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:

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.


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

INCORRECT

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.

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.
Pull 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:
Again, 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.
We 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.
Follow 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.
This 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).
To 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
and 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