Hip strengthening/ Clams

Clams:

This is a great exercise to work runner's weak gluteal muscles. The athlete will lie on their side, knees together and bent at 90 degrees. They will rotate their upper leg upward, keeping their feet together. After 15 slow repetitions, a low grade fatigue will be felt in the glut region.

The Bridge

This is a simple exercise that will help to build functional strength in your gluteals and core.


Start with the level one bridge. Both feet are on the ground with knees bent. Toes up to minimize the activity of the hamstrings during this exercise. Contract your gluteals or buttock muscles and tighten lower abdominals simultaneously. Push through your heels and lift pelvis off of the ground slowly and under control. Lift until your pelvis in line with your thighs. Do not arch back. If you are arching you're probably going to high. Lower your pelvis back to the floor under control. Remember are to keep both sides of pelvis level as to not let either hip drop during the movement.



Once you are able to perform level one with minimal fatigue and with good form and control, move on to level two. This level is performed using a single leg. The same principles apply. Use buttock muscles or gluteal to lift pelvis off of the floor. It is important to remember while performing this movement to maintain a level pelvis. Weakness can be seen if the unsupported side of the pelvis drops during initiation of the movement or throughout the movement. Keep core tight and perform slowly to maximize gluteal activation.

This exercise along with clams and standing band exercises are a great functional warm-up before a run. We also recommend doing these exercises on off days/strength training days to increase functional strength and prevent many lower extremity injuries.

Hamstrings

Here is a great post on Hamstring pulls written by Vern Gambetta. Here is a link to his blog. http://www.gambetta.com/blog.html

Wednesday, April 02, 2008

Hamstring Pulling Season
We have just started hamstring pulling season (AKA Major League Baseball Season) So far in first two days of the season there have bee two hamstring pulls. Do you ever wonder why? Is it the cold weather? No I don’t think so although can be a factor at times. Are they out of shape? I hope not they have spent six weeks in spring training getting game fit. Based on my observations over the years here is my take on the hamstring pull situation in baseball and for that matter other sports. Too much emphasis on static stretching in warm-up. Warm-up to stretch, do not stretch to warm-up. Flexibility of the hamstring is basically a non factor in hamstring pulls, it is dynamic hip flexibility that is important. You don't get that wallowing around on the ground in pregame stretch. Lack of sufficient warm-up. The current rage in warm-up does not involve enough movement, way too much at walking tempo, you need to build the warm-up in a crescendo to top speed sprints. Another reason is too much emphasis on linear running mechanics, very little on turns. The hamstring is a transverse plane muscle that is stressed when running a curve and on deceleration. There is too much strengthening using non functional exercises in prone and supine positions. The solutions are simple, but require understanding muscle function and compliance to a program. More lunges in all planes, step-ups both low and high, more emphasis on running turns and at least two days a week of all out sprinting outside the game. It takes time and preparation with attention to detail.

Our interpretation for distance runners. Stop doing static stretching as a warm-up! Stop doing hamstring curls for strengthening! As Vern says, we must keep our functional mobility (ability to squat, lunge and step up/down). Check out the archives on our blog for exercises to address functional mobility/strength.

Be Hip!

(c) http://www.physiotherapy.co.uk/
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!

You Don't Have Squat?

Photo Credit: Dan in conjuction with Horizon International Inc.

The big question is: Should I squat? Squatting, in my opinion, is one the fundamental movements that the human body can and should be able to do if all parts are functioning normally. Certainly, there are exceptions to being able to squat fully. Knee, hip, back, ankle, or foot injuries may limit your ability to perform a full squat. However, from the time a baby begins the developmental sequence, a squat is a way to get up and down from the floor, keep a good center of gravity, and keep stability when losing balance. Over time, adults tend to lose this ability because we don't squat. The result is muscle imbalance. These muscle imbalances can be seen from the shoulders all the way down to the ankles. The muscle imbalances translate over to all athletic movements, including running. Performing a correct squat requires a good mix of core strength, hip mobility and stability (like John mentioned in his previous post: Got Strength), knee stability, and ankle mobility/stability. Many times when performing a squat in a mirror, a person can see, or even, feel the muscle imbalances.

GOT strength?

This morning my daughter & I went to run inside as it is 0 degrees outside. We ran on a local indoor track which as you can image was fairly crowded. As we ran, I again found myself watching people warm-up and then accessing the way they run. There was a female teenage runner who was stretching her hamstring over her head. She obviously was very flexible. A few laps later, I saw her running. What I observed was the following: as she landed and went to foot flat, her swing leg's hip dropped several inches, creating an un-level pelvis. On the stance leg, her femur and knee rotated inward. As her leg went through swing, the knees almost touched. In other words she has a lot of wasted motion and it all started with the hip drop. These issues could eventually lead to injury. I have seen this gait pattern many times, especially in flexible young female runners. This type of runner is, dare I say TOO flexible! She could improve her running mechanics and prevent injury by actually spending more time strengthening. She needs to work on hip stability/ NOT flexibility. The exercises we have and will post are good examples of the type of functional strength training she would benefit from the most. These types of exercises work the hip and leg muscles in similar ways they are used with running. They are also functional mobility exercises which means that they require strength and mobility. Mobility she's GOT/ just no strength!

The Squat

A good squat with correct form starts at the head and ends at the feet. One can use a stick behind the neck or above the head. We prefer to use something overhead to "kick in" or activate the core muscles. A little forward bend is allowed to keep center of gravity. Too much forward bend can indicate muscle imbalance (In the video, you can observe some core weakness as I perform the squat and the stick comes a little too far forward ;)). Knees, hips, and ankles should stay in alignment throughout the movement. If performing in a mirror, observe "favoring" one side to the other or rotating one way to another. This can be a sign of weakness or decreased mobility or both. Varying opinions are out there about proper foot alignment. I like to have my feet straight or rotated out slightly. More importantly, the heels should stay flat on the floor. How far should I go? Lots of opinions on this one also. If you look at the activity you are training for, let's say running, you'll see that your knees go out over your toes and your hips need mobility and stability (for efficient stride). I like to go to 90-90 (that is, thighs to parallel). Take note: I would rather do a smaller range of movement (not so far down) correctly, than doing a larger movement incorrectly. Quality of movement over quantity. Later we will show some simple exercises to help correct some of the imbalances commonly observed during a squat.