One of the topics I have delved into while in graduate school is running injuries. One researcher estimated as many as 80% of all runners will experience a running related injury at some point during their running career. The most common running related injuries in long distance runners are IT band syndrome, Achilles tendinopathy, and anterior knee pain When looking at running stride, researchers have repeatedly found that people who land on their heel with their foot in front of the body experience more ground reactive forces than those who land with their foot under their center of mass. The higher ground reactive forces lead to an increase in impact up the skeleton, resulting in a more jolting motion. These individuals are also more likely to land with a straight knee, which results in less muscular stiffness. Muscular stiffness helps dissipate the forces in the skeleton.
The other contributing factor to injuries in runners is weak hips. While no direct link has been found between excessive foot motion and injuries (the shoe companies must be bummed about that), weak hips cause dysfunction down the kinetic chain, starting at the knee joint. The hips control both excessive inward movement of the knee and inward movement of the tibia, one of the lower leg bones. Excessive movement in either of these bones causes increased stress at the knee. Since the muscles in the hips aren’t doing what they are supposed to in order to control the inward motion of these bones, other muscles take over, namely the IT band and the Achilles tendon. This leads to overuse injuries in these areas.
Many people feel like it is their right to be able to go out and start a running program. I think we need to change the way we think about this. There are hundreds, if not thousands of couch to 5K programs on the internet. Few address the fact that most Americans sit in a chair all day. We don’t use our hips the way nature intended us to. For a sedentary person to go, literally, from the couch to running, even if the mileage is increased slowly, there is a high chance of injury because we are asking deconditioned muscles to stabilize joints and accelerate and decelerate movement in a way they aren’t accustomed to.
I think sedentary individuals who want to participate in a running program should start with a hip-strengthening program. Not much research has been done in this area, but I believe the amount of injuries experienced by runners, particularly new runners, would be dramatically reduced if individuals took the time to get strong where they should be strong in order to withstand the forces generated by running. Most people can’t perform a perfect squat, let along a single leg squat, and we expect them to be able to go outside and perform thousands of little single leg half squats while propelling their bodies forward? It doesn’t make very much sense.
After you have perfected the double leg squat, the progression is the single leg squat. To perform a single leg squat, stand up tall. I like to have something in front of me, like a bench or a chair that I can reach towards. Pick the left foot up, so the left leg is slightly behind you. Sit your right hip back by bending the right knee, reaching your hands out to touch the object in front of you. It’s as though you are sitting in a chair with the right hip. Keep the pelvis level, the shoulders level, and keep the abdomen engaged so you don’t arch your lower back. Press through the heel to return to standing. There should not be pain in your knee. Don’t worry about how far down you go at first. Eventually, you want the thigh close to parallel with the floor. Start with 6-8 repetitions per side and work up to 12.
Yours in health and wellness,