete package for doing so.  However, more often than not, there is some hip flexor involvement with low back pain or lower extremity issues in runners and non-runners alike.  Therefore the suggestions mentioned above are a solid addition to any athlete’s preventative or maintenance program, in order to intelligently reduce the risk of potential injury.

Be well and go get it.