Thursday, March 27, 2008

Be Hip!

This weeks topic on take and run Thursday is running injuries. This guy has a problem. Check out that hip position. This is a great picture of hip drop which is a problem we see often. The left hip drop is most likely because of right Gluteus Medius weakness. The primary function of this muscle during gait and running is to help stabilize the hip when the foot is in contact with the ground. It controls stance leg hip adduction. This can lead to multiple running injuries including ITBFS, knee, groin, lateral hip & lower back pain. The best way to correct this problem is to train/strengthen this muscle the same way it functions during gait. That is with the right foot on the ground. With my left groin strain last year, we noticed that my pain would increase in cushioned running shoes which allowed more pronation. We also noted that along with that I had more right hip drop (left gluteal medius weakness). I initially worked on left single leg stance exercises while simulating where my hip should be during stance (level hips). This is done by contracting or squeezing my left buttock/ leveling the pelvis. I would hold this position for 5 to 10 seconds and would fatigue very quickly. I then progressed to higher level functional exercises but only if I could maintain this position. In my case, flexibility had very little to do with why I was having pain with running. With a different neutral running shoe and increased functional strength of my hip I was able to return to pain-free running.

Our previous post on the step down, is an example of one of the higher level exercises. We will post some more video of others. Check out this related post. Got strength?
I hope this helped to explain this common hip issue.
Be hip!


Paul said...

This is a really good post! I had this issue which lead to some hip/knee injuries. Took me a while to fix it. It help to know what the cause is!

Database Diva said...

I wonder if this has been the source of my knee, hip and back problems? I also had a groin pull in 2006. How did you find out that this was your problem? Did someone watch you run and mention the hip drop?

Thanks for a very interesting post. I'm off to check out the step down post!

John said...

Thanks for your comment Diva. I found out about this problem because I am a physical therapist and I work with Lou who is also a PT/runner/co author of this blog. I was having problems recovering from a groin strain which I suffered from slipping on ice. I was continuing to have pain as I returned to running despite being pain-free during my daily activities. I also had symmetrical groin flexibility. We ran some video on my running and saw that my right hip dropped when my left foot was on the ground more than my left hip. I also did the step down exercise and noted that my left butt cheek (glut) fatigued much quicker than my right side. I had trouble keeping my hips level during that exercise. As I said in the post I also felt more pain when I wore my usual training shoes. I switched to another neutral shoe that did not allow my foot/leg to roll into pronation as far (stiff midsole not soft). These changes and exercises helped my injury. I would recommend you seek out Sports Medicine MD or a PT to help you identify your muscle imbalances and gait deviations.
good luck!